This blog is to share the latest research and development of acupuncture and raise the awareness of alternative treatments for your conditions, and is for information only.

Thursday 15 December 2016

Acupuncture is very effective in treating trigger finger

Trigger finger, also known as stenosing tenosynovitis, is a painful condition in which one of your fingers gets stuck as it bents towards the palm. Recently it was reported that acupuncture could significantly improve symptoms of trigger finger after a few sessions of treatment. The clinical study was published in the journal of Acupuncture in Medicine.
Trigger finger occurs when the affected finger's tendon sheath becomes irritated and inflamed that narrows the space within the sheath that surrounds the tendon in the affected finger. This interferes with the normal gliding motion of the tendon through the sheath, leading your finger become locked in a bent position. People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. Treatment of trigger finger varies depending on the severity and includes avoiding activities that causes pain, a small splint to hold the finger at the night, local steroid injection and surgery. However, results of therapies are not all satisfactory.
Recently Dr. Inour and colleagues in Japan conducted a small clinical study to assess the effect of acupuncture performed at the synovial and ligamentous tendon sheath (A1 pulley site) on pain during snapping and the severity of the snapping phenomenon in patients with trigger finger. Acupuncture was performed on 19 fingers of 15 patients. Acupuncture needles were inserted into the radial and ulnar sides of the flexor tendon at the A1 pulley of the affected finger. Treatment was performed daily up to a maximum of five times. Before and after each treatment, pain during snapping and the severity of snapping were evaluated using a visual analogue scale (VAS).
It was found that VAS scores for pain and snapping severity were significantly improved immediately after the first treatment and reached statistical significance from the second treatment onwards. Similarly, a significant improvement in the severity of snapping was observed from the second treatment. Patients with clinically significant improvements had a significantly shortened duration of the disorder.
Authors proposed that acupuncture may reduce inflammation/swelling of the synovial membrane of the tendon sheath and could be effective alternative treatment for patients with trigger finger.
Reference
M Inour et al., Acupuncture for the treatment of trigger finger in adults: a prospective case series. Acupunct Med doi:10.1136/acupmed-2016-011068.   https://www.ncbi.nlm.nih.gov/pubmed/27401746  

Thursday 1 December 2016

Acupuncture promoted activity of hippocampal neural stem cells in Alzheimer’s model.

Acupuncture stimulation at specific acupoints improved cerebral microenvironment and promoted the proliferation and differentiation of transplanted hippocampal neural stem cells (NSCs) and improved cognitive function of Alzheimer’s model. It has been reported in journal of Molecular Neurobiology.

NSCs, with the potential for neural regeneration, represent a promising clinical strategy for Alzheimer’s. However, under the influence of the host microenvironment, only few grafted NSCs survive, proliferate, and differentiate into functional neural cells, which eventually results in decreased anti-dementia efficacy.

Recently, Dr. Lan Zhao and colleagues in China conducted a study to evaluate whether acupuncture will improve host microenvironment grated with NSCs in Alzheimer’s model. Acupuncture stimulation was applied, 24 hrs after hippocampal NSCs transplantation, at CV17, CV12, CV6, and bilateral ST36 acupoints for 30 s daily for 15 days. Five days after acupuncture, behavioural tests showed that acupuncture significantly improved cognitive functions compared with control group. Biochemical studies revealed that acupuncture markedly increased expression of neurotrophic factors, such as basic fibroblast growth factor, epidermal growth factor and brain derived neurotrophic factor in the hippocampal tissues compared with control group, indicating that acupuncture improved hippocampal microenvironment leading to better survival, proliferation and differentiation of hippocampal NSCs, resulting in improved cognitive function.

Reference
Zhao L, et al., Acupuncture Improves Cerebral Microenvironment in Mice with Alzheimer's Disease Treated with Hippocampal Neural Stem Cells. Mol Neurobiol. 2016 Aug 24. [Epub ahead of print]      https://www.ncbi.nlm.nih.gov/pubmed/27558235

Friday 18 November 2016

Mechanisms underlying effect of GB34 acupoint in Parkinson’s disease

Although both clinical observation and model studies showed that stimulation of GB34 acupoint improved motor function in Parkinson’s, its mechanism behind is unclear. Very recently two reports of PD model studies shed the light on the question.

Dr. Tian and colleagues in China investigated the effect and mechanism of stimulating GB34 in PD model. They observed first that there was an aggregation of toxic protein, alpha-synuclein closely linked to PD, in the dopamine cells in the brain of PD model. Stimulation at GB34 promoted the autophagic clearance of alpha-synuclein, in a manner different from mammalian target of rapamycin (mTOR)-dependent pathway. Further improvement in the motor function at the behavior level of model was observed. Authors suggested that connection between acupuncture and autophagy not only provides a new route to understanding the molecular mechanism of acupuncture treatment in Parkinson’s.

Later, Dr. Park and colleagues in Korea conducted a series of in vitro and in vivo studies of Parkinson’s. Firstly they found that melanin-concentrating hormone (MCH) in hypothalamus of brain is a neuroprotective agent, then that MCH protected dopamine cells in both vitro and vivo studies. Further stimulation at GB34 activated hypothalamic MCH biosynthesis which can be blocked by MCH-R1 antagonist, then releasing MCH-activated MCH receptors (MCH-Rs) in the dopamine terminals, and showed dopaminergic neuroprotection. MCH is an important metabolic hormone that reportedly influences sleep control and affects learning and memory. About 80 % of patients with PD experienced sleep disturbances, and they showed substantial losses of MCH neurons in the hypothalamus. Moreover, this loss of MCH neurons has been significantly correlated with the clinical stages of PD and regarded as hypothalamic dysfunction in PD. This study suggested that acupuncture stimulation at GB34 activated MCH may play an important role in neuroprotection of Parkinson’s.

