Acupuncture affects regional blood flow in various organs

Trends in Acupuncture Therapy for Microcirculation and Hemorheology from 1998 to 2023: A Bibliometric and Visualized Study

Background

The aim of this study is to explore and illustrate the focal points concerning acupuncture's impact on microcirculation and hemorheology over the past 26 years, and to identify future directions in this field.

Methods

Data in this area were gathered from the Web of Science Core Collection database. Employing CiteSpace, VOSviewer, Scimago Graphica, and Microsoft Excel software, we analyzed authors, institutions, and countries to evaluate scientific collaboration. Moreover, we carried out an analysis of keyword clustering, references, and burst detection to examine the prominent research areas and emerging trends in this domain.

Results

The study analyzed 706 documents, 471 institutions, 632 journals, 40 countries, 581 keywords, and 3289 authors related to acupuncture for microcirculation and hemorheology. Data revealed a consistent increase in research output over 26 years. China, with the most publications and citations, significantly contributed to the field, often collaborating with the United States. Elisabet Stener-Victorin and the China Academy of Chinese Medical Sciences were the most productive author and institution, respectively. The journal Evidence-based Complementary and Alternative Medicine held the most influence. Common keywords included "vasoactive substances", "neurotransmitters", "signaling pathways", and "oxidative stress", among others. Research topics focused on female infertility, ischemic stroke, and pain syndromes, with treatment approaches such as electroacupuncture, manual acupuncture, auricular acupuncture, and cupping therapy.

Conclusion

Women's infertility, ischemic stroke, and pain syndromes have emerged as hotspots in research. Future directions may include comparative studies of traditional and modern acupuncture techniques to evaluate their respective therapeutic effects. There is potential for in-depth research in these areas and the discovery of new intervention strategies as well as mechanisms.

Impact of Ejaculation upon Effect of Acupuncture on Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Secondary Analysis of a Randomized Controlled Trial

Background

Acupuncture can improve chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Ejaculation frequencies might impact the conditions of CP/CPPS. The present study aimed to explore the impact of different ejaculation frequencies on the effect of acupuncture among men with CP/CPPS.

Methods

This was a secondary analysis of the data from a multicenter, randomized, clinical trial. Eligible participants were patients with moderate to severe CP/CPPS, who had taken 8-week acupuncture treatment, and followed until week 32. Participants fell into the category of 0-3, 4-7, or at least 8 according to their monthly ejaculation frequencies reported at baseline. The primary outcome was the proportion of responders, defined as men who reported at least 6 points reduction from baseline in the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) total score at weeks 8 and 32.

Results

214 participants were included in this secondary analysis, of whom 42 reported a monthly ejaculation frequency of 0-3, 89 reported a frequency of 4-7, and 83 reported a frequency of at least 8. At week 8, 52.20% participants with an ejaculation frequency of 0-3 responded to the acupuncture treatment, 65.38% participants with a frequency of 4-7 responded, and 63.09% participants with a frequency of at least 8 responded. At week 32, 56.14%, 59.57%, and 68.36% participants responded in the three groups, respectively. No significant differences were observed between three groups (all P>0.05).

Conclusion

Acupuncture can improve symptoms of CP/CPPS, regardless of ejaculation frequencies. Ejaculation frequencies may not affect the efficacy of acupuncture on CP/CPPS among Chinese men.

Trial registration

ClinicalTrials.gov, NCT03213938.

Molecular Mechanism of Electroacupuncture Regulating Cerebral Arterial Contractile Protein in Rats with Cerebral Infarction Based on MLCK Pathway

OBJECTIVE

To explore the effect of electroacupuncture (EA) intervention on the vasoconstriction of cerebral artery smooth muscle cells after cerebral infarction.

