Lecture Notes

The hope for RSD -- Reflex-Sympathetic Disorder - Case Study 

Neck & Shoulder Pain

Randomized trial of long term effect of acupuncture for shoulder pain. - "The acupuncture group had consistently better results in every secondary outcome measure than the control group. Acupuncture is an effective long-term treatment for patients with shoulder pain (from soft tissues lesions) in a primary care setting."
Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and 3-year follow-up study. - "Adequate acupuncture treatment may reduce chronic pain in the neck and shoulders and related headache. The effect lasted for 3 years."
Acupuncture and arthroscopic acromioplasty. - "Following arthroscopic acromioplasty, real acupuncture compared to sham acupuncture offered significantly greater improvement via: (1) lower pain level, (2) less analgesic use, (3) range of motion, and (4) patient satisfaction."
Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. - "Acupuncture is superior to Sham in improving motion-related pain and ROM following a single session of treatment in chronic neck pain patients."
Randomized trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain. - "Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments."

Headache

Acupuncture in patients with tension-type headache: randomised controlled trial
Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. - "Acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. Expansion of NHS acupuncture services should be considered." Free Full Text
Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care. - "Acupuncture for chronic headache improves health related quality of life at a small additional cost; it is relatively cost effective compared with a number of other interventions provided by the NHS." Free Full Text
Non-pharmacological approaches to chronic headaches: transcutaneous electrical nerve stimulation, lasertherapy and acupuncture in transformed migraine treatment. - "The response in the groups differed over time, probably due to the different timing of applications of the three methods. TENS, lasertherapy and acupuncture proved to be effective in reducing the frequency of headache attacks. Acupuncture showed the best effectiveness over time."
Acupuncture versus placebo versus sumatriptan for early treatment of migraine attacks: a randomized controlled trial. - "In this trial acupuncture and sumatriptan were more effective than a placebo injection in the early treatment of an acute migraine attack. When an attack could not be prevented, sumatriptan was more effective than acupuncture at relieving headache."
Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine. - "Acupuncture proved to be adequate for migraine prophylaxis. Relative to flunarizine, acupuncture treatment exhibited greater effectiveness in the first months of therapy and superior tolerability.'

Women's Health

Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea. - "The findings suggest that acupressure at Sanyinjiao can be an effective, cost-free intervention for reducing pain and anxiety during dysmenorrhoea, and we recommend its use for self-care of primary dysmenorrhoea."
A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women. - "We suggest that acupuncture is a viable alternative treatment of vasomotor symptoms in postmenopausal women and cannot recommend superficial needle insertion as an inactive control treatment."
Use of acupressure to improve gastrointestinal motility in women after trans-abdominal hysterectomy. - "Our conclusions are that non-invasive acupressure of these meridian points can significantly improve GI motility and can be incorporated into the technical curriculum and clinical education program of nursing schools. Patients and their family members can be taught to continue this procedure at home to enhance GI motility in patients who have undergone TAH."

Fertility and Pregnancy."

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. - "Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group."
Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. - "Acupuncture was superior to stabilising exercises in this study."
Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. - "The total labor time (3 cm dilatation to delivery) was significantly shorter in the SP6 acupressure intervention group than in the control group (p = 0.006)."
Acupuncture: a promising treatment for depression during pregnancy. - "Acupuncture holds promise for the treatment of depression during pregnancy."
A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. - "Nerve stimulation therapy is effective in reducing nausea and vomiting and promoting weight gain in symptomatic women in the first trimester of pregnancy."
Success of acupuncture and acupressure of the Pc 6 acupoint in the treatment of hyperemesis gravidarum. - "Acupuncture (p < 0.0001) and acupressure (p < 0.1) are effective, nonpharmacologic methods for the treatment of HG. Copyright 2004 S. Karger GmbH, Freiburg"
Can acupuncture ease the symptoms of menopause? - "Acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances."
Acupuncture relieves pelvic and low-back pain in late pregnancy. - "Acupuncture relieves low-back and pelvic pain without serious adverse effects in late pregnancy."
Effects of acupuncture and moxa treatment in patients with semen abnormalities. - "The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause."
Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study. - "The results of our pilot study indicate that acupuncture can be an effective treatment option in more than two-thirds of patients with psychogenic erectile dysfunction."

Pediatrics

A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. - "This study showed that active acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. No serious adverse effect was identified. A large-scale study is required to confirm the safety of acupuncture for children."
Acupressure versus oxybutinin in the treatment of enuresis. - "In conclusion, nocturnal enuresis can be partially treated by oxybutinin but acupressure could be an alternative non-drug therapy. Acupressure has the advantages of being non-invasive, painless and cost-effective."