References
Tian T et al., Acupuncture promotes mTOR-independent autophagic clearance
of aggregation-prone proteins in mouse brain. Sci Rep. 2016 Jan 21;6:19714.    http://www.nature.com/articles/srep19714

Park JY et al., Novel Neuroprotective Effects of Melanin-Concentrating Hormone in Parkinson’s Disease. Mol Neurobiol. 2016 Nov 14.  https://www.ncbi.nlm.nih.gov/pubmed/27844281

Monday 31 October 2016

Mechanisms of electroacupuncture reducing hypertension

Although acupuncture was effective in lowing blood pressure in hypertension, its mechanisms of action is not clear. Very recently a study in hypertension model showed that electroacupuncture-induced increase in mRNA level of preproenkephalin in the rostral ventrolateral medulla is closely associated with significantly decreased blood pressure. The report was published in journal of Scientific Reports.

Dr. M Li and colleagues in the USA investigated the mechanisms of action of electroacupuncture in lowing blood pressure in hypertension model. Electroacupuncture was applied at ST36-37 acupoints overlying the deep peroneal nerve for 30 min twice a week for five weeks. Elevated blood pressure was markedly reduced after six sessions of treatment and remained low 72 hrs after electroacupuncture compared with control groups. Biochemical studies found that mRNA level of preproenkephalin in the brain area called rostral ventrolateral medulla was significantly increased in those electroacupuncture-treated hypertension model. Further, microinjection of ICI 174,864, a δ-opioid receptor antagonist, into the rVLM of electroacupuncture-treated hypertension model partially reversed effect of electroacupuncture on increased blood pressure. This suggested that blood pressure lowing action of electroacupuncture was very closely linked to the elevated levels of preproenkephalin in the brain rostral ventrolateral medulla of hypertension model.

Reference

M Li et al., Repetitive Electroacupuncture Attenuates Cold-Induced Hypertension through Enkephalin in the Rostral Ventral Lateral Medulla. Scientific RepoRts| 6:35791 | DOI: 10.1038/srep35791.   http://www.nature.com/articles/srep35791

Sunday 16 October 2016

Acupuncture is very effective in treating primary headache disorders

Recently a review paper by Drs. Coeytaux and Befus found that acupuncture treatment is quite effective in treating migraine, tension-type headache and several different types of chronic headache disorders. The study was published in journal of Headache.

Drs. Coeytaux and Befus reviewed many systematic reviews and meta-analyses studies, including three arguably most important and informative systematic reviews of effectiveness of acupuncture for primary headache disorders and papers showing that acupuncture was superior to sham acupuncture for relieving pain and reducing the use of medication for acute migraine attacks.

They found that there is a sufficient number of published trials that showed acupuncture is effective as an adjunct to usual care in the management or prevention of common headache disorders compared with usual care only, medication management and sham acupuncture 2 month after treatment, although the outcome of the longer-follow-up was mixed. Further, growing literatures presented that acupuncture is a cost-effective in the Germany and United Kingdom.

The authors suggested that additional sham controlled trials are not likely to definitively clarify the extent to which nonspecific effects contribute to observed clinical benefit associated with acupuncture. “This area of research and practice would be well served by comparative effectiveness, safety, or cost-effectiveness trials. Such trials could provide clear guidance to patients and their healthcare providers who seek to better understand what benefits, potential harms, and economic costs they might expect from acupuncture relative to other therapeutic approaches for treating or preventing migraine, tension-type headache, medication overuse headache, or other common headache disorders.”

Reference
RR Coeytaux & D Befus, Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40.    https://www.ncbi.nlm.nih.gov/pubmed/27411557

Saturday 1 October 2016

Acupuncture treatment markedly improved psoriasis – a case report

Acupuncture treatment significantly improved psoriasis in a patient who suffered the upsetting skin condition for 20 years. A case reported was recently published in journal of Acta Dermatovenerologica Croatica.

Psoriasis is an autoimmune and recurring condition that caused raised, red and scaly patches to appear on the skin. Conventional treatments such as topical, phototherapy and systemic approaches help to keep the condition under control. However the outcome is not always satisfactory and often associated with long-term adverse effect.

Recently Dr. Darija Mahović and colleague in Croatia reported a case of acupuncture treatment to a patient with severe psoriasis and chronic migraine. The patient was given acupuncture on the head, arms and legs for 30 min once a day for 10 days with interval of 2-3 days between treatments. Patients did not use any specific topical anti-psoriatic treatment during acupuncture. Patient stated that very soon after each acupuncture treatment she noted a significant improvement regarding psoriasis lesion and “she has not had such a good skin for a long time”. Meanwhile, patient’s chronic migraine was markedly relieved following acupuncture treatment.

Authors suggest that dermatologists should be informed about the potential of acupuncture for psoriasis treatment.

Reference
D Mahović & F Mrsić, Acupuncture as a Complementary Method of Traditional Psoriasis Treatment: Myth or Reality? Acta Dermatovenerol Croat. 2016;24(3):221-222.     . https://www.ncbi.nlm.nih.gov/pubmed/27663925

Monday 19 September 2016

Acupuncture improved MCI in patients with post-cerebral infarction

Acupuncture in combination with nimodipine showed a sustainable improvement of cognitive function in patients with post-cerebral infarction. It was reported in journal of BMC Complementary and Alternative Medicine.

