Acupuncture and moxibustion increases pregnancy rate in women undergoing IVF with failure of embryo implantation

In vitro fertilization (IVF) technique has helped millions infertile people have their children since its development in 1970s. It is estimated approximately 4 million children have been born by IVF treatment in 2010.  It brings happiness and joy to millions families worldwide. Although IVF technique has been greatly improved pregnancy rate remains near 30% and are considered low. Many unsuccessful IVFs brought tremendous stress, financial pressure on infertile couples. With the help of acupuncture as adjuvant more and more infertile couples have their dreams come true. Many studies investigated mechanisms underlying the important roles of acupuncture in IVF and suggested acupuncture regulating menstrual cycle and ovulation, increasing blood flow that helps endometrial receptivity, stimulation beta endorphin levels influencing the secretion of steroid hormones.

It has been reported that when embryo implantation, a critical stage of IVF, failed pregnancy rate was down to less than 10%. Recently it was shown that acupuncture plus moxibustion improved pregnancy rate of IVF when embryo implantation failed. In a randomized controlled clinical trial, 84 infertile patients with two unsuccessful attempts of IVF were divided into three groups, as acupuncture treated group, sham treatment group and control group. In acupuncture group, patients received moxibustion first at 9 acupoints then needling at 12 acupoints for 4 sessions. Patients in sham group received the needling at non acupoints. It was found that clinical pregnancy rate in acupuncture treated group was significantly higher than sham and control groups. The study suggests that acupuncture plus moxibustion as adjuvant increased pregnancy rate in infertile women undergoing IVF with the failure of embryo implantation.

Reference:

di Villahermosa et al., Acupunct Med 2013;31:157-161.  http://aim.bmj.com/content/31/2/157.short

Scalp acupuncture is very effective in halting progress of multiple sclerosis

Scalp acupuncture is very effective in relieving symptoms of multiple sclerosis and halting its progression. A case study is reported in journal Global Advances in Health and Medicine.

Multiple sclerosis (MS) is an autoimmune disease affecting nerve fibres in the brain and spine cord. In normal condition, nerve fibres are wrapped with a sheet called myelin which insulates the fibres from disruption and ensures the signal transduction. When something goes wrong with body’s immune system it attacks the healthy tissue, in this case, the myelin being worn down or destroyed. As a result, the exposed nerve fibres are less able to transmit signals between different parts of brain and spine cord. Subsequently symptoms occur in any part of the body, including blurring of vision, difficulty with mobility and balance, fatigue, muscle weakness and tightness, trouble with controlling urine and problems of cognitive and mood. Although the exact cause of MS is unclear many factors are believed to be involved in the development of MS, such as genetic factor, environmental effect, vitamin D deficit, viral infection. MS has basically two forms: relapsing form (occurring in isolated attacks) and progressive forms (building up over time). During course of disease, symptoms may go away completely, but permanent neurological conditions often occur, especially as the disease progresses. There is currently no cure for MS. The medications are effective in either alleviating certain symptoms or slow the progression of the disease. Approximately 50% of patients with MS use alternative medicines such as acupuncture to alleviate their conditions.

Dr. Jason Jishun Hao in the United States and colleagues reported a case study showing the beneficial effects of scalp acupuncture on a MS patient who had had MS for 20 years. The report said “The patient received scalp acupuncture once a week for 10 weeks, then once a month for six sessions. After the 16 treatments, the patient showed remarkable improvements. He was able to stand and walk without any problems. The numbness and tingling in his limbs did not bother him anymore. He had more energy and had not experienced incontinence of urine or dizziness after the first treatment. He was able to return to work full time. At this writing, the patient has been in remission for 26 months”.

This case study showed that scalp acupuncture is very effective in alleviating MS symptoms, halting the disease progression. This should encourage more studies with large sample size to explore full beneficial effects on patients with MS. 

Reference:

Hao JJ et al., Glob Adv Health Med. 2013, 2(1):8-13.  http://www.ncbi.nlm.nih.gov/pubmed/24278838

Acupuncture alleviates sciatica

Sciatica is a set of symptoms, including pain in the lower back, buttock and leg, numbness, tingling, muscle weakness around the leg and foot. The sciatica is caused by the irritation, compression or damage of the sciatic nerve. The slipped disc is the common cause of sciatica and other causes include injury, a narrow spinal canal, infection and a growth within spine such as a tumour.  Sciatica is different to other back pain and it radiates out from lower back, down the buttock and into the leg including calf. Sciatica pain ranges from being mild to severe and is often made worse by laughing, sneezing and bending backward etc. The sciatic nerve is derived from spinal nerves lumbar 4 through 5, sacral 1, 2 and 3; and innervates nearly the whole of the skin of the leg, the muscle of the back of thigh, and those of the leg and foot. So the areas affected by sciatica depend on affected nerve roots. For example, symptoms occurring in the thigh may indicate affected nerve roots being lumbar 4 and 5. Some cases of sciatica may come and go without the need of treatment. Most cases of sciatica can just be alleviated by painkillers. Management of chronic sciatica requires exercise therapy, analgesics, corticosteroid spinal injection and consideration of surgery. However the effectiveness of these therapies is inconclusive.

