1
|
Martins Filho HMDA, Mangueira MDAMM, Nóbrega LGD, Gama Filho OP, Neto OP, Mangueira NM, Zângaro RA. Effects of Laser Acupuncture on Metabolic Functions of Sedentary People: A Double-Blind Randomized Clinical Trial. Photobiomodul Photomed Laser Surg 2024. [PMID: 39344803 DOI: 10.1089/photob.2023.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2024] Open
Abstract
Background: Laser acupuncture regulates energy flow and restores body fluid metabolism. Objective: To evaluate the effects of the laser acupuncture protocol (LAP) on hepatic and renal metabolism in sedentary people. Methods: Longitudinal, double-blind, and randomized clinical trial with 29 participants, adults, both sexes, sedentary, without pre-existing metabolic diseases, subdivided into control and laser groups. Based on the STandards for Reporting Interventions in Clinical Trials of Acupuncture 2010 guidelines, 10 laser applications (660 nm ±10 nm wavelength, 100 mW power. The irradiation tip has a diameter of 5 mm, which corresponds to an area of 0.19 cm2, totaling a power density of 0.52 W/cm2 and considering the irradiation time of 90 s, the energy density applied was 47.3 J/cm2) were performed on the acupoints of metabolic functions (LR3, SP6, ST36, and LI4) and blood samples were collected for fasting glycemia, lipid profile (HDL, LDL, total cholesterol, and triglycerides), liver function (AST/GOT and ALT/GPT), and renal function (serum creatinine and urea). A repeated measures analysis of variance (ANOVA) with Bonferroni corrected post hoc comparisons was applied to compare statistical differences between groups and times, adopting p < 0.05 as the null hypothesis. Results: The laser stimulated changes in serum lipid profile values and renal and hepatic functions. There was a significant (p = 0.014) reduction in LDL ("bad" cholesterol) from 105.75 ± 32.83 pre- to 84.32 ± 18.38 mg/dL postintervention, associated with cardioprotective function. Positive significant (p = 0.035) impacts were also observed in the reduction of creatinine (0.86 ± 0.12 mg/dL to 0.75 ± 0.12 mg/dL) and the enzyme AST/GOT (33.73 ± 12.95 U/L to 20.80 ± 4.99 U/L, p = 0.002). Conclusion: LAP applied to basal metabolism acupoints promoted positive metabolic changes in the lipid profile (LDL), and in main markers of the liver (AST/GOT) and kidney (creatinine) functions, contributing to risk control of cardiovascular diseases.
Collapse
Affiliation(s)
| | | | - Luciano Gonçalves da Nóbrega
- Anhembi Morumbi University-UAM, São José dos Campos, Brazil
- Center for Innovation, Technology and Education-CITE, São José dos Campos, Brazil
| | | | - Osmar Pinto Neto
- Anhembi Morumbi University-UAM, São José dos Campos, Brazil
- Center for Innovation, Technology and Education-CITE, São José dos Campos, Brazil
- Department of Kinesiology, California State University San Marcos (CSUSM), San Marcos, California, USA
| | - Nilton Maciel Mangueira
- Center for Innovation, Technology and Education-CITE, São José dos Campos, Brazil
- Post-Graduate Program in Medical Sciences (PGCM), Rio de Janeiro State University-UERJ, Rio de Janeiro, Brazil
- Department of Morphology, Federal University of Maranhão-UFMA, São Luís, Brazil
| | - Renato Amaro Zângaro
- Anhembi Morumbi University-UAM, São José dos Campos, Brazil
- Center for Innovation, Technology and Education-CITE, São José dos Campos, Brazil
| |
Collapse
|
2
|
Chae Y, Lee JH, Lee MS. Using the right design controls for acupuncture trials: Methodological rigor and validity in research. Integr Med Res 2024; 13:101026. [PMID: 38434794 PMCID: PMC10904908 DOI: 10.1016/j.imr.2024.101026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Acupuncture treatment can be defined as a medical procedure with an acupuncture needle at acupoints. Establishing suitable control settings is essential, based on the target elements of the acupuncture therapy. In order to properly design a clinical trial or an experiment, a control group must be established. Here, we overview the significance of the control group and its limitations in acupuncture research. Clinical trials have employed a variety of study designs and controls for acupuncture treatment in order to compare the effects of actual treatments with control groups that include no treatment or treatment as usual, sham acupuncture at true acupoints, real acupuncture at non-acupoints, and sham acupuncture at non-acupoints. In order to determine the point-specificity of acupuncture, real acupuncture at non-acupoints should be taken into consideration, whereas sham acupuncture at the same true acupoints should be used to determine the needling-specific effect of acupuncture. It is crucial to choose the optimum control for acupuncture treatments depending on the study's main goal and to interpret the results in accordance with the research design.
Collapse
Affiliation(s)
- Younbyoung Chae
- Department of Meridian and Acupoints, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Department of Korean Convergence Medical Science, KIOM School, University of Science & Technology (UST), Daejeon, Republic of Korea
- Athinoula A. Martinos Center for Biomedical imaging, Department of Radiology, Massachusettes General Hospital, Harvard Medical School, Boston, MA, USA
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Department of Korean Convergence Medical Science, KIOM School, University of Science & Technology (UST), Daejeon, Republic of Korea
| |
Collapse
|
3
|
Ma S. Stimuli-induced NOergic Molecules and Neuropeptides Mediated Axon Reflexes Contribute to Tracers along Meridian Pathways. Curr Top Med Chem 2024; 24:393-400. [PMID: 38243932 PMCID: PMC11111350 DOI: 10.2174/0115680266260220240108114337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024]
Abstract
An abundance of studies from different international groups have demonstrated tracers along linear pathways resembling meridians over the body surface of humans. All experiments of the studies have been conducted by injection of a radiotracer solution or tracer dyes in a volume of solution into acupuncture points (acupoints). The solution injected into acupoints produces much stronger mechanical stimuli than acupuncture, which causes axon reflex. Anatomical studies have demonstrated that acupoints/meridians exist higher number of small nerve fibers and blood vessels with rich nitric oxide (NO) and neuropeptides in the cutaneous tissues as structures for the biomolecules mediated axon reflexes. Recent advances have determined that NO and calcitonin generelated peptides play crucial roles in the comprehension of the axon reflex. The stimuli-evoked axon reflex and NOergic biomolecules/neuropeptides increase local blood flow with higher levels in acupoints/meridians, which move radioactive substances or tracer dyes in the skin and subcutaneous tissue under a linear path resembling acupoints and meridians, the important phenomena of meridians induced by the stimuli. The evidence and understanding of the biomolecular processes of the tracers along linear pathways resembling meridians have been summarized with an emphasis on recent developments of NO and neuropeptides mediating stimuli-evoked axon reflexes to increase local blood flow with higher levels in acupoints/meridians, which move radioactive substances or tracer dyes in the skin and subcutaneous tissue contributing to tracers along linear pathways resembling meridians in this mini-review.