METHODS

Male Wistar rats were randomly divided into 3 groups by a random number table: the model group (n=24), the EA group (n=24), and the normal group (n=6). The model and the EA groups were divided into different time subgroups at 0.5, 1, 3, and 6 h after middle cerebral artery occlusion (MCAO), with 6 rats in each subgroup. MCAO model was established using intraluminal suture occlusion method. The EA group was given EA treatment at acupoint Shuigou (GV 26) instantly after MCAO for 20 min. The contents of cerebrovascular smooth muscle MLCK, the 3 subunits of myosin light chain phosphatase (MLCP) MYPT1, PP1c-δ and M20, as well as myosin-ATPase activity were detected using immunohistochemistry and Western blotting.

RESULTS

The overall expression level of the MYPT1 and PP1c-δ in the model group was significantly higher (P<0.01). After EA intervention, the 0.5 h group expression level was close to that of the normal group (P>0.05), and the other subgroups were still significantly higher than the normal group (P<0.01). After EA intervention, the expression level of each subgroup was significantly lower than the corresponding model group. There was a significant difference between the 0.5 and 1 h subgroups (P<0.01), while a difference was also observed between the 3 and 6 h subgroups (P<0.05). The dynamic change rule gradually increased with the prolongation of infarction time within 6 h after infarction.

CONCLUSION

EA intervention can inhibit contraction of cerebral vascular smooth muscle cells and regulate smooth muscle relaxation by regulating MLCK pathway.

Effectiveness of acupuncture for patients with vascular dementia: A systematic review and meta-analysis

OBJECTIVES

This meta-analysis assessed the treatment effectiveness of acupuncture in patients with vascular dementia.

METHODS

The PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure were searched to identify eligible randomized controlled trials (RCTs). The odds ratios (ORs) and weighted mean differences (WMDs) with 95 % confidence intervals (CIs) were used to assess the pooled effect estimates using a random-effects model for categorical and continuous outcomes, respectively.

RESULTS

Thirty-four RCTs (2672 patients) were selected for the final meta-analysis. The use of acupuncture showed association with an increased incidence of effective rate (OR: 3.28; 95 % CI: 2.54-4.24; P < 0.001). The pooled WMDs revealed that acupuncture was significantly associated with an improvement in the Hasegawa dementia scale (HDS) (WMD: 4.31; 95 % CI: 3.15-5.47; P < 0.001), and Mini-Mental State Examination scores (MMSE) (WMD: 3.07; 95 % CI: 2.40-3.74; P < 0.001). However, the use of acupuncture showed no association with the level of Activities of daily living (ADL) (WMD: 1.93; 95 % CI: - 2.53 to 6.38; P = 0.397). Finally, acupuncture was associated with lower levels of Scale for the differentiation of syndromes of vascular dementia (SDSVD) (WMD: - 2.15; 95 % CI: - 4.14 to - 0.16; P = 0.034), and National Institutes of Health stroke scale (NIHSS) (WMD: - 3.90; 95 % CI: - 4.87 to - 2.94; P < 0.001).

CONCLUSIONS

Acupuncture is probably helpful in vascular stroke, but strong supportive data are not yet available. Acupuncture should be used cautiously, owing to the analysis of this study based on low to moderate evidence. Further high-quality, large-scale RCTs should be conducted.

The Efficacy of Acupuncture on Patients with Erectile Dysfunction: A Review

Erectile dysfunction (ED) is one of the most common sexual dysfunctions in men. The prevalence of ED has been increasing in recent years, which has critically affected male reproductive health and quality of life. According to various guidelines, phosphodiesterase-5 inhibitors are the most commonly recommended drugs for treating ED. However, many patients turn to alternative therapies because of adverse reactions, such as headache, and the poor efficacy of these drugs. Acupuncture is a long-established treatment in traditional Chinese medicine (TCM) and has been approved by the World Health Organization for improving penile erection as well as other discomforts in patients. However, previous systematic reviews have not discussed the characteristics and the related mechanisms of acupuncture treatment. Therefore, this study focuses on summarizing the characteristics and advantages of TCM in acupuncture treatment for ED based on relevant literature and on predicting and analyzing the related mechanisms.

