Acupunct Med. 2004 Dec;22(4):214-20; discussion 220.
The effectiveness of an acupuncturist working in general practice--an audit.
Harborow PW, Ogden J.
Department of General Practice, Guys, Kings and St Thomas' School of Medicine, King's College, London.
This audit was based in general practice and examined 49 consecutive referrals to a UK trained traditional Chinese
acupuncturist. It aimed to assess the type of patients referred to an acupuncturist, subsequent changes in health status, whether
the effectiveness of acupuncture was related to the type of presenting problem and to examine which factors were predictive of
the success of acupuncture. The referred patients had a wide variety of conditions which were categorised as to whether or not
there was empirical evidence from trials of responsiveness to acupuncture (evidence based vs non evidence based). Patients
completed measures of their health status prior to treatment and at two and six month follow ups. In addition, the referring GP's
beliefs about the prognosis of the problem and the therapist's and patient's expectations of success were measured at baseline.
The results showed that referred patients reported poorer health status than a historical sample of general practice patients and
that they showed significant improvements in all aspects of health status following acupuncture. In particular, patients
showed improved energy, pain, emotional reactions, sleep and reduced social isolation at two months which were
maintained at six months. Physical mobility was improved at six months. In addition, the results indicated that the best
predictors of effectiveness were the therapist's and patient's expectations of success at baseline. Effectiveness was not related
to the category of condition (evidence based or not) nor to the GP's expectations about the prognosis of the condition. The
results are discussed in terms of implications for the role of acupuncture in General Practice and selectively targeting patients
who would be responsive to such an approach.
PAIN
Acupunct Med. 2006 Dec;24 Suppl:S33-39.
Efficacy, effectiveness, safety and costs of acupuncture for chronic pain - results of a large research initiative.
Witt CM, Brinkhaus B, Reinhold T, Willich SN.
BACKGROUND: The aim of the 'Acupuncture Model Project of the Techniker Krankenkasse' was to determine efficacy,
effectiveness, safety and cost effectiveness of acupuncture treatment in standard medical care. METHODS: We evaluated a
total of 304 674 patients (34.5% men, aged 53.1+/-13.8 and 65.5% women, aged 49.5+/-14.2) who were in the care of over 10
000 physicians and received on average 10+/-3 acupuncture treatments for chronic pain (osteoarthritis of the hip or knee, low
back pain, neck pain, headache) during a period of three months. RESULTS AND CONCLUSIONS: Our findings demonstrate
that for the diagnoses examined, acupuncture in addition to usual care was an effective and safe treatment.
Whether the effects of acupuncture can be attributed primarily to specific or nonspecific mechanisms appeared to depend on the
diagnosis, and should be investigated in further studies. Using acupuncture as an adjunctive treatment was more expensive than
usual care alone, but was cost-effective according to internationally accepted threshold values.
Eur J Med Res. 2005 Jun 22;10(6):263-72.
Long-term improvement in pain coping for cLBP and gonarthrosis patients following body needle acupuncture: a
prospective cohort study.
Kukuk P, Lungenhausen M, Molsberger A, Endres HG.
Department of Medical Informatics, Statistics and Epidemiology, Ruhr University Bochum, Germany.
BACKGROUND: Little is known about potential long-term effects of body acupuncture. The aim of the study was to determine
such long-term effects 3 and 6 months after the end of a course of acupuncture treatment for chronic low-back pain (cLBP) or
chronic pain caused by gonarthrosis. METHODS: Prospective cohort study with patients who had received 10 sessions of needle
body acupuncture within a maximum of 10 weeks. Data source was our survey of all patients receiving acupuncture treatment in
Germany. A total of 1096 eligible patients with cLBP or gonarthrosis pain were identified (68.1% female) and invited by letter to
participate in the study. Ultimately 249 patients remained, with no loss of representativeness. Two telephone interviews were
conducted 3 and 6 months after the last acupuncture session using standardized questionnaires, available as electronic case
report forms. The primary target criteria were self-assessment of pain tolerability prior to the start of acupuncture and after the
end of treatment, and pain intensity (GCPS) over time. Secondary target criteria were changes to functional impairment (HFAQ
for cLBP, WOMAC for gonarthrosis), quality of life (SF12), depression (CES-D) and patient global assessment of treatment
effectiveness (PGA). For the indication cLBP, pain-related fear avoidance beliefs (FABQ) were also queried. RESULTS: Pain
tolerability before acupuncture was reported as being significantly worse than pain tolerability at the time of the two
post-acupuncture interviews. The scores for all post-acupuncture questionnaires showed no significant changes over time, with
the exception of treatment effectiveness for gonarthrosis. Mean scores for each of the questionnaires at the 3 and 6 month
follow-up interviews were as follows: cLBP: Pain tolerability (pre: 6.8, post: 3.4 / 3.4), pain intensity (41.8 / 42.6), PGA (2.4 / 2.6),
SF12 physical (35.8 / 35.8), SF12 mental (45.3 / 46.9), CES-D (14.9 / 14.9), HFAQ (67.2 / 67.1), FABQ total (2.9 / 2.9).
GONARTHROSIS: Pain tolerability (pre: 6.9, post: 3.6 / 3.9), pain intensity (42.9 / 42.8), PGA (2.6 / 2.9), SF12 physical (32.2 /
31.3), SF12 mental (45.0 / 46.2), CES-D (15.6 / 14.7), WOMAC total (34.6 / 34.0). CONCLUSIONS: Pain tolerability was
significantly improved after acupuncture and remained so up to 6 months after treatment. The mean scores of almost all
questionnaires did not change significantly between 3 and 6 months. We therefore conclude that acupuncture had a
long-term effect on important aspects of cognitive and emotional pain coping.
Pain. 2006 Dec 15;126(1-3):245-55. Epub 2006 Aug 23.
Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study.
Vas J, Perea-Milla E, Mendez C, Sanchez Navarro C, Leon Rubio JM, Brioso M, Garcia Obrero I.
Pain Treatment Unit, Dos Hermanas A Primary Healthcare Centre, Dos Hermanas, Sevilla, Spain. jvas@acmas.com
Chronic neck pain is highly prevalent. To determine the efficacy and safety of acupuncture, in comparison with transcutaneous
nerve stimulation-placebo (TENS-placebo) in the treatment of chronic uncomplicated neck pain, a single blind prospective study
was designed, to be carried out at a Primary Healthcare Centre, with random assignment to two parallel groups and with
evaluation and analysis by independent evaluators. A random assignment was made from 123 patients of the 149 initially
recruited. These patients had been diagnosed with uncomplicated neck pain and experienced neck motion-related pain intensity
equal to or exceeding 30 on a visual analogue scale (VAS) from 0 to 100 mm. The treatment with acupuncture was compared
with TENS-placebo, applied over 5 sessions in three weeks. The primary endpoint was the change in maximum pain intensity
related to motion of the neck, one week after the final treatment. Sensitivity was analysed per protocol (PP) and variant analyses
were by intention to treat (ITT). Adjustment was made for confounders by multiple linear regression, including baseline values
and rescue therapy. By ITT analysis, the change in the pain-VAS variable was greater among the experimental group (28.1
(95% CI 21.4-34.7)). The improvements in quality of life (physical aspect), active neck mobility and reduced rescue medication
were clinically and statistically significant. In the treatment of the intensity of chronic neck pain, acupuncture is more
effective than the placebo treatment and presents a safety profile making it suitable for routine use in clinical
practice.
Clin J Pain. 2007 Feb;23(2):128-35.
Acupuncture for chronic low back pain in routine care: a multicenter observational study.
Weidenhammer W, Linde K, Streng A, Hoppe A, Melchart D.
Department of Internal Medicine II, Center for Complementary Medicine Research, Technische Universitat Munchen, Germany.
Wolfgang.Weidenhammer@lrz.tu-muenchen.de
OBJECTIVE: To investigate patient characteristics and outcomes after undergoing acupuncture treatment for chronic low back
pain (cLBP) in Germany and to analyze chronification, pain grading, and depression as predictors for treatment outcomes.
PATIENTS AND METHODS: Patients with cLBP (ICD-10 diagnoses M54.4 or M54.5) who underwent acupuncture therapy (mean
number of sessions 8.7+/-2.9) within the framework of a reimbursement and research program sponsored by German statutory
sickness funds were included in an observational study. Patients were asked to complete detailed questionnaires that included
questions on intensity and frequency of pain and instruments measuring functional ability, depression, and quality of life (SF-36)
before and after treatment and 6 months after beginning acupuncture. Participating physicians assessed pain chronification in
patients. RESULTS: A total of 2564 patients (mean age 57.7+/-14.0 y, 78.7% female), who were treated by 1607 physicians,
were included in the main analysis. After 6 months (6-mo follow-up), 45.5% of patients demonstrated clinically
significant improvements in their functional ability scores. The mean number of days with pain was decreased by
half (from 21 to 10 d/mo). Employed patients (employed patient subgroup analysis) reported a 30% decrease from baseline in
days of work lost. In all, 8.1% of patients reported adverse events, the majority of which were minor. Subgroup analyses focusing
on pain severity, stage of chronification, and depression revealed statistically significant relationships both to baseline measures
and to reduction of pain after acupuncture. CONCLUSIONS: Acupuncture treatment is associated with clinically relevant
improvements in patients suffering from cLBP of varying degrees of chronification and/or severity.
Pain. 2004 Dec;112(3):289-98.
Randomised trial of long term effect of acupuncture for shoulder pain.
Guerra de Hoyos JA, Andres Martin Mdel C, Bassas y Baena de Leon E, Vigara Lopez M, Molina Lopez T, Verdugo Morilla FA,
Gonzalez Moreno MJ.
Andalusia Public Health Service, C/La Maria 26, DP 41008 Sevilla, Spain. med010042@saludalia.es
The objective of the study is to compare the efficacy of electro-acupuncture with placebo-acupuncture for the treatment of
shoulder pain. This study comprised of a prospective, randomized, placebo controlled trial, with independent evaluator set in a
Public primary care clinic in Spain. The participants are patients aged from 25 to 83 years with shoulder pain. Patients were
randomly allocated to two treatments over eight weeks, with electro-acupuncture or skin non-penetrating placebo-acupuncture,
both able to take diclofenac if needed for intense pain. Primary outcome measure was the difference between groups in pain
intensity (visual analogue scale-VAS). Secondary outcomes were differences between groups in pain intensity measured by
Lattinen index, in range of motion (goniometer), functional ability (SPADI), quality of life (COOP-WONCA charts), NSAIDS intake,
credibility (Borkoveck and Nau scale) and global satisfaction (10 points analogue scale). Assessments were performed before,
during and three and six months after treatment. At six month follow-up after treatment the acupuncture group showed a
significantly greater improvement in pain intensity compared with the control group [VAS mean difference 2.0 (95% CI 1.2-2.9)].
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.
Pain. 2004 Jun;109(3):299-307.
Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and
3-year follow-up study.
He D, Veiersted KB, Hostmark AT, Medbo JI.
Department of General Practice and Community Medicine, University of Oslo, Norway. dong.he@samfunnsmed.uio.no
The study was carried out to examine whether acupuncture treatment can reduce chronic pain in the neck and shoulders and
related headache, and also to examine whether possible effects are long-lasting. Therefore, 24 female office workers (47+/-9
years old, mean+/-SD) who had had neck and shoulder pain for 12+/-9 years were randomly assigned to a test group (TG) or a
control group (CG). Acupuncture was applied 10 times during 3-4 weeks either at presumed anti-pain acupoints (TG) or at
placebo-points (CG). A physician measured the pain threshold (PPT) in the neck and shoulder regions with algometry before the
first treatment, and after the last one and six months after the treatments. Questionnaires on muscle pain and headache were
answered at the same occasions and again 3 years after the last treatment. The intensity and frequency of pain fell more for TG
than for CG (Pb < or = 0.04) during the treatment period. Three years after the treatments TG still reported less pain than
before the treatments (Pw < 0.001) contrary to what CG did (Pb < 0.04) The degree of headache fell during the treatment period
for both groups, but more for TG than for CG (Pb=0.02) Three years after the treatments the effect still lasted for TG (Pw <
0.01) while the degree of headache for CG was back to the pre-treatment level (Pb < 0.001) PPT of some muscles rose during
the treatments for TG and remained higher 6 months after the treatments (Pw < 0.05) which contrasts the situation for CG.
Adequate acupuncture treatment may reduce chronic pain in the neck and shoulders and related headache. The
effect lasted for 3 years.
