1
|
Harsinay A, Patil A, Ali-Khan S, Sweitzer K, Leckenby JI. Needles, Herbs, and Electricity: A Meta-Analysis of Traditional Eastern Medicine in the Management of Facial Paralysis. Facial Plast Surg 2024; 40:441-449. [PMID: 38537704 DOI: 10.1055/a-2295-7720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
In Eastern nations, interventions like acupuncture and herbal medicine are often first-line for patients presenting with facial paralysis. Despite the rising popularity of Eastern medicine in Western nations, the literature assessing whether Eastern medicine interventions should be recommended for patients with facial paralysis is lacking. This meta-analysis aims to define what Eastern medicine interventions exist for the management of facial paralysis and assess whether current research supports these approaches as safe and effective. The PubMed and Cochrane databases were reviewed in accordance with PRISMA guidelines. Inclusion criteria consisted of peer-reviewed studies published between 2000 and 2023 that reported on Eastern medicine, also described as, "complementary" or "alternative" interventions for facial paralysis. Effective and cured rates were the primary outcomes extracted from the literature. Interventions within these studies were categorized into six groups: (1) standard acupuncture, (2) special needle therapies, (3) needle therapy + other alternative treatments, (4) herbal medicine, (5) alternative treatments + Western medicine, and (6) Western medicine alone. A multiple-treatment meta-analysis was performed to assess differences in effective and cured rates. Fifteen studies involving Eastern medicine for the treatment of facial paralysis met the inclusion criteria. No significant differences were found in effective and cured rates across groups. Multiple quality concerns were noted, such as the lack of control groups, blinding, and randomization noted in several studies. Many studies failed to report complications, preventing conclusions from being drawn on the safety of these Eastern medicine interventions. This meta-analysis was unable to support the recommendation of Eastern medicine approaches for patients with facial paralysis. No Eastern medicine treatments, combination of Eastern medicine treatments, or Eastern medicine treatments given with Western medicine were seen to be more effective than Western medicine alone.
Collapse
Affiliation(s)
- Ariel Harsinay
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Anusha Patil
- School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Safi Ali-Khan
- Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Keith Sweitzer
- Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
| | - Jonathan I Leckenby
- Department of Plastic Surgery, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
2
|
Gawde P, Shah H, Patel H, Bharathi KS, Patel N, Sethi Y, Kaka N. Revisiting Migraine: The Evolving Pathophysiology and the Expanding Management Armamentarium. Cureus 2023; 15:e34553. [PMID: 36879707 PMCID: PMC9985459 DOI: 10.7759/cureus.34553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Migraine affects about one billion people worldwide yearly and is one of the most common neurologic illnesses, with a high prevalence and morbidity, particularly among young adults and females. Migraine is associated with many comorbidities, including stress, sleep difficulties, and suicidal ideation. Migraine, despite its widespread occurrence, is underdiagnosed and undertreated. Because of the complicated and primarily unknown mechanisms of migraine formation, several social and biological risk factors, such as hormone imbalances, genetic and epigenetic impacts, and cardiovascular, neurological, and autoimmune illnesses, have been proposed. Through the mid-20th century diversion of the now-defunct vascular theory, the pathophysiology of migraine has developed from a historical study of the "humours" to a distinct entity as a neurological disorder. The range of therapeutic targets has broadened significantly, increasing the number of specialized clinical trials. Understanding the biology of migraine through careful research has resulted in the identification of major therapeutic classes: (i) triptans, serotonin 5-HT1B/1D receptor agonists, (ii) gepants, calcitonin gene-related peptide (CGRP) receptor antagonists, (iii) ditans, 5-HT1F receptor agonists, (iv) CGRP monoclonal antibodies, and (v) glurants, mGlu5 modulators, with further targets being explored. This review provides a comprehensive overview of the most recent literature on epidemiology and risk factors and exposes knowledge gaps.
