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

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 

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/

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

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 

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

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