Acupuncture Continuing Education News
Electro-acupuncture is found effective in reducing inflammation and pain. A review published in Anesthesiology - The Journal of the American Society of Anesthesiologists concludes that electro-acupuncture is more effective at the 2 - 10 Hz setting than the 100 Hz setting for the relief of inflammation and neuropathic pain. The investigators note that electro-acupuncture “blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms.”
Details reveal that electro-acupuncture activates natural endogenous opioids and other biochemicals that desensitize sensory receptors for painful stimuli (nociceptors). The researchers note that electro-acupuncture desensitizes “peripheral nociceptors and reduce(s) proinflammatory cytokines peripherally and in the spinal cord, and serotonin and norepinephrine, which decrease(s) spinal N-methyl-D-aspartate receptor subunit GluN1 phosphorylation.” This results in less pain and inflammation.
The reviewers note that electro-acupuncture demonstrates unique characteristics. Electro-acupuncture activates the nervous system differently in healthy conditions than when treating pain related conditions. In addition, the reviewers note that studies now “suggest that electroacupuncture, when combined with low dosages of conventional analgesics, provides effective pain management which can forestall the side effects of often-debilitating pharmaceuticals.”
The California Acupuncture Board presented information on the acupuncture workforce in the USA at recent stakeholder meetings in San Francisco and Los Angeles. The data presented by the California Acupuncture Board Executive Director, Terri Thorfinnson, J.D., covered work hours, income and educational status for licensed acupuncturists in California and nationwide. This provides a greater understanding of the acupuncture profession in the USA.
The largest national percentage of acupuncturists working less than 30 hours per week makes $40,000 per year or less. Notably, there is a similar quantity of acupuncturists making either $40,000 per year or less compared with those making between $81,000 and $160,000 per year for those acupuncturists working more than 30 hours per week. A small proportion of acupuncturists earn greater than $161,000 per year.
New evidence finds acupuncture and Chinese herbal medicine effective for the treatment of menstrual pain.One study reveals a popular herbal medicine for the relief of cramping and pain. Another study found acupuncture as effective as non-steroidal anti-inflammatory drugs (NSAIDs) for menstrual related pain. The first and most recent study on Traditional Chinese Medicine (TCM) for the treatment of menstrual discomfort was conducted in Taiwan.
This new study finds Dan Gui Shao Yao San the primary herbal formula consumed in Taiwan for the treatment of primary dysmenorrhea. This type of dysmenorrhea is characterized by lower abdominal cramping and pain prior or during menstruation and is not due to endometriosis. Approximately 53% of Taiwanese women with primary dysmenorrhea use Traditional Chinese Medicine (TCM) and over 90% of this group sought the relief of menstruation related pain. The study notes that Dan Gui Shao Yao San is the most commonly prescribed herbal formula for this condition and it contains both “sedative and anti-inflammatory agents.”
The White House released an official statement confirming denial of all Medicare reimbursements for acupuncture services by licensed acupuncturists. This is the official response to the White House We The People website petition, which garnered over 30,000 signatures. The citizen petition requested that acupuncture be included in the Medicare system and notes, “Studies have shown that when an Acupuncturist is directly involved in patient care for pain management and other issues, the patient recovers quicker with less medication required.” The petition to the Obama Administration specifically requests that acupuncturists become recognized as health care providers.
In 2010, President Barak Obama commented that “it is pretty well documented through scientific studies that acupuncture, for example, can be very helpful in relieving certain things like migraines and other ailments — or at least as effective as more intrusive interventions.” However, there is no national legislation to support licensed acupuncturists in the Medicare system and the Centers for Medicare & Medicaid Services (CMS) is relying on antiquated research to block acupuncture from the Medicare system.
The Principle Deputy Administrator at the CMS, Jonathan Blum, gives a detailed account on the exclusion of acupuncturists from the Social Security Act and Medicare system in the official White House response. Blum outlines obstacles to providing acupuncture care within the Medicare system. The first two obstacles are largely legislative issues. He notes that acupuncturists are not defined as “providers” in Medicare regulations. Further, Blum cites that the Social Security Act does not include licensed acupuncturists as “physicians” in the Medicare system. There is another more serious obstacle to acupuncture access within the Medicare system that is generated by the CMS.
CT scans reveal anatomical structures of acupuncture points. A CT (computerized tomography) scan is a series of X-rays used to create cross-sectional images. In this study published in the Journal of Electron Spectroscopy and Related Phenomena, researchers used in-line phase contrast CT imaging with synchrotron radiation on both non-acupuncture points and acupuncture points. The CT scans revealed clear distinctions between the non-acupuncture point and acupuncture point anatomical structures.
Acupuncture points have a higher density of micro-vessels and contain a large amount of involuted microvascular structures. The non-acupuncture points did not exhibit these properties.
The researchers note that the state-of-the-art CT imaging techniques used in this study allow for improved three-dimensional (3D) imaging of a large field of view without artifacts. This greatly improves imaging of soft tissue and allowed the researchers to make this important discovery.
The acupuncture points ST36 (Zusanli) and ST37 (Shangjuxu) were shown to have very distinct structural differences than surrounding areas. At the acupuncture points, microvascular densities with bifurcations “can be clearly seen around thick blood vessels” but non-acupuncture point areas showed few thick blood vessels and none showed fine, high density structures. The acupuncture points contained fine structures with more large blood vessels that are several dozen micrometers in size plus beds of high density vascularization of vessels 15-50 micrometers in size. This structure was not found in non-acupuncture point areas.
Acupuncture and herbs relieve premenstrual syndrome (PMS) according to recent research. A meta-analysis of 8 acupuncture studies and 11 herbal medicine studies revealed a success rate of 50% or greater for the reduction of PMS and premenstrual dysphoric disorder (PMDD). No incidence of major adverse events occurred. As a result, the researchers concluded that the acupuncture and herbal medicines investigated in the study are both safe and effective.