Patients with cerebral vascular disease such as stroke often develop cognitive dysfunction ranging from mild cognitive impairment (MCI) to dementia. It was reported that nearly 50% of patients developed MCI within four years after stroke. Clinical studies showed that cholinesterase inhibitors donepezil, galantamine, and rivastigmine produced some beneficial effect in patients with MCI. However none of them was approved for the treatment of vascular cognitive impairment due to the uncertain effect of drugs. Acupuncture has been used to treat cognitive impairment in China for a long time.

Dr. S Wang and colleagues in China conducted a randomized clinical study to assess the efficacy and safety of acupuncture alone or in combination with nimodipine to treat cerebral infarction-induced MCI. A total of 126 patients with post-cerebral infarction MCI were recruited and randomly divided into 3 groups, nimodipine alon group (30 mg/time and 3 times daily), acupuncture alone group and acupuncture combined nimodipine group. Patients were assessed with Montreal Cognitive Assessment (MoCA) scale before treatment, at the end of 3-month treatment and post-treat 3-month follow-up. Acupuncture stimulation was manually applied at following acupoints: DU20, EX-HN1, ST2, GB20, GB12, BL10, DU26, HT7, PC6, ST40, SP6 and LR3, 30 min each time, 6 times a week for 3 months.

At the end of study, all three treatment groups showed a significant improvement judged by MoCA scale compared with respective baseline; however, the significant improvement was markedly higher in combination group compared nimodipine alone and acupuncture alone group. Further, at the 3-month follow-up the sustained improvement was more significant in combination group compared other two groups. No adverse effect was reported with three groups at the end of study.

The study suggested that acupuncture could be used as an adjunct therapy to drug treatment to further improve cognitive function in patients with post-infarction.

Reference:
S Wang et al., Efficacy and safety assessment of acupuncture and nimodipine to treat mild cognitive impairment after cerebral infarction: a randomized controlled trial. BMC Complementary and Alternative Medicine (2016) 16:361.   http://www.ncbi.nlm.nih.gov/pubmed/27623621

Wednesday 31 August 2016

Acupuncture could become a valuable addition to oncology

Recently a group of scientists and clinicians in Poland studies many clinical trials about the effectiveness of acupuncture therapy to cancer patients with different conditions. They suggest that acupuncture could be a route addition to cancer treatment. The study was published in journal of Contemporary Oncology.

The scientists and clinicians looked at effect of acupuncture on different conditions including nausea and chemotherapy-induced vomiting, cancer pain, chemotherapy-induced leucopoenia, radiation induced xerostomia, hot flushes, anxiety-like behavioural and stress, chemotherapy-induced peripheral neuropathy, cancer-related fatigue, hiccup and lymphoedema. They found that acupuncture treatment improved all symptoms mentioned above. The improvement was rated from moderate to significant.

They also summarized the mechanisms of action of acupuncture ranging from anti-inflammation, neural modulation, regulation of neuropeptide release and modulating multi-signal pathways related to the activities of immune systems.

The authors suggest that acupuncture could a part of route modality of modern oncology although more studies about procedural methodology are needed.

Reference
A Kilian-Kita et al., Acupuncture: could it become everyday practice in oncology? Contemp Oncol (Pozn) 2016; 20 (2): 119–123.   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925730/

Monday 15 August 2016

Acupuncture helped alleviate headache associated with traumatic brain injury

A recent study showed that acupuncture either traditional Chinese acupuncture or auricular acupuncture significantly alleviated headache among retired Service members with traumatic brain injury. The report was published in the journal of Medical Acupuncture.

Headache after traumatic brain injury also called post-traumatic headache is one of the most common symptoms and 80% of the Service members with traumatic brain injury suffered chronic or recurrent headache. Although conventional medication is effective in relieving pain it always has potential to produce adverse effects following long-term use.

Dr. Jonas and colleagues conducted a randomized exploratory clinical study to evaluate the effectiveness of acupuncture in patients with post-traumatic headache. The patients were randomly allocated into three groups, one with traditional Chinese acupuncture, the 2nd group with auricular acupuncture and the 3rd group with usual care as a control. Ten 60-minute acupuncture sessions were applied over a 6-week time period. Outcome measures include the Headache Impact Test (HIT), the Numerical Rating Scale (NRS) and other perimeters for sleep, depression and anxiety and were performed before treatment (baseline) and at the end of the treatment. 

It was found that both traditional Chinese acupuncture and auricular acupuncture significantly alleviated headache judged by the outcome measures compared with baseline. Further, acupuncture significantly improved headache compared with control group. There was no difference in sleep, depression and anxiety between acupuncture and control group.

Authors suggested that acupuncture should be a part of standard treatment for trauma spectrum response, including post-traumatic headache.

Reference
Jonas WB et al., A Randomized Exploratory Study to Evaluate Two Acupuncture Methods for the Treatment of Headaches Associated with Traumatic Brain Injury. Med Acupunct. 2016 Jun 1;28(3):113-130.    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926228/

Monday 1 August 2016

Acupuncture significantly improved ophthalmoplegia caused by oculomotor nerve palsy

The oculomotor nerve paralysis usually causes ophthalmoplegia, leading to the impairment of eye movements or the response of pupils to light. Acupuncture treatment with patients suffering from oculomotor nerve palsy-induced ophthalmoplegia markedly improved the condition, according to a report recently published in journal of Evidence-Based Complimentary and Alternative Medicine.

The oculomotor nerve innervates the eyelid and four external ocular muscles including the medial rectus, superior rectus, inferior rectus and inferior oblique and others. People with oculomotor nerve palsy have double vision when looking a certain direction, the eyelid drop and widened pupil. The oculomotor nerve palsy is caused by either the pressure on the nerve or inadequate blood flow to the nerve, such as diabetes, hypertension and other disorders that affect blood supply to the oculomotor nerve. The common approach involves treatment to the causes and symptom therapy; either is in many cases not satisfactory.  

