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El Iskandarani S, Deng G. Acupuncture in hematologic malignancies and hematopoietic cell transplantation. Blood Rev 2022; 56:100985. [PMID: 35725779 PMCID: PMC10359773 DOI: 10.1016/j.blre.2022.100985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/02/2022]
Abstract
Acupuncture is an integrative medicine modality that has been used historically and studied recently for managing various symptoms and diseases. Patients with hematological malignancies often experience a high symptom burden including pain, fatigue, nausea, vomiting, and insomnia. Pharmacological interventions are the mainstay of managing these symptoms, although they may not provide adequate control or are not well tolerated due to side effects. There have been many randomized controlled trials of acupuncture on reduction of these symptoms. In this review, we will summarize the current evidence on the effect of acupuncture on the management of common symptoms experienced by patients with hematological malignancies and the current understanding of acupuncture's mechanism of action. The evidence is the strongest for reducing pain and nausea vomiting, less strong for symptoms such as peripheral neuropathy, fatigue, constipation, insomnia, night sweat, and pruritus.
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Affiliation(s)
- Sarah El Iskandarani
- Memorial Sloan Kettering Cancer Center, Integrative Medicine Service, New York, NY, USA
| | - Gary Deng
- Memorial Sloan Kettering Cancer Center, Integrative Medicine Service, New York, NY, USA.
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Effect of Acupuncture on Delayed Emesis for the Patients Who Received High-Emetogenic Chemotherapy with Standard Antiemetic Prophylaxis (KHMC-HO-01): An Open-Label, Randomized Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9688727. [PMID: 35422869 PMCID: PMC9005265 DOI: 10.1155/2022/9688727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022]
Abstract
Background Chemotherapy-induced nausea and vomiting (CINV) is one of the most important issues associated with chemotherapy. The additional or synergistic effect of acupuncture on CINV remains controversial. Methods Patients were randomized into either the group that received standard antiemetics with acupuncture (Arm A) or standard antiemetics only (Arm C). Acupuncture with manual stimulation was applied at eight predefined points and was started before the first cycle of chemotherapy on the first day and two additional sessions were administered on the second day of chemotherapy. Acute and delayed CINV was assessed using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and the MASCC Antiemesis Tool (MAT). The primary outcome was the delayed nausea score assessed using the RINVR. Results Overall, 42 patients were included. In the delay phase, the severity of delayed nausea was slightly lower without significance in Arm A than in Arm C (5.35 vs. 5.98, p = 0.3011). Similarly, patients in Arm A reported less severe vomiting than those in Arm C (0.75 vs. 1.25, p = 0.3064). Delayed nausea and vomiting assessed by the MAT showed significant relief with acupuncture compared to standard antiemesis alone. In terms of acute emesis, there was no significant difference between the two arms according to either scoring method. Conclusions Delayed nausea after HEC tended to decrease with acupuncture using the RINVR score, though it was also not significant. With the MAT assessment, delayed emesis (nausea and vomiting) was significantly improved with acupuncture, suggesting a promising effect of acupuncture. This trial is registered with KCT0006477.
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Püsküllüoğlu M, Tomaszewski KA, Grela-Wojewoda A, Pacholczak-Madej R, Ebner F. Effects of Transcutaneous Electrical Nerve Stimulation on Pain and Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Systematic Review. Medicina (B Aires) 2022; 58:medicina58020284. [PMID: 35208610 PMCID: PMC8876365 DOI: 10.3390/medicina58020284] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
Transcutaneous electrical nerve stimulation (TENS) is the usage of a mild electrical current through electrodes that stimulate nerves. Patients with malignancies experience pain and chemotherapy-induced peripheral neuropathy. A systematic review was performed to find research evaluating the effect of TENS on these two common symptoms decreasing the quality of life in cancer patients. PubMed, the Cochrane Central Register of Controlled Trials and EMBASE were searched. Original studies, namely randomized controlled trials, quasi-randomized controlled trials and controlled clinical trials, published between April 2007 and May 2020, were considered. The quality of the selected studies was assessed. Seven papers were incorporated in a qualitative synthesis, with 260 patients in total. The studies varied in terms of design, populations, endpoints, quality, treatment duration, procedures and follow-up period. Based on the results, no strict recommendations concerning TENS usage in the cancer patient population could be issued. However, the existing evidence allows us to state that TENS is a safe procedure that may be self-administered by the patients with malignancy in an attempt to relieve different types of pain. There is a need for multi-center, randomized clinical trials with a good methodological design and adequate sample size.
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Affiliation(s)
- Mirosława Püsküllüoğlu
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, 00-001 Krakow, Poland; (A.G.-W.); (R.P.-M.)
- Labcorp (Polska) Sp. z o.o., 05-825 Warsaw, Poland
- Correspondence:
| | - Krzysztof A. Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, Poland;
- Scanmed St. Raphael Hospital, 30-693 Krakow, Poland
| | - Aleksandra Grela-Wojewoda
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, 00-001 Krakow, Poland; (A.G.-W.); (R.P.-M.)
| | - Renata Pacholczak-Madej
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, 00-001 Krakow, Poland; (A.G.-W.); (R.P.-M.)
- Department of Anatomy, Medical College, Jagiellonian University, 31-008 Krakow, Poland
| | - Florian Ebner
- Helios Amper-Klinikum Dachau, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität, 85221 München, Germany;
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Mayan M, Alvadj T, Wildge S, Punja S, Jou H, Vohra S. Toward integrated pediatric medicine: Key learnings from the pediatric integrative medicine trial. Explore (NY) 2021; 18:432-437. [PMID: 34305004 DOI: 10.1016/j.explore.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/26/2021] [Accepted: 07/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The purpose of this study is to explore the facilitators to integrating complementary therapies in conventional pediatric hospital practice based on the experiences of parents, healthcare providers, and complementary therapy providers. DESIGN This study is part of a larger research study that examined the introduction of a pediatric integrative medicine service in an acute care children's hospital in Canada. A qualitative descriptive study was conducted using semi-structured one-on-one telephone and in-person interviews with a sample of parents of children, as well as healthcare providers and complementary therapy providers. RESULTS A total of 50 individuals, from key-stakeholder groups, were interviewed between May 2014 and January 2016. This study identified the following facilitators for the integration of complementary therapies within conventional care: 1) stakeholders' open-mindedness and familiarity with care practices outside of their experiences; 2) stakeholders' open communication, respect for eachothers' roles in the process of care, and appreciation for the role of complementary therapies within conventional medicine; and 3) stakeholders' receptiveness to redefining the meaning of a 'positive outcome' in the context of hospital care. CONCLUSION The findings of this study demonstrate that some of the existing barriers to the integration of complementary therapies in conventional hospital care could be mediated by creating an environment where the fundamental value of commitment to patient wellbeing is equally shared by all stakeholders.
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Affiliation(s)
- Maria Mayan
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Tatjana Alvadj
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
| | - Sarah Wildge
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Salima Punja
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Hsing Jou
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Sunita Vohra
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
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Tack L, Lefebvre T, Blieck V, Cool L, Pottel H, Eygen KV, Derijcke S, Vergauwe P, Schofield P, Chandler R, Lane P, Boterberg T, Debruyne PR. Acupuncture as a Complementary Therapy for Cancer Care: Acceptability and Preferences of Patients and Informal Caregivers. J Acupunct Meridian Stud 2021; 14:67-74. [DOI: 10.51507/j.jams.2021.14.2.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/11/2021] [Accepted: 02/21/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Laura Tack
- Department of Medical Oncology, Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Tessa Lefebvre
- Department of Medical Oncology, Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Virginie Blieck
- College for Traditional Chinese Medicine & Karel de Grote University College, Antwerp, Belgium
| | - Lieselot Cool
- Department of Medical Oncology, Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Hans Pottel
- Department of Public Health and Primary Care at Kulak, Catholic University Leuven Kulak, Kortrijk, Belgium
| | - Koen Van Eygen
- Department of Haematology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Sofie Derijcke
- Department of Pneumology, General Hospital Groeninge, Kortrijk, Belgium
| | - Philippe Vergauwe
- Department of Gastro-Enterology, General Hospital Groeninge, Kortrijk, Belgium
| | | | - Rebecca Chandler
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Pauline Lane
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Philip R. Debruyne
- Department of Medical Oncology, Kortrijk Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- School of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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Comparative Effectiveness of Pediatric Integrative Medicine: A Pragmatic Cluster-Controlled Trial. CHILDREN-BASEL 2021; 8:children8040311. [PMID: 33923869 PMCID: PMC8072575 DOI: 10.3390/children8040311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
Symptoms of pain, nausea/vomiting, and anxiety (PNVA) are highly prevalent in pediatric inpatients. Poorly managed symptoms can lead to decreased compliance with care, and prolonged recovery times. Pharmacotherapy used to manage PNVA symptoms is of variable effectiveness and carries safety risks. Complementary therapies to manage these symptoms are gaining popularity due to their perceived benefits and low risk of harm. Pediatric integrative medicine (PIM) is the combination of complementary therapies with conventional medicine in pediatric populations. A two-arm, cluster-controlled, pragmatic clinical trial was carried out to compare the effectiveness of a PIM service in conjunction with usual care, versus usual care only to treat PNVA symptoms in hospitalized pediatric patients. The primary outcome was the improvement of PNVA symptom severity using a 10-point numerical rating scale. Participant enrollment occurred between January 2013 and January 2016. A total of 872 participants (usual care n = 497; PIM n = 375) were enrolled. The PIM therapies significantly reduced PNVA symptom severity (p < 0.001). This study found that a hospital-based PIM service is both safe and effective for alleviating PNVA symptoms. Future research should carry out this work in other pediatric inpatient divisions, and in other sites to determine the reproducibility of findings.
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Garcia GT, Ribeiro RF, Faria Santos IB, Gomes FDC, de Melo-Neto JS. Electrical Stimulation of PC 6 to Control Chemotherapy-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review and Meta-Analysis. Med Acupunct 2021; 33:22-44. [PMID: 33613810 DOI: 10.1089/acu.2020.1431] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: A complementary treatment for managing chemotherapy-induced nausea and vomiting (CINV) with promising results is electrostimulation of Pericardium 6 (PC 6; Neiguan). This review was conducted to evaluate the effects of electrostimulation therapy at PC 6 to control CINV in patients with cancer. The review was registered on PROSPERO (CRD42018087753). Methods: This systematic review and meta-analysis of clinical trials was accomplished according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies written in English, Portuguese, or Spanish that met the eligibility criteria organized according to the PICO [Patient, Problem or Population; Intervention; Comparison, Control, or comparator; Outcome(s)] anagram were included. Descriptors used to search the databases were identified and selected according to the Medical Subject Headings of the National Library of Medicine. The primary outcomes evaluated were the frequency and severity of nausea, vomiting, and general emesis after the experimental protocol. The secondary outcomes evaluated were the numbers of antiemetic pills taken and the patients' quality of life. Results: Fourteen articles were included. There was a reduction in the mean number of episodes of acute nausea (mean difference [MD] = -2.08; 95% confidence interval [95%CI] = -2.76, -1.39) and acute vomiting (MD = -0.91; 95% CI = -1.39, -0.42) or delayed (MD = -0.85; 95%CI = -1.47, -0.23) in patients given the treatment. The other analyses of nausea, vomiting and emesis showed no differences. Conclusions: Electrostimulation at PC6 has an effect on controlling general emesis, and acute nausea and vomiting in different phases of recovery from chemotherapy in patients with cancer.
