Acupuncture Continuing Education News
Acupuncture benefits patients with dry eyes. Optical coherence tomography with biomicroscopy demonstrates that acupuncture significantly reduces dry eyes for patients with lipid tear deficiency (LTD) and non-Sjögren syndrome (Non-SSDE) related dry eyes. Acupuncture successfully increased abnormally reduced tear meniscus parameters including tear meniscus height, tear meniscus depth, and tear meniscus area. The tear meniscus is a thin film of tear fluid that, when absent, indicates dry eyes. The researchers note that acupuncture “provided a measurable improvement of the tear meniscus dimensions….”
The study employed the highest standards using a randomized parallel-group intervention type of clinical study with a sample size of 96 human dry eye patients. A total of 44 patients were in the acupuncture group and 52 patients were in the control group. The acupuncture group received acupuncture treatments three time per week for four weeks for a total of 12 acupuncture treatments per patient. Participants did not use any other type of therapy to treat dry eyes. Acupuncture points selected for use in the study were consistent with Traditional Chinese Medicine (TCM) theory and included:
- Jingming (BL1)
- Cuanzhu (BL2)
- Yangbai (GB14)
- Sizhukong (SJ23)
- Taiyang (Extra1)
- Sibai (ST2)
- Hegu (LI4)
- Taichong (LR3)
- Guangming (GB37)
- Sanyinjiao (SP6)
- Fengchi (GB20)
Acupuncture needles were manually inserted and the de qi response was elicited. Total needle retention time was 30 minutes. An RTVue-100 optical coherence tomography device, manufactured by a Fremont (California) company, non-invasively captured eye cross-section images using light waves. This device was the first FDA cleared spectral domain optical coherence tomography unit capable of capturing both corneal and retinal imaging.
Acupuncture is safe and effective for allergy treatments. Research published in American Journal of Rhinology & Allergy finds acupuncture effective for the treatment of allergic rhinitis. This condition is often referred to as hay fever and is characterized by a runny nose, postnasal drip, sneezing, watery or itchy eyes, and irritation of the ears or throat. Acupuncture significantly lowered Immunoglobulin E (IgE), an antibody associated with allergies and hypersensitivities, in allergic rhinitis patients. In addition, subjective measures demonstrated acupuncture’s ability to improve quality of life scores. Acupuncture demonstrated significant efficaciousness in reducing allergic rhinitis symptoms including the reduction of nasal symptoms.
The researchers conducted a meta-analysis sorting for quality investigations from 174 randomized-controlled allergic rhinitis studies. A final selection of 13 quality trials consisting of a total sample size of 2,365 patients was examined. The researchers note that the study includes recent “multicenter, randomized, parallel-controlled trials with high quality” to support consistency of conclusions.
A primary outcome measure was the nasal symptom score. The researchers state that the, “Acupuncture group produced significantly greater diminution of nasal symptoms than did (the) control group.” Two randomized-controlled trials tested for a physical component score. Both demonstrated that acupuncture “was superior to the control group in improving physical health.” Three of the studies tested for IgE changes and all documented significant reductions in serum IgE. Two studies examined an overall mental component score. Both indicated “a significant trend in favor of the acupuncture group” for mental symptom improvement.
The researchers note, “Our meta-analysis showed that (the) acupuncture group has (a) superior effect in reduction of both rhinitis symptoms and the requirement for antiallergic medication compared with (the) control group.” The quality of life score significantly improved with acupuncture and was a measure of several components: sleep, non-nasal/eye symptoms, emotional function, practical problems, nasal symptoms, eye symptoms, activities. Serum IgE score improvements were found in the acupuncture group. The researchers note that, “This result showed strong and consistent evidence that acupuncture treatment leads to favorable responses in immunologic outcomes, which have been shown to be helpful in trials of proven therapeutic modalities, such as allergen-specific immunotherapy.”
Liu et al. compared allergic rhinitis acupuncture treatment with loratadine, a histamine antagonist drug used for the treatment of allergies. In the short term, acupuncture achieved a 96.7% total effective rate and the medication group achieved a 93.3% total effective rate. However, a long term follow-up demonstrated acupuncture’s ability to produce significantly superior positive patient outcomes. The follow-up reveals that acupuncture achieved an 86.7% total effective rate and loratadine achieve a 56.7% total effective rate. The researchers conclude, “The acupuncture at three nasal points and the acupoints selected by syndrome differentiation achieves the similar short-term efficacy on perennial allergic rhinitis as compared with the oral administration of loratadine. The acupuncture therapy presents the obvious advantages on long-term efficacy.”
Acupuncture immediately and significantly relieves lower back pain. Researchers applied acupuncture to hospital emergency department patients with acute lower back pain in a controlled study. The data indicates that acupuncture is both safe and effective in relieving lower back pain.
The study evaluated the effects of acupuncture on acute lower back pain patients receiving outpatient care in the emergency department of Changhua Christian Hospital (Taiwan). A true acupuncture group was compared with a sham acupuncture group in this controlled study. True acupuncture was applied to the following acupoints:
- Hegu (LI4)
- Shousanli (LI10)
- Yanlingquan (GB34)
- Taichong (LR3)
All needles were manually stimulated to elicit the de qi response. De qi sensations are often described by patients as dull, heavy, deep pressure, pulling, numb, aching, radiating, electrical, refreshing, and tingling. Acupuncturists may also experience a tugging or electrical sensation on the needle at the arrival of de qi. Needle retention time totaled 15 minutes for each patient.
The true acupuncture group demonstrated a significant reduction in lower back pain within 15 minutes of receiving acupuncture treatment. A three day follow-up interview confirmed lasting results. The true acupuncture group significantly outperformed the sham acupuncture group within 15 minutes of treatment and three days following treatment. The results indicate that true acupuncture has immediate and lasting effects.
Acupuncture repairs injured nerves. Findings published in Neural Regeneration Research demonstrate that acupuncture causes injured lower and upper limb motor nerves to repair. Electromyographic nerve conduction tests of acupuncture patients with nerve injuries document “an effective response” in 80% of patients participating in the study. Electromyography confirms that acupuncture significantly improves motor nerve conduction velocity and amplitude and also promotes functional nerve repair.
The researchers made an important discovery. A special set of acupuncture points resulted in good to excellent clinical responses at a very high rate. Using only local acupuncture points, patients had an effective rate of 38.5%. By adding acupuncture points to the Du meridian in addition to local acupuncture points, the effective rate jumped to 80%.
The Du meridian is a pathway composed of 28 primary acupuncture points plus extra acupoints. Many of the Du meridian acupuncture points are located on the midline of the back below the spinous processes of the vertebrae. In Traditional Chinese Medicine (TCM), the application of acupuncture points to the Du meridian (Governor vessel) are used for the treatment of many disorders including spine and brain ailments, vertigo, numbness, tremors, febrile diseases, and infertility.
