Research

PVA Procedure

Primary Acupoint

SecondaryAcupoint

1. Crown

EX.HN.3 (Yintang)

GV.20 (Baihui)

2. Vishuddhi

EX.HN.3 (Yintang)

GV.14 (Dazhui)

3. Mingmen

EX.HN.3 (Yintang)

GV.4 (Mingmen)

4. Anahata

EX.HN.3 (Yintang)

CV.17 (Danzhong)

5. Manipura

EX.HN.3 (Yintang)

CV.6 (Qihai)

6. Muladhara

EX.HN.3 (Yintang)

CV.4 (Guanyuan)

Table 1. Acupoints Utilized in the PVA Procedures

Procedure

PVA Specific Indications

Crown Liver

Fire Rising; memory loss, inability to concentrate, acute or chronic panic attack, emotional disturbance

Vishuddhi

Wind Invasion of Gallbladder; whiplash, neck and shoulder pain, headache, sadness

Mingmen

Kidney Qi/Yang Deficiency; enervation, fatigue, back pain, postoperative neuralgia, neurasthenia, boredom

Anahata

Lung Qi Deficiency; hiatus hernia, neurasthenia, introversion, emotional disturbance

Manipura

Qi Stagnation in Middle Jiao; constipation, chronic fatigue, postoperative paralytic ileus, anger, irritability

Table 2. Specific Indications of the PVA Procedures

CLINICAL PROTOCOL

The PVA clinical protocol encompasses the Crown, Vishuddhi, Mingmen, Anahata, Manipura, and Muladhara vital energetic alignments (see Table I and Figure). The eight-step protocol. delineated below. is appropriate after integrated TCM and biomedical diagnostic assessment has found which side of the body remains out of alignment as a result of the previous traumatic injury or surgery.

Step 1 The primary acupoint, EX.HN3, is needled obliquely (45º angle) in the direction of the flow of Qi down the midline of the face on the Du meridian to a depth of 0.5 cun utilizing the reinforcing method until De Qi is attained.

Step 2 The secondary acupoint is needled obliquely (45' angle) to a depth of 0.5 cun in the direction of the flow of Qi up the Ren (front midline) or Du (back midline) meridians utilizing the reinforcing method until De Qi is attained.

Step 3 The acupuncturist stands to one side of the patient and holds the primary needle with the left hand and the secondary needle with the right hand.

Step 4 The patient is asked to attempt to focus her or his eyes on a small object a short distance (3-5 metres) away.

Step 5 The acupuncturist gives both needles a simultaneous 1/4 turn (90º) toward the side of the patient's body that is out of alignment.

Step 6 The patient is asked if there is any change in eyesight or vision. The expected response is that the distant object has come into in much clearer focus. If this response is not obtained, both needles are given a simultaneous 1/2 turn (180º) in the opposite direction. When the expected response is obtained, the PVA procedure continues as follows.

Step 7 The primary needle is gently "forced" in 3 times to reinforce and set ("fix") the correct vital energetic alignment, and the same manipulation is performed on the secondary needle.

Step 8 While both needles remain in place, the patient is asked whether he or she feels more "grounded" or "embodied."

A positive response is expected, but if the response is negative the entire procedure may be repeated with or without the addition of tertiary acupoints. The needles are retained for 5-10 minutes.

The follow-up framework I have found to be effective in sustaining vital energetic alignment is PVA treatment once a week for three weeks, then every second week for six weeks and, finally, once a month for three months. Most patients, however, do not need such intensive follow-up, and in many cases one or two PVA treatments is all that is required.

Dr Steven KH Aung MD OMD PhD

9904 - 106 St, Edmonton, Alberta T5K 1C4, Canada
Tel [403]426-2760. Fax [403]426-5650

http://www.acupunctureaustralia.org/pages/journalarticles.htm#EightVessels

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BEYOND ENDORPHINS IN ACUPUNCTURE ANALGESIA
The Science Behind The Art
Dr. Linus Soh F.A.M.A.S.

In the last 20 years much has been written about acupuncture and its efficiency in relieving pain. The ancient Chinese clinicians practised acupuncture based on Traditional Chinese Medicine (TCM) principles using well established guidelines. Their reasoning were based on empirical responses rather than scientific principles. This discussion hopes to bring to highlight some recent research findings. Acupuncture research however cannot stagnate as we move towards the next century in pursuit of a better understanding of its mechanics.

