Acupuncture reduced risk of stroke in patients with fibromyalgia

 

A nationwide matched cohort study in Taiwan showed the acupuncture treatment was effective on reducing risk of stroke in patients with fibromyalgia compared with patients with fibromyalgia but not received acupuncture treatment. The data was reported the results on the Plos One journal.

Fibromyalgia is a disorder characterized by chronic widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. The cause of fibromyalgia is not clear. It is believed that fibromyalgia amplifies painful sensations by affecting the way the brain and spinal cord process painful and nonpainful signals. Factors such as genetics, infections and physical and emotional events may lead to the occurrence of disorder. There is presently no cure for the condition. Pain reliever, antidepressants, physiotherapy and counselling should help alleviate symptoms. Acupuncture has been shown to effectively relief the muscle pain and reduce stress for a long time.

Studies showed that patients with fibromyalgia, particularly younger patients, had a higher risk tendency of stroke than those without fibromyalgia. Depression and sleep disorders, closely linked with fibromyalgia were also associated with a higher risk of stroke.

A group of scientists in Taiwan conducted a nationwide matched cohort study to evaluate the effectiveness of acupuncture in reducing risk of stroke in patients with fibromyalgia. Patients diagnosed with fibromyalgia between 1 January 2000 and 31 December, 2010 recorded in the Taiwanese National Health Insurance Research were enrolled in the study.

The comparison between the age, sex and comorbidities, and the hazard ratios of acupuncture and non-acupuncture cohorts were analysed using a Cox regression model. The difference in the prevalence of stroke between the acupuncture and non-acupuncture cohorts was assessed using the Kaplan–Meier method and the log-rank test. Patients with fibromyalgia were identified and divided into acupuncture (n=65,487) and non-acupuncture (n=65,487) cohorts with similar distributions in the baseline characteristics after performing a propensity score matching with a 1:1 ratio.

The Kaplan-Meier analysis with the log-rank test showed a significantly lower cumulative incidence of stroke in the acupuncture cohort than that in the non-acupuncture cohort (p<0.0001). In the follow-up 5-year period, 4,216 patients in the acupuncture cohort (11.01 per 1000 person-years) compared with 6,849 patients in the non-acupuncture cohort (19.82 per 1000 person-years) suffered from stroke (adjusted HR 0.53, 95% CI 0.51–0.55).

The data showed that acupuncture decreased the incidence of stroke regardless of the patient’s age, sex, comorbidities, and conventional drug use in patients with fibromyalgia in Taiwan.

Reference:

Acupuncture decreased the risk of stroke among patients with fibromyalgia in Taiwan: A nationwide matched cohort study. Huang MC, Yen HR, Lin CL, Lee YC, Sun MF, Wu MY.PLoS One. 2020 Oct 1;15(10):e0239703. doi: 10.1371/journal.pone.0239703.

https://pubmed.ncbi.nlm.nih.gov/33002009/

Treatment of Covid-19 disease with traditional Chinese medicine

Acupuncture and herbal medicine are effective for the treatment of COVID-19 virus. An article published on the Healthcmi.com website reported that 87% of COVID-19 patients in Beijing received traditional Chinese medicine (TCM including acupuncture and herbs) and the total effective rate for patients receiving TCM is 92%, quoted from the Beijing Health Commission report.

Coronaviruses are a large group of viruses that are known to infect both humans and animals and in humans cause respiratory illness that range from common colds to much more serious infections. The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (Sars), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases and 774 deaths. Cases of Covid-19 first emerged in late 2019, when a mysterious illness was reported in Wuhan, China. The cause of the disease was soon confirmed as a new kind of coronavirus, and the infection has since spread to many countries around the world and become a pandemic.

While the cause of the current outbreak was initially unknown, on January 7 2020 Chinese health authorities identified that it was caused by to a strain of coronavirus that hadn’t been encountered in humans before. Five days later the Chinese government shared the genetic sequence of the virus so that other countries could develop their own diagnostic kits. That virus is now called Sars-CoV-2. However, to avoid confusion with SARS the WHO calls it the covid-19 virus (coronavirus disease 2019) when communicating with the public.

Although symptoms of covid-19 virus are often mild – the most common symptoms are a fever and dry cough – in some cases they lead to more serious respiratory tract illness including pneumonia and bronchitis. These can be particularly dangerous in older patients, or people who have existing health conditions, and this appears to be the case with Covid-19 disease.