The research published in Neural Regeneration Research confirms the Du meridian’s significant role in the treatment of nerve injuries. Electroacupuncture was applied to both the upper and lower limb groups at a rate of once per day, five times per week for a total of six weeks. The total number of acupuncture treatments was 30 sessions per patient. The researchers conclude, “Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury.”
The acupuncture points used in the study were a protocolized set of two acupuncture point prescriptions, one for the upper limbs and one for the lower limbs. The upper limb acupuncture point prescription consisted of local acupoints at the site of the injured nerve plus the following Du meridian acupoints:
- Baihui (DU20)
- Fengfu (DU16)
- Dazhui (DU14)
- Shenzhu (DU12)
The lower limb acupuncture point prescription consisted of local meridian acupoints at the site of the injured nerve plus the following Du meridian acupoints:
- Jizhong (DU6)
- Mingmen (DU4)
- Yaoyangguan (DU3)
- Yaoshu (DU2)
The local acupuncture points used in the study were chosen based on the area of nerve injury. Radial nerve injuries were treated with the following acupuncture points:
- Jianyu (LI15)
- Binao (LI14)
- Quchi (LI11)
- Hegu (LI4)
- Yangxi (LI5)
Acupuncture successfully lowers blood pressure in patients with hypertension. Researchers conducted a randomized, controlled clinical trial of 120 patients. Groups 1 and 2 received medications but group 1 also received acupuncture in addition to usual care. The group receiving acupuncture had significantly lower blood pressure. In addition, the acupuncture group had significantly less anxiety.
A related hypertension study had similar findings. A randomized, controlled clinical trial compared two groups. Group 1 received health education and lifestyle intervention. Group 2 received acupuncture in addition to the health education and lifestyle intervention. The hypertension reduced in both groups, however, the acupuncture group had significantly superior patient outcomes.
The researchers used a protocolized acupuncture point prescription to achieve the clinical results. Acupuncture point Baihui (DU20) was threaded towards acupuncture point Qianding (DU21). DU20, located at the vertex of the head, is considered one of the most important acupuncture points in Traditional Chinese Medicine (TCM). Classical indications for using DU20 include the treatment of hypertension.
The hypertension research supports the ancient TCM principles with a modern scientific investigation. According to TCM principles, DU20 is a sea of marrow acupuncture point that clears the senses, calms the spirit, extinguishes liver wind and stabilizes the ascendent yang. In modern terms, this indicates acupuncture at DU20 for the treatment of hypertension, dizziness, headaches, vertigo, tinnitus, nasal congestion, coma, shock, mental disorders and prolapsed organs.
Acupuncture benefits sleep and reduces insomnia. Researchers conducted a single-blinded, randomized, placebo-controlled investigation comparing acupuncture with sham acupuncture and estazolam, a benzodiazepine medication. True (verum) acupuncture produced significantly superior patient outcomes for insomnia patients including improvements in sleep quality and total sleep time.
A two month follow-up to the treatment regime demonstrates that acupuncture is superior to sham acupuncture and estazolam for the improvement of sleep quality. True acupuncture also produced superior clinical results for sleep efficiency and daytime functioning. Acupuncture improved daytime functioning including: fatigue reduction, reduced sleepiness, increased alertness and concentration, reduced mood disturbances.
The researchers adhered to Traditional Chinese Medicine (TCM) manual acupuncture techniques and attribute the positive patient outcomes to following traditional treatment protocol guidelines. According to TCM principles, de qi is an indication of the effectiveness of acupuncture. The research team ensured that de qi was achieved at most of the acupuncture points. De qi is often subjectively reported as fullness or a radiating sensation felt at acupuncture points during needling. It is also reported as a tugging or pulling motion by acupuncturists applying the needles. The researchers note that de qi was achieved at 85% of the acupuncture points and that this may have been the reason for the effectiveness of the acupuncture.
Reporting on TCM theory concerning healthy sleep, the researchers note that sleep is regarded as a cycle. There is an energetic daytime functioning of individuals and a restful nocturnal sleep portion of the cycle. If the cycle is broken, there may be low spiritedness in the daytime and hyperarousal states in the nighttime. The function of acupuncture is to restore the normal cycle. Acupuncture points used in the study were classically based selections from TCM:
- Shenting (DU24)
- Sishencong (EX-HN1)
- Baihui (DU20)
- Shenmen (HT7)
- Sanyinjiao (SP6)
Acupuncture not only restored nighttime sleep but also improved daytime energetics. In contrast, patients in the estazolam medication group experienced adverse effects. This included daytime sleepiness that typically ceased by midday. The researchers note, “The trial implied that verum acupuncture was superior in improving sleep quality and daytime functioning of primary insomnia compared with estazolam and sham acupuncture.” The researchers also note that true acupuncture increased total sleep time and “improved sleep quality (SQ) and vitality (VT), decreased daytime dysfunction (DD) and sleepiness (ESS score).”
Acupuncture combined with antidepressants is safe and effective for the treatment of depression. A meta-analysis of thirteen quality randomized-controlled trials published in the Journal of Affective Disorders finds acupuncture combined with antidepressant therapy is “more effective than antidepressants alone….” The therapeutic effects of the combination are rapid and the data finds acupuncture effective in reducing the adverse effects associated with antidepressant medications.
Researchers note, “This meta-analysis reveals clear evidence of greater antidepressant activity with acupuncture combined with a(n) SSRIs compared with SSRIs alone….” SSRIs (selective serotonin reuptake inhibitors) are a class of antidepressants that increase levels of serotonin in the brain. The researchers note that acupuncture has been shown to stimulate neurotransmitters in the brain thereby increasing serotonin and norepinephrine levels. They add that acupuncture increases the “activity of serotonergic neurons in the reward system pathway of the brain.” They note, “Acupuncture treatments have also been shown to increase nocturnal melatonin secretion and reduce insomnia and anxiety.”
The researchers note that acupuncture’s ability to increase opiod peptides in the body may account for its ability to provide rapid relief from depression. They note, “acupuncture is capable of rapidly increasing the bodily release of endogenous opioid peptides associated with the production of pleasure and relief of anxiety and gastrointestinal discomfort.”
The researchers cite laboratory research finding electroacupuncture and manual acupuncture effective in relieving depression. Real-time polymerase chain reaction genomic research confirms that acupuncture normalizes a broad spectrum of gene expression, decreases damage to hippocampal neurons, and regulates “serum levels of corticosterone and adrenocorticotropic hormone.” The researchers note that “acupuncture may treat depression by influencing the neuroendocrine and immune systems through the regulation of levels of serotonin, norepinephrine, dopamine, endorphins and glucocorticoids…, stimulating hypothalamic and hippocampal responses…, and by regulating the expression of certain genes.”