Since the discovery of enkephalins from pigs' brains (by Hughes, Kosterlitz at Aberdeen) in 1975, the scientific community has tried to explain scientifically how acupuncture's pain relieving mechanisms really works. When Beta-endorphin was discovered (by C.H. Li at Stanford University) in 1976 and dynorphin ( by Goldstein) in 1979 it began to become clear that electro-acupuncture (EA) will increase the levels of B-endorphin at 2-4Hz and dynorphin at 100-200Hz. Enkephalins will be released at frequencies

2-200Hz. Based on the tail flick latency response in rats, Professor Han (Beijing University) also found that naloxone will even block EA response to high frequency stimulation. This was previously unknown as the dose of naloxone used was 1-2mg/kg whereas Han used 10-20mg/kg. In his experiments on rats Professor Han also used Captopril (a commonly used ACE inhibitor in general practice). When injected into the peri-aqueductal grey (PAG) Captopril prolongs the analgesic effects of EA as it is also an enkephalinase inhibitor.

Anti-opioid substances (AOS) were also described. These are released due to excessive EA and are thought to account for acupuncture tolerance. Indeed GABA and CCK8 have also been found to be increased after excessive morphine usage. Morphine tolerance hence often equated to EA tolerance. Whether the biochemical interaction are similar needs clarification. Recent studies show that the two main morphine metabolites are morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G). M3G antagonises morphine analgesia while M6G is an agonist. This relationship needs to be translated to EA tolerance but much research needs to be done. It may also help us understand the difficulty in treating patients addicted to opiates with EA.

At the last IASP conference in 1993, researchers have mentioned the discovery of morphine within the human body. This endogenous morphine (not endorphins) was found in patients who were taking L-Dopa for Parkinson's disease. As these patients were not on morphine medication the plasma levels of morphine must have been produced by the body itself. However, so far no details are known of the exact pathways involved. Perhaps in the future EA responses may have to be interpreted in a different manner in the light of this new knowledge.

The 1993 IASP Conference in Paris also produced evidence of a new pain pathway. The French team described this new pathway, called the spino-ponto-amygdaloid pathway. Noxious stimuli have been shown to project to the lateral parabrachial (PB) nucleus at the pontine level, and then directly to the central nucleus of the amygdala. Morphine needed to depress the noxious signals in the PB and amygdala are lower than that required at the spinal levels. This new pathway which have been implicated in the affective emotional aspects of pain. It seems to be highly sensitive to morphine. The amygdala has also been researched by Professor Han and has been found to involve serotonin and endorphins. When tested with cinanserin (a serotonin receptor blocker) and naloxone, EA analgesia was attenuated. This nucleus seem to play a big role in facilitating EA responses for pain relief. The discovery of this new pain pathway should add impetus for more research.

Serotonin (5HT) receptors sites have also been the subject of intense scrutiny over the last few years. There are now many subtypes of 5HT receptors namely 5HT, 5HT2, 5HT3, 5HT4 etc. 5HT1 is further subdivided into 5HT1A, 5HT1B, 5HT1C, 5HT1D. Research into the latter has given us sumatriptan which is a currently clinically used for migraine. The effect of EA on release of monoamines (down the descending inhibitory pathway) is well documented. Research using cinanserin (a 5HT receptor antagonist) and parachlorophenylalanine (PCPA - a 5HT synthesis antagonist) have shown EA to be decreased markedly. Conversely, Tryptophan (the precursor of 5HT) would enhance EA. However the many subtypes of 5HT receptors add a new challenge to acupuncture research. It is interesting to speculate if different frequencies will stimulate different 5HT receptors. If this is more clearly understood perhaps TCM may one day be explained along scientific paradigms.

Research into naloxone have shown that ultra-low doses (in nanograms) can have an analgesic effect. This seemingly paradoxical effect have mystified and at the same time excited scientists around the world. Various experiments performed in rat models of clinically induced arthritic pain have shown that extremely low doses of naloxone can have a paradoxical analgesic effect, while high doses induce hyperalgesia. It must be remembered that we often use naloxone for reversal of opiate toxicity.

Recent research into spinal receptor systems have revealed an important receptor which is currently the centre of great scientific interest. The NMDA (N-methyl-D-Aspartate) receptor reflects Aspartate and Glutamate activity in nociception. Ketamine (a NMDA antagonist) has been shown to produce analgesia when introduced to the dorsal horn. Glutamate and GABA seem to have opposing effects on neuronal cells. GABA anti-sera has been used to reverse acupuncture and morphine tolerance as well as non-responders to EA. Quite clearly the NMDA receptor should be more thoroughly researched in relation to acupuncture induced analgesia.

