CM NEWS – Acupuncture has been proved to provide effective and persistent relief of migraine headaches, according to a new study in Italy.
To check the effectiveness of a true acupuncture treatment according to traditional Chinese medicine (TCM) in migraine without aura, researchers of the Department of Medico-Surgical Specialities of University of Padua in Italy compared true acunpuncture to a standard mock acupuncture protocol, an accurate mock acupuncture healing ritual, and untreated controls. Read more
Reuters Health – Acupuncture can bring some relief to people with knee arthritis, but the benefits may be at least partly from a placebo effect, a new research review suggests.
In an analysis of 9 clinical trials from the past 15 years, researchers found that acupuncture generally seemed to improve knee arthritis sufferers’ pain and stiffness in the short term. The patients had osteoarthritis, a degenerative joint disease associated with age, as opposed to arthritis associated with an autoimmune disorder.
However, a closer look showed that the benefits were limited to trials that compared acupuncture with doing nothing or with “usual care,” such as anti-inflammatory medication.
In trials that compared acupuncture with “sham” acupuncture, on the other hand, there was no clear evidence that the real therapy was more effective.
Sham acupuncture is accomplished by using non-penetrating needles, or inserting needles only into the superficial layer of skin, at random sites rather than the specific points used in real acupuncture. In studies that evaluated electro-acupuncture, the sham version involved phony electrodes and “mock” electrical stimulation of acupuncture points.
The point is to keep study participants from knowing whether they were receiving the real or the placebo treatment. This helps separate the specific effects of a therapy from any placebo effects — where people feel better simply because they believe they’ve been treated.
The new findings suggest that the benefits of acupuncture for knee arthritis are at least partly due to patients’ expectations, the study authors report in the Annals of Internal Medicine.
However, that doesn’t mean acupuncture is not worthwhile, according to the researchers, led by Eric Manheimer of the University of Maryland School of Medicine in Baltimore.
Research does suggest that acupuncture has a “genuine biological effect,” and there was evidence in some studies that the real therapy resulted in somewhat better short-term effects than sham acupuncture, the researchers note.
For their study, Manheimer and his colleagues combined the results of nine clinical trials conducted in Europe, the U.S. and Thailand. The trials included a total of more than 3,500 subjects.
Each trial included a patient group that received acupuncture for knee arthritis, as well as a “control” group. In some studies, control patients were placed on a waiting list for acupuncture, while in others they received some standard therapy that acupuncture patients did not. Control patients in other studies received sham acupuncture.
In general, the Manheimer’s team found, only studies that pitted acupuncture against doing nothing, or against standard care, showed clear benefits. The results of the sham-controlled trials were too mixed to show any benefits, according to the researchers.
The investigators do not, however, dismiss the potential benefits of acupuncture for knee arthritis. Indeed, they note, a possible explanation for the mixed results is that sham acupuncture had some actual biological effects.
Given the overall safety of acupuncture, the researchers conclude, patients can still consider it as one option in a “multidisciplinary approach” to treating knee arthritis.
CM NEWS – Needling specific acupoints may help patients with dementia, a recently published study shows. The acupoint combo seems to increase cerebral glucose metabolism in the brain, as indicated by cerebral functional imaging. Read more
CM NEWS – So now not only acupuncture can control pain, it can also help a mother to have a smooth breast feeding experience.
A group of Swedish scientiests set out to compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation, and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms in a randomised, non-blinded, controlled study.
The researchers are from Department of Obstetrics and Gynaecology of Helsingborg Hospital and Faculty of Social and Life Sciences, Karlstad University in Swede.
205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture.
All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe).
Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby’s attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes.
“If acupuncture treatment is acceptable to the mother, this, together with care interventions such as correction of breast feeding position and babies’ attachment to the breast, might be a more expedient and less invasive choice of treatment than the use of oxytocin nasal spray,” the researchers wrote.
However, no significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics.
The researchers add that midwives, nurses or medical practitioners with specialist competence in breast feeding should be the primary care providers for mothers with inflammatory symptoms of the breast during lactation. The use of antibiotics for inflammatory symptoms of the breast should be closely monitored in order to help the global community reduce resistance development among bacterial pathogens.
