Acupuncture Continuing Education

Acupuncture News and Research

 

Memorial Sloan Kettering Cancer Center (New York, USA) and University of York (York, UK) researchers conclude that acupuncture is “more effective than both usual care and sham acupuncture” for the treatment of chronic pain. The researchers state that their conclusion is based on “robust evidence from high-quality trials on acupuncture” with a sample size of approximately 18,000 patients. Specifically, the researchers find acupuncture effective for alleviating pain due to knee osteoarthritis, low back pain, headaches, and migraines. [1] They add, “Acupuncture was also found to be better than standard medical care for all of these chronic pain conditions.” Moreover, the researchers find acupuncture a cost-effective treatment modality for the alleviation of both knee pain and depression. The researchers note, “Our research also provides a valuable basis for considering the potential role of acupuncture as a referral option in health care and enabling providers and policy-makers to make decisions based on robust sources of evidence.” [2]

 

Acupoint LI11 (Quchi)Patient receiving acupuncture therapy

 

Health Policy
Cost efficiency can have a dramatic impact public policy in regards to healthcare recommendations. The efficacy of acupuncture has been well studied for a variety of conditions but its cost efficiency has widely overlooked. To that end, the National Institute for Health Research (UK) conducted a massive meta-analysis in which they examined the efficacy and cost efficiency of acupuncture for a range of conditions: musculoskeletal pain of the neck and low back, osteoarthritis of the knee, headache and migraine, and depression. They synthesized data for nearly 18,000 patients with chronic pain and depression and found that acupuncture was more effective than both sham acupuncture and usual care for all the conditions studied. In addition, when considering high quality studies, acupuncture was found to be cost efficient for osteoarthritis of the knee. In a randomized controlled trial of acupuncture and counseling in comparison to standard care for the treatment of depression (in which half the patients experienced comorbid pain), the researchers found that acupuncture is equally effective as counseling and that acupuncture is more cost efficient than counseling. These results provide policymakers and healthcare professionals a more nuanced perspective for recommending acupuncture as an alternative or adjunct treatment for chronic pain and depression. 

Researchers demonstrate that acupuncture is an effective treatment for migraines. The results of their investigation were published in JAMA Internal Medicine (Journal of the American Medical Association). The investigation reveals that acupuncture reduces migraine attack frequency, duration, and intensity. True acupuncture was compared with sham acupuncture and only true acupuncture reduced migraine recurrence rates. Importantly, the effects of true acupuncture provided long-term clinical benefits to migraine sufferers, including lower pain intensity levels and a shorter duration of suffering per each attack.

 

GB8 (Shuaigu) 

 

The researchers find that, “True acupuncture exhibited persistent, superior, and clinically relevant benefits for migraine prophylaxis, reducing the migraine frequency, number of days with migraine, and pain intensity to a greater degree than SA [sham acupuncture] or WL [wait list].” They add that acupuncture produced an additional benefit. Patients receiving true acupuncture demonstrated significant improvements in the “emotional domain of quality of life.” The research team concludes, “Acupuncture should be considered as one option for migraine prophylaxis in light of our findings.” The title of the work in JAMA Internal Medicine was entitled The long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial

Researchers find acupuncture effective for the alleviation of constipation. Zhejiang Tongde Hospital researchers tested the validity of an ancient acupuncture point prescription used for the treatment of constipation with a controlled scientific clinical experiment. The researchers find acupuncture “increases the contractile activity of intestinal smooth muscle and benefits bowel movements.” The researchers add that acupuncture “significantly improves CSBMs [complete spontaneous bowel movements] for patients with severe functional constipation.” The Zhejiang Tongde Hospital findings were published in research entitled Electroacupuncture in Treating Severe Functional Constipation: A Randomized Controlled Trial.

 

Acupuncturist needling acupoint ST25 (Tianshu)Acupuncturist needling ST25 (Tianshu) 

Seventy humans participated in the study. All participants suffered from functional constipation. This is a form of constipation without a known organic etiology. Functional constipation is characterized by two or less defecations per week, fecal incontinence, painful or hard bowel movements, large diameter stools, or volitional stool retention. 