The researchers note that acupuncture may be an effective standalone treatment modality for partial responders and nonresponders to antidepressant medications. Citing Wu et al., they note “that acupuncture has the potential to be an effective, safe and well-tolerated monotherapy for depression and a viable augmentation agent for partial responders and nonresponders to antidepressant treatment.” They add that two other meta-analyses confirm these findings citing that acupuncture “significantly reduces depressive severity” and is safe and effective for post-stroke depression patients.
The researchers analysed the trials and determined a set of acupuncture points that were most commonly used across all of the studies:
Topping the list for the most common points across all studies were acupuncture points GV20 and Yintang. The total sample size was 1,046 human subjects. The total number of acupuncture treatments ranged between 9 and 36. The majority of participants received acupuncture in the course of a six week treatment window.
Acupuncture speeds restoration of consciousness following general anesthesia. Researchers used sham controls and determined that induction of pain did not play a role in this recuperative process. The research team notes that the ability of acupuncture to accelerate the revival of consciousness may be due to its ability to enhance cerebral blood flow, cardiac output and ventilation. The researchers add that acupuncture may help to optimize operating room management by improving “turnover time by accelerating recovery time.”
The researchers investigated the effects of two acupuncture points: DU26, KI1. Their data indicates that these points accelerate the revival of consciousness and that these acupuncture points, when used together, may have a synergistic effect. Citing several other studies, the researchers note that the data supports the use of acupuncture in the perioperative setting for many purposes. The researchers document that acupuncture has been employed for several perioperative uses: reduction of opioid use, stabilization of cardiac function, reduction of nausea and vomiting, and alleviation of the adverse effects due to anesthesia and surgery.
The researchers cite important SPECT imaging findings including that acupuncture increases cerebral blood flow for patients with brain injuries. The increase is correlated with “improvements in consciousness.” Electroacupuncture at DU26 increases ventilation for both the frequency and amplitude of breathing. Additionally, reports suggest that acupuncture enhances the recovery of consciousness after cardiac arrest and hypovolemic shock.
The researchers outlined the Traditional Chinese Medicine (TCM) theoretical principles relating to consciousness and acupuncture. The ancient principles stipulate that consciousness resides in the heart and is supported by the kidneys. The researchers suggest that this may be a clue as to why acupuncture point KI1, a jing-well point of the kidney channel, is effective in reviving consciousness.
The researchers cited several other TCM theories. Loss of consciousness is due to yin or yang deficiency. It may also be caused by jue syndrome, which is from an imbalance between qi and blood “induced by deficiency of qi and accumulation of phlegm.”
The researchers note that TCM theory suggests that loss of consciousness may be due to imbalances of yin and yang and further note that this may be why acupuncture point DU26 has historically been employed for resuscitation. They note that DU26 is “located near the meeting point of Renmai with Dumai channels, the meridians receiving yang from heaven and yin from earth respectively.” They add that DU26, located above the upper lip on the midline at the junction of the upper third and lower two thirds of the philtrum, has historically been considered one of the most important acupuncture points in TCM for resuscitation.
Acupuncture provides significant relief for migraine sufferers. Researchers conducted a randomized-controlled trial of 87 patients comparing the effectiveness of two acupuncture point prescriptions. Both protocols were effective, however, one approach delivered significantly superior patient outcomes.
Two groups were compared. Patients in group 1 received acupuncture at Siguan and gallbladder meridian acupuncture points. Siguan, roughly translated as the four gates, is a combination of acupuncture points Hegu (LI4) and Taichong (LR3). Gallbladder meridian points used in group 1 included:
Group 2 did not receive acupuncture needling at Siguan but received acupuncture at acupuncture points:
Treatments were applied three times per week for six weeks in both groups. Migraine frequency, intensity and duration were compared after completion of the six week regime of care and in a three month follow-up investigation.
After the six weeks of patient care, group 1 exhibited a total effective rate of 95.2% and group 2 exhibited an 80.0% total effective rate. The three month follow-up documents an 88.1% total effective rate for group 1 and a 75.6% total effective rate for group 2. Based on these findings, the researchers conclude that Siguan combined with gallbladder meridian acupuncture points is more effective than the acupuncture point prescription used in group 2 wherein only gallbladder meridian points were used.
Jie Yang et al. note that acupuncture “induce(s) different cerebral glucose metabolism changes in pain-related brain regions and reduce(s) intensity of pain” for patients with migraines. In a randomized-controlled study using PET-CT neuroimaging, acupuncture was shown to be effective for migraine pain reduction. The imaging revealed that acupuncture raised glycometabolism in the middle temporal cortex, orbital front cortex, middle frontal gyrus, angular gyrus, post cingulate cortex, the precuneus and the middle cingulate cortex. Acupuncture simultaneously lowered glycometabolism in the parahippocampus, hippocampus, fusiform, postcentral gyrus, and the cerebellum in migraine patients. The study also showed that acupuncture point choices determined changes in brain glycometabolism. The researchers note that this measurable phenomenon indicates acupuncture point specificity.
Subjects with migraines were separated into three groups: Traditional Acupuncture Group (TAG), Controlled Acupuncture Group (CAG), non-intervention group. The non-intervention group did not receive treatment. The TAG group received acupuncture stimulation at acupuncture points:
- TB5 (Waiguan)
- GB34 (Yanglingquan)
- GB20 (Fengchi)
The CAG group received acupuncture needling at acupuncture points:
- ST8 (Touwei)
- LI6 (Pianli)
- ST36 (Zusanli)
The TAG group showed the most significant reductions in migraine related pain. Additionally, the glycometabolism was higher in the TAG group than in the non-intervention group in the:
- Middle temporal cortex
- Orbital frontal cortex
- Middle frontal gyrus
- Angular gyrus
- Post cingulate cortex
- Middle cingulate cortex
The TAG group decreased glycometabolism over the non-intervention group in the:
- Postcentral gyrus
The CAG group more greatly increased glycometabolism over the non-intervention group in the:
- Middle temporal cortex
- Supratemporal gyrus
- Supramarginal gyrus
- Middle cingulate cortex
The CAG group decreased glycometabolism more greatly than the non-intervention group in the cerebellum.
Vijayalakshmi et al. find electroacupuncture more effective than “conventional drug therapy” for the treatment of migraines. Electroacupuncture significantly outperformed the drug flunarizine in the treatment of migraines. Acupuncture patients demonstrated superior patient outcomes for several measures: pain relief, psychological profile improvements, overall quality of life, disability reduction. The researchers conclude that acupuncture is an effective alternative or adjunct method of care for migraine patients.
Photoacoustic tomography of the brain during acupuncture reveals cerebral responses to acupuncture needle stimulation. Researchers have developed new photoacoustic imaging techniques for use during acupuncture that employ short laser pulses to generate ultrasonic waves in living tissues. The techniques generate high ultrasonic resolution images with sharp contrast. The images show structural and functional images of cerebral responses to acupuncture.