Collapse
Affiliation(s)
- Prathamesh Gawde
- Medicine and Surgery, Lokmanya Tilak Municipal Medical College, Mumbai, IND
| | - Harsh Shah
- Medicine and Surgery, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Harsh Patel
- Internal Medicine, GMERS (Gujarat Medical Education and Research Society) Medical College, Sola, Ahmedabad, IND
| | | | - Neil Patel
- Medicine and Surgery, GMERS (Gujarat Medical Education and Research Society) Medical College, Himmatnagar, IND
| | - Yashendra Sethi
- Medicine and Surgery, Government Doon Medical College, Dehradun, IND
| | - Nirja Kaka
- Medicine and Surgery, GMERS (Gujarat Medical Education and Research Society) Medical College, Himmatnagar, IND
| |
Collapse
|
3
|
Evaluation of the effect of acupuncture on pain of patients with refractory trigeminal neuralgia. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2021. [DOI: 10.1007/s11726-021-1273-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
4
|
Yu J, Tu M, Shi Y, Liu Y, He X, Qiu F, Xu Y, Sun R, Jiang Y, Fang J. Acupuncture therapy for treating postherpetic neuralgia: A protocol for an overview of systematic reviews and meta-analysis. Medicine (Baltimore) 2020; 99:e23283. [PMID: 33217857 PMCID: PMC7676539 DOI: 10.1097/md.0000000000023283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Postherpetic neuralgia (PHN) is the most common complication and sequela of herpes zoster (HZ) that greatly affects the life and emotional experience of patients. Acupuncture therapy has been confirmed as an effective and safe treatment for PHN. Several systematic reviews (SRs) and meta-analysis (MAs) have reported the evidence of acupuncture therapy for treating PHN. However, the evidence has not been systematically synthesized. This overview aims to synthesize and assess the reliability of evidence generated from these SRs and MAs of acupuncture therapy for PHN. METHODS We will conduct a systematic search of the China Biology Medicine (CBM), VIP database, Wangfang database, China National Knowledge Infrastructure (CNKI), Pubmed, Cochrane Library, Excerpt Medical Database (Embase), and Web of Science to identify eligible SRs and MAs, from their inception to October 31, 2020. We will use Assessment of Multiple Systematic Reviews-2 (AMSTAR2) for methodological quality assessment, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for report quality assessment, Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for the quality of evidence assessment, and ROBIS for the bias assessment. Our reviewers will conduct systematic reviews, qualification evaluation, data extraction, methodological quality, and evidence quality screening in pairs. The outcomes include pain intensity, Quality of life (QoL), Hamilton Anxiety Scale (HAMA), Global impression, and adverse events. All the extracted data will be provided in tabular form to summarize characteristics of each review. The evidence will be a narrative synthesis of the type and content of the intervention and the results reported. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSIONS This overview will provide comprehensive evidence of acupuncture therapy for patients with PHN. ETHICS AND DISSEMINATION This review will not involve private information of participants, so the ethical approval will not be required. The results will be disseminated in a peer-reviewed journal or conference presentation. Important protocol modifications will be updated on PROSPERO. PROSPERO REGISTRATION NUMBER CRD42020178738.
Collapse
Affiliation(s)
- Jie Yu
- Department of Acupuncture and Massage, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Mingqi Tu
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Yan Shi
- Department of Acupuncture and Massage, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
| | - Yingjun Liu
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Xiaofen He
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Fanghui Qiu
- Department of Acupuncture and Massage, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine
| | - Yunyun Xu
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Ruohan Sun
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Yongliang Jiang
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| | - Jianqiao Fang
- Department of Neurobiology and Acupuncture Research, the Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, China
| |
Collapse
|
5
|
Takeshima T, Wan Q, Zhang Y, Komori M, Stretton S, Rajan N, Treuer T, Ueda K. Prevalence, burden, and clinical management of migraine in China, Japan, and South Korea: a comprehensive review of the literature. J Headache Pain 2019; 20:111. [PMID: 31805851 PMCID: PMC6896325 DOI: 10.1186/s10194-019-1062-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/28/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The objective of this review was to determine the unmet needs for migraine in East Asian adults and children. METHODS We searched MEDLINE and EMBASE (January 1, 1988 to January 14, 2019). Studies reporting the prevalence, humanistic and economic burden, and clinical management of migraine in China (including Hong Kong and Taiwan), Japan, and South Korea were included. Studies conducted before 1988 (before the International Headache Society [IHS] first edition of the International Classification of Headache Disorders) were not included. RESULTS We retrieved 1337 publications and 41 met the inclusion criteria (28 from China, 7 from Japan, and 6 from South Korea). The 1-year prevalence of migraine (IHS criteria) among adults ranged from 6.0% to 14.3%. Peak prevalence ranged from 11% to 20% for women and 3% to 8% for men (30- to 49-year-olds). For children, prevalence of migraine increased with age. Information on the economic burden and clinical management of migraine was limited, particularly for children. When reported, migraine was significantly associated with high levels of disability and negative effects on quality of life. Studies suggested low levels of disease awareness/diagnosis within each country. Of individuals with migraine from China, 52.9% to 68.6% had consulted a physician previously, 37.2% to 52.7% diagnosed with headache had not been diagnosed with migraine previously, and 13.5% to 18% had been diagnosed with migraine previously. Of individuals with migraine from Japan, 59.4% to 71.8% had never consulted a physician previously, 1.3% to 7.3% regularly consulted physicians for their headache, and only 11.6% of individuals with migraine were aware that they had migraine. In addition, studies suggested that over-the-counter medication use was high and prescription medication use was low in each country. CONCLUSIONS This review suggests that there are unmet needs for migraine in terms of sufficient and appropriate diagnosis, and better management and therapies for treatment of migraine in East Asia. The findings are limited by a lack of recent information and significant gaps in the literature. More recent, population-based studies assessing disease burden and clinical management of migraine are needed to confirm unmet needs for migraine across East Asia.