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Huang L, Zhao Y, Xiang M. Knowledge Mapping of Acupuncture for Cancer Pain: A Scientometric Analysis (2000-2019). J Pain Res 2021; 14:343-358. [PMID: 33574698 PMCID: PMC7872910 DOI: 10.2147/jpr.s292657] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Objective This study aimed to demonstrate the state of the present situation and trends concerning the global use of acupuncture for cancer pain in the past 20 years. Methods Searched the Web of Science database from 2000 to 2019 related to acupuncture for cancer pain, and then used CiteSpace to conduct scientometric analysis to acquire the knowledge mapping. Results Yearly output has increased year by year, and the growth rate has become faster after 2012. According to the cluster analysis of institutions, authors, cited references, and keywords, 4, 4, 15, and 14 categories were obtained, respectively. The most productive countries, institutions, and authors are the USA, Mem Sloan Kettering Cancer Center, and Mao JJ, whose frequencies are 196, 24, and 17, respectively. However, the most important of them are Australia, Univ. Maryland, and Bao T, owing to their highest centrality, they are 0.90, 0.21, and 0.09 separately. Moreover, cited references that contributed to the most co-citations are Crew KD (2010), however, the most key cited reference is Roscoe JA (2003). Keywords such as acupuncture, pain, breast cancer, palliative care, and quality of life are the most frequently used. But auricular acupuncture is the crucial keyword. In the cluster analysis of institutions, authors, cited references, and keywords, the more convincing research categories are multiple myeloma, placebo effect, neck malignancies, and early breast cancer, with S values of 0.990, 0.991, 0.990, and 0.923, respectively. Therefore, they can be regarded as research hotspots in this field. Conclusion Based on the scientometric analysis in the past 20 years, the knowledge mapping of the country, institution, author, cited reference, and the keyword is gained, which has an important guiding significance for quickly and accurately positioning the trend in this field.
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Affiliation(s)
- Li Huang
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Yanqing Zhao
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Minhong Xiang
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
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Grant SJ, Kwon K, Naehrig D, Asher R, Lacey J. Characteristics and Symptom Burden of Patients Accessing Acupuncture Services at a Cancer Hospital. Integr Cancer Ther 2021; 20:15347354211002253. [PMID: 33840252 PMCID: PMC8044564 DOI: 10.1177/15347354211002253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Patients with cancer are often impacted by a significant symptom burden. Cancer hospitals increasingly recognize the value of complementary and integrative therapies to support the management of cancer related symptoms. The aim of this study is to provide a better understanding of the demographic characteristics and symptoms experienced by cancer patients who access acupuncture services in a tertiary hospital in Australia. METHODS A retrospective audit was conducted of patients that presented to the acupuncture service at Chris O'Brien Lifehouse between July 2017 and December 2018. Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCaW) outcome measures were used. The quantitative data was analyzed using descriptive statistics and Principal Component Analysis. RESULTS A total of 127 inpatients and outpatients (mean age 55, range 19-85) were included with 441 individual surveys completed (264 ESAS, 177 MYCaW). Patients were predominantly female (76.8%) and breast cancer was the most prevalent primary diagnosis (48%). The most prevalent symptoms in the ESAS were sleep problems (88.6%), fatigue (88.3%), lack of wellbeing (88.1%), and memory difficulty (82.6%). Similarly, symptoms with the highest mean scores were numbness, fatigue, sleep problems and hot flushes, whilst neuropathy, and hot flashes were scored as the most severe (score ≥7) by patients. Cluster analysis yielded 3 symptom clusters, 2 included "physical symptoms" (pain, sleep problems, fatigue and numbness/neuropathy), and (nausea, appetite, general well-being), whilst the third included "psychological" symptoms (anxiety, depression, spiritual pain, financial distress). The most frequent concerns expressed by patients (MyCaW) seeking acupuncture were side effects of chemotherapy (24.6%) and pain (20.8%). CONCLUSION This audit highlights the most prevalent symptoms, the symptoms with the greatest burden and the types of patients that receive acupuncture services at an Australian tertiary hospital setting. The findings of this audit provide direction for future acupuncture practices and research in hospital settings.
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Affiliation(s)
- Suzanne J. Grant
- NICM Health Research Institute, Western Sydney University, NSW, Australia
- Chris O’Brien Comprehensive Cancer Centre, Camperdown, NSW, Australia
| | - Ki Kwon
- NICM Health Research Institute, Western Sydney University, NSW, Australia
| | - Diana Naehrig
- Chris O’Brien Comprehensive Cancer Centre, Camperdown, NSW, Australia
- University of Sydney, NSW, Australia
| | - Rebecca Asher
- National Health Medical Research Council, Sydney, NSW, Australia
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, NSW, Australia
- Chris O’Brien Comprehensive Cancer Centre, Camperdown, NSW, Australia
- University of Sydney, NSW, Australia
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Chen L, Wu X, Chen X, Zhou C. Efficacy of Auricular Acupressure in Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:8868720. [PMID: 34394394 PMCID: PMC8357499 DOI: 10.1155/2021/8868720] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 06/14/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND More than 40% of patients with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) remained the most debilitating side effects of treatment even in the era of new antiemetics. OBJECTIVE The purpose of this review was to systematically evaluate the clinical effect of auricular acupressure (AA) in prevention and treatment of chemotherapy-induced nausea and vomiting. METHODS The following databases were searched: PubMed, Cochrane Library, EMBASE, the Web of Science, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang, and VIP (from database inception to April 2020). Eligible randomized controlled trials of auricular acupressure in treating CINV were collected, including crossover randomized design study. The meta-analysis was carried out by RevMan software (5.3). RESULTS Totally 19 RCTs with 1449 patients met the inclusion criteria. Compared with control groups, the relief efficiency of overall CINV was enhanced by AA combined with antiemetics (RR = 1.31, CI 1.22 to 1.41, p ≤ 0.001). Although the therapeutic effect on acute nausea and vomiting was not obvious, AA still played an important role in reducing delayed nausea and vomiting (delayed nausea frequency: RR = 0.68, CI -1.01 to -1.35, p ≤ 0.001; delayed vomiting frequency: RR = 0.91, CI -1.22 to -0.61, p ≤ 0.001). The likelihood of adverse reactions related to antiemetics was reduced by AA combined with antiemetics (RR = 0.62, CI 0.53 to 0.74, p ≤ 0.001). Statistically significant association was found between AA and incidence of constipation, diarrhea, and tiredness, while there was no statistically significant association between AA and abdominal distension or headache. CONCLUSION Auricular acupressure supplementation benefited delayed chemotherapy-induced nausea and vomiting as well as constipation, diarrhea, and tiredness. AA alone or AA supplementation has little effect on acute nausea and acute vomiting. There is no conclusion on whether AA alone is superior to antiemetics in the management of delayed CINV. Further studies are needed to confirm the efficacy of auricular acupressure alone in delayed CINV and anticipatory CINV. The results of this review provided the basis for further research with more rigorous study designs, adequate sample sizes, and standardized implementation to confirm the efficacy of auricular acupressure.
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Affiliation(s)
- Lichan Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Xiaohong Wu
- Shantou University Medical College, Shantou, China
| | - Xisui Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chunjiao Zhou
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Aichner S, Haile A, Hoffmann V, Olliges E, Tschöp MH, Meissner K. The Role of Tactile Stimulation for Expectation, Perceived Treatment Assignment and the Placebo Effect in an Experimental Nausea Paradigm. Front Neurosci 2019; 13:1212. [PMID: 31798402 PMCID: PMC6863803 DOI: 10.3389/fnins.2019.01212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 10/28/2019] [Indexed: 12/25/2022] Open
Abstract
Introduction Tactile stimulation during a placebo treatment could enhance its credibility and thereby boost positive treatment expectations and the placebo effect. This experimental study aimed to investigate the interplay between tactile stimulation, expectation, and treatment credibility for the placebo effect in nausea. Methods Ninety healthy participants were exposed to a 20-min vection stimulus on two separate days and were randomly allocated to one of three groups on the second day after the baseline period: Placebo transcutaneous electrical nerve stimulation (TENS) with tactile stimulation (n = 30), placebo TENS without tactile stimulation (n = 30), or no intervention (n = 30). Placebo TENS was performed for 20 min at a dummy acupuncture point on both forearms. Expected and perceived nausea severity and further symptoms of motion sickness were assessed at baseline and during the evaluation period. At the end of the experiment, participants in the placebo groups guessed whether they had received active or placebo treatment. Results Expected nausea decreased significantly more in the placebo groups as compared to the no treatment control group (interaction day × group, F = 6.60, p = 0.003, partial η2 = 0.20), with equal reductions in the two placebo groups (p = 1.0). Reduced expectation went along with a significant placebo effect on nausea (interaction day × group, F = 22.2, p < 0.001, partial η2 = 0.35) with no difference between the two placebo groups (p = 1.0). Twenty-three out of 29 participants in the tactile placebo group (79%) but only 14 out of 30 participants (47%) in the non-tactile placebo group believed that they had received the active intervention (p = 0.015). Bang’s blinding index (BI) indicated random guessing in the non-tactile placebo group (BI = 0; 95% CI, −0.35 to 0.35) and non-random guessing in the direction of an “opposite guess” in the tactile placebo group (BI = −0.52; 95% CI, −0.81 to −0.22). Conclusion Tactile stimulation during placebo TENS did not further enhance positive treatment expectations and the placebo effect in nausea but increased the credibility of the intervention. Further trials should investigate the interaction between perceived treatment assignment, expectation, and the placebo effect during the course of a trial.
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Affiliation(s)
- Simone Aichner
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Anja Haile
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Verena Hoffmann
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Elisabeth Olliges
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
| | - Matthias H Tschöp
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München, Munich, Germany.,German Center for Diabetes Research (DZD), Munich, Germany.,Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - Karin Meissner
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
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12
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Bao T, Deng G, DeMarzo LA, Zhi WI, DeRito JL, Blinder V, Chen C, Li QS, Green J, Pendleton E, Mao JJ. A Technology-Assisted, Brief Mind-Body Intervention to Improve the Waiting Room Experience for Chemotherapy Patients: Randomized Quality Improvement Study. JMIR Cancer 2019; 5:e13217. [PMID: 31697238 PMCID: PMC6873148 DOI: 10.2196/13217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/21/2019] [Accepted: 07/23/2019] [Indexed: 01/19/2023] Open
Abstract
Background Patients waiting for chemotherapy can experience stress, anxiety, nausea, and pain. Acupressure and meditation have been shown to control such symptoms. Objective This study aimed to evaluate the feasibility and effectiveness of an integrative medicine app to educate patients about these self-care tools in chemotherapy waiting rooms. Methods We screened and enrolled cancer patients in chemotherapy waiting rooms at two Memorial Sloan Kettering Cancer Center locations. Patients were randomly assigned into an intervention arm in which subjects watched acupressure and meditation instructional videos or a control arm in which they watched a time- and attention-matched integrative oncology lecture video. Before and after watching the videos, we asked the patients to rate four key symptoms: stress, anxiety, nausea, and pain. We performed the analysis of covariance to detect differences between the two arms postintervention while controlling for baseline symptoms. Results A total of 223 patients were enrolled in the study: 113 patients were enrolled in the intervention arm and 110 patients were enrolled in the control arm. In both groups, patients showed significant reductions in stress and anxiety from baseline (all P<.05), with the treatment arm reporting greater stress and anxiety reduction than the control arm (1.64 vs 1.15 in stress reduction; P=.01 and 1.39 vs 0.78 in anxiety reduction; P=.002). The majority of patients reported that the videos helped them pass time and that they would watch the videos again. Conclusions An integrative medicine self-care app in the waiting room improved patients’ experiences and reduced anxiety and stress. Future research could focus on expanding this platform to other settings to improve patients’ overall treatment experiences.