Researchers using photoacoustic imaging measured brain blood circulation changes when applying acupuncture at acupoint KD1 (Yongquan). KD1 is located on the sole of the foot between the second and third metatarsal bones in a depression formed with then foot is plantar flexed. According to Traditional Chinese Medicine (TCM) principles, KD1 benefits the sensory organs, calms the spirit and helps the qi to descend. It is indicated for use in reviving consciousness, controlling seizures including epilepsy, and for the treatment of shock, vertex headaches, blurry vision, foot disorders, coughing with blood and insomnia.
The researchers developed photoacoustic imaging techniques to augment MRI (magnetic resonance imaging) and PET (positron emission tomography) imaging of responses to acupuncture. The researchers note that MRI imaging excels in recording oxygen level changes in the blood but is expensive and has low spatial and temporal resolution. They note that PET scans excel in recording glucose metabolism and blood flow but patients must be injected with tracer isotopes prior to imaging. The researchers add that near infrared spectroscopy has helped scientists to understand the mechanisms of acupuncture on the body.
Acupuncture relieves sinus problems due to allergies. Research published in the American Journal of Rhinology & Allergy incorporates a meta-analysis of high quality allergy related studies comparing groups receiving acupuncture versus control groups. The researchers documented that acupuncture “produced significantly greater diminution of nasal symptoms” in the acupuncture group. They add, “Our meta-analysis showed that (the) acupuncture group has superior effect(s) in reduction of both rhinitis symptoms and the requirement for antiallergic medication compared with (the) control group.”
The research team notes that allergic rhinitis is a nasal hypersensitivity reaction to allergens. Common triggers include irritants such as dust mites, animal dander, and pollens. Reactions include nasal congestion, rhinorrhea (“runny nose”), sneezing, and pruritus (severe itching). Allergic rhinitis affects approximately 1.4 billion people with increasing numbers. Medications used to combat allergic rhinitis include antihistamines, corticosteroids, mast cell stabilizers, anticholinergics, and antileukotrienes.
Biomedicine And Acupuncture
The researchers note potential biological mechanisms making acupuncture effective for the treatment of allergic rhinitis. One mechanism is the ability of acupuncture to modulate cytokines, which are immune system cell secretions, and another is the ability of acupuncture to induce anti-inflammatory actions. The researchers identified changes in IgE as a result of acupuncture treatment for the treatment of allergic rhinitis. IgE is a class of immunoglobulins including antibodies that react to pollen, spores, animal dander and othe substances. IgE levels often rise significantly during allergic reactions. The researchers note, “Our meta-analysis of serum IgE levels in three included trials showed a significant decrease of IgE for the acupuncture group compared with the control group. This result showed strong and consistent evidence that acupuncture treatment leads to favorable responses in immunologic outcomes, which have been shown to be helpful in trials of proven therapeutic modalities, such as allergen-specific immunotherapy.”
Quality Of Research
This groundbreaking research distinguishes itself from prior investigations by including the “latest multicenter, randomized, pararallel-controlled trials.” Stringent inclusion criteria included:
- Randomized controlled trials
- Diagnosis of allergic rhinitis
- Acupuncture compared with sham acupuncture or other control
A total of 174 abstracts were considered for inclusion but this was narrowed down to a limited number of trials meeting the inclusion criteria. All included trials reported on nasal symptoms, medication relief, quality of life, total IgE, or safety. A total of 2,365 participants made it to the final adoption in the research. This included 1,126 patients in the acupuncture treatment group and 1,239 in the control group.
The researchers conclude that acupuncture for the treatment of allergic rhinitis is indicated as a safe and effective modality of care in this meta-analysis. As a result, the researchers encourage continued research on this topic including future randomized-controlled trials to confirm the meta-analysis.
Acupuncture relieves Parkinson’s disease symptoms. Researchers document the ability of acupuncture to reduce pain, anxiety, depression, hot flashes and abnormal sweating in a clinical case history. The patient responded with significant positive patient outcomes after a 2 week regime of acupuncture treatments given at a rate of five days per week.
Parkinson’s disease is a progressive nervous system disorder affecting movement. Changes include the onset of tremors, slowness of movements, shuffling, difficulty swallowing, fainting, reduced arm sway, rigidity and dysfunction of speech and gait. There is no known biomedical cure but medications including levodopa, COMT inhibitors, MAO-B inhibitors, dopamine agonists and other medications are used to control symptoms. Surgical interventions include the implantation of deep brain stimulators.
Acupuncture successfully reduces pain, autonomic nervous system dysfunction, and mental illness in Parkinson’s disease patients. Researchers from the Aizu Medical Center (Fukushima Medical University) delivered the patient care and collected the data. Additional support and came from an investigator at the Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (Yamagata University).
The case history documents acupuncture’s ability to address specific concerns of an 81 year old female patient suffering from Parkinson’s disease. Complications included a history of hypertension and lumbar fracture. The patient had been prescribed medications including anti-inflammatory and psychiatric drugs. Her symptoms persisted and acupuncture was initiated.
Manual acupuncture was applied at acupuncture points: LR3, LI4, KI5, KI7, SP6, GB34, BL18, BL15, GB20. Needles were retained for ten minutes per session. Electroacupuncture at 1 Hz for 7 minutes was applied to: KI10, LR9, BL23, BL25. The researchers note that the electroacupuncture was applied to relax the muscle tension. Seirin brand acupuncture needles of 40 - 50 mm length and 0.14 - 0.18 diameter were used. The researchers note that Traditional Chinese Medicine (TCM) theory guided the needle selection process. UB15, LR3, and SP6 were chosen for their ability to treat both depression and anxiety. LR3, KI7, BL18, and GB34 were chosen for their ability to treat hot flashes and paroxysmal sweating.
The researchers note that the patient's lower leg pain decreased. Hot flashes and paroxysmal sweating incidences reduced. The patient showed very significant reductions in depression and anxiety scores. In addition, her “steps became larger” and there was a significant reduction in bradykinesia, a complication often correlated with Parkinson’s disease characterized by slowness and impairment of movements and reflexes.
In related research, University of Arizona doctors find acupuncture effective for the treatment of balance and gait disorders in Parkinson’s disease patients. The research team from the surgery and neurology departments measured significant clinical improvements in overall balance, gait speed and stride length. The results were published in Neurology, the official journal of the American Academy of Neurology.
Patients were randomly assigned to an acupuncture group or a control group. The acupuncture group received electroacupuncture. The control group received sham acupuncture to rule out variables including the placebo effect. Patients received one treatment per week for three weeks and each treatment duration lasted a total of 30 minutes.
Objective measurements were taken from various positions and during many types of activities. Balance measurements included assessment of the relationship between the mediolateral center of mass sway with the anteroposterior sway. These measurements were taken with the eyes open, closed and during multitasking. Gait measurements were taken during fast walking, postural transitions and related activities.