Collapse
Affiliation(s)
- Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Qi Wan
- Department of Neurology, Jiangsu Province Hospital, Nanjing, China
| | | | - Mika Komori
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., 5-1-28, Isogamidori, chuo-ku, Kobe, 651-0086, Japan
| | | | | | - Tamas Treuer
- GPORWE International, Lilly Hungaria Kft, Budapest, Hungary
| | - Kaname Ueda
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., 5-1-28, Isogamidori, chuo-ku, Kobe, 651-0086, Japan.
| |
Collapse
|
6
|
Liu H, Li XW, Du J. Acupuncture treatment on idiopathic trigeminal neuralgia: A systematic review protocol. Medicine (Baltimore) 2019; 98:e14239. [PMID: 30681609 PMCID: PMC6358347 DOI: 10.1097/md.0000000000014239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The objective of this systematic review protocol is to provide the methods for evaluating the effectiveness and safety of acupuncture on the treatment of idiopathic trigeminal neuralgia (ITN). METHODS AND ANALYSIS We will search randomized controlled trials (RCTs) on this subject in 8 electronic databases and they are Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), the Wan-Fang Database, and Chinese Scientific Journal Database (VIP database). Other relevant literatures will be manually searched as a complement. Only RCTs related to acupuncture for ITN in English or Chinese will be included, without limitation of publication types. The risk of bias and trial quality will be assessed by the Cochrane collaboration's tool. All data will be analyzed by RevMan V.5.3.3 statistical software. ETHICS AND DISSEMINATION Ethical approval is not necessary as this paper does not involve patient data. This protocol will be disseminated by a peer-review journal or conference presentation. TRIAL REGISTRATION NUMBER PROSPERO CRD42015022173 STRENGTHS AND LIMITATIONS OF THIS STUDY:: This systematic review will evaluate the effectivity and safety of acupuncture treatment on idiopathic trigeminal neuralgia. Two authors will perform independently study selection, data extraction and quality assessment, in order to ensure that all included studies are not personal bias. The result of this systematic review may give clinicians more ways to assist patient in relieving trigeminal neuralgia.This shortage of systematic review is due to language barriers, only 2 languages of the trials can be included, other related studies may be missing. Different methods of acupuncture and quality of methodologies may result in essential heterogeneity.
Collapse
Affiliation(s)
- Hao Liu
- Department of Acupuncture and Moxibustion, Tongde Hospital of Zhejiang Province
- Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China
| | - Xin-Wei Li
- Department of Acupuncture and Moxibustion, Tongde Hospital of Zhejiang Province
- Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China
| | - Jia Du
- Department of Acupuncture and Moxibustion, Tongde Hospital of Zhejiang Province
- Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China
| |
Collapse
|
7
|
Hu H, Chen L, Ma R, Gao H, Fang J. Acupuncture for primary trigeminal neuralgia: A systematic review and PRISMA-compliant meta-analysis. Complement Ther Clin Pract 2018; 34:254-267. [PMID: 30712736 DOI: 10.1016/j.ctcp.2018.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/22/2018] [Accepted: 12/23/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE Acupuncture is increasingly used by patients with primary trigeminal neuralgia (PTN). We aimed to evaluate the efficacy and safety of acupuncture for PTN. METHODS Seven databases were searched. Risk of bias was assessed and meta-analyses were conducted. The evidence level was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS Thirty-three RCTs were included. Meta-analysis results demonstrated that the effect of both manual acupuncture (MA) and electro-acupuncture (EA) for improving response rate and recurrence rate was more significant than carbamazepine. Besides, MA achieved more significant effect on alleviating pain intensity. Moreover, acupuncture combined with carbamazepine had a more positive effect on response rate than carbamazepine alone. CONCLUSIONS Acupuncture might have some positive effects for PTN. Nevertheless, the level of all evidence was low or very low. We could not yet draw a firm conclusion on the efficacy of acupuncture for PTN.
Collapse
Affiliation(s)
- Hantong Hu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China; Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Lifang Chen
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Ruijie Ma
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Hong Gao
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China
| | - Jianqiao Fang
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China; Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, China.
| |
Collapse
|
8
|
Sezgin Y. The Acupuncture Therapeutic Approach in Temporal Arteritis Vasculitis: A Case Report. J Acupunct Meridian Stud 2018; 11:116-118. [PMID: 29436372 DOI: 10.1016/j.jams.2017.12.002] [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: 12/12/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022] Open
Abstract
Temporal arteritis is a form of vasculitis that involves the large- and medium-diameter arteries and leads to progressive headache. Symptoms may be accompanied by vision disorder, subfebrile temperature, fatigue, lack of appetite, weight loss, sweating, and joint pains. While cortisone therapy reduces the symptoms, its effects in terms of improving quality of life are limited. We opted to benefit from the effects of acupuncture to reduce symptoms and increase quality of life in a case of temporal arteritis, a chronic disease. A 75-year-old woman presented with pain on both sides of the head. The pain occurred in the form of agonizing attacks 2-3 times a week. Accompanying neck pain was present, together with continuous lethargy and fatigue. Physical examination revealed decreased cutaneous elasticity and muscle mass, and a depressive mood state was present. The patient was first administered six sessions of acupuncture therapy directed toward the migraine etiology. When no response was achieved, we investigated temporal and parietal region points associated with headache in the literature. Points GB1,8,18, ST8, SI19, and BL8 were added to the treatment. The pain attacks and their frequency decreased following acupuncture therapy. In conclusion, while cortisone is the first preference in the treatment of temporal arteritis, we think that acupuncture aimed at the cause of accompanying symptoms can also be useful.