Recently, Dr. JQ Bi and colleagues in China conducted a pilot randomized controlled clinical study to assess the effect of acupuncture on the oculomotor palsy. A total of 40 patients with oculomotor palsy were randomly divided into acupuncture and control group (n=20 each group). Acupuncture stimulation was applied on acupoints ST1, EX-HN4, EX-HN5 and bilateral LI4 for 20 min each time, three times a week for four weeks. For sham control group, the same acupoints were applied but without the insertion of needles into the skin. The treatment outcome is measured by monitoring the cervical range of motion (CROM), the palpebral fissure size, response rate, at the baseline and the end of treatment.

It was reported, at the end of the study that acupuncture treatment significantly improved the conditions judged by the outcome measurements, e.g. CROM, the palpebral fissure size, response rate, compared with control group. No adverse effect was reported. The study suggested that acupuncture could be a feasible treatment for oculomotor palsy.

Reference
JQ Bi et al., Acupuncture for the Treatment of Oculomotor Paralysis: A Pilot Randomised Controlled Trial. Evidence-Based Complementary and Alternative Medicine, Volume 2016, Article ID 3961450,6 pages.     http://www.hindawi.com/journals/ecam/2016/3961450/

Friday 15 July 2016

Acupuncture cured sudden sensorineural hearing loss – a case report

A female patient suffering from sudden sensorineural hearing loss was treated with acupuncture for one month and recovered completely. Three months follow-up showed her hearing maintained normal. A case report was recently published in journal of Medicine.

Sudden sensorineural hearing loss (SSHL), also known as sudden deafness, occurs when you lose your hearing very quickly. SSHL happens when the inner ear, the cochlea in the inner ear, or the nerve pathway between the ear and brain is damaged. There are so many of causes of SSHL so sometimes it is difficult to tell the exact cause of the hearing loss. The common treatment of SSHL is steroids which reduces inflammation and swelling. However, effect of steroids is not always satisfactory and usually accompanied with adverse effects with chronic use.

Dr. Y Jin and M Lu in China reported a case study of acupuncture treatment for SSHL. A 26-year-old female patient with right ear sudden hearing loss coupled with fullness sought for acupuncture treatment one day after her hearing loss. She was diagnosed as SSHL. Hearing exams showed her initial hearing loss thresholds was less than 40 dB and was classified as mild SSHL. Acupuncture stimulation at acupoints GB2, SI19 and TE21 was performed for 30 min each time, once a day for a month. Patient reported slight hearing improvement during 2nd week treatment and a marked hearing improvement during 3rd week treatment with better sleepiness during night.  By the end of treatment patient reported her hearing went back to normal. Hearing exams showed hearing thresholds were normal. Three month follow-up found she maintained a normal hearing with her right ear.

This report suggests that acupuncture can be an effective alternative treatment for SSHL. Acupuncture may exert its effect through reducing inflammation, increasing local circulation and enhance nerve function recovery.

Reference
Y Jin & M Lu, Acupuncture as a primary and independent treatment in the acute phases of sudden sensorineural hearing loss - Case Report. Medicine (2016) 95:26.    http://www.ncbi.nlm.nih.gov/pubmed/27368045

Monday 27 June 2016

What do we know so far about acupuncture treatment with amyotrophic lateral sclerosis?

Recently an article summarized our understanding about acupuncture to amyotrophic lateral sclerosis (ALS). The article was published in journal of Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration.

Pre-clinical model studies showed that acupuncture stimulation improved motor neuron survival and delayed loss of motor performance and this was accompanied by reduced inflammatory reaction in acupuncture treated group compared with control group. However, there were many flaws in the designs of studies, including small sample size, non-blind raters.

Clinical studies from separate three groups revealed that effect of acupuncture treatment varied from achieving significant improvement in motor function in some patients to minor alleviation in other patients. However, there was incomplete detail regarding the ALS diagnoses, lack of a control group, failure to use validated ALS outcome measures in those reports.

Nonetheless, some evidence suggests that acupuncture can at least alleviate two common ALS symptoms: pain and spasticity with little adverse effect.

Reference
The ALSUntangled Group (2015) ALSUntangled No. 28: Acupuncture, Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16:3-4, 286-289, DOI:10.3109/21678421.2015.1039240.    http://www.tandfonline.com/doi/full/10.3109/21678421.2016.1172818

Sunday 19 June 2016

Acupuncture therapy improved sexual function in women with hypoactive sexual desire disorder

A prospective cohort pilot study showed that acupuncture therapy significantly improved sexual function in premenopausal women with hypoactive sexual desire disorder. The study was recently published in journal of Sexual Medicine.

Hypoactive sexual desire disorder (HSDD) is the most common form of sexual dysfunction in women. It was estimated that HSDD affected up to 43% women in the United State. However, standard options have not demonstrated symptomatic improvement and conventional pharmacologic medications have not been consistently helpful.

Recently Dr. SH Oakley and colleagues in the United States conducted a prospective cohort pilot study to assess the effectiveness of acupuncture on HSDD. Thirteen patients with HSDD were enrolled for the study. They were given acupuncture treatment 25 min each time, twice a week for 5 consecutive weeks. Outcome measurements include Female Sexual Function Index [FSFI] questionnaire, The Female Sexual Distress Scale Revised (FSDS-R) questionnaire and were monitored before treatment and one week after intervention. It was found that acupuncture significantly improved sexual function, in particular desire, arousal, lubrication and orgasm.

The results of study suggest that acupuncture can act as therapeutic option with women with low sexual desire.