The researchers tabulated the results and measured an overall improvement in balance by 31% in the acupuncture group. Gait speed improved by 10% and stride length increased by 5% for patients receiving true acupuncture. Control group patients showed no improvements.
Balance, gait and stride length significantly improved due to the application of electroacupuncture. Use of a sham acupuncture control group eliminated the possibility of the placebo effect in the final results. As a result, the University of Arizona doctors conclude, “EA (electroacupuncture) is an effective therapy in improving certain aspects of balance and gait disorders in PD (Parkinson’s disease).”
CT scan imaging reveals unique anatomical structures of acupuncture points. Published in Biomedical Engineering and Informatics, researchers used in-line phase contrast CT imaging with synchrotron radiation to capture images of acupuncture points. They compared non-acupuncture point locations with real Traditional Chinese Medicine (TCM) acupuncture points. The CT scans reveal unique distinctions between the non-acupuncture points and acupuncture point structures.
State-of-the-art synchrotron radiation CT techniques allowed for improved soft tissue imaging and a larger field of view. The CT technological breakthrough led to the discovery of unique acupuncture point characteristics. A detailed look at acupuncture point ST37 (Shangjuxu) reveals a concentrated number of involuted microvascular structures. Non-acupuncture points lacked the dense concentration of microvascular vessels and involuted structures found in acupoints.
The researchers note that the in-line imaging techniques employed in the study improved the light path, enhanced the field of view and eliminated artifacts. The technological advancement allowed for a new look at the microstructures at ST37 and other points. The researchers note that acupuncture points have small microvascular structures and their bifurcations “can be clearly seen around the thick blood vessels.” In addition, acupuncture points demonstrate a dense number of fine microvascular structures. On the other hand, non-acupuncture points show thick blood vessels absent the unique, fine structures found in true acupuncture points. The researchers conclude, “Our results demonstrated again the existence of acupoints, and also show that the acupoints are special points in mammals.”
In a prior study published in the Journal of Electron Spectroscopy and Related Phenomena, the research team used in-line phase contrast CT imaging with synchrotron radiation on both non-acupuncture points and acupuncture points and made similar discoveries. The CT scans revealed clear distinctions between the non-acupuncture point and acupuncture point anatomical structures.
In an identical finding, acupuncture points had a higher density of micro-vessels and contained a large amount of involuted microvascular structures. The non-acupuncture points did not exhibit these properties. Similarly, the researchers noted that the advanced CT imaging techniques allowed for improved three-dimensional (3D) imaging of a large field of view without artifacts and enhanced soft tissue visualization.
Acupuncture points ST36 (Zusanli) and ST37 (Shangjuxu) demonstrated very distinct structural differences from 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.
The latest in acupuncture research for pain management, addiction recovery, and insomnia is featured in upcoming live webinars for acupuncture CEUs at HealthCMi. Visit the HealthCMi live webinar web page because it features complete information about upcoming events.
The January 20th webinar features acupuncture for the treatment of pain and addiction. A recent study demonstrating the power of a special acupuncture point for morphine addiction recovery will be presented. Licensed acupuncturists receive CEU and PDA credit for attending the live webinar.
The February 10th webinar continues the presentation of the latest research for pain management with acupuncture. A special focus is given to recent research on acupuncture for the treatment of lower back pain and disc degeneration. The March 10th webinar presents modern research for the treatment of pain plus important research demonstrating the effectiveness of acupuncture for the treatment of insomnia. More webinars will be posted; expect HealthCMi to present at least one live webinar per month.
The live webinars are designed for licensed acupuncturists to obtain continuing education credit, however, the general public is welcome. All live webinars feature a two-way interactive question and answer section. This makes the webinar widely accessible to everyone. All that is needed is a good internet connection. The webinar can run on an iPhone, Android, iPad, Mac and Windows PC.
Acupuncture exerts post-operative anti-inflammatory responses thereby preventing abdominal adhesions. Published in the Journal of Surgical Research, investigators have discovered a major biological mechanism that may be responsible for these beneficial effects. The research team concludes, “EA (electroacupuncture) ST36 might reduce the postoperative local inflammatory response, attenuate the angiogenesis and alleviate the adhesion formation partly via activating the cholinergic anti-inflammatory mechanism.”
The team’s findings build on earlier research proving that electroacupuncture prevents post-operative abdominal adhesions. In looking for clues as to how acupuncture exerts its anti-inflammatory effects, they discovered that electroacupuncture at acupoint ST36 “reduced TNF-α and VEGF levels in adhesive tissue homogenates 7 days after surgery….” Even more interesting, only true acupuncture points used in the study exhibited these effects. Electroacupuncture at “non-channel acupoints...had no suppressive effects on TNF-α and VEGF levels. TNF (Tumor Necrosis Factor) is a cytokine that is involved in various biological functions including septic shock and wasting syndrome. VEGF (Vascular Endothelial Growth Factor) is a signal protein produced by cells that engage vasculogenesis and angiogenesis.
Histopathological and macroscopic evaluations confirm that electroacupuncture at ST36 reduces post-operative adhesion formation. In addition, the researchers note that electroacupuncture at ST36 “significantly decreased angiogenesis evidenced by reduced CD31 positive microvessel density (MVD) in adhesive tissue.” CD31 (Cluster of Differentiation) is a protein that regulates neutrophil removal and expresses in vascular tumors, sarcomas and carcinomas.
Related research confirms the anti-inflammatory effects of acupuncture. Another recent study reveals that acupuncture at acupoints GV20 and GB7 regulates the cascade of endogenous inflammatory chemicals released after a stroke. These acupuncture points prevent inflammation by inhibiting IL-1beta in the brain tissue region of a hematoma. IL-1beta is a pro-inflammatory cytokine, a cell-signaling protein molecule used in intercellular communication.
Scalp acupuncture causes a rapid decrease of IL-6 (Interleukin-6), another cytokine involved in the inflammatory response. Left unchecked, IL-6’s pro-inflammatory effects are pathological. IL-6 mediates fevers, crosses the blood-brain barrier and is found in high levels in patients with metastatic cancer.
The researchers note that acupuncture at GV20 and Taiyang has an “inhibitory effect on the immune-inflammatory reaction mediated by TNF-(alpha) expression….” Additionally, acupuncture at GV20 and GB7 “promoted heat shock protein 70 (HSP70) mRNA expression in brain tissue….” HSP70 helps cells fold proteins and have the ability to protect cells from stress. Other scalp acupuncture research shows “improved mitochondrial energy metabolism in (the) brain….”