Collapse
Affiliation(s)
- Shengxing Ma
- Department of Obstetrics and Gynecology, Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, David Geffen School of Medicine at UCLA and Harbor-UCLA Medical Center, Torrance, CA 90502, United States
| |
Collapse
|
4
|
Napadow V, Harris RE, Helmer KG. Birth of the Topological Atlas and Repository for Acupoint Research. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:769-773. [PMID: 37943513 PMCID: PMC10732155 DOI: 10.1089/jicm.2023.0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Affiliation(s)
- Vitaly Napadow
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Karl G. Helmer
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
5
|
Lee B, Kwon CY, Lee HW, Nielsen A, Wieland LS, Kim TH, Birch S, Alraek T, Lee MS. Needling Point Location Used in Sham Acupuncture for Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis. JAMA Netw Open 2023; 6:e2332452. [PMID: 37672270 PMCID: PMC10483312 DOI: 10.1001/jamanetworkopen.2023.32452] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Importance When sham acupuncture is set as a control in evaluating acupuncture, the sham needling technique is usually different from acupuncture. However, the sham procedure is conducted either at the same points that are used for the acupuncture group or at nonindicated points. Objective To assess whether the outcome of sham acupuncture varies according to the needling points in sham-controlled trials of acupuncture for chronic nonspecific low back pain (CLBP) as an example. Data sources Searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Allied and Complementary Medicine Database were conducted on February 12, 2023. Study selection Randomized clinical trials (RCTs) assessing the outcomes of acupuncture in sham acupuncture-controlled or waiting list-controlled trials on CLBP were included. Data extraction and synthesis Two researchers independently extracted data on study characteristics and outcomes and assessed quality. Sham acupuncture was classified according to whether it was conducted at the same acupuncture points used in the acupuncture group, referred to as sham acupuncture therapy (verum) (SATV) or at different points, referred to as sham acupuncture therapy (sham) (SATS). Clinical similarity, transitivity, and consistency tests were conducted, followed by a random-effects frequentist network meta-analysis (NMA). Main outcomes and measures The primary outcome was pain, and the secondary outcome was back-specific function. The first assessment after the end of treatment was chosen for analysis. Effect sizes are reported as standardized mean differences (SMD) with 95% CIs. The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence for findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results Ten RCTs involving 4379 participants were included. In comparison with SATS, acupuncture was significantly associated with improvements in both pain (SMD, -0.33; 95% CI, -0.52 to -0.15) and function outcomes (SMD, -0.13; 95% CI, -0.25 to -0.02); however, there were no differences between acupuncture and SATV. In comparison with SATS, SATV was significantly associated with better pain (SMD, -0.45; 95% CI, -0.88 to -0.03) and function outcomes (SMD, -0.30; 95% CI, -0.56 to -0.05). The risk of bias that could affect the interpretation of the results was usually low, and the certainty of evidence was moderate to low. Conclusions and relevance In this NMA, sham acupuncture needling at the same points as those in acupuncture was not a true placebo control for assessing the efficacy of acupuncture for CLBP and might underestimate the outcome of acupuncture in clinical settings.
Collapse
Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Republic of Korea
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Arya Nielsen
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - L. Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea
| | - Stephen Birch
- Kristiania University College, School of Health Sciences, Oslo, Norway
| | - Terje Alraek
- Kristiania University College, School of Health Sciences, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine, Institute of Health Sciences, Tromsø, Norway
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| |
Collapse
|
6
|
Zhang X, Yang W, Shang J, Dan W, Shi L, Tong L, Yang G. The lower He-sea points playing a significant role in postoperative ileus in colorectal cancer treated with acupuncture: based on machine-learning. Front Oncol 2023; 13:1206196. [PMID: 37564931 PMCID: PMC10411531 DOI: 10.3389/fonc.2023.1206196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/04/2023] [Indexed: 08/12/2023] Open
Abstract
Background Postoperative ileus (POI) is a common complication following abdominal surgery, which can lead to significant negative impacts on patients' well-being and healthcare costs. However, the efficacy of current treatments is not satisfactory. The purpose of this study was to evaluate the therapeutic effects of acupuncture intervention and explore the regulation of acupoint selection for treating POI in colorectal cancer (CRC) patients. Methods We searched eight electronic databases to identify randomized controlled trials (RCTs) on acupuncture for POI in CRC and conducted a meta-analysis. Subsequently, we utilized the Apriori algorithm and the Frequent pattern growth algorithm, in conjunction with complex network and cluster analysis, to identify association rules of acupoints. Results The meta-analysis showed that acupuncture led to significant reductions in time to first defecation (MD=-20.93, 95%CI: -25.35, -16.51; I2 = 93.0%; p < 0.01; n=2805), first flatus (MD=-15.08, 95%CI: -18.39, -11.76; I2 = 96%; p < 0.01; n=3284), and bowel sounds recovery (MD=-10.96, 95%CI: -14.20, -7.72; I2 = 94%; p < 0.01; n=2043). A subgroup analysis revealed that acupuncture not only reduced the duration of POI when administered alongside conventional care but also further expedited the recovery of gut function after colorectal surgery when integrated into the enhanced recovery after surgery (ERAS) pathway. The studies included in the analysis reported no instances of serious adverse events associated with acupuncture. We identified Zusanli (ST36), Shangjuxu (ST37), Neiguan (PC6), Sanyinjiao (SP6), Xiajuxu (ST39), Hegu (LI4), Tianshu (ST25), and Zhongwan (RN12) as primary acupoints for treating POI. Association rule mining suggested potential acupoint combinations including {ST37, ST39}≥{ST36}, {PC6, ST37}≥{ST36}, {SP6, ST37}≥{ST36}, and {ST25, ST37}≥{ST36}. Conclusion Meta-analysis indicates acupuncture's safety and superior effectiveness over postoperative care alone in facilitating gastrointestinal recovery. Machine-learning approaches highlight the importance of the lower He-sea points, including Zusanli (ST36) and Shangjuxu (ST37), in treating POI in CRC patients. Incorporating additional acupoints such as Neiguan (PC6) (for pain and vomiting) and Sanyinjiao (SP6) (for abdominal distension and poor appetite) can optimize treatment outcomes. These findings offer valuable insights for refining treatment protocols in both clinical and experimental settings, ultimately enhancing patient care.
