Acupuncture add-on treatment improved both motor and non-motor symptoms in Parkinson’s disease

Acupuncture plus anti-parkinsonian drug significantly improved motor symptoms and non-motor symptoms in patients with Parkinson’s, and particularly efficacious at early stage of Parkinson’s. Acupuncture add-on treatment also markedly reduced nitric oxide level serum compared with anti-parkinsonian drug along group. A clinical study was recently reported in the journal of Evidence-Based Complementary and Alternative Medicine.

Parkinson’s is caused by the loss of dopamine and other neurotransmitters in central nervous system and is characterized by the motor dysfunction such as bradykinesia, resting tremor, rigidity and gait and postural imbalance. Although many non-motor symptoms developed before or parallelly with motor symptoms they were not always diagnosed and properly treated. Anti-parkinsonian drugs such as dopamine agonists are used to treat motor-related symptoms and have some severe side effects e.g. involuntary movement; while many non-motor symptoms were left untreated or mistreated, leading to significantly downgrad the quality of life of the PD patients. 

Acupuncture has been used to treat resting tremor and many motor and non-motor symptoms. However efficacy of acupuncture treatment in Parkinson’s is inconsistent and controversial.

Recently researchers led by Dr. Z Wei in China carried out a clinical study to assess the efficacy of acupuncture add-on in PD in particular to evaluate on both motor and non-motor effect. Fifty patients with Parkinson’s treated with levedopa were divided into acupuncture add-on group (n=30) and drug alone group (n=20). While all patients were continually taking their route anti-parkinsonian drug levedopa, patients in acupuncture add-on group were given electroacupuncture at bilateral GF20, LI4 and central DU14 and DU16 for 30 each time, once every 3 days. Ten-treatment was a course and two course in total within 2 months. Outcome measures for both motor-function (UPDRS III scores) and non-motor conditions such as depression and sleep disturbance and questionnaire for quality of life were assessed before and after the treatment.

Data showed that acupuncture add-on treatment significantly improved many motor functions such tremor, bradykinesia, and rigidity and non-motor conditions e.g. depression and sleep disturbance compared with drug alone group. Biochemical studies revealed that many inflammatory-related markers such as TNF-alpha,IL-1beta,and PGE2 were significantly reduced in acupuncture add-on group compared with drug alone group.

Authors concluded that acupuncture add-on is effective on most motor symptoms and some non-motor symptoms in particular at the early stage of Parkinson’s. Anti-inflammatory effect may be the underlying mechanism of acupuncture add-on treatment in Parkinson’s.

Reference:

F Wang et al., Effect and Potential Mechanism of Electroacupuncture Add-On

Treatment in Patients with Parkinson’s Disease. Evidence-Based Complementary and Alternative Medicine, Volume 2015, Article ID 692795,11 pages.     http://www.hindawi.com/journals/ecam/2015/692795/

Acupuncture improved the clinical pregnancy rate during IVF

Electroacupuncture stimulation enhanced the clinical pregnancy rate in patients with decreased ovarian reserve during IVF and embryo transfer cycles, according to a clinical study published in the Journal of Obstetrics and Gynaecological Research.

Although IVF is commonly used to treat infertility the success rate is not satisfactory. As many women, undergoing IVF treatment, had a decreased or diminished ovarian reserve. Ovarian reserve is a capacity of the ovary to provide egg cells that are capable of fertilization, resulting in a healthy and successful pregnancy. So improve ovarian reserve is very important to enhance pregnancy rate during IVF.

Recently a group of researchers in China conducted a clinical study to assess the effect of acupuncture on pregnancy rate in patients with decreased ovarian reserve during IVF and embryo transfer cycles. Two-hundred-forty patients were randomly allocated into acupuncture group, placebo group, artificial endometrial cycle treatment group and control group.

Electroacupuncture was given to following acupoints: RN3, RN4, DU3, DU4, SP6, ST25, BL23 and EX-CA1; for 30min, once a day during ovulation cycle until the day of egg retrieval. Outcome measures include pregnancy-related perimeters such as, AFC, basal estradiol (E2) level, basal FSH level, basal luteinizing hormone (LH) level, AMH level, FSH/LH ratio, ovarian artery resistance index (RI), ovarian artery pulsatility index (PI), and systolic/diastolic flow velocity ratio (S/D).

At the end of treatment, if was found that the number of egg cells retrieved and average number of embryos transferred were higher in the acupuncture group and artificial endometrial cycle group than those of control groups. Antral follicle count and anti-Müllerian hormone levels were increased, whereas the estradiol level, follicle-stimulating hormone level, and follicle-stimulating hormone/luteinizing hormone ratio were significantly decreased following acupuncture and artificial endometrial group compared with control groups.