Researchers have discovered an anatomical structure located at acupuncture points. Wang, et. al., have identified a “vessel-like structure” made of “calcitonin gene related peptide (CGRP)-positive neurofibers in local tissues” at acupuncture points. The researchers discovered that “CGRP-positive nerve fibers were found to distribute in the dermis and subcutaneous layers of local tissues of acupoint ST 44, ST 36 and ST 32, mainly concentrating around the vessel-like structure.” They add, “CGRP-positive neurofibers are an important element in the local tissues of acupoint ST 44, ST 36 and ST 32 regions….”
Miyauchi, et. al., note, “The calcitonin gene-related peptide (CGRP) plays important roles as a neurotransmitter/neuromodulator in the central nervous system, and as a potent vasodilator when secreted from peripheral, perivascular nerves through its specific receptors.” Wang, et. al,. used a laser confocal microscope to make the discovery of CGRP positive nerve fibers at acupuncture points. This research solves one piece of the biological mystery behind the structure and mechanism of acupuncture’s effective actions on human health.
CGRP is a type of neurotransmitter. Nerve fibers that are positive for the presence of CGRP play many roles in human physiology. For example, Hara-Irie, et. al., note that “CGRP-positive nerve fibers could be a crucial element in bone metabolism during bone growth and development.” Kunst, et. al., from the Yale School of Medicine (New Haven, Connecticut) note that CGRP is “a wake-promoting neuropeptide that regulates sleep maintenance at night.” Evans, et. al., from the University of Miami School of Medicine (Miami, Florida) note that CGRP is “a potent vasodilator neuropeptide.” The density of nerve fibers containing CGRP located at acupuncture points may correlate to the ability of acupuncture to stimulate signal conduction and induce health benefits.
Hongbao Ma of the Department of Medicine, Michigan State University (East Lansing) notes, “Calcitonin gene-related peptide (CGRP) is a 37 amino acid vasoactive neuropeptide that is widely distributed in central and peripheral nervous systems in mammals. CGRP was discovered in 1982 by molecular cloning of calcitonin (CT) gene.” Ma adds, “CGRP is secreted by primary afferents and causes primary hyperalgesia, and its expression increases in (the) dorsal horn under sensitization conditions. CGRP plays (an) important role in blood pressure system.” Given the discovery of CGRP in 1982, it is not unusual that the vessel-like physical structures of CGRP associated with acupuncture points have only recently been discovered.
Russell, et. al. note, “CGRP is a highly potent vasodilator and, partly as a consequence, possesses protective mechanisms that are important for physiological and pathological conditions involving the cardiovascular system and wound healing. CGRP is primarily released from sensory nerves and thus is implicated in pain pathways. The proven ability of CGRP antagonists to alleviate migraine has been of most interest in terms of drug development, and knowledge to date concerning this potential therapeutic area is discussed.”
Ling Zhao et. al., conclude that acupuncture is effective in the treatment of migraines and reduces pain intensity levels. Zhou et. al., find acupuncture effective in the prevention of migraines and links acupuncture’s therapeutic benefits to its ability to stimulate MLCK expression. The expression of myosin light-chain kinase (MLCK) is involved in the regulation of smooth muscle contraction. The researchers document a correlation between acute migraine attacks and decreases of MLCK via the CGRP signal system. The researchers discovered that applying acupuncture to acupoint GB20 (Fengchi) successfully upregulates MLCK expression and has “preventative and curative” effects for migraine patients.
In another investigation, Morry Silberstein, et. al., conclude that acupuncture points are related to both unmyelinated and myelinated afferent nerve fibers in a unique neuroanatomical structure not found in other areas of the body. The researchers used light microscopy on silver stained sections of acupuncture point P6 (silver stained human cadaver sample) and used confocal light microscopy on a live subject for acupuncture points GB20 and SP6. Control sites were compared with the acupuncture points.
At acupuncture points, it was discovered that a nerve bundle extended to the dermal-epidermal junctions. Each bundle branched into 2 sections perpendicular to each other. This anatomical phenomenon was not observed at the control sites. The researchers concluded that this acupoint neuroanatomical finding suggests that, “acupuncture may incise afferent unmyelinated axonal branch points, disrupting both neural transmission to the spinal cord and crosstalk along meridians, while simultaneously stimulating larger, myelinated afferents, thus explaining both the immediate and long-lasting effects of acupuncture.”
In another body of research by Chenglin, et. al., CT scans reveal unique anatomical structures of acupuncture points. A CT (computerized tomography) scan is a series of X-rays used to create cross-sectional images. In a 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 view this important finding.
The acupuncture points ST36 (Zusanli) and ST37 (Shangjuxu) were shown to have distinct structural differences from 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.
Tenderness at acupuncture point SP6 (Sanyinjiao) is linked to incidences of menstrual cramping with pain. Tenderness at this lower leg acupuncture point has been associated with dysmenorrhea in Traditional Chinese Medicine (TCM) for over a thousand years. Now, researchers have completed a randomized study to test the scientific basis for this phenomenon. The researchers discovered a significant “tenderness at Sanyinjiao (SP6) exists in women undergoing primary dysmenorrhea.”
The term dysmenorrhea refers to painful cramps occurring before or during the menstrual period. The symptoms of dysmenorrhea include abdominal pain and pressure, hip and lower back pain, and inner thigh pain. Primary dysmenorrhea is a type of recurring menstrual cramps not caused by other diseases.
The use of SP6 in acupuncture is highly defined and established. Indications for the use of acupoint SP6 in TCM are abdominal pain and distention, dysmenorrhea, irregular menstruation, uterine bleeding, leukorrhea, uterine prolapse, infertility, delayed labor, nocturnal emissions, enuresis, dysuria, lower limb disorders, vertigo from deficiency and insomnia. TCM theory states that SP6 benefits the spleen and kidneys, transforms dampness, and spreads the liver qi. SP6, roughly translated as three yin junction, is also the meeting point of the three lower yin meridians.
Research supports using SP6 for the treatment of dysmenorrhea. Shi, et. al., measured significant pain relief induced by needling acupuncture point SP6 for patients with primary dysmenorrhea. Blood samples were taken of participants during the study. It was shown that although acupuncture decreased menstrual pain, the beneficial effects were not related to changes in plasma levels of prostaglandins. The researchers conclude that the analgesic effects of SP6 are not mediated by prostaglandin variations in the bloodstream.
Another study of 66 patients finds acupuncture, combined with cupping and moxibustion, effective for the relief of menstrual pain. The patients had significant relief of menstrual pain within 2 - 6 acupuncture treatments. This study employed the use of SP6 and other acupuncture points: CV4 (Guanyuan), SP10 (Xuehai), K3 (Taixi), SP8 (Diji).
Licensed acupuncturists often combine acupuncture with herbal medicine for the treatment of gynecological conditions. Research backs up this time honored approach to patient care. A high quality study finds acupuncture and Chinese herbal medicine effective for the relief of endometriosis related pain. The total effective rate for auricular acupuncture was over 90%. The total effective rate for Chinese herbal medicine was 60%. A closer look reveals that the effective rate for mild to moderate dysmenorrhea due to endometriosis for both auricular acupuncture and Chinese herbal medicine is similar. However, auricular acupuncture showed greater efficacy for the relief of severe dysmenorrhea due to endometriosis. The randomized, blinded controlled trial was of high quality and a laparoscopy was required to confirm the diagnosis of endometriosis.