Rheumatology (Oxford). 2007 Mar;46(3):384-90. Epub 2007 Jan 10.
Acupuncture treatment for chronic knee pain: a systematic review.
White A, Foster NE, Cummings M, Barlas P.
Peninsula Medical School, Universities of Exeter and Plymouth, Plymouth, UK. adrian.white@pms.ac.uk
OBJECTIVES: To evaluate the effects of acupuncture on pain and function in patients with chronic knee pain. METHODS:
Systematic review and meta-analysis of randomized controlled trials of adequate acupuncture. Computerized databases and
reference lists of articles were searched in June 2006. Studies were selected in which adults with chronic knee pain or
osteoarthritis of the knee were randomized to receive either acupuncture treatment or a control consisting of sham (placebo)
acupuncture, other sham treatments, no additional intervention (usual care), or an active intervention. The main outcome
measures were short-term pain and function, and study validity was assessed using a modification of a previously published
instrument. RESULTS: Thirteen RCTs were included, of which eight used adequate acupuncture and provided WOMAC
outcomes, so were combined in meta-analyses. Six of these had validity scores of more than 50%. Combining five studies in
1334 patients, acupuncture was superior to sham acupuncture for both pain (weighted mean difference in WOMAC pain
subscale score = 2.0, 95% CI 0.57-3.40) and for WOMAC function subscale (4.32, 0.60-8.05). The differences were still
significant at long-term follow-up. Acupuncture was also significantly superior to no additional intervention. There were
insufficient studies to compare acupuncture with other sham or active interventions. CONCLUSIONS: Acupuncture that meets
criteria for adequate treatment is significantly superior to sham acupuncture and to no additional intervention in
improving pain and function in patients with chronic knee pain. Due to the heterogeneity in the results, however, further
research is required to confirm these findings and provide more information on long-term effects.
Arthritis Rheum. 2006 Nov;54(11):3485-93.
Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional
nonrandomized arm.
Witt CM, Jena S, Brinkhaus B, Liecker B, Wegscheider K, Willich SN.
Institute for Social Medicine, Epidemiology, and Health Economics, Charite University Medical Center, 10098 Berlin, Germany.
claudia.witt@charite.de
OBJECTIVE: To investigate the effectiveness of acupuncture in addition to routine care, compared with routine care alone, in the
treatment of patients with chronic pain due to osteoarthritis (OA) of the knee or hip. METHODS: In a randomized, controlled trial,
patients with chronic pain due to OA of the knee or hip were randomly allocated to undergo up to 15 sessions of acupuncture in
a 3-month period or to a control group receiving no acupuncture. Another group of patients who did not consent to
randomization underwent acupuncture treatment. All patients were allowed to receive usual medical care in addition to the study
treatment. Clinical OA severity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) and health-related
quality of life (Short Form 36) were assessed at baseline and after 3 months and 6 months. RESULTS: Of 3,633 patients (mean
+/- SD age 61.8 +/- 10.8 years; 61% female), 357 were randomized to the acupuncture group and 355 to the control group, and
2,921 were included in the nonrandomized acupuncture group. At 3 months, the WOMAC had improved by a mean +/- SEM of
17.6 +/- 1.0 in the acupuncture group and 0.9 +/- 1.0 in the control group (3-month scores 30.5 +/- 1.0 and 47.3 +/- 1.0,
respectively [difference in improvement 16.7 +/- 1.4; P < 0.001]). Similarly, quality of life improvements were more pronounced in
the acupuncture group versus the control group (P < 0.001). Treatment success was maintained through 6 months. The
changes in outcome in nonrandomized patients were comparable with those in randomized patients who received acupuncture.
CONCLUSION: These results indicate that acupuncture plus routine care is associated with marked clinical
improvement in patients with chronic OA-associated pain of the knee or hip.
Health Technol Assess. 2004 Nov;8(48):iii, 1-35.
Acupuncture of chronic headache disorders in primary care: randomised controlled trial and economic analysis.
Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith CM, Ellis N, Fisher P, Van Haselen R, Wonderling D, Grieve R.
Integrative Medicine Service, Biostatistics Service, Memorial Sloan-Kettering Cancer Center, New York, USA.
OBJECTIVES: To determine the effects of a policy of using acupuncture, compared with a policy of avoiding acupuncture, on
headache in primary care patients with chronic headache disorders. The effects of acupuncture on medication use, quality of
life, resource use and days off sick in this population and the cost-effectiveness of acupuncture were also examined. DESIGN:
Randomised, controlled trial. SETTING: General practices in England and Wales. PARTICIPANTS: The study included 401
patients with chronic headache disorder, predominantly migraine. INTERVENTIONS: Patients were randomly allocated to receive
up to 12 acupuncture treatments over 3 months or to a control intervention offering usual care. MAIN OUTCOME MEASURES:
Outcome measures included headache score; assessment of Short Form 36 (SF-36) health status and use of medication at
baseline, 3 months and 12 months; assessment of use of resources every 3 months; and assessment of incremental cost per
quality-adjusted life-year (QALY) gained. RESULTS: Headache score at 12 months, the primary end-point, was lower in the
acupuncture group than in controls. The adjusted difference between means was 4.6. This result was robust to sensitivity
analysis incorporating imputation for missing data. Patients in the acupuncture group experienced the equivalent of 22 fewer
days of headache per year. SF-36 data favoured acupuncture, although differences reached significance only for physical role
functioning, energy and change in health. Compared with controls, patients randomised to acupuncture used 15% less
medication, made 25% fewer visits to GPs and took 15% fewer days off sick. Total costs during the 1-year period of the study
were on average higher for the acupuncture group than for controls because of the acupuncture practitioners' costs. The mean
health gain from acupuncture during the year of the trial was 0.021 QALYs, leading to a base-case estimate of GBP9180 per
QALY gained. This result was robust to sensitivity analysis. Cost per QALY dropped substantially when the analysis incorporated
likely QALY differences for the years after the trial. CONCLUSIONS: The study suggests that acupuncture leads to
persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. It is
relatively cost-effective compared with a number of other interventions provided by the NHS. Further studies could examine the
duration of acupuncture effects beyond 1 year and the relative benefit to patients with migraine with compared to tension-type
headache. Trials are also warranted examining the effectiveness and cost-effectiveness of acupuncture in patients with
headache receiving more aggressive pharmacological management.
Headache. 2005 Oct;45(9):1113-23.
A randomized, controlled trial of acupuncture for chronic daily headache.
Coeytaux RR, Kaufman JS, Kaptchuk TJ, Chen W, Miller WC, Callahan LF, Mann JD.
UNC School of Medicine, Chapel Hill, NC27599-7595, USA.
BACKGROUND: Approximately 4% of adults experience headaches nearly every day. Nonpharmacologic interventions for
frequent headaches may be appropriate because medical management alone is often ineffective. OBJECTIVE: To assess the
efficacy of acupuncture as an adjunct to medical management for chronic daily headache (CDH). METHODS: We conducted a
randomized, controlled trial of 74 patients with CDH that compared medical management provided by neurologists to medical
management plus 10 acupuncture treatments. Primary outcome measures were daily pain severity and headache-related quality
of life (QoL). RESULTS: Patients who received only medical management did not demonstrate improvement in any of the
standardized measures. Daily pain severity scores trended downward but did not differ between treatment groups (P= .60).
Relative to medical management only, medical management plus acupuncture was associated with an improvement of 3.0 points
(95% CI, 1.0 to 4.9) on the Headache Impact Test and an increase of 8 or more points on the role limitations due to physical
problems, social functioning, and general mental health domains of the Short Form 36 Health Survey. Patients who received
acupuncture were 3.7 times more likely (CI, 1.7 to 8.1) to report less suffering from headaches at 6 weeks (absolute risk
reduction 46%; number needed to treat 2). CONCLUSION: Headache-specialty medical management alone was not associated
with improved clinical outcomes among our study population. Supplementing medical management with acupuncture,
however, resulted in improvements in health-related QoL and the perception by patients that they suffered less
from headaches.
Pediatr Neurol. 1997 Sep;17(2):129-33.
Acupuncture and the opioid system: implications in management of migraine.
Pintov S, Lahat E, Alstein M, Vogel Z, Barg J.
Department of Neurobiology; the Weizmann Institute of Science; Rehovot, Israel.
We investigated the effectiveness of acupuncture in childhood migraine in 22 children with migraine, randomly divided into two
groups: a true acupuncture group (12 children) and a placebo acupuncture group (10 children). Ten healthy children served as
a control group. Opioid activity in blood plasma was assayed by two methods: (1) determination of total (panopioid) activity with
an opiate radioreceptor assay, and (2) determination of beta-endorphinlike immunoreactivity by radioimmunoassay. The true
acupuncture treatment led to significant clinical reduction in both migraine frequency and intensity. At the beginning of the study,
significantly greater panopioid activity was evident in plasma of the control group than in plasma of the migraine group. The true
acupuncture group showed a gradual increase in the panopioid activity in plasma, which correlated with the clinical improvement.
After the tenth treatment, the values of opioid activity of the true acupuncture group were similar to those of the control group,
whereas the plasma of the placebo acupuncture group exhibited insignificant changes in plasma panopioid activity. In addition, a
significant increase in beta-endorphin levels was observed in the migraine patients who were treated in the true acupuncture
group as compared with the values before treatment or with the values of the placebo acupuncture group. The results
suggest that acupuncture may be an effective treatment in children with migraine headaches and that it leads to an
increase in activity of the opioidergic system.
Acupunct Med. 2006 Mar;24(1):16-22.
The use of acupuncture in the treatment of temporomandibular dysfunction--an audit.
Rosted P, Bundgaard M, Pedersen AM.
Sheffield University, Sheffield, UK. Prosted@aol.com
OBJECTIVE: Temporomandibular dysfunction often represents a major therapeutic problem in a dental practice. Evidence from
clinical studies suggests that acupuncture may be useful in the treatment of temporomandibular dysfunction. However, most
studies have been performed in university settings. The aims of this study were to determine if the results of acupuncture
treatment of temporomandibular dysfunction in general dental practice are comparable to the results obtained in previous
studies in university clinics, and whether the treatment approach differs from that used in previous studies. METHODS: The case
reports submitted by 15 dentists applying for the diploma of the British Dental Acupuncture Society were combined into one
audit. All dentists were informed before submitting the forms that the data might be used for scientific purposes. The criteria for
Pain Syndrome Dysfunction were used as inclusion criteria. A visual analogue scale (VAS) was used to assess the pain intensity
before and after acupuncture treatment. The acupuncture points and technique used were recorded for each treatment.
RESULTS: A total number of 70 case reports were received. Ten patients were excluded, as they did not fulfil the criteria. The
remaining 60 patients (50 female) fulfilled an average of 3.2 of the Pain Syndrome Dysfunction criteria, out of a possible five.
Their mean age was 40.6 years (range 14-68). The average duration of temporomandibular dysfunction was 32 months (range
1-180). The patients received a mean of 3.4 treatments, each treatment lasting on average 12 minutes. The dentists used only
manual stimulation, and mainly acupuncture points over the temporomandibular joint and in the masticatory muscles, points on
the neck, and additional relaxing points. The mean pain scores were 7.35 (SD 1.52) before treatment and 2.67 (SD 0.58) after
treatment (P < 0.001). A beneficial effect was observed in 85% with an average reduction in the pain intensity of 75%.
CONCLUSION: This audit shows that the results of using acupuncture in the treatment of temporomandibular dysfunction in a
general dental practice are comparable to those obtained in clinical studies in university settings. Also the therapeutic approach
of using acupuncture is similar. Thus, acupuncture is a simple, relatively safe and potentially efficacious and useful
technique in the management of temporomandibular dysfunction in a general dental practice.
J Dent. 2007 Mar;35(3):259-67. Epub 2006 Nov 13.
The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: a randomised controlled
trial.
Smith P, Mosscrop D, Davies S, Sloan P, Al-Ani Z.
School of Dentistry, The University of Manchester, Higher Cambridge Street, Manchester M15 6FH, United Kingdom.
OBJECTIVES: To compare the effect of real acupuncture and sham acupuncture in the treatment of temporomandibulat joint
myofascial pain, in order to establish the true efficacy of acupuncture. METHODS: A double blind randomised controlled trial
conducted in the TMD Clinic, at the School of Dentistry, The University of Manchester. Twenty-seven patients were assigned to
one of two treatment groups. Group 1 received real acupuncture treatment whilst Group 2 received a sham acupuncture
intervention. Both the assessor and the patient were blinded regarding the group allocation. Baseline assessment of the
outcome variables was made prior to the first treatment session, and was repeated following the last treatment. RESULTS: The
results demonstrated that real acupuncture had a greater influence on clinical outcome measure of TMJ MP than those of sham
acupuncture, and the majority of these reached a level of statistical significance. CONCLUSION: Acupuncture had a positive
influence on the signs and symptoms of TMJ MP. In addition, this study provides evidence that the Park Sham Device was
a credible acupuncture control method for trials involving facial acupoints.