Collapse
Affiliation(s)
- Yılmaz Sezgin
- Department of Family Medicine, University of Health Science, I˙stanbul Educational Research Hospital, I˙stanbul, Turkey.
| |
Collapse
|
9
|
Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. THE JOURNAL OF PAIN 2017; 19:455-474. [PMID: 29198932 DOI: 10.1016/j.jpain.2017.11.005] [Citation(s) in RCA: 392] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/27/2017] [Accepted: 11/06/2017] [Indexed: 12/23/2022]
Abstract
Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for 4 chronic pain conditions. We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for nonspecific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. Trials were only included if allocation concealment was unambiguously determined to be adequate. Raw data were obtained from study authors and entered into an individual patient data meta-analysis. The main outcome measures were pain and function. An additional 13 trials were identified, with data received for a total of 20,827 patients from 39 trials. Acupuncture was superior to sham as well as no acupuncture control for each pain condition (all P < .001) with differences between groups close to .5 SDs compared with no acupuncture control and close to .2 SDs compared with sham. We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at 1 year. In secondary analyses, we found no obvious association between trial outcome and characteristics of acupuncture treatment, but effect sizes of acupuncture were associated with the type of control group, with smaller effects sizes for sham controlled trials that used a penetrating needle for sham, and for trials that had high intensity of intervention in the control arm. We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. Although factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain after acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominantly by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment. PERSPECTIVE Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.
Collapse
Affiliation(s)
| | | | - George Lewith
- University of Southampton, Southampton, United Kingdom (deceased)
| | | | | | - Karen J Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | | | - Claudia M Witt
- University Hospital Zurich, University of Zurich, Zurich, Switzerland; Charite-Universitätsmedizin, Berlin, Germany; University of Maryland School of Medicine, Baltimore, Maryland
| | | |
Collapse
|
10
|
Ju ZY, Wang K, Cui HS, Yao Y, Liu SM, Zhou J, Chen TY, Xia J. Acupuncture for neuropathic pain in adults. Cochrane Database Syst Rev 2017; 12:CD012057. [PMID: 29197180 PMCID: PMC6486266 DOI: 10.1002/14651858.cd012057.pub2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Neuropathic pain may be caused by nerve damage, and is often followed by changes to the central nervous system. Uncertainty remains regarding the effectiveness and safety of acupuncture treatments for neuropathic pain, despite a number of clinical trials being undertaken. OBJECTIVES To assess the analgesic efficacy and adverse events of acupuncture treatments for chronic neuropathic pain in adults. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, four Chinese databases, ClinicalTrials.gov and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 14 February 2017. We also cross checked the reference lists of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) with treatment duration of eight weeks or longer comparing acupuncture (either given alone or in combination with other therapies) with sham acupuncture, other active therapies, or treatment as usual, for neuropathic pain in adults. We searched for studies of acupuncture based on needle insertion and stimulation of somatic tissues for therapeutic purposes, and we excluded other methods of stimulating acupuncture points without needle insertion. We searched for studies of manual acupuncture, electroacupuncture or other acupuncture techniques used in clinical practice (such as warm needling, fire needling, etc). DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. The primary outcomes were pain intensity and pain relief. The secondary outcomes were any pain-related outcome indicating some improvement, withdrawals, participants experiencing any adverse event, serious adverse events and quality of life. For dichotomous outcomes, we calculated risk ratio (RR) with 95% confidence intervals (CI), and for continuous outcomes we calculated the mean difference (MD) with 95% CI. We also calculated number needed to treat for an additional beneficial outcome (NNTB) where possible. We combined all data using a random-effects model and assessed the quality of evidence using GRADE to generate 'Summary of findings' tables. MAIN RESULTS We included six studies involving 462 participants with chronic peripheral neuropathic pain (442 completers (251 male), mean ages 52 to 63 years). The included studies recruited 403 participants from China and 59 from the UK. Most studies included a small sample size (fewer than 50 participants per treatment arm) and all studies were at high risk of bias for blinding of participants and personnel. Most studies had unclear risk of bias for sequence generation (four out of six studies), allocation concealment (five out of six) and selective reporting (all included studies). All studies investigated manual acupuncture, and we did not identify any study comparing acupuncture with treatment as usual, nor any study investigating other acupuncture techniques (such as electroacupuncture, warm needling, fire