Reference
Oakley SH et al., Acupuncture in premenopausal women with hypoactive sexual desire disorder: a prospective cohort pilot study. Sex Med. 2016 Mar 28. pii: S2050-1161(16)00032-5.    http://www.ncbi.nlm.nih.gov/pubmed/27033339

Sunday 12 June 2016

Acupuncture and Metformin combined therapy is more effective than Metformin monotherapy in treating type 2 diabetes mellitus

 When acupuncture was combined with Metformin to treat patients with type 2 diabetes mellitus, combined therapy induced significant loss of body weight and improved insulin sensitivity compared with Metformin alone. A randomized clinical study was reported in journal of Nutrition & Diabetes.

Metformin monotherapy is a first-line drug to type 2 diabetes mellitus, but its effectiveness does not meet the expectation. Many patients with type 2 diabetes mellitus were not satisfied with the outcome of treatment.

Recently a group of clinical scientists led by Professor BM Zhu conducted a randomized clinical study to assess the effect of combined acupuncture with Metformin on type 2 diabetes mellitus compared with Metformin monotherapy. Thirty-nine patients were divided into combined group and mono group. Patients in combined group were given Metformin and acupuncture treatment. Electroacupuncture was performed on 10 body acupoints plus some ear acupoints for 30 min each time, on alternative day, 10 times within 3 weeks. Mono group were given Metformin only. Outcomes were measured by changes in serum inflammatory markers, lipid profiles and adipokines at the baseline and end of 3-week treatment.

It was found that acupuncture combined Metformin therapy significantly improved body weight, body mass index, fasting blood sugar, fasting insulin compared with Metformin monotherapy group. Further, combined therapy markedly reduced serum inflammatory markers, lipid profiles and adipokines compared with monotherapy group.

The study suggested that acupuncture combined Metformin therapy is more effective in treating type 2 diabetes mellitus than Metformin monotherapy.

Reference
Firouzjaei A et al., Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients. Nutr Diabetes. 2016 May 2;6:e209. doi: 10.1038/nutd.2016.16.    http://www.ncbi.nlm.nih.gov/pubmed/?term=Firouzjaei%20A%5BAuthor%5D&cauthor=true&cauthor_uid=27136447

Monday 6 June 2016

Objective assessment of efficacy of electroacupuncture in the treatment of gait disorder in Parkinson’s disease

A report was just published to confirm the efficacy of electroacupuncture treatment on gait in patients with Parkinson’s, by using body-worn sensors, an objective monitoring device. The pilot study was published by journal PLOS one.

Parkinsonian gait is mainly characterized by general slow movement, in particular by a reduction of gait speed and stride length. The progressive nature of symptoms leads to the freezing of gait and falls. Parkinsonian gait tends to be difficult treated, as drug treatment and deep brain stimulation have limited efficacy. Acupuncture has been effectively used to relieve parkinsonian symptoms; however, its efficacy remains controversy.

Recently Dr. H Lei and colleagues in the United States conducted a clinical study by using wearable sensor technology, to objectively assess the efficacy of acupuncture treatment on gait in patients with Parkinson’s. PD patients were randomly allocated into real acupuncture group (n=10) and sham acupuncture group (n=5). In real group, electroacupuncture was applied on different acupoints on the scalp, body and limbs, for 30min, once a week for 3 weeks. In sham group, acupuncture needles were applied just under skin, ca 4mm at non-acupoints on the scalp, body and limbs without stimulation. The participants and assessors were masked to eliminate potential bias effect. Outcomes were monitored at baseline and after completion of treatments. Measurements included gait analysis perimeters. In addition, Unified Parkinson's Disease Rating Scale (UPDRS), short Falls Efficacy Scale-International (FES-I), and visual analog scale (VAS) for pain were utilized.

Results showed that electroacupuncture treatment statistically significantly improved gait symptoms judged by all gait objective measurements compared with sham acupuncture control group. In particular gait speed was markedly improved compared with sham control.

This was the first participants- and assessors- masked randomized control study that, using body-worn sensor technology to objectively assess potential benefits of EA in enhancing spatio-temporal parameters of gait in PD patients.

Reference
Lei H et al., A Pilot Clinical Trial to Objectively Assess the Efficacy of Electroacupuncture on Gait in Patients with Parkinson's Disease Using Body Worn Sensors. PLoS One. 2016 May 26;11(5):e0155613.   http://www.ncbi.nlm.nih.gov/pubmed/27227460 

Tuesday 31 May 2016

Acupuncture helps relieve pain in people with endometriosis

Endometriosis is a chronic, estrogen-dependent disorder characterised by growth of endometrial tissue in sites other than the uterus, most commonly in the pelvic cavity, but also in other parts of the body. The cause of endometriosis is not known, but many factors are thought to be involved in its development. These include retrograde menstruation; an abnormal quantity or quality of endometrial cells; embryonic cells giving rise to deposits in distant sites around the body; and the production of antibodies against endometrial cells.

This ectopic endometrial tissue responds to the hormonal changes of the menstrual cycle, with subsequent bleeding, inflammation, and pain. If the ovaries are affected, endometriotic ovarian cysts may develop. Common symptoms include dysmenorrhoea, dyspareunia, non-cyclical pelvic and abdominal pain, and subfertility. The prevalence is estimated to vary from 2-22% of women and, in women with dysmenorrhoea, the incidence of endometriosis is 40-60%.

Recently some review articles showed that acupuncture is specifically of benefit in people with endometriosis. Acupuncture provides effective pain relief, by stimulating nerves located in muscles and other tissues, leading to release of endorphins and other neurohumoral factors, and changing the processing of pain in the brain and spinal cord. Acupuncture reduces inflammation by promoting release of vascular and immunomodulatory factors. Acupuncture exerts regulating levels of prostaglandins.

