Latest Acupuncture News
- Acupuncture Plus Herbs Relieve Perimenopause Insomnia
- Acupuncture Lowers Anxiety & Pain After Mastectomy
- Acupuncture Improves Circulation
- Acupuncture & Herbs Relieve Arthritis and Diabetes
- Acupuncture Benefits Sleep, Reduces Stress
- Acupuncture Reduces Periodontitis Bone Loss
- Acupuncture & Herbs Raise IVF Live Birth Rate
Acupuncture Continuing Education News
Combining acupuncture with a special Traditional Chinese Medicine (TCM) herbal formula relieves perimenopausal insomnia. Acupuncture, as a standalone treatment modality, is found effective for the treatment of perimenopausal related insomnia in a recent study. However, when a special herbal formula was added to the treatment regime, the total effective rate increased significantly. Researchers conclude that acupuncture combined with herbal medicine “is a simple and effective clinical intervention for the patients with perimenopausal insomnia….”
The researchers note that acupuncture combined with the herbal medicine formula Zi Shen Tiao Gan Tang (kidney reinforcing and liver regulating decoction) demonstrates the ability to “regulate endocrine functions” and nervous system functions. The researchers add that the acupuncture plus herbal medicine treatment protocol outlined in the study helps patients “avoid side effects from sedatives” through the use of this effective alternative to drugs. The following are the effective rates, acupuncture points, and herbs used to achieve positive patient outcomes for patients with perimenopausal insomnia.
The total effective rate for acupuncture combined with Zi Shen Tiao Gan Tang was 96.83%. Using the same acupuncture point prescription without the use of herbal medicine achieved a 74.60% total effective rate. The total effective rate was broken down into three categories: cure, remarkable effect, effect.
A cure was defined as sleep time restoration to normal or sleep time exceeding six hours of sound sleep with the patient being “full of energy” after waking. A remarkable effect was defined as pronounced sleep improvements with an increase of sleep time by three hours. Effect was defined by sleep time increasing to a greater length than prior to the study but less than a three hour improvement. Acupuncture plus herbal medicine achieved a cure rate of 34.92%, a remarkable effect rate of 31.75%, and an effect rate of 30.16%. Acupuncture without the addition of herbal medicine achieved a 26.98% cure rate, a remarkable effective rate of 25.39%, and an effect rate of approximately 22.22%.
Acupuncture reduces anxiety and pain for breast cancer patients that have had a mastectomy or breast reconstruction surgery. Researchers from the Mayo Clinic (Rochester, Minnesota) conclude that acupuncture “significantly improves symptoms of postoperative pain, anxiety, and tension, and demonstrates a trend toward improved postoperative relaxation.” They add that “acupuncture can be integrated into a busy postsurgical clinical practice” and “acupuncture may be an important intervention in the postoperative setting for breast cancer patients.”
The Mayo Clinic researchers note that there are “several important implications” from the study. The researchers tested the feasibility of incorporating acupuncture into a postoperative medical setting for mastectomy and breast reconstruction patients. The results suggest that acupuncture is feasible in this environment and note that acupuncture “can be successfully incorporated into a busy postoperative clinical setting….” The researchers note, “it appears that acupuncture can be incorporated into a postoperative inpatient setting without disrupting patient care or activities of care team members.”
All patients in the study noted that it was worthwhile and no patients indicated dissatisfaction. The researchers note that there was “a high degree of participant satisfaction in acupuncture.” The Mayo Clinic researchers add that satisfaction levels indicate “the value of acupuncture for surgical patients….” The researchers note that acupuncture improves the quality of life for patients citing that “acupuncture can have favorable effects on anxiety, tension and postoperative pain….” They add that the “study’s results suggest that acupuncture can be integrated successfully ino the postoperative care of breast surgery recipients.”
The study’s acupuncture point prescription was protocolized to a standardized set of acupuncture points. The prescription was based on the Traditional Chinese Medicine (TCM) principles of calming shen, tonifying qi and blood, and moving qi and blood. Acupuncture points included:
- DU20 (Baihui)
- Ex-HN3 (Yintang)
- LI4 (Hegu)
- LI11 (Quchi)
- PC6 (Neiguan)
- SP10 (Xuehai)
- SP6 (Sanyinjiao)
- ST36 (Zusanli)
- LV3 (Taichong)
- GB40 (Qiuxu)
The researchers selected the acupuncture points for their ability to address several indications including: headache, nausea, vomiting, GI pain, and musculoskeletal pain. The points were also chosen to induce a calming effect for the relief of anxiety. Acupuncture needles were Seirin J-type of two sizes: 0.16 x 15 mm, 0.20 x 30 mm. Needles were inserted and the de qi sensation was induced by manual acupuncture techniques. The acupuncture points were applied by a licensed acupuncturist (Minnesota Board of Medical Practice) with a masters degree level of training and who is certified by the National Certification Committee for Acupuncture and Oriental Medicine (NCCAOM).