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Affiliation(s)
- Ting Bao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gary Deng
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lauren A DeMarzo
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - W Iris Zhi
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Janice L DeRito
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Victoria Blinder
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Connie Chen
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Qing S Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jamie Green
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Eva Pendleton
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jun J Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Baek JY, Trinh TA, Huh W, Song JH, Kim HY, Lim J, Kim J, Choi HJ, Kim TH, Kang KS. Electro-Acupuncture Alleviates Cisplatin-Induced Anorexia in Rats by Modulating Ghrelin and Monoamine Neurotransmitters. Biomolecules 2019; 9:biom9100624. [PMID: 31635295 PMCID: PMC6843597 DOI: 10.3390/biom9100624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 01/31/2023] Open
Abstract
Anorexia is common in patients with cancer, mostly as a side effect of chemotherapy. The effect of electro-acupuncture (EA) on ameliorating cancer-related symptoms have been studied in animal models and in clinical trials. The aim of this study was to determine optimal conditions for the application of EA to alleviate anorexia, followed by the study of molecular mechanisms affecting its therapeutics. Anorexia was induced in male Wistar rats by injecting cisplatin, which was then followed by EA treatment at CV12, the acupuncture point located in the center of the abdominal midline. Body weight and food intake were measured daily throughout the duration of the study. The levels of monoamine neurotransmitters in the plasma were quantitatively analyzed by HPLC-ECD. Gastrointestinal hormone concentrations were elucidated with ELISA kits. RT-qPCR was performed to evaluate the mRNA expression of ghrelin (GHRL), neuropeptide Y (NPY), and pro-opiomelanocortin. The expression of c-Fos in the nucleus tractus solitarii was detected using western blotting analysis. The optimal conditions of EA to alleviate anorexia in rats was determined to be 1 unit for intensity and 10 Hz for frequency. EA treatment at CV12 reduced the levels of plasma monoamine neurotransmitters 5-hydroxytryptamine, 5-hydroxyindoleacetic acid, dopamine, and norepinephrine; as well as stimulated the expression of GHRL and NPY to alleviate cisplatin-induced anorexia in rats. EA stimulation at CV12 could be used to treat cisplatin-induced anorexia in rats.
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Affiliation(s)
- Ji Yun Baek
- College of Korean Medicine, Gachon University, Seongnam 13120, Korea.
- Department of Food Science, Gyeongnam National University of Science and Technology, Jinju 52725, Korea.
| | - Tuy An Trinh
- College of Korean Medicine, Gachon University, Seongnam 13120, Korea.
| | - Wonsang Huh
- College of Korean Medicine, Gachon University, Seongnam 13120, Korea.
| | - Ji Hoon Song
- College of Korean Medicine, Gachon University, Seongnam 13120, Korea.
| | - Hyun Young Kim
- Department of Food Science, Gyeongnam National University of Science and Technology, Jinju 52725, Korea.
| | - Juhee Lim
- College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Seongnam 13488, Korea.
| | - Jinhee Kim
- College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Seongnam 13488, Korea.
| | - Hyun Jin Choi
- College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Seongnam 13488, Korea.
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul 02447, Korea.
| | - Ki Sung Kang
- College of Korean Medicine, Gachon University, Seongnam 13120, Korea.
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14
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Brinkhaus B, Kirschbaum B, Stöckigt B, Binting S, Roll S, Carstensen M, Witt CM. Prophylactic acupuncture treatment during chemotherapy with breast cancer: a randomized pragmatic trial with a retrospective nested qualitative study. Breast Cancer Res Treat 2019; 178:617-628. [PMID: 31520284 DOI: 10.1007/s10549-019-05431-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/30/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE This study investigated the effect of additional prophylactic acupuncture during chemotherapy on quality of life and side effects compared to standard treatment alone in breast cancer patients. METHODS In a pragmatic trial, newly diagnosed breast cancer patients were randomized to additional acupuncture treatments over 6 months or standard care alone (control group). The primary outcome was the disease-specific quality of life (FACT-B). Twenty qualitative semi-structured interviews were conducted with ten patients from each group regarding their subjective experiences. RESULTS A total of 150 women (mean age 51.0 (SD 10.0) years) were randomized. For the primary endpoint, FACT-B total score after 6 months, no statistically significant difference was found between groups (acupuncture: 103.5 (95%, CI 88.8 to 107.2); control (101.4 (- 97.5 to 105.4); difference 2.0 (- 3.4 to 7.5) p = 0.458)). Qualitative content analyses showed that patients in the acupuncture group described positive effects on psychological and physical well-being. For both patient groups, coping strategies were more important than reducing side effects. CONCLUSIONS Breast cancer patients receiving prophylactic acupuncture during chemotherapy did not show better quality of life in the questionnaires in contrast to the reported positive effects in the qualitative interviews. Coping strategies for cancer appear to be important. TRIAL REGISTRATION clinicaltrials.gov; NCT01727362. Prospectively registered 11 July 2012; https://clinicaltrials.gov/ct2/show/NCT01727362 . The manuscript adheres to CONSORT guidelines.
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Affiliation(s)
- Benno Brinkhaus
- Charité - Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr. 57, 10098, Berlin, Germany.
| | | | - Barbara Stöckigt
- Charité - Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr. 57, 10098, Berlin, Germany
| | - Sylvia Binting
- Charité - Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr. 57, 10098, Berlin, Germany
| | - Stephanie Roll
- Charité - Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr. 57, 10098, Berlin, Germany
| | | | - Claudia M Witt
- Charité - Universitätsmedizin Berlin, corporatemember of Freie Universität Berlin, Humboldt-Universität zuBerlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Luisenstr. 57, 10098, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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15
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What can a third sector organisation provide for people with breast cancer that public health services cannot? Developing support services in response to service evaluation. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Mayan M, Alvadj T, Punja S, Jou H, Wildgen S, Vohra S. Parents' experiences of an inpatient pediatric integrative medicine service for symptom management. Explore (NY) 2019; 15:415-418. [PMID: 31377302 DOI: 10.1016/j.explore.2019.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pediatric integrative medicine (PIM) refers to the combination of treatments from conventional medicine and complementary therapies for which there is evidence of safety and effectiveness. As pediatric use of complementary therapies increases, it is important to determine parental views on the use of these therapies by their children. OBJECTIVE To describe parental experiences with a PIM service for management of pain, nausea/vomiting and anxiety in the context of an inpatient pediatric cardiology unit. DESIGN Telephone interviews were carried out with the parents of pediatric cardiology inpatients. The interviews focused on their and their child's experiences with the PIM service while in the hospital. Interviews were transcribed, and analyzed using qualitative content analysis. RESULTS Data saturation was reached after nine interviews conducted during the period between June 2015 and January 2016. Parents self-reported that the PIM service was particularly helpful at alleviating symptoms of anxiety in their children. Moreover, because their children were more at ease, parents also felt less anxiety. CONCLUSION Pediatric integrative medicine as an adjunct to conventional care is seen as beneficial by parents of children admitted to a pediatric cardiology unit.
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Affiliation(s)
- Maria Mayan
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Tatjana Alvadj
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Salima Punja
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada
| | - Hsing Jou
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada
| | - Sarah Wildgen
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Sunita Vohra
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada.
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Abstract
Nausea is a bothersome symptom that is commonly seen in the pediatric population. The pathophysiology of nausea is complex and involves the central nervous system, the enteric nervous system, gastrointestinal tract motility, and psychologic influences. Pharmacologic and nonpharmacologic therapies are available for treating nausea. Mind-body interventions (hypnosis, biofeedback), botanicals and supplements (ginger, enteric-coated peppermint oil), aromatherapy, and acupuncture have emerging evidence for effectively treating pediatric nausea. [Pediatr Ann. 2019;48(6):e236-e242.].
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18
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Kang KS, Huh W, Bang Y, Choi HJ, Baek JY, Song JH, Kang JW, Kim TH. Electroacupuncture for chemotherapy-induced anorexia through humoral appetite regulation: A preliminary experimental study. Exp Ther Med 2019; 17:2587-2597. [PMID: 30906450 PMCID: PMC6425152 DOI: 10.3892/etm.2019.7250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 09/13/2018] [Indexed: 12/24/2022] Open
Abstract
Chemotherapy-induced anorexia (CIA), which may lead to severe nutrition-associated problems, is a common complication associated with anti-cancer therapies. In the present study, the anti-anorexigenic effect of electroacupuncture (EA) was explored through assessing a change in appetite-associated peptides and c-Fos expression in a rat model of cisplatin-induced anorexia. In order to identify the most effective acupuncture point, 20 male Wistar rats (divided into five groups including the normal saline control, cisplatin only control and three groups according to the acupoints stimulated) were subjected to EA for 10 min at CV12, ST36 or PC6 daily for 4 days. Subsequently, the rats received intraperitoneal injections of cisplatin (6 mg/kg) to induce CIA. Food intake and reduction in body weight gain as the anorexia-associated outcomes were assessed daily for up to 3 days after cisplatin injection, and CV12 was eventually chosen as the most effective acupoint to test the anti-anorexigenic effect of EA. Furthermore, food intake, body weight and the concentrations of appetite-associated peptides, including ghrelin, cholecystokinin (CCK) and 5-hydroxytryptamine (5-HT), in addition to c-Fos expression, were comparatively assessed between the CV12 EA group (n=6; rats treated with EA at CV12 daily for 4 days) and a control group (n=6; rats without treatment). The results indicated that the CV12 EA group exhibited a better outcome regarding food intake and body weight compared with the controls. Although there was no statistically significant difference observed, the secretion of serum ghrelin and CCK was increased in the CV12 EA group compared with that in the control group. The plasma level of 5-HT after cisplatin injection in the CV12 EA group was lower compared with that in the control, although no statistical significance was reached. Although not statistically significant, the expression of c-Fos protein in the nucleus tractus solitarius (NTS) was reduced in the CV12 EA rats. In addition, the hypothalamic mRNA levels of brain-derived neurotrophic factor (BDNF) were significantly increased in the CV12 EA group. In the hypothalamus, the expression of neuropeptide Y mRNA slightly increased in the cisplatin + CV12 EA group compared with the cisplatin only control group. In conclusion, the anti-anorexigenic effect of EA on CIA may be associated with an increase in the secretion of ghrelin and CCK and a decrease in the secretion of 5-HT into the serum, a reduction of c-Fos expression in the NTS and an increase in BDNF mRNA expression in the hypothalamus.
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Affiliation(s)
- Ki Sung Kang
- Department of Preventive Medicine, College of Korean Medicine, Gachon University, Seongnam, Gyeonggi-do 13120, Republic of Korea
| | - Wonsang Huh
- Department of Preventive Medicine, College of Korean Medicine, Gachon University, Seongnam, Gyeonggi-do 13120, Republic of Korea
| | - Yeojin Bang
- College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Seongnam, Gyeonggi-do 13488, Republic of Korea
| | - Hyun Jin Choi
- College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Seongnam, Gyeonggi-do 13488, Republic of Korea
| | - Ji Yun Baek
- Department of Preventive Medicine, College of Korean Medicine, Gachon University, Seongnam, Gyeonggi-do 13120, Republic of Korea
| | - Ji Hoon Song
- Department of Medicine, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jung Won Kang
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul 02447, Republic of Korea
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19
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Dimitrova A, Murchison C, Oken B. Local effects of acupuncture on the median and ulnar nerves in patients with carpal tunnel syndrome: a pilot mechanistic study protocol. Trials 2019; 20:8. [PMID: 30611294 PMCID: PMC6320582 DOI: 10.1186/s13063-018-3094-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/02/2018] [Indexed: 12/02/2022] Open
Abstract
Background While acupuncture’s mechanism of action is not fully understood, there is consensus that the nervous system plays a key role in processing its effects. This research is based on the structural theory of acupuncture, which aims to correlate the location of acupuncture points to peripheral nerves, spinal segments, and spinal plexuses. This mechanistic study explores the close anatomical association between the Pericardium meridian/median nerve and the Heart meridian/ulnar nerve in an attempt to produce electrophysiologic data measuring acupuncture’s direct, nerve-specific effect on the underlying nerves. Specifically, the purpose of this research is to use nerve conduction studies (NCSs) and quantitative sensory testing (QST) to assess for any local, nerve-specific effect of three acupuncture modalities on two anatomically distinct nerves in the forearm — the median and ulnar nerves — in subjects with carpal tunnel syndrome (CTS). The choice of CTS as an injured nerve model allows for comparisons between the response in an injured nerve (median) to that of a healthy one (ulnar). Methods Subjects with mild to moderate CTS will be randomized to three intervention groups: manual acupuncture and low- and high-frequency electroacupuncture. Each subject will receive two treatments, 1 week apart, to points in the forearm, which overlay the median nerve (Pericardium meridian) or the ulnar nerve (Heart meridian). Acupuncture will be administered in random order to minimize learning effects in sensory testing. During Week 1, baseline NCS and QST (vibration and cold detection thresholds) will be obtained in both nerve territories, followed by acupuncture and post-acupuncture NCS and QST measurements in both nerve territories. During Week 2, repeat baseline QST and NCS measurements will be obtained, followed by acupuncture to points overlying the nerve not treated in Week 1, followed by post-acupuncture NCS and QST measurements in both nerve distributions. Discussion This works aims to capture and characterize the local effects of acupuncture on an underlying nerve and compare them to those on a neighboring nerve. Quantifying acupuncture’s effects using physiologic parameters and discrete values could standardize treatment regimens and help assess their therapeutic effect. Trial registration ClinicalTrials.gov, NCT03036657. Registered on 30 January 2017. Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s13063-018-3094-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexandra Dimitrova
- Department of Neurology, Oregon Health &Science University, 3181 SW Sam Jackson Park Road, Mail Code CR120, Portland, OR, 97239, USA.