Researchers find acupuncture effective for the treatment of post-stroke upper limb spasticity. A combination of scalp and body style acupuncture reduces muscle tension and spasticity of the upper limbs for stroke patients. In a protocolized study from Tianjin University of Traditional Chinese Medicine, researchers determined that integrated application of both scalp and body style acupuncture point prescriptions produces significant positive treatment outcomes among post-stroke patients with upper limb spasticity. After completion of acupuncture therapy, Ashworth scores (spasticity measurements in patients with central nervous system lesions) significantly improved.

 

Upper body acupoints 

 

Tianjin University of Traditional Chinese Medicine researchers (Wang et al.) compared the efficacy of two approaches to patient care. They determined that upper limb spasticity acupuncture treatments are more effective when conventional body style acupuncture is combined with scalp acupuncture. Clinical results demonstrate that using only body style acupuncture is not as effective as the combination of scalp and body style acupuncture. Ashworth scores improved for all acupuncture patients; however, patients receiving both scalp and body style acupuncture demonstrated significantly greater improvements on the Ashworth scale. 

Harvard Medical School, Massachusetts General Hospital, and Beth Israel Deaconess Medical Center (Boston) researchers find acupuncture effective for the treatment of carpal tunnel syndrome, an entrapment neuropathy affecting the arm, wrist, and hand. Results were published in Brain, a journal founded in 1878 that is dedicated to the publication of landmark findings in both clinical neurology and translational neuroscience. Additional members of the research team hailed from Logan University (Missouri), Korean Institute of Oriental Medicine (Daejeon, South Korea), Spaulding Rehabilitation Hospital (Medford, Massachusetts), and Harvard Vanguard Medical Associates (Boston, Massachusetts).

 

LI4 (Hegu) for CTS 

 

The research team used subjective and objective instruments to measure patient outcomes. The Boston Carpal Tunnel Syndrome Questionnaire assessed pain and paraesthesia. Nerve conduction studies assessed median nerve improvements. Brain imaging data using fMRIs (functional magnetic resonance imaging) was used to measure somatotopic arrangements. Somatotopy maps the correspondence of specific points on the body to specific areas of the brain and other areas of the central nervous system.

Researchers find acupuncture effective for the treatment of chronic bronchitis. Shijiazhuang Hospital of Traditional Chinese Medicine researchers determined that acupuncture increases immunoglobulin production and stabilizes overall health for elderly patients suffering from chronic bronchitis. Immunoglobulins function as antibodies, which are immune system proteins in the blood that counteract antigens (e.g., viruses, bacteria, toxins, foreign substances). The researchers subjectively and objectively determined that a specific combination of acupuncture points alleviates chronic bronchitis. The acupuncture point prescription employed in the study relieves symptoms and clinical improvements are quantifiable with blood assays.

 

Back Shu acupoints

 

Liang et al. (Shijiazhuang Hospital of Traditional Chinese Medicine) conducted a protocolized investigation on the clinical efficacy of Feishu (BL13) and Sihua (Four Flower) acupuncture for elderly patients with chronic bronchitis. Sihua (four flower) acupuncture refers to the application of acupoints Geshu (BL17) and Danshu (BL19) during an acupuncture session. Liang et al. determined that acupuncture enhanced immunoglobulin levels while simultaneously providing significant clinical improvements.

Acupuncture relieves pain due to shingles, reduces the need for painkillers, speeds the healing of herpes zoster lesions, and reduces the incidence of postherpetic neuralgia (PHN). Tianjing University of Traditional Chinese Medicine researchers combined acupuncture with standard drug therapy. Patients receiving both drug therapy and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients using only drug therapy.

 

Jiaji acupoint applied to human 

 

Three month follow-up examinations determined that the incident rate of postherpetic neuralgia plummeted to 3.33% in the group receiving acupuncture plus drug therapy. The group receiving only drug therapy had a PHN incident rate of 30%. The addition of acupuncture to the treatment protocol decreased the PHN rate by 26.67%.

Researchers find acupuncture effective for the alleviation of tinnitus. This is significant given the intractability associated with this disorder. A research team in Sichuan, China, achieved significant positive patient outcomes by employing the use of electrical stimulation to acupuncture points. Compared with conventional manual acupuncture therapy, the addition of electroacupuncture to the treatment protocol increased clinical effectiveness for the treatment of tinnitus by 25.1%. Conventional manual acupuncture achieved a 64.5% total effective rate; however, electroacupuncture achieved an 89.6% total effective rate.