Zhou, et. al., find acupuncture combined with moxibustion and herbs is more effective for reducing menstrual pain and cramping than ibuprofen. The results were published based on research of a randomized investigation of patients with primary dysmenorrhea. Data points were taken at three, six and nine months after the beginning of treatment. The long-term positive clinical outcomes for patients having received acupuncture, moxibustion and herbal medicine was significantly superior to patients having taken ibuprofen.
Research conducted at the Affiliated Hospital of Hubei College of Medicine and Pharmacy involved a trial of 90 patients with primary dysmenorrhea. The patients were randomly divided into two study groups. Group 1 received acupuncture, herbal hot compresses and moxibustion. Group 2 received oral administration of ibuprofen at 300 mg per dose, three times daily. The treatment lasted for three menstrual cycles.
During the course of treatment, dietary restrictions were applied to both group 1 and group 2. Patients were advised to avoid eating raw, cold, pungent or very spicy foods. Patients were advised to increase their consumption of fresh vegetables and fruits. In addition, patients were advised to avoid prolonged exposure to cold temperatures on the lower abdomen. The total effective rate observed in the acupuncture group was much higher than that of the ibuprofen group.
The hot compresses were applied to the umbilical region and local regions of pain on the lower abdomen. The herbal medicines in the compresses were Dan Shen 10g, Yan Hu Suo 10g and Yi Mu Cao 30g. The herbs were decocted for one hour and strained. A 10 cm x 15 cm flannel cloth was soaked in the decoction, removed and squeezed to remove excess fluid. The cloth was applied to the patient. One hot compress treatment lasted for fifteen minutes.
Customization of acupuncture points was applied according to TCM differential diagnostics. Primary acupuncture points used in the study were:
In cases of excess, the following were added:
For cases of deficiency, the following acupuncture points were added:
Reinforcing and reducing acupuncture needle manipulation techniques were applied until a deqi sensation was achieved. Moxa was applied to needles. The needles were withdrawn after the use of 3 - 5 cones of moxa. The approximate treatment time was 30 minutes. Acupuncture, moxibustion and hot compresses were applied once daily for a period of six days. The treatment started one week before the menstrual period began and ended by the first day of the menstrual cycle. The treatment resumed before the next menstrual period. One course of treatment comprised one menstrual period and the entire treatment lasted for three courses. The acupuncture group significantly outperformed the ibuprofen group at three, six and nine months after the beginning of treatment. The results indicate that acupuncture combined with moxibustion and herbal compresses is safe and effective for the treatment of primary dysmenorrhea.
A different approach to using acupuncture points includes injecting vitamins. Researchers at the University of California (UCSF, San Francisco) injected vitamin K1 into acupuncture point SP6. They discovered that the acupuncture point injections of vitamin K alleviate dysmenorrhea. The women participating in the study experienced less menstrual pain and a shorter duration of menstrual symptoms.
A survey of the participants finds 94% “agreeable to receiving injection therapy” and 77% would receive monthly injections if the treatment were made available. The researchers note, “This finding is consistent with outcomes from the Obstetrics and Gynecology Hospital in Shanghai, China, where the protocol was developed.”
Acupuncture reduces cholesterol. Researchers measured the effects of needling acupuncture point ST40 (Fenglong) on plasma cholesterol levels. In a laboratory experiment, electroacupuncture successfully downregulated LDL cholesterol. Simultaneously, electroacupuncture downregulated several proinflammatory macrophages linked to dyslipidemia: MCP-1, ICAM-1, IL-1gamma. The researchers conclude that electroacupuncture at ST40 downregulates plasma total cholesterol, LDL cholesterol and proinflammatory macrophages in cases of hyperlipidemia.
A related laboratory experiment reveals similar findings. Zhang, et. al., conclude that electroacupuncture lowers levels of cholesterol and triglycerides in cases of high cholesterol. Acupuncture points LI11 (Quchi), CV12 (Zhongwan) and ST40 effectively lowered LDL cholesterol, total cholesterol and triglycerides.
Ling Li, et. al., concur that acupuncture lowers both cholesterol and triglycerides. The laboratory research measured biochemical responses to electroacupuncture at acupoint ST40 to map the mechanisms by which acupuncture reduces hyperlipidemia. The study documents that electroacupuncture induces expression of nNOS and Mt1. The NNOS enzyme mediates nitric oxide signaling and plays an important role in cellular signaling, vascular tone, blood pressure, insulin secretion, airway tone, angiogenesis and peristalsis. Mt1 plays an important role in the protection against oxidative stress. Based on these findings, the researchers conclude that electroacupuncture and its effect on nitric oxide signaling transduction is physiologically related to its cholesterol and triglyceride lowering effects.
Y. F. Chen, et. al., conclude that acupuncture prevents and reverses dangerous cellular accumulations of fatty materials in cases of high cholesterol. The laboratory research confirms that needling ST40 prevents and reverses the formation of foam cells. This type of cell forms at the site of fatty streaks and is the beginning of atherosclerotic plaque formation in blood vessels. The presence of foam cells is indicative of an increased risk of heart attacks and strokes. Based on the research, the investigators note that acupuncture could “play an essential role in treating hyperlipidemia and stopping it from developing into a further level.”
Oxidized LDL cholesterol creates inflammation within blood vessels. Macrophages are attracted to the site of inflammation and consume the LDL cholesterol. Ordinarily, macrophages defend against bacteria and other pathogens. However, macrophages may become engulfed in fatty materials when attempting to eliminate excess cholesterol. Under a microscope, one can see that the macrophages become overrun with cholesterol and other fatty materials. The damaged macrophages take on a foamy appearance, hence the name foam cell. Foam cells indicate that dangerous plaques are beginning to form within the vessels. The researchers conclude that electroacupuncture at acupuncture point ST40 “prevents and reverse(s) the formation of foam cell(s).” In this way, acupuncture helps to fight hyperlipidemia and prevent heart disease.
Acupuncture relieves postpartum depression. Researchers conclude that acupuncture combined with psychological intervention has a similar total efficacy rate for the treatment of postpartum depression as the drug fluoxetine hydrochloride (Prozac®). Acupuncture plus psychological intervention had a 90.7% total effective rate and fluoxetine hydrochloride had a 90.5% total effective rate. The researchers note that acupuncture did not cause any adverse reactions but fluoxetine hydrochloride caused nausea, dizziness, and loss of appetite.