It can be seen from the above discussion we may have to rethink how acupuncture works. More and more research have enabled us to understand the complexities of nociceptive afferent stimulation of the dorsal horn, especially laminae I & II. It is to be hoped that acupuncture researchers will keep up with the new knowledge and perhaps unravel the mechanics of how acupuncture works in pain relief.

References
Pharmacological Approaches to the Treatment of Chronic Pain: New Concepts and Critical Issues - Progress in Pain Research and Management Volume 1. IASP Press 1994
Editors - H.L. Fields, J.C. Liebeskind

Proceedings of the 7th World Congress on Pain - Progress in Pain Research and Management Volume 2. IASP Press 1994
Editors - G.F. Gebhart,D.L. Hammond & T.S. Jensen

The Neurochemical Basis of Pain Relief by Acupuncture
Professor J.S. Han - 1987

http://www.acupunctureaustralia.org/pages/journalarticles.htm#EightVessels

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Chinese herbal medicine for primary dysmenorrhoea

X Zhu, M Proctor, A Bensoussan, CA Smith, E Wu

Cochrane Database of Systematic Reviews 2007 Issue 4 (Status: New)

Authors' conclusions

The review found promising evidence supporting the use of CHM for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials.

Plain language summary

Chinese herbal medicine may help reduce menstrual pain.

Dysmenorrhoea is a very common complaint that refers to painful menstrual cramps in abdomen. Primary dysmenorrhoea refers to pain of an unknown cause (i.e. no medical condition is identified). Nonsteroidal anti-inflammatory drugs or the contraceptive pill have been used successfully for treatment but more women are looking for non-drug therapies. Chinese herbal medicine has been used for centuries in China and it is currently used in public hospitals in China for the treatment of primary dysmenorrhoea. The review found promising evidence for the use of Chinese herbal medicine in reducing menstrual pain in the treatment of primary dysmenorrhoea compared to conventional medicine such as NSAIDs and the oral contraceptive pill, acupuncture and heat compression. No significant adverse effects were identified in this review, however the findings should be interpreted with caution due to the generally low methodological quality of the included studies.

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Abstract

Chinese herbal medicine for primary dysmenorrhoea

X Zhu, M Proctor, A Bensoussan, CA Smith, E Wu

Cochrane Database of Systematic Reviews 2007 Issue 4 (Status: New)

This version first published online: 17 October 2007 in Issue 4, 2007

Date of Most Recent Substantive Amendment: 8 August 2007

This record should be cited as: Zhu X, Proctor M, Bensoussan A, Smith CA, Wu E. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005288. DOI: 10.1002/14651858.CD005288.pub2.

Background

Conventional treatment for primary dysmenorrhoea (PD) has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Chinese herbal medicine (CHM) may be a suitable alternative.

Objectives

To determine the efficacy and safety of CHM for PD when compared with placebo, no treatment, and other treatment.

Search strategy

The Cochrane Menstrual Disorders and Subfertility Group Trials Register (to 2006), MEDLINE (1950 to January 2007), EMBASE (1980 to January 2007), CINAHL (1982 to January 2007), AMED (1985 to January 2007), CENTRAL (The Cochrane Library issue 4, 2006), China National Knowledge Infrastructure (CNKI, 1990 to January 2007), Traditional Chinese Medicine Database System (TCMDS, 1990 to Dec 2006), and the Chinese BioMedicine Database (CBM, 1990 to Dec 2006) were searched. Citation lists of included trials were also reviewed.

Selection criteria

Any randomized controlled trials (RCTs) involving CHM versus placebo, no treatment, conventional therapy, heat compression, another type of CHM, acupuncture or massage. Exclusion criteria were identifiable pelvic pathology and dysmenorrhoea resulting from the use of an intra-uterine contraceptive device (IUD).

Data collection and analysis

Quality assessment, data extraction and data translation were performed independently by two review authors. Attempts were made to contact study authors for additional information and data. Data were combined for meta-analysis using either Peto odds ratios or relative risk (RR) for dichotomous data or weighted mean difference for continuous data. A fixed-effect statistical model was used, where suitable. If data were not suitable for meta-analysis, any available data from the trial were extracted and presented as descriptive data.