| | - Charles Murchison
- Department of Neurology, Oregon Health &Science University, 3181 SW Sam Jackson Park Road, Mail Code CR120, Portland, OR, 97239, USA
| | - Barry Oken
- Department of Neurology, Oregon Health &Science University, 3181 SW Sam Jackson Park Road, Mail Code CR120, Portland, OR, 97239, USA
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Hall M, Bifano SM, Leibel L, Golding LS, Tsai SL. The Elephant in the Room: The Need for Increased Integrative Therapies in Conventional Medical Settings. CHILDREN (BASEL, SWITZERLAND) 2018; 5:children5110154. [PMID: 30453586 PMCID: PMC6262478 DOI: 10.3390/children5110154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/10/2018] [Accepted: 11/10/2018] [Indexed: 01/18/2023]
Abstract
Pediatric integrative therapy programs are essential to the treatment and well-being of patients. Identifying an effective integrative therapy model within conventional pediatric medical settings, however, often proves difficult. Our goal in this article is to explore varied solutions to increase access and inclusion of integrative therapies in an effort to promote best practice and holistic care. The main methods applied in this article are vignettes that illustrate how the integrative therapies in a metropolitan academic hospital successfully treat the patient by complementing conventional medicine. This leads to comprehensive care. The central finding of the article proposes viable solutions to increase interdisciplinary collaboration both internally within the institution and externally. Integrative therapists detail how they were able to increase visibility and yield best practice through increased educational initiatives and interdisciplinary collaboration.
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Affiliation(s)
- Missy Hall
- Child Life Department, New York-Presbyterian Morgan Stanley Children's Hospital Columbia University Medical Center, 3959 Broadway, New York, NY 10032, USA.
| | - Susanne M Bifano
- Child Life Department, New York-Presbyterian Morgan Stanley Children's Hospital Columbia University Medical Center, 3959 Broadway, New York, NY 10032, USA.
| | - Leigh Leibel
- Division of Hematology/Oncology, Columbia University Medical Center, 161 Ft. Washington Ave, Suite 922, New York, NY 10032-3789, USA.
| | - Linda S Golding
- Pastoral Care, New York-Presbyterian Milstein Columbia University Medical Center, 622 W. 168th St., New York, NY 10032-3789, USA.
| | - Shiu-Lin Tsai
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, 3959 Broadway, CHN-W116, New York, NY 10032.
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Zhang HW, Lin ZX, Cheung F, Cho WC, Tang J. Moxibustion for alleviating side effects of chemotherapy or radiotherapy in people with cancer. Cochrane Database Syst Rev 2018; 11:CD010559. [PMID: 30480754 PMCID: PMC6517257 DOI: 10.1002/14651858.cd010559.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Moxibustion, a common treatment in traditional Chinese medicine, involves burning herbal preparations containing Artemisia vulgaris on or above the skin at acupuncture points. Its intended effect is to enhance body function, and it could reduce the side effects of chemotherapy or radiotherapy and improve quality of life (QoL) in people with cancer. OBJECTIVES To assess the effects of moxibustion for alleviating side effects associated with chemotherapy, radiotherapy or both in people with cancer. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid and AMED (Allied and Complementary Medicine Database) from their inception to February 2018. We also searched databases in China including the Chinese BioMedical Literature Database (CBM), Chinese Medical Current Contents (CMCC), TCMonline, Chinese Dissertation Database (CDDB), China Medical Academic Conference (CMAC) and Index to Chinese Periodical Literature from inception to August 2017. Registries for clinical trials and other resources were also searched. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing moxibustion treatment, including moxa cone and moxa stick, versus sham, no treatment or conventional treatment. DATA COLLECTION AND ANALYSIS Two review authors (HWZ and FC) independently extracted data on study design, participants, treatment and control intervention, and outcome measures, and they also assessed risk of bias in the included studies. We performed meta-analyses, expressing dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean differences (MD), with 95% confidence intervals (CI). MAIN RESULTS We included 29 RCTs involving 2569 participants. Five RCTs compared moxibustion versus no treatment, 15 compared moxibustion plus conventional treatment versus conventional treatment, one compared moxibustion versus sham moxibustion, and eight compared moxibustion versus conventional medicine. The overall risk of bias was high in 18 studies and unclear in 11 studies. Studies measured outcomes in various ways, and we could rarely pool data.Moxibustion versus no treatment: low-certainty evidence from single small studies suggested that moxibustion was associated with higher white blood cell counts (MD 1.77 × 109/L; 95% CI 0.76 to 2.78; 80 participants, low-certainty evidence) and higher serum haemoglobin concentrations (MD 1.33 g/L; 95% CI 0.59 to 2.07; 66 participants, low-certainty evidence) in people with cancer, during or after chemotherapy/radiotherapy, compared with no treatment. There was no evidence of an effect on leukopenia (RR 0.50, 95% CI 0.10 to 2.56; 72 participants, low-certainty evidence) between study groups. The effects on immune function (CD3, CD4, and CD8 counts) were inconsistent.Moxibustion versus sham moxibustion: low-certainty evidence from one study (50 participants) suggested that moxibustion improved QoL (measured as the score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30)) compared with sham treatment (MD 14.88 points; 95% CI 4.83 to 24.93). Low-certainty evidence from this study also showed reductions in symptom scores for nausea and vomiting (MD -38.57 points, 95% CI -48.67 to -28.47) and diarrhoea (MD -13.81, 95% CI -27.52 to -0.10), and higher mean white blood cell count (MD 1.72 × 109/L, 95% CI 0.97 to 2.47), serum haemoglobin (MD 2.06 g/L, 95% CI 1.26 to 2.86) and platelets (MD 210.79 × 109/L, 95% CI 167.02 to 254.56) when compared with sham moxibustion.Moxibustion versus conventional medicines: low-certainty evidence from one study (90 participants) suggested that moxibustion improved WBC count eight days after treatment ended compared with conventional medicines (MD 0.40 × 109/L; 95% CI 0.15 to 0.65). Low-certainty evidence from two studies (235 participants) suggested moxibustion improved serum haemoglobin concentrations compared with conventional medicines (MD 10.28 g/L; 95% CI 4.51 to 16.05).Moxibustion plus conventional treatment versus conventional treatment alone: low-certainty evidence showed that moxibustion plus conventional treatment was associated with lower incidence and severity of leukopenia (WHO grade 3 to 4) (RR 0.14, 95% CI 0.01 to 2.64; 1 study, 56 participants), higher QoL scores on the EORTC QLQ-C30 (MD 8.85 points, 95% CI 4.25 to 13.46; 3 studies, 134 participants, I² = 26%), lower symptom scores for nausea and vomiting (RR 0.43, 95% CI 0.25 to 0.74; 7 studies, 801participants; I² = 19%), higher white blood cell counts (data not pooled due to heterogeneity), higher serum haemoglobin (MD 3.97 g/L, 95% CI 1.40 to 6.53; 2 studies, 142 participants, I² = 0%). There was no difference in platelet counts between the two groups (MD 13.48 × 109/L; 95% CI -16.00 to 42.95; 2 studies, 142 participants; I² = 34%).Most included studies did not report related adverse events, such as burning or allergic reactions. AUTHORS' CONCLUSIONS Limited, low-certainty evidence suggests that moxibustion treatment may help to reduce the haematological and gastrointestinal toxicities of chemotherapy or radiotherapy, improving QoL in people with cancer; however, the evidence is not conclusive, and we cannot rule out benefits or risks with this treatment. High-quality studies that report adverse effects are needed.
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Affiliation(s)
- Hong Wei Zhang
- The Chinese University of Hong KongSchool of Chinese MedicineShatin, N.T., Hong KongChina
| | - Zhi Xiu Lin
- The Chinese University of Hong KongSchool of Chinese MedicineShatin, N.T., Hong KongChina
| | - Fan Cheung
- The Chinese University of Hong KongSchool of Chinese MedicineShatin, N.T., Hong KongChina
| | | | - Jin‐Ling Tang
- The Chinese University of Hong KongDivision of Epidemiology, The Jockey Club School of Public Health and Primary CarePrince of Wales HospitalSatin, New TerritoriesHong Kong SARChina
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Dimitrova A, Murchison C, Oken B. The Case for Local Needling in Successful Randomized Controlled Trials of Peripheral Neuropathy: A Follow-Up Systematic Review. Med Acupunct 2018; 30:179-191. [PMID: 30147819 DOI: 10.1089/acu.2018.1297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: This work follows-up on a systematic review, published in 2017, of acupuncture for the treatment of mono- and polyneuropathy and associated symptoms. Previously reviewed trials of acupuncture for neuropathy primarily used acupuncture points in close proximity to underlying nerves. Further exploration of point selection for the treatment of each neuropathic condition is needed to assess the anatomical relationships between acupuncture points and peripheral nerves with respect to the treatment of neuropathy. Methods: The 13 randomized controlled trials included in the original review studied acupuncture for neuropathy caused by diabetes, Bell's palsy, carpal tunnel syndrome (CTS), human immunodeficiency virus (HIV), and idiopathic causes. The present review reexamines all acupuncture points used, focusing on specific neuropathic condition treated. Anatomical diagrams are presented to highlight acupuncture points underlying the nerves' anatomical relationships. Each selected acupuncture point is reviewed in detail, including its Traditional Chinese Medicine theory-based function, the point's indications for use, and the peripheral nerve most closely associated with it. Results: In Bell's palsy, the majority of selected acupuncture points were associated with the ipsilateral facial nerve. In CTS, the majority of the selected acupuncture points were closely associated with the median nerve and its branches. In polyneuropathy caused by diabetes, HIV, or idiopathic causes, most selected acupuncture points were in close proximity to peripheral nerves. Conclusions: All reviewed trials of acupuncture for neuropathy and neuropathic pain use acupuncture points that are closely associated with the peripheral nerves treated. Local needling is crucial for successful treatment of peripheral neuropathy.
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Affiliation(s)
| | - Charles Murchison
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Barry Oken
- Department of Neurology, Oregon Health & Science University, Portland, OR
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Zia FZ, Olaku O, Bao T, Berger A, Deng G, Fan AY, Garcia MK, Herman PM, Kaptchuk TJ, Ladas EJ, Langevin HM, Lao L, Lu W, Napadow V, Niemtzow RC, Vickers AJ, Shelley Wang X, Witt CM, Mao JJ. The National Cancer Institute's Conference on Acupuncture for Symptom Management in Oncology: State of the Science, Evidence, and Research Gaps. J Natl Cancer Inst Monogr 2018; 2017:4617820. [PMID: 29140486 DOI: 10.1093/jncimonographs/lgx005] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 08/07/2017] [Indexed: 12/20/2022] Open
Abstract
The Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, at the National Cancer Institute (NCI) held a symposium on "Acupuncture for Cancer Symptom Management" on June 16 and 17, 2016. Invited speakers included 19 scientists and scholars with expertise in acupuncture and cancer research from the United States, Europe, and China. The conference reviewed the NCI's grant funding on acupuncture, analyzed the needs of cancer patients, reviewed safety issues, and assessed both the current scientific evidence and research gaps of acupuncture in oncology care. Researchers and stakeholders presented and discussed basic mechanisms of acupuncture; clinical evidence for specific symptoms; and methodological challenges such as placebo effects, novel biostatistical methods, patient-reported outcomes, and comparative effectiveness research. This paper, resulting from the conference, summarizes both the current state of the science and clinical evidence of oncology acupuncture, identifies key scientific gaps, and makes recommendations for future research to increase understanding of both the mechanisms and effects of acupuncture for cancer symptom management.