Acupuncture exerts analgesia by releasing of antinociceptive substance such as adenosine locally and endorphin centrally, reducing inflammation and promoting regeneration of sciatic nerve if it was damaged. Studies of acupuncture on back pain and chronic sciatica showed that acupuncture treatment is significantly better than no treatment and is as good as standard therapy. It is best to approach sciatica using a combined treatments including acupuncture, Tui Na (Chinese medical message), cupping and stretching. Overall, the treatments should relax and stretch the tendons and fascia while strengthening muscles, allowing back to naturally heal. Also practising tai chi, the Chinese exercise and meditation, is very effective to strengthen the lower back and relax it.

Reference:

Takano T et al., J Pain. 2012 Dec;13(12):1215-23.  http://www.ncbi.nlm.nih.gov/pubmed/23182227

Therapeutic benefits of acupuncture in post-stroke aphasia patients

Aphasia, the loss or impairment of language caused by brain damage, is one of the most common neurological symptoms after stroke. Approximately one in every three or four patients who have acute stroke will suffer from aphasia. Aphasia often results in significant disability and handicap. It is a major obstacle for patients to live independently in the community. While the main treatment for aphasia is speech and language therapies, the effectiveness of these conventional therapies has not been conclusively proved. Pharmacologic treatments involved in using drugs acting on catecholamine system such as bromocriptine and dexamfetamine. Those drugs are effective in alleviating some forms of aphasia after stroke but the adverse effects sometimes surpass their beneficial effects.

Acupuncture has been used in stroke rehabilitation in Asian countries for a very long time. Studies showed beneficial therapeutic effects of acupuncture on patients with acute stroke aphasia. Recently researchers in Hong Kong investigated the effects of acupuncture on chronic stroke aphasia and its underlying mechanisms using non-invasive technique, functional magnetic resonance imaging. They found a significant correlation between improved language scores and increased brain activity in speech areas in the damaged hemisphere in chronic stroke aphasia patients after 8-week acupuncture treatment. In another study, acupuncture stimulation at the language implicated acupoint Sanyangluo (SJ8) activated brain language areas of patients with chronic stroke aphasia whose language was improved assessed by word generation task tests.

These studies suggest acupuncture may exert its beneficial effects via its ability to activate specific brain language areas in chronic stroke aphasia patients.

Reference:

Chau ACM et al., J Acupunct Meridian Stud 2010;3(1):53−57.  http://www.ncbi.nlm.nih.gov/pubmed/20633517

Li G et al., Complement Ther Med. 2011, Suppl 1:S49-59.

http://www.ncbi.nlm.nih.gov/pubmed/21195295

Scalp acupuncture

Chinese scalp acupuncture is a contemporary acupuncture technique that has been established on the foundation of classic acupuncture, moxibustion and Western medical knowledge such as anatomy and neurophysiology. In china, five varieties of scalp acupuncture techniques are used in clinic practice. Scalp acupuncture is also popular in Japan, Korea and other East Asian countries.

Although the scalp has numerous traditionally identified acupoints along several major meridians, e.g. the governing vessel, bladder, gallbladder, stomach, triple warmer, modern scalp acupuncture differs from body acupuncture. Firstly, scalp is mapped to different treatment zones that associated with broad body regions and body functions. Although the zones include a few standard acupoints the concept of scalp acupuncture is based on treatment zones corresponding to relevant body functions and body regions and not based on meridians. Secondly, scalp acupuncture is more convenient as the patient can receive treatment at any position and is less pain than body acupuncture. Finally, for most conditions scalp acupuncture seems to be more effective.

Reference:

FC Wang ed. Scalp acupuncture therapy. Beijing: People's Medical Publishing House; 2007:4-7.

L Shoukang, Scalp acupuncture therapy and its clinical application, Journal of Traditional Chinese Medicine 1991; 11(4):272–280.

Wonder of the Shénmén (HT7) acupoint

Acupoint Shénmén (English translation: God Doors) locates at the wrist, palm side of the wrist, ulnar side stripes and is one of most common used acupoint at the hand Shaoyin meridian. The combination of Shénmén acupoint with other acupoints has been used to treat many conditions including insomnia, depression, anxiety, chest pain, epilepsy, arrhythmias, and hypertension.

It has been reported that the Shénmén (HT7) is one of favourite acupoint for the treatment of insomnia and other sleep disorders. Shénmén with Sanyinjiao (SP6), Neiguan (PC6) and Zhaohai (KI6) are very effective in improving insomnia.

For depression and anxiety, Shénmén acupoint in combination with Zusanli (ST36), Shenshu (BL23), Neiguan (PC6), Taiyang and Tongli (HT5) will reduce the levels of anxiety and depression even after one or two acupuncture sessions.

The Shénmén (HT7) with acupoints from the same meridian such as Lingdao (HT4), Tongli (HT5) and Yinxi (HT6) are often used to chest pain and arrhythmias.

Recently the Shenmen (HT7), Fenglong (ST40), Taixi (KI3) and Zusanli (ST36) acupoints are used to improve memory function in Alzheimer’s disease and dementia. The results are encouraging as cognitive function of patients with Alzheimer’s have been improved.