Main results

Thirty-nine RCTs involving a total of 3475 women were included in the review. A number of the trials were of small sample size and poor methodological quality. Results for CHM compared to placebo were unclear as data could not be combined (3 RCTs). CHM resulted in significant improvements in pain relief (14 RCTs; RR 1.99, 95% CI 1.52 to 2.60), overall symptoms (6 RCTs; RR 2.17, 95% CI 1.73 to 2.73) and use of additional medication (2 RCTs; RR 1.58, 95% CI 1.30 to 1.93) when compared to use of pharmaceutical drugs. Self-designed CHM resulted in significant improvements in pain relief (18 RCTs; RR 2.06, 95% CI 1.80 to 2.36), overall symptoms (14 RCTs; RR 1.99, 95% CI 1.65 to 2.40) and use of additional medication (5 RCTs; RR 1.58, 95% CI 1.34 to 1.87) after up to three months follow up when compared to commonly used Chinese herbal health products. CHM also resulted in better pain relief than acupuncture (2 RCTs; RR 1.75, 95% CI 1.09 to 2.82) and heat compression (1 RCT; RR 2.08, 95% CI 2.06 to 499.18).

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ABOUT THE INSTITUTE FOR TRADITIONAL MEDICINE (ITM)

The Institute for Traditional Medicine and Preventive Health Care, Inc. (ITM), is a non-profit 501(c)(3) organization established in 1979, incorporated in 1983, and moved to its current head office in 1988. ITM was founded by and is directed by Subhuti Dharmananda, Ph.D.

Traditional medicine refers to ideas, experiences, and substances that have been handed down generation to generation from ancient times, where the origins are obscure but where the continuity of basic understanding has been assured by a formal structure. Among the primary traditional medical systems still active today are the Chinese, Tibetan, and Indian (Ayurvedic). ITM enriches the lives of people seeking traditional medicine knowledge and services by clarifying the nature of traditional medicine and demonstrating how it can be utilized in the modern setting.

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Acupuncture for Osteoarthritis of the Knee Study Results Acupuncture on a knee

NCCAM, National Institutes of Health
9000 Rockville Pike
Bethesda, Maryland 20892 USA
Web: nccam.nih.gov
E-mail: info@nccam.nih.gov

A landmark study has shown that acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. The study, the largest Phase III clinical trial of acupuncture for knee osteoarthritis, was funded by NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, both components of the National Institutes of Health.

Acupuncture Relieves Pain and Improves Function in Knee Osteoarthritis

NIH News Advisory National Institutes of Health U.S. Department of Health and Human Services		National Center for Complementary and Alternative Medicine (NCCAM) National Institute of Arthritis and Musculoskeletal and Skin Diseases

Embargoed for release: Monday, December 20, 2004 5 p.m. ET		Contact: NCCAM Press Office, 301-496-7790

Acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. This landmark study was funded by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), both components of the National Institutes of Health. The findings of the study--the longest and largest randomized, controlled phase III clinical trial of acupuncture ever conducted--were published in the December 21, 2004, issue of the Annals of Internal Medicine.¹

The multi-site study team, including rheumatologists and licensed acupuncturists, enrolled 570 patients, aged 50 or older with osteoarthritis of the knee. Participants had significant pain in their knee the month before joining the study, but had never experienced acupuncture, had not had knee surgery in the previous 6 months, and had not used steroid or similar injections. Participants were randomly assigned to receive one of three treatments: acupuncture, sham acupuncture, or participation in a control group that followed the Arthritis Foundation's self-help course for managing their condition. Patients continued to receive standard medical care from their primary physicians, including anti-inflammatory medications, such as COX-2 selective inhibitors, non-steroidal anti-inflammatory drugs, and opioid pain relievers.

"For the first time, a clinical trial with sufficient rigor, size, and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee," said Stephen E. Straus, M.D., NCCAM Director. "These results also indicate that acupuncture can serve as an effective addition to a standard regimen of care and improve quality of life for knee osteoarthritis sufferers. NCCAM has been building a portfolio of basic and clinical research that is now revealing the power and promise of applying stringent research methods to ancient practices like acupuncture."

"More than 20 million Americans have osteoarthritis. This disease is one of the most frequent causes of physical disability among adults," said Stephen I. Katz, M.D., Ph.D., NIAMS Director. "Thus, seeking an effective means of decreasing osteoarthritis pain and increasing function is of critical importance."