Heartwire – A study billed as the first rigorous, randomized trial in the West to test acupuncture against a sham (fake) needle technique to treat hypertension suggests that, performed properly, acupuncture may produce blood-pressure changes on a par with monotherapy in mild to moderate hypertension.
“It’s certainly not like a wonder drug; it’s not a massive effect, but it’s a clear effect,” lead investigator Dr Frank A Flachskampf (Universitätsklinikum Erlangen, Germany) said.
Smaller randomized trials have been performed in China, with mixed results, while one randomized study in the West found no difference in blood-pressure lowering between traditional Chinese acupuncture, standardized acupuncture, and a sham procedure, the authors note. This earlier study did not use ambulatory blood-pressure measurements, believed to be superior to office-based measurements.
Results of their study are published online June 4, 2007 in Circulation.
For the study, 160 outpatients with uncomplicated, mild to moderate hypertension were randomized to six weeks of acupuncture performed by Chinese medicine practitioners, trained in China, or to a sham procedure. In both arms, patients underwent 22 sessions, each 30 minutes in length. By the end of the six weeks, 24-hour ambulatory systolic and diastolic blood pressures were significantly reduced from baseline in the acupuncture-treated patients (5.4 mm Hg and 3.0 mm Hg, respectively), and this change was also significantly different from values in the sham-treated patients, in whom no meaningful changes were seen.
After three and six months, however, the blood-pressure reductions disappeared, leading investigators to conclude that ongoing acupuncture treatments would be required to maintain the blood-pressure reductions.
“The main finding is that for the first time in a reasonably sized but still relatively small randomized study, this establishes beyond a reasonable doubt that acupuncture lowers blood pressure,” Flachskampf commented. “It’s a modest but undeniable effect on both systolic and diastolic blood pressure.”
The extent of the blood-pressure reductions are comparable to those seen with ACE-inhibitor monotherapy or aggressive lifestyle changes, including radical salt restrictions, he added.
A “demanding” alternative to drugs
Flachskampf had some caveats, acknowledging that the regular acupuncture sessions used in the study represent a significant time investment: each acupuncture session lasted 30 minutes—not including transportation and administrative time—and took place several times a week. The study subjects were also reasonably healthy, with no other major risk factors and with only mild to moderate hypertension.
“This is clearly something that would probably not work as well with very sick people or people with blood pressure at dangerous levels,” he said. “We cannot easily extrapolate to people, for example, with complicated hypertension who have had a myocardial infarction.”
Flachskampf believes, however, that acupuncture likely represents an attractive option in specific patients, particularly those averse to taking medical therapy who are open to so-called “alternative” medicine.
“This is probably only for people who somehow relate to this spiritually, who say I am profoundly against taking drugs and I’m very fond of Oriental wisdom or things like that,” Flachskampf told heartwire. “I don’t want to make a joke about this, but this certainly needs more compliance than taking two or three pills a day. It’s much more demanding.”
Unlike drugs, acupuncture appeared to have few or no side effects, although two people complained that the needles were painful. “Clearly, many millions of Chinese get acupuncture without any major problems so I think this is really a minor point,” Flachskampf observed.
[Circulation 2007; DOI: 10.1161/CIRCULATIONAHA.106.661140. Flachskampf FA, Gallasch J, Gefeller O, et al. “Randomized trial of acupuncture to lower blood pressure.” ]
CM NEWS – A special form of acupoint treatment can help push your bowel without needing you to take any medication, a recent study finds.
To test the therapeutic effect, safety of acupoint application for treatment of constipation, scientists of the First Hospital of Guangzhou University of TCM in China used a special form of acupoint treatment called herbs-partitioned moxibustion (???).
42 cases were randomly divided into a treatment group of 22 cases and a control group of 20 cases.
In herbs-partitioned moxibustion, a small “cake” made up of herbs was placed on the specific acupoints and was lit up.