Xiangyun acupuncture

Acupuncture as an adjunctive treatment for cancer-induced bone pain

Pain caused by bone metastasis has several impacts on the quality of life of many patients with cancer. Adequate pain relief improves the quality of life and functional status. However conventional analgesia often has undesired side effects. For example, strong analgesics, namely opiates, are first-line therapy in alleviating caner-induce bone pain despite severe side effects, including enhanced bone destruction with sustained administration.

Recently Dr. Paley and colleagues in the UK discussed acupuncture treatment for cancer-induced bone pain by reviewing the physiological rational for using acupuncture to treat cancer-induced bone pain and the risk and benefits of acupuncture in clinical practice. They analysed the evidence from some major databases and found that

“Available physiological evidence supports potentially efficacious effects of acupuncture for reduction of CIBP. Clinical literature suggests that acupuncture may be effective as an adjunctive treatment for CIBP and that risks are manageable. However, there is a need for well-designed randomised controlled trials to investigate efficacy and effectiveness in patients”.

The report concluded that acupuncture could provide background analgesia or rapid onset analgesia for breakthrough pain.

Reference:

CA Paley (2011) Physiotherapy 97:256–263.  http://www.ncbi.nlm.nih.gov/pubmed/21820545

Acupuncture treatment for depression during pregnancy

Depression is a medical condition and results from a combination of factors such as life style, family history, personality and stressful events. Changes in brain chemistry such as neurotransmitters are believed to play a big role in depression. It is known that women are at greater risk of depression at certain time in their lives, such as puberty, during pregnancy, and during perimanopause. The hormonal and physical changes and added responsibility of new life can lead to postnatal depression, also called postpartum. It is characterized by feelings of sadness, indifference, exhaustion and anxiety. It affects approximately one in every ten women who have had a child. Pharmacologic treatments of depression during pregnancy increasingly raise the concerns about the safety for the developing foetus, and pregnant women are often reluctant to take antidepressant medication. Consequently there is a need for safe, effective alternative treatments for depression during pregnancy.

Dr. Manber and colleagues studied the therapeutic efficacy of acupuncture on pregnant women with depression. The results are particularly interesting. One hundred and fifty women were randomly assigned to 1 of 3 groups: (1) acupuncture, in which depressive symptoms were specifically addressed (n = 52); (2) valid controlled acupuncture, which was not specifically tailored for depression (n = 49); and (3) massage therapy (n = 49). The treatment consisted of 12 sessions (25 to 30 min each) over an 8-week period. Patients and the treating acupuncturist were blinded. Symptoms were assessed using the Hamilton Rating Scale for Depression-17 and Beck Depression Inventory. At the end of the treatment, women who received acupuncture specific for depression experienced greater rate of reduction in symptom severity compared with the control groups. They also had significantly greater response rate than control groups.

In conclusion, acupuncture treatment demonstrated symptom reduction and response rate comparable to those observed in standard medication. Acupuncture could be a viable treatment option for depression during pregnancy.

Reference

R Manber et al., (2010) Obstet Gynecol. 115(3):511-20. http://www.ncbi.nlm.nih.gov/pubmed/20177281

A simple way to relief hayfever symptoms

After one of the wettest January and February on record, many people are keen to enjoy the promise of warmer days in spring. However for people with seasonal allergies such as hayfever, they have to face the unpleasant prospect of itchy eyes and running noses which interfere with their daily life. Although medications such as antihistamines, eye drops and nasal sprays help alleviate the symptoms they can sometimes cause unwanted side effects, such as blurred eye vision, headache and stomach pain.

Massaging a few facial acupuncture points, however, can be useful to relieve hayfever symptoms. The first is the Cuanzhu (English translation: Bamboo Gathering), in the indentation of inner eye socket where the bridge of nose meets the ridge of eyebrows (A), should be pressed upward toward the top of the head. It is believed pressing this point helps relieve sinus pain, headaches, red and watery eyes, etc. The second acupoint is the Sibai (English translation: Four Whites), located below the pupil, in the depression at the infraorbiral foreman (B), and should be pressed downward toward the mouth. Pressing it helps relieve red, itchy and painful eyes, excessive lacrimation etc. The third is the Yingxiang (English translation: Welcome Fragrance), in the middle point lateral to the border of the ala nasi and in the nasolabial groove (C), should be pressed diagonally as if you are aiming your eye on the opposite side. Pressing this point helps clearing nasal congestion. It is better to practise acupoint pressing in the evening time, shortly before going to sleep. Just sit on the sofa or lie in the bed, using the fingers of both hands to press above acupoints with gentle force for one or two minutes. You can press all three points together or press one point each time; whichever is easier for you.

These acupoints have been used to effectively treat seasonal allergy for long time. The practise is cost free and has no side effects if you can manage to practise by yourself. 

2014 World Acupuncture & Integrative Medicine Conference in Houston

World Federation of Acupuncture – Moxibustion Societies (WFAS) Conference on Integrative Medicine to be held on November 1 & 2, 2014. The conference is jointly sponsored by the WFAS and the China Academy of Chinese Medical Sciences (CACMS); and jointly hosted by American College of Acupuncture & Oriental Medicine (ACAOM) and the City of Houston.