Collapse
Affiliation(s)
- Xu Zhang
- Department of Nutrition, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Wenjing Yang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Junliang Shang
- Department of Surgery, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Wenchao Dan
- School of Graduates, Capital Medical University, Beijing, China
| | - Lin Shi
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Li Tong
- Department of Nutrition, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Guowang Yang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| |
Collapse
|
7
|
Comparative Study of Different Acupoints for Treating Acute Myocardial Ischemia in Mice. J Cardiovasc Transl Res 2023:10.1007/s12265-022-10346-6. [PMID: 36689154 DOI: 10.1007/s12265-022-10346-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/09/2022] [Indexed: 01/24/2023]
Abstract
Acupuncture point specificity has been recognized as a key scientific issue in traditional Chinese medicine (TCM), but there is limited clinical trial or animal study to verify the characteristics of PC6, BL15, and ST36 in the protection from myocardial injury. We aimed to compare the effects among these three acupoints on the acute myocardial infarction mice model and to explore possible mechanisms for the first time. We found that PC6 is the most appropriate acupoint to deliver efficacy and safety to treat acute MI in mice. BL15 stimulation improved the systolic function, but increased the risk of arrhythmia. ST36 only slightly attenuated systolic function and had no effect on arrhythmia during MI. RNA profiles of skin tissue in local acupoints demonstrated that the most altered DEGs and related pathways may partly support its best effects of PC6 treatment on MI injury, and support the observed phenomenon of the acupoint specificity.
Collapse
|
8
|
Chae Y, Beissner F, Kim HY, Harris RE, Napadow V. Editorial: Neural substrates of acupuncture: From peripheral to central nervous system mechanisms, volume II. Front Neurosci 2023; 16:1119829. [PMID: 36741061 PMCID: PMC9893636 DOI: 10.3389/fnins.2022.1119829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Affiliation(s)
- Younbyoung Chae
- Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, Republic of Korea,*Correspondence: Younbyoung Chae ✉
| | - Florian Beissner
- Insula Institute for Integrative Therapy Research, Hanover, Germany
| | - Hee-Young Kim
- Department of Physiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Richard E. Harris
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, United States
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, United States
| |
Collapse
|
9
|
Zhang NM, Daly D, Terblanche M, Joshi S, Tacey M, Vesty G, Zheng Z. Doctors' and Nurses' Attitudes of Acupuncture and Acupressure use in Perioperative Care: An Australian National Survey. Pain Manag Nurs 2022; 23:800-810. [PMID: 36153218 DOI: 10.1016/j.pmn.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 08/07/2022] [Accepted: 08/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Acupuncture and acupressure are not being systematically used in the management of postoperative nausea and vomiting and pain, despite being included in the guidelines. AIM To examine the beliefs, attitudes, and knowledge of Australian nurses/midwives and doctors toward the perioperative use of AA for the management of postoperative nausea and vomiting and pain; to explore the barriers and enablers influencing acupuncture and acupressure integration into hospital setting. METHODS A mixed-mode approach was undertaken for data collection. An online approach was used to recruit respondents from Australian College of Perioperative Nurses. Three hospitals from three different Australian states were selected via convenience sampling. RESULTS A total of 421 usable surveys were included in data analysis. The respondents comprised 14.3% doctors and 72.9% nurses/midwives. Overall, 69.4% were female, 85% were trained in Australia with 35% and 51.4% having knowledge or personal exposure to AA in general respectively. Over 60% of the respondents agreed AA should be routinely integrated into perioperative care, and over 80% would recommend AA to their patients if it was provided at their hospital, and, 75% would be willing to receive further education. The three main reported barriers included: perceived lack of scientific evidence (80.9%), unavailability of credentialed provider (77.2%) and lack of reimbursement (60.4%). CONCLUSIONS Positive attitudes are reported by Australian doctors and nurses toward AA. This is despite of low levels of knowledge or personal exposure to AA. Further studies are required to explore the implementation of barriers and address respondent calls for further education.
Collapse
Affiliation(s)
- Nancy Ming Zhang
- School of Health and Biomedical Science, RMIT University, Bundoora, Melbourne, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - David Daly
- Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital, Melbourne, Australia
| | - Morne Terblanche
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Sumati Joshi
- Operating Theatre, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia
| | - Mark Tacey
- Northern Health, Epping, Victoria, Australia; School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Gillian Vesty
- School of Accounting, RMIT University, Melbourne, Australia
| | - Zhen Zheng
- School of Health and Biomedical Science, RMIT University, Bundoora, Melbourne, Australia.
| |
Collapse
|
10
|
Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
| |
Collapse
|
11
|
Chen JK, Tsai WT, Lin SZ, Wang SH, Wang GC, Wang TC, Chen HP, Ho TJ. Using radial pulse wave as hemodynamic measurements to quantify effects of acupuncture therapy for patients with traumatic brain injury and ischemia stroke. J Tradit Complement Med 2022; 12:594-598. [DOI: 10.1016/j.jtcme.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/15/2022] [Accepted: 08/27/2022] [Indexed: 10/31/2022] Open
|
12
|
Graca S, Citkovitz C. From Bench to Bedside and Back Again: Developments in the Evidence-Informed Practice (and Practice-Informed Research) of Acupuncture. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:613-617. [PMID: 35862030 DOI: 10.1089/jicm.2022.0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Sandro Graca
- Department of Research, Northern College of Acupuncture, York, United Kingdom
| | - Claudia Citkovitz
- Massachusetts College of Pharmacy and Health Sciences, New England College of Acupuncture, Worcester, MA, USA
| |
Collapse
|
13
|
Yang E, Lu W, Muñoz-Vergara D, Goldfinger E, Kaptchuk TJ, Napadow V, Ahn AC, Wayne PM. Skin Temperature of Acupoints in Health and Disease: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:552-568. [PMID: 35475679 DOI: 10.1089/jicm.2021.0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Despite substantial progress made in the field of acupuncture research, the existence and specificity of acupoints remain controversial. In recent years, the concept of acupoint sensitization has emerged as a theoretical framework for understanding acupoints as dynamic functional entities that are sensitized in pathological conditions. Based on this premise, some have claimed that specific acupoints are thermally distinct between healthy and clinical populations, but no systematic review has been conducted to synthesize and evaluate the quality of studies supporting such claims. In this review, we provide a summary and quality assessment of the existing literature addressing the question of whether changes in skin temperature at specific acupoints are indicative of pathological conditions. Methods: A systematic literature search was performed in PubMed, EMBASE, and AltHealthWatch (EBSCO Host), by combining variations of search terms relevant to acupoints and temperature. The search was limited to the English language, and publication dates ranged from database inception to December 2020. Two authors independently screened all resulting abstracts and subsequently read full-text articles for eligibility. Information on study design, sample, acupoints, parameters of skin temperature assessments, and main findings were extracted from included studies. Quality of the thermal sensing methodology was evaluated using a thermal assessment checklist, adapted from the Thermographic Imaging in Sports and Exercise Medicine (TISEM) consensus checklist, and a modified Newcastle-Ottawa Scale (NOS) for case-control studies. Results: The search strategy yielded a total of 1771 studies, of which 10 articles met the eligibility criteria. Eight studies compared skin temperature at acupoints in healthy versus clinical populations, and two studies assessed within-subject changes in temperature of acupoints in relation to changes in health status. There were seven clinical conditions examined in the included studies: chronic bronchial asthma, chronic hepatitis, hyperplasia of mammary glands, infertility, intracranial hypertension, obesity, and primary dysmenorrhea. There were numerous methodological quality issues related to skin temperature measurements. Eight studies with case-control designs reported significant differences between healthy and clinical populations in temperature at certain acupoints. Two studies with pre-post designs reported that changes in health-disease status could be associated with changes in temperature at specific acupoints. Conclusion: A review of the available literature suggests that certain acupoints may be thermally distinct between healthy and unhealthy states. However, given the methodological limitations and heterogeneity across included studies, no definitive conclusion could be drawn as to whether changes in skin temperature at specific acupoints are indicative of pathological conditions.