needling).One study compared acupuncture with sham acupuncture. We are uncertain if there is any difference between the two interventions on reducing pain intensity (n = 45; MD -0.4, 95% CI -1.83 to 1.03, very low-quality evidence), and neither group achieved 'no worse than mild pain' (visual analogue scale (VAS, 0-10) average score was 5.8 and 6.2 respectively in the acupuncture and sham acupuncture groups, where 0 = no pain). There was limited data on quality of life, which showed no clear difference between groups. Evidence was not available on pain relief, adverse events or other pre-defined secondary outcomes for this comparison.Three studies compared acupuncture alone versus other therapies (mecobalamin combined with nimodipine, and inositol). Acupuncture may reduce the risk of 'no clinical response' to pain than other therapies (n = 209; RR 0.25, 95% CI 0.12 to 0.51), however, evidence was not available for pain intensity, pain relief, adverse events or any of the other secondary outcomes.Two studies compared acupuncture combined with other active therapies (mecobalamin, and Xiaoke bitong capsule) versus other active therapies used alone. We found that the acupuncture combination group had a lower VAS score for pain intensity (n = 104; MD -1.02, 95% CI -1.09 to -0.95) and improved quality of life (n = 104; MD -2.19, 95% CI -2.39 to -1.99), than those receiving other therapy alone. However, the average VAS score of the acupuncture and control groups was 3.23 and 4.25 respectively, indicating neither group achieved 'no worse than mild pain'. Furthermore, this evidence was from a single study with high risk of bias and a very small sample size. There was no evidence on pain relief and we identified no clear differences between groups on other parameters, including 'no clinical response' to pain and withdrawals. There was no evidence on adverse events.The overall quality of evidence is very low due to study limitations (high risk of performance, detection, and attrition bias, and high risk of bias confounded by small study size) or imprecision. We have limited confidence in the effect estimate and the true effect is likely to be substantially different from the estimated effect. AUTHORS' CONCLUSIONS Due to the limited data available, there is insufficient evidence to support or refute the use of acupuncture for neuropathic pain in general, or for any specific neuropathic pain condition when compared with sham acupuncture or other active therapies. Five studies are still ongoing and seven studies are awaiting classification due to the unclear treatment duration, and the results of these studies may influence the current findings.
Collapse
Affiliation(s)
- Zi Yong Ju
- Shanghai University of Traditional Chinese MedicineCollege of Acumox and TuinaShanghaiChina
| | - Ke Wang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineResearch Lab of Surgery of Integrated Traditional and Western MedicineShanghaiChina
| | - Hua Shun Cui
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture and MoxibustionShanghaiChina
| | - Yibo Yao
- Longhua Hospital, Shanghai Traditional Chinese Medicine UniversityDepartment of Anorectal Surgery725 South Wanping Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Shi Min Liu
- Shanghai University of Traditional Chinese MedicineCollege of Acupuncture and TuinaShanghaiChina
| | - Jia Zhou
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineCardiothoracic SurgeryShanghaiChina
| | - Tong Yu Chen
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineCardiothoracic SurgeryShanghaiChina
| | - Jun Xia
- The Ingenuity Centre, The University of NottinghamSystematic Review Solutions LtdTriumph RoadNottinghamUKNG7 2TU
| | | |
Collapse
|
11
|
Abstract
Background: Trigeminal neuralgia (TN) is the most common cranial neuralgia in adults, with a slightly higher incidence in women than in men. This chronic pain condition affects the trigeminal nerve, also known as the 5th cranial nerve. It is one of the most deeply distributed nerves in the head. Antiseizure drugs are the main biomedical treatment of TN. However, TN is not the only source of facial pain. Background persistent idiopathic facial pain (PIFP) is also a chronic disorder, recurring daily for more than 2 hours per day over more than 3 months. PIFP occurs in the absence of a neurologic deficit. The underlying pathophysiologies of TN and PIFP are still unknown, and treatment options have not been sufficiently evaluated. Nevertheless, neuropathic mechanisms could be relevant in both TN and PIFP. Cases: A 65-year-old Caucasian female with left facial pain was diagnosed by a neurologist with TN ∼2.5 years prior to seeking acupuncture treatment. A 42-year-old Caucasian female with left and right facial pain was diagnosed by a neurologist with PIFP ∼3 years prior to commencing acupuncture treatment. The cause of facial pain was treated with 60-minute sessions of I Ching Balance Acupuncture (ICBA) twice per week. Prior to each session, the effect of the previous session was recorded carefully in the patients' files. Results: A complete dissipation of pain was achieved after 29 and 60 ICBA sessions in the TN and the PIFP patient, respectively. Conclusions: The present article is the one of the first to demonstrate the efficacy of ICBA treatment for refractory facial pain. As the present article shows, ICBA treatment affects facial pain of different types successfully. However, additional larger-scale studies are necessary to validate the efficacy of ICBA in TN and PIFP treatment.