In this study, the special herbal cake was made with Sanleng (??, Rhizoma Spargani), Ezhu (??, Rhizoma Zedoariae), Dahuang (??, Radix et Rhizoma Rhei) and Bingpian (??, Borneolum). The cake was then applied at acupoints Tianshu (???, ST 25), Qihai (???, CV 6), Guanyuan (??? CV 4).
The control group were treated with oral administration of Congrong Tongbian Oral Liquid (???????), a laxative that can be bought over the counter.
Acupoint Tianshu has been clinically proven to be effective in dealing with constipation for centuries. In combination with other adjuvant points as indicated by symptom differentiation, are very effective in the treatment of diseases of the digestive system.
Acupoint Qihai has been involved in treating back pain, overly frequent urination at night, and some gynecological conditions.
Acupoint Guangyuan is said to be effective in treating urological diseases, erectile dysfunction, menstrual cramps etc. It’s also involved in treating insomnia and panic disorder.
What is moxibustion? Practitioners use moxa, or mugwort herb, to warm regions and acupuncture points with the intention of stimulating circulation through the points and inducing a smoother flow of blood and qi.
Medical historians believe that moxibustion pre-dated acupuncture, and needling came to supplement moxa after the 2nd century BC. Different schools of acupuncture use moxa in varying degrees. For example a 5-element acupuncturist will use moxa directly on the skin, whilst a TCM-style practitioner will use rolls of moxa and hold them over the point treated. It can also be burnt atop a fine slice of ginger root to prevent scarring.
There are two types of moxibustion: direct and indirect. In direct moxibustion, a small, cone-shaped amount of moxa is placed on top of an acupuncture point and burned. This type of moxibustion is further categorized into two types: scarring and non-scarring. With scarring moxibustion, the moxa is placed on a point, ignited, and allowed to remain onto the point until it burns out completely. This may lead to localized scarring, blisters and scarring after healing.
With non-scarring moxibustion, the moxa is placed on the point and lit, but is extinguished or removed before it burns the skin. The patient will experience a pleasant heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring unless the moxa is left in place for too long.
Indirect moxibustion is currently the more popular form of care because there is a much lower risk of pain or burning. In indirect moxibustion, a practitioner lights one end of a moxa stick, roughly the shape and size of a cigar, and holds it close to the area being treated for several minutes until the area turns red. Another form of indirect moxibustion uses both acupuncture needles and moxa. A needle is inserted into an acupoint and retained. The tip of the needle is then wrapped in moxa and ignited, generating heat to the point and the surrounding area. After the desired effect is achieved, the moxa is extinguished and the needle(s) removed.
In the present study, a herbal cake was applied on the acupoints instead of moxa. This practice is also called herbs-partitioned moxibustion (???).
The results were very positive for the moxibustion group. The total effective rate was 81.8% in the treatment group and 50.0% in the control group, the treatment group being better than the control group (P < 0.05).
Patients in the treatment group made their first bowel movement 5.1 hours +/- 2.8 hours after treatment, whereas the first defecation time for the control group was 10.1 hours +/- 7.3 hours after treatment.
The scientists then conclude that TCM acupoint application therapy has a definite therapeutic effect on constipation.
AHN – Acupuncture is effective at relieving back and pelvic muscle pain during pregnancy, a common complaint among pregnant women as they enter into the final trimesters. A study has found that one in three pregnant women suffer severe back and pelvic pain as the pregnancy progresses.
This is because the center of gravity of a pregnant woman is off and she has to arch her back to balance her bulging tummy, leading to an extra strain on back and pelvic muscles.
Experts believe that stretching exercises, coupled with special pillows and acupuncture could help relieve back and pelvic pain that often occur during pregnancy.
The study tracked almost 1,500 pregnant women from Sweden, Iran, Brazil, Thailand and Australia and found that those who participated in the suggested exercises involving acupuncture reported a reduction in pain levels.
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care.
Authors also found that expectant mothers benefited by the use of an Ozzlo pillow – a curved pillow designed to support the pregnant abdomen when lying down and that 60 percent of women trying acupuncture reported a substantial pain relief.