Acupuncture significantly enhances peripheral blood flow. Photoplethysmography results published in Electron Devices and Solid-State Circuits demonstrates that acupuncture induces “significant elevation of peripheral blood flow.” The research team making this discovery notes that a prior investigation using single-channel photoplethysmography demonstrates that acupuncture enhances “local microvascular blood flow in tissue surrounding Zusanli after acupuncture at that site.” The new research takes the investigation another step further. Using multi-channel photoplethysmography, the researchers demonstrate that needling acupuncture point ST36 (Zusanli) induces “significant elevations in whole body peripheral blood flow and parasympathetic activities after acupuncture at Zusanli.”
The ancient principles of traditional Chinese medicine (TCM) posit acupuncture as a means to regulate qi and blood flow throughout the body through a transporting network of meridians and acupuncture points along those meridians. The researchers note that the study “reinforces the theory of traditional Chinese medicine….” The researchers measured acupuncture’s ability to induce “significant elevations in peripheral blood flow over the upper and lower limbs during and after acupuncture.” Based on the findings, the researchers conclude that “the results of this study support the theory of Chinese medicine that acupuncture at Zusanli augments systemic gastrointestinal and circulatory functions.”
The researchers provide background concerning the need for this investigation. In 1996, the World Health Organization (WHO) denoted that acupuncture is beneficial in the treatment of 64 conditions including those involving pain, psychiatric concerns, neurological disorders, digestive imbalances, respiratory disorders, dermatological conditions, and gynecological diseases. They add that in Taiwan, acupuncture is commonly used for the treatment of many conditions including “stroke, dementia, Parkinson’s disease, epilepsy, Bell’s palsy, carpal tunnel syndrome, and headache.” The study was designed to clarify the mechanisms by which acupuncture exerts its effective actions.
Research finds acupuncture combined with herbal medicine effective for the treatment of rheumatoid arthritis. Acupuncture combined with the herbal formula Dang Gui Si Ni Tang resulted in a total effective rate of 93.75%. The research demonstrates that acupuncture combined with the herbal formula has a “significant curative effect on rheumatoid arthritis….” While these findings are hopeful, the 93.75% total effective rate represents all clinically significant improvements and does not represent a cure rate.
Dang Gui Si Ni Tang, translated as Angelica Decoction for Frigid Extremities, is a Traditional Chinese Medicine herbal formula included in the Shang Han Lun (Treatise on Cold Damage Disorders), written in 220 CE. In the book, the herbal formulation is recommended for patients with a sensation of chilled hands and feet combined with a small and weak pulse, which is attributed to an external weakness of yang.
Dang Gui Si Ni Tang is categorized as an herbal formula that warms the channels and disperses cold. The formula warms the channels, expels the cold, nourishes the blood, and invigorates blood stasis. Dang Gui Si Ni Tang contains:
- Dang Gui (Radix Angelicae Sinensis)
- Gui Zhi (Ramulus Cinnamomi)
- Shao Yao (Radix Paeoniae)
- Xi Xin (Herba Asari)
- Zhi Gan Cao (Radix Glycyrrhizae Preparata)
- Mu Tong (Akebiae Caulis)
- Da Zao (Fructus Jujubae)
Another study investigated Dan Gui Si Ni Tang’s therapeutic effects for diabetics. Patients with diabetic foot ulcers due to blood stasis or kidney yang deficiency were randomized into an herbal group and a drug group. The randomized-controlled trial selected patients from the Maoming Hospital of Traditional Chinese Medicine at the Guangzhou University of Chinese Medicine. The treatment group received a modified version of Dang Gui Si Ni Tang and the control group received treatment with cilostazol, a quinolinone derivative used to relieve symptoms due to peripheral vascular disease.
Acupuncture successfully improves sleep quality and reduces both stress and depression in the elderly. Published in Neuroscience Letters, researchers made this determination based on a randomized, placebo-controlled study. The researchers note that “the rigorous methodology employed in this study ensured the reliability of the results concerning the improved sleep quality and relaxation effects involved with acupuncture during aging.”
Acupuncture significantly improved the Pittsburg sleep quality index (PSQI) scores, indicating substantial sleep quality improvements. In addition, beck depression inventory (BDI) and the perceived stress scale (PSS) measures demonstrated significant clinical improvements. True acupuncture demonstrated significant positive patient outcomes for improvements in sleep quality and reduction of both depression and stress. The researchers note, “No significant changes were observed in the placebo group.” The researchers add that the strict controls employed during the study “demonstrate the real effects of acupuncture.”
Acupuncture was applied to elderly patients in a hospital outpatient setting. Licensed acupuncturists applied the acupuncture needles while patients rested in a supine position on a stretcher. Acupuncture was applied at a rate of twice per week for a total of 25 minutes of needle retention time per treatment session. Each patient received a grand total of 10 acupuncture treatments. Sterile disposable acupuncture needles were applied to acupuncture points:
- SP6 (Sanyinjiao)
- LI4 (Hegu)
- ST36 (Zusanli)
- LV3 (Taichong)
- PC6 (Neiguan)
- Ex-NH3 (Yintang)
Manual needle stimulation was applied to the needles frequently during each acupuncture treatment session. For the placebo-controlled sham acupuncture group, acupuncture needles were applied to areas of the body not associated with classic acupuncture points as defined by Traditional Chinese Medicine (TCM). In addition, the placebo-controlled group’s needles were applied to a superficial depth without needle stimulation.