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Affiliation(s)
- Farah Z Zia
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Oluwadamilola Olaku
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ting Bao
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ann Berger
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Gary Deng
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Arthur Yin Fan
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Mary K Garcia
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Patricia M Herman
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ted J Kaptchuk
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Elena J Ladas
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Helene M Langevin
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Lixing Lao
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Weidong Lu
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Vitaly Napadow
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Richard C Niemtzow
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Andrew J Vickers
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Xin Shelley Wang
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Claudia M Witt
- Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
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Acupuncture for Nausea and Vomiting. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Efficacy and Safety of Sipjeondaebo-Tang for Anorexia in Patients with Cancer: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:8780325. [PMID: 29441116 PMCID: PMC5758845 DOI: 10.1155/2017/8780325] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/18/2017] [Accepted: 12/06/2017] [Indexed: 12/19/2022]
Abstract
Background Anorexia occurs in about half of cancer patients and is associated with high mortality rate. However, safe and long-term use of anorexia treatment is still an unmet need. Objective The purpose of the present study was to examine the feasibility of Sipjeondaebo-tang (Juzen-taiho-to, Shi-Quan-Da-Bu-Tang) for cancer-related anorexia. Methods A total of 32 participants with cancer anorexia were randomized to either Sipjeondaebo-tang group or placebo group. Participants were given 3 g of Sipjeondaebo-tang or placebo 3 times a day for 4 weeks. The primary outcome was a change in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes included Visual Analogue Scale (VAS) of anorexia, FAACT scale, and laboratory tests. Results Anorexia and quality of life measured by FAACT and VAS were improved after 4 weeks of Sipjeondaebo-tang treatment. However, there was no significant difference between changes of Sipjeondaebo-tang group and placebo group. Conclusions Sipjeondaebo-tang appears to have potential benefit for anorexia management in patients with cancer. Further large-scale studies are needed to ensure the efficacy. Trial Registration This trial is registered with ClinicalTrials.gov NCT02468141.
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Li S, Lei Y, Chen JDZ. Chemotherapy-Induced Pica in Rats Reduced by Electroacupuncture. Neuromodulation 2017; 21:254-260. [PMID: 29094451 DOI: 10.1111/ner.12712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 08/21/2017] [Accepted: 09/11/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Acupuncture or electroacupuncture (EA) has been applied for treating chemotherapy-induced emesis with limited success. The aims of this study were to investigate the anti-emetic effect of EA and to explore underlying anti-emetic mechanisms. MATERIALS AND METHODS Rats were chronically implanted with a pair of stainless steel leads at acupoint pericardium 6 (PC6). Effects of EA with different parameters on cisplatin-induced nausea were assessed by pica (intake of kaolin, a surrogate of nausea in species without vomiting reflex). C-fos expressions in the area postrema (AP) and nucleus tractus solitarii (NTS) were analyzed. Subdiaphragmatic vagotomy was used to study involvement of the vagal pathway. RESULTS 1) EA at 20 Hz/0.6 msec reduced kaolin intake in the first and second days after cisplatin injection compared with the sham-EA group (first day: 1.0 ± 0.2 vs. 1.9 ± 0.3 g, p = 0.017; second day: 0.4 ± 0.2 vs.1.1 ± 0.3 g, p = 0.010). However, EA at 10 Hz/1.2 msec was ineffective on both days. 2) Subdiaphragmatic vagotomy significantly reduced cisplatin-induced kaolin intake (1.1 ± 0.3 vs. 2.2 ± 0.3 g, p = 0.014) and also blocked the inhibitory effect of EA on kaolin intake in the first day. 3) Cisplatin significantly increased the expression of c-fos in the NTS and AP. Vagotomy greatly reduced c-fos expression in both NTS and AP. EA reduced the cisplatin-induced c-fos expression in the AP but not the NTS. CONCLUSIONS EA at PC6 with appropriate parameters has an inhibitory effect on cisplatin-induced nausea. The anti-emetic effect of the EA is centrally medicated involving the AP via the vagal pathway as well as the potential effect on AP by reducing the release of hormones.
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Affiliation(s)
- Shiying Li
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA.,Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
| | - Yong Lei
- Veterans Research and Education Foundation, VA Medical Center, Oklahoma City, OK, USA
| | - Jiande D Z Chen
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
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Deng G, Giralt S, Chung DJ, Landau H, Siman J, Search B, Coleton M, Vertosick E, Shapiro N, Chien C, Wang XS, Cassileth B, Mao JJ. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer 2017; 26:657-665. [PMID: 28920142 DOI: 10.1007/s00520-017-3881-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/11/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE Hematopoietic stem cell transplantation (HCT) is potentially curative for a number of hematologic malignancies, but is associated with high symptom burden. We conducted a randomized sham-controlled trial (RCT) to evaluate efficacy and safety of acupuncture as an integrative treatment for managing common symptoms during HCT. METHODS Adult patients with multiple myeloma undergoing high-dose melphalan followed by autologous HCT (AHCT) were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Patients and clinical evaluators, but not acupuncturists, were blinded to group assignment. Symptom burden, the primary outcome was assessed with the MD Anderson Symptom Inventory (MDASI) at baseline, during transplantation, and at 15 and 30 days post transplantation. RESULTS Among 60 participants, true acupuncture produced nonsignificant reductions in overall MDASI core symptom scores and symptom interference scores during transplantation (P = .4 and .3, respectively), at 15 days (P = .10 and .3), and at 30 days posttransplantation (P = .2 and .4) relative to sham. However, true acupuncture was significantly more efficacious in reducing nausea, lack of appetite, and drowsiness at 15 days (P = .042, .025, and .010, respectively). Patients receiving sham acupuncture were more likely to increase pain medication use posttransplantation (odds ratio 5.31, P = .017). CONCLUSIONS Acupuncture was well tolerated with few attributable adverse events. True acupuncture may prevent escalation of symptoms including nausea, lack of appetite, and drowsiness experienced by patients undergoing AHCT, and reduce the use of pain medications. These findings need to be confirmed in a future definitive study. TRIAL REGISTRATION NCT01811862.
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Affiliation(s)
- Gary Deng
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
| | - Sergio Giralt
- Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David J Chung
- Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Heather Landau
- Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonathan Siman
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Benjamin Search
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Marci Coleton
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Emily Vertosick
- Health Outcomes Research Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nathan Shapiro
- Health Outcomes Research Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine Chien
- Health Outcomes Research Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xin S Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Barrie Cassileth
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
| | - Jun J Mao
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA
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Wang H, Yu MW, Shi GX, Zhang GL, Li QW, Zhang CX, Han Y, Xu YM, Zhang Q, Wang XM, Yang GW. WITHDRAWN: Effect of acupuncture therapy on lung cancer patients with cancer-related fatigue during chemotherapy: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2017. [DOI: 10.1016/j.conctc.2017.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Armstrong K, Gokal R, Chevalier A, Todorsky W, Lim M. Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain. J Altern Complement Med 2017; 23:295-299. [PMID: 28266863 PMCID: PMC5393407 DOI: 10.1089/acm.2016.0313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Although acupuncture and microcurrent are widely used for chronic pain, there remains considerable controversy as to their therapeutic value for neck pain. We aimed to determine the effect size of microcurrent applied to lower back acupuncture points to assess the impact on the neck pain. DESIGN This was a cohort analysis of treatment outcomes pre- and postmicrocurrent stimulation, involving 34 patients with a history of nonspecific chronic neck pain. SUBJECTS AND SETTINGS Consenting patients were enrolled from a group of therapists attending educational seminars and were asked to report pain levels pre-post and 48 hours after a single MPS application. INTERVENTIONS AND MEASUREMENTS Direct current microcurrent point stimulation (MPS) applied to standardized lower back acupuncture protocol points was used. Evaluations entailed a baseline visual analog scale (VAS) pain scale assessment, using a VAS, which was repeated twice after therapy, once immediately postelectrotherapy and again after a 48-h follow-up period. All 34 patients received a single MPS session. Results were analyzed using paired t tests. Results and Outcomes: Pain intensity showed an initial statistically significant reduction of 68% [3.9050 points; 95% CI (2.9480, 3.9050); p = 0.0001], in mean neck pain levels after standard protocol treatment, when compared to initial pain levels. There was a further statistically significant reduction of 35% in mean neck pain levels at 48 h when compared to pain levels immediately after standard protocol treatment [0.5588 points; 95% CI (0.2001, 0.9176); p = 0.03], for a total average pain relief of 80%. CONCLUSIONS The positive results in this study could have applications for those patients impacted by chronic neck pain.
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Affiliation(s)
| | - Raman Gokal
- University of Manchester, Manchester, United Kingdom
| | | | | | - Mike Lim
- Advanced Pain Rehab, Crystal Lake, IL
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Dimitrova A, Murchison C, Oken B. Acupuncture for the Treatment of Peripheral Neuropathy: A Systematic Review and Meta-Analysis. J Altern Complement Med 2017; 23:164-179. [PMID: 28112552 PMCID: PMC5359694 DOI: 10.1089/acm.2016.0155] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Neuropathy and its associated pain pose great therapeutic challenges. While there has been a recent surge in acupuncture use and research, little remains known about its effects on nerve function. This review aims to assess the efficacy of acupuncture in the treatment of neuropathy of various etiologies. METHODS The Medline, AMED, Cochrane, Scopus, CINAHL, and clintrials.gov databases were systematically searched from inception to July 2015. Randomized controlled trials (RCTs) assessing acupuncture's efficacy for poly- and mononeuropathy were reviewed. Parallel and crossover RCTs focused on acupuncture's efficacy were reviewed and screened for eligibility. The Scale for Assessing Scientific Quality of Investigations in Complementary and Alternative Medicine was used to assess RCT quality. RCTs with score of >9 and active control treatments such as sham acupuncture or medical therapy were included. RESULTS Fifteen studies were included: 13 original RCTs, a long-term follow-up, and a re-analysis of a prior RCT. The selected RCTs studied acupuncture for neuropathy caused by diabetes, Bell's palsy, carpal tunnel syndrome, human immunodeficiency virus (HIV), and idiopathic conditions. Acupuncture regimens, control conditions, and outcome measures differed among studies, and various methodological issues were identified. Still, the majority of RCTs showed benefit for acupuncture over control in the treatment of diabetic neuropathy, Bell's palsy, and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-related neuropathy, and there is insufficient evidence for its benefits in idiopathic neuropathy. Acupuncture appears to improve nerve conduction study parameters in both sensory and motor nerves. Meta-analyses were conducted on all diabetic neuropathy and Bell's palsy individual subject data (six RCTs; a total of 680 subjects) using a summary estimate random effects model, which showed combined odds ratio of 4.23 (95% confidence interval 2.3-7.8; p < 0.001) favoring acupuncture over control for neuropathic symptoms. CONCLUSIONS Acupuncture is beneficial in some peripheral neuropathies, but more rigorously designed studies using sham-acupuncture control are needed to characterize its effect and optimal use better.
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Affiliation(s)
- Alexandra Dimitrova
- Department of Neurology, Oregon Health and Science University , Portland, OR
| | - Charles Murchison
- Department of Neurology, Oregon Health and Science University , Portland, OR
| | - Barry Oken
- Department of Neurology, Oregon Health and Science University , Portland, OR
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Reduced Need for Rescue Antiemetics and Improved Capacity to Eat in Patients Receiving Acupuncture Compared to Patients Receiving Sham Acupuncture or Standard Care during Radiotherapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:5806351. [PMID: 28270851 PMCID: PMC5320299 DOI: 10.1155/2017/5806351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/10/2017] [Indexed: 02/04/2023]
Abstract
Objective. To evaluate if consumption of emesis-related care and eating capacity differed between patients receiving verum acupuncture, sham acupuncture, or standard care only during radiotherapy. Methods. Patients were randomized to verum (n = 100) or sham (n = 100) acupuncture (telescopic blunt sham needle) (median 12 sessions) and registered daily their consumption of antiemetics and eating capacity. A standard care group (n = 62) received standard care only and delivered these data once. Results. More patients in the verum (n = 73 of 89 patients still undergoing radiotherapy; 82%, Relative Risk (RR) 1.23, 95% Confidence Interval (CI) 1.01–1.50) and the sham acupuncture group (n = 79 of 95; 83%, RR 1.24, CI 1.03–1.52) did not need any antiemetic medications, as compared to the standard care group (n = 42 out of 63; 67%) after receiving 27 Gray dose of radiotherapy. More patients in the verum (n = 50 of 89; 56%, RR 1.78, CI 1.31–2.42) and the sham acupuncture group (n = 58 of 94 answering patients; 62%, RR 1.83, CI 1.20–2.80) were capable of eating as usual, compared to the standard care group (n = 20 of 63; 39%). Conclusion. Patients receiving acupuncture had lower consumption of antiemetics and better eating capacity than patients receiving standard antiemetic care, plausible by nonspecific effects of the extra care during acupuncture.