The theme of the conference is: East Meets West, Shaping the Future of Healthcare: Promoting global health and well-being through acupuncture and traditional Chinese medicine. The conference will focus on WHO’s " Beijing Declaration” proposal for the development of traditional medicine and WHA 62.13 of the World Health Assembly resolutions for promoting acupuncture, acupuncture legislation, acupuncture standards, acupuncture education, training and research and other aspects of academic exchanges, including develop the science of acupuncture-moxibustion, and assist in and strengthen the understanding and co-operation between international acupuncture-moxibustion societies.

All individuals with an interest in acupuncture and integrative medicine are invited to submit abstracts for oral and poster presentation. Abstract submission deadline is May 15, 2014. WFAS Houston 2014 will be held on October 31 – November 2, 2014, at the newly renovated Royal Sonesta Hotel in Houston, Texas, USA.

Acupuncture is an effective therapy for irritable bowel syndrome

Irritable bowel syndrome (IBS) is functional disorder of digestive system, commonly including abdominal cramps, bloating, diarrhoea and constipation. The condition often begins when a person is between 20-30 years of age. Women are more likely to develop IBS and often suffer more symptoms during their periods. Around 20% of people in the UK are affected by IBS. It is the most common functional digestive condition seen by GPs. Because it is typically a chronic and recurrent disorder the cost in terms of social, economic and health care utilization is substantial. 

The cause of IBS is unclear. Approximately 50% people with IBS can relate the start of symptoms to the stressful event. IBS symptoms tend to get worse during time of stress or anxiety. It is believed that hypersensitivity of sensory nerve in gut, infection in gut and intolerance of certain foods play important roles in the IBS. Reducing stress and anxiety, regular exercise, healthy diet and lifestyle tend to relieve IBS symptoms. Medications are necessary for some people with IBS to alleviate the symptoms; however, sometimes treatments are unsatisfactory.

Acupuncture is used to treat IBS in many countries including UK and its clinical efficacy of relieving symptoms in IBS was investigated. Recently an open pragmatic randomized controlled clinical trial was carried out by researchers in the Department of Health Science, University of York, UK. 233 patients with IBS, with average duration of 13 years were recruited and divided into two groups. 116 patients with IBS were given 10 weekly individualized acupuncture sessions, while 117 patients without acupuncture treatment as control group. The study showed that there was a significant reduction in IBS symptom severity score in patients within acupuncture group compared with control group by the end of treatment. The benefits of acupuncture lasted for further 9 months when the follow up tests were carried out at 6, 9 and 12 months. This study provides strong evidence suggesting acupuncture is very effective in treating IBS.

Reference:

H Macpherson et al., (2012) BMC Gastroenterology. 12:150.  http://www.ncbi.nlm.nih.gov/pubmed/23095376

Acupuncture therapy for Alzheimer’s disease

Alzheimer’s disease (AD) is the most common form of dementia. It was first described by German neuropathologist and psychiatrist Alois Alzheimer in 1906 and was named after him. AD is a neurodegenerative disorder and is recognized to progress through three stages: preclinical, mild cognitive impairment and dementia. In preclinical stage, the biomarkers such as plasma amyloid beta measurement can be used as prognostic marker. A recent study identified a set of lipid metabolites in blood plasma that showed 90% accurate prediction of those who would go on to show cognitive impairment within 3 years. In mild cognitive impairment, patients have cognitive deficits, where the memory of recent facts and spatial orientation is affected but not functional impairment. In AD dementia, a decline in two or more cognitive domains have gradually progressed to the points that functioning at work or daily activities such as speech is impaired. Currently there is no cure for the disease. The medication is only symptomatic relief with adverse effects.

In China acupuncture is utilized to enhance memory and recently is used to treat Alzheimer’s. Clinical studies recruited 20 AD patients reported that acupuncture stimulation at the Baihui (GV 20), Shenshu (BL 23), Xuehai (SP 10) and Geshu (BL 17) acupoints for 12 weeks was very effective in improving AD symptoms judged by the scores of Alzheimer’s Disease Assessment Scale-Cognitive Section. The biochemical study showed that the concentration of isoprostane, a marker for peroxidation of fatty acid, was significantly decreased in cerebrospinal fluid, blood and urine of patients with AD after acupuncture treatments. Although this study had a small sample size it showed acupuncture is a promising alternative therapy for Alzheimer’s disease.

Reference:

H Zhu (2010) Zhongguo Zhen Jiu. 30(1):18-21.  http://www.ncbi.nlm.nih.gov/pubmed/20353108

Possible mechanisms of acupuncture therapy in insomnia

Insomnia is a sleep disorder that millions of people worldwide have to live with. It is believed that at least a third of people in the UK have episodes of insomnia at sometimes of their life. Insomnia is often defined as difficulty initiating sleep, inability to go back to sleep and frequent waking up during the night. It can be either acute lasting one to several nights, or chronic, even last months to years. A lack of sleep can affect the mood and cause tiredness, fatigue and depression even injury during the day. Severe and chronic insomnia is worse enough to interfere with normal physical, emotional, mental and social functioning. It tends to be more common in women and more likely to occur with age, but more often the sleep disturbance is attributable to some medical conditions. So the first step in treating insomnia is to identify the underlying health problems, such as cold and allergies, high blood pressure and some pain medication, etc. Cognitive behavioural therapy may help some people avoiding the thoughts and behavioural affecting their sleep. Sleeping tablets are considered to be the last source of the treatment due to the side effects and drug dependent effects.