The acupuncture point prescription choice was similar to a prescription in a related study. The researchers note that Sun et al. used acupuncture points including ST36, SP6, PC6, and LV3 in an investigation of acupuncture’s effects on major depressive disorder (MDD). The researchers note that Sun et al. “found similar antidepressant effects of electroacupuncture (EA) as compared to fluoxetine-treated patients.” Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. It is also known by its trade names including Prozac and Sarafem.
The researchers add that electroacupuncture “had a faster onset of action, better response rate, and better improvement rate than fluoxetine, indicating that acupuncture can be a good intervention method for ameliorating psychological distress and depressive symptoms, thereby promoting relaxation and well-being.” Although there were similarities to Sun et al., the sleep researchers employed manual acupuncture stimulation whereas Sun et al. employed electroacupuncture. This contrast demonstrates that both electroacupuncture and manual acupuncture have therapeutic value in the treatment of depression.
Acupuncture reduces tooth socket bone loss due to periodontitis. Researchers conducting a laboratory experiment on the effects of periodontitis discovered that electroacupuncture decreases periodontal tissue destruction and also reduces pro-inflammatory mediators and a key pro-resorptive factor. Histomorphometry and microtomography confirm that electroacupuncture effectively reduces bone loss in the alveoli, the jawbone sockets containing the roots of teeth. The research was published in the Journal of Periodontology Online, an official publication of the American Academy of Periodontology.
The researchers identified key biochemical reductions in pro-inflammatory mediators. Application of electroacupuncture decreased expression of IL-1β, a pro-inflammatory cytokine, which is a cell-signaling protein used in intercellular communication. Zhe Liu et al. also measured reductions in IL-1β caused by the application of acupuncture. In an entirely different experiment on a different set of acupuncture points, GV20 and GB7, Zhe Liu et al. found that acupuncture reduces IL-1β in the brain tissue region of a hematoma after a stroke.
The periodontal experiment conducted by Lisboa et al. examined the effects of electroacupuncture on laboratory mice with ligature induced periodontitis. Acupuncture points LI4 (Hegu), LI11 (Quchi), ST36 (Zusanli) and ST44 (Neiting) were applied. The researchers identified another pro-inflammatory modulator that was downregulated by the application of acupuncture at these points. Expression of MMP-8 decreased. MMP-8 is a protein active in the breakdown of extracellular matrixes.
About the Acupuncture Points
All acupuncture points chosen for use in the periodontitis study were selected from either the large intestine hand-yangming or stomach leg-yangming channels. The stomach leg-yangming channel traverses several areas related to oral health. The primary stomach channel begins beside the nose near the ala nasi at LI20 and ascends to the root of the nose where it intersects with UB1. Next, the channel descends along the lateral side of the nose and enters the upper gums. Then, it joins acupuncture point DU26 and circles back around the corner of the mouth, meeting CV24 at the mentolabial groove. From there, it follows the angle of the jaw and runs upward in front of the ear. Another branch separates on the lower jaw and descends along the throat and enters the supraclavicular fossa.
In vitro fertilization (IVF) live birth success rates may increase with traditional Chinese medicine adjuvant care, including both acupuncture and herbal medicine. In this retrospective cohort study, researchers reviewed 1,231 IVF patient records and compared live birth outcomes for patients receiving IVF only and patients receiving IVF plus Chinese medicine.
Acupuncture was combined with Chinese medicine dietetics, lifestyle, and nutritional recommendations, and if appropriate, Chinese herbal medicine. The research team used the term whole-systems traditional Chinese medicine (WS - TCM) for the integrated protocol. WS -TCM was compared with two groups: women who underwent usual IVF care, women who elected to have two standardized acupuncture sessions on the day of IVF embryo transfer. WS - TCM was associated with a significant increase in live births compared with both groups.
The live birth rate was increased in both fresh donor and non-donor IVF embryo transfers. In the cycles using donor eggs (N=162), patients who elected WS - TCM care had an 85.7% live birth rate. A live birth rate of 62.5% occured in donor IVF patients receiving only usual IVF care and a 59.5% live birth rate occurred in women who elected day of embryo transfer acupuncture. For women who did IVF with their own eggs (N=1,069), the WS-TCM group's live birth rate was 61.3% compared with 48.2% in the usual IVF care group and 50.8% in acupuncture group.
All integrated Chinese medicine treatments were individualized to each patient. The researchers note that Chinese medicine focused on regulating the menstrual cycle in four phases for the treatment of reproductive concerns: menses, follicular, ovulation, luteal. During the menstrual cycle, treatment focused on regulating the menses and alleviating dysmenorrhea. The follicular phase focused on regulating reproductive hormones plus endometrial and follicular development. The ovulation phase focused on ovulation induction and the luteal phase involves regulating hormones.
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.
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