During the course of the study, led by Brian M. Berman, M.D., Director of the Center for Integrative Medicine and Professor of Family Medicine at the University of Maryland School of Medicine, Baltimore, Maryland, 190 patients received true acupuncture and 191 patients received sham acupuncture for 24 treatment sessions over 26 weeks. Sham acupuncture is a procedure designed to prevent patients from being able to detect if needles are actually inserted at treatment points. In both the sham and true acupuncture procedures, a screen prevented patients from seeing the knee treatment area and learning which treatment they received. In the education control group, 189 participants attended six, 2-hour group sessions over 12 weeks based on the Arthritis Foundation's Arthritis Self-Help Course, a proven, effective model.

On joining the study, patients' pain and knee function were assessed using standard arthritis research survey instruments and measurement tools, such as the Western Ontario McMasters Osteoarthritis Index (WOMAC). Patients' progress was assessed at 4, 8, 14, and 26 weeks. By week 8, participants receiving acupuncture were showing a significant increase in function and by week 14 a significant decrease in pain, compared with the sham and control groups. These results, shown by declining scores on the WOMAC index, held through week 26. Overall, those who received acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function compared to baseline assessments.

"This trial, which builds upon our previous NCCAM-funded research, establishes that acupuncture is an effective complement to conventional arthritis treatment and can be successfully employed as part of a multidisciplinary approach to treating the symptoms of osteoarthritis," said Dr. Berman.

Acupuncture--the practice of inserting thin needles into specific body points to improve health and well-being--originated in China more than 2,000 years ago. In 2002, acupuncture was used by an estimated 2.1 million U.S. adults, according to the Centers for Disease Control and Prevention's 2002 National Health Interview Survey.² The acupuncture technique that has been most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. In recent years, scientific inquiry has begun to shed more light on acupuncture's possible mechanisms and potential benefits, especially in treating painful conditions such as arthritis.

¹Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12):901-910.

²Barnes P, Powell-Griner E, McFann K, Nahin R. CDC Advance Data Report #343. Complementary and Alternative Medicine Use Among Adults: United States, 2002. May 27, 2004.

The National Center for Complementary and Alternative Medicine (NCCAM) is dedicated to exploring complementary and alternative medical (CAM) practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCAM's Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases. For additional information, call NIAMS's Clearinghouse toll free at 1-877-22-NIAMS, or visit the NIAMS Web site at http://www.flacupunctureworks.com/Research/tabid/80/ctl/Edit/mid/414/www.niams.nih.gov.

Video footage of acupuncture for the knee

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Acupuncture: Get the Facts

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Traditional and Evidence-Based Acupuncture in Headache Management: Theory, Mechanism, and Practice

Chong-hao Zhao, MD, PhD, DABMA; Mark J. Stillman, MD; Todd D. Rozen, MD

Posted 07/07/2005

Conclusion

Despite preliminary research evidence suggesting acupuncture may suppress nociceptive TNC and spinal DH neurons via modulation of the release of neuropeptides and neurotransmitters, the exact mechanisms by which acupuncture relieves the headache are not fully understood. Empiric evidence and results of clinical investigations suggest that acupuncture may be a promising treatment option in the treatment of headache, especially migraine. Acupuncture is a safe and minimally invasive procedure, and may specifically benefit those patients who cannot tolerate headache medications. Further well-designed acupuncture studies should illuminate acupuncture's analgesic mechanisms and value in managing various headaches.

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Efficacy of acupuncture and moxibustion in treating Bell's palsy: a multicenter randomized controlled trial in China.

Li Y , Liang FR , Yu SG , Li CD , Hu LX , Zhou D , Yuan XL , Li Y , Xia XH

Chin Med J (Engl). 2004 Oct;117(10):1502-6.