The authors of articles suggest that acupuncture can be used as an independent or complement therapy for the treatment of endometriosis.

Reference:
Lund I, Lundeberg T. Is acupuncture effective in the treatment of pain in endometriosis? J Pain Res. 2016 Mar 24;9:157-65. http://www.ncbi.nlm.nih.gov/pubmed/27069371


Kong S et al., The Complementary and Alternative Medicine for Endometriosis: A Review of Utilization and Mechanism. Evidence-Based Complementary and Alternative Medicine, Volume 2014 (2014), Article ID 146383, 16 pages.  http://www.hindawi.com/journals/ecam/2014/146383/

Sunday 22 May 2016

Acupuncture helped relieve symptoms and improve the quality of life of patients with multiple sclerosis

Acupuncture as a part of holistic approach significantly alleviated many symptoms and enhanced the quality of life of women with multiple sclerosis (MS), according to a report published in the Journal of Holistic Nursing.

Recently Dr. H Becker and colleagues in the USA conducted a study to assess whether integrated acupuncture treatment with wellness class for women with MS. Fourteen women with MS were assigned into the study. Acupuncture treatment with needles inserted into 11 body sites, 2 head sites and 3 auricular sites were applied following wellness class. The assessment consists of 1). Self efficacy: the 28-item Self-Rated Abilities for Health Practices Scale, used to assess participants’ beliefs about their ability to perform health promoting behaviours. 2). Stress Perception includes the10-item Perceived Stress Scale (PSS). 3). Patient report outcome, 4). Quality of life report.

It was found that after 8-weekly acupuncture session following wellness class, all patients reported a significant reduction in self-reported fatigue, stress, pain, depression, anxiety, and sleep interference. They also reported an overall significantly increase in health-promoting behaviors, self-efficacy for health promotion, social functioning, and the quality of life.

The study suggested that combination of acupuncture with wellness class provided an effective alternative approach to the treatment management of daily life of patients with MS.

Reference
Becker H et al., Integrating Acupuncture Within a Wellness Intervention for Women With Multiple Sclerosis: A Feasibility Study. J Holist Nurs. 2016 May 9. pii: 0898010116644833.     http://www.ncbi.nlm.nih.gov/pubmed/27161425

Wednesday 11 May 2016

How does acupuncture help improve polycystic ovary syndrome?

Although acupuncture has been used to effectively relieve many symptoms of polycystic ovary syndrome (PCOS), its mechanisms of action is poorly understood. Recently studies on PCOS models reported that acupuncture stimulation rebalanced pituitary-ovary axis function and normalized altered expression of genes and proteins related to reproductive and endocrine function.

PCOS is a common condition affecting endocrine and reproductive systems in women, resulting abnormal follicular development and ovulation dysfunction due to imbalance of steroid hormone releasing. Main features of PCOS include irregular periods, high levels of male hormones in the body and polycystic ovaries.  It has been suggested that hormone imbalance, insulin resistance, environmental and genetic factors are associated with the occurrence of PCOS. Many women with PCOS suffer from infertility. Although some medications help many women with PCOS get pregnant, the side effects of medication often cause serious concern.

Professor E Stener-Victorin and colleagues in Sweden conducted a serious study to investigate the mechanisms of acupuncture action on PCOS models. They found that either manual or electro acupuncture (2 Hz) stimulation at ST27, ST28, ST29, SP6 and SP9 acupoints for 45 min, just one session, improved insulin sensitivity, stimulated glucose uptake and the effect maintained nearly one hour after stimulation.

In another study, electroacupuncture stimulation for 15 or 25 min, from Monday to Friday for 5-6 weeks on PCOS models significantly improved pituitary-ovary axis by normalizing luteinizing hormone secretion, increasing ovarian expression of genes and proteins related to endocrine function and reproductive function. The results of acupuncture were as effective as those of the drug control groups.

Those studies showed that acupuncture stimulation could exert multiple modulations on endocrine system and metabolic system on PCOS models. Further clinical studies should be carried out to confirm the experimental data.

Reference
Maliqueo M et al., Circulating gonadotropins and ovarian adiponectin system are modulated by acupuncture independently of sex steroid or β-adrenergic action in a female hyperandrogenic rat model of polycystic ovary syndrome. Mol Cell Endocrinol. 2015 Sep 5;412:159-69.   http://www.ncbi.nlm.nih.gov/pubmed/25963796

Benrick A et al., Enhanced insulin sensitivity and acute regulation of metabolic genes and signaling pathways after a single electrical or manual acupuncture session in female insulin-resistant rats. Acta Diabetol. 2014 Dec;51(6):963-72.   http://www.ncbi.nlm.nih.gov/pubmed/25218925 

Thursday 5 May 2016

Acupuncture exerted a specific long-term therapeutic effect on irritable bowel syndrome

A 24-month follow up study of acupuncture treatment to irritable bowel syndrome (IBS) suggests that significant beneficial effects of acupuncture observed between 3 and 9 months after treatment on IBS are unlikely to be due to the non-specific effect, rather likely is associated with the underlying physiological mechanisms of action. The study was recently published in journal Acupuncture in Medicine.

Dr. H MacPherson and colleagues conducted a 24-month follow up study having published their 12-month study in journal of BMC Gastroenterology (MacPherson et al. BMC Gastroenterology 2012, 12:150). In their 12-month study they found that acupuncture treatment significantly reduced IBS Symptom Severity Scores at the end of 3-month treatment (acupuncture weekly to 10 sessions) compared with the usual care control group. The benefits largely persisted 3, 6 and 9 months after treatment.