J Clin Oncol. 2003 Nov 15;21(22):4120-6.
Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial.
Alimi D, Rubino C, Pichard-Leandri E, Fermand-Brule S, Dubreuil-Lemaire ML, Hill C.
Pain Management Unit, INSERM, U521, Villejuif, France.
PURPOSE: During the last 30 years, auricular acupuncture has been used as complementary treatment of cancer pain when
analgesic drugs do not suffice. The purpose of this study is to examine the efficacy of auricular acupuncture in decreasing pain
intensity in cancer patients. PATIENTS AND METHODS: Ninety patients were randomly divided in three groups; one group
received two courses of auricular acupuncture at points where an electrodermal signal had been detected, and two placebo
groups received auricular acupuncture at points with no electrodermal signal (placebo points) and one with auricular seeds fixed
at placebo points. Patients had to be in pain, attaining a visual analog score (VAS) of 30 mm or more after having received
analgesic treatment adapted to both intensity and type of pain, for at least 1 month of therapy. Treatment efficacy was based on
the absolute decrease in pain intensity measured 2 months after randomization using the VAS. RESULTS: The main outcome
was pain assessed at 2 months, with the assessment at 1 month carried over to 2 months for the eight patients who interrupted
treatment after 1 month. For three patients, no data were available because they withdrew from the study during the first month.
Pain intensity decreased by 36% at 2 months from baseline in the group receiving acupuncture; there was little change for
patients receiving placebo (2%). The difference between groups was statistically significant (P <.0001). CONCLUSION: 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.
Mayo Clin Proc. 2006 Jun;81(6):749-57.
Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial.
Martin DP, Sletten CD, Williams BA, Berger IH.
Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
martin.david@mayo.edu
OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of fibromyalgia. PATIENTS AND METHODS: We
conducted a prospective, partially blinded, controlled, randomized clinical trial of patients receiving true acupuncture compared
with a control group of patients who received simulated acupuncture. All patients met American College of Rheumatology criteria
for fibromyalgia and had tried conservative symptomatic treatments other than acupuncture. We measured symptoms with the
Fibromyalgia Impact Questionnaire (FIQ) and the Multidimensional Pain Inventory at baseline, immediately after treatment, and
at 1 month and 7 months after treatment. The trial was conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty
patients participated in the study: 25 in the acupuncture group and 25 in the control group. Total fibromyalgia symptoms, as
measured by the FIQ, were significantly improved in the acupuncture group compared with the control group during the study
period (P = .01). The largest difference in mean FIQ total scores was observed at 1 month (42.2 vs 34.8 in the control and
acupuncture groups, respectively; P = .007). Fatigue and anxiety were the most significantly improved symptoms during the
follow-up period. However, activity and physical function levels did not change. Acupuncture was well tolerated, with minimal
adverse effects. CONCLUSION: This study paradigm allows for controlled and blinded clinical trials of acupuncture. We found
that acupuncture significantly improved symptoms of fibromyalgia. Symptomatic improvement was not restricted to
pain relief and was most significant for fatigue and anxiety.
Altern Ther Health Med. 2006 Mar-Apr;12(2):34-41.
Effectiveness of acupuncture in the treatment of fibromyalgia.
Singh BB, Wu WS, Hwang SH, Khorsan R, Der-Martirosian C, Vinjamury SP, Wang CN, Lin SY.
Southern California University of Health Sciences, Whittier, USA.
CONTEXT: Fibromyalgia syndrome (FMS) is a prevalent musculoskeletal disorder associated with pain, mood state alteration,
and disability. A structured and effective treatment plan for palliative care has not been established. The genesis of FMS is not
clear. FMS occurs primarily in adult women. DESIGN: Using a quasi-experimental clinical design and following the criteria of the
American College of Rheumatology (ACR), for FMS, 21 participants completed the study. The mean age was 53.6 years. The
data were collected at baseline and at 1 and 2 months. Acupuncture treatments included 17 points for FMS symptoms, and 8
outcome measures were collected. RESULTS: The Fibromyalgia Impact Questionnaire (FIQ) showed significant differences at 1
and 2 months. For the SF-12, 3 subscales showed significant differences between baseline and 2 months. Four of 6 items were
significantly changed. The mean number of general health symptoms was significantly decreased by 2 months. For the
Catastrophe Index, significant differences were found for baseline vs 2 months. Pain threshold scores were significantly different
at end of treatment for 5 bilateral tender points. There was significant improvement in Beck Depression items for both 1- and
2-month periods. In a multivariate regression model, 5 covariates were included--age, number of weeks in treatment, number of
doctors treating, number of general symptoms, and baseline FIQ score. The results indicated significant age effect. This
analysis showed that the higher the FIQ score, the more positive the change experienced by study participants. Number of
weeks in treatment, number of doctors who treated, and total number of general health symptoms did not have a significant
effect on outcomes. CONCLUSIONS: Significant improvement was experienced by participants at 8 weeks of
treatment. Acupuncture treatment as delivered was effective at reducing FMS symptoms in this outcome study.
J Altern Complement Med. 2005 Aug;11(4):663-71.
Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and
treatment frequency.
Harris RE, Tian X, Williams DA, Tian TX, Cupps TR, Petzke F, Groner KH, Biswas P, Gracely RH, Clauw DJ.
Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI 48106, USA.
reharris@med.umich.edu
OBJECTIVES: The objective of this study was to investigate whether typical acupuncture methods such as needle placement,
needle stimulation, and treatment frequency were important factors in fibromyalgia symptom improvement.
DESIGN/SETTINGS/SUBJECTS: A single-site, single-blind, randomized trial of 114 participants diagnosed with fibromyalgia for at
least 1 year was performed. INTERVENTION: Participants were randomized to one of four treatment groups: (1) T/S needles
placed in traditional sites with manual needle stimulation (n = 29): (2) T/0 traditional needle location without stimulation (n = 30);
(3) N/S needles inserted in nontraditional locations that were not thought to be acupuncture sites, with stimulation (n = 28); and
(4) N/0 nontraditional needle location without stimulation (n = 2 7). All groups received treatment once weekly, followed by twice
weekly, and finally three times weekly, for a total of 18 treatments. Each increase in frequency was separated by a 2-week
washout period. OUTCOME MEASURES: Pain was assessed by a numerical rating scale, fatigue by the Multi-dimensional
Fatigue Inventory, and physical function by the Short Form-36. RESULTS: Overall pain improvement was noted with
25%-35% of subjects having a clinically significant decrease in pain; however this was not dependent upon "correct"
needle stimulation (t = 1.03; p = 0.307) or location (t = 0.76; p = 0.450). An overall dose effect of treatment was observed, with
three sessions weekly providing more analgesia than sessions once weekly (t = 2.10; p = 0.039). Among treatment responders,
improvements in pain, fatigue, and physical function were highly codependent (all p < or = 0.002). CONCLUSIONS: Although
needle insertion led to analgesia and improvement in other somatic symptoms, correct needle location and stimulation were not
crucial.
J Altern Complement Med. 2006 Nov;12(9):851-6.
A pilot study of external qigong therapy for patients with fibromyalgia.
Chen KW, Hassett AL, Hou F, Staller J, Lichtbroun AS.
Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School,
Piscataway, NJ, USA. kchen@compmed.umm.edu
OBJECTIVES: Although qigong is an important part of Traditional Chinese medicine (TCM) based on a philosophy similar to
acupuncture, few studies of qigong exist in the Western medicine literature. To evaluate qigong therapy as a modality in treating
chronic pain conditions such as fibromyalgia syndrome (FMS), we report a pilot trial of 10 women with severe FMS who
experienced significant improvement after external qigong therapy (EQT). DESIGN: Ten patients with FMS completed five to
seven sessions of EQT over 3 weeks with pre- and posttreatment assessment and a 3-month follow-up. Each treatment lasted
approximately 40 minutes. OUTCOME MEASURES: Tender point count (TPC) and Fibromyalgia Impact Questionnaire (FIQ)
were the primary measures. McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI), anxiety, and self-efficacy were
the secondary outcomes. RESULTS: Subjects demonstrated improvement in functioning, pain, and other symptoms. The mean
TPC was reduced from 136.6 to 59.5 after EQT treatment; mean MPQ decreased from 27.0 to 7.2; mean FIQ from 70.1 to 37.3;
and mean BDI from 24.3 to 8.3 (all p < 0.01). Many subjects reported reductions in other FMS symptoms, and two reported they
were completely symptom-free. Results from the 3-month follow-up indicated some slight rebound from the post-treatment
measures, but still much better than those observed at baseline. CONCLUSIONS: Treatment with EQT resulting in complete
recovery for some FMS patients suggests that TCM may be very effective for treating pain and the multiplicity of
symptoms associated with FMS. Larger controlled trials of this promising intervention are urgently needed.
J Chin Med Assoc. 2005 Dec;68(12):591-4.
Acupuncture resulting in immediate bronchodilating response in asthma patients.
Chu KA, Wu YC, Lin MH, Wang HC.
Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road,
Kaohsiung 813, Taiwan, ROC. kachu@vghks.gov.tw
There are some encouraging results in the English literature that show acupuncture resulting in an immediate improvement in
pulmonary function, but there are also studies that have not demonstrated any benefit. We present 3 patients with persistent
asthma who experienced immediate bronchodilatation after acupuncture without the use of any short-acting bronchodilator. After
needle stimulation on selected acupoints, clinical symptoms such as dyspnea and wheezing improved. Pulmonary function test
showed immediate improvement in forced expiratory volume in 1 second (FEV1), more than 20% as compared with baseline
FEV1. Pulmonary function returned to baseline within 4 hours after acupuncture in 2 patients. From our observations of
these 3 asthma patients, acupuncture may improve clinical dyspnea symptoms and performance on pulmonary
function tests. Further large-scale controlled studies should be conducted to determine the effectiveness of acupuncture in the
treatment of asthma.
Allergy. 1984 Jul;39(5):379-85.
Acupuncture and bronchial asthma.
Christensen PA, Laursen LC, Taudorf E, Sorensen SC, Weeke B.
Seventeen patients with stable bronchial asthma were randomly assigned to receive either correct acupuncture or placebo
acupuncture. The study lasted 11 weeks and consisted of a pre-therapy, therapy, and post-therapy period. The patients
received 10 treatments during a 5-week period. The effect of therapy on pulmonary function was assessed daily by the patients
at home. Morning and evening peak expiratory flow rate, number of puffs beta 2-agonist aerosol needed, as well as subjective
symptoms of asthma were recorded in a diary. The correctly treated group improved significantly throughout the study.
Also, compared with the placebo group, a significant improvement was found in all assessed parameters 2 weeks
after beginning therapy. Hereafter, no differences could be shown.
J Altern Complement Med. 2003 Oct;9(5):659-70.
Effect of acupuncture or acupressure on quality of life of patients with chronic obstructive asthma: a pilot study.
Maa SH, Sun MF, Hsu KH, Hung TJ, Chen HC, Yu CT, Wang CH, Lin HC.
School of Nursing, Chang Gung University, Tao-Yuan, Taiwan.
OBJECTIVES: Acupuncture and acupressure are known to relieve symptoms associated with asthma, but the benefits to patients
with chronic obstructive asthma have not been fully evaluated. In this pilot clinical study, acupuncture or acupressure was
incorporated into the standard care for adult patients with chronic obstructive asthma to determine their contribution to the
improvement of their quality of life and relief of symptoms. DESIGN: A prospective, randomized study that involved 8 weeks of
treatment at Chang Gung Memorial Hospital (Tao-Yuan, Taiwan) was conducted between March 1997 and September 1998.
Forty-one (n = 41) patients with chronic obstructive asthma were enrolled. Patients were randomly assigned to receive
acupuncture in addition to standard care (n = 11), acupressure and standard care (n = 17), or standard care alone (n = 13).
Twenty (20) acupuncture treatments were administered, and self-administered acupressure was performed daily for 8 weeks.