BACKGROUND: Bell's palsy involves acute facial paralysis due to inflammation of the facial nerve. Acupuncture and moxibustion (acu-moxi) is beneficial in treating facial palsy. In order to verify the efficacy of acu-moxi on Bell's palsy, a randomized single-blind, multicenter clinical trial was performed. METHODS: A total of 480 patients from four clinical centers were involved in this trial, of whom 439 completed the trial and 41 did not. All patients were randomly assigned to either the control group or to one of two treatment groups. The control group was treated with prednisone, vitamin B1, vitamin B12, and dibazole; the treatment groups were treated either with acu-moxi alone or in combination with prednisone, Vitamin B1, vitamin B12, and dibazole. Symptoms and signs, the House-Brackmann scale, and facial disability index (FDI) scores were assessed and determined both pre- and post-treatment to evaluate the effectiveness of the treatment methods. RESULTS: The characteristics of the control and two treatment groups were comparable without statistically significant differences before treatment. There were significant differences between the control and treatment groups after treatment (chi(2) = 15.265, P = 0.018). According to evaluations based on the House-Brackmann scale and FDI scores, the effectiveness of treatment in the two treatment groups was better than in the control group and was most effective in patients receiving acu-moxi treatment alone (Z = -2.827, P = 0.005). CONCLUSION: The efficacy of acu-moxi treatment for Bell's palsy is verified scientifically.

Acupuncture and Tuina College, Chengdu University of TCM, Chengdu 610075, China. jialee@mail.sc.cninfo.net

PMID=15498373

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Effects of acupuncture on the gastric motivity in patients with functional dyspepsia

Chen JY , Pan F , Xu JJ

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005 Oct;25(10):880-2.

OBJECTIVE: To observe the effects of the acupuncture on the gastric motivity in patients with functional dyspepsia (FD). METHODS: Ninety FD patients were randomly divided into 3 groups: the treated group, the control groups, 1 and 2, 30 patients in each group. Patients in the treated group received acupuncture treatment, those in the control group 1 and group 2 orally took Cisapride and Marzulene-s granule respectively. Changes in scores of symptoms, electrogastrographic figure, gastric emptying time estimated by B-ultrasonic examination and plasma level of motilin in the 3 groups before and after treatment were observed. RESULTS: Symptoms were obviously improved in the treated and control group 1 after treatment, which were better than those in the control group 2 (P < 0.01). Gastro-electric frequency and rhythm in the treated group and control group 1 were improved more significantly than those in before treatment (P < 0.01). Gastric emptying time and plasma motilin improved in the treated group and the control group 1 after treatment, when compared with before treatment, the difference was significant respectively (P < 0.05). CONCLUSION: Acupuncture could significantly improve the gastric motility of FD patients.

Provincial Hospital of Integrative Chinese and Western Medecine, Hangzhou. chjy@hzcnc.com

PMID=16313107

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Incidence rate and acupuncture-moxibustion treatment of post-stroke depression

Liu SK , Zhao XM , Xi ZM

Zhongguo Zhen Jiu. 2006 Jul;26(7):472-4.

OBJECTIVE: To understand the incidence of post-stroke depression (PSD) and the therapeutic effect of acupuncture-moxibustion. METHODS: Five hundred and sixty cases were rating with Hamilton depression scale, and lesion parts, gender, age and property of stroke between the PSD and non-PSD were compared by analysis of variance, chi2 test, and then the patients of PSD were randomly divided into two groups and treated respectively with Prozac-20 and acup-moxibustion at Sishencong (EX-HN 1), Anmian, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Taichong (LR 3), Zhaohai (KI 6), Shenmai (BL 62). RESULTS: The total incidence rate of PSD was 43.9%, with no relation to the lesion parts, gender, age and property of stroke (P > 0.05), and there were very significant differences in HAMD scores before and after treatment in the two groups (P < 0.0001), with no significant difference in the effective rate between the two groups (P > 0.05). CONCLUSION: PSD has a high incidence and influences the recovery of nervous function, and it should be treated at early stage. Acup-moxibustion and Prozac-20 have similar therapeutic effect.

The First Central Hospital of Baoding City, Hebei 071000, China. liusukun2003@yahoo.com.cn

PMID=16903595

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A systematic review of randomized controlled trials of acupuncture in the treatment of depression.

Leo RJ , Ligot JS

J Affect Disord. 2006 Aug

BACKGROUND: Acupuncture has become a popular complementary and alternative treatment approach. This review examined the randomized controlled trials (RCTs) examining the effects of acupuncture treatment of depression. METHODS: RCTs of the treatment of depression with acupuncture were located using MEDLINE, Allied and Complementary Medicine and the Cochrane Central Register of Controlled Trials. The methodology of RCTs was assessed using the Jadad criteria, and elements of research design, i.e., randomization, blinding, assessment of attrition rates, were quantified for systematic comparisons among studies. RESULTS: Among the 9 RCTs examined, five were deemed to be of low quality based upon Jadad criteria. The odds ratios derived from comparing acupuncture with control conditions within the RCTs suggests some evidence for the utility of acupuncture in depression. General trends suggest that acupuncture modalities were as effective as antidepressants employed for treatment of depression in the limited studies available for comparison. However, placebo acupuncture treatment was often no different from intended verum acupuncture. LIMITATIONS: The RCTs extracted were limited by small sample sizes, imprecise enrollment criteria, problems with randomization, blinding, brief duration of study and lack of longitudinal follow-up. CONCLUSIONS: Despite the findings that the odds ratios of existing literature suggest a role for acupuncture in the treatment of depression, the evidence thus far is inconclusive. However, efforts are being made to standardize complementary approaches to treat depression, and further systematized research into their use is warranted.