 

Ear Sanjiao on a Doll

 

The Sichuan research team cited prior research and Traditional Chinese Medicine (TCM) theory as the basis for the development of their electroacupuncture clinical protocol. Zhang et al. identified acupuncture point Tinggong (SI19) as an important area for the treatment of tinnitus in prior research. The Sichuan researchers included SI19 in the study because the work of Zhang et al. finds SI19 effective for benefitting the ears, reducing tinnitus, improving conduction in the auditory nerves, and because electroacupuncture creates rhythmic contractions of the muscles in the region of the ear to promote circulation and subsequent delivery of nutrients to the hearing system.

Acupuncture is effective for the treatment of polycystic ovarian syndrome. Researchers find acupuncture effective for normalizing hormone levels and improving the overall health of patients with polycystic ovarian syndrome. Scientific data demonstrates that acupuncture produces significant improvements in menstrual regularity, restores ovulation pattern regularity, increases pregnancy rates, regulates hormonal secretions, normalizes basal body temperature patterns, and increases embryo survival rates. Fertility enhancements provided by acupuncture apply to both natural conception and IVF (in vitro fertilization) patients.

 

Back shu points on a woman 

 

Research published in the Shanghai Journal of Acupuncture and Moxibustion entitled Advances In Clinical Research On Acupuncture Moxibustion Treatment For Polycystic Ovarian Syndrome cites several clinical studies. Let’s take a look at the finings. Chen et al. applied stimulation with acupuncture at sacral plexus acupoints and paraspinal acupoints. Acupuncture treatment sessions were regularly administered over the course of three menstruation cycles. Upon completion of all acupuncture therapy, follow-up examinations (including ultrasound imaging) demonstrated significant improvements in menstrual regularity, ovulation frequency, and cervical mucus consistency. In addition, the pregnancy rate of patients in the study increased significantly. 

Shanghai University of Traditional Chinese Medicine researchers find acupuncture effective for the treatment of insomnia. Results were obtained by implementing a protocolized acupuncture point prescription combined with moxibustion and TDP heat lamp therapy. After one week of therapy, acupuncture with moxa and TDP produced a 67.5% total effective rate for the relief of insomnia. After two weeks, the total effective rate increased to 77.5%.

 

HT7  (Shenmen), PC6 (Neiguan)

 

The researchers compared results with another treatment group receiving Traditional Chinese Medicine (TCM) herbal therapy. Participants in the herbal medicine group received of modified version of Gui Pi Tang or An Shen Ding Zhi Tang, dependent upon differential diagnostics. The herbal medicine group achieved a 32.5% total effective rate after one week. After two weeks, the herbal medicine group had a 52.5% total effective rate.

Acupuncture plus herbal medicine regulates heart beats and improves patient outcomes for patients taking drugs. Researchers from the Tianjing University of Chinese Medicine tested the efficacy of combining acupuncture and herbs with drug therapy. The addition of the Traditional Chinese Medicine (TCM) therapies increased positive patient outcomes by 28% for patients with tachycardia, arrhythmias, and palpitations.

 

Needles and herbs

 

The researchers tested the drug metoprolol tartrate (brand name Lopressor) in combination with acupuncture and herbs. Drug therapy, as a standalone treatment, produced a 64% total effective rate. Adding acupuncture and herbs to the treatment regimen increased the total efficactive rate to 92%.

Researchers find acupuncture effective for increasing bone strength and preventing bone loss. In a laboratory investigation, electroacupuncture significantly enhanced outcomes by increasing the efficacy of physical therapy procedures. The application of electroacupuncture significantly improved bone density and strength when engaging in load-bearing exercises and treadmill running exercises. Based on the results of the study, the researchers conclude that acupuncture significantly increases bone strength and density, stimulates peripheral nerve repair, and increases the effectiveness of physical therapy procedures.

 

Back Needles on Shu Points 

 

Researchers at Washington University (St. Louis, Missouri), in association Heilongjiang University (Harbin, China), find electroacupuncture with load-bearing exercise is effective for increasing bone mass density (BMD) and bone strength after sciatic nerve injury. Their laboratory tests, conducted on rabbits, also show that levels of the neuropeptide Substance P (SP) were increased in correlation with bone health by application of electroacupuncture. This study shows that damage to the peripheral nervous system (PNS) can have a detrimental effect on bone health, and that electroacupuncture at Huatuojiaji (Jiaji) points enhance the effects of load-bearing exercise for the improvement of bone health and peripheral innervation. 