Collapse
Affiliation(s)
- Arkady Kotlyar
- Outpatient Pain Clinic, Kaplan Medical Center, Rehovot, Israel
| |
Collapse
|
12
|
Patil S, Sen S, Bral M, Reddy S, Bradley KK, Cornett EM, Fox CJ, Kaye AD. The Role of Acupuncture in Pain Management. Curr Pain Headache Rep 2016; 20:22. [PMID: 26896946 DOI: 10.1007/s11916-016-0552-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Acupuncture is a traditional Chinese practice of medicine that has gained popularity in Western culture and around the world. It involves the insertion of thin needles into the skin to stimulate nerves, muscles, and connective tissues throughout the body with the goal of alleviating pain, tension, and stress. More broadly, acupuncture is actually a family of different procedures. Conceptually, it is believed to stimulate the body's meridians, or energy-carrying channels, in an attempt to correct imbalances and to restore health. These benefits are thought to be derived from the proximity of acupoints with nerves through intracellular calcium ions. This lesson outlines a brief history of acupuncture and how it may be used to treat various types of physical and emotional pain and specific conditions, including overactive bladder and psoriasis. Acupuncture has been demonstrated to enhance endogenous opiates, such as dynorphin, endorphin, encephalin, and release corticosteroids, relieving pain and enhancing the healing process. There are associated risks; however, serious side effects are rare. When compared to traditional methods of pain management, more studies are warranted in order to establish the efficacy of acupuncture and its place in pain management.
Collapse
Affiliation(s)
| | - Sudipta Sen
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Matthew Bral
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Shanthi Reddy
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | | | | | - Charles J Fox
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Science Center, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
| |
Collapse
|
13
|
Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:430143. [PMID: 26495012 PMCID: PMC4606196 DOI: 10.1155/2015/430143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/21/2015] [Indexed: 12/01/2022]
Abstract
Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03). Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs.
Collapse
|
14
|
Li P, Qiu T, Qin C. Efficacy of Acupuncture for Bell's Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One 2015; 10:e0121880. [PMID: 25974022 PMCID: PMC4431843 DOI: 10.1371/journal.pone.0121880] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 02/18/2015] [Indexed: 11/19/2022] Open
Abstract
Acupuncture has emerged as an alternative therapy for Bell’s palsy in both adults and children. However, the use of acupuncture is controversial. We conducted a systematic review and meta-analysis to assess the efficacy of acupuncture for Bell’s palsy. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, irrespective of any language restrictions. Randomized controlled trials comparing acupuncture with other therapies for Bell’s palsy in adults or children were included. Fourteen randomized controlled trials involving 1541 individuals were included in this meta-analysis. Significant association was observed in acupuncture with a higher effective response rate for Bell’s palsy (relative risk, 1.14; 95% confidence interval, 1.04–1.25; P = 0.005) but there was a heterogeneity among the studies (I2 = 87%). An assessment of the included studies revealed a high risk of bias in methodological quality. An evaluation of the incidence of complications was not available, owing to incomplete data. Acupuncture seems to be an effective therapy for Bell’s palsy, but there was insufficient evidence to support the efficacy and safety of acupuncture. However, the results should be interpreted cautiously, because of the poor quality and heterogeneity of the included studies.
Collapse
Affiliation(s)
- Pingping Li
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Tangmeng Qiu
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Chao Qin
- Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
- * E-mail:
| |
Collapse
|
15
|
Empirical versus Etiological Approaches in Oriental Medical Research. J Acupunct Meridian Stud 2015; 8:99-102. [PMID: 25952127 DOI: 10.1016/j.jams.2014.11.007] [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: 08/11/2014] [Revised: 10/13/2014] [Accepted: 11/06/2014] [Indexed: 11/23/2022] Open
Abstract
Although Oriental medicine, by nature, may be considered an etiology-based approach to healing, its role in modern research is primarily empirical. The absolute dependence on symptomatic presentation to establish acupuncture point selection goes against the grain of traditional Oriental methods, which emphasize pulse, tongue, and other diagnostic tools to determine the overall biological and psychological conditions of the patient. Recently introduced diagnostic methods in Oriental medical research indicate a potential shift from empirically to etiologically centered designs. This article reviews current mainstream approaches to efficacy trial designs and proceeds with the analysis of newer research models, such as a constitutional approach spearheaded in Korea by the field of four-constitutional medicine.
Collapse
|
16
|
Sha F, Ye X, Zhao W, Xu CL, Wang L, Ding MH, Bi AL, Wu JF, Jiang WJ, Guo DD, Guo JG, Bi HS. Effects of electroacupuncture on the levels of retinal gamma-aminobutyric acid and its receptors in a guinea pig model of lens-induced myopia. Neuroscience 2014; 287:164-74. [PMID: 25542423 DOI: 10.1016/j.neuroscience.2014.12.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 12/05/2014] [Indexed: 12/01/2022]
Abstract
Gamma-aminobutyric acid (GABA) is a major inhibitory neurotransmitter of the retina and affects myopic development. Electroacupuncture (EA) is widely utilized to treat myopia in clinical settings. However, there are few reports on whether EA affects the level of retinal GABA during myopic development. To study this issue, in the present study, we explored the changes of retinal GABA content and the expression of its receptor subtypes, and the effects of EA stimulation on them in a guinea pig model with lens-induced myopia (LIM). Our results showed that the content of GABA and the expression of GABAA and GABAC receptors of retina were up-regulated during the development of myopia, and this up-regulation was inhibited by applying EA to Hegu (LI4) and Taiyang (EX-HN5) acupoints. Moreover, these effects of EA show a positional specificity. While applying EA at a sham acupoint, no apparent change of myopic retinal GABA and its receptor subtypes was observed. Taken together, our findings suggest that LIM is effective to up-regulate the level of retinal GABA, GABAA and GABAC receptors in guinea pigs and the effect may be inhibited by EA stimulation at LI4 and EX-HN5 acupoints.
