Acupuncture effect is more sustainable than drug treatment in treating irritable bowel syndrome

When acupuncture was compared with medication in treating irritable bowel syndrome (IBS), it was found improvement induced by acupuncture was more significant and lasted markedly longer than medication. The study was published in the journal of China and Foreign Medical Treatment. 

IBS is a common, long-term condition that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhoea or constipation, or both. IBS is a chronic condition that you'll need to manage it for long term. The precise cause of IBS isn't known; however it is believed that it's related to increased sensitivity of the gut and problems digesting food. Conventional medication relieves symptoms but causes advertise effect if it is chronically used. Acupuncture has been used to help improve the symptoms of IBS for a long time in China.

A clinical study to compare the effectiveness of acupuncture with conventional medication was conducted with recruitment of 98 patients who suffered from type-D (diarrhea predominant) IBS, that were allocated into acupuncture group (n=49) and drug treatment group (n=49) respectively. In acupuncture group needles were applied on the following acupoints ST36, ST37, ST39, ST25 and CV4, once daily for consecutive 5 days (one course), then 2-day interval for total 4 courses.  Patients in drug treatment group were treated with the drugs flupentixol/melitracen (0.5/10 mg) and bacillus licheniformis (0.25 g) once daily for consecutive 4 weeks. Outcome measures included symptom scores and the total effective rates for each group. Symptom scores were used to assess loose bowel movements, frequency of bowel movements, and mucus in the stools. The total effective rates were calculated according to the degree of improvements. The cured, markedly effective, and effective cases were added together to calculate the total effective rate for each group. All measurements were monitored at the base line, the end of the treatment and 6 months after treatment.

The results showed that the acupuncture treatment had significantly greater relief, with a total effective rate of 97.96%, compared with 83.67% in the drug treatment group. Six-month follow up showed that only 6.12% of patients receiving acupuncture experienced recurrence of symptoms, compared with 24.49% in the drug treatment group.

The study indicated that acupuncture is not only more effective for relieving IBS symptoms but has more sustainable effect.

Reference:

Wang X, Therapeutic Effect of warm needle acupuncture on Diarrhea-Type Irritable Bowel Syndrome. China and Foreign Medical Treatment, 2018, Vol.29 pp.173-174.   https://www.healthcmi.com/Acupuncture-Continuing-Education-News/1972-acupuncture-beats-drugs-for-ibs-relief

Acupuncture is more effective than drug treatment in relieving gout symptoms

Acupuncture therapy is shown to be more effective than conventional medication for gouty arthritis in a clinical study which was recently reported in the journal of Chinese Medicine Report.

Gouty arthritis is caused by a build-up of a substance called uric acid in the blood, resulting in the formation of small crystal deposits in and around the joints. It's estimated that 1-2% people are affected by gout in the developed countries. Men over 30 and women after the menopause are more likely affected. Gout is seen more common in men than women. People with obesity, diabetes mellitus, hypertension, hyperlipidaemia, and chronic renal disease are prone to developing gout. Conventional medications help relief pain and reduce hyperuricaemia. However, long term use of such medications could cause many adverse effects. Acupuncture has been used to effectively treat gout for a long time.

A clinical study has been recently conducted to assess the efficacy of acupuncture on the gout in comparison with conventional medication. A total of 92 patients with acute gouty arthritis were recruited and randomly allocated to either acupuncture group (n=46) or the medication group (n=46). In acupuncture group the filiform needles were applied on the following primary acupoints bilaterally: Zusanli (ST36), Sanyinjiao (SP6), Yinlingquan (SP9), Quchi (LI11) and ashi points for 30 mins a day for 5 consecutive days, then 2-day break followed by another 5-day consecutive treatment. In addition some secondary acupoints were applied according to patient’s affected joints. In medication group, patients were given indomethacin enteric-coated 75 mg tablets twice daily for 10 days. The study’s outcome measures included a VAS (visual analog scale) for pain, serum levels of uric acid and pro-inflammatory chemokine interleukin 8 (IL-8), and monitored at the beginning and end of the study.