The American College of Physicians formally recommends acupuncture for the treatment of back pain. Published in the prestigious Annals of Internal Medicine, clinical guidelines were developed by the American College of Physicians (ACP) to present recommendations based on evidence. Citing quality evidence in modern research, the ACP notes that nonpharmacologic treatment with acupuncture for the treatment of chronic low back pain is recommended. The official grade by the ACP is a “strong recommendation.” [1]

 

Seirin needles with electroacupuncture stimulation of the lower back 

 

A major goal of the recommendation is for acupuncture and other nonpharmacological therapies to replace drug therapy as a primary source of pain relief. Treatment with opioids is only recommended, with an official “weak recommendation,” when other modalities do not provide adequate relief. A strong recommendation is also made by the American College of Physicians for the treatment of both acute and subacute lower back pain with heat, massage, acupuncture, and spinal manipulation. [2] The recommendations were approved by the ACP Board of Regents and involves evidence based recommendations from doctors at the Penn Health System (Philadelphia, Pennsylvania), Minneapolis Veterans Affairs Medical Center (Minnesota), and the Yale School of Medicine (New Haven, Connecticut). 

Researchers confirm that acupuncture is more effective than two drugs (ibuprofen and diclofenac) for long-term relief of knee osteoarthritis pain, inflammation, and motor impairment. In one investigation, acupuncture plus herbal medicine outperformed acupuncture plus ibuprofen for pain relief. In another independent investigation, acupuncture outperformed diclofenac for relief of pain, inflammation, and motor impairment due to knee osteoarthritis. Let’s take a look at both investigations.

 

Knee needle insertion at ST35. 

 

Acupuncture plus herbs outperforms ibuprofen for the alleviation of knee pain, inflammation, and dysfunction. Guangxi Lingshan County Hospital of Traditional Chinese Medicine researchers investigated the benefits of drugs, electroacupuncture, and herbal medicine for the treatment of knee osteoarthritis. The results of the randomized-controlled clinical trial finds acupuncture plus herbs more effective than the ibuprofen (a nonsteroidal anti-inflammatory drug) plus acupuncture protocol. 

Acupuncture benefits memory, learning, and the brain in an Alzheimer’s disease study. In a controlled experiment, researchers discovered two important clinical benefits provided by stimulation of scalp acupuncture points; acupuncture improves spatial learning and memory. Additionally, the researchers discovered that acupuncture improves brain glucose metabolism. Let’s take a look at the results.

 

Human brain illustrated 

 

Researchers at the Beijing University of Chinese Medicine demonstrate that electroacupuncture improves spatial memory and learning in mice with Alzheimer’s disease (AD). [1] To test electroacupuncture’s effectiveness for the treatment of Alzheimer’s disease and its related upregulation of glucose metabolism in the hippocampus, the researchers chose three scalp acupuncture points. All three acupoints affect the Governing Vessel (Du Mai), an acupuncture channel traditionally used to nourish the spine and brain in Traditional Chinese Medicine (TCM). [2] The findings were published by Cao et al. in the Frontiers in Aging Neuroscience journal

Researchers find acupuncture equally effective for the treatment of hypertension as the drug nifedipine, a pharmaceutical medication used for the treatment of high blood pressure and angina. Nifedipine is a calcium channel blocker that relaxes the heart muscles and blood vessels. Researchers at the Jiaozuo Tongren Hospital compared the effects of acupuncture therapy with the administration of nifedipine for the immediate reduction of high blood pressure levels in patients with primary hypertension. In the Jiaozuo Tongren Hospital randomized-controlled clinical trial, both acupuncture and nifedipine successfully reduced blood pressure by 30 – 40 mmHg. [1]

 

SP10 in the Vastus Medialis 

 

The researchers determined that acupuncture and nifedipine provided different advantages for the management of hypertension. Data points measured immediate and short-term benefits of both therapies. At the 5, 10, 15, and 20 minute data points after treatment, nifedipine produced lower systolic and diastolic blood pressures. However, at the 30 and 60 minute data points after treatment, there was no statistical difference between the effects of acupuncture and nifedipine for both systolic and diastolic blood pressure management. 