Acupuncture inhibits mammalian target of rapamycin, promotes autophagy and attenuates neurological deficits in a rat model of hemorrhagic stroke

BACKGROUND

Intracerebral hemorrhage (ICH) accounts for approximately 15% of all stroke cases. Previous studies suggested that acupuncture may improve ICH-induced neurological deficits. Therefore, we investigated the effects of acupuncture on neurological deficits in an animal model of ICH.

METHODS

Adult male Sprague-Dawley rats were injected with autologous blood (50 μL) into the right caudate nucleus. Additional rats underwent sham surgery as controls. ICH rats either received acupuncture (GV20 through GB7 on the side of the lesion) or sham acupuncture (1 cm to the right side of the traditional acupuncture point locations). Some ICH rats received acupuncture plus rapamycin injection into the right lateral ventricle. Neurological deficits in the various groups were assessed based on composite neurological score. The perihemorrhagic penumbra was analyzed by histopathology following hematoxylin-eosin staining. Levels of autophagy-related proteins light chain (LC)3 and p62 as well as of mammalian target of rapamycin (mTOR)-related proteins, and phosphorylated (p)-mTOR and p-S6K1 (ribosomal protein S6 kinase beta-1), were assessed by Western blotting.

RESULTS

Acupuncture significantly improved composite neurological scores 7 days after ICH (17.7 ± 1.49 vs 14.8 ± 1.32, p < 0.01). Acupuncture augmented autophagosome and autolysosome accumulation based on transmission electron microscopy. Acupuncture significantly increased expression of LC3 (p < 0.01) but decreased expression of p62 (p < 0.01). Acupuncture also reduced levels of p-mTOR and p-S6K1 (both p < 0.01).

CONCLUSION

Acupuncture improved neurological deficits in a rat model of ICH, possibly by inhibiting the mTOR pathway and activating autophagy.

Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review

OBJECTIVE

to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care.

METHOD

a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers.

RESULTS

eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%).

CONCLUSION

while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.

Multipoint transcutaneous electrical stimulation reduces median effective plasma concentration of propofol: A randomised clinical trial

BACKGROUND AND AIMS

Previous work shows that transcutaneous electrical stimulation (TES) has analgesic and sedative effects. However, it is unclear whether TES can affect the sedative effect of propofol or not. This study was designed to assess the effect of TES on median effective plasma concentration (Cp50) of propofol and haemodynamic changes before and after tracheal intubation.

METHODS

48 patients belonging to ASA I or II posted for thyroidectomy were randomly allocated into control and TES groups. Up-and-down method was used to determine Cp50 of propofol. The average concentration of propofol in each crossover was calculated and the average concentration of those six values was defined as Cp50 of propofol.

RESULTS

Cp50 of propofol was 3.70 ± 0.28 μg/mL and 3.08 ± 0.31 μg/mL in control and TES groups, respectively (P < 0.05). There were no significant differences in MAP (90.3 ± 12.4 mmHg vs. 97.0 ± 10.8 mmHg, 94.2 ± 18.7 mmHg vs. 98.3 ± 16.6 mmHg and 84.9 ± 14.1 mmHg vs. 91.6 ± 16.2 mmHg) and HR (78.2 ± 11.3 b/min vs. 75.6 ± 9.5 b/min, 90.9 ± 15.4 b/min vs. 90.4 ± 14.9 b/min and 86.7 ± 13.7 b/min vs. 84.0 ± 15.9 b/min) at T0, T1 and T2 between two groups. In TES group, HR changes at T1 and T2 were significantly higher than those at T0.

CONCLUSION

TES can make an assistant effect on sedation and decrease Cp50 of propofol. But the haemodynamic fluctuations in TES group, especially the HR changes, seem to be more obvious than those in control group.

