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Tiwari S, Sapkota N. Is single-point acupuncture effective in treating acute low back pain? Clin Case Rep 2021; 9:e05130. [PMID: 34853688 PMCID: PMC8614094 DOI: 10.1002/ccr3.5130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 01/08/2023] Open
Abstract
Acupuncture is often used for acute and chronic low back pain; however, its efficacy is controversial, primarily for acute low back pain (ALBP). An acupuncture point, GV-26, could be used as an analgesic acupoint to treat acute low back pain. Our study suggests that single acupuncture could relieve ALBP within a short time without any adverse events. Acupuncture can be integrated with allopathic (western) medicine and used in the hospital's emergency department to treat acute painful conditions.
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Affiliation(s)
- Sagun Tiwari
- Department of Neurology and RehabilitationSeventh People’s Hospital of Shanghai University of TCMShanghaiPR China
- Shanghai University of TCMShanghaiPR China
- Life Care HospitalChitwanNepal
- One Hope Polypathic HospitalDhangadhiNepal
| | - Namrata Sapkota
- Net Fresh HospitalBharatpur Metropolitan CityChitwanNepal
- Om Wellness HospitalBiratnagarNepal
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Sung WS, Hong Y, Jeon SR, Yoon J, Chung EK, Jo HG, Kim TH, Shin S, Lee HJ, Kim EJ, Seo BK, Choi J, Nam D. Efficacy and safety of thread embedding acupuncture combined with acupuncture for chronic low back pain: A randomized, controlled, assessor-blinded, multicenter clinical trial. Medicine (Baltimore) 2020; 99:e22526. [PMID: 33285673 PMCID: PMC7717797 DOI: 10.1097/md.0000000000022526] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Low back pain is a very common disease. Many patients with chronic low back pain (CLBP) have been treated by complementary and alternative medicine such as acupuncture (AT) treatment. A type of AT, thread embedding acupuncture (TEA), consists of a thread that can continually stimulate at the AT points and has mechanical and chemical effects. Although TEA was widely used in clinical practice, there was little evidence of its efficacy and safety for CLBP. METHODS This clinical trial was randomized, controlled, assessor-blinded, two-armed, parallel, and conducted in multiple centers. Four Korean medical institutions recruited 38 outpatients with CLBP. The participants were randomly allocated to a treatment group (TEA combined with AT) or a control group (only AT) in a 1:1 ratio. All participants received conventional AT twice a week for 8 weeks (16 sessions) at 15 AT points (GV3 and bilateral BL23, BL24, BL25, BL26, BL40, BL60, and EX-B5) and the treatment group participants additionally received TEA once a week for 8 weeks (8 sessions) on 10 AT points in the multifidus, spinal erector, and lumbar quadrate muscles. The primary outcome measure of this study was the change of visual analog scale (VAS) from baseline (0 week) to the end of intervention (8 weeks). Secondary outcome measures included clinically relevant improvement (minimal clinically important difference) and 3% to 50% decrease on VAS, disability level (Korean version of Roland and Morris disability questionnaire), quality of life (Korean version of European quality of life 5dimension), global assessment (patient global impression of change), economic analysis, credibility test, and safety assessment. RESULTS The treatment group showed a significant reduction in VAS scores when compared with the control group (-33.7 ± 25.1 vs -15.6 ± 17.0, P = .013). As for the secondary outcome measures, the treatment group showed significant difference in 50% decrease on VAS and patient global impression of change. There was no serious adverse event associated with TEA and AT. CONCLUSION This clinical trial documents the efficacy and safety of TEA combined with AT for the management of CLBP.
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Affiliation(s)
- Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do
| | - Yejin Hong
- Department of Clinical Korean Medicine, Graduate School
| | - Sae-Rom Jeon
- Department of Clinical Korean Medicine, Graduate School
| | - Jimin Yoon
- Department of Pharmacy, College of Pharmacy
| | | | | | - Tae-Hun Kim
- Clinical Trial Center, Korean Medicine Hospital, Department of Korean Medicine
| | - Seungwon Shin
- Clinical Trial Center, Korean Medicine Hospital, Department of Korean Medicine
| | - Hyun-Jong Lee
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do
| | - Byung-Kwan Seo
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong
| | - Jieun Choi
- Department of Clinical Korean Medicine, Graduate School
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Yeo S, van den Noort M, Bosch P, Lim S. A study of the effects of 8-week acupuncture treatment on patients with Parkinson's disease. Medicine (Baltimore) 2018; 97:e13434. [PMID: 30557997 PMCID: PMC6320216 DOI: 10.1097/md.0000000000013434] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a degenerative brain disorder, resulting in decreased neural responses in the supplementary motor area, putamen, and thalamus. Previous research showed that acupuncture was able to improve the motor dysfunction. The primary aim of this study is to assess the efficacy of longer acupuncture treatment for preventing brain degeneration in patients with PD. METHODS Ten outpatients with PD were recruited from Kyung Hee Medical Hospital. Behavioral and neural responses were examined before and after 8 weeks of acupuncture treatment. A semi-individualized treatment approach was used; patients were treated for 15 minutes with 120-Hz electro-acupuncture at the right GB34 and Taechung (LR3), followed by manual acupuncture based on the individual symptoms of the patient. RESULTS Immediately after 8 weeks of acupuncture treatment, the Unified Parkinson's Disease Rating Scale (UPDRS) sub-scores and the depression scores for the patients had statistically decreased compared to the scores before acupuncture treatment; moreover, 8 weeks later, these scores remained stable. Compared to the neural responses before the acupuncture stimulation, those after the acupuncture treatment were significantly higher in the thalamus, cingulate gyrus, anterior cingulate, lingual gyrus, parahippocampal gyrus, lateral globus pallidus, mammillary body, middle temporal gyrus, cuneus, and fusiform gyrus. Finally, a positive correlation was found between the UPDRS and the mean magnetic resonance signal change for the thalamus. CONCLUSION This study found beneficial clinical effects of 8-week acupuncture treatment in the brains of patients with PD.