Collapse
Affiliation(s)
- EunMee Yang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Weidong Lu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dennis Muñoz-Vergara
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Esme Goldfinger
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Ted J Kaptchuk
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Vitaly Napadow
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Andrew C Ahn
- PhysioQ Organization, Boston, MA, USA
- Department of Medicine, Veteran Affairs Boston Healthcare System, West Roxbury, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| |
Collapse
|
14
|
Acupuncture mechanism studies employing task-based fMRI: a scoping review protocol. Syst Rev 2022; 11:128. [PMID: 35733154 PMCID: PMC9215030 DOI: 10.1186/s13643-022-02007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acupuncture is a widely used alternative and complementary therapy. Functional magnetic resonance imaging (fMRI) is an important technique to explore the underlying mechanism of acupuncture, and the task-based fMRI can reflect the instant effects or sustained effects of acupuncture in the brain. This scoping review aims to summarize the characteristics of acupuncture mechanism studies employing task-based fMRI and conclude a reference for future studies. METHODS/DESIGN This review will follow the Guidance for Conducting Scoping Reviews. Eligible articles will be collected from 7 databases (PubMed, Embase, Cochrane, CNKI, WanFang, VIP, and CBM) with the related keywords such as "Acupuncture" and "fMRI"; those articles should be published from January 1, 2000, to December 31, 2021; and the language should be restricted in English or Chinese. Each research step will involve at least two reviewers. The PRISMA-ScR (Preferred Reporting Items for Systemic Reviews and Meta-Analysis Extension for Scoping Reviews) will be used to organize the review. Data will be extracted from the illegible articles, and findings will be presented in tables and narrative form. A descriptive qualitative approach to analysis will be conducted to form the scoping review. DISCUSSION This review aims to clarify the extent of acupuncture mechanism studies employing task-based fMRI. It is supposed to make a critical evaluation or propose quality requirements for future studies by summarizing the objectives and designs of eligible studies. What is more, directional suggestions will be provided for further studies. SCOPING REVIEW REGISTRATION Open Science Framework https://osf.io/zjrdc/ .
Collapse
|
15
|
Cui X, Liu K, Gao X, Zhu B. Advancing the Understanding of Acupoint Sensitization and Plasticity Through Cutaneous C-Nociceptors. Front Neurosci 2022; 16:822436. [PMID: 35620665 PMCID: PMC9127573 DOI: 10.3389/fnins.2022.822436] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Acupoint is the key area for needling treatment, but its physiology is not yet understood. Nociceptors, one of the responders in acupoints, are responsible for acupuncture manipulation and delivering acupuncture signals to the spinal or supraspinal level. Recent evidence has shown that various diseases led to sensory hypersensitivity and functional plasticity in sensitized acupoints, namely, acupoint sensitization. Neurogenic inflammation is the predominant pathological characteristic for sensitized acupoints; however, the underlying mechanism in acupoint sensitization remains unclear. Recent studies have reported that silent C-nociceptors (SNs), a subtype of C nociceptors, can be “awakened” by inflammatory substances released by sensory terminals and immune cells under tissue injury or visceral dysfunction. SNs can transform from mechano-insensitive nociceptors in a healthy state to mechanosensitive nociceptors. Activated SNs play a vital role in sensory and pain modulation and can amplify sensory inputs from the injured tissue and then mediate sensory hyperalgesia. Whether activated SNs is involved in the mechanism of acupoint sensitization and contributes to the delivery of mechanical signals from needling manipulation remains unclear? In this review, we discuss the known functions of cutaneous C nociceptors and SNs and focus on recent studies highlighting the role of activated SNs in acupoint functional plasticity.
Collapse
|
16
|
Asano H, Plonka D, Weeger J. Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Med Acupunct 2022; 34:96-106. [PMID: 35509875 PMCID: PMC9057891 DOI: 10.1089/acu.2021.0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective This systematic review and meta-analysis assess the effectiveness of acupuncture as an adjunct to standard therapy in the management of nonspecific chronic low back pain (NScLBP), compared with standard therapy alone. Methods A systematic literature search of full-text articles of randomized controlled trials in the date range of 2000-2020, utilizing PubMed and EBSCO databases, was performed to evaluate the efficacy of acupuncture treatment for nonspecific chronic lower back pain. The outcomes of interest were pain intensity and disability. The methodological quality of each study was evaluated using Cochrane risk-of-bias criteria. The studies were combined using meta-analysis when statistical pooling of data was possible. Results This systematic review included 5 studies of which 4 were included in the meta-analysis. Acupuncture as an adjunct to standard therapy had clinically meaningful reduction in self-reported pain at post-treatment (mean difference = -1.04 [95% confidence interval (CI), -1.59 to -0.49], P < 0.001, I 2 = 46.1%) and at intermediate term (mean difference = -0.82 [95% CI, -1.13 to -0.50], P < 0.001, I 2 = 0%), compared with standard care. Levels of disability showed similar clinically meaningful reduction at post-treatment and intermediate term. Conclusion Both the systematic review and meta-analysis demonstrate that acupuncture as an adjunct to standard therapy is a safe and effective method in reducing pain and disability among adults with NScLBP.
Collapse
Affiliation(s)
- Hitomi Asano
- Emperor's College of Traditional Oriental Medicine, Santa Monica, CA, USA
| | - Derek Plonka
- Emperor's College of Traditional Oriental Medicine, Santa Monica, CA, USA
| | | |
Collapse
|
17
|
Zhou S, Zhang SS, Crowley-McHattan ZJ. A scoping review of the contralateral effects of unilateral peripheral stimulation on neuromuscular function. PLoS One 2022; 17:e0263662. [PMID: 35139128 PMCID: PMC8827438 DOI: 10.1371/journal.pone.0263662] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/21/2022] [Indexed: 12/28/2022] Open
Abstract
It is known that resistance exercise using one limb can affect motor function of both the exercised limb and the unexercised contralateral limb, a phenomenon termed cross-education. It has been suggested that cross-education has clinical implications, e.g. in rehabilitation for orthopaedic conditions or post-stroke paresis. Much of the research on the contralateral effect of unilateral intervention on motor output is based on voluntary exercise. This scoping review aimed to map the characteristics of current literature on the cross-education caused by three most frequently utilised peripheral neuromuscular stimulation modalities in this context: electrical stimulation, mechanical vibration and percutaneous needling, that may direct future research and translate to clinical practice. A systematic search of relevant databases (Ebsco, ProQuest, PubMed, Scopus, Web of Science) through to the end of 2020 was conducted following the PRISMA Extension for Scoping Review. Empirical studies on human participants that applied a unilateral peripheral neuromuscular stimulation and assessed neuromuscular function of the stimulated and/or the unstimulated side were selected. By reading the full text, the demographic characteristics, context, design, methods and major findings of the studies were synthesised. The results found that 83 studies were eligible for the review, with the majority (53) utilised electrical stimulation whilst those applied vibration (18) or needling (12) were emerging. Although the contralateral effects appeared to be robust, only 31 studies claimed to be in the context of cross-education, and 25 investigated on clinical patients. The underlying mechanism for the contralateral effects induced by unilateral peripheral stimulation remains unclear. The findings suggest a need to enhance the awareness of cross-education caused by peripheral stimulation, to help improve the translation of theoretical concepts to clinical practice, and aid in developing well-designed clinical trials to determine the efficacy of cross-education therapies.
Collapse
Affiliation(s)
- Shi Zhou
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- * E-mail:
| | - Shuang-Shuang Zhang
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Zachary J. Crowley-McHattan
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| |
Collapse
|
18
|
Liu S, Wang Z, Su Y, Qi L, Yang W, Fu M, Jing X, Wang Y, Ma Q. A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature 2021; 598:641-645. [PMID: 34646018 PMCID: PMC9178665 DOI: 10.1038/s41586-021-04001-4] [Citation(s) in RCA: 276] [Impact Index Per Article: 92.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 09/07/2021] [Indexed: 11/09/2022]
Abstract
Somatosensory autonomic reflexes allow electroacupuncture stimulation (ES) to modulate body physiology at distant sites1-6 (for example, suppressing severe systemic inflammation6-9). Since the 1970s, an emerging organizational rule about these reflexes has been the presence of body-region specificity1-6. For example, ES at the hindlimb ST36 acupoint but not the abdominal ST25 acupoint can drive the vagal-adrenal anti-inflammatory axis in mice10,11. The neuroanatomical basis of this somatotopic organization is, however, unknown. Here we show that PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia (for example, the periosteum) but not abdominal fascia (for example, the peritoneum), are crucial for driving the vagal-adrenal axis. Low-intensity ES at the ST36 site in mice with ablated PROKR2Cre-marked sensory neurons failed to activate hindbrain vagal efferent neurons or to drive catecholamine release from adrenal glands. As a result, ES no longer suppressed systemic inflammation induced by bacterial endotoxins. By contrast, spinal sympathetic reflexes evoked by high-intensity ES at both ST25 and ST36 sites were unaffected. We also show that optogenetic stimulation of PROKR2Cre-marked nerve terminals through the ST36 site is sufficient to drive the vagal-adrenal axis but not sympathetic reflexes. Furthermore, the distribution patterns of PROKR2Cre nerve fibres can retrospectively predict body regions at which low-intensity ES will or will not effectively produce anti-inflammatory effects. Our studies provide a neuroanatomical basis for the selectivity and specificity of acupoints in driving specific autonomic pathways.
Collapse
Affiliation(s)
- Shenbin Liu
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
- Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Science, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Zhifu Wang
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Yangshuai Su
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
- Meridians Research Center, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu Qi
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Wei Yang
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Mingzhou Fu
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Xianghong Jing
- Meridians Research Center, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanqing Wang
- Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Science, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Qiufu Ma
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
19
|
Miller DW, Roseen EJ, Stone JA, Gardiner P, Olson J, Rosen S, Wayne P, Davis R, Coeytaux R. Incorporating Acupuncture Into American Healthcare: Initiating a Discussion on Implementation Science, the Status of the Field, and Stakeholder Considerations. Glob Adv Health Med 2021; 10:21649561211042574. [PMID: 34471570 PMCID: PMC8404666 DOI: 10.1177/21649561211042574] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/21/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The field of implementation science is the study of methods that promote the uptake of evidence-based interventions into healthcare policy and practice. While acupuncture has gained significant traction in the American healthcare landscape, its journey has been somewhat haphazard and non-linear. METHODS In June 2019, a group of thirty diverse stakeholders was convened by the Society for Acupuncture Research with the support of a Patient Centered Outcomes Research Institute, Eugene Washington Engagement Award. This group of stakeholders represented a diverse mix of patients, providers, academicians, researchers, funders, allied health professionals, insurers, association leaders, certification experts, and military program developers. The collective engaged in discussion that explored acupuncture's status in healthcare, including reflections on its safety, effectiveness, best practices, and the actual implementation of acupuncture as seen from diverse stakeholder viewpoints. OBJECTIVES A primary goal was to consider how to utilize knowledge from the field of implementation science more systematically and intentionally to disseminate information about acupuncture and its research base, through application of methods known to implementation science. The group also considered novel challenges that acupuncture may present to known implementation processes. FINDINGS This article summarizes the initial findings of this in-person meeting of stakeholders and the ongoing discussion among the subject matter experts who authored this report. The goal of this report is to catalyze greater conversation about how the field of implementation science might intersect with practice, access, research, and policymaking pertaining to acupuncture. Core concepts of implementation science and its relationship to acupuncture are introduced, and the case for acupuncture as an Evidence Based Practice (EBP) is established. The status of the field and current environment of acupuncture is examined, and the perspectives of four stakeholder groups--patients, two types of professional practitioners, and researchers--are explored in more detail.
Collapse
Affiliation(s)
- David W. Miller
- University Hospitals, Connor Integrative Health Network, Rainbow Babies and Children’s Hospital, Cleveland, Ohio
| | - Eric J. Roseen
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Jennifer A.M. Stone
- Department of Anesthesia, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Paula Gardiner
- Department of Family Medicine, University of Massachusetts Medical School, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Juli Olson
- U.S. Department of Veterans Affairs, Washington, District of Columbia
| | | | - Peter Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Robert Davis
- Society for Acupuncture Research, Burlington, Vermont
| | - Remy Coeytaux
- Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - on behalf of the PCORI-SAR Stakeholder Group
- University Hospitals, Connor Integrative Health Network, Rainbow Babies and Children’s Hospital, Cleveland, Ohio
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
- Department of Anesthesia, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- Department of Family Medicine, University of Massachusetts Medical School, University of Massachusetts Medical School, Worcester, Massachusetts
- U.S. Department of Veterans Affairs, Washington, District of Columbia
- Crane Herbs, Austin, Texas
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
- Society for Acupuncture Research, Burlington, Vermont
- Center for Integrative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
20
|
Li YM. Three hand yin meridians in ancient Chinese medicine were established initially based on arterial structures. J Anat 2021; 238:1494-1496. [PMID: 33521950 PMCID: PMC8128774 DOI: 10.1111/joa.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 12/25/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yong Ming Li
- Dermatopathology Service and Herb Acupuncture ClinicBridgewaterNJUSA
| |
Collapse
|
21
|
In Vivo Visualization of the Pericardium Meridian with Fluorescent Dyes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5581227. [PMID: 33854554 PMCID: PMC8021474 DOI: 10.1155/2021/5581227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 12/04/2022]
Abstract
The anatomical basis of acupuncture meridians continues to be enigmatic. Although much attention has been placed on potential correlations with inter/intramuscular fascia or lower electrical impedance, animal studies performed in the past 40 years have shown that tracer dyes—specifically Tc-99m pertechnetate—injected at strategic skin points generate linear migrations closely aligning with acupuncture meridians. To evaluate whether this phenomenon is also observable in humans, we injected two fluorescent dyes—fluorescein sodium and indocyanine green (ICG)—into the dermal layer both at acupuncture points (PC5, PC6, and PC7) and a nonacupoint control. Fifteen healthy volunteers were enrolled in this study. Of the 19 trials of fluorescein injected at PC6, 15 (79%) were associated with slow diffusion of the dye proximally along a path matching closely with the pericardium meridian. Furthermore, the dye emerged and coalesced proximally at exactly acupoint PC3. Injections of ICG at the acupoints PC5, PC6, or PC7 showed a similar trajectory close to the injection site but diverged when migrating proximally, failing converge on acupoint PC3. Injections of either dye at an adjacent PC6-control did not generate any notable linear pathway. Both ultrasound imaging and vein-locating device did not reveal any corresponding vessels (arterial or venous) at the visualized tracer pathway but did demonstrate correlations with intermuscular fascia.
Collapse
|
22
|
Mast Cell Degranulation and Adenosine Release:Acupoint Specificity for Effect of Electroacupuncture on Pituitrin-Induced Acute Heart Bradycardia in Rabbits. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:1348914. [PMID: 33082816 PMCID: PMC7563041 DOI: 10.1155/2020/1348914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
Acupuncture is a medical modality based on the theory of traditional Chinese medicine, and its effect is relatively dependent on acupoint specificity. However, there is little knowledge on acupoint specificity versus acupuncture outcomes because of the deficiency of rigorous investigation on this topic, which has impeded the growing legitimacy of acupuncture in the mainstream of medicine as an evidence-based therapy. Therefore, it is of utmost importance to clarify this critical issue. The present study aims to verify the phenomenon of acupoint specificity in acupuncture-induced cardiovascular regulation and explore the biological mechanism by measuring mast cells' degranulation and adenosine release. This study was conducted to explore the specificity of acupoints in an acute bradycardia rabbit model. After electroacupuncture (EA) stimulation at PC6, PC control (con) 1, PC con 2, LU7, LI11, and nonacupoint, only the PC6 group showed a significant improvement in relative heart rate as compared to that of the model group. There was no significant difference between the relative heart rate of other EA groups and that of the model group. Historical results also showed that the ratio of degranulated mast cells in PC6 was significantly higher than other acupoints and control points. From the results of high-performance liquid chromatography (HPLC), a transient elevation of adenosine concentration during EA was only observed on acupoints and control points (P < 0.05) along the pericardium meridian. The EA-induced adjustment on acute bradycardia exhibits a relative specificity of acupoints, which may be related to mast cell degranulation and adenosine release in local acupoint areas. Increased degranulation of mast cells and augmentation of adenosine release during EA may be the mechanisms for PC6 having significantly better acupuncture effects than other acupoints and nonacupoints.
Collapse
|
23
|
Ma SX. Establishing an adequate dose of acupuncture is essential for clinical trial studies. CLINICAL RESEARCH AND TRIALS 2020; 6:10.15761/crt.1000295. [PMID: 35382135 PMCID: PMC8979409 DOI: 10.15761/crt.1000295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
IMPORTANCE A number of recent clinical trials have demonstrated that acupuncture is more effective for treating chronic pain conditions compared to sham and no acupuncture, but some research questions have remained unaddressed and are standing in the way of further progress. OBSERVATIONS AND ADVANCES The effectiveness of acupuncture for pain conditions compared to usual care have been demonstrated, which has significantly enhanced the position of acupuncture in multiple pain guidelines following these studies. However, the studies also generated some conflicting results with difficulty in comparing each other. Research examining an adequate dose of acupuncture therapy with optimal intervention parameters and time table has also long been neglected and is now urgent. The dose of acupuncture depends on stimulation parameters: force/intensity and speed/frequency of manual acupuncture (MA) or electroacupuncture (EA) and time table (number of treatment sessions and duration). Various frequencies and intensities of MA and EA stimulation have been utilized in individual research. Different acupuncture treatment sessions (once, twice, three to five times per week) and periods (4, 6, 8, and 12 weeks) have been used in these clinical trials. One clinical trial using one session of needle acupuncture and laser at 12 weeks (8 to 12 treated sessions) did not improve pain in patients with chronic knee pain but similar trials of osteoarthritis knee have significant effects of pain improvement after biweekly sessions of needle acupuncture for 8 weeks of treatment. CONCLUSIONS AND RELEVANCE Determining a right treatment regimen on correct acupuncture point(s) for acupuncture is a critical first step for acupuncture clinical trials. Appropriate acupuncture parameters such as acupuncture stimulation technique, treatment sessions, and treatment duration must be considered in acupuncture clinical trials. An adequate dose of acupuncture for clinical trials should be established following dose finding workshops for acupuncture before the studies, which not only improve the therapeutic effects of the therapies but also allow the comparisons between trials and between the acupuncture community/practice and trial studies.
Collapse
Affiliation(s)
- Sheng-Xing Ma
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center and Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California at Los Angeles and Harbor-UCLA Medical Center, Torrance, CA 90502, U.S.A
| |
Collapse
|
24
|
Kelleher DC, Kirksey MA, Wu CL, Cheng SI. Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy? Reg Anesth Pain Med 2020; 45:468-473. [PMID: 32193284 DOI: 10.1136/rapm-2019-100947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 01/29/2023]
Abstract
The current US opioid health-related crisis underscores the importance for perioperative physicians to optimize various approaches to pain management. Multimodal techniques and enhanced recovery after surgery (ERAS) protocols are frequently cited as the most effective strategies for improving the experience of pain and reducing opioid exposure. Complementary medicine (CM) techniques, while frequently shown to be effective at reducing opioid and other pharmacologic agent use, are rarely discussed as part of these multimodal strategies. In general, CM therapies are low-cost with minimal associated risk, making them an ideal choice for incorporation into ERAS and other opioid-sparing protocols. In this Daring Discourse, we discuss the benefits and challenges of incorporating CM therapy into anesthetic practice. We hope that anesthesiologists can become more familiar with the current evidence regarding perioperative CM therapy, and begin incorporating these therapies as part of their comprehensive multimodal approach to perioperative pain management.
Collapse
Affiliation(s)
- Deirdre C Kelleher
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA
| | - Meghan A Kirksey
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA.,Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Christopher L Wu
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA.,Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Stephanie I Cheng
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA.,Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| |
Collapse
|
25
|
Fears R, Griffin GE, Larhammar D, Ter Meulen V, van der Meer JWM. Globalization of Traditional Chinese Medicine: what are the issues for ensuring evidence-based diagnosis and therapy? J Intern Med 2020; 287:210-213. [PMID: 31697414 DOI: 10.1111/joim.12989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/16/2022]
Affiliation(s)
- R Fears
- European Academies Science Advisory Council, German National Academy of Sciences Leopoldina, Halle (Saale), Germany
| | - G E Griffin
- Institute of Infection and Immunity, St. George's, University of London, London, UK
| | - D Larhammar
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - V Ter Meulen
- European Academies Science Advisory Council, German National Academy of Sciences Leopoldina, Halle (Saale), Germany
| | | |
Collapse
|
26
|
Choi DH, Chae Y. Minimisation of variations in locating an acupuncture point using a laser-device. Integr Med Res 2019; 8:261-263. [PMID: 31799115 PMCID: PMC6881613 DOI: 10.1016/j.imr.2019.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 11/19/2022] Open
Abstract
Background Identifying accurate acupoint is an essential component in clinical practice. A laser device can provide us with a visual guide for locating acupoints by dividing the space equally between two landmarks on the body. In this study, we compared the accuracy between the naked-eye and a laser device to locate an acupoint. Methods Twenty-two participants were asked to mark acupoint PC5 on a male volunteer’s arm using two different methods: without a laser device (naked-eye) and with a laser device. The distributions of the acupoints were estimated by the kernel density estimation methods. Results The overall distribution of acupoints was less when the laser device method was used, compared to the naked-eye method. We found significant differences in the longitudinal axis between the two methods, but no significant differences in the horizontal axis. Conclusions Our findings suggest that direct measurement of the acupoint location using a laser device can reduce variations in locating points. Laser-assisted tools will help practitioners locate the acupoints more accurately and should be considered as standard practice, especially in acupuncture research and education.
Collapse
Affiliation(s)
| | - Younbyoung Chae
- Corresponding author at: Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, Republic of Korea.
| |
Collapse
|
27
|
de Matos NMP, Pach D, Xing JJ, Barth J, Beyer LE, Shi X, Kern A, Lukic N, Ettlin DA, Brügger M, Witt CM. Evaluating the Effects of Acupuncture Using a Dental Pain Model in Healthy Subjects - A Randomized, Cross-Over Trial. THE JOURNAL OF PAIN 2019; 21:440-454. [PMID: 31521794 DOI: 10.1016/j.jpain.2019.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/20/2019] [Accepted: 08/25/2019] [Indexed: 10/26/2022]
Abstract
Acupuncture is a complementary and nonpharmacological intervention that can be effective for the management of chronic pain in addition to or instead of medication. Various animal models for neuropathic pain, inflammatory pain, cancer-related pain, and visceral pain already exist in acupuncture research. We used a newly validated human pain model and examined whether acupuncture can influence experimentally induced dental pain. For this study, we compared the impact of manual acupuncture (real acupuncture), manual stimulation of a needle inserted at nonacupuncture points (sham acupuncture) and no acupuncture on experimentally induced dental pain in 35 healthy men who were randomized to different sequences of all 3 interventions in a within-subject design. BORG CR10 pain ratings and autonomic responses (electrodermal activity and heart rate variability) were investigated. An initial mixed model with repeated measures included preintervention pain ratings and the trial sequence as covariates. The results showed that acupuncture was effective in reducing pain intensity when compared to no acupuncture (β = -.708, P = .002), corresponding to a medium Cohen's d effect size of .56. The comparison to the sham acupuncture revealed no statistically significant difference. No differences in autonomic responses between real and sham acupuncture were found during the intervention procedures. PERSPECTIVE: This study established a dental pain model for acupuncture research and provided evidence that experimentally induced dental pain can be influenced by either real acupuncture or manual stimulation of needles at nonacupuncture points. The data do not support that acupoint specificity is a significant factor in reducing experimental pain.