Acupuncture is commonly used to treat insomnia in China. The treatment not only improves sleep problems also treats some causes of underlying conditions, such as depression, anxiety and pain etc. Acupuncture research of insomnia found that acupuncture regulates different components of sleep-related neuron transmitters or mediators. Firstly, acupuncture regulated release of gamma-aminobutyric acid (GABA), a neurotransmitter, important in regulating sleep. Sleeping tablets such as benzodiazepine, zolpidem, and eszopiclone exerted their sleep enhancing effects by regulating GABA neurotransmission. Acupuncture stimulation at certain acupoints increased GABA release, acting as sleep tablet but without side effects. Secondly, it mediated melatonin release. Melatonin is a hormone, secreted from the pineal gland in the brain. Melatonin was reported to be involved in regulating the body’s circadian rhythm of sleep-awake cycle and played an important role in maintaining normal sleep. Clinical trials reported that melatonin was safe component and effective in treating primary insomnia. Acupuncture significantly increased nocturnal melatonin secretion in patients with anxiety, and this was associated with the significantly improvement in total sleep time and sleep efficiency. Thirdly, acupuncture regulated the endogenous opioidergic neurotransmissions which were involved in the mediating sleep-awake cycle. Finally, it is well-known that acupuncture treatment alleviates depression and anxiety and helps sleep. Together, scientific evidence supports acupuncture as an effective treatment for insomnia.

Reference:

K Zhao (2013) Acupuncture for the treatment of insomnia. In BY Zeng, K Zhao & FR Liang (Eds), Neurobiology of Acupuncture (Int Rev Neurobiol. Vol. 111: pp. 217-234). New York: Academic Press. http://www.ncbi.nlm.nih.gov/pubmed/24215925

Deqi sensation enhanced effectiveness of acupuncture treatment for facial paralysis

Facial paralysis is a common condition that involves the paralysis of any structure innervated by facial nerve. Bell’s palsy is the most common cause of acute facial paralysis. Patients experience facial weakness on affected side, loss of taste and sometimes inability to perform normal communications. The condition also affects the eyelid and mouth, making it difficult to open and close them. Patients are typically under great psychological stress in addition to their physical limitations due to this problem. The cause of Bell’s palsy is believed to be associated with inflammation of the facial nerve, possibly due to a viral infection, leading to its inability to control the facial muscles on the affected side.  The treatment of facial paralysis should be carried out in the early stage aiming at restoring the strength of facial muscles.

Effectiveness of acupuncture in clinical trials of many conditions such as back pain is not conclusive. One of the reasons is whether Deqi sensation is induced during acupuncture treatment. Acupuncture stimulation elicits a sensory sensation termed deqi which literally means “the arrival of vital energy” in traditional Chinese medicine. Multiple unique sensations experienced by the patients around the site of needle manipulation are described as tingling, soreness, fullness, aching, warmth and heaviness. A recent clinical trial involved 338 patients with Bell’s palsy in China. The patients were divided into the deqi group (needles were manipulated until deqi is reached) and control group (needles were not manipulated). The researchers reported that patients in deqi group showed better facial function, better disability assessment and better quality of life compared to the patients in control group and they conclude that acupuncture treatment with deqi sensation had a greater therapeutic effect because it may enhance excitability, flexibility and reactivity of the nerve system.

Reference:

SB Xu et al., (2014) CMAJ. 185(6):473-9.  http://www.ncbi.nlm.nih.gov/pubmed/23439629

Acupuncture helps relief hayfever symptoms

Hayfever suffers who is seeking alternative treatment should read the report from Daily Mail.


"Researchers at the University of Erlangen in Nuremberg, Germany, and the Charite University Medical Centre in Berlin, recruited 52 hayfever sufferers aged between 20 and 58."

"Half received a six week treatment regime that combined weekly acupuncture with herbal medicine every day, while the other half had needles inserted into non-acupoints and were given a non-active herbal formula.

The results showed that 85% of those on acupuncture and herbal medicine reported an improvement in well-being, compared to just 40% in the other group."

Read more: http://www.dailymail.co.uk/health/article-316088/Can-needles-help-hayfever.html#ixzz2vq1JaOdR 

Acupuncture treatment for trigeminal neuralgia

Trigeminal neuralgia is a neuropathic pain syndrome, characterised by severe stabbing or piercing pain in the face that comes on suddenly. The pain is almost on one side of the face and may last from a few seconds to several minutes and repeats up to hundreds of times throughout the day. The episodes of pain can be trigged by chewing, smiling, talking and shaving etc. Living with trigeminal neuralgia can be difficult and it can interfere with quality of life. In the UK, trigeminal neuralgia affects 4 to 5 people out of every 100,000 population each year. It occurs more frequently over the age of 50 and almost twice as many women as men. It has been described as one of the most painful conditions known to humankind. There is currently no cure. Although the exact causes are not always clear, trigeminal neuralgia is believed to be induced by compression of the trigeminal nerve or other relevant conditions. Medication normally provides temporary symptom relief. Surgical approaches have been performed for the relief of pain. However, invasive treatments have many adverse effects such as hearing loss or facial numbness.