Six-minute walking, the Dyspnea Visual Analogue Scale, the modified Borg scale, St. George's Respiratory Questionnaire
(SGRQ), and the Bronchitis Emphysema Symptom Checklist (BESC) were used at the beginning and end of the 8 weeks of
treatment. RESULTS: The total SGRQ score of acupuncture subjects showed an average 18.5-fold improvement (95%
confidence interval [CI] 1.54-211.48, p = 0.02); the improvement for the acupressure subjects was 6.57-fold (95% C.I.
0.98-44.00, p = 0.05). Additionally, for patients who received acupressure, the irritability domain score determined by the BESC
exhibited an 11.8-fold improvement (95% C.I. 0.88-158.64, p = 0.06) after adjustment for covariables. The other variables did
not differ from those of the controls. CONCLUSIONS: 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.
J Altern Complement Med. 2000 Dec;6(6):519-25.
Immunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized controlled study.
Joos S, Schott C, Zou H, Daniel V, Martin E.
Department of Anaesthetics, University of Heidelberg, Germany. s.joos@gmx.de
OBJECTIVE: According to Traditional Chinese Medicine (TCM) acupuncture is a suitable treatment for complex chronic diseases
such as bronchial asthma. In a randomized, controlled study we investigated immunologic effects of Chinese acupuncture on
patients with allergic asthma. PATIENTS AND METHODS: The effects of acupuncture treatment given according to the principles
of TCM (TCM group, n = 20) were compared with those of acupuncture treatment using points not specific for asthma (control
group, n = 18). All patients were treated 12 times for 30 minutes over a time period of 4 weeks. Patients' general well-being and
several peripheral blood parameters (eosinophils, lymphocyte subpopulations, cytokines, in vitro lymphocyte proliferation) were
determined before and after acupuncture treatment. RESULTS: In the TCM group, significantly more patients indicated an
improvement in general well-being (79% in the TCM group versus 47% in the control group; p = 0.049) after acupuncture
treatment. The following changes were found in the TCM group: within the lymphocyte subpopulations the CD3+ cells (p = 0.005)
and CD4+ cells (p = 0.014) increased significantly. There were also significant changes in cytokine concentrations: interleukin
(IL)-6 (p = 0.026) and IL-10 (p = 0.001) decreased whereas IL-8 (p = 0.050) rose significantly. Additionally, the in vitro
lymphocyte proliferation rate increased significantly (p = 0.035) while the number of eosinophils decreased from 4.4% to 3.3%
after acupuncture (p > 0.05). The control group, however, showed no significant changes apart from an increase in the CD4+
cells (p = 0.012). CONCLUSION: The results imply that asthma patients benefit from acupuncture treatment given in
addition to conventional therapy. Furthermore, acupuncture performed in accordance with the principles of TCM
showed significant immune-modulating effects.
.
Am J Chin Med. 1993;21(2):113-7.
Beneficial effect of acupuncture on adult patients with asthma bronchiale.
Zwolfer W, Keznickl-Hillebrand W, Spacek A, Cartellieri M, Grubhofer G.
Department of Anaesthesia and Intensive Care, University of Vienna, Austria.
In a retrospective study 17 patients with long-standing history of asthma bronchiale were treated with acupuncture at the
outpatient unit of the Department of Anaesthesia and Intensive Care in the University Hospital of Vienna. The subjective
effectiveness of the treatment was determined using a standard questionnaire, which was sent to the patients' homes half a year
after starting acupuncture treatment. Over 70% of our patients reported a significant improvement of their ailments
after ten weeks of treatment as well as half a year after starting acupuncture.
Allergy. 2004 Sep;59(9):953-60
Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a
randomized-controlled clinical trial.
Brinkhaus B, Hummelsberger J, Kohnen R, Seufert J, Hempen CH, Leonhardy H, Nogel R, Joos S, Hahn E, Schuppan D.
Department of Medicine I, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen Germany.
BACKGROUND: Patients with allergic rhinitis (AR) increasingly use complementary medicine. The aim of this study was to
determine whether traditional Chinese therapy is efficacious in patients suffering from seasonal AR. METHODS: Fifty-two
patients between the ages of 20 and 58 who had typical symptoms of seasonal AR were assigned randomly and in a blinded
fashion to (i) an active treatment group which received a semi-standardized treatment of acupuncture and Chinese herbal
medicine, and (ii) a control group which received acupuncture applied to non-acupuncture points in addition to a non-specific
Chinese herbal formula. All patients received acupuncture treatment once per week and the respective Chinese herbal formula
as a decoction three times daily for a total of 6 weeks. Assessments were performed before, during, and 1 week after treatment.
The change in severity of hay fever symptoms was the primary outcome measured on a visual analogue scale (VAS). RESULTS:
Compared with patients in the control group, patients in the active treatment group showed a significant
after-treatment improvement on the VAS (P = 0.006) and Rhinitis Quality of Life Questionnaire (P = 0.015).
Improvement on the Global Assessment of Change Scale was noted in 85% of active treatment group participants
vs 40% in the control group (P = 0.048).
Chinese therapy may be an efficacious and safe treatment option for patients with seasonal AR.
A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent
allergic rhinitis.
Ng DK, Chow PY, Ming SP, Hong SH, Lau S, Tse D, Kwong WK, Wong MF, Wong WH, Fu YM, Kwok KL, Li H, Ho JC.
Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Rd, Kowloon, SAR, Hong Kong. dkkng@ha.org.hk
OBJECTIVE: To compare active acupuncture with sham acupuncture for the treatment of persistent allergic rhinitis among
children. METHODS: Subjects with persistent allergic rhinitis were recruited from the pediatric outpatient clinic. They were
randomized to receive either active acupuncture or sham acupuncture. Main outcome measures included daily rhinitis scores,
symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood
eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and
adverse effects. RESULTS: Eighty-five patients were recruited from the pediatric outpatient clinic at Kwong Wah Hospital, in
Hong Kong. Thirteen patients withdrew before randomization; 35 patients (mean age: 11.7 +/- 3.2 years) were randomized to
receive active acupuncture for 8 weeks, and 37 patients (mean age: 11 +/- 3.8 years) were randomized to receive sham
acupuncture for 8 weeks. Acupuncture was performed twice per week for both groups. Both the assessing pediatricians and the
patients were blinded. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving
active acupuncture, during both the treatment and follow-up periods. The visual analog scale scores for immediate improvement
after acupuncture were also significantly better for the active acupuncture group. There was no significant difference in the
following outcome measures between the active and sham acupuncture groups: daily relief medication scores, blood eosinophil
counts, serum IgE levels, and nasal eosinophil counts, except for the IgE levels before and 2 months after acupuncture in the
sham acupuncture group. No severe adverse effects were encountered. Numbness, headache, and dizziness were found in both
the active and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting. CONCLUSIONS: 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.
J Neuropsychiatry Clin Neurosci. 2004 Winter;16(1):19-28.
Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report.
Spence DW, Kayumov L, Chen A, Lowe A, Jain U, Katzman MA, Shen J, Perelman B, Shapiro CM.
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
The response to acupuncture of 18 anxious adult subjects who complained of insomnia was assessed in an open prepost
clinical trial study. Five weeks of acupuncture treatment was associated with a significant (p = 0.002) nocturnal increase in
endogenous melatonin secretion (as measured in urine) and significant improvements in polysomnographic measures of sleep
onset latency (p = 0.003), arousal index (p = 0.001), total sleep time (p = 0.001), and sleep efficiency (p = 0.002). Significant
reductions in state (p = 0.049) and trait (p = 0.004) anxiety scores were also found. These objective findings are
consistent with clinical reports of acupuncture's relaxant effects. Acupuncture treatment may be of value for some
categories of anxious patients with insomnia.
J Assoc Nurses AIDS Care. 2001 Jan-Feb;12(1):27-39.
Effects of individualized acupuncture on sleep quality in HIV disease.
Phillips KD, Skelton WD.
Department of Administrative and Clinical Nursing, College of Nursing, University of South Carolina, USA.
Although it may begin at any point, sleep disturbance often appears early in HIV disease and contributes to decreased quality of
life during the course of the illness. Relatively few studies have explored the complex nature of poor sleep quality in HIV disease
or tested interventions to improve sleep quality. The purpose of this study was threefold: explore the nature of sleep quality in
HIV disease, test the relationship between pain and sleep quality, and test the effectiveness of acupuncture delivered in a group
setting for improving sleep quality in those who are HIV infected. A pretest, posttest, preexperimental design was used to test the
effects of acupuncture on sleep quality. Participating in the study were 21 HIV-infected men and women between the ages of 29
and 50 years who reported sleep disturbance three or more times per week and who scored greater than 5 on the Pittsburgh
Sleep Quality Index. The Wrist Actigraph was used to measure sleep activity, and the Current Sleep Quality Index was used to
measure sleep quality for 2 nights before and after a 5-week acupuncture intervention (10 treatments). Acupuncture was
individualized to address insomnia and other symptoms reported by the participants. Sleep activity and sleep quality
significantly improved following 5 weeks of individualized acupuncture delivered in a group setting.
Forsch Komplementarmed. 1999 Feb;6 Suppl 1:29-31.
Acupuncture and insomnia.
Montakab H.
Forsch Komplementarmed. 1999 Feb;6 Suppl 1:29-31. German.
40 patients with primary difficulties in either falling asleep or remaining asleep were diagnosed according to the traditional
Chinese medicine, allocated to specific diagnostic subgroups and treated individually by a practitioner in his private practice.
The patients were randomized into two groups, one receiving true acupuncture, the other needled at non-acupuncture points for
3-5 sessions at weekly intervals. The outcome of the therapy was assessed in several ways, first and foremost by an objective
measurement of the sleep quality by polysomnography in a specialized sleep laboratory, performed once before and once after
termination of the series of treatments. Additional qualitative results were obtained from several questionnaires. The objective
measurement showed a statistically significant effect only in the patients who received the true acupuncture. The subjective,
qualitative assessment was better in the proper treatment group than in the control group but was not calculated statistically for
methodological reasons. Based on the results of this study, it can be concluded that true and individualized
acupuncture indeed shows efficacy in primary sleep disorders. However, a direct influence by the therapist cannot be
excluded.
Zhongguo Zhen Jiu. 2005 Nov;25(11):771-2.
Clinical observation on acupuncture at Zhaohai (KI 6) and Shenmai (BL 62) for treatment of insomnia.
Wang SG.
Shunyi District Hospital of TCM, Beijing 101300, China.
OBJECTIVE: To observe therapeutic effect of acupuncture at Zhaohai (KI 6) and Shenmai (BL 62) on insomnia. METHODS:
Seventy-eight cases of insomnia were randomly divided into a treatment group of 40 cases and a control group of 38 cases.
The treatment group were treated with acupuncture at Zhaohai (KI 6) using reinforcing method and at Shenmai (BL 62) using
reducing method, combined with acupuncture at acupoints selected according to syndrome differentiation. The control group
were treated with acupuncture at acupoints selected according to syndrome differentiation. Their therapeutic effects were
compared. RESULTS: The cured rate and the total effective rate were 62.5% and 97.5% in the treatment group, and
31.6% and 68.4% in the control group, respectively, with significant difference between the two groups (P < 0.01).
CONCLUSION: Acupuncture at Zhaohai (KI 6) and Shenmai (BL 62) has a better therapeutic effect on insomnia.
Am J Chin Med. 2005;33(4):525-33.
Electroacupuncture therapy for weight loss reduces serum total cholesterol, triglycerides, and LDL cholesterol
levels in obese women.
Cabioglu MT, Ergene N.
Cabioglu Acupuncture Treatment Clinic, Selcuklu 42040, Konya, Turkey. tugcab@yahoo.com
Our purpose in this study was to investigate the effect of acupuncture therapy on body weight and on levels of the serum total
cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol in obese
women. Fifty-five women were studied in three groups as follows: (1) control group (n = 12; mean age = 43.3 +/- 4.3, and mean
body mass index {BMI} = 32.2 +/- 3.4); (2) electroacupuncture (EA) (n = 22; mean age = 39.8 +/- 5.3, and BMI = 34.8 +/- 3.3);
and (3) diet restriction (n = 21; mean age = 42.7 +/- 3.9, and BMI = 34.9 +/- 3.3). EA was performed using the ear points,
Sanjiao (Hungry) and Shen Men (Stomach), and the body points, LI 4, LI 11, St 25, St 36, St 44 and Liv 3, once daily, for 30
minutes, for 20 days, whereas patients on diet restriction had a 1425 Kcal diet program, that consisted of 1425 Kcal daily for 20
days. There was a 4.8% weight reduction in patients with EA application, whereas patients on diet restriction had a 2.5% weight
reduction. There were significant decreases in total cholesterol and triglyceride levels in EA and diet groups compared with the
control group (p < 0.05 in both cases). Furthermore, there was a decrease in LDL levels in the EA group compared with the
control group (p < 0.05). No significant changes could be found in HDL levels among the three groups. Our results suggest
that EA application in obese women may decrease the serum total cholesterol, triglyceride, and LDL cholesterol
levels by increasing the serum beta endorphin level. This lipolytic effect of EA may also reduce the morbidity of obesity by
mobilizing the energy stores that result in weight reduction.