Full-text available: http://linkinghub.elsevier.com/retrieve/pii/S0165-0327(06)00280-1

Department of Psychiatry, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, United States.

PMID=16899301

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Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial.

Brinkhaus B , Hummelsberger J , Kohnen R , Seufert J , Hempen CH , Leonhardy H , Nögel R , Joos S , Hahn E , Schuppan D

Allergy. 2004 Sep;59(9):953-60.

BACKGROUND: Patients with allergic rhinitis (AR) increasingly use complementary medicine. The aim of this study was to determine whether traditional Chinese therapy is efficacious in patients suffering from seasonal AR. METHODS: Fifty-two patients between the ages of 20 and 58 who had typical symptoms of seasonal AR were assigned randomly and in a blinded fashion to (i) an active treatment group which received a semi-standardized treatment of acupuncture and Chinese herbal medicine, and (ii) a control group which received acupuncture applied to non-acupuncture points in addition to a non-specific Chinese herbal formula. All patients received acupuncture treatment once per week and the respective Chinese herbal formula as a decoction three times daily for a total of 6 weeks. Assessments were performed before, during, and 1 week after treatment. The change in severity of hay fever symptoms was the primary outcome measured on a visual analogue scale (VAS). RESULTS: Compared with patients in the control group, patients in the active treatment group showed a significant after-treatment improvement on the VAS (P = 0.006) and Rhinitis Quality of Life Questionnaire (P = 0.015). Improvement on the Global Assessment of Change Scale was noted in 85% of active treatment group participants vs 40% in the control group (P = 0.048). No differences between the two groups could be detected with the Allergic Rhinitis Symptom Questionnaire. Both treatments were well-tolerated. CONCLUSIONS: The results of this study suggest that traditional Chinese therapy may be an efficacious and safe treatment option for patients with seasonal AR.

Full-text available: http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0105-4538&date=2004&volume=59&issue=9&spage=953

Department of Medicine I, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen Germany.

PMID=15291903

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Effects of acupuncture on clinical symptoms and pulmonary function in the patient of bronchial asthma.

Zhang WP

Zhongguo Zhen Jiu. 2006 Nov;26(11):763-7.

OBJECTIVE: To explore the clinical therapeutic effect of acupuncture on bronchial asthma. Methods One hundred and four cases of asthma at persistent period and remission stage were divided into a treatment group and a control group with stratified random method of illness degrees. The treatment group were treated with antiasthma agents plus acupuncture at Quchi (LI 11), Lieque (LU 7), Yuji (LU 10), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), once each day, 10 sessions constituting one course, and the control group with anti-asthma agents at the same dose. Changes of clinical symptoms and pulmonary function after treatment were investigated. Results Clinical symptoms significantly improved, the score for asthma symptoms decreased and the wheeze in the lung reduced, severity and grading of the disease significantly improved in the treatment group with significant differences as compared with those in the control group (all P< 0.05). And the first second forced expiratory volume (FEV1), peak of forced expiratory flow rate (PEF), FEF(25%-75%) (% PRED), FEF(75%-85%) (% PRED), FEF50% (%PRED), FEF75% (% PRED) more significantly improved in the treatment group than in the control group (P < 0.05 or P < 0.01 or P < 0.001). Six months later, the incidence rate of asthma acute attack in the treatment group was lower than that in the control group (P < 0.05), and the dose of anti-asthma agents in the 50% of patients in the treatment group was reduced by 1/3-1/4. CONCLUSION: Acupuncture can improve clinical symptoms and pulmonary function and reduce the dose of anti-asthma agents, and has a certain long-term therapeutic effect.

China Academy of Chinese Medical Sciences, Beijing 100700, China. 168zhwp@sina.com

PMID=17165494

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Efficacy of auricular acupressure as an adjuvant therapy in substance abuse treatment: a pilot study.