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Ben-Horin I, Kahan P, Ryvo L, Inbar M, Lev-Ari S, Geva R. Acupuncture and Reflexology for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer. Integr Cancer Ther 2017; 16:258-262. [PMID: 28150504 PMCID: PMC5759933 DOI: 10.1177/1534735417690254] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Treatment of chemotherapy-induced peripheral neuropathy (CIPN), which affects approximately 30% to 40% of patients treated with neuropathy-causing agents, is mainly symptomatic. Currently available interventions are of little benefit. STUDY DESIGN This study was conducted as a retrospective analysis of the efficacy of acupuncture and reflexology in alleviating CIPN in breast cancer patients. METHODS Medical records of 30 consecutive breast cancer patients who received both chemotherapy and treatment for CIPN according to our Acupuncture and Reflexology Treatment for Neuropathy (ART-N) protocol between 2011 and 2012 were reviewed. Symptom severity was rated at baseline, during, and after treatment. RESULTS The records of 30 breast cancer patients who had been concomitantly treated with chemotherapy and ART-N for CIPN were retrieved. Two records were incomplete, leaving a total of 28 patients who were enrolled into the study. Twenty patients (71%) had sensory neuropathy, 7 (25%) had motor neuropathy, and 1 (4%) had both sensory and motor neuropathy. Only 2 (10%) of the 20 patients with grades 1 to 2 neuropathy still reported symptoms at 12 months since starting the ART-N protocol. All 8 patients who presented with grades 3 to 4 neuropathy were symptom-free at the 12-month evaluation. Overall, 26 patients (93%) had complete resolution of CIPN symptoms. CONCLUSION The results of this study demonstrated that a joint protocol of acupuncture and reflexology has a potential to improve symptoms of CIPN in breast cancer patients. The protocol should be validated on a larger cohort with a control group. It also warrants testing as a preventive intervention.
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Affiliation(s)
- Idan Ben-Horin
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Peretz Kahan
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Larisa Ryvo
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Inbar
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Shahar Lev-Ari
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Ravit Geva
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
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Vohra S, Schlegelmilch M, Jou H, Hartfield D, Mayan M, Ohinmaa A, Wilson B, Spavor M, Grundy P. Comparative effectiveness of pediatric integrative medicine as an adjunct to usual care for pediatric inpatients of a North American tertiary care centre: A study protocol for a pragmatic cluster controlled trial. Contemp Clin Trials Commun 2016; 5:12-18. [PMID: 29740618 PMCID: PMC5936744 DOI: 10.1016/j.conctc.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background Some pediatric tertiary care centres in North America supplement conventional care with complementary therapies, together known as pediatric integrative medicine (PIM). Evidence to support the safety and efficacy of PIM is emerging, but the cost-effectiveness of an inpatient PIM service has yet to be assessed. Methods/Design This study is a pragmatic cluster controlled clinical trial. Usual care will be compared to usual care augmented with PIM in three pediatric divisions; oncology, general medicine, and cardiology at one large urban tertiary care Canadian Children's Hospital. The primary outcome of the feasibility study is enrolment; the primary outcome of the main study is cost-effectiveness. Other secondary outcomes include the prevalence and severity of key symptoms (i.e. pain, nausea/vomiting and anxiety), efficacy of PIM interventions, patient safety, and parent satisfaction. Discussion This trial will be the first to evaluate the comparative effectiveness, both clinical and cost, of a PIM inpatient service. The evidence from this study will be useful to families, clinicians and decision makers, and will describe the clinical and economic value of PIM services for pediatric patients admitted to hospital.
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Affiliation(s)
- Sunita Vohra
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
- Corresponding author.
| | - Michael Schlegelmilch
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
| | - Hsing Jou
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
| | - Dawn Hartfield
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-597 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Maria Mayan
- Community-University Partnership, Faculty of Extension, University of Alberta, 2-281 Enterprise Square, 10230 Jasper Avenue, Edmonton, AB T5J 4P6, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Institute of Health Economics, 1200 10405 Jasper Avenue, Edmonton, AB T5J 3N4, Canada
| | - Bev Wilson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-516 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Maria Spavor
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-529 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Paul Grundy
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-469 Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
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Somatoautonomic reflexes in acupuncture therapy: A review. Auton Neurosci 2016; 203:1-8. [PMID: 27876359 DOI: 10.1016/j.autneu.2016.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/21/2016] [Accepted: 11/15/2016] [Indexed: 02/06/2023]
Abstract
Oriental therapies such as acupuncture, moxibustion, or Anma, have been used to treat visceral disorders since ancient times. In each of these therapies, stimulation of the skin or underlying muscles leads to excitation of afferent nerves. The sensory information is carried to the central nervous system, where it is transferred to autonomic efferents, thus affecting visceral functions. This neuronal pathway, known as the "somatoautonomic reflex", has been systematically studied by Sato and his colleagues for over a half century. Nearly all their studies were conducted in anesthetized animals, whereas human patients are conscious. Responses in patients or the events following therapeutic somatic stimulation may differ from those observed in anesthetized animals. In fact, it is increasingly apparent that the responses in patients and animals are not always coincident, and the differences have been difficult for clinicians to reconcile. We review the mechanism of the "somatoautonomic reflex" as described in anesthetized animals and then discuss how it can be applied clinically.
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Kim KH, Lee MS, Kim T, Kang JW, Choi T, Lee JD. Acupuncture and related interventions for symptoms of chronic kidney disease. Cochrane Database Syst Rev 2016; 2016:CD009440. [PMID: 27349639 PMCID: PMC8406453 DOI: 10.1002/14651858.cd009440.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND People living with chronic kidney disease (CKD) experience a range of symptoms and often have complex comorbidities. Many pharmacological interventions for people with CKD have known risks of adverse events. Acupuncture is widely used for symptom management in patients with chronic diseases and in other palliative care settings. However, the safety and efficacy of acupuncture for people with CKD remains largely unknown. OBJECTIVES We aimed to evaluate the benefits and harms of acupuncture, electro-acupuncture, acupressure, moxibustion and other acupuncture-related interventions (alone or combined with other acupuncture-related interventions) for symptoms of CKD. In particular, we planned to compare acupuncture and related interventions with conventional medicine, active non-pharmacological interventions, and routine care for symptoms of CKD. SEARCH METHODS We searched the Cochrane Kidney and Transplant Specialised Register up to 28 January 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched Korean medical databases (including Korean Studies Information, DBPIA, Korea Institute of Science and Technology Information, Research Information Centre for Health Database, KoreaMed, the National Assembly Library) and Chinese databases (including the China Academic Journal). SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that investigated the effects of acupuncture and related point-stimulation interventions with or without needle penetration that involved six sessions or more in adults with CKD stage 3 to 5, regardless of the language and type of publication. We excluded studies that used herbal medicine or co-interventions administered unequally among the study groups. DATA COLLECTION AND ANALYSIS Two authors independently extracted data and assessed risk of bias. We calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. Primary outcomes were changes in pain and depression, and occurrence of serious of adverse events. MAIN RESULTS We included 24 studies that involved a total of 1787 participants. Studies reported on various types of acupuncture and related interventions including manual acupuncture and acupressure, ear acupressure, transcutaneous electrical acupuncture point stimulation, far-infrared radiation on acupuncture points and indirect moxibustion. CKD stages included pre-dialysis stage 3 or 4 and end-stage kidney disease on either haemodialysis or peritoneal dialysis.None of the included studies assessed pain outcomes, nor formally addressed occurrence of serious adverse events, although three studies reported three participant deaths and three hospitalisations as reasons for attrition. Three studies reported minor acupuncture-related harms; the remainder did not report if those events occurred.All studies were assessed at high or unclear risk of bias in terms of allocation concealment. Seventeen studies reported outcomes measured for only two months.There was very low quality of evidence that compared with routine care, manual acupressure reduced scores of the Beck Depression Inventory score (scale from 0 to 63) (3 studies, 128 participants: MD -4.29, 95% CI -7.48 to -1.11, I(2) = 0%), the revised Piper Fatigue Scale (scale from 0 to 10) (3 studies, 128 participants: MD -1.19, 95% CI -1.77 to -0.60, I(2) = 0%), and the Pittsburgh Sleep Quality Index (scale from 0 to 21) (4 studies, 180 participants: MD -2.46, 95% CI -4.23 to -0.69, I(2) = 50%).We were unable to perform further meta-analyses because of the paucity of data and problems with clinical heterogeneity, such as different interventions, comparisons and timing of outcome measurements. AUTHORS' CONCLUSIONS There was very low quality of evidence of the short-term effects of manual acupressure as an adjuvant intervention for fatigue, depression, sleep disturbance and uraemic pruritus in patients undergoing regular haemodialysis. The paucity of evidence indicates that there is little evidence of the effects of other types of acupuncture for other outcomes, including pain, in patients with other stages of CKD. Overall high or unclear risk of bias distorts the validity of the reported benefit of acupuncture and makes the estimated effects uncertain. The incomplete reporting of acupuncture-related harm does not permit us to assess the safety of acupuncture and related interventions. Future studies should investigate the effects and safety of acupuncture for pain and other common symptoms in patients with CKD and those undergoing dialysis.
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Affiliation(s)
- Kun Hyung Kim
- School of Korean Medicine, Pusan National UniversityDepartment of Acupuncture & MoxibustionBeom‐eo riMul‐geum eupYangsanKorea, South626‐770
| | - Myeong Soo Lee
- Korea Institute of Oriental MedicineMedical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South305‐811
| | - Tae‐Hun Kim
- College of Korean Medicine, Kyung Hee UniversityKorean Medicine Clinical Trial Center#23 Kyungheedae‐roDongdaemun‐guSeoulKorea, South130‐872
| | - Jung Won Kang
- College of Korean Medicine, Kyung Hee UniversityDepartment of Acupuncture & Moxibustion1, Hoegi‐DongDongdaemun‐GuSeoulKorea, South130‐702
| | - Tae‐Young Choi
- Korea Institute of Oriental MedicineMedical Research Division461‐24 Jeonmin‐dong, Yuseong‐guDaejeonKorea, South305‐811
| | - Jae Dong Lee
- Kyung Hee UniversityDepartment of Acupuncture & Moxibustion, College of Korean MedicineSeoulKorea, South
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Brittner M, Le Pertel N, Gold MA. Acupuncture in Pediatrics. Curr Probl Pediatr Adolesc Health Care 2016; 46:179-83. [PMID: 26867822 DOI: 10.1016/j.cppeds.2015.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 12/20/2022]
Abstract
There has been extensive research on the use of acupuncture in adults with a wide array of conditions. Much less research has been conducted on the use of acupuncture in children. In this article, we review the history and philosophy of acupuncture, and the literature on its effectiveness and safety in children and adolescents, giving special attention to the pediatric and adolescent conditions that have been most studied in high-quality randomized controlled trials (RCTs).