Changes in Blood Circulation of the Tendons and Heart Rate Variability During and After Acupuncture

Objective: The purpose of this study was to investigate the changes in blood circulation of tendons and heart rate variability (HRV) during and after acupuncture in order to elucidate the mechanisms of acupuncture-induced changes in tendon blood circulation. Materials and Methods: During 10 minutes of acupuncture treatment and a recovery period of 40 minutes, blood volume (THb) and oxygen saturation (StO₂) of treated and nontreated tendons were measured using red laser lights. In addition, HRV was also measured during the experimental period. Results: THb and StO₂ of the treated tendons significantly increased during acupuncture, and then remained high during the recovery period. THb and StO₂ of the nontreated tendons did not change during acupuncture but gradually increased during the recovery period. In addition, the increase in THb of the nontreated tendons were significantly correlated with that of the treated tendons during the latter half of the recovery period. Heart rate (HR) continued to decrease during acupuncture and suddenly returned to the initial level after removal of the needle. The low-frequency (LF)/high-frequency (HF) ratio tended to increase during the recovery period. During the latter half of the recovery period, the changes in THb for both the treated and nontreated tendons were negatively correlated with the change in HR but not with changes in the LF/HF ratio. Conclusions: These results suggest that changes in blood circulation of tendons after acupuncture treatment were controlled by the autonomic nervous system, which could not be detected by HRV analysis.

Acupuncture prevents the postpartum reduction in matrix metalloproteinase type-2 immunoexpression, tissue concentration and enzyme activity in bovine caruncles

The objectives of this study were to determine the effects of acupuncture in dairy cows (Bos taurus) on caruncular matrix metalloproteinase type-2 (MMP2) at 0, 2 and 4 hr after calving. Acupuncture (n = 6) was applied at 0 and 2 hr after calving to 6 points that relax the cervix and stimulate uterine contractions. Controls (n = 9) were kept in a stanchion for 15 min without acupuncture. All of the cows in the study delivered their placenta in <4 hr. Formalin-fixed caruncles were paraffin-embedded and subjected to routine immunohistochemistry to determine MMP2 expression, which was scored by a single observer. Flash frozen caruncles were homogenized, and protein concentration was determined. MMP2 concentrations were calculated using commercial bovine ELISAs. MMP2 enzyme activity was determined using zymography. The mean value for each time point for each cow was used to calculate the mean ± SEM for each treatment group. MMP2 was predominantly localized to the epithelial and subepithelial stromal cells of the caruncles in both treatment groups. MMP2 immunoexpression was lower 4 hr after calving in the control cows (p = 0.012) but not in the acupuncture treated cows indicating that acupuncture treatment maintained MMP expression. MMP2 tissue concentration was lower 2 hr after calving in the control cows (p = 0.048) but not in the acupuncture treated cows. MMP2 enzyme activity decreased from 0 to 2 hr after calving in control cows (p = 0.046) but not in acupuncture treated cows. This study provides physiologic evidence for the effects of acupuncture on the bovine reproductive tract and substantiates the use of this treatment in cases of placental retention.

Acupuncture and dry eye: current perspectives. A double-blinded randomized controlled trial and review of the literature

Purpose: Dry eye disease (DED) is a common disorder that negatively impacts quality of life and vision. Prior studies have shown some benefit of acupuncture for dry eye, but very few have included control group to mitigate placebo effect. This study was designed with a sham acupuncture control group to evaluate true acupuncture treatment effect.

Methods: This is a prospective, randomized, double-blinded, sham-acupuncture-controlled trial. Acupuncture treatment for dry eye was performed as per the Niemtzow Protocol. Twenty-four patients received true acupuncture and twenty-five received sham acupuncture. Treatment efficacy was assessed by the Ocular Surface Disease Index (OSDI) Questionnaire, ocular surface staining, tear flow, tear film break-up time (TBUT), and a general questionnaire. Atmospheric data were collected to control for the effect of atmospheric conditions on symptoms of dry eye.

Results: OSDI scores in the treatment group improved compared to baseline (1 week, p<0.01, 1 month p<0.05, 3 months p<0.05, and 6 months p<0.01). OSDI scores in the control group improved, but did not reach significance (p=0.09). Secondary outcome measures showed no significant improvement in TBUT, Schiermer’s Test, ocular surface grading, or artificial tear application. However, at 3 months, a significant reduction in the frequency of eye closing was observed among participants receiving true acupuncture treatment when compared to baseline (p=0.002). Furthermore, intragroup analysis showed significant reduction in symptoms of discomfort (p=0.01), dryness (p=0.001), scratchiness (p=0.001), and redness (p=0.01) in the true acupuncture group at 3 months.

