Acupuncture helped alleviate pain after thyroid surgery

Better management of postoperative pain in patients undergoing thyroid surgery is important for recovery. It was reported that acupuncture had a synergistic effect in relieving pain in patients after thyroidectomy according a study published in journal of Surgery.

Appropriate control of postoperative pain following thyroid surgery is essential for a speedy recovery. Conventional pain relief medications such as opioids and/or non-opioids normally are effective in relieving or stopping pain after surgery. However, they induced many unwanted side effects such as worsening of anesthetics-induced nausea and vomiting, sedation and slowing of gastric emptying and gastro-intestine motility and many more. Acupuncture has been reported to be effective in relieving postoperative pain in many conditions only with minimal side effect.

Dr. M Iacobone and colleagues in Italy performed a randomised, controlled clinical trial to assess the efficacy of acupuncture in reducing pain after thyroid surgery. One hundred forty patients with thyroidectomy were randomly divided into control group (n=79) and acupuncture group (n=70). Patients in control group were treated with analgesic acetaminophen, and patients in acupuncture group were treated with acupuncture plus acetaminophen. Acupuncture was give at acupoints LI4 and PC6, ca. 30 min before surgery and in the morning of postoperative day 1, for 30 min with or without electro stimulation. Pain was assessed according to the intraoperative pain measured by remifentanil consumption during anesthesia and postoperative pain, measured by Numeric Rating Scale, the McGill Pain Questionnaire, and acetaminophen consumption.

Overall, patients with acupuncture required less acetaminophen at day 2 and day 3 after operation compared with controls. Patients with electroacupuncture performed better than manual acupuncture. They required less remifentanil and acetaminophen than controls at day 2 and 3 after surgery and showed a trend toward better Numeric Rating Scale and McGill scores from day 1 to 3 after surgery compared with controls. Patients in acupuncture also experienced less side-effects than control group.

Authors suggested that acupuncture may be effective in reducing pain in patients following thyroid surgery.

Reference:

Iacobone M et al., The effects of acupuncture after thyroid surgery: A randomized, controlled trial. Surgery 2014;156:1605-13.   http://www.sciencedirect.com/science/article/pii/S0039606014005406

How does acupuncture help to prevent muscular dystrophy?

Muscular dystrophy has a profound effect on patient’s daily life, especially physical activities. How to prevent muscle atrophy is critical for maintaining quality of life. Acupuncture was reported to be able to partially prevent skeletal muscle atrophy in a basic research study, according to the results published in journal of Biochemical and Biophysical Research Communications.

Muscular dystrophy is a group of muscle diseases that is characterised by the progressive muscle weakness, defects in muscle proteins and eventually death of muscle cells. It is a group of inherited genetic conditions due to the mutation of the specific genes that cause the changes in muscle structure and muscle dysfunction. Muscular dystrophy could happen in any age group depending on the genes affected. The common symptom of muscular dystrophy is gradually muscle weakness of affected part of body. There is no cure for the condition and conventional approaches are only temporarily symptom relief.

Researchers in Japan considered acupuncture in place of exercise training is an alternative non-pharmacological therapy that might prevent muscle atrophy and evaluated effects of acupuncture on skeletal muscle atrophy caused by hindlimb-suspension in mice, a model of muscular dystrophy. Acupuncture needles were inserted into gastrocnemius muscle of hindlimb-suspended mice with or without electro-stimulation for 30 min a day for 2 weeks. At the end of acupuncture biomedical techniques including molecular biology were employed to study the changes in affected muscle including the alterations in gene expression.

It was found that muscle mass was significantly reduced by hindlimb-suspension. Acupuncture especially electroacupuncture significantly improved muscle mass, although the level of improvement was insufficient compared with normal control. Acupuncture down-regulated the genes involved in muscle degeneration and up-regulated the genes involved in muscle protein synthesis.

Authors suggested that acupuncture partially prevented muscle atrophy due to its action to modulate the genes involved in muscle protein synthesis.

Reference

A Onda et al., Acupuncture ameliorated skeletal muscle atrophy induced by hindlimb suspension in mice. Biochemical and Biophysical Research Communications 410 (2011) 434–439.  http://www.ncbi.nlm.nih.gov/pubmed/21672518

Can acupuncture alleviate myofascial pain syndrome?

Manual acupuncture and electroacupuncture are more effective in alleviating myofascial pain intensity, increasing cervical range of motion than sham acupuncture in women with myofascial pain syndrome. A clinical trial was reported in the Brazilian Journal of Physical Therapy.