In their 24-month follow up study, no statistical significant difference of IBS Symptom Severity Scores was found between acupuncture group and usual care group at 24-month. They suggested that this may be, at least in part, linked with the progressive improvement reported within the usual care group.


The follow up study also found a statistically significant difference favouring acupuncture at 12-month, which was only shown a statistical tendency in the previous report. Further, authors suggested that sustainable therapeutic effects between the end of treatment at 3 months through 24 month indicated that obvious benefits of acupuncture represented more than a simple placebo response.

Reference
MacPherson H  et al., Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial. Acupunct Med. 2016 Mar 15. pii: acupmed-2015-010854. doi: 10.1136/acupmed-2015-010854.   http://aim.bmj.com/content/early/2016/03/15/acupmed-2015-010854.abstract

Tuesday 26 April 2016

How did acupuncture help recovery in experimental ischemic stroke model?

A literature review study found that acupuncture stimulation significantly enhanced neurogenesis in the brain of experimental ischemic stroke model, according to a report published in journal of Scientific Reports.

Neurogenesis naturally occurs only in very a few small regions of the adult brain. However, neurogenesis is considered too weak to produce any significant compensation in response to brain injury. Promoting endogenous neurogenesis such as neural stem/progenitor cells appears to offer a promising therapeutic strategy for treating stroke.

Recent studies showed that acupuncture treatment played a neuroprotective role in treating patients with stroke. Other studies reported acupuncture enhanced neurogenesis in the brain of experimental ischemic stroke.

A group of scientists in China undertook a preclinical systematic review and meta-analysis to assess the current evidence for effect of acupuncture on neurogenesis in treating ischaemic stroke. Thirty-four studies represented a total of 1617 experimental subjects were included in the review study.

The data showed that acupuncture improved neurological deficits and reduced brain edema in experimental ischemia, and that the mechanisms mostly involved in enhancing endogenous neurogenesis including proliferation, migration and differentiation of neural stem/progenitor cells. Acupuncture was found to be effective in promoting neurogenesis, particularly from day 7 to day 14 after ischemia; neurocyte proliferation peaked at day 7 while differentiation peaked at day 14. These results suggested an optimum time window in stroke for acupuncture therapy.

Authors suggested that the study may help the planning and improve the likelihood of success of future clinical trials, provide empirical evidence to improve the rigor of the conducting and reporting of preclinical research.

Reference
Lu L et al., Acupuncture for neurogenesis in experimental ischemic stroke: a systematic review and meta-analysis. Sci Rep. 2016 Jan 20;6:19521.    http://www.ncbi.nlm.nih.gov/pubmed/26786869

Tuesday 15 March 2016

How does acupuncture help improve motor function after spinal cord injury?

Spinal cord injury often leads to the severe dysfunction below the injury site. Regeneration and functional recovery after spinal cord injury are very limited due to irreversible pathophysiological processes, although slow recovery of injured spinal cord neurons and limited neurite outgrowth might be achieved.

Electroacupuncture has been used to treat patients with spinal cord injury and is effective in promoting functional recovery. However, the mechanisms of electroacupuncture action are not fully understood. Recently many studies of spinal cord injury models reported very interesting results. The following is the summary of some studies.

JH Yang and colleagues reported, in a SCI model by compressing the T8–9 segments using a modified Nystrom method, that electroacupuncture stimulation of ST36, GB39, ST32 and SP6 for 2-6 weeks increased GDNF mRNA expression and increased AChE activity at the injury site of medium and large neurons in the spinal cord anterior horn, and increased motor neuron activities compared with control group.

DX Jiang and colleagues reported, a model of intervertebral disc extrusion by inserting a silica gel pad into the left ventral surface of T13, electroacupuncture stimulation at the bilateral ST36 and ST44 for 14 days increased blood flow in the first lumbar vertebra (L1). Microvessel density in the T13 segment of the spinal cord was increased significantly as well. The number of normal neurons was higher in the ventral horn of the spinal cord compared with control group.

The results of those studies are quite encouraging and shed some light on the action of electroacupuncture. However, more studies both preclinical and clinical are needed to provide more information about mechanism of acupuncture.

References:
Jiang DX et al., Electroacupuncture improves microcirculation and neuronal morphology in the spinal cord of a rat model of intervertebral disc extrusion. Neural Regen Res. 2015 Feb;10(2):237-43.  http://www.ncbi.nlm.nih.gov/pubmed/25883622

Yang JH, et al., Electroacupuncture promotes the recovery of motor neuron function in the anterior horn of the injured spinal cord. Neural Regen Res. 2015 Dec;10(12):2033-9.    http://www.ncbi.nlm.nih.gov/pubmed/26889195 

Wednesday 9 March 2016

Acupuncture helps improve both motor and non-motor symptoms of Parkinson’s disease

Literature review study found that acupuncture treatment alleviated both motor and non-motor symptoms of Parkinson’s disease according to a report published in journal of CNS Neuroscience and Therapeutics.

In this article, we have studied the clinical reports of acupuncture treatment for Parkinson’s, which were listed in Medline, PubMed, EMBASE, CNKI, and CINAHL databases in the past 15 years. It was found that acupuncture either manual or electroacupuncture stimulation at specific acupoints relieved some motor symptoms in patients with Parkinson’s and markedly improved many non-motor symptoms such as psychiatric disorders, sleep problems, and gastrointestinal symptoms. When it was used as an adjunct for levodopa, acupuncture improved therapeutic efficacy and reduced dosage and the occurrence of side effects of levodopa.