Conclusion: Both true and sham acupuncture improved OSDI at 1 week after treatment, however, the improvement in OSDI was significantly greater in the true treatment groups than the sham group at 6 months after acupuncture. True acupuncture treatment improved many subjective assessments of dry eye symptoms, however, other common indicators used to objectively assess dry eye (tear flow, corneal staining, TBUT) remained unchanged. While there were trends towards improvement in the sham acupuncture group, this did not reach statistical significant during the study period. This suggests a true treatment effect of acupuncture rather than a placebo effect. Acupuncture can, therefore, be an effective adjunct to routine clinical treatment of dry eye.

Influence of Different Durations of Electroacupuncture Stimulation on Skin Blood Flow and Muscle Blood Volume

Objective

To determine whether skin blood flow (SBF) and muscle blood volume (MBV) responses differ according to the duration of electroacupuncture (EA) stimulation.

Methods

Two experiments were conducted. In Experiment 1, healthy male students (n=20) were randomly divided into two groups (an EA group and a no-stimulation group). In Experiment 2, healthy male students (n=37) were randomly divided into three groups with different stimulation durations of EA (5, 10 and 15 min). EA stimulation on the quadriceps femoris muscle was administered with a frequency of 1 Hz. SBF and MBV were estimated before, during and after stimulation.

Results

In Experiment 1 there was a significant difference between the groups (p=0.001). In the EA stimulation group, MBV increased immediately following EA (p=0.045) and 5 min (p=0.005) and 10 min (p=0.002) after EA compared with baseline. No significant change was observed in the no-stimulation group. In Experiment 2 there was no significant difference between the groups. All three stimulation durations (5, 10 and 15 min) yielded increases in MBV after stimulation compared with baseline. SBF following stimulation for 5 and 10 min was increased compared with baseline.

Conclusions

Based on these findings, we consider that 10 min EA stimulation could be a sufficient duration to induce a blood flow response in a clinical situation when increasing the blood flow is desirable.

Therapeutic Effect of Superficial Acupuncture in Treating Myofascial Pain of the Upper Trapezius Muscle: A Randomized Controlled Trial

The aim of this study was to compare the treatment efficacies of superficial acupuncture and traditional acupuncture on trigger points of the upper trapezius muscle. Forty people were recruited and randomly allocated to the traditional and superficial acupuncture groups. Each subject received two treatments per week in a four-week period. Outcomes were measured by visual analogue scale (VAS), the Northwick Park neck pain questionnaire scores (NPQ), and pressure pain threshold (PPT) assessments of trigger points. Data collected before the interventions were considered as baseline. Assessments were performed after the first treatment and at the end of the second and fourth weeks of treatment. Patients reported significant (p<0.05) and immediate improvements in VAS and PPT for both superficial acupuncture and traditional acupuncture after the first treatment and after two and four weeks. Significant improvements (p<0.05) in NPQ were attained after two weeks of treatments in both groups. Because superficial acupuncture is associated with less pain while producing immediate pain relief, we recommend it for treating myofascial pain syndrome in the upper trapezius muscle.

Response to acupuncture treatment in horses with chronic laminitis

There is a need for evidence-based scientific research to address the question of the effectiveness of acupuncture in improving clinical signs of laminitis in horses. The objective of this study was to compare lameness levels before and after 2 acupuncture treatments in horses with chronic laminitis. Twelve adult horses with chronic laminitis received 2 acupuncture treatments 1 week apart. The points were treated using dry needling, hemo-acupuncture, and aqua-acupuncture. Lameness level was objectively evaluated using an inertial sensor-based lameness evaluation system (Lameness Locator), as well as routine examinations following American Association of Equine Practitioners scoring before the first and 1 week after the second acupuncture treatment. Data were analyzed using Wilcoxon signed-rank test and P-values < 0.05 were considered statistically significant. Both the Lameness Locator (P = 0.0269) and routine lameness examination (P = 0.0039) showed a significant reduction in lameness severity. Our results support using acupuncture, along with other treatment options, in treating chronic equine laminitis.