Qing Fei Pai Du Tang is recommended by the Chinese National Administration of Traditional Chinese Medicine (NATCM) for treating Covid-19 disease. In a study led by Dr. Li Yu that 701cases of COVID-19 patients treated with Qing Fei Pai Du Tang, 130 patients were cured, symptoms including fever and coughing completely resolved in an additional 51 patients, symptom improvements occurred in an additional 268 patients, and stabilization occurred in 212 patients. In a detailed analysis of 351 patients, Dr. Li and colleagues noted that 112 patients had a body temperature in excess of 37.3 degrees Celsius. After taking Qing Fei Pai Du Tang for one day, 51.8% of patients’ body temperatures returned to normal. After 6 days, 94.6% returned to normal temperature.

Of the 351 patients, 214 had coughs, one day of after drinking Qing Fei Pai Du Tang, 46.7% of patients’ coughs completely resolved. Six days later, 80.6% had significant reductions in coughing. In related findings from two independent investigations, the herbal medicine Lian Hua Qing Wen Capsule helped resolve COVID-19 symptoms and promoted recovery.

The China Association of Acupuncture and Moxibustion issued Acupuncture Treatment Guidelines for COVID-19 (2nd ​edition). The guidelines have been divided into three stages: prevention, treatment, and recovery.

Prevention stage, acupuncture is to strengthen zheng qi (healthy energy) and to benefit lung and spleen functions to combat foreign pathogens, basically improve immune system. The primary acupoints are categorized into 3 groups; 1–2 acupoints are selected from each group during one acupuncture session:

Group 1: BL12 (Fengmen), BL13 (Feishu), BL20 (Pishu);

Group 2: LI4 (Hegu), LI11 (Quchi), LU5 (Chize), LU10 (Yuji);

Group 3: CV6 (Qihai), ST36 (Zusanli), SP6 (Sanyinjiao)

A secondary set is added dependent upon individual symptoms.

For fever, the following acupoints are added: GV14 (Dazhui), CV22 (Tiantu), LU6 (Kongzui)

For nausea, loose stools, enlarged tongue with greasy coating, and soft (soggy) pulse, the following acupoints are added: GV14 (Zhongwan), ST25 (Tianshu), ST40 (Fenglong)

For fatigue and poor appetite, the following acupoints are added: CV12 (Zhongwan), CV9 (Shuifen), CV7 (Yinjiao), KI16 (Qizhousixue), BL20 (Pishu)

For clear nasal discharge, sore and painful back, pale tongue with white coating, and moderate pulse, the following acupoints are added: BL10 (Tianzhu), BL12 (Fengmen), GV14 (Dazhui)

Treatment stage, acupuncture is applied to interrupt disease progress based on the Pei Tu Sheng Jin (bank up earth to engender metal) principle and to relieve low mood. The primary acupoints selected for this stage are categorized into 3 groups.

For mild to moderate cases, 2–3 acupoints are selected from groups 1 and 2 during each acupuncture session. For severe cases, additional 2–3 acupoints are recommended from group 3.

Group 1: LI4 (Hegu), LR3 (Taichong), CV22 (Tiantu), LU5 (Chize), LU6 (Kongzui), ST36 (Zusanli), SP6 (Sanyinjiao)

Group 2: BL11 (Dashu), BL12 (Fengmen), BL13 (Feishu), BL15 (Xinshu), BL17 (Geshu)

Group 3: LU1 (Zhongfu), CV17 (Danzhong), CV6 (Qihai), CV4 (Guanyuan), CV12 (Zhongwan)

A secondary set is added dependent upon individual symptoms.

For persistent fever, the following acupoints are added: GV14 (Dazhui), LI11 (Quchi), EX-UE11 (Shixuan), EX-HN6 (Erjian)

For chest tightness and shortness of breath, the following acupoints are added: PC6 (Neiguan), LU7 (Lieque), CV14 (Juque), LR14 (Qimen), KI6 (Zhaohai)

For coughing with sputum, the following acupoints are added: LU7 (Lieque), ST40 (Fenglong), EX-B1 (Dingchuan)

For diarrhea with loose stools, the following acupoints are added: ST25 (Tianshu), ST37 (Shangjuxu)

For cough with yellow and sticky sputum and constipation, the following acupoints are added: CV22 (Tiantu), TB6 (Zhigou), ST25 (Tianshu), ST40 (Fenglong)

For low grade fever, nausea, loose stools, and a pale-red tongue with a white-greasy coating, the following acupoints are added: BL13 (Feishu), ST25 (Tianshu), SP14 (Fujie), PC6 (Neiguan)

Recovery stage, acupuncture is applied to eliminate pathogens from the body and to recover lung and spleen functions. The following primary acupoints are recommended: P6 (Neiguan), ST36 (Zusanli), GV14 (Zhongwan), ST25 (Tianshu), CV6 (Qihai)

A secondary set of acupuncture points are added dependent upon individual symptoms. For lung and spleen qi deficiency, sets of points are added for specific conditions:

If lung symptoms (e.g., chest tightness, shortness of breath) are pronounced, CV17 (Danzhong), BL13 (Feishu), and LU1 (Zhongfu) are added.