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Affiliation(s)
- Mindy Brittner
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
| | - Noemie Le Pertel
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
| | - Melanie A Gold
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
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Chao MT, Chang A, Reddy S, Harrison JD, Acquah J, Toveg M, Santana T, Hecht FM. Adjunctive acupuncture for pain and symptom management in the inpatient setting: protocol for a pilot hybrid effectiveness-implementation study. JOURNAL OF INTEGRATIVE MEDICINE 2016; 14:228-38. [PMID: 27181130 PMCID: PMC5050044 DOI: 10.1016/s2095-4964(16)60252-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Effective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes and patient satisfaction. Common pharmacologic approaches for pain, though effective, have serious side effects and are not appropriate for all inpatients. Findings from randomized controlled trials (RCTs) support the efficacy of acupuncture for many symptoms relevant to inpatients including postoperative pain, cancer-related pain, nausea and vomiting, and withdrawal from narcotic use. However, the extent to which findings from RCTs translate to real-world implementation of acupuncture in typical hospital settings is unknown. METHODS/DESIGN In partnership with the launch of a clinical program offering acupuncture services to inpatients at the University of California San Francisco's Mount Zion Hospital, we are conducting a pilot study using a hybrid effectiveness-implementation design to: (1) assess the effectiveness of acupuncture to manage pain and other symptoms and improve patient satisfaction; and (2) evaluate the barriers and facilitators to implementing an on-going acupuncture service for inpatients. During a two-month pre-randomization phase, we evaluated and adapted clinical scheduling and treatment protocols with acupuncturists and hospital providers and pretested study procedures including enrollment, consent, and data collection. During a six-month randomization phase, we used a two-tiered consent process in which inpatients were first consented into a study of symptom management, randomized to be offered acupuncture, and consented for acupuncture if they accepted. We are also conducting in-depth interviews and focus groups to assess evidence, context, and facilitators of key provider and hospital administration stakeholders. DISCUSSION Effectiveness research in "real-world" practice settings is needed to inform clinical decision-making and guide implementation of evidence-based acupuncture practices. To successfully provide clinical acupuncture services and maintain a rigorous research design, practice-based trials of acupuncture require careful planning and attention to setting-specific, contextual factors. TRIAL REGISTRATION This trial has been registered in ClinicalTrials.gov. The identifier is NCT01988194, registered on November 5, 2013.
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Affiliation(s)
- Maria T. Chao
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
- Division of General Internal Medicine at the Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - Alexandra Chang
- Departments of Anesthesiology and Internal Medicine, Loma Linda University, Loma Linda, California, USA
| | - Sanjay Reddy
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
- Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - James D. Harrison
- Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Joseph Acquah
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
| | - Miria Toveg
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
| | - Trilce Santana
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
| | - Frederick M. Hecht
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143-1726, USA
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MacPherson H, Hammerschlag R, Coeytaux RR, Davis RT, Harris RE, Kong JT, Langevin HM, Lao L, Milley RJ, Napadow V, Schnyer RN, Stener-Victorin E, Witt CM, Wayne PM. Unanticipated Insights into Biomedicine from the Study of Acupuncture. J Altern Complement Med 2016; 22:101-7. [PMID: 26745452 PMCID: PMC4761810 DOI: 10.1089/acm.2015.0184] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Research into acupuncture has had ripple effects beyond the field of acupuncture. This paper identifies five exemplars to illustrate that there is tangible evidence of the way insights gleaned from acupuncture research have informed biomedical research, practice, or policy. The first exemplar documents how early research into acupuncture analgesia has expanded into neuroimaging research, broadening physiologic understanding and treatment of chronic pain. The second describes how the acupuncture needle has become a tool to enhance biomedical knowledge of connective tissue. The third exemplar, which illustrates use of a modified acupuncture needle as a sham device, focuses on emergent understanding of placebo effects and, in turn, on insights into therapeutic encounters in treatments unrelated to acupuncture. The fourth exemplar documents that two medical devices now in widespread use were inspired by acupuncture: transcutaneous electrical nerve stimulators for pain control and antinausea wrist bands. The final exemplar describes how pragmatic clinical trial designs applied in acupuncture research have informed current general interest in comparative effectiveness research. In conclusion, these exemplars of unanticipated outcomes of acupuncture research comprise an additional rationale for continued support of basic and clinical research evaluating acupuncture and other under-researched therapies.
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Affiliation(s)
- Hugh MacPherson
- 1 Department of Health Sciences, University of York , York, United Kingdom
| | - Richard Hammerschlag
- 2 Research Department, Oregon College of Oriental Medicine , Portland, OR.,3 The Institute for Integrative Health , Baltimore, MD
| | - Remy R Coeytaux
- 4 Duke Clinical Research Institute , Durham, NC.,5 Department of Community and Family Medicine, Duke University , Durham, NC
| | | | - Richard E Harris
- 7 Department of Anesthesiology, University of Michigan , Ann Arbor, MI
| | - Jiang-Ti Kong
- 8 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford, CA
| | - Helene M Langevin
- 9 Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA
| | - Lixing Lao
- 10 School of Chinese Medicine, The University of Hong Kong , Hong Kong .,11 Center for Integrative Medicine, School of Medicine, University of Maryland , Baltimore, MD
| | - Ryan J Milley
- 2 Research Department, Oregon College of Oriental Medicine , Portland, OR
| | - Vitaly Napadow
- 12 Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Harvard Medical School, Charlestown, MA.,13 Department of Radiology, Logan University , Chesterfield, MO.,14 Department of Biomedical Engineering, Kyunghee University , Yongin, Korea
| | | | - Elisabet Stener-Victorin
- 16 Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden
| | - Claudia M Witt
- 17 Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich , Zurich, Switzerland
| | - Peter M Wayne
- 9 Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA
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Wu X, Chung VCH, Hui EP, Ziea ETC, Ng BFL, Ho RST, Tsoi KKF, Wong SYS, Wu JCY. Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews. Sci Rep 2015; 5:16776. [PMID: 26608664 PMCID: PMC4660374 DOI: 10.1038/srep16776] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022] Open
Abstract
Acupuncture and related therapies such as moxibustion and transcutaneous electrical nerve stimulation are often used to manage cancer-related symptoms, but their effectiveness and safety are controversial. We conducted this overview to summarise the evidence on acupuncture for palliative care of cancer. Our systematic review synthesised the results from clinical trials of patients with any type of cancer. The methodological quality of the 23 systematic reviews in this overview, assessed using the Methodological Quality of Systematic Reviews Instrument, was found to be satisfactory. There is evidence for the therapeutic effects of acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. There is conflicting evidence regarding the treatment of cancer-related pain, hot flashes and hiccups, and improving patients' quality of life. The available evidence is currently insufficient to support or refute the potential of acupuncture and related therapies in the management of xerostomia, dyspnea and lymphedema and in the improvement of psychological well-being. No serious adverse effects were reported in any study. Because acupuncture appears to be relatively safe, it could be considered as a complementary form of palliative care for cancer, especially for clinical problems for which conventional care options are limited.
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Affiliation(s)
- Xinyin Wu
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Vincent CH Chung
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Edwin P Hui
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong
- Comprehensive Cancer Trials Unit, The Chinese University of Hong Kong, Hong Kong
| | - Eric TC Ziea
- Chinese Medicine Department, Hong Kong Hospital Authority, Hong Kong
| | - Bacon FL Ng
- Chinese Medicine Department, Hong Kong Hospital Authority, Hong Kong
| | - Robin ST Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Kelvin KF Tsoi
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
- Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong
| | - Samuel YS Wong
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Justin CY Wu
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong
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Furyk JS, Meek RA, Egerton‐Warburton D. Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. Cochrane Database Syst Rev 2015; 2015:CD010106. [PMID: 26411330 PMCID: PMC6517141 DOI: 10.1002/14651858.cd010106.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nausea and vomiting is a common and distressing presenting complaint in emergency departments (ED). The aetiology of nausea and vomiting in EDs is diverse and drugs are commonly prescribed. There is currently no consensus as to the optimum drug treatment of nausea and vomiting in the adult ED setting. OBJECTIVES To provide evidence of the efficacy and safety of antiemetic medications in the management of nausea and vomiting in the adult ED setting. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 8), MEDLINE (OvidSP) (January 1966 to August 2014), EMBASE (OvidSP) (January 1980 to August 2014) and ISI Web of Science (January 1955 to August 2014). We also searched relevant clinical trial registries and conference proceedings. SELECTION CRITERIA We included randomized controlled trials (RCTs) of any drug in the treatment of nausea and vomiting in the treatment of adults in the ED. Study eligibility was not restricted by language or publication status. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, data extraction and assessment of risk of bias in included studies. We contacted authors of studies to obtain missing information if required. MAIN RESULTS We included eight trials, involving 952 participants, of which 64% were women. Included trials were generally of adequate quality, with six trials at low risk of bias, and two trials at high risk of bias. Three trials with 518 participants compared five different drugs with placebo; all reported the primary outcome as mean change in visual analogue scale (VAS) (0 to 100) for nausea severity from baseline to 30 minutes. Trials did not routinely report other primary outcomes of the change in nausea VAS at 60 minutes or number of vomiting episodes. Differences in mean VAS change from baseline to 30 minutes between placebo and the drugs evaluated were: metoclopramide (three trials, 301 participants; mean difference (MD) -5.27, 95% confidence interval (CI) -11.33 to 0.80), ondansetron (two trials, 250 participants; MD -4.32, 95% CI -11.20 to 2.56), prochlorperazine (one trial, 50 participants; MD -1.80, 95% CI -14.40 to 10.80), promethazine (one trial, 82 participants; MD -8.47, 95% CI -19.79 to 2.85) and droperidol (one trial, 48 participants; MD -15.8, 95% CI -26.98 to -4.62). The only statistically significant change in baseline VAS to 30 minutes was for droperidol, in a single trial of 48 participants. No other drug was statistically significantly superior to placebo. Other included trials evaluated a drug compared to "active controls" (alternative antiemetic). There was no convincing evidence of superiority of any particular drug compared to active control. All trials included in this review reported adverse events, but they were variably reported precluding meaningful pooling of results. Adverse events were generally mild, there were no reported serious adverse events. Overall, the quality of the evidence was low, mainly because there were not enough data. AUTHORS' CONCLUSIONS In an ED population, there is no definite evidence to support the superiority of any one drug over any other drug, or the superiority of any drug over placebo. Participants receiving placebo often reported clinically significant improvement in nausea, implying general supportive treatment such as intravenous fluids may be sufficient for the majority of people. If a drug is considered necessary, choice of drug may be dictated by other considerations such as a person's preference, adverse-effect profile and cost. The review was limited by the paucity of clinical trials in this setting. Future research should include the use of placebo and consider focusing on specific diagnostic groups and controlling for factors such as intravenous fluid administered.
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Affiliation(s)
- Jeremy S Furyk
- James Cook UniversityAnton Breinl Centre for Public HealthTropical Medicine and Rehabilitaiton SciencesTownsvilleAustralia
- University Hospital Geelong; Barwon HealthEmergency MedicineRyrie StreetDouglasGeelongVictoriaAustralia3220
| | - Robert A Meek
- Monash HealthDepartment of Emergency MedicineMelbourneAustralia
- Monash UniversityDepartment of MedicineMelbourneAustralia
| | - Diana Egerton‐Warburton
- Monash HealthDepartment of Emergency MedicineMelbourneAustralia
- Monash UniversityDepartment of MedicineMelbourneAustralia
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Abstract
In a previous systematic review of the worldwide literature of randomized controlled trials (RCTs) involving needle insertion into acupuncture points for symptom management in cancer patients, we identified only one high-quality RCT that was deemed to have a low risk of bias. Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 with no language limits applied. A total of 41 RCTs met all inclusion criteria and were rated. In the current review, we examined 18 trials published since our last report. The purpose of this update was to emphasize important recent findings and discuss how concerns such as blinding, separating non-specific placebo effects from specific needling effects, determining biologic mechanisms and dosing parameters, evaluating determinants of response such as expectation, controlling for sources of bias, and the lack of standardization in treatment and study methods may affect the interpretation of study results.