Researchers find acupuncture and herbs effective for improving acute appendicitis patient outcomes. An emergency medical condition often requiring an appendectomy, acute appendicitis may alternately be treated with drug therapy under controlled conditions in a hospital setting. Fujian University hospital researchers combined acupuncture and herbs with standard drug therapy. The addition of acupuncture and herbs to the drug therapy treatment protocol increased the total effective rate by 23.69%. In addition, adverse affects due to medical intervention dropped to 7.89% from 28.95% with the addition of acupuncture and herbs to the treatment protocol. Based on the data, the researchers conclude that the addition of acupuncture and herbs to drug therapy is safe, effective, and reduces iatrogenic complications for patients with acute appendicitis. [1]

 

Extra Point Lanweixue 

 

Patients receiving only drug therapy had a 71.05% total treatment effective rate. However, that number improves to a 94.74% total treatment effective rate when acupuncture and herbs are added to the treatment protocol. Drug therapy produced 17 patients that were completely cured and 10 patients improved significantly. The study group receiving drug therapy plus acupuncture and herbs had a total of 29 patients that were completely cured and 7 patients significantly improved. 

Researchers find acupuncture combined with clomiphene more effective than clomiphene plus supplementary hormonal pharmaceuticals for the treatment of infertility. The combination of acupuncture plus clomiphene produces significantly higher pregnancy rates for women with anovulatory infertility than clomiphene plus estradiol cypionate and dydrogesterone. The data was published in the report entitled Effects of Acupuncture on the Endometrium in Anovulatory Cases Treated by Clomiphene: A Clinical Observation.

 

CV6 and Moxa

 

The addition of acupuncture to clomiphene therapy increased pregnancy rates, lowered the resistance and pulsatility indices of the uterine arteries, and reduced the adverse effects caused by clomiphene. The increase in positive patient outcomes combined with reductions of adverse effects supports the research team’s (Taian Maternal and Child Health Care Hospital) conclusion, “TCM [Traditional Chinese Medicine] can be either applied alone or combined with Western medicine to up pregnancy rates and treat infertility. With the help of TCM [i.e., acupuncture], treatment for infertility can be more effective while producing much less adverse effects.” [1] 

Acupuncture successfully alleviates depression when combined with moxibustion. Guangzhou University of Chinese Medicine researchers (Second Affiliated Hospital) determined that acupuncture plus moxibustion provides both short and long-term benefits for patients suffering from depression. The university researchers discovered that traditional manual acupuncture stimulation increases the rate of positive patient outcomes. When manual acupuncture techniques were used to elicit deqi at the acupoints, the total treatment efficacy rate significantly improved.

 

Back Shu Points

 

Deqi encompasses a specific set of sensations elicited by manual acupuncture stimulation. The researchers determined that achieving the arrival of deqi sensations produces superior patient outcomes for patients suffering from depression. In addition, true acupuncture was found effective and sham acupuncture did not produce significant positive patient outcomes. The sham controls eliminated concerns regarding the placebo effect and confirmed the validity of the true acupuncture results. 

Acupuncture reduces inflammation and researchers have discovered how it works. In a laboratory controlled scientific investigation, a key biological marker has been identified, quantified, and directly correlated with the application of acupuncture. Acupuncture successfully downregulates a proinflammatory biochemical (tumor necrosis factor alpha), which results in anti-inflammatory responses. In addition, the researchers have mapped the neural pathways by which acupuncture signaling stimulates anti-inflammatory effects.

 

TNFa22Crystal Structure of TNF-α  

Researchers in Korea have identified a mechanism by which acupuncture stimulation at the acupoint ST36 (Zusanli) has an anti-inflammatory effect. By downregulating tumor necrosis factor alpha (TNF-α), acupuncture relieves systemic inflammation. By testing the effects that a splenic neurectomy and vagotomy have on TNF-α levels in the spleen and the brain, Lim et al. found that the anti-inflammatory effects of ST36 (Zusanli) rely on the vagus nerve pathway. Both manual acupuncture stimulation (MAC) and electroacupuncture (EAC) induce c-Fos protein generation. However, only manual acupuncture stimulation has the effect of downregulating TNF-α; electroacupuncture has the opposite effect when applied to ST36.