The study showed that electroacupuncture enhanced pregnancy rate in patients with decreased ovarian reserve during IVF and embryo transfer cycle.

Reference

Zheng Y, et al., Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles. J Obstet Gynaecol Res. 2015 Oct 12. doi: 10.1111/jog.12810.  http://www.ncbi.nlm.nih.gov/pubmed/26455718

Acupuncture at forbidden acupoints may not be harmful during pregnancy

A review article regarding safety of obstetric acupuncture stated that acupuncture at forbidden acupoints does not increase the risk of adverse pregnancy outcome in controlled clinical trials. The paper was published in the journal of Acupuncture in Medicine.

It has long been regarded that some acupoints, such as, SP6三阴交, BL27小肠俞, BL28膀胱俞, BL29中膂俞, BL31上髎, BL32次髎, BL33中髎, BL60中髎, BL67至阴 should not be used during pregnancy. These acupoints are called “forbidden” acupoints because they are historically believed to be abortifacient among traditional acupuncture practioners. However, the forbidden acupoint argument is not widely upheld by the practioners of Western medical acupuncture, assumed that the concerns are historical rather than evidence-based.

Recently Dr. DJ Carr in London, Britain reviewed scientific evidence concerning forbidden acupoints to help acupuncture practioners and researchers to make decisions regarding their use.

He collected the data from 1). A total of 15 clinical trials (n=823 women, n=4549–7234 treatments), following acupuncture at one or more forbidden points. 2). Observational studies, including one particularly large retrospective cohort of 5885 pregnant women needled at forbidden points at all stages of pregnancy, 3). Systematic review and meta-analysis of trials of acupuncture for term labour induction and scrutiny of case series of miscarriage and IUFD indicate there is no reliable evidence that acupuncture/EA at forbidden points can induce miscarriage or labour even under favourable circumstances. 4). Laboratory experiments on pregnant models have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption.

The review study suggests that 1). Acupuncture at forbidden points is not associated with increased rates of adverse pregnancy outcome in observational studies. 2). Acupuncture at forbidden points does not induce miscarriage or labour. 3). Acupuncture at forbidden points does not cause harm to pregnant models.

Reference:

DJ Carr, The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med 2015;0:1–7. doi:10.1136/acupmed-2015-010936.   http://aim.bmj.com/content/early/2015/09/11/acupmed-2015-010936.abstract

Acupuncture enhanced therapeutic effect of speech-therapy in patients with stuttering

In stuttering patients, laser acupuncture treatment could help maintaining the therapeutic effect of speech-therapy and reduce stuttering relapsing; according to a recent clinical study which was published in the journal of Advanced Biomedical Research.

Stuttering is a speech disorder in which sounds, syllables or words are repeated or prolonged, disrupting the normal flow of speech. These speech disturbance may accompanied by struggling behaviours, such as rapid eye blinks or tremors of lips. Stuttering can make it difficult to communicate with other people, which often affect person’s quality of life. Although the cause of stuttering is not clear around 9% of people with a family history of stuttering are link with genetic alternation. Stuttering may occur after a stroke, head injury or other type of brain trauma. The common approach for stuttering treatment is speech-therapy, which is effective in many cases but is tend to relapse in some cases. 

Recently a clinical study was conducted to assess the effectiveness of laser acupuncture on patients with stuttering. Twenty patients with stuttering were randomly divided into acupuncture plus speech-therapy group (n=10) and speech-therapy alone group (n=10). Single blind laser acupuncture was given at following acupoints: H5, LI4, P6, SI17, St9, CV23, CV24, and EX5 for 30 seconds. Outcome measures included by the percentage of stuttered syllables (% SS) and the speech rate based on the number of syllables per minute (SPM), which were evaluated before, immediate after laser acupuncture and 3 month after intervention.

It was shown that laser acupuncture enhanced effect of speech-therapy judged by the improvement of percentage of SS and SPM compared with speech-therapy alone treatment. Laser acupuncture helped reduce the relapsing of stuttering 3 month after treatment compared with control group.

The study showed that in patients with stuttering laser acupuncture improved the effect of speech-therapy and reduced relapsing of stuttering during follow-up observation. However, more studies with bigger sample sizes and improvement in study design are needed to confirm the effectiveness of acupuncture on stuttering.

Reference

B Shafiei et al., Determining the effect of laser acupuncture in treating stutterers in comparison with speech therapy. Adv Biomed Res. 2015; 4: 8.    http://www.ncbi.nlm.nih.gov/pubmed/25625114