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Vanbockstael J, Coquan E, Gouerant S, Allouache D, Faveyrial A, Noal S, Delcambre C, Galais MP, Héron JF, Lefebvre AC, Sevin E, Hrab I, Polycarpe F, André M, Kaluzinski L, Gervais R, Gunzer K, Vié B, Saucier G, Lemenand N, Grellard JM, Clarisse B, Dugué AE, Joly F. How to improve the prevention of chemotherapy-induced nausea and vomiting? The French NAVI study. Support Care Cancer 2015; 24:1131-8. [PMID: 26268784 DOI: 10.1007/s00520-015-2882-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/29/2015] [Indexed: 01/30/2023]
Abstract
PURPOSE Chemotherapy-induced nausea and vomiting (CINV) still remain frequent. The procedure for announcing the diagnosis (PAD) was an emblematic measure of the first French Plan Cancer aiming at providing patients with time to listen, information after cancer diagnosis, and discussion on treatments and their side effects. We aimed at assessing the risk factors of CINV, focusing on patients' satisfaction with the PAD. METHODS This prospective multicentre study assessed the frequency and intensity of CINV among chemonaïve patients during the first cycle of treatment. CINV was defined by ≥1 emetic episode or reported nausea intensity ≥3 on a 0-10 scale. Multivariate analysis was used to identify factors related to global CINV onset including satisfaction with the PAD (satisfaction score ≥the median on a 0-10 scale). RESULTS Data from 291 patients (women, 85.2%; mean age, 57 years) were analyzed. Most patients (69.4%) received highly emetogenic chemotherapy regimens and 77.7% received antiemetic drugs consistent with international guidelines. Acute, delayed and overall CINV were experienced by 40.4, 34.8 and 52.4% of patients, respectively. Sixty-seven per cent of patients were satisfied with the PAD. No relation was noted between PAD satisfaction and CINV onset. The nausea and vomiting dimension of the QLQ-C30 questionnaire before chemotherapy (OR 3.62), motion sickness history (OR 2.73), highly emetogenic CT (OR 2.73), anxiety (OR 1.99) and younger age (OR 1.96) were independent predictive factors. CONCLUSIONS Although patients were mostly satisfied with the PAD, half of them experienced CINV. A state of anxiety could be identified during the PAD to be managed.
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Affiliation(s)
| | - Elodie Coquan
- Centre François Baclesse, Department of Oncology, Caen, France.
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France.
| | - Sophie Gouerant
- Rouen University Hospital, Department of Oncology, Rouen, France
- Centre Henri Becquerel, Department of Oncology, Rouen, France
| | | | | | - Sabine Noal
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | | | | | | | - Emmanuel Sevin
- Centre François Baclesse, Department of Oncology, Caen, France
| | - Ioana Hrab
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Michel André
- Hôpital Monod, Department of Oncology, Flers, France
| | - Laure Kaluzinski
- Centre Hospitalier Public du Cotentin, Department of Oncology, Cherbourg-Octeville, France
| | - Radj Gervais
- Centre François Baclesse, Department of Oncology, Caen, France
| | | | - Brigitte Vié
- Clinique Armoricaine, Department of Oncology, Saint-Brieuc, France
| | | | - Noëmie Lemenand
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Jean-Michel Grellard
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Bénédicte Clarisse
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Audrey Emmanuelle Dugué
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
| | - Florence Joly
- Centre François Baclesse, Clinical Research Department, av général Harris, Caen, 14000, France
- Université de Caen Basse-Normandie, UMR-S1077, Caen, France
- INSERM, U1086, Caen, France
- CHU de Caen, Department of Oncology, Caen, France
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Hack CC, Voiß P, Lange S, Paul AE, Conrad S, Dobos GJ, Beckmann MW, Kümmel S. Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine. Geburtshilfe Frauenheilkd 2015; 75:675-682. [PMID: 26257404 DOI: 10.1055/s-0035-1557748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 06/21/2015] [Accepted: 06/21/2015] [Indexed: 12/25/2022] Open
Abstract
With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patient's quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patients' wellbeing and quality of life, reducing stress, and improving patients' mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle.
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Affiliation(s)
- C C Hack
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - P Voiß
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen ; Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Lange
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - A E Paul
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - S Conrad
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - G J Dobos
- Klinik für Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
| | - M W Beckmann
- Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen
| | - S Kümmel
- Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen
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Chen B, Hu SX, Liu BH, Zhao TY, Li B, Liu Y, Li MY, Pan XF, Guo YM, Chen ZL, Guo Y. Efficacy and safety of electroacupuncture with different acupoints for chemotherapy-induced nausea and vomiting: study protocol for a randomized controlled trial. Trials 2015; 16:212. [PMID: 25963295 PMCID: PMC4445984 DOI: 10.1186/s13063-015-0734-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 04/27/2015] [Indexed: 11/23/2022] Open
Abstract
Background Many patients experience nausea and vomiting during chemotherapy treatment. Evidence demonstrates that electroacupuncture is beneficial for controlling chemotherapy-induced nausea and vomiting (CINV). However, the acupoint or matching acupoint with the best efficacy for controlling CINV still remains unidentified. Methods/Design This study consists of a randomized controlled trial (RCT) with four parallel arms: a control group and three electroacupuncture groups (one with Neiguan (PC6), one with Zhongwan (CV12), and one with both PC6 and CV12). The control group received standard antiemetic only, while the other three groups received electroacupuncture stimulation with different acupoints besides the standard antiemetic. The intervention is done once daily from the first day (day 1) to the fourth day (day 4) during chemotherapy treatment. The primary outcome measures include frequency of nausea, vomiting and retching. The secondary outcome measures are the grade of constipation and diarrhea, electrogastrogram, assessment of quality of life, assessment of anxiety and depression, and other adverse effects during the chemotherapy. Assessments are scheduled from one day pre-chemotherapy (day 0) to the fifth day of chemotherapy (day 5). Follow-ups are done from day 6 to day 21. Discussion The aim of this study is to evaluate the efficacy and safety of electro-acupuncture with different acupoints in the management of CINV. Trial registration The register number of randomized controlled trial is NCT02195908. The date of registration was 21 July 2014.
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Affiliation(s)
- Bo Chen
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Shu-xiang Hu
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Bao-hu Liu
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Tian-yi Zhao
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Bo Li
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Yan Liu
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Ming-yue Li
- Clinical Practice Teaching Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Xing-fang Pan
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Yong-ming Guo
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Ze-lin Chen
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
| | - Yi Guo
- Acu-moxibustion and Tuina Department of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. .,Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
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Sallam HS, Song J, Chen JZ. Electroacupuncture via Chronically Implanted Electrodes: Potential Treatment for Chemotherapy-Induced Delayed Emesis. Neuromodulation 2015; 18:494-8; discussion 498. [DOI: 10.1111/ner.12303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 03/11/2015] [Accepted: 03/11/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Hanaa S. Sallam
- Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
| | - Jun Song
- Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
| | - Jiande Z. Chen
- Department of Internal Medicine; University of Texas Medical Branch; Galveston TX USA
- Ningbo Pace Translational Medical Research Center; Ningbo China
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Sullivan A, Gilbar P, Curtain C. Complementary and Alternative Medicine Use in Cancer Patients in Rural Australia. Integr Cancer Ther 2015; 14:350-8. [DOI: 10.1177/1534735415580679] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim. Numerous studies have demonstrated the high prevalence of complementary and alternative medicine (CAM) use in metropolitan cancer cohorts but few have been conducted in regional and remote populations. This study aimed to investigate the trends and regional variations in CAM use by cancer patients at a regional cancer care center in Toowoomba, South East Queensland, Australia. Methods. All English-speaking adult cancer patients attending the regional cancer care center were invited to participate. Eligible patients were provided a self-administered questionnaire that was developed based on published surveys. Ethics approval was obtained. Results. Overall 142 patients completed the questionnaire and 68% were currently or had previously used at least one form of CAM. CAM users and nonusers did not differ significantly by region, age, gender, time since diagnosis, income, town size, treatment intent, or metastases. CAM users were more likely to have a higher level of education. Concurrent CAM use with conventional treatment was reported by approximately half of respondents. The most common reason for CAM use was “to improve general physical well-being.” The most common sources of CAM information were family (31%) and friends (29%). Disclosure of CAM use to either the general practitioner or specialist was reported by 46% and 33% of patients, respectively. The most common reason for nondisclosure was “doctor never asked.” Conclusion. This study supports previous research that CAM use is as common in regional and remote areas as metropolitan areas. Nondisclosure of CAM use to health professionals was common. Future research needs to focus on strategies to improve communication between patients and health professionals about the use of CAM.
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Affiliation(s)
- Aimee Sullivan
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Prince of Wales Hospital, Sydney, New South Wales, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Peter Gilbar
- Toowoomba Hospital, Toowoomba, Queensland, Australia
- Department of Medicine (Rural Clinical School), The University of Queensland, Toowoomba, Queensland, Australia
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Bhutta MF, Schilder AGM, Burton MJ. Acupressure for motion sickness. Hippokratia 2015. [DOI: 10.1002/14651858.cd007165.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Mahmood F Bhutta
- West Wing - John Radcliffe Hospital; Department of Otolaryngology; Headley Way Oxford UK OX3 9DU
| | - Anne GM Schilder
- Faculty of Brain Sciences, University College London; evidENT, Ear Institute; 330 Grays Inn Road London UK WC1X 8DA
- University Medical Center Utrecht; Department of Otorhinolaryngology & Julius Center for Health Sciences and Primary Care; Utrecht Netherlands
| | - Martin J Burton
- UK Cochrane Centre; Summertown Pavilion 18 - 24 Middle Way Oxford UK OX2 7LG
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Integrative Therapy Use for Management of Side Effects and Toxicities Experienced by Pediatric Oncology Patients. CHILDREN-BASEL 2014; 1:424-40. [PMID: 27417488 PMCID: PMC4928739 DOI: 10.3390/children1030424] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/11/2014] [Accepted: 10/29/2014] [Indexed: 01/29/2023]
Abstract
Integrative Therapies (IT), otherwise known as Complementary and Alternative Medicine, are widely used among pediatric oncology patients, despite a paucity of available evidence. This review summarizes surveys that describe the prevalence of IT use by pediatric oncology patients, both during therapy and in survivorship, as well as the modalities being used. Additionally, the evidence that exists for specific treatments that appear to be efficacious in controlling specific symptoms is described. Finally, there are recommendations for practitioners on how to best counsel patients about IT use.
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Nevasic audio program for the prevention of chemotherapy induced nausea and vomiting: A feasibility study using a randomized controlled trial design. Eur J Oncol Nurs 2014; 19:282-91. [PMID: 25534959 DOI: 10.1016/j.ejon.2014.10.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 09/26/2014] [Accepted: 10/27/2014] [Indexed: 11/22/2022]
Abstract
PURPOSE Pharmacological therapy is only partially effective in preventing or treating chemotherapy induced nausea and vomiting (CINV). Therefore, exploring the complementary role of non-pharmacological approaches used in addition to pharmacological agents is important. Nevasic uses specially constructed audio signals hypothesized to generate an antiemetic reaction. The aim of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) to evaluate the effectiveness of Nevasic to control CINV. METHODS A mixed methods design incorporating an RCT and focus group interviews. For the RCT, female breast cancer patients were randomized to receive either Nevasic plus usual care, music plus usual care, or usual care only. Data were analysed using descriptive statistics and linear mixed-effects models. Five focus group interviews were conducted to obtain participants' views regarding the acceptability of the interventions in the trial. RESULTS 99 participants were recruited to the RCT and 15 participated in focus group interviews. Recruitment targets were achieved. Issues of Nevasic acceptability were highlighted as weaknesses of the program. This study did not detect any evidence for the effectiveness of Nevasic; however, the results showed statistically significant less use of anti-emetics (p = 0.003) and borderline non-significant improvement in quality of life (p = 0.06). CONCLUSIONS Conducting a non-pharmacological intervention using such an audio program is feasible, although difficulties and limitations exist with its use. Further studies are required to investigate the effectiveness of Nevasic from perspectives such as anti-emetic use, as well as its overall effect on the levels of nausea and vomiting.
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Ling WM, Lui LYY, So WKW, Chan K. Effects of Acupuncture and Acupressure on Cancer-Related Fatigue: A Systematic Review. Oncol Nurs Forum 2014; 41:581-92. [DOI: 10.1188/14.onf.581-592] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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