Collapse
Affiliation(s)
- F Sha
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China
| | - X Ye
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China
| | - W Zhao
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China
| | - C-L Xu
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China
| | - L Wang
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China; Jining Medical University, Jining, Shandong Province 272000, China
| | - M-H Ding
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China
| | - A-L Bi
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China
| | - J-F Wu
- Shandong University of Traditional Chinese Medicine, Jinan 250002, China
| | - W-J Jiang
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China
| | - D-D Guo
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China
| | - J-G Guo
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China
| | - H-S Bi
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, No. 48#, Yingxiongshan Road, Jinan 250002, China; Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, No. 48#, Yingxiongshan Road, Jinan 250002, China; Eye Institute of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China; Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No. 48#, Yingxiongshan Road, Jinan 250002, China.
| |
Collapse
|
17
|
Ju Z, Cui H, Guo X, Yang H, He J, Wang K. Molecular mechanisms underlying the effects of acupuncture on neuropathic pain. Neural Regen Res 2014; 8:2350-9. [PMID: 25206545 PMCID: PMC4146043 DOI: 10.3969/j.issn.1673-5374.2013.25.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/25/2013] [Indexed: 01/27/2023] Open
Abstract
Acupuncture has been used to treat neuropathic pain for a long time, but its mechanisms of action remain unknown. In this study, we observed the effects of electroacupuncture and manual acu-puncture on neuropathic pain and on ephrin-B/EphB signaling in rats models of chronic constriction injury-induced neuropathic pain. The results showed that manual acupuncture and elec-puncture significantly reduced mechanical hypersensitivity following chronic constriction injury, es-pecially electroacupuncture treatment. Real-time PCR results revealed that ephrin-B1/B3 and EphB1/B2 mRNA expression levels were significantly increased in the spinal dorsal horns of chronic constriction injury rats. Electroacupuncture and manual acupuncture suppressed the high sion of ephrin-B1 mRNA, and elevated EphB3/B4 mRNA expression. Electroacupuncture signifi-cantly enhanced the mRNA expression of ephrin-B3 and EphB3/B6 in the dorsal horns of neuro-pathic pain rats. Western blot results revealed that electroacupuncture in particular, and manual acupuncture, significantly up-regulated ephrin-B3 protein levels in rat spinal dorsal horns. The re-sults of this study suggest that acupuncture could activate ephrin-B/EphB signaling in neuropathic pain rats and improve neurological function.
Collapse
Affiliation(s)
- Ziyong Ju
- College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Huashun Cui
- Department of Acupuncture, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiaohui Guo
- College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Huayuan Yang
- College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jinsen He
- College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ke Wang
- Department of Cardiothoracic Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| |
Collapse
|
18
|
Yeh CH, Chiang YC, Hoffman SL, Liang Z, Klem ML, Tam WWS, Chien LC, Suen LKP. Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:934670. [PMID: 25165482 PMCID: PMC4140110 DOI: 10.1155/2014/934670] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/17/2014] [Indexed: 11/30/2022]
Abstract
Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [-2.36, -0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.
Collapse
Affiliation(s)
- Chao Hsing Yeh
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA 15261, USA
| | - Yi Chien Chiang
- Department of Nursing, Chang Gung University of Science and Technology, No. 261,Wen-hwa 1st Road, Kwei-shan, Taoyuan 333, Taiwan
| | - Samuel L. Hoffman
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA 15261, USA
| | - Zhan Liang
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, 440 Victoria Building, Pittsburgh, PA 15261, USA
| | - Mary Lou Klem
- Falk Library, University of Pittsburgh, 200 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - Wilson W. S. Tam
- The Jockey Club School of Public Health and Primary Care, The Chinese Hong Kong University, Hong Kong
| | - Lung-Chang Chien
- Division of Biostatistics, University of Texas School of Public Health San Antonio Regional Campus, Research to Advance Community Health Center, University of Texas Health Science Center at San Antonio Regional Campus, 7411 John Smith Drive, Suite 1050 Room 505, San Antonio, TX 78229, USA
| | - Lorna Kwai-Ping Suen
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| |
Collapse
|
19
|
Effects of chronic electroacupuncture on depression- and anxiety-like behaviors in rats with chronic neuropathic pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:158987. [PMID: 24795763 PMCID: PMC3984799 DOI: 10.1155/2014/158987] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/24/2014] [Indexed: 01/09/2023]
Abstract
Growing evidence indicates that chronic neuropathic pain is frequently accompanied by an array of psychiatric diseases, such as depression and anxiety. Electroacupuncture (EA), as one therapy of traditional Chinese medicine, has displayed potent antidepressant-like effects in numerous clinical studies. The present study was designed to examine the possible effects of EA on the depressive and anxiety disorders induced by neuropathic pain. A classic rat model of neuropathic pain was produced by chronic constriction injury (CCI) of the sciatic nerve. EA was performed on acupoints “Bai-Hui” (GV20) and unilateral “Yang-Ling-Quan” (GB34). The antidepressive and anxiolytic effects of EA treatment were analyzed using the forced swimming test (FST) and the elevated plus maze (EPM) test, respectively. CCI resulted in remarkable depression- and anxiety-like behaviors, whereas the chronic EA treatment significantly improved the behavioral deficits of CCI rats. Moreover, the phosphorylation level of the NMDA receptor type 1 (NR1) subunit was decreased in the hippocampus of CCI rats. Intriguingly, continuous EA treatment effectively blocked this decrease in the levels of pNR1. These results suggested that EA has antidepressive and anxiolytic effects on rats with neuropathic pain and that this might be associated with restoring the phosphorylation of NR1 in the hippocampus.