Postpartum depression’s biomedical signs and symptoms occur after childbirth and include: mood swings, unhappiness, insomnia, hypersomnia, psychomotor retardation, suicidal tendencies, cognitive dysfunction, low libido, exhaustion, anger, irritability, lack of appetite, not bonding with the baby, low self-esteem. In Traditional Chinese Medicine (TCM), postpartum depression belongs to depression syndrome and may include: depression, low energy, stifling chest sensation, sighing, loss of appetite, insomnia or dream disturbed sleep, frustration, crying, anger, worry, sadness, melancholy.
Subjects in the acupuncture plus psychological intervention group received acupuncture once per day at a rate of five sessions per week for a total of six weeks. The acupuncture needles were 0.35 x 25 mm and were retained for 30 minutes during each acupuncture session. The acupuncture points used in the study were: Baihui (GV20), Sishencong (EX-HN1), Neiguan (PC6), Taichong (LR3), Sanyinjiao (SP6), Zusanli (ST36). Moderate needling techniques were applied to achieve deqi sensations and patient comfortability.
The researchers note, “By regulating the exciting and inhibiting process of the cerebral cortex via the nervous system and immune system, acupuncture is able to balance various neurotransmitters among the intracephalic neuronal synapses, reduce the brain’s reaction to stress, relax the stressful spirit, regulate and treat the physical symptoms and relieve the depressive and anxious state.” They mapped out the acupuncture point selection choices based on TCM theory and note, “Those acupoints in combination are used to correct deficiency and expel blood stasis for both causative factors and symptoms, in order to realize the effects to soothe the liver, regulate qi, wake up the brain and tranquilize the heart-mind.”
GV20 and Sishencong were chosen because, “The head is the gathering site of all yang and the house of the mind.” LI4 and LR3 is the classic Siguan point combination, often referred to as the four gates in English. The researchers note that both are yuan-primary points and together they regulate qi, blood, yin and yang. They also “soothe the liver and regulate qi, open the orifice and calm the mind.” PC6 was cited as a luo-connecting point that benefits heart qi and calms the mind. SP6 was chosen for its ability to access the three yin meridians of the foot and for its ability to regulate qi and blood. ST36 was chosen for its ability to benefit stomach qi, source qi and blood production.
The researchers contrasted integrative complementary medicine with a conventional drug therapy approach to care. Both approaches achieved similar positive patient outcomes. However, the acupuncture plus psychological intervention regime caused no adverse effects whereas the medication regime of care caused several adverse effects.
In related research, a meta-analysis of 87 papers published between 2002 and 2012 finds acupuncture effective in the treatment of labor pain and for the treatment of postpartum complications. Acupuncture was also found effective in inducing uterine contractions and shortening the birthing process. The report calls for continued research on acupuncture, herbal medicine and other forms of complementary medicine for the treatment of human reproductive issues.
An important study on acupuncture for the treatment of depression was recently conducted by University of York researchers. In a randomized controlled trial, the researchers note that acupuncture causes a “significant reduction in symptoms of depression in the short to medium term, and are not associated with serious adverse events.” The researchers conclude that acupuncture is both safe and effective as an adjunct therapy to primary care for patients with depression.
Acupuncture effectively treats posttraumatic stress disorder (PTSD). Researchers conducting a randomized controlled study of active duty US military service personnel concludes that acupuncture significantly improves patient outcomes for PTSD patients. Acupuncture also induced secondary improvements: reduced depression and pain, improved mental and physical health functioning.
The researchers note that there is underutilization of mental healthcare for PTSD patients. The research team notes that US military personnel have a 17% PTSD rate after combat deployment. However, research confirms that war veterans are reticent towards receiving medical care for PTSD.
The researchers note several examples of underutilization. An examination of Iraq and Afghanistan War veterans with PTSD, anxiety disorder or clinical depression finds that 81% acknowledge that they have mental health disorders. However, only 41% “reported interest in receiving help.” Only 30% sought professional help and 14% saw a mental health specialist. In addition, 25% of service members felt that mental healthcare does not work, 28% felt mental healthcare providers were untrustworthy and 41% felt that mental health treatment “would be embarrassing.”
A study of the general population reveals that only 7% of individuals with PTSD had initial contact with primary care treatment within the first year of illness. A national study reports that 59% of men and 26% of women “believed that PTSD treatment would not help.” The researchers note that acupuncture is “a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain….” They add that the underutilization of mental healthcare workers “suggests(s) that a novel and effective treatment option may help increase the proportion of those with PTSD who seek early treatment.” They note, “Acupuncture is a novel and therapeutic option that may help to improve population reach of PTSD treatment.”
The study concludes, “Acupuncture was effective for reducing PTSD symptoms.” The researchers determined that a brief course of acupuncture care “is an effective treatment adjunct for PTSD….” Patients using acupuncture combined with usual care “showed significantly greater improvements” over patients receiving usual care only. The researchers document, “The benefits associated with acupuncture were wide ranging and robust, yielding improvements in PTSD, depression, and pain severity of sufficient magnitude to benefit global mental and physical health functioning.”
The main goal of the study was to evaluate a short course of acupuncture care for military related PTSD. Patients in the study were active duty military members that were primarily recruited from clinics at the Walter Reed Army Medical Center. Other active duty patients included those from referrals. The study design was 8 acupuncture treatments over a 4 week period. Acupuncture in combination with usual care was compared with patients receiving usual care only without acupuncture. A 12 week follow-up documented significantly greater clinical improvements in the patients receiving the acupuncture combination therapy.
Acupuncture points were applied with filiform needles. Seirin brand J type needles of 0.14, 0.16, and 0.2 mm were used plus 0.2 mm L type needles. Acupuncture points used in the study included:
UB13, UB14, UB15, UB18m, UB20, UB23
Needle retention time was 15 - 30 minutes dependent upon the acupuncture point prescription.
In related research, acupuncture is found more effective than paroxetine (Aropax, Paxil, Sereupin) for relief of PTSD due to earthquake trauma. Researchers from the Chengdu University of Traditional Chinese Medicine and the Chengdu Military General Hospital conducted a randomized controlled clinical investigation of 138 patients with earthquake induced PTSD. Electroacupuncture was applied to the treatment group at GV20 (Baihui), Sishencong (Ex-HN 1), GV24 (Shenting) and GB20 (Fengchi). The medication group received oral administration of paroxetine. The medication group showed improvements. However, the reduction scores of PTSD including specific scores for anxiety and depression reduction were better in the electroacupuncture group than the paroxetine group. Based on this investigation, the researchers recommend further studies to measure the effects of electroacupuncture on PTSD patients.
Acupuncture for the treatment of concussions, insomnia, dizziness, headaches, and PTSD is used in the US military. Stars and Stripes published an article on this topic by Dr. Stuessi, a Navy sports medicine physician who works in a special concussion care center. He notes, “I’ve found phenomenal, off-the-charts results doing acupuncture for sleep, for dizziness and headaches.”
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