Response of Local Nitric Oxide Release to Manual Acupuncture and Electrical Heat in Humans: Effects of Reinforcement Methods

This study was to examine the influences of manual acupuncture (MA) and electrical heat corresponding to reinforcing methods on nitric oxide (NO) release over the skin regions in humans. A device with collecting solution was taped to the skin surface along pericardium (PC) or lung (LU) meridian. Acupuncture needles were gently inserted into PC 4 with reinforcing stimulation (low force/rate) for 20 minutes in the MA group. LU11 on the finger was heated (43-44°C) by electrical heat for 20 minutes. Biocapture was consecutively conducted for two 20-minute intervals during and after each treatment. Total nitrite and nitrate (NO _x^-) in the collecting samples were quantified using chemiluminescence in blinded fashion. Baseline NO _x^- levels are higher and tended to be higher over PC and LU acupoints during the 1st biocapture. NO _x^- levels over PC regions were consistently increased by MA during both intervals. NO _x^- concentrations over LU acupoints were increased and tended to be increased by electrical heat in the 1st and 2nd biocapture. The results suggest that reinforcing MA and electrical heat induce NO released from the local skin regions with higher levels at acupoints, which improve local circulation and contribute to the beneficial effects of the therapies.

The Effect of Transcutaneous Electrical Nerve Stimulation of Sympathetic Ganglions and Acupuncture Points on Distal Blood Flow

Transcutaneous electrical nerve stimulation (TENS) is a widely-practiced method to increase blood flow in clinical practice. The best location for stimulation to achieve optimal blood flow has not yet been determined. We compared the effect of TENS application at sympathetic ganglions and acupuncture points on blood flow in the foot of healthy individuals. Seventy-five healthy individuals were randomly assigned to three groups. The first group received cutaneous electrical stimulation at the thoracolumbar sympathetic ganglions. The second group received stimulation at acupuncture points. The third group received stimulation in the mid-calf area as a control group. Blood flow was recorded at time zero as baseline and every 3 minutes after baseline during stimulation, with a laser Doppler flow-meter. Individuals who received sympathetic ganglion stimulation showed significantly greater blood flow than those receiving acupuncture point stimulation or those in the control group (p<0.001). Data analysis revealed that blood flow at different times during stimulation increased significantly from time zero in each group. Therefore, the application of low-frequency TENS at the thoracolumbar sympathetic ganglions was more effective in increasing peripheral blood circulation than stimulation at acupuncture points.

Scalp acupuncture attenuates neurological deficits in a rat model of hemorrhagic stroke

BACKGROUND

Hemorrhagic stroke accounts for approximately 15% of all stroke cases, and is associated with high morbidity and mortality. Limited human studies suggested that scalp acupuncture could facilitate functional recovery after cerebral hemorrhage. In the current study, we used an animal model of cerebral hemorrhage to examine the potential effects of scalp acupuncture.

METHODS

Adult male Sprague-Dawley rats received autologous blood (50μL) into the right caudate nucleus on the right side under pentobarbital anesthesia, and then received scalp acupuncture (DU20 through GB7 on the lesion side) or sham acupuncture (1cm to the right side of the acupoints) (n=10 per group). A group of rats receiving autologous blood into the caudate nucleus but no other intervention, as well as a group of rats receiving anesthesia but no blood injection to the brain (n=10 per group) were included as additional controls. Composite neuroscore, corner turn test, forelimb placing test, wire hang task and beam walking were used to evaluate the behavior of rats. Hematoxylin and Eosin (HE) staining was used to observe the histopathological changes. Western blot was used to detect the content of tumor necrosis factor alpha (TNF-α) and nuclear factor-KappaB (NFκB) protein expression.

RESULTS

Scalp acupuncture attenuated neurological deficits (p<0.01 or <0.05 vs. sham acupuncture using a variety of behavioral tests) at 1-7days after the treatment. The brain content of TNF-α and NFκB was decreased (p<0.01 for both).