Although the evidence for the effectiveness of acupuncture for treating PD is inclusive, data from the reviewed studies showed that therapeutic potential of acupuncture in treating Parkinson’s seems rather promising. More studies, either comparative effectiveness research or high-quality placebo-controlled clinical studies should be conducted.

Reference
Zeng BY & Zhao K, Effect of Acupuncture on the Motor and Nonmotor Symptoms in
Parkinson’s Disease—A Review of Clinical Studies. CNS Neurosci Ther. 2016 Feb 4. doi: 10.1111/cns.12507.    http://www.ncbi.nlm.nih.gov/pubmed/26843036

Wednesday 2 March 2016

Acupuncture lowered the risk of acute myocardial infarction in stroke patients

A retrospective cohort study showed that stroke patients receiving acupuncture treatment had a decreased risk of developing acute myocardial infarction compared with the stroke patients without acupuncture. The report was published in journal of BMC Complementary and Alternative Medicine.

It has been reported that patients with stroke have a high risk of developing heart conditions such as acute myocardial infarction which is a fatal attack. How to reduce the risk of acute myocardial infarction in stroke patients remains a big concern in primary care.

Recently, a group of scientists in Taiwan, China, conducted a retrospective cohort study to evaluate whether acupuncture could reduce the risk of acute myocardial infarction. They evaluated the data from 23475 stroke patients aged between 40-79 year-old, receiving acupuncture and compared with 46950 propensity score-matched stroke patients without acupuncture treatment.

The study found that acupuncture treatment reduced the risk of developing acute myocardial infarction in stroke patients.

Reference:
Chuang SF et al., Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study. BMC Complementary and Alternative Medicine (2015) 15:318.   http://www.ncbi.nlm.nih.gov/pubmed/26353964

Wednesday 24 February 2016

Acupuncture needles with direct electrical stimulation helped speed up nerve regeneration and function recovery after forearm ulnar nerve injury – a case report

A male patient with deep cutting wound and total rupture of right proximal forearm ulnar nerve was treated with direct electrical stimulation of acupuncture needles plus daily rehabilitation activities recovered most of function and returned to work around three months of after surgery. A case study reported in journal of Complementary Therapies in Medicine.

A 32-year old male patient, in Taiwan, China, suffered a deep cut from a broken washbasin and total rupture of right proximal forearm ulnar nerve and partial rupture of many associated tendons. The wound immediately underwent irrigation and muscle and ulnar nerve repair surgery. Two weeks after operation, electroacupuncture was applied, using 2 needles inserted in the cubital tunnel along the site of the injured ulnar nerve and 10 needles inserted according to the origins of muscles innervated by the ulnar nerve and affected by the injury, and other 4 needles were inserted along the suture scar line to avoid possible soft tissue contractures. The procedure was executed once a week for 6 months plus daily rehabilitation activities.

The outcome was monitored using the Rosén and Lundborg (R&L) protocol and DASH scores once a month. The results gathered on the first day of intervention were regarded as the baseline.

It was found that pain/discomfort domain was the first to reach stable amelioration after the first month. The motor and sensory and domains reached stable growth in third and fourth months, respectively. The patient returned to work in third month after operation.

Authors suggested that direct electrical stimulation at the proximal site of the injured nerve can augment nerve regeneration by means of acceleration of axon regeneration, earlier target muscle reinnervation, improvements in axonal conduction speeds, and up-regulation and electrophoretic movement of neurotrophic and neurogrowth factors such as BDNF and its trkB receptors.

Reference

Tang YJ et al., Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report. Complementary Therapies in Medicine 24 (2016) 103–107.    http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30024-8/abstract

Thursday 18 February 2016

Acupuncture is effective in treating melasma

Melasma (also called Cholasma in pregnant women) is a commonly acquired dermatological condition characterized by hyper-pigmented patches on the sun exposed area of skin, mostly on the face. Acupuncture with facial acupoints alone or plus body acupoints were reported to improve melasma, according to a randomized clinical study published in journal of Complementary Therapies in Clinical Practice.

Melasma is a type of hyper pigmentation. It is caused by the build up of excess melanin, which creates patches of darker skin. It can be a side effect of the contraceptive pill, pregnancy, and hormone replacement medications. The frequent location of melasma on the face makes it a significant cosmetic condition that has a strong emotional impact on the individual, affecting their quality of life to an extent that they frequently seek treatment. Presently, a combination of hydroquinone (HQ) with steroids and tretinoin is considered the first line of treatment for the condition. However, concerns of the safety and side effects associated with long-term use of HQ are raised.

Recently scientists in Thailand conducted a randomized clinical study to assess the effect of facial acupuncture with or without body acupuncture on the melasma. Forty-one patients with melasma were divided into facial acupuncture only group (n=20) and facial acupuncture plus body acupuncture group (n=21). Facial acupuncture was performed with needles inserted at the rims of melasma and at the angle of 15 degree with needle tips towards the lesion centre. Body acupuncture was performed at 11 acupoints. The duration of treatment was 30 min a session, two sessions a week for a total 8 consecutive weeks.  Assessment of the melasma area and darkness of its pigmentation were carried out before and after treatment.

At the end of 8-week treatment it was found that facial acupuncture with or without body acupuncture significantly reduced the melasma area and darkness of its pigmentation compared with the base line. There was no recorded side effect.

This was the first randomized clinical study of effectiveness of facial acupuncture on melasma. Authors suggested that facial acupuncture could be a safe and cost-effective treatment for patients with melasma.

Reference:
L Rerksuppaphol et al., Randomized clinical trial of facial acupuncture with or without body acupuncture for treatment of melasma. Complementary Therapies in Clinical Practice 22 (2016) 1-7.    http://www.sciencedirect.com/science/article/pii/S1744388115300128