Myofascial pain syndrome is a chronic pain disorder caused by multiple trigger points and fascial constrictions. Pressure on sensitive points in the muscle (trigger points) causes pain in seemingly unrelated parts of the body (referred pain), decreased range of motion, pseudo-weakness of the involved muscle. Myofascial pain syndrome normally occurs after a muscle has been contracted repetitively due to jobs, hobbies and stress-related muscle tension. The prevalence of myofascial pain syndrome in general population is reported to reach up to 85%. The conventional treatment includes physical therapy and pain medication but the outcome is not always satisfactory.

Dr. MBD Gavião and colleagues in Brazil assessed the effect of acupuncture for myofascial pain of upper trapezius and cervical range of motion in a double-blinded, randomized clinical trial. Seventy-two women patients with myofascial pain of upper trapezius and cervical range of motion were allocated to manual acupuncture (n=24), electroacupuncture group (n=25) and sham acupuncture group (n=23). Acupuncture was applied on acupoints GB20, GB21, LI4 and LV3 and two Ashi points for 30 min,  needles are with (electroacupuncture) or without (manual acupuncture) connection to small electrical current device. Sham acupuncture needles are applied 1 cm distal to acupoints. Pain Visual Analogue scale, fleximetry and the head and neck movements were evaluated before and after treatment and follow-up.

Both manual acupuncture and electroacupuncture markedly reduced myofascial pain intensity of upper trapezius and increased cervical range of motion after treatment compared with sham acupuncture. Follow-up assessment found the therapeutic effect of acupuncture was still maintained compared with sham acupuncture 28 days after treatment.

Authors suggest that acupuncture was superiorly effective in reducing myofascial pain and effect is sustainable compared with sham acupuncture treatment.

Reference:

MFM Aranha et al., Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded,  randomized clinical trial. Braz J Phys Ther.      http://dx.doi.org/10.1590/bjpt-rbf.2014.0066.   http://www.ncbi.nlm.nih.gov/pubmed/25424524

Acupuncture treatment cured postoperative adhesive intestinal obstruction symptoms – a case report

Acupuncture exerted a complete symptomatic relief in a patient suffering from recurrent postoperative adhesive intestinal obstruction (PAIO). A case report was published in the journal of Acupuncture in Medicine.

Adhesive intestinal obstruction is caused by a variety of pathologic processes. The most common cause of adhesive intestinal obstruction is abdomino-pelvic surgery followed by malignancy, Crohn disease, and hernias. Main signs and symptoms associated with adhesive intestinal obstruction include abdominal pain, vomiting, constipation, and diarrhea. Treatments for the condition include gastric decompression, bowel rest and anti-inflammatory agents. However those treatments are not always effective. Surgical adhesiolysis is invasive and may cause new adhesion development, leading to recurrent episode of adhesive intestinal obstruction.

Recently Dr. CC Tseng in Taiwan, China used acupuncture to treat a patient with recurrent postoperative adhesive intestinal obstruction. A 49-year-old woman patient had an open appendicectomy for acute appendicitis in 1995. Then she developed intermittent abdominal pain, vomiting, constipation after operation and required several treatments in hospital. She had two surgical adhesiolysises performed in 1999 and in 2005 separately due to the recurrent and severe adhesive intestinal obstruction. Since then she continued to experience abdominal pain, vomiting, constipation and these affected her sleep and overall quality of life. The patient sought acupuncture as alternative treatment and was given acupuncture treatment at acupoints ST36 and ST25 for 20 min, three times a week for total 4 weeks. The pain intensity was measured with the Visual Analogue scale after each treatment. After the first treatment session, patient felt markedly reduction in abdominal pain. After the 3^rd treatment her nausea stopped and sleep was back to normal. After 4-week treatment the patient felt free of symptoms and was able to live a normal life. In an 8-year follow-up after the last acupuncture treatment in 2006 the patient said the symptoms have nerve reoccurred.

Reference

CC Tseng & A Tseng, Effect of acupuncture on postoperative adhesive intestinal obstruction. Acupunct Med2015;0:1–2. doi:10.1136/acupmed-2015-010843.   http://aim.bmj.com/content/early/2015/06/01/acupmed-2015-010843.extract

Acupuncture may be more effective than drugs in treating Alzheimer’s disease

Acupuncture may be more effective than drugs in treating Alzheimer’s disease (AD). Acupuncture improves effect of drugs for treating AD in terms of enhancing cognitive function. A systematic review study reported its data in the journal Medicine.

There is increasing number of reports regarding clinical trials of acupuncture treatment for AD during past 10 years. Most of studies were performed in China and were published in Chinese. The effectiveness and safety of acupuncture on AD has not been systematic reviewed until recently.