Acupuncture has been reported to successfully treat a patient with resistant trigeminal neuralgia. A 66-year-old woman, with facial pain on the left side of her face for 25 years, was diagnosed with trigeminal neuralgia by a neurologist. The pain was evaluated using a visual analog scale (1-10). The patient rated her pain as 10 and experienced no beneficial effects from several approaches including medication, nerve block etc. The patient was given acupuncture treatment 3 times a week. She felt almost pain free after fourth session. By the end of 14 session treatments the patient was completely pain free (visual analog scale=0) and was still pain free at the end of sixth month. This study suggests that patients with resistant trigeminal neuralgia should seek after acupuncture treatment.

Reference:

H Sert et al., (2009) Clinics, 64:1225-6.  http://www.ncbi.nlm.nih.gov/pubmed/?term=sert+h%2C+trigeminal

Acupuncture reliefs hayfever symptoms

The spring is on its way. The warm air, fresh flowers and long days are coming. For some it is time to enjoy spring season. For others runny nose, itchy eyes etc are following. In the UK there are around 13 million people suffering from hayfever. Many hayfever suffers take antihistamines such as Claritin or use eye drops and nasal sprays to control the symptoms.

Hayfever can be dealt effectively with alternative approaches such as acupuncture. Acupuncture can prevent hayfever symptoms and chuck out them. It is better to go for acupuncture before symptoms kick in. However if the preventive window is missed acupuncture can still eliminate hayfever symptoms. It is common for people to notice an immediate relieving of blocked nasal passages after acupuncture treatment.

Acupuncture studies on allergic rhinitis reported that acupuncture stimulation reduces inflammation by promoting release of vascular immunomodulatory factors, and increase local microcirculation which helps dispersal of swelling. Clinical studies showed acupuncture has similar efficacy to antihistamines.

Refeence:

YQ Zhang (2009) J Tradit Chin Med. 29(3):186-9. http://www.ncbi.nlm.nih.gov/pubmed/19894382

CICM TCM Graduate Diploma Cours

Here ATCM office forwards you TCM Graduate Diploma course information offered by College of Integrated Chinese Medicine. The second intake of CICM’s Graduate Diploma in Chinese Herbal Medicine will start at CICM on 21st March 2014. This course is accredited by the ATCM Accreditation Board. For detailed information, please see the attached flyer. Anyone who may be interested please contact Charlotte Ribeiro (Chinese Herbal Medicine Course Registrar) on the College number (0118 950 8880) or Frances Turner (Chinese Herbal Medicine Course Director) on 07510 710245, or email her atfrancesturner.info@gmail.com.  Kind Regards ATCM OfficeThe Association of Traditional Chinese Medicine and Acupuncture UK314 Premier House112 Station RoadEdgwareHA8 7BJTel:  ++44(0)20 8951 3030Fax: ++44(0)20 8951 3030Email: info@atcm.co.uk Website: www.atcm.co.uk <http://www.atcm.co.uk/>

Acupuncture reduces high blood pressure

Approxiamately 25% of the adult population in the UK have hypertension (i.e. a blood pressure of 140/90mmHg or more), and over half of those over the age of 60s are affected according to the report published by National Clinical Guideline Centre in 2011. The prevalence is strongly influenced by age and lifestyle factors. Raised systolic pressure is the more dominant feature of hypertension in older patients, while raised diastolic pressure is more common in younger patients (i.e. those under 50 years of age). High blood pressure can be lowered by several classes of drugs and by such lifestyle changes as salt intake restriction, exercise and weight loss. Lifestyle interventions, however, are difficult to achieve and even more difficult to maintain. Drug therapy is costly, fraught with compliance, and accompanied by unwanted side effects.

Acupuncture is effective in lowing blood pressure. Professor Longhurst and his colleagues (Susan-Samueli Center for Integrative Medicine, University of California, USA) have focused on acupuncture blood regulation research over past 20 years. They found that acupuncture stimulation at acupoints such as Neiguan, Jianshi, Zusanli and Shangjuxu activated somatic input to different brain regions, leading to prolonged release of opioids and other neurotransmitters, and rebalancing autonomic outflow , guiding to a long-last reduction of blood pressure. Acupuncture treatment on above acupoints once weekly for two months appears to reduce blood pressure of subjects with mild to moderate hypertension. The response is slow in onset (occurring 2-4 weeks) and prolonged in duration, with decrease that can lasts days or weeks depending on how many times it is applied. Normally 1 or 2 times acupuncture treatment per month will maintain normal blood pressure after blood pressure of subject is back to normal.