Exp Biol Med (Maywood). 2003 Nov;228(10):1201-7.
Effects of bilateral auricular acupuncture stimulation on body weight in healthy volunteers and mildly obese
patients.
Shiraishi T, Onoe M, Kojima TA, Kageyama T, Sawatsugawa S, Sakurai K, Yoshimatsu H, Sakata T.
Department of Neurophysiology, Division of Human Structure and Function, The Tokai University School of Medicine, Isehara
259-1193, Japan. whitston@hanada.ac.jp
We investigated the effects of auricular acupuncture stimulation on non-obese healthy volunteers and mildly obese patients.
Subjects (n = 55 and 5, respectively) averaged 34.5 years old, and BMI was 24.3 and less than 27.5 kg/m2, respectively. We
also studied the effects of single-blind sham treatment in approximately 500 age-, sex-, and BMI-matched subjects. Small (0.15 x
2.0 mm) auricular needles were placed intracutaneously into the bilateral cavum conchae identified by having a resistance of
less than 100 kOmega/cm2. In the 2-week pretreatment the period, in which body weight was measured without auricular
acupuncture stimulation, 57.1% of the subjects showed a reduction in body weight. This indicates that charting one's own body
weight might itself be a useful method of weight control. In the auricular acupuncture treatment period, 35 healthy subjects of 55
(63.6%) showed a decreased body weight, 11 (20%) showed an increased body weight, and 9 (16.4%) showed no change in
body weight. The obese patients showed individual variation, but all achieved weight reduction, with a highly significant
correlation between body weight and fat volume. The CT/MRI cross-sectional pictures supported these findings. Sham treatment
had no statistically significant effect on body weight. These results suggest that success in achieving weight reduction can be
partly attributed to the act of charting of one's own weight pattern. Bilateral auricular acupuncture stimulation can help
reduce body weight both in mildly obese patients and in healthy non-obese subjects. In conclusion, this is in accord
with the bilateral auricular acupuncture stimulation that it may be useful in the treatment of the obesity. We propose a possible
mechanism for the weight-reducing effects of bilateral auricular acupuncture stimulation.
Aust Fam Physician. 1998 Jul;27 Suppl 2:S73-7.
Stimulation of auricular acupuncture points in weight loss.
Richards D, Marley J.
Department of General Practice, University of Adelaide, South Australia.
OBJECTIVE: Many overweight people are aware that diets can help with weight loss but have difficulty in suppressing their
appetite. Acupuncture stimulates the auricular branch of the vagal nerve and raises serotonin levels, both of which have been
shown to increase tone in the smooth muscle of the stomach, thus suppressing appetite. The aim of this study was to determine
the effectiveness of transcutaneous electrical nerve stimulation of specific auricular acupuncture points on appetite suppression.
METHODS: Sixty overweight subjects, randomly divided into an active and a control group, used the AcuSlim device twice daily
for four weeks. The active group attached the AcuSlim to the acupuncture ear points shenmen and stomach, whereas the
control group attached the device to their thumb where there are no acupuncture points. The goal of a 2 kg weight loss was set
and changes in appetite and weight were reported after four weeks. RESULTS: Of those who responded, 95% of the active
group noticed suppression of appetite, whereas none of the control group noticed such a change. None of the control group lost
the required 2 kg, with only 4 subjects losing any weight at all. Both the number of subjects who lost weight and the mean weight
loss were significantly higher in the active group (p < 0.05). CONCLUSION: Frequent stimulation of specific auricular
acupuncture points is an effective method of appetite suppression which leads to weight loss.
Int J Obes Relat Metab Disord. 1996 Sep;20(9):830-6.
Preliminary results of triple therapy for obesity.
Huang MH, Yang RC, Hu SH.
Department of Rehabilitation Medicine, Kaohsiung Medical College Hospital, Taiwan, ROC.
OBJECTIVE: To evaluate the effectiveness of triple therapy in treatment of simple obesity. SUBJECTS: Forty-five cases of simple
obesity with a body mass index (BMI) above 30 kg/m2 and percentage of body fat more than 25% in males, and 30% in females
were collected. Subjects were composed of 8 males and 37 females ranging in age from 16 to 70 years old with a mean age of
33.8 years. METHODS: The triple therapy for obesity included weekly auricular acupuncture, diet control and aerobic
exercise counseling for eight weeks. The reduction in body weight and body fat were measured upon just completing the
therapeutic course. The changes of body weight in follow-up at one month and one year later were also analyzed respectively.
RESULTS: The results showed a 4.4 +/- 2.9 kg reduction in body weight and a 5.6 +/- 3.0% reduction in body fat after
completing the treatment course. Five cases had their body weight reduced to within the normal range, 18 cases showed a
marked effect (body weight reduced by more than 5 kg and body fat reduced more than 5%), 16 cases were considered
effective (body weight reduced by 2-5 kg and body fat reduced by 1-5%), and 6 cases were considered to be ineffective (body
weight reduced by less than 2 kg and body fat reduced by less than 1%). The rate of effectiveness was 86.7%. The rate of body
weight rebound (weight regained more than 1.5 kg) was 6.7% and 18.9% one month and one year later, respectively. The
effectiveness of weight reduction was significant correlated with the compliance of participants with each therapeutic method, but
not with age. No special side effects were noted during or after the treatment except for two cases who had intolerable pain
when receiving auricular acupuncture. CONCLUSION: The triple therapy resulted in a satisfactory body weight reduction
and a good maintenance of the target weight after treatment. Furthermore, more frequent aerobic exercise during the
treatment course contributed greatly to body weight reduction and maintenance, as indicated by the correlation analysis.
Am J Chin Med (Gard City N Y). 1975 Jul;3(3):285-7.
The treatment of exogenous obesity employing auricular acupuncture.
Soong YS.
This article reports on the treatment of 21 obesity patients employing auricular acupuncture. The auricular points used were
Mouth, Shen-men, Stomach, Hunger and Spleen, and the period of treatment lasted from two to six weeks. The weight loss in
these patients varied from 2 to 16 pounds. The rationale for using these points and cautions for this type of treatment were
discussed.
Pharmacol Biochem Behav. 2006 Jan;83(1):145-9. Epub 2006 Feb 23.
The association of serum leptin with the reduction of food intake and body weight during electroacupuncture in
rats.
Kim SK, Lee G, Shin M, Han JB, Moon HJ, Park JH, Kim KJ, Ha J, Park DS, Min BI.
Department of East-West Medicine, Graduate School, Kyung-Hee University, Seoul, South Korea.
Previous studies indicate that acupuncture or electroacupuncture (EA) treatment reduces body weight and food intake in rats by
increasing the level of anoretic peptides and decreasing that of orexigenic peptides in the hypothalamus. Considering a
well-established role of leptin as a major regulator for feeding behavior in the hypothalamus, we hypothesized that EA might
exert its effect via increasing serum leptin levels. In this study, we tested our hypothesis by evaluating the effects of EA on food
intake and body weight, as well as on serum leptin levels in rats. Rats were randomly divided into 3 groups: AL (fed ad libitum
with no treatments), Holder (fed ad libitum with daily holder restraint) and EA (fed ad libitum with daily holder restraint and 100 Hz
EA stimulation) groups. During the four-week experimental period, daily food intake and body weight were measured. At the end
of the experiment, levels of serum leptin and corticosterone, and plasma epinephrine (Epi) and norepinephrine (NE) were
determined. Here we demonstrate that EA treatment indeed led to reduction of food intake and body weight, and to an increase
of serum leptin levels. The level of Epi, NE, and corticosterone increased in the Holder group, but such increase in the level of
aforementioned stress hormones was not observed in the EA group. Overall, our results suggest that EA treatment
reduces food intake and body weight in rats possibly through increasing leptin levels, and that this effect of EA is
not due to the stress caused by the daily holder restraint.
Digestion. 2001;64(3):184-90.
Effect of electrical stimulation on acupuncture points in diabetic patients with gastric dysrhythmia: a pilot study.
Chang CS, Ko CW, Wu CY, Chen GH.
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang
Road, Taichung 407, Taiwan. changcs@vghtc.vghtc.gov.tw
BACKGROUND/AIMS: Abnormal gastric slow-wave frequencies have been observed in diabetic gastroparesis and are
associated with impaired antral motor activity. In this study, we aimed at evaluating the effect of acupuncture on gastric slow
waves in diabetic patients with symptoms suggesting gastric motor dysfunction. METHODS: Fifteen patients with type II diabetes
who had had dyspeptic symptoms for more than 3 months were enrolled. Two acupuncture needles were inserted into the
subjects' legs at the Zusanli points, and electrical stimulation (2-Hz pulses) was delivered for 30 min. Cutaneous
electrogastrography was performed for 30 min at baseline, for 30 min during acupuncture, and for an additional 30 min after
acupuncture. Serum gastrin, motilin, and human pancreatic polypeptide levels were also measured. RESULTS: There was a
significant increase in the percentages of normal frequency during and after acupuncture (baseline vs. acupuncture and after
acupuncture 21.99 +/- 19.38% vs. 45.93 +/- 19.72 and 48.92 +/- 19.56%; p < 0.01). In addition, the percentage of tachygastric
frequency was decreased significantly during and after acupuncture. The dominant frequency was also changed significantly.
There was an increase of serum human pancreatic polypeptide during acupuncture (baseline vs. acupuncture 56.96 +/- 27.64
vs. 73.11 +/- 22.37 pmol/l; p < 0.05). CONCLUSIONS: The results of this study revealed that electrical stimulation at the
Zusanli points could increase the percentage of normal electrogastrography frequency and decrease the
percentage of tachygastric frequency in diabetic patients. The data indicate that acupuncture may enhance the
regularity of gastric myoelectrical activity in diabetic patients.
Diabetologia. 2000 Jun;43(6):809-13.
A sustained, non-insulin related, hypoglycaemic effect of electroacupuncture in diabetic Psammomys obesus.
Shapira MY, Appelbaum EY, Hirshberg B, Mizrahi Y, Bar-On H, Ziv E.
Division of Internal Medicine, Hadassah University Hospital, Hebrew University, Hadassah Medical School, Jerusalem, Israel.
AIM/HYPOTHESIS: Electroacupuncture has been shown to induce a short-term hypoglycaemic effect in streptozotocin diabetic
rats. We designed an experiment to investigate the effect of electroacupuncture in Psammomys obesus, a model of insulin
resistance and non-insulin-dependent diabetes mellitus. METHODS: We divided 29 diabetic Psammomys randomly into three
groups: abdominal electroacupuncture (real, n = 11), back electroacupuncture (placebo, n = 9) and control (anaesthesia, n =
9). Electroacupuncture was carried out on days 1, 3 and 5 of the experiment. During the first week of the experiment, blood
glucose was tested three times on treatment days and once on the following days. Over the next 2 weeks, blood glucose was
tested every other day. Animals were weighed at the same time of blood sampling. After 3 weeks, at the end of the experiment,
blood was drawn for measurement of insulin, fructosamine, cholesterol and triglycerides. RESULTS: At day 5 (end of
intervention), blood glucose (as per cent of primary concentrations, means +/- SE) was 57 +/- 10, 93 +/- 13 and 89 +/- 11 for
the real, placebo and control groups respectively (p = 0.02). At day 8, blood glucose 68 +/- 14, 86 +/- 16 and 97 +/- 9 for the
real, placebo and control groups respectively (p = 0.04). At day 22, blood glucose was 79 +/- 11, 85 +/- 15 and 131 +/- 2 for the
real, placebo and control groups (p = 0.04). Comparison of the decline in blood glucose, throughout the 3 weeks, between the
real and placebo groups by ANOVA was highly significant (p < 0.0001), the difference between the placebo and control groups
at the same time was not significant (p > 0.05). Animal weight gain, serum insulin, fructosamine, cholesterol and triglycerides
were not significantly different between real and placebo groups. CONCLUSION/INTERPRETATION: Electroacupuncture at
special abdominal acupoints induces a sustained hypoglycaemic effect in diabetic Psammomys compared with
electroacupuncture at non-specific points, without weight loss. No hypoinsulinaemic effect was shown in the real and
placebo groups.