Dr. Zhou and colleagues in China evaluated the effectiveness and safety of acupuncture in treating AD by systematic review and meta-analysis. Meta-analysis is a statistical technique used for contrasting and combining results from different studies in the hope of identifying patterns among studies. Ten randomized controlled studies with a total of 585 subjects were used in the study. 

They found that the combined results from 6 randomized controlled studies showed acupuncture is better than drug at improving scores on the Mini Mental State Examination (MMSE) scale, indicating the enhancement in the cognitive function. Evidence from pooled data of 3 trials revealed that acupuncture plus drug denepezil was more effective at improving MMSE scale than denepezil alone. In a broad review they found that only 2 out of 141 acupuncture clinical trials reported the incidence of acupuncture-related adverse effect. Only 7 of 3416 patients reported to have adverse reactions relevant to acupuncture.

Authors conclude that “Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating AD in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients’ ability to carry out their daily lives.”

However, more clinical studies with better protocol design and better standards are urgently needed to prove the effectiveness of acupuncture in treating AD in more countries.

Reference:

J Zhou et al., The effectiveness and safety of acupuncture for patients with Alzheimer disease: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2015 Jun; 94(22):e933.

http://www.ncbi.nlm.nih.gov/pubmed/26039131

Acupuncture is an effective poststroke rehabilitation tool

Acupuncture therapy increased quality of life, improved mobility and activities of daily living of poststroke patients. The finding in which a review article recently reported in the Journal of Evidence-Based Complementary and Alternative Medicine.

It has been reported that approximately half of stroke survivors suffers from hemiparesis, cognitive deficits including difficulty in solving problems, dementia, memory impairment, depression and difficulty in communication. These significantly degraded their independence, quality of life and sense of emotional well-being. Although conventional poststroke rehabilitation helps many stroke patients restore some of their physical or emotional function the outcome is not always satisfactory.

Recently Ms. C Farmer from University of California, in the United States studied some clinical trials which assessed the effect of acupuncture on the poststroke patients suffering from chronic stroke symptoms. She found that overall those clinical studies consist of a set of strengths and weakness that suggest the acupuncture as a worthy addition to the poststroke patient rehabilitation. Acupuncture in particular is effective in improving quality of life, enhancing mobility and cognitive function. There were no adverse effects.

Author stated that among the reviewed study there was a common consensus, based on the data that acupuncture is a safe and effective treatment for poststroke rehabilitation.

Reference:

C Farmer, Bringing holistic treatments to the attention of medicine: acupuncture as an effective poststroke rehabilitation tool. Journal of Evidence-Based Complementary & Alternative Medicine, 2015 Apr;20(2):120-5.   http://www.ncbi.nlm.nih.gov/pubmed/25552471

Acupuncture improved sleep quality, depression and stress in elderly people

Acupuncture treatment helped get better sleep, improved depression and stress in elderly people as recently reported in journal Neuroscience Letter.

It is known that the sleep quality in elderly people is quite poor due to aging process. Poor sleep in elderly population causes tiredness, loss of interest of daily activity, stress and depression, and can significantly impair the quality of their life. Poor sleep is believed to be associated with many detrimental physiological and psychological changes such as alterations in brain neurotransmitters which are important for maintaining a healthy body and mood.

Recently doctors in Brazil conducted a clinical study to assess the effect of acupuncture on sleep quality in elderly people. Forty-eight elderly (aged 60-77) were randomly assigned into acupuncture group and placebo group. In acupuncture group acupoints SP6, LI4, ST36, LIV3, PC6 and EX-NH3 were stimulated for 25 min, twice a week for total 10 sessions. In placebo group, needle sites were far away from true acupoints, stimulation is superficial and no needle was inserted. Sleep quality, depression and stress were evaluated by the Pittsburgh sleep quality index (PSQI), the Beck Depression Inventory (BDI) and the perceived stress scale (PSS) before and after treatment. It was found that acupuncture markedly improved the sleep quality, depression and stress in all treated participants compared with placebo treatment.

The study also investigated effect of acupuncture on immunosenecence and brain derived neurotrophic factor. No difference was found between acupuncture and placebo groups.

The authors suggest that in elderly population acupuncture could be a very effective treatment for sleep problem, depression and stress without side effect.

Reference:

Zuppa C et al., Acupuncture for sleep quality, BDNF levels and immunosenescence: A randomized controlled study. Neuroscience Letters 587 (2015) 35–40.   http://www.ncbi.nlm.nih.gov/pubmed/25511549