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

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

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

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

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/

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 2^nd group with auricular acupuncture and the 3^rd 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/

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/