Life Sci. 2006 Aug 1;79(10):967-71. Epub 2006 May 17.
Enhanced insulin sensitivity using electroacupuncture on bilateral Zusanli acupoints (ST 36) in rats.
Chang SL, Lin KJ, Lin RT, Hung PH, Lin JG, Cheng JT.
Graduate Institute of Integration of Chinese and Western Medicine, China Medical University, Taichung City, Taiwan, ROC.
slchang@mail.cmu.edu.tw
In this study, intravenous glucose tolerance test (ivGTT) and insulin challenge test (ICT) were applied to evaluate the influence
of electroacupuncture (EA) on insulin sensitivity in rats. Firstly, hypoglycemic activity was confirmed on normal Wistar rats
(36+/-12%) and streptozotocin (STZ)-induced diabetic rats (13+/-8%) after 60 min of 15 Hz EA on bilateral Zusanli acupoints.
The rats were divided into the experiment group (EG) and control group (CG) randomly. After fasting, plasma glucose and
insulin levels were assayed in the normal Wistar rats undergoing ivGTT. Plasma glucose levels and hypoglycemic activity were
also evaluated in the normal Wistar rats and STZ diabetic rats during ICT. As the data showed, EA improved the glucose
tolerance from 15 to 90 min (p<0.005 compared with the plasma glucose levels of the CG) during ivGTT. In addition, significant
improvement in the Homeostasis Model Assessment (HOMA) index was found in the EG from 15 to 90 min (p<0.005 compared
with the CG). More hypoglycemic activity was achieved in normal Wistar and STZ diabetic rats in the EG than in the CG (from 30
to 60 min) during ICT. In conclusion, the results suggest that 15 Hz EA at bilateral Zusanli acupoints improved glucose
tolerance. Thus, EA should be considered as an alternative method for improving insulin sensitivity and/or increase
insulin-hypoglycemic activity in rats.
Gynecological Endocrinology, 1992 Sep, 6(3):171-81.
Auricular acupuncture in the treatment of female infertility.
By Gerhard I; Postneek F.
Abstract: Following a complete gynecologic--endocrinologic workup, 45 infertile women suffering from oligoamenorrhea (n = 27)
or luteal insufficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 45 women who
received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies,
menstrual cycle and tubal patency.
Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate
medication. Women treated with hormones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four
women of each group had abortions. Endometriosis (normal menstrual cycles) was seen in 35% (38) of the women of each
group who failed to respond to therapy with pregnancy. Only 4 of the women who responded to acupuncture or hormone
treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile
after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group.
Women who became pregnant after acupuncture suffered more often from menstrual abnormalities and luteal insufficiency with
lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved
pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated
with acupuncture had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those
receiving hormones.
Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of
the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture
group. Side-effects were observed only during hormone treatment. Various disorders of the autonomic nervous system
normalized during acupuncture. Based on our data, auricular acupuncture seems to offer a valuable alternative
therapy for female infertility due to hormone disorders.
Fertil Steril. 2006 May;85(5):1352-8. Epub 2006 Apr 5.
Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K.
Department of Reproductive Medicine, Christian-Lauritzen-Institut, Ulm, Germany. paulus@reprotox.de
OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing
a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no
acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent,
160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through
random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).
INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control
group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was
defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer. RESULT(S): 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. CONCLUSION(S): Acupuncture seems to be a useful tool for
improving pregnancy rate after ART.
Zhong Xi Yi Jie He Za Zhi. 1989 Apr;9(4):199-202, 195.
Changes in serum FSH, LH and ovarian follicular growth during electroacupuncture for induction of ovulation.
Yu J, Zheng HM, Ping SM.
Changes in serum FSH, LH and follicular sizes were observed in chronically anovulatory patients during electroacupuncture
treatment (EAT) for induction of ovulation. 7 cases were diagnosed as PCOD, 3 as dysfunctional uterine bleeding, and 1 as
hypogonadotropic amenorrhea. Among them 8 cases complained of infertility for 2.7 years on average. Ovulation was
confirmed by pregnancy or the combination of biphasic BBT and ultrasonographic evidence. During one cycle with 3-day EAT
on acupoints Ren 3, 4, Extra 16 and Sp 6, ovulation resulted in 5 patients (ovulatory group) and among the 5 cases, 3 of 4
infertile cases became pregnant. The other 5 cases remained in anovulation (anovulatory group); of them 3 cases got biphasic
BBT, but no typical ovulatory signs were found on ultrasonography; 2 cases remained in monophasic BBT. Serum FSH, LH
values were elevated in ovulatory group, and FSH pulsatile frequency increased significantly during EAT (from 2.10 +/- 0.42/4h
to 3.70 +/- 1.64/4h), but not in anovulatory group. No apparent changes were found in serum LH pulsatile frequency and
pulsatile amplitudes of FSH and LH in this study. In ovulatory group diameters of ovarian follicles increased markedly, while
diameters of anovulatory group stopped to grow at 14-16 mm. It is suggested that ovulation may be induced by EAT via a
regulation on hypothalamic-pituitary function leading to normal secretion of FSH and LH.
Acta Obstet Gynecol Scand. 2000 Mar;79(3):180-8.
Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.
Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO.
Department of Obstetrics and Gynecology, Goteborg University, Sweden.
BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and
related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four
women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized,
longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA
treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns
were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood
samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine
women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and
after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a
significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone
concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin
concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no
effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with
PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced
metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to
pharmacological ovulation induction.
Hum Reprod. 1996 Jun;11(6):1314-7.
Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture.
Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M.
Department of Obstetrics and Gynaecology, Fertility Centre Scandinavia, University of Gothenburg, S-413 45 Gothenburg,
Sweden.
In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow impedance, 10 infertile but
otherwise healthy women with a pulsatility index (PI) >=3.0 in the uterine arteries were treated with EA in a prospective,
non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated
with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects
on the PI. The baseline PI was measured when the serum oestradiol was <=0.1 nmol/l, and thereafter the women were given EA
eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10-14
days after the EA period. Skin temperature on the forehead (STFH) and in the lumbrosacral area (STLS) was measured during
the first, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both
shortly after the eighth EA treatment (P < 0.0001) and 10-14 days after the EA period (P < 0.0001). STFH increased
significantly during the EA treatments. It is suggested that both of these effects are due to a central inhibition of the
sympathetic activity.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005 Apr;25(4):360-2.
Clinical observation on effect of Chinese herbs in adjusting hypoestrogenemia status by clomiphene to promote
ovulation.
Ma SX, Yin DE, Zhu YL.
Institute of Infertility, Traditional Chinese Medicine Hospital of Ju County, Shandong. shuxium@yahoo.com.cn
OBJECTIVE: To explore the effect of Yijing Huoxue Cuyun Decoction (YHCD) in adjusting hypoestrogenemic response induced
by clomiphene. METHODS: Infertile patients caused by ovulation disturbance were randomly divided into 2 groups. The 60
patients in the observed group were treated with clomiphine plus YHCD, and the 58 patients in the control group were given
clomiphine plus estradiol valerate. RESULTS: By scoring on the cervical relaxation and improvement of cervical mucus, 38
patients (63.3%) in the observed group had Insler score of more than 8 points, while that in the control group was only 25
(43.1%), comparison between the two groups showed significant difference (P < 0.05). The endometrium thickening in the
observed group was 0.98 +/- 0.19 cm, significantly different to that in the control group (0.85 +/- 0.21 cm, P < 0.01). Twenty-five
patients in the observed group (41.7%), and fourteen patients in the control group (24.1%), respectively got pregnancy, the
pregnant rate in the former was obviously higher than that in the latter (P < 0.05). CONCLUSION: YHCD can ameliorate
hypoestrinemia induced by clomiphene and increase the pregnant rate in patients.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Apr;24(4):299-302.
Therapeutic effect of Chinese herbal medicines for nourishing blood and reinforcing shen in treating patients
with anovulatory sterility of shen-deficiency type and its influence on the hemodynamics in ovarian and uterine
arteries.
Xia YW, Cai LX, Zhang SC.
Xiyuan Hospital, China Academy of TCM, Beijing 100091.
OBJECTIVE: To observe the clinical therapeutic effect of Nuzhen Yunyu Decoction (NYD, a Chinese recipe for nourishing blood
and reinforcing Shen) and its influence on the hemodynamic parameters in ovarian and uterine arteries. METHODS: Sixty-eight
patients were randomly divided into two groups at the ratio of 2:1, 45 in the TCM group treated with Chinese medicine and 23 in
the control group treated with clomiphene citrate. Menstrual cycle were taken as the indexes for clinical observation; basal body
temperature, cervical mucus, vaginal exfoliative cells, serum hormones and B ultrasonic examination were taken as the indexes
for ovulation and pregnancy assessment. The hemodynamic parameters of uterus and ovary were determined by using color
Doppler ultrasonography, and the growth of follicles and ovulation, thickness of uterine endometrium were also monitored
continuously. RESULTS: Results of 3 cycles treatment and 1 year follow-up study showed that the ovulation promoting rate,
pregnancy rate and abortion rate in the two groups were similar, but the treated group showed better effects than that of
control group, in such aspects as regulating menstruation, promoting growth and development of follicle,
strengthening endometrium, improving blood supply and circulation of uterine and ovary (P < 0.05, P < 0.01).
CONCLUSION: NYD has the effects of ovulation promotion and holistic regulation of reproductive system.
Chang Gung Med J. 2003 Jun;26(6):449-52.
Pregnancy in premature ovarian failure after therapy using Chinese herbal medicine.
Chao SL, Huang LW, Yen HR.
Department of Gynecology and Pediatrics, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taipei,
Taiwan.
We present ovulation that occurred after the administration of traditional Chinese herbal medicine for 3 months in a woman with
premature ovarian failure (POF) and secondary amenorrhea for 8 years. Traditional Chinese medicine concentrated herbal
extracts of cooked rehmannia, Chinese yam, wolfberry fruit, dogwood fruit, cyathula root, dodder seed, antler glue,
tortoise-plastron glue, epimedium and morinda root were prescribed, which were a modification of the herbal formula
Zuo-gui-wan. When the patient discontinued the Chinese herbal medicine treatment and tried therapy with clomiphene citrate,
neither ovulation nor conception occurred. Eight months after beginning clomiphene citrate therapy, the concentrations of
follicle stimulating hormone and luteinizing hormone were still in the postmenopausal range. The modified formula of
Zuo-gui-wan was prescribed again and the patient conceived 1 month after taking Zuo-gui-wan. Thus, we suggested that
Chinese herbal medicine restored ovarian function effectively and promptly, and offers another option for
treating infertility in patients with POF.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001 Jun;21(6):416-8.
Clinical study on treatment of oviduct obstruction by integrative traditional Chinese and Western medicine.
Kang JL, Xia W, He QY.
Department of Gynecology and Obstetrics, First People's Hospital of Guangzhou, Guangzhou 510180.
OBJECTIVE: To find an effective and practical treatment of oviduct obstruction (OvO). METHODS: One hundred and twenty
OvO patients were randomly divided into three groups, the TCM-WM group, treated with integrative traditional Chinese and
western medicine, the TCM group treated with Chinese herbal medicine alone and the WM group treated with western medicine
alone. The therapeutic effect as well as the effect of treatment on serum C-reactive protein (CRP) and interleukin-1 beta (IL-1
beta) were observed. RESULTS: After treatment, the fallopian tube patency rate was 86.7% and the pregnant rate 85.0% in the
TCM-WM group, while in the TCM group was 66.7% and 63.3% respectively, and in the WM group 53.3% and 50.0%
respectively. Comparison among the three groups showed that the effect in the TCM-WM group was significantly
superior to that in the other two groups (P < 0.01). The levels of CRP and IL-1 beta were all lowered after 3 courses of
treatment, and the effect was more evident in the TCM-WM group (P < 0.01). CONCLUSION: TCM-WM treatment is a good and
practical method in treating oviduct obstruction.
Am J Chin Med. 1991;19(2):145-54.
Successful treatment of a hyperprolactinemic infertile woman with a pituitary microadenoma using hachimijiogan.
Otani S, Usuki S, Iwasaki H, Inoue S, Yamashita K.
Department of Obstetrics and Gynecology, University of Tsukuba, Ibaraki, Japan.