   

Reference:

J Longhurst et al., (2013) Acupuncture Regulation of Blood Pressure: Two Decades of Research. In BY Zeng, K Zhao & FR Liang (Eds), Neurobiology of Acupuncture (Int Rev Neurobiol. Vol. 111: pp. 257-270). New York: Academic Press.
http://www.ncbi.nlm.nih.gov/pubmed/24215927

Acupuncture treatment for carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most common median entrapment neuropathy and occurs when the median nerve, which runs from forearm into the palm of hand, becomes pressed or squeezed at the wrist. The median nerve controls sensation to the palm side of the thumb and fingers (not the little finger), and impulses to some small muscles in the hand that allow the finger and thumb to move. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of hand – houses median nerve and tendons. Sometimes, thickening from irritated tendons or other swellings narrows the tunnel and causes the median nerve to be compressed. The results may be pain, numbness and weakness in the hand and wrist. Symptoms usually start gradually, with frequent burning, itching, and numbness in the palm of hand and fingers, especially the thumb, the index finger and middle finger. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrist. In chronic and/or untreated cases, some CTS suffers may not tell between hot and cold by touch. Conventional treatment for CTS includes non-surgical treatment such as nonsteroidal anti-inflammatory drugs, oral steroidal and injection of corticosteroids into neural wrist splinting. These medications normally provide temporal pain relief. However, symptoms generally reoccur within one year. Surgery is considered as a definitive treatment. Although symptoms may be relieved immediately after surgery, full recovery can take months. Some patients may have infection, nerve damage, stiffness and scare at the wrist. In addition, surgery drives up costs.

Acupuncture is used to treatment CTS for many years. Clinical studies reported that acupuncture treatment produced a significant improvement in symptoms, with effects similar to steroids treatment and night splinting.  The mechanisms underlying the effectiveness of acupuncture have been investigated using functional magnetic resonance imaging (fMRI), a non-invasive technique looking neuronal activity in the brain. fMRI imaging studies showed pain of CTS patients coincided with sensorimotor hyperactivation and an overlapping representation of adjacent fingers within the primary somatosensory cortex and changes in subcortical limbic regions. Following a 5 week course of acupuncture treatment, there is a significant reduction in pain and paresthesia in CTS patients and partial release from hyperactivation, and more focused somatosensory cortex finger representation. CTS patients demonstrated a more closely separated somatotopic representations for 2nd and 3rd fingers (both are innervated by median nerve) compared to healthy adults. After acupuncture treatment, the 2nd and 3rd fingers representation moved further apart, similar to the separation found in healthy adults. Further changes in limbic regions are restored following acupuncture.

The findings of study demonstrate that effectiveness of acupuncture to CTS is mediated by modulating cortical and subcortical brain activity.

Reference:

V Napadow (2007) Human Brain Mapping 28:159 –171.

http://www.ncbi.nlm.nih.gov/pubmed/16761270

Acupuncture, adenosine and back pain

Back pain is one of the most frequent complaints. It is reported that one third of the people living in the UK are affected by low back pain. In the UK back pain is estimated to cost the economy over £12 billion per year and place a huge burden on society. Back pain usually originates from the muscles, nerves, bones and joints or other structures in the spine. Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and range of motion, or an inability to stand straight. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

Although acupuncture is very effective in alleviating back pain in many patients its mechanisms of acupuncture-mediated analgesia has not been fully understood. It has been suggested that primary mechanism implicated in the anti-nociceptive effect of acupuncture involves release of opioid peptides in the central nervous system in response to long lasting activation of ascending tracts during intermittent stimulation. However, acupuncture is conventionally applied in close proximity to the locus of pain and analgesia is restricted to the ipsilateral side, indicating a peripheral and local action of acupuncture. Recent studies found that acupuncture stimulation at Zusanli on human subjects and pain models triggers increase in interstitial adenosine, a pain relieving substance, which reduce the severity of pain through activation adenosine A1 receptors. However acupuncture stimulation at the control point, 2 cm lateral to Zusanli acupoint did not elevate the interstitial levels of adenosine.

These studies together with other reports suggest that acupuncture stimulation at specific acupoints, on the one hand increase local adenosine level, on the other hand release opioid peptide in the brain, leading to the long lasting anti-nociceptive effect.

Reference:

T Takano et al., (2012) The Journal of Pain, Vol 13:1215-1223. http://www.ncbi.nlm.nih.gov/pubmed/23182227

Acupuncture-induced migraine relieving is related to acupoint specificity

Migraine is a chronic neurological disorder characterized by recurrent moderate and severe headache aggravated by stressors. The pain is usually pulsating and unilateral and is often accompanied by nausea, vomiting, phonophobia or photophobia. Migraine, occurring generally in younger people of working age, imposes significant economic, healthcare and social costs. Although many migraine patients benefit in some aspects the medication they also continue to experience discomfort, interference with activities of daily life, and other adverse effects from pharmacological treatments.

Acupuncture has been widely used to treat migraine in China. Acupuncture treatment is very effective in alleviating pain with minimal side effects and cost saving. Acupuncture-induced migraine relieving is now popular in Western countries. Many clinical studies focused on migraine have reported with mixed results. One of the key issues is acupuncture point specificity. Some clinical studies reported a definitive specific effect of alleviating migraine, while other studies showed non-specific effects of acupuncture on relieving migraine.

One of approaches to define acupoint specificity is brain imaging such as positron emission tomography combined with computed tomography (PET/CT) which exhibits specific neuronal activity following acupuncture stimulation. In a recent study, patients with migraine were enrolled to investigate acupoint specificity using PET/CT. Patients were divided into treatment group and control group. Patients in treatment group received stimulation at specific acupoints of Shaoyang meridians, which is traditionally used to treat migraine. In control group acupoints on Yangming meridians, which are less used for migraine treatment according to the theory of traditional Chinese medicine, were stimulated. At the end of treatment patients in treatment group showed greater pain reduction than patients in control group. PET/CT showed a higher brain metabolism in the middle temporal cortex and orbital frontal cortex and cerebellum in treatment group compared with control group. These findings are in favour of the functional specificity of migraine-treatment-related-acupoints.