Surgery

Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. - "Vomiting, was significantly reduced by acupuncture from 39.6% to 24.8% (p = 0.03)."
Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting.The ReliefBand compared favorably to ondansetron (4 mg intravenously) when used for prophylaxis against postoperative nausea and vomiting. Furthermore, the acustimulation device enhanced the antiemetic efficacy of ondansetron after plastic surgery."
Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. - "Preoperative insertion of intradermal needles reduces postoperative pain, the analgesic requirement, and opioid-related side effects after both upper and lower abdominal surgery. Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery."

Stroke

Does acupuncture help stroke patients become more independent? - "Patients may be more likely to remain independent and in their own homes one year post stroke if they receive acupuncture."
The effect of acupuncture on motor cortex excitability and plasticity. - "We demonstrate for the first time that acupuncture has a real and enduring effect on motor cortex functional changes, in terms of cortical excitability and output mapping using transcranial magnetic stimulation."
Effects of acupuncture on hemorheology, blood lipid content and nail fold microcirculation in multiple infarct dementia patients. - "It is indicated that acupuncture can effectively regulate the affected hemodynamic state in MID"
Antispastic effect of electroacupuncture and moxibustion in stroke patients. - "This study suggests that EA can temporarily reduce spasticity due to stroke, and if applied repeatedly it can maintain reduced spasticity."
The effect of electro-acupuncture on motor function recovery in patients with acute cerebral infarction: a randomly controlled trial. - "Early acupuncture treatment for acute stroke patients may improve motor functions, and consequently the activities of daily living."
Clinical study on treatment of senile vascular dementia by acupuncture. - "Indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment."

Bell's Palsey

Efficacy of acupuncture and moxibustion in treating Bell's palsy: a multicenter randomized controlled trial in China. - "According to evaluations based on the House-Brackmann scale and FDI scores, the effectiveness of treatment in the two treatment groups was better than in the control group and was most effective in patients receiving acu-moxi treatment alone (Z = -2.827, P = 0.005). CONCLUSION: The efficacy of acu-moxi treatment for Bell's palsy is verified scientifically."

Fibromyalgia

Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. - "We observed a significant decrease in pain at rest, at activity, and increase in pain threshold in the laser group compared to other groups. Improvement according to Nottingham Health Profile gave the superiority of the laser treatment. However, those differences among the groups were not observed at 6-month follow up."

Physiological Effects

Biophotonics in the infrared spectral range reveal acupuncture meridian structure of the body. - "Evidence of the existence of the acupuncture meridian structure in the human body."
Acupuncture and endorphins. - "Studies on the mechanisms of action have revealed that endogenous opioid peptides in the central nervous system play an essential role in mediating the analgesic effect of EA. Further studies have shown that different kinds of neuropeptides are released by EA with different frequencies."
Functional MRI in healthy subjects during acupuncture: different effects of needle rotation in real and false acupoints. - "The observation that rotating the needle strengthened the effects of acupuncture only at real acupoints suggests that, as claimed in Chinese traditional medicine, stimulation of these acupoints has a specific effect on cortical neuronal activity, absent with sham acupoints."
Relations between brain network activation and analgesic effect induced by low vs. high frequency electrical acupoint stimulation in different subjects: a functional magnetic resonance imaging study. - "These results suggest that functional activities of certain brain areas might be correlated with the effect of EAS-induced analgesia, in a frequency-dependent dynamic. EAS-induced analgesia with low and high frequencies seems to be mediated by different, though overlapped, brain networks. The differential activations/de-activations in brain networks across subjects may provide a neurobiological explanation for the mechanisms of the induction and the individual variability of analgesic effect induced by EAS, or that of manual acupuncture as well."
A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods. - " These results indicate that different brain networks are involved during manual and electroacupuncture stimulation. It suggests that different brain mechanisms may be recruited during manual and electroacupuncture."
Acupuncture produces central activations in pain regions. - "This indicates that acupuncture could relieve pain by unbalancing the equilibrium of distributed pain-related central networks."

For Athletes - Staying Healthy!

Acupuncture and responses of immunologic and endocrine markers during competition. - "1). Exercise-induced decrease of salivary SIgA and increase of salivary cortisol were inhibited by acupuncture. 2). Acupuncture improved subjective rating of muscle tension and fatigue. 3). The POMS score was modulated by acupuncture. CONCLUSION: These results support the effectiveness of acupuncture for physical and mental well-being of athletes."