A hyperprolactinemic infertile woman with a pituitary microadenoma, who was resistant to bromocriptine as a method of bringing
on pregnancy, succeeded in having a normal pregnancy and delivery with Hachimi-jio-gan treatment. This paper reports that
the patient did not succeed in pregnancy in spite of 16 months of bromocriptine treatment, though her prolactin level gradually
decreased and continued to be between 40-60 ng/ml with Hachimi-jio-gan treatment. Although the level of prolactin of the
patient did not normalize, she, nevertheless, succeeded in having a normal pregnancy and delivery.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 1992 Aug;12(8):473-4, 452-3.
Preliminary report of the treatment of luteal phase defect by replenishing kidney. An analysis of 53 cases.
Zhang HY, Yu XZ, Wang GL.
Xijing Hospital, Fourth Military Medical University, Shaanxi.
53 patients with Luteal phase defect (LPD) were treated with different Chinese medicinal herbs at different phases of menstrual
cycle. On the 5th day of the menstrual cycle, the treatment was implemented with the rationale of "nourishing the Kidney Yin,
invigorating the Spleen and replenishing the Qi, promoting the blood circulation and enriching the Blood" which might promote
follicular development. The principle for the postovulatory treatment was that "invigorating the Kidney and strengthening the
Yang" might enhance the development of corpus luteum and maintain its function. The patients were treated for three
menstrual cycles. There were significant improvement in the luteal phase of endometrium, and prolonged basal body
temperature elevation in progestational stage with a tendency for normalization of the wave forms and its amplitude after the
treatment. In the mid-progestational stage, the level of serum LH and PRL were reduced (P < 0.05) and that of serum progestin
(P) rose significantly (P < 0.01), as compared with those before the treatment. The findings suggested that Chinese herbal
medicines capable of replenishing the Kidney could regulate the hypothalamus-pituitary-ovarian axis and thus
improve the luteal function. Among the 53 cases, 22 (41.5%) conceived but 68.18% of them required other measures to
preserve the pregnancy.
Clin Exp Hypertens. 1997 Oct;19(7):1047-63.
Cardiovascular and endocrine effects of acupuncture in hypertensive patients.
Chiu YJ, Chi A, Reid IA.
Chiu General Hospital, Kaohsiung, Taiwan.
It has been reported that acupuncture can decrease blood pressure in patients with hypertension, possibly by an endocrine
mechanism. The aim of the present study was to investigate the effects of acupuncture on arterial blood pressure and the
secretion of renin, vasopressin and cortisol in hypertensive patients. Acupuncture was performed in fifty untreated essential
hypertensive patients resting in the supine position. Thirty min after acupuncture there were decreases in systolic pressure
from 169 +/- 2 to 151 +/- 2 mm Hg, diastolic pressure from 107 +/- 1 to 96 +/- 1 mm Hg, and heart rate from 77 +/- 2 to 72 +/- 2
bpm (P < 0.01). Plasma renin activity decreased from 1.7 +/- 0.4 to 1.1 +/- 0.2 ng/ml/2h (P < 0.01), but there were no significant
changes in plasma vasopressin or cortisol concentrations. These results confirm that acupuncture decreases blood
pressure in hypertensive patients, and suggest that the decrease results, at least in part, from a decrease in
renin secretion.
Neurol Res. 2007;29 Suppl 1:S98-103.
Acupuncture, a promising adjunctive therapy for essential hypertension: a double-blind, randomized, controlled
trial.
Yin C, Seo B, Park HJ, Cho M, Jung W, Choue R, Kim C, Park HK, Lee H, Koh H.
Department of Acupuncture, CHA Biomedical Center, College of Medicine, Pochon CHA University, Seoul 135-081, Korea.
BACKGROUND: This study assessed effects of acupuncture as an add-on to conventional antihypertensive managements such
as medication or lifestyle modification for hypertensive or pre-hypertensive subjects. METHODS: A randomized, double-blind,
placebo-controlled trial was conducted at Kyung Hee University Hospital. Forty-one hypertensive or pre-hypertensive (systolic
BP> or =120 mmHg or diastolic BP> or =80 mmHg) volunteers were recruited and randomly assigned into real or sham
acupuncture groups. The hypertensive subjects on antihypertensive medication continued their medication. Acupuncture point
prescriptions were partially individualized, based on the Saam acupuncture theory. Park's sham needle method was adopted for
the sham procedure. Measurements were performed at baseline, weeks 4 and 8. BP, scales of overall health and pain, and
anticipation or satisfaction for the treatments, were recorded. RESULTS: Thirty subjects completed the intervention, all of whom
were on antihypertensive medication. The sham acupuncture group showed no significant change in mean BP, while
the real acupuncture group showed a significant (p<0.01) decrease in mean BP after 8 weeks of intervention from
136.8/83.7 to 122.1/76.8 mmHg. Other factors showed no difference between the groups throughout the study. CONCLUSION:
Acupuncture seems to offer an additional benefit to the treatment of hypertensive patients.
Cardiol Rev. 2004 May-Jun;12(3):171-3.
Acupuncture in the treatment of heart failure.
Middlekauff HR.
University of California-Los Angeles School of Medicine, Division of Cardiology, Los Angeles, California 90095, USA.
Few clinical studies evaluating the efficacy of acupuncture in heart failure have been performed. These studies have focused
on the acupoint Neiguan (P6) in patients experiencing heart failure and have variably reported either an acute increase in
ventricular contractility and/or relaxation or no effect on ventricular contractility and/or relaxation. To date, clinical studies have
been hampered by small enrollment, inadequate controls, and unblinded design. Recent scientific studies of animal models of
acupuncture support the concept that acupuncture produces release of endogenous opioids in the central nervous system,
which in turn could inhibit central sympathetic outflow. Patients experiencing heart failure have markedly elevated sympathetic
activity, and those with the greatest sympathetic activation have the worst survival. Preliminary data from our laboratory
suggests that acupuncture could be sympatholytic in heart failure. We found that sympathetic activation during acute
mental stress was virtually eliminated after acupuncture. More studies defining the efficacy of acupuncture, and its
mechanisms, in the treatment of heart failure are warranted.
Clin Rehabil. 1997 Aug;11(3):192-200.
A one year follow-up study on the effects of acupuncture in the treatment of stroke patients in the subacute stage:
a randomized, controlled study.
Kjendahl A, Sallstrom S, Osten PE, Stanghelle JK, Borchgrevink CF.
Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
OBJECTIVE: We recently reported that acupuncture treatment of stroke patients in the subacute stage gave additive
therapeutic benefit. The purpose of the present study was to determine, approximately one year after discharge from the
rehabilitation hospital, whether the group differences still remained. DESIGN: The patients were randomized into two groups:
one acupuncture group and one control group, considering gender and side of hemispheral localization of lesion. With regard
to the main parameters the groups were comparable at baseline. SETTING: Initially, 45 stroke patients admitted to Sunnaas
Rehabilitation Hospital were included in the study: median 40 days post stroke. SUBJECTS: Forty-one of the patients were
available one year after the treatment period: 21 patients in the acupuncture group and 20 controls. INTERVENTION: All
subjects received an individually adapted, multidisciplinary rehabilitation programme. The acupuncture group received
additional treatment with classical acupuncture for 30 min three to four times weekly for six weeks. MAIN OUTCOME
MEASURES: The patients were evaluated at inclusion, after six weeks and approximately 12 months after discharge from the
rehabilitation hospital. The Motor Assessment Scale (MAS) for stroke patients, Sunnaas Index of Activity of Daily Living (ADL)
and Nottingham Health Profile (NHP) were used. In addition, the social situations of the patients were recorded at one year
follow-up. RESULTS: The results show that the acupuncture group improved significantly more than the controls,
both during the treatment period of six weeks, and even more during the following year, both according to MAS,
ADL, NHP and the social situation. CONCLUSION: Although the mechanism of the effects is debatable, there seems to be a
positive long-term effect of acupuncture given in the subacute stage post stroke.
J Altern Complement Med. 2005 Feb;11(1):175-7.
Does acupuncture help stroke patients become more independent?
Hopwood V, Lewith GT.
Complementary Medicine Research Unit, Aldermoor Health Centre, Southampton, UK. val.hopwoodaacp@btinternet.com
This short speculative report describes the outcome of three studies looking at the effect of acupuncture on stroke recovery
and the subsequent place of residence of the subjects entered. It is not a systematic review and does not endeavor to provide
comprehensive data on the effect of acupuncture on post-stroke recovery. Our observations demonstrate that patients
may be more likely to remain independent and in their own homes one year post stroke if they receive
acupuncture. This conclusion is supported by our study and two previous trials. It may be that acupuncture improves
post-stroke perception, thereby enhancing independence.
J Tradit Chin Med. 2001 Dec;21(4):270-2.
The effect of electro-acupuncture on motor function recovery in patients with acute cerebral infarction: a
randomly controlled trial.
Pei J, Sun L, Chen R, Zhu T, Qian Y, Yuan D.
Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032.
The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the
motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical
and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or
passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement
according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months
after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as
compared with the control group (P < 0.05). Also, the results showed greater reduction of neurological deficit in the
electro-acupuncture group than in the control group. CONCLUSION: Early acupuncture treatment for acute stroke
patients may improve motor functions, and consequently the activities of daily living.
Int J Neurosci. 2007 Apr;117(4):519-23.
Effectiveness of combined acupuncture therapy and conventional treatment on shoulder range of motion and
motor power in stroke patients with hemiplegic shoulder subluxation: a pilot study.
Shin BC, Lim HJ, Lee MS.
Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Wonkwang University, Iksan, South Korea.
shinbc@hanmail.net
The aim of this study was to elucidate the effects of combined conventional rehabilitation therapy and acupuncture on the
active shoulder range of motion (ROM) and motor power in stroke patients with hemiplegic shoulder subluxation. Twenty-one
patients received a combination of acupuncture and rehabilitation treatment at a hospital, and their active shoulder ROM and
motor power were assessed at admission and discharge. The therapy produced significant improvements in joint
mobility, such as in flexion, extension, internal rotation, external rotation, abduction, and adduction (p < .001), and in motor
power (p < .05) in stroke patients with hemiplegic shoulder subluxation.
Arch Phys Med Rehabil. 2007 Feb;88(2):159-66.
The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors.
Mukherjee M, McPeak LK, Redford JB, Sun C, Liu W.
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS
66160-7601, USA.
OBJECTIVE: To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after
electro-acupuncture treatment. DESIGN: Crossover design. SETTING: University medical center research laboratory.
PARTICIPANTS: Seven chronic stroke subjects (age, 63.14+/-7.01y). INTERVENTION: Participants received two 6-week
treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only.
Muscle strength and spasticity of the wrist joint were quantified by using the Biodex multijoint System 3 Pro. Electro-acupuncture
was given through a commercial electro-acupuncture device. MAIN OUTCOME MEASURES: Velocity sensitivity of averaged
speed-dependent reflex torque (VASRT); segmented averaged speed-dependent reflex torque (SASRT); Modified Ashworth
Scale (MAS) scores; and integrated electromyographic activity of the affected wrist flexors during passive stretch of the affected
wrist joint. RESULTS: VASRT was reduced significantly in the combined treatment group (P=.02) after the 6-week period, but
not in the strengthening-only group (P=.23); however, no significant immediate effect of electro-acupuncture was observed
(P>.05). MAS scores also showed a significant reduction (P<.01). SASRT did not differ significantly across different positions of
the joint or across velocity; however, significant differences were present between the 2 treatment groups (P<.05) for each
position and at all the velocities except at 20 degrees /s. Integrated electromyographic activity showed a trend for reduction
after the combined treatment. CONCLUSIONS: A combination of electro-acupuncture and muscle strengthening
exercise for 6 weeks significantly reduced spasticity. The effect of spasticity reduction was consistent across different
joint positions and different velocities of passive stretch.
Neuroepidemiology. 1993;12(2):106-13.
A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture.
Hu HH, Chung C, Liu TJ, Chen RC, Chen CH, Chou P, Huang WS, Lin JC, Tsuei JJ.
Department of Neurology, Taipei Veterans General Hospital, Taiwan, Republic of China.