Tian X , Krishnan S

Altern Ther Health Med. 2006 Jan-Feb ;12(1):66-9.

CONTEXT: Substance abuse and its related problems have become a serious public health issue, particularly in underserved border and rural communities. Conventional therapies have not always been effective. Literature regarding the use of auricular acupressure in substance abuse treatment is limited. OBJECTIVE: To examine the efficacy of auricular acupressure in addition to usual care in substance abuse treatment, which has been limited. DESIGN AND SETTING: This placebo-controlled pilot study was carried out in a community mental health center in a US-Mexico border city (Las Cruces) in southwestern New Mexico. PARTICIPANTS: A majority were Hispanic males with an average age of 32.8 years. Participants reported an average lifetime use of drug of choice of 14 years. INTERVENTION: In addition to usual care, participants received specific acupressure treatment and placebo acupressure treatment. The acupressure treatment was offered once a week for 6 consecutive weeks. MAIN OUTCOME MEASURES: The Hopkins Symptom Checklist (SCL-20) Depression Scale was administered before and after 6 weeks of treatment to assess changes in emotional distress. Brief Substance Craving Scale was used at baseline and weekly for 6 weeks to assess changes in craving. RESULTS: Both specific and placebo acupressure groups showed a significant reduction in craving at the end of treatment, with the specific acupressure group having a greater and more steady reduction in craving. Both specific acupressure and usual-care-only groups demonstrated a significant reduction in emotional stress. CONCLUSION: Overall, there was a positive response to the specific auricular acupressure treatment on psychological distress, craving, and drug/alcohol use measures. These encouraging preliminary results need to be duplicated in studies with larger sample sizes and longer treatment phases.

Department of Health Science at New Mexico State University, Las Cruces, NM, USA.

PMID=16454149

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Therapeutic modulation of the psychoneuroimmune system by medical acupuncture creates enhanced feelings of well-being.

Walling A

J Am Acad Nurse Pract. 2006 Apr;18(4):135-43.

PURPOSE: This article includes an explanation of how stressors disrupt physiologic regulatory mechanisms leading to disease states, how environmental challenges alter the function of the psychoneuroimmune system, and how correction of aberrant action potentials will stabilize homeostatic regulatory functions, inducing an escape response from stressors and leading to enhanced feelings of well-being. An explanation of how medical acupuncture accomplishes this stabilization concludes the article. DATA SOURCE: Extensive review of the worldwide scientific literature from the 1970s through current literature, on acupuncture, neurophysiology, and psychoneuroimmune system, using the theoretical framework of Martha Rogers. CONCLUSIONS: It is estimated that 80% of all illnesses are stress induced, although the physiologic mechanisms by which stress induces detrimental changes are not well understood by the medical profession. Introducing specific rhythmic electrical impulses slightly more intense than the nervous system already generates with the intervention of medical acupuncture can therapeutically alter aberrant signals induced by stressors, which may result in the release of neuropeptides and stabilization of homeostatic regulation so that health outcomes are improved. As neurological activity is altered, the firing pattern of nerves is changed. This is a change in the electrical pattern that leads to a change in the biochemical pattern. Thus, medical acupuncture is a therapy that is in agreement with Martha Rogers' conceptual model. Therapeutic techniques may improve the individual's level of wellness by direct actions toward homeostatic stabilization of the autonomic nervous system. These techniques will not change the amount of stressors a person is subject to but will change the physiological response to them. When the nervous system is in homeostatic balance, individuals will report enhanced feelings of well-being, be more effective in coping with their conditions of living, and therefore be less susceptible to illness. IMPLICATIONS FOR PRACTICE: Nurse practitioners have an opportunity to expand into an unused dimension for nursing care through direct treatment of the central and autonomic nervous system that will influence the psychoneuroimmune system. A prescriptive theory explaining medical acupuncture provides for therapeutic interventions at the primary, secondary, and tertiary level of care. Primary preventive interventions alter the effects of stress before it leads to illness by assisting homeostatic stability of the autonomic nervous system. Secondary interventions allow treatment of many health conditions regulated by neurological activity. Tertiary care provides a method to assist autonomic regulation when the body is no longer able to maintain homeostatic stability because of chronic illness or injury.

Full-text available: http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1041-2972&date=2006&volume=18&issue=4&spage=135

wme1@comcast.net

PMID=16573726

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