Results showed that mean VAS scores were 4.26 in the medication group and 4.31 in the acupuncture group before treatment. The scores fell to 1.61 and 0.78 respectively at the end of treatment, indicating significant decrease in pain in both groups. However, pain reduction in the acupuncture group is greater (p<0.05) than medication group. Mean uric acid levels were 519.92 µmol/L in the medication group and 525.06 µmol/L in the acupuncture group respectively before treatment. Uric acid levels fell to 437.28 µmol/L and 426.53 µmol/L respectively following treatment. Mean IL-8 levels were 38.24 µg/L in the medication group and 38.81 µg/L in the acupuncture group before treatment, then, IL-8 levels fell to 26.23 µg/L and 26.04 µg/L respectively after treatment. The clinical symptoms e.g. mean mobility scores were 1.57, redness and swelling were 1.92 and joint function was 1.63 in medication group before treatment. In acupuncture group corresponding scores were 1.59, 1.99, and 1.65 respectively before treatment. At the end of treatment, these scores fell to 0.89, 1.25, and 0.92 in the medication group and 0.56, 0.72, and 0.72 in the acupuncture group. Although both groups demonstrated improvements in clinical conditions, symptom relief was significantly greater in the acupuncture group (p<0.05) than that of medication group.

Present study demonstrated that acupuncture markedly improved clinical symptoms and reduced both serum uric acid and IL-8 levels in patients with gouty arthritis and offers an effective and well-tolerated alternative treatment for gout.

Reference:

Z Chen (2019) “Clinical Observation on Acupuncture Treatment of Acute Gout Arthritis” Chinese Medicine Research Vol.16(3) pp.75-78.

Acupuncture improves chemotherapy-induced hand-foot syndrome in cancer patients

Patients with rectal cancer treated with acupuncture showed a significant reduction in severity of chemotherapy-induced hand-foot syndrome compared with control group. The report was published in the World Journal of Acupuncture-Moxibustion.

Hand-foot syndrome (HFS) is also called palmar-plantar erythrodysesthesia. It is an adverse effect of some cancer chemotherapies. Hand-foot syndrome causes abnormal sensation, such as tingling, numbness, burning or itching on the palms and soles, as well as redness, swelling, and pain on the palms of the hands and/or the soles of the feet. Sometimes blisters appear. Hand-foot syndrome sometimes occurs elsewhere on the skin, such as the knees or elbows. But this is less common.

Relieving side effects is an important part of cancer care and treatment. Topical anti-inflammatory medications may help relieve some symptoms. In addition, the doctor may lower the chemotherapy dose or change your chemotherapy schedule, or even may need to temporarily stop your chemotherapy until the symptoms of hand-foot syndrome improve. This could significantly hamper the efficacy of chemotherapy. Acupuncture has been used to treat inflammatory-related conditions.

Recently a clinical study was conducted to assess effect of acupuncture on hand-foot syndrome induced by chemotherapy in patients with rectal cancer. A total of sixty patients with rectal cancer were enlisted and randomly divided into acupuncture group (n=30), and vitamin 6 group (n=30) as the control. The primary acupoints included GV20, LI4, TB5, ST36 and ashi points and supplementary acupoints included KD3, SP6 and GB34 when it is necessary. Acupuncture needles were applied on above acupoints and retained for 30 mins, daily for 2 weeks. Patients within control group took vitamin B6 (oral, 300mg) daily for a total of two weeks.

The primary outcome measures included the Common Toxicity Criteria of the National Cancer Institute of Canada (CTC) and the Karnofsky Performance Scale (KPS). The CTC grades symptoms using a scale of 1–4, with higher scores indicating increased severity. The KPS is on a scale of 0–100, with higher scores indicating an increased ability to perform daily activities and lower scores indicating increased levels of disability. Patients whose CTC scores were reduced to grade 1 following treatment, with a disappearance of symptoms and a KPS score of ≥ 90 were categorized as cured. For patients whose CTC scores were reduced to ≥ grade 1, with an improvement in symptoms, and a KPS score of 80–89, the treatments were categorized as effective. For patients showing no obvious improvements and had KPS scores of < 80, the treatments were categorized as ineffective. In addition, the QLQ-C30 (Quality of Life Questionnaire Core), a 30-item functional scale covering the areas of PF (physical function), RF (role function), CF (cognitive function), EF (emotional function), and SF (social function) were also monitored before and after the treatment.