The effectiveness of acupuncture in acute stroke remains largely untested and unproved. A randomized, controlled trial was
carried out to study the feasibility of acupuncture in combination with conventional supportive treatment for acute stroke
patients. A total of 30 patients, aged 46-74, with the onset of symptoms within 36 h were enrolled into the study after
appropriate screening. All patients gave informed consent. Basing on the same supportive treatment, patients were randomly
assigned to a treatment with or without acupuncture. The procedure and acupoint selection were discussed and decided
through several meetings of a group of senior acupuncture doctors in Taiwan. Acupuncture was applied 3 times/week for 4
weeks. During the study period, there were no problems in conducting this trial in terms of patient availability and acceptance,
and physician cooperation. A significantly better neurologic outcome was observed in the acupuncture group on day
28 and day 90. The improvement in neurologic status was greatest in patients with a poor neurologic score at baseline. There
were no important side effects except for one episode of dizziness related to acupuncture treatment. The data and results of
this study will be used as a guideline for planning a full-scale clinical trial, e.g. sample size calculation, method of randomization
with stratification of prognostic factors, choosing acupuncture points and technique of acupuncture.
Auton Neurosci. 2005 Mar 31;118(1-2):93-101.
Low and high frequency acupuncture stimulation inhibits mental stress-induced sweating in humans via different
mechanisms.
Ogata A, Sugenoya J, Nishimura N, Matsumoto T.
Department of Physiology, School of Medicine Aichi Medical University, Nagakute, Aichi 480-1195, Japan.
The effects of acupuncture stimulation at 5 Hz and 100 Hz on mental stress-induced sweating were analyzed, and the
mechanisms involved were examined using the rate of sweat expulsion as an estimate of central sudomotor outflow. Mental
arithmetic was imposed on 25 young healthy volunteers for 2 min before, during and after the stimulation. Acupuncture
stimulation was delivered to either the Zusanli (leg) or Hegu (hand) acupoint, and the sweat rate was measured quantitatively
during mental arithmetic on the palm or the sole, respectively. When stimulation at 5 Hz was applied to the Zusanli acupoint, the
palmar sweat rate (paSR), rate of sweat expulsion (Fsw) and paSR/Fsw were reduced during the stimulation, whereas when it
was applied to the Hegu acupoint, plantar SR (plSR) and Fsw were reduced, but plSR/Fsw was not altered. When stimulation at
100 Hz was applied to Zusanli, paSR and paSR/Fsw were reduced, but Fsw was unchanged whereas when it was applied to
Hegu, neither plSR, Fsw nor plSR/Fsw was altered. The results suggest that acupuncture stimulation at 5 Hz affects both the
supraspinal rhythm-generating mechanism and the mechanisms situated below (probably the spinal cord), whereas stimulation
at 100 Hz only affects the mechanisms below the rhythm-generating mechanism. Thus, acupuncture stimulation at 5 Hz and
at 100 Hz may reduce mental stress-induced sweating through different mechanisms.
Auton Neurosci. 2002 Sep 30;100(1-2):90-5.
An alternative method to enhance vagal activities and suppress sympathetic activities in humans.
Wang JD, Kuo TB, Yang CC.
Department of Traditional Chinese Medicine, Tzu-Chi General Hospital, Dalin, Taiwan.
Vagal withdrawal and/or sympathetic overactivity is always accompanied by various kinds of stress and is dangerous to the
body. We proposed that mild acupuncture on the Sishencong points may effectively enhance vagal activities but suppress
sympathetic regulations of the heart in humans. Experiments were carried out on nine healthy male volunteers, while they were
lying in a quiet room during 2-4 P.M. Acupuncture was applied 2 mm deep into the skin using standard stainless acupuncture
needles at the Sishencong points, which are located on the vertex of the head, each 1 cm away from Baihui (GV 20) in four
directions. Four points around the temporal area were selected as control points. Forty minutes of precordial ECG signals
before, during, and after acupuncture were recorded continuously. Frequency-domain analysis of the stationary RR intervals
was performed to evaluate the total variance, high-frequency power (HF, 0.15-0.40 Hz) and low-frequency power (LF, 0.04-0.15
Hz) in normalized units (LF%). Acupuncture on the Sishencong points resulted in an increased HF but a decreased LF%
compared with the before acupuncture stage. Such effects did not occur when manual acupuncture was applied to the control
points. The differences in the heart rate dynamics between Sishencong and the control groups took place 10 min after initiation
of acupuncture and persisted even after the removal of the needles. Based on these results, we concluded that manual
acupuncture on the Sishencong points enhanced cardiac vagal and suppressed sympathetic activities in humans.
The underlying mechanisms and potential applications warrant further investigations.
J Clin Psychiatry. 2002 Jul;63(7):628-40.
Alternative treatments for depression: empirical support and relevance to women.
Manber R, Allen JJ, Morris MM.
Department of Psychiatry and Behavioral Sciences, Stanford University, Calif. 94305, USA. rmanber@stanford.edu
BACKGROUND: This article is a critical review of the efficacy of selected alternative treatments for unipolar depression
including exercise, stress management techniques, acupuncture, St. John's wort, bright light, and sleep deprivation. Issues
related to women across the life span, including pregnancy and lactation, are highlighted. DATA SOURCES: Evidence of
efficacy is based on randomized controlled trials. A distinction is made between studies that address depressive symptoms and
studies that address depressive disorders. The review emphasizes issues related to effectiveness, such as treatment
availability, acceptability, safety, and cost and issues relevant to women. DATA SYNTHESIS: Exercise, stress reduction
methods, bright light exposure, and sleep deprivation hold greater promise as adjuncts to conventional treatment than as
monotherapies for major depression. The evidence to date is not sufficiently compelling to suggest the use of St. John's wort in
favor of or as an alternative to existing U.S. Food and Drug Administration-regulated compounds. Initial evidence suggests
that acupuncture might be an effective alternative monotherapy for major depression, single episode.
CONCLUSION: This review indicates that some unconventional treatments hold promise as alternative or complementary
treatments for unipolar depression in women and have the potential to contribute to its long-term management. Additional
research is needed before further recommendations can be made, and there is an urgent need to carefully document and
report the frequency of minor and major side effects.
Med J Aust. 1982 Jan 9;1(1):28-9.
Smoking withdrawal and acupuncture.
Fuller JA.
Nicotine addiction makes it very difficult for most smokers to quit. This study examined the relapse rate of 194 people (118 men
and 76 women) who were given acupuncture treatment to help them stop smoking. Ninety five per cent of patients quit smoking
after three acupuncture treatments. Fifty-five (32%) of the 174 patients who replied to a mailed questionnaire said they had not
smoked since treatment; the success rate was: one week, 86%; six months 41%; 12 months, 34% and 24 months, 30%. There
were no further relapses amongst those patients who abstained for more than 24 months. Eighty-five per cent of those who
responded reported that acupuncture had eased the symptoms of smoking withdrawal. However, if the patient's
motivation is weak, subsequent relapse will occur.
Int J Neurosci. 2007 May;117(5):571-8.
Smoking cessation after acupuncture treatment.
Cabioglu MT, Ergene N, Tan U.
Department of Physiology, Selcuk University. Faculty of Meram Medical, Konya. Turkey.
Acupuncture is applied, especially in treatment of pain, hemiplegia, obesity, and psychological illnesses including addiction.
Recently, ear and body acupuncture have been frequently used in the treatment of smoking. An increase in levels of endorphin,
enkephalin, epinephrine, norepinephrine, serotonin, and dopamine in the central nervous system and plasma has been
reported as the most important mechanism of acupuncture. That is, acupuncture application may increase the levels of
endorphin, enkephalin, epinephrine, norepinephrine, serotonin, and dopamine in the central nervous system and plasma. The
authors think that acupuncture application provides the patients with deterioration in the taste of smoking,
decrease in desire of smoking, and the obstruction of psychological symptoms that appear as a result of smoking
cessation. Because of these effects it is presumed that acupuncture application may be used as an important method for
smoking cessation treatment.
J Urban Health. 2005 Jun;82(2):285-95. Epub 2005 May 4.
Acupuncture for substance abuse treatment in the Downtown Eastside of Vancouver.
Janssen PA, Demorest LC, Whynot EM.
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada V62-1Y6.
pjanssen@interchange.ubc.ca
In British Columbia, Canada, the City of Vancouver's notorious Downtown Eastside (DES) represents the poorest urban
population in Canada. A prevalence rate of 30% for HIV and 90% for hepatitis C makes this a priority area for public-health
interventions aimed at reducing the use of injected drugs. This study examined the utility of acupuncture treatment in reducing
substance use in the marginalized, transient population. Acupuncture was offered on a voluntary, drop-in basis 5 days per week
at two community agencies. During a 3-month period, the program generated 2,755 client visits. A reduction in overall use of
substances (P=.01) was reported by subjects in addition to a decrease in intensity of withdrawal symptoms
including "shakes," stomach cramps, hallucinations, "muddle-headedness," insomnia, muscle aches, nausea,
sweating, heart palpitations, and feeling suicidal, P<.05. Acupuncture offered in the context of a community-based harm
reduction model holds promise as an adjunct therapy for reduction of substance use.
Digestion. 2004;69(3):131-9. Epub 2004 Apr 26.
Acupuncture and moxibustion in the treatment of active Crohn's disease: a randomized controlled study.
Joos S, Brinkhaus B, Maluche C, Maupai N, Kohnen R, Kraehmer N, Hahn EG, Schuppan D.
Department of Medicine I-Gastroenterology, Research Group for Alternative Medicine, Friedrich Alexander University of
Erlangen-Nuremberg, Erlangen, Germany. s.joos@gmx.de
BACKGROUND: Acupuncture has traditionally been used in the treatment of inflammatory bowel disease in China and is
increasingly being applied in Western countries. The purpose of this study was to investigate the efficacy of acupuncture in the
treatment of active Crohn's disease (CD). METHODS: A prospective, randomized, controlled, single-blind clinical trial was
carried out to analyze the change in the CD activity index (CDAI) after treatment as a main outcome measure, and the changes
in quality of life and general well-being, serum markers of inflammation (alpha(1)-acid glycoprotein, C-reactive protein) as
secondary outcome measures. 51 patients with mild to moderately active CD were treated in a single center for complementary
medicine by three trained acupuncturists and randomly assigned to receive either traditional acupuncture (TCM group, n = 27)
or control treatment at non-acupuncture points (control group, n = 24). Patients were treated in 10 sessions over a period of 4
weeks and followed up for 12 weeks. RESULTS: In the TCM group the CDAI decreased from 250 +/- 51 to 163 +/- 56 points as
compared with a mean decrease from 220 +/- 42 to 181 +/- 46 points in the control group (TCM vs. control group: p = 0.003). In
both groups these changes were associated with improvements in general well-being and quality of life. With regard to general
well-being, traditional acupuncture was superior to control treatment (p = 0.045). alpha(1)-acid glycoprotein concentration fell
significantly only in the TCM group (p = 0.046). CONCLUSIONS: Apart from a marked placebo effect, traditional
acupuncture offers an additional therapeutic benefit in patients with mild to moderately active CD.
J Gastroenterol. 2006 May;41(5):408-17..
Acupuncture for functional gastrointestinal disorders.
Takahashi T.
Department of Surgery, Duke University Medical Center, Durham, NC 27705, USA.
Functional gastrointestinal (GI) symptoms are common in the general population. Especially, motor dysfunction of the GI tract
and visceral hypersensitivity are important. Acupuncture has been used to treat GI symptoms in China for thousands of years. It
is conceivable that acupuncture may be effective in patients with functional GI disorders because it has been shown to alter acid
secretion, GI motility, and visceral pain. Acupuncture at the lower limbs (ST-36) causes muscle contractions via the
somatoparasympathetic pathway, while at the upper abdomen (CV-12) it causes muscle relaxation via the somatosympathetic
pathway. In some patients with gastroesophageal reflux disease (GERD) and functional dyspepsia (FD), peristalsis and gastric
motility are impaired. The stimulatory effects of acupuncture at ST-36 on GI motility may be beneficial to patients with GERD or
FD, as well as to those with constipation-predominant irritable bowel syndrome (IBS), who show delayed colonic transit. In
contrast, the inhibitory effects of acupuncture at CV-12 on GI motility may be beneficial to patients with diarrhea-predominant
IBS, because enhanced colonic motility and accelerated colonic transit are reported in such patients. Acupuncture at CV-12
may inhibit gastric acid secretion via the somatosympathetic pathway. Thus, acupuncture may be beneficial to GERD patients.
The antiemetic effects of acupuncture at PC-6 (wrist) may be beneficial to patients with FD, whereas the antinociceptive effects
of acupuncture at PC-6 and ST-36 may be beneficial to patients with visceral hypersensitivity. In the future, it is expected that
acupuncture will be used in the treatment of patients with functional GI disorders.