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Affiliation(s)
- Sujung Yeo
- College of Korean Medicine, Sang Ji University, Wonju
| | - Maurits van den Noort
- Department of Meridian and Acupoint, College of Korean Medicine and Research Group of Pain and Neuroscience, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - Peggy Bosch
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Nijmegen, The Netherlands
| | - Sabina Lim
- Department of Meridian and Acupoint, College of Korean Medicine and Research Group of Pain and Neuroscience, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
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Yeo S, Lim S, Choe IH, Choi YG, Chung KC, Jahng GH, Kim SH. Acupuncture stimulation on GB34 activates neural responses associated with Parkinson's disease. CNS Neurosci Ther 2013; 18:781-90. [PMID: 22943145 DOI: 10.1111/j.1755-5949.2012.00363.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a degenerative brain disorder that is caused by neural defects in the substantia nigra. Numerous studies have reported that acupuncture treatment on GB34 (Yanglingquan) leads to significant improvements in patients with PD and in PD animal models. Studies using functional magnetic resonance imaging (fMRI) have shown that patients with PD, compared to healthy participants, have lower neural responses in extensive brain regions including the putamen, thalamus, and the supplementary motor area. OBJECTIVE This study investigated the reported association between acupuncture point GB34 and PD. METHODS Using fMRI, neural responses of 12 patients with PD and 12 healthy participants were examined before and after acupuncture stimulation. RESULTS Acupuncture stimulation increased neural responses in regions including the substantia nigra, caudate, thalamus, and putamen, which are impaired caused by PD. CONCLUSIONS Areas associated with PD were activated by the acupuncture stimulation on GB34. This shows that acupuncture treatment on GB34 may be effective in improving the symptoms of PD. Although more randomized controlled trials on the topic will be needed, this study shows that acupuncture may be helpful in the treatment of symptoms involving PD.
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Affiliation(s)
- Sujung Yeo
- Department of Meridian & Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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Karatay S, Akcay F, Yildirim K, Erdem FH, Alp F. Effects of some acupoints (Du-14, Li-11, St-36, and Sp-6) on serum TNF-α and hsCRP levels in healthy young subjects. J Altern Complement Med 2011; 17:347-50. [PMID: 21438784 PMCID: PMC3078501 DOI: 10.1089/acm.2009.0461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES This study was performed to investigate the effect of immune-related acupuncture points on serum tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hsCRP) levels. METHODS Ninety (90) healthy volunteers (aged 20-30 years) were randomly assigned into five equal groups. Acupuncture needles were placed into single acupoints bilaterally in each group. The points were Da Zhui (Du-14), Qu Chi (Li-11), Zu San Li (St-36), San Yin Jiao (Sp-6) and a sham point, which is not an acupoint. Manual acupuncture treatment was performed in 6 sessions of 30 minutes each, 3 times per week for 2 weeks. Serum samples were obtained before and after the acupuncture treatments and the serum TNF-α and hsCRP levels were measured. RESULTS The TNF-α values (mean ± standard deviation) in the Du-14, Li-11, St-36, Sp-6, and sham acupuncture groups at baseline were 37.63 ± 10.58, 37.36 ± 10.24, 33.83 ± 7.36, 35.73 ± 6.75, and 32.05 ± 5.66 pg/mL, respectively. After treatment, the mean TNF-α values were 35.89 ± 11.61, 34.80 ± 6.98, 35.89 ± 9.22, 33.30 ± 5.45, and 33.78 ± 5.98 pg/mL, respectively. In the serum TNF-α levels, no significant change was seen in any of the groups (p > 0.05). The mean hsCRP values in the Du-14, Li-11, St-36, Sp-6, and sham acupuncture groups at baseline were 0.90 ± 0.77, 1.07 ± 1.35, 0.77 ± 0.54, 0.75 ± 0.54, and 0.94 ± 0.68 mg/L, respectively. After treatment, they were 1.09 ± 1.17, 0.84 ± 0.43, 0.74 ± 0.49, 0.80 ± 0.53, and 0.62 ± 0.44 mg/L, respectively. In the statistical analysis, it was found that hsCRP levels were significantly reduced in the sham acupuncture group (p < 0.01). There was not any significant difference between acupuncture and sham groups in terms of serum TNF-α and hsCRP values (p > 0.05). CONCLUSIONS Acupoints, which are considered to have effects on the immune system, may not mediate the immune system via TNF-α, a known inflammatory cytokine, directly in healthy young individuals. However, the changes related to hsCRP values in the sham group need future confirmation studies.