PMS occurs during the late luteal phase of the menstrual cycle. The research notes that up to “25% of menstruating women report moderate-to-severe premenstrual symptoms. Approximately 5% report severe symptoms.” Acupuncture demonstrated the ability to reduce symptoms by 77.8% within 2-4 treatments. The treatment protocol yielding these results employed the use of acupuncture points DU20, LI4, HT3, CV3, CV4, CV6, PC6, GB34, UB23 and ear Shenmen. In addition, these results were significantly superior to the sham acupuncture controls.
Hand acupuncture was found more effective than traditional acupuncture for the treatment of hot flashes. Hand moxibustion demonstrated very high improvement rates for the treatment of anxiety, mood swings, swelling and depression. Notably, there were no differences in treatment outcomes between acupuncture treatments given during the luteal and follicular phases. The researchers concluded that these findings demonstrate that acupuncture treatments “need not be limited only to the luteal phase.”
As with acupuncture, no serious adverse events were reported with the herbal medicines investigated in the study. The herbal medicines were effective in the relief of PMS and included the herbal formulas Dan Zhi Xiao Yao San and Xiao Yao San. Groups treated with either hand acupuncture, Vitex Agnus castus or Xiao Yao San demonstrated over a 70% improvement in the reduction of PMS symptoms. The findings of this recent study are confirmed in another study entitled the Therapeutic effect of Vitex agnus castus in patients with premenstrual syndrome. That study concludes, “Vitex agnus can be considered as an effective and well tolerated treatment for the relief of symptoms of mild and moderate PMS.” The same findings were concluded in the study Treatment of Premenstrual Syndrome with a Phytopharmaceutical Formulation Containing Vitex agnus castus.
New research published in Translational Andrology and Urology finds distal acupuncture effective in assisting local anesthesia for surgical procedures on the penis.Acupuncture has long been used in combination with conventional anesthetics during surgery and for post-operative pain. This new study investigates the effects of combining acupuncture points on the arm with local anesthetics to produce a more comfortable experience for the patient. The goal was to determine if this combination can facilitate a shift from general and spinal anesthesia to local anesthesia for penile surgeries.
A study of 1,481 males undergoing penile surgery investigated the efficacy of applying distal acupuncture points combined with topical nerve blocks. The main points used were LI4 (Hegu), LI10 (Shousanli), LI11 (Quchi), TB5 (Waiguan) and PC6 (Neiguan). The researchers discovered that the combination of acupuncture with local nerve blocks facilitated surgical interventions. The investigators note that this approach minimizes adverse effects and results in a more rapid return to daily living activities.
The researchers discovered that the use of acupuncture was effective for relaxing patients during diagnostic procedures including pharmaco-cavernosography and ultrasonography. Acupuncture was also successful in treating patient discomfort during preoperative preparations for penile venous stripping, penile corporoplasty, urethroplasty, vaso-vasostomy, penile arterial reconstruction, penile implants and penectomy. The researchers note that it is “meaningful to enhance those specific nerve blocks in penile surgeries” with acupuncture. They also note that acupuncture did not introduce significant difficulties into the surgical protocol. In addition, the researchers conclude that, “Acupuncture assisted Local anesthesia on an outpatient basis for penile surgeries appears to be highly promising.”
New research discovers acupuncture and moxibustion effective for the treatment of knee osteoarthritis. The researchers concluded that acupuncture was both safe and effective. In addition, acupuncture and moxibustion showed long term results.
Acupuncture points were chosen based on local pain indications and syndrome differentiation. Both local and distal acupuncture were applied on the affected acupuncture meridians. Acupuncture was applied to UB23 (BL23, Shenshu) and local Ah Shi points with lifting, thrusting and rotating techniques. Reinforcing and reducing methods were applied according to differential diagnostics. Moxibustion was applied with a moxa stick over local painful sites following acupuncture. Acupuncture was applied once per day for 5 days comprising 1 session. A two day break between a total of 2 sessions was given.
Another group did not received acupuncture but instead received a treatment of oral supplements and injections. In a comparison of the two groups, acupuncture was found significantly more effective in the long-term relief of knee pain due to osteoarthritis over the supplement/injection group. The second group received oral administration of glucosamine sulfate combined with knee joint cavity injections. The injections included sodium hyaluronate and triamcinolone acetonide acetate.
A new laboratory experiment reveals that acupuncture regulates steroid hormones to reduce biochemical reactions to stress. Acupuncture upregulates hormones in some areas while downregulating in other areas to maintain balance within the body when it is exposed to stress. Western blot analysis confirmed behavioral testing that acupuncture biochemically reduces stress reactions.
The researchers discovered that acupuncture reduces stress by regulating glucocorticoid receptor (GR) protein expression. Acupuncture simultaneously upregulated GR protein expression in the hippocampus, hypothalamic paraventricular nucleus (PVN) and pituitary gland while decreasing expression in the adrenal cortex when laboratory rats were exposed to stress. This counters the opposite biochemical phenomenon caused by unpredictable chronic mild stress (UCMS). The researchers note that acupuncture balances bodily biochemistry in this dual-directional manner.
The researchers conducted a controlled experiment on different acupuncture points on laboratory rats and discovered that hormone reactions to acupuncture are point specific. Control groups did not receive acupuncture. Two groups received different sets of acupuncture points combined with exposure to unpredictable chronic mild stress. Group 1 received acupuncture at LR14 (Qimen) and UB23 (Shenshu). Group 2 received acupuncture at SP6 (Sanyinjiao) and KI9 (Zhubin).
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