Collapse
|
20
|
Dong Z, Sun Y, Lu P, Wang Y, Wu G. Electroacupuncture and lumbar transplant of GDNF-secreting fibroblasts synergistically attenuate hyperalgesia after sciatic nerve constriction. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2013; 41:459-72. [PMID: 23711135 DOI: 10.1142/s0192415x1350033x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Electroacupuncture (EA) has been shown to induce potent analgesic effects on neuropathic pain in both patients and rodents. Cell therapy to release antinociceptive agents near the pain processing centers of the spinal cord is a promising next step in the development of treatment modalities. This study investigated the effects of the combination of EA and cell therapy by glial cell line-derived neurotrophic factor (GDNF) on neuropathic pain in rats. The hyperalgesic state was induced by chronic constriction injury (CCI) of the sciatic nerve and fibroblasts genetically modified to secrete bioactive GDNF (FBs-GDNF) were used for cell therapy. Fifty-eight rats with neuropathic pain were randomly divided into five groups (CCI+PBS, n = 11; CCI+FBs-GDNF, n = 12; CCI+EA+PBS, n = 11; CCI+EA+FBs-pLNCX2, n = 12; CCI+EA+FBs-GDNF, n = 12). On the 7th day after CCI, the rats received intrathecal transplantation of FBs-GDNF or control fibroblasts (FBs-pLNCX2). In the meantime, EA was administered once every other day from the 7th day after CCI surgery for 21 days. The paw withdrawal latency (PWL) to radiant heat was measured every other day. The results showed that the ipsilateral PWL of the rats from all three EA treatment groups significantly increased starting on the 12th day compared with the PBS control group. Strikingly, the group which received EA treatment and FBs-GDNF transplantation (CCI+EA+FBs-GDNF) showed a significantly decreased thermal hyperalgesia after 2 weeks post CCI surgery compared with the groups which received EA treatment and FBs-pLNCX2 transplantation (CCI+EA+FBs-pLNCX2) or PBS (CCI+EA+PBS) as well as the FBs-GDNF transplantation group without EA treatment (CCI+FBs-GDNF). Our data suggest that EA and cell therapy can synergistically attenuate hyperalgesia in neuropathic pain rats.
Collapse
Affiliation(s)
- Zhiqiang Dong
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Institute of Brain Research, Shanghai Medical College, Fudan University, Shanghai 200032, China.
| | | | | | | | | |
Collapse
|
21
|
Cumberworth A, Mabvuure NT, Norris JM, Watts S. Is acupuncture beneficial in the treatment of Bell's palsy?: best evidence topic (BET). Int J Surg 2012; 10:310-2. [PMID: 22564830 DOI: 10.1016/j.ijsu.2012.04.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 04/28/2012] [Accepted: 04/29/2012] [Indexed: 11/19/2022]
Abstract
A best evidence topic in facial nerve surgery was written according to a structured protocol. The question addressed was: in [patients with Bell's palsy], does [acupuncture] improve [facial nerve function and/or pain]? A total of 43 papers were identified using the reported search protocol, of which three articles represented the best available evidence to answer the clinical question. Two of these articles were review papers and together encompassed 13 primary articles. Publication details, type of study, patients studied, outcomes and results are tabulated. The two level 1 articles concluded that before firm conclusions can be drawn, better designed trials are required in order to establish whether acupuncture confers any benefit to patients with Bell's palsy. The level 2 randomised controlled trial (RCT) suggested that two methods of acupuncture were associated with significant improvements in pain in Bell's palsy, although the trial was poorly controlled and had risk of bias. Therefore, the clinical bottom line is that until well designed trials are able to clearly demonstrate a role for acupuncture in Bell's palsy, its efficacy should be considered to remain unproven.
Collapse
|
22
|
Fu JY, Zhang X, Zhao YH, Tong HF, Chen DZ, Huang MH. Scientific production and citation impact: a bibliometric analysis in acupuncture over three decades. Scientometrics 2012. [DOI: 10.1007/s11192-012-0737-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|