Arthritis

Treatment of rheumatoid arthritis with electromagnetic millimeter waves applied to acupuncture points--a randomized double blind clinical study.- "Patients from group I (n=4) reported significant pain relief and reduced joint stiffness during and after the course of therapy. Patients from group II (n=4) revealed no improvement during the study. Patients from group III reported the changes of pain and joint stiffness only after real MW sessions. After further large-scale clinical investigations MWT may become a non-invasive adjunct in therapy of patients with RA."
Study: Acupuncture Can Ease Osteoarthritis Pain From NPR

Cancer

Acupuncture: Role in Comprehensive Cancer Care--A Primer for the Oncologist and Review of the Literature. - "A majority of the current studies have shown beneficial effects that warrant further investigation with large trial sizes."
Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. - "The observed reduction in pain intensity measured on the VAS represents a clear benefit from auricular acupuncture for these cancer patients who are in pain, despite stable analgesic treatment."

Heart Disease

The effects of acupuncture in treatment of coronary heart diseases. - "A clinical study on acupuncture at point Neiguan (PC 6) was conducted on the basis of successful treatment of patients with angina pectoris and acute myocardial infarct. The effective rate (91.3%) was found to be far superior to isosorbide dinitrate and nifedipine (P < 0.01)."
Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. - "Continuous 24-h PC6 acupressure therapy as an adjunct to standard antiemetic medication for post-MI nausea and vomiting is feasible and is well accepted and tolerated by patients. In view of its benefits, further studies are worthwhile using earlier onset of treatment."
Acupuncture inhibits sympathetic activation during mental stress in advanced heart failure patients. - "Acute acupuncture attenuates sympathoexcitation during mental stress in advanced HF patients."

World Health Organization's Report on Acupuncture

Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. - A comprehensive review of the worlds literature that determines condiditions effectively treated with acupuncture.
The effect of acupuncture on the coronary arteries as evaluated by coronary angiography: a preliminary report. - "Coronary dilation following acupuncture showed a relationship to patients with Syndrome X. The mean dilatation with acupuncture was 68.8% of that caused by isosorbide dinitrate. These findings may help to clarify the mechanism of acupuncture treatment."

Addiction/Alcoholism

Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study. - "This study confirms that adequate acupuncture treatment may help motivated smokers to reduce their smoking, or even quit smoking completely, and the effect may last for at least 5 years. Acupuncture may affect the subjects' smoking by reducing their taste of tobacco and their desire to smoke. Different acupoints have different effects on smoking cessation. Copyright 2001 American Health Foundation and Academic Press."
Acupuncture in the treatment of alcohol withdrawal symptoms: a randomized, placebo-controlled inpatient study. - "We conclude that acupuncture as an adjunctive treatment to carbamazepine medication shows promise for the treatment of alcohol withdrawal symptoms. Further investigation of this treatment modality appears to be warranted."

Vocal Problems

A Randomized Treatment-Placebo Study of the Effectiveness of Acupuncture for Benign Vocal Pathologies. - "Results revealed significant improvement in the treatment group in all three aspects when compared with the placebo group. The acupuncture effect was maintained into the second week after the completion of acupuncture treatment."

Common Cold

Preventive and curative effects of acupuncture on the common cold: a multicentre randomized controlled trial in Japan - "A significantly positive effect of acupuncture was demonstrated in the summed questionnaire data"

Allergies

Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. - "The results of this study suggest that traditional Chinese therapy may be an efficacious and safe treatment option for patients with seasonal AR."
Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial. - "The results indicate that acupuncture is an effective and safe alternative treatment for the management of SAR."

Diabetes

Clinical observation on acupuncture treatment in 35 cases of diabetic gastroparesis. - "It can be concluded that in addition to the routine treatment for controlling blood sugar, acupuncture can give quite good therapeutic effects on diabetic gastroparesis."

Effect of acupuncture or acupressure on quality of life of patients with chronic obstructive asthma: a pilot study. - "Patients with clinically stable, chronic obstructive asthma experienced clinically significant improvements in quality of life when their standard care was supplemented with acupuncture or acupressure."

Gastrointestinal Issues

The treatment of obesity by acupuncture.It has been reported that acupuncture application in obesity treatment is effective in procuring weight loss.
Acupuncture and moxibustion in the treatment of active Crohn's disease: a randomized controlled study. - "Apart from a marked placebo effect, traditional acupuncture offers an additional therapeutic benefit in patients with mild to moderately active CD. Copyright 2004 S. Karger AG, Basel"

Mechanism of Action

The mechanism of acupuncture and clinical applications
The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI
Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study.

Acupuncture in the news

Scientists prove acupuncture works BBC News
Acupuncture 'more than a placebo' BBC News
On Pins and Needles:Acupuncture for Arthritis Relief ABC News
Impact of acupuncture goes beyond the acknowledged placebo effect
Acupuncture: A Cure for Infertility? NBC News
US News, Alternative Medicine Goes Mainsteam