The results showed that in the acupuncture group, there were 5 cured (16.7%), 16 effective (53.3%), and 9 ineffective (30%) cases, yielding a total effective rate of 70.0% for rectal cancer patients receiving chemotherapy. In vitamin B6 control group, there were 4 cured (13.3%), 7 effective (23.3%), and 19 ineffective (63.3%) cases, yielding a total effective rate of 36.7% for rectal cancer patients receiving chemotherapy. Positive outcomes with improvements in PF, EF, and CF were greater in the acupuncture group, being of statistical significance (p<0.05) compared with vitamin B6 group.

The data of this study suggests that acupuncture is an effective treatment for hand-foot syndrome, with the ability to alleviate symptoms and improve overall quality of life with rectal cancer patients receiving chemotherapy.

Reference:

F Li et al., Chemotherapy-induced hand-foot syndrome in rectal cancer treated with acupuncture. World Journal of Acupuncture-Moxibustion. 2018, Vol.28 pp. 151-155.     https://www.sciencedirect.com/science/article/pii/S1003525718301144

Acupuncture is very effective in improving essential tremor

Acupuncture with different techniques was used to treat essential tremor. Zone style scalp needling technique produced a 96% total effective rate, compared to conventional acupuncture which produced a 73% total effective rate, is more effective in improving essential tremor. The results of the clinical study were published in the Shanghai Journal of Acupuncture and Moxibustion.

Essential tremor is a neurological disorder that causes uncontrollable shake or tremble of parts of the body. The shake usually appears in hands first and, then gradually affects other parts of body such as arms, head, eyelids, other muscles and even voice box (larynx). The shake is more noticeable when the person is trying to hold a position or do something, such as drink or writes and can be triggered by anxiety, fatigue, caffeine, poor sleep. The cause of essential tremor is not clear, but  it is believed to be linked with genetic and environmental factors. Medications such as propranolol can reduce in tremor while produce adverse effects with long term use. Alternative treatment such acupuncture has shown its effective in help improve essential tremor with only minor side effects.

Dr. C Wang colleagues in Heilongjiang University of Chinese Medicine, China conducted a comparative study to assess the effectiveness of zone style scalp needling acupuncture and conventional scalp acupuncture in treating patients with essential tremor. Sixty patients with essential tremor were randomly allocated into two equal groups, one received zone style scalp acupuncture with body acupoints and the other receiving standard scalp acupuncture with body style acupoints.

In the zone style scalp acupuncture group, acupuncture needles were inserted over a wedge-shaped area around GV20 and MHN1 acupoints and applied bilaterally to the middle third portion of the chorea tremor control area. The needles were swiftly inserted at 30^o to a depth at the epicranial aponeurosis level. The twirling technique was applied at 200 per minute, two minutes per needle for scalp points. The complimentary body acupoints: GB20 (Fengchi), MHN9 (Taiyang), LI11 (Quchi), TB5 (Waiguan), LI4 (Hegu), GB31 (Fengshi), GB34 (Yanglingquan), ST36 (Zusanli), SP6 (Sanyinjiao), LV3 (Taichong) were inserted perpendicularly.

In conventional acupuncture group, following acupoints were applied: Chorea tremor control area, GV20 (Baihui), GV14 (Dazhui), GB20 (Fengchi), LI4 (Hegu), SI8 (Xiaohai), LI11 (Quchi), LI10 (Shousanli), TB5 (Waiguan). The needles were inserted perpendicularly and twirled slightly.

In both groups, acupuncture treatments were administered for 30 mins, once a day for six consecutive days, each week, for total four weeks. Essential tremor scores were assessed before and after treatment. A follow-up interview, three months follow-up after the end of acupuncture treatments, was used to assess relapse rates.