If spleen symptoms (e.g., poor appetite, diarrhea) are pronounced, CV13 (Shangwan) and SP9 (Yinlingquan) are added. 

For patients with qi and yin deficiency, the following acupoints are recommended for specific presentations:

If there is fatigue and shortness of breath, CV17 (Danzhong) and CV8 (Shenque) are added.

If there is dry mouth and thirst, KI3 (Taixi) and TB4 (Yangchi) are added.

If there are palpitations, BL15 (Xinshu) and BL14 (Jueyinshu) are added.

If there s profuse sweating, LI4 (Hegu), KI7 (Fuliu), and ST36 (Zusanli) are added.

If there is insomnia, HT7 (Shenmen), EX-HN3 (Yintang), EX-HN 19 (Anmian), and KI1 (Yongquan) are added.

Additional guidelines were published for patients with sputum and stasis blocking the channels with underlying lung and spleen deficiency:

For patients with lung, spleen and heart symptoms (e.g., chest tightness, shortness of breath), BL13 (Feishu), BL20 (Pishu), BL15 (Xinshu), BL17 (Geshu), LU1 (Zhongfu), and CV17 (Danzhong) are added. If sputum is unproductive, ST40 (Fenglong) and EX-B1 (Dingchuan) are added.

The aforementioned acupoints can be stimulated with acupuncture, moxibustion, or massage. If acupuncture is used, needles should be manipulated with the mild reinforcement and attenuation (Ping Bu Ping Xie) technique during the 20–30 minute needle retention time. If moxibustion is applied, the moxa should warm the points for 10–15 minutes. Treatment is administered once daily.

Reference:

https://www.healthcmi.com/Acupuncture-Continuing-Education-News/2010-acupuncture-and-herbs-covid-19-coronavirus-findings

Acupuncture therapy improved radiation-induced xerostomia in cancer patients

Acupuncture treatment has been shown to significantly reduce severe radiation-induced xerostomia in patient with head and neck cancer compared with standard care control in a randomized clinical trial, according to the data published in the JAMA Network Open.

Xerostomia, or oral dryness, is one of the most common complaints experienced by cancer patients who have radiotherapy of the oral cavity and neck region. Radiation-induced xerostomia (RIX), together with difficulty in chewing, swallowing and speaking can have a significant impact on the quality of life. At present there is no causal treatment for established xerostomia. Temporary symptomatic relief can be provided by moistening agents and saliva substitutes. Acupuncture has been reported to effectively relieve RIX.

A phase 3, randomized, sham-controlled, patient- and assessor-blinded clinical trial was conducted to assess effect of true acupuncture (TA n=132), compared with sham acupuncture (SA n=134) or a standard care control (SCC n=133) on the incidence or severity of RIX among patients with head and neck cancer. Acupuncture treatment was given concurrently with a 6- to 7-week course of radiation therapy. In TA group acupuncture needles were inserted into following body acupoints: Ren 24, LU7, and K6. The following ear points were used: Shenmen, Point Zero, Salivary Gland 2' (SG 2-prime), and Larynx. All points were used bilaterally except for Ren 24, which is located in the midline. In SA group non-penetrating needles with the Park device were placed at inactive points 0.5-1.0 cun away from true acupoints. In SCC group patients received standard care information about oral hygiene such as brushing with fluoride toothpaste, flossing, and daily use of fluoride tray applications.

The criterion standard for measuring xerostomia XQ was used to compare patient-reported outcome scores for xerostomia among the TA, SA, and SCC groups. The acupuncture expectancy scale18 was used to evaluate the association of baseline expectations related to acupuncture with clinical response. Adverse events were recorded using Common Terminology Criteria for Adverse Events version 3.0. Patient-reported Xerostomia Questionnaires (XQs) and sialometry data were collected at baseline, at the end of radiation therapy (week 7), and 3, 6, and 12 months after the end of radiation therapy.

Results showed that xerostomia score in the TA group was significantly lower than in the SCC group and marginally lower but not statistically significant different from the SA group. One year after radiation therapy follow-up showed that incidence of clinically significant xerostomia followed a similar pattern with 38 patients in the TA group (34.6%), 54 patients in the SA group (47.8%), and 60 patients in the SCC group (55.1%) experiencing clinically significant xerostomia.

Data from this phase 3, randomized clinical trial suggested that acupuncture therapy statistical significantly reduced the incidence of radiation-induced xerostomia compared with standard care controls in patients with head and neck cancer.

Reference:

Garcia MK, et al. (2019) Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer: A Randomized Clinical Trial. JAMA Netw Open. PMID 31808921.     https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2757250