Reference:

J Yang et al. BMC Complementary and Alternative Medicine 2012, 12:123.

http://www.biomedcentral.com/1472-6882/12/123

Acupuncture therapy for non-motor symptoms of Parkinson’s disease

Non-motor symptoms (NMS) of Parkinson’s disease (PD) are common but often are not well recognized in clinic practice due to the lack of spontaneous complaints from patients and of effective procedures of identification. NMS occurs throughout the course of the disease. Some of them, such as depression, fatigue and smelling dysfunction, may appear at the earliest stage of the disease in not treated patients. Others appear at the advanced stage of the disease. At the time of diagnosis, the prevalence of NMS among PD patients is 21% (pain, urinary symptoms, depression and anxiety) and goes up to 88% after 7 years disease progression. NMS of PD ranges from autonomic dysfunction, neuropsychiatric disorders, sleep disturbance to gastrointestinal syndromes and many others and are under-treated. Indeed, non-motor aspects of PD have greater influence on quality of life and institutionalization rates, and healthcare cost. In general NMS of PD respond poorly if at all to dopaminergic treatment, indicating the involvement of other neurotransmitters besides the dopamine.

Acupuncture including manual and electroacupuncture is effective in treat both motor symptoms and non-motor symptoms of PD. Studies about the mechanisms of acupuncture reported that acupuncture stimulation modulates the expression of neurotransmitters such as serotonin, glutamate and gammaaminobutyric acid etc in the brain.  Available clinic studies showed that acupuncture therapy significantly improves NMS such as depression, anxiety, insomnia, pain, orthostasis, constipation, fatigue and vomiting, leading to the improvement of quality of life in PD patients.

Reference:

Cristian A et al., Evaluation of acupuncture in the treatment of Parkinson’s disease: a double-blind pilot study. Movement Disorders, 2005, Vol. 20:1185-1188.
http://www.ncbi.nlm.nih.gov/pubmed/?term=cristian+a%2C+acupuncture

National Acupuncture Awareness Week: 3-10 March

This week is the National Acupuncture Awareness Week. I would like to offer free consultation through the e-mail or telephone. If there is any question you want to ask please send an e-mail to byzeng99@gmail.com or call 07565490748. 

Acupuncture therapy for drug-resistant epilepsy

Epilepsy is a neurological disorder where recurrent seizures are caused by abnormal electrical discharges from the brain and incurs devastating effects on both patients and their families. Most seizures can be controlled by a single antiepileptic drug. Unfortunately some patients require more than one antiepileptic medication to control their seizures. Drug-resistant epilepsy is a seizure that has failed to respond to at least one monotherapy treatment with a standard antiepileptic drug. Vagus nerve stimulation has been used to drug-resistant epilepsy. During the process of vagus nerve stimulation, the left vagus nerve was stimulated by an implanted electrode which sometimes causes the safety and practicability issues.

Acupuncture techniques can be classified in two major categories: one is non-invasive technique, including acupressure, auricular acupuncture and transcutaneous electrical stimulation; and the other is invasive technique, including needles and electroacupuncture. Recently as transcutaneous auricular vagus nerve stimulation is used as an alternative therapy for drug-resistant epilepsy. In a pilot study, 47 of 50 patients with drug-resistant epilepsy completed the 24-week treatment, during treatment 3 patients dropped off. After 8-week treatment 6 of 47 patients (12%) showed no seizure and 12 patients (24%) had reduced seizure frequency. By the end of 24-week treatment, 8 patients (16%) were seizure free and 19 patients (38%) displayed reduction in seizure frequency.

The results of the study showed that transcutaneous auricular vagus nerve stimulation, one type of acupuncture therapies, is effective in suppress epileptic seizures and is a safe and economical treatment option for drug-resistant epilepsy.

Reference:

P Rong et al., (2014) Chin Med J, 127 (2):300-304.
http://www.ncbi.nlm.nih.gov/pubmed/24438620

Acupuncture enhanced anti-parkinsonian effect of levodopa in patients with Parkinson's disease

Since its introduction in the 1970s, levodopa has remained the most effective treatment for the motor symptoms of PD. However, as PD patients receive chronic treatment with levodopa they gradually develop two main clinical phenomena: fluctuation in motor response and a variety of involuntary movements, known as levodopa-induced dyskinesia. The frequency of these motor complications has been estimated between 40-60%, after approximately 5 years of levodopa medication, but increase to 90% after 10 years of treatment.  Those adverse effects of levodopa medication are often disturbing and have huge impact on quality of life of PD patients. In China, combination of acupuncture and levodopa is often used to treat patients with PD. Many clinical studies reported that combined treatment had better therapeutic effects than levodopa treatment alone. The combined treatment showed prolonged and better alleviation of motor symptoms. 

Reference:

Chang XH et al., Observation on therapeutic effect of acupuncture combined with medicine on Parkinson disease. Zhongguo Zhen Jiu. 2008 Sep;28(9):645-7.   http://www.ncbi.nlm.nih.gov/pubmed/18822978