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Affiliation(s)
- Saliha Karatay
- Department of Physical Medicine and Rehabilitation, Medical Faculty, Ataturk University, Erzurum, Turkey.
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Lund I, Lundeberg T. On the threshold - evaluation of variability in effects of acupuncture in a gender perspective. Chin Med 2010; 5:32. [PMID: 20815910 PMCID: PMC2942886 DOI: 10.1186/1749-8546-5-32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Accepted: 09/04/2010] [Indexed: 01/09/2023] Open
Abstract
Variable results of pain alleviation in response to acupuncture have been reported, complicating its interpretation. Sources of variability are probably multi-factorial, including the contribution of gender related effects. Gender related variation in perceived pain has been discussed frequently, but documented effects of acupuncture referring to gender are sparse. Furthermore, factors such as operationalisation of the outcome variable and the statistical method for evaluation could also be sources of variability. When pain is regarded as subjective, the produced data should be treated as ordinal. The rank-based method by Svensson, taking the non-metric qualities of the ordinal data into account as well as the variability at the group and the individual level, is therefore an alternative. The present commentary aims to (1) evaluate changes in electrical sensory thresholds and electrical pain thresholds after low frequency electro-acupuncture separately in healthy women and men; (2) introduce and exemplify the method by Svensson in a user-friendly approach. To analyze the systematic patterns of change in thresholds, indicating evidence of treatment on a group level, the relative position (RP) and relative concentration (RC), were measured. The variation related to the individual, the relative rank variation (RV) was also measured. The results were divergent between women (n = 23) and men (n = 22), i.e. unchanged sensory threshold after acupuncture at the group level in women while changed in men. The assessed pain threshold after acupuncture on the other hand was changed towards higher levels in women and unchanged in men. The individual variation was apparent in both women and men but larger in women. For statistical analysis of the variability for both group and individual related effects, the rank-based method by Svensson could be used. The present study indicates that evaluation of sensory and pain threshold response should be analysed separately in women and men.
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Affiliation(s)
- Iréne Lund
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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Abstract
The use of acupuncture for pain in pediatrics is a long-standing practice in Eastern cultures. Despite growing interest in the West, there has been relatively little systematic research on acupuncture for chronic pediatric pain. In particular, there is a paucity of randomized clinical trials testing the efficacy of acupuncture for chronic pain problems in pediatric populations. This commentary briefly reviews the history of acupuncture for pain and includes a summary of extant findings regarding potential mechanisms of its analgesic effects. Key areas for future research to advance the application of acupuncture to chronic pediatric pain problems are outlined.
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Lai X, Zhang G, Huang Y, Tang C, Yang J, Wang S, Zhou SF. A cerebral functional imaging study by positron emission tomography in healthy volunteers receiving true or sham acupuncture needling. Neurosci Lett 2009; 452:194-9. [PMID: 19383438 DOI: 10.1016/j.neulet.2009.01.052] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Revised: 01/20/2009] [Accepted: 01/21/2009] [Indexed: 11/28/2022]
Abstract
Our recent studies have demonstrated that needling in Baihui, Shuigou and Shenmen enhances glucose metabolism in the frontal lobes, thalamus, temporal lobe, and the lentiform nucleus in vascular dementia. This study examined the effect of true, sham and overt needling in Waiguan (TE5) on cerebral changes by positron emission tomography (PET) technique. Eighteen healthy volunteers were randomized to receive overt control, true or sham needling therapy. To manipulate true needling, a needle was inserted into 15+/-2mm into Waiguan and "deqi" was achieved by proper needle manipulation. For sham needling, needles with a blunt tip were pushed against the skin as the shaft moved into the handle, giving an illusion of insertion. For overt placebo, blunt needles were used and subjects did not receive any needling penetration. The tracer used was (18)fluoride-deoxygluocse. PET images obtained were processed and analyzed by the SPM2 software. Compared with overt needling, brain areas BA7, 13, 18, 19, 21, 22, 27, 38, 40, 42 and 45 in Waiguan true needling group were significantly activated and areas BA4, 6, 7, 19, 22 and 41 in sham needling group showed obvious activation. Compared to sham needling group, marked activation points were found in the areas of BA13 and 42 and left cerebellum in true needling group. Our study revealed a marked difference in brain metabolic changes between true and sham needling in Waiguan. Further studies are needed to explore the cerebral changes in patients with acupuncture and the pathological implications.
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Affiliation(s)
- Xinsheng Lai
- College of Acupuncture and Massage, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510407, China
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