The data showed that zone style scalp acupuncture produced a 96% of the total effective rate, compared with 73% (P<0.05) of total effective rate by conventional scalp acupuncture. The relapse rate of the zone style scalp acupuncture group was 13.81% and was 45.5% for the conventional scalp acupuncture group (P<0.05) respectively. The clinical study suggested that zone style scalp acupuncture is more effective than conventional acupuncture in improving essential tremor.

Reference

C Wang & Z Zheng. Therapeutic Observation of Scalp Cluster Needling in Treating Essential Tremor. Shanghai Journal of Acupuncture and Moxibustion 10 (2017): 1216-1219.
https://caod.oriprobe.com/issues/1769687/toc.htm

Electroacupuncture helped improve bowel and bladder function in patients with transverse myelitis

Electroacupuncture was used to treat patients with transverse myelitis to help improve bowel and bladder functions. Results of the clinical study were published in the journal of Acupuncture in Medicine.

Transverse myelitis is a condition in which a section of the spinal cord becomes inflamed. This neurological disorder often damages the insulating material myelin, the covering for nerve cell fibers, disrupting the messages that the spinal cord nerves send throughout the body. As a result, communications between nerve cells in the spinal cord and the rest of the body can be interrupted. The exact reason for transverse myelitis is not know. There are many conditions that appear to initiate the disorder, including infection, multiple sclerosis etc. Symptoms of transverse myelitis range from back pain to more serious problems, such as paralysis or loss of bowel control and bladder dysfunction. There is no cure for transverse myelitis. The treatments to prevent or minimize the permanent dysfunction include corticosteroid, antiviral and other immunosuppressive medications. Alternative medications such as acupuncture have been used to enhance patient’s recovery.

Recently, a small clinical study was conducted to explore the effect of electroacupuncture on bowel and bladder function of patients with transverse myelitis. Sixteen participants were recruited. Electroacupuncture was applied at acupoints bilateral BL32, BL33, and BL35 for 30 min, once a day, five times a week for the first 4 weeks; and once every other day, three times a week for the following 4 weeks. Patients were then followed up for 6 months. Bladder and bowel function were assessed at baseline, 8-week after acupuncture and 6-month follow respectively.

Data showed that at baseline, all 16 patients had abnormal voiding and needed assisted measures >50% of the time to empty the bladders. Following 8-week treatment, five patients (31%) resumed normal voiding; six patients (38%) achieved partially normal voiding assisted by pressing the abdomen to empty the bladder without catheterization, and five patients (31%) didn’t show significant improvement. The residual urine volume (RUV) markedly decreased by 100 mL (IQR 53–393 mL) in nine patients with bladder voiding dysfunction. The number of weekly urinary incontinence episodes, 24-hour urinary episodes, and nocturia episodes per night statistical significantly diminished by 14 (95% CI 5 to 22), 5 (95% CI 1 to 9), and 4 (95% CI 0 to 7) episodes, respectively in 11 patients with urinary incontinence. Following 8-week acupuncture treatment to eight patients with faecal retention, four (50%) resumed normal bowel movements, three (38%) regained partially normal bowel movements, and one (13%) didn’t have any change.

It has been suggested that electroacupuncture stimulation at BL32 and BL33 might directly or indirectly involved in the S2–3 nerve roots, which are the parasympathetic centre of the spinal cord, innervate the muscles in the pelvic area, such as the pelvic floor, urethral sphincters, bladder and anal sphincter muscles. It is plausible that acupuncture stimulation at S2–S3 might enhance recovery of the muscle function.

The preliminary study showed that electroacupuncture might be a promising alternative for the management of bladder and bowel dysfunction in patients with transverse myelitis. Further studies with larger sample and randomized controlled trials are needed to validate the present results.

Reference

Wu J et al., Effects of electroacupuncture on bladder and bowel function in patients with transverse myelitis: a prospective observational study. Acupunct Med. 2018 Aug;36(4):261-266   https://www.ncbi.nlm.nih.gov/pubmed/29909400