CONCLUSIONS

Scalp acupuncture could improve neurological deficits in a rat model of hemorrhagic stroke.

Effectiveness of Traditional Chinese Acupuncture versus Sham Acupuncture: a Systematic Review

OBJECTIVE

to identify and synthesize the evidence from randomized clinical trials that tested the effectiveness of traditional Chinese acupuncture in relation to sham acupuncture for the treatment of hot flashes in menopausal women with breast cancer.

METHOD

systematic review guided by the recommendations of the Cochrane Collaboration. Citations were searched in the following databases: MEDLINE via PubMed, Web of Science, CENTRAL, CINAHL, and LILACS. A combination of the following keywords was used: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, and vasomotor symptoms.

RESULTS

a total of 272 studies were identified, five of which were selected and analyzed. Slight superiority of traditional acupuncture compared with sham acupuncture was observed; however, there were no strong statistical associations.

CONCLUSIONS

the evidence gathered was not sufficient to affirm the effectiveness of traditional acupuncture compared with sham acupuncture.

OBJETIVO

identificar e sintetizar as evidências oriundas de ensaios clínicos randomizados que testaram a efetividade da acupuntura tradicional chinesa em relação à sham acupuntura para o tratamento dos fogachos em mulheres com câncer de mama no climatério.

MÉTODO

revisão sistemática guiada pelas recomendações da Colaboração Cochrane. A busca foi realizada nas bases de dados: MEDLINE via PubMed, Web of Science, CENTRAL Cochrane, CINAHL e LILACS. Adotou-se a combinação dos descritores: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms.

RESULTADOS

foram identificados 272 estudos, sendo 5 selecionados e analisados. Foi observada discreta superioridade da acupuntura tradicional em relação à sham, entretanto, sem fortes associações estatísticas.

CONCLUSÕES

as evidências obtidas não foram suficientes para afirmar quanto à efetividade da acupuntura tradicional em relação à sham.

OBJETIVO

Identificar y sintetizar la evidencia de un ensayo clínico aleatorizado que examinó la eficacia de la acupuntura tradicional en relación a la acupuntura sham para el tratamiento de sofocos en las mujeres menopáusicas con cáncer de mama.

MÉTODO

Revisión sistemática guiada por las recomendaciones de la Colaboración Cochrane. Las referencias bibliográficas se buscaron en las siguientes bases de datos: MEDLINE vía PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL y LILACS. Se utilizó una combinación de las siguientes palabras clave: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms.

RESULTADOS

Se identificó un total de 272 estudios, cinco de los cuales fueron seleccionados y analizados. Se encontró una ligera superioridad de la acupuntura tradicional comparada con la acupuntura sham; sin embargo, no se encontraron asociaciones estadísticas fuertes.

CONCLUSIONES

La evidencia obtenida no fue suficiente para confirmar la eficacia de la acupuntura tradicional comparada con la acupuntura sham.

Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review

Objectives. This systematic review aimed to summarize and evaluate the findings of studies investigating the local microcirculatory effects following acupuncture stimulation. Methods. MEDLINE, EMBASE, OASIS, and Cochrane library were searched to identify randomized controlled trials (RCTs) published before January 30, 2015. Studies demonstrating any type of microcirculation response to manual acupuncture in healthy subjects and patients were included. The risk of bias and the reliability of the experimental conditions were evaluated to determine quality assessment. Results. Eight RCTs met the inclusion criteria; there was at least one acupuncture-induced change in a microcirculatory parameter. Of the seven studies in healthy subjects, four reported significant increases in blood flow following acupuncture compared with control, whereas one other study observed reductions in microcirculation immediately after acupuncture needling. The studies that assessed patients with either fibromyalgia or trapezius myalgia found significant increases in blood flow in the skin and muscle. Additionally, the degree and duration of increases in microcirculation varied depending on the condition of the subjects and the manipulation technique. Conclusions. The current evidence regarding the local effects of acupuncture in terms of blood flow remains insufficient for reliable conclusions due to few well-designed studies. Additional well-designed studies are needed to clarify these issues.