Collapse
Affiliation(s)
- Nuno M P de Matos
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel Pach
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.
| | - Jing Jing Xing
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Lara Elena Beyer
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Xuemin Shi
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Alexandra Kern
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Nenad Lukic
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Dominik A Ettlin
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mike Brügger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine Baltimore, Baltimore, Maryland
| |
Collapse
|
28
|
de Medeiros MA. Perspectives in complementary medicine: mechanisms and controversies over the use of acupuncture for pain management. Pain Manag 2019; 9:435-439. [DOI: 10.2217/pmt-2019-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Magda Alves de Medeiros
- Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Seropedica, Rio de Janeiro, Brazil
| |
Collapse
|
29
|
Magalhães-Sant'Ana M. The Emperor's New Clothes-An Epistemological Critique of Traditional Chinese Veterinary Acupuncture. Animals (Basel) 2019; 9:ani9040168. [PMID: 30991678 PMCID: PMC6523156 DOI: 10.3390/ani9040168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/27/2019] [Accepted: 04/11/2019] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Complementary and alternative medicines have gained increased popularity in the veterinary field. Among them, Traditional Chinese Veterinary Medicine, including acupuncture, has emerged as one of the main alternatives to conventional veterinary medicine. This paper relies upon an epistemological approach to investigate conceptual, historical and scientific assertions about veterinary acupuncture made by their advocates. Argument by analogy is used to demonstrate that Traditional Chinese Veterinary Medicine is based on pre-scientific principles, similar to those of humoral medicine and bloodletting, and that acupuncture is, in effect, a placebo. The paper concludes with recommendations for veterinary regulators and colleagues. Abstract Within the last few decades, complementary and alternative medicines have gained increased popularity in the veterinary field. Although many authors have exposed the scientific fallacies and historical misconceptions used to justify such therapies, those efforts have not succeeded in detracting veterinary practitioners from embracing them. Notably, Traditional Chinese Veterinary Medicine (TCVM), including acupuncture, has emerged as one of the main alternatives to conventional veterinary medicine. In this paper, analogical reasoning is used to investigate conceptual, historical and scientific assertions made by the advocates of TCVM. The paper is divided into two parts: The first aims to appraise conceptual and historical claims made by veterinary acupuncturists. I defend that TCVM is a pre-scientific construct, similar to humoral doctrine, and that acupuncture is analogous to bloodletting. The second part is focused on scientific evidence of clinical application of acupuncture in the dog, showing how science is yet to validate veterinary acupuncture and defending that claims of efficacy are due to placebo effect. It is suggested that veterinary acupuncture needs to abandon Traditional Chinese Medicine and embrace science-based medicine tout court. On the other hand, high quality scientific studies, including randomized controlled trials, need to be presented. Veterinary regulators must bring the issue of non-conventional therapies into their agendas.
Collapse
Affiliation(s)
- Manuel Magalhães-Sant'Ana
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal.
- Ordem dos Médicos Veterinários, Av. Filipe Folque, 10J, 4º Dto., 1050-113 Lisboa, Portugal.
| |
Collapse
|
30
|
Nierhaus T, Chang Y, Liu B, Shi X, Yi M, Witt CM, Pach D. Somatosensory Stimulation With XNKQ Acupuncture Modulates Functional Connectivity of Motor Areas. Front Neurosci 2019; 13:147. [PMID: 30914909 PMCID: PMC6421982 DOI: 10.3389/fnins.2019.00147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/08/2019] [Indexed: 01/10/2023] Open
Abstract
Xingnao Kaiqiao (XNKQ) acupuncture is an acupuncture technique used for stroke patients. In 24 healthy volunteers, we applied this complex acupuncture intervention, which consists of a manual needle-stimulation on five acupuncture points (DU26 unilaterally, PC6, and SP6 bilaterally). XNKQ was compared to three control conditions: (1) insertion of needles on the XNKQ acupuncture points without stimulation, (2) manual needle-stimulation on five nearby non-acupuncture points, and (3) insertion of needles on the non-acupuncture points without stimulation. In a within-subject design, we investigated functional connectivity changes in resting-state functional magnetic resonance imaging (fMRI) by means of the data-driven eigenvector centrality (EC) approach. With a 2 × 2 factorial within-subjects design with two-factor stimulation (stimulation vs. non-stimulation) and location (acupuncture points vs. non-acupuncture points), we found decreased EC in the precuneus after needle-stimulation (stimulation<non-stimulation), whereas the factor location showed no statistically significant EC differences. XNKQ acupuncture compared with needle-stimulation on non-acupuncture points showed decreased EC primarily in subcortical structures such as the caudate nucleus, subthalamic nucleus, and red nucleus. Post-hoc seed-based analysis revealed that the decrease in EC was mainly driven by reduced temporal correlation to primary sensorimotor cortices. The comparison of XNKQ acupuncture with the other two (non-stimulation) interventions showed no significant differences in EC. Our findings support the importance of the stimulation component of the acupuncture intervention and hint toward the modulation of functional connectivity by XNKQ acupuncture, especially in areas involved in motor function. As a next step, similar mechanisms should be validated in stroke patients suffering from motor deficits. ClinicalTrials.gov ID: NCT02453906
Collapse
Affiliation(s)
- Till Nierhaus
- Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Yinghui Chang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Bin Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuemin Shi
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ming Yi
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing, China.,Key Laboratory for Neuroscience, Ministry of Education/National Health Commission, Peking University, Beijing, China
| | - Claudia M Witt
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Daniel Pach
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
31
|
Feinstein D. Energy psychology: Efficacy, speed, mechanisms. Explore (NY) 2018; 15:340-351. [PMID: 30718189 DOI: 10.1016/j.explore.2018.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/17/2018] [Accepted: 11/23/2018] [Indexed: 12/31/2022]
Abstract
The most well known forms of "energy psychology" combine cognitive and exposure techniques with the stimulation of selected acupuncture points (acupoints) by tapping on them. Most clinicians who learn and utilize an acupoint tapping protocol integrate the approach within their existing clinical frameworks rather than using it as a stand-alone therapy. The method has been highly controversial, with its efficacy, purported speed, and explanatory models all questioned. Nonetheless, its utilization within clinical settings and as a self-help method has continued to expand since it was introduced more than three decades ago. This paper reviews the most salient criticisms of the method and presents research and empirically based theoretical constructs that address them. More than 100 peer-reviewed outcome studies-51 of which are randomized controlled trials-provide an evidential base for evaluating the claims and criticisms surrounding the approach. This review concludes that a growing body of evidence indicates that acupoint-based energy psychology protocols are rapid and effective in producing beneficial outcomes in the treatment of anxiety, depression, PTSD, and possibly other conditions. Mechanisms by which acupoint tapping might bring about these treatment outcomes are also proposed.
Collapse
|
32
|
Napadow V. When a White Horse is a Horse: Embracing the (Obvious?) Overlap Between Acupuncture and Neuromodulation. J Altern Complement Med 2018; 24:621-623. [PMID: 29792511 DOI: 10.1089/acm.2018.29047.vtn] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|