Acupuncture treatment for ischaemic stroke in young adults: protocol for a randomised, sham-controlled clinical trial

INTRODUCTION

Stroke in young adults is not uncommon. Although the overall incidence of stroke has been recently declining, the incidence of stroke in young adults is increasing. Traditional vascular risk factors are the main cause of young ischaemic stroke. Acupuncture has been shown to benefit stroke rehabilitation and ameliorate the risk factors for stroke. The aims of this study were to determine whether acupuncture treatment will be effective in improving the activities of daily living (ADL), motor function and quality of life (QOL) in patients of young ischaemic stroke, and in preventing stroke recurrence by controlling blood pressure, lipids and body weight.

METHODS AND ANALYSIS

In this randomised, sham-controlled, participant-blinded and assessor-blinded clinical trial, 120 patients between 18 and 45 years of age with a recent (within 1 month) ischaemic stroke will be randomised for an 8-week acupuncture or sham acupuncture treatment. The primary outcome will be the Barthel Index for ADL. The secondary outcomes will include the Fugl-Meyer Assessment for motor function; the World Health Organization Quality of Life BREF (WHOQOL-BREF) for QOL; and risk factors that are measured by ambulatory blood pressure, the fasting serum lipid, body mass index and waist circumference. Incidence of adverse events and long-term mortality and recurrence rate during a 10-year and 30-year follow-up will also be investigated.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Ethics Committee of The Third Affiliated Hospital of Zhejiang Chinese Medical University. Protocol V.3 was approved in June 2013. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone during follow-up calls enquiring on the patient's post-study health status.

TRIAL REGISTRATION NUMBER

ChiCTR-TRC- 13003317; Pre-results.

Decreased peripheral and central responses to acupuncture stimulation following modification of body ownership

Acupuncture stimulation increases local blood flow around the site of stimulation and induces signal changes in brain regions related to the body matrix. The rubber hand illusion (RHI) is an experimental paradigm that manipulates important aspects of bodily self-awareness. The present study aimed to investigate how modifications of body ownership using the RHI affect local blood flow and cerebral responses during acupuncture needle stimulation. During the RHI, acupuncture needle stimulation was applied to the real left hand while measuring blood microcirculation with a LASER Doppler imager (Experiment 1, N = 28) and concurrent brain signal changes using functional magnetic resonance imaging (fMRI; Experiment 2, N = 17). When the body ownership of participants was altered by the RHI, acupuncture stimulation resulted in a significantly lower increase in local blood flow (Experiment 1), and significantly less brain activation was detected in the right insula (Experiment 2). This study found changes in both local blood flow and brain responses during acupuncture needle stimulation following modification of body ownership. These findings suggest that physiological responses during acupuncture stimulation can be influenced by the modification of body ownership.

Overview of the Relevant Literature on the Possible Role of Acupuncture in Treating Male Sexual Dysfunction

Objective

To systematically review scientific reports on the effectiveness of acupuncture to treat male sexual dysfunction.

Methods

The Medline database was searched for published clinical trials of acupuncture for erectile dysfunction (ED) and premature ejaculation (PE) with English abstracts. Risk of bias was assessed for randomised controlled trials (RCTs).

Results

Seven studies on two conditions of male sexual dysfunction met the inclusion criteria. Three out of four RCTs were patient-blinded, but all had a high risk of bias. Three suggested that acupuncture has a therapeutic effect as compared with sham acupuncture. Comparisons with paroxetine were inconsistent. Other uncontrolled studies and case series suggested satisfactory improvements of ED and PE after acupuncture.

Conclusions

Acupuncture appears to have promise for treating male sexual dysfunction, but in view of the small number of studies and their variable quality, doubts remain about its effectiveness. Further studies are justified.

Miniscalpel-Needle versus Steroid Injection for Plantar Fasciitis: A Randomized Controlled Trial with a 12-Month Follow-Up

Plantar fasciitis is the most common cause of heel pain in adults. A novel alternative medical instrument, the miniscalpel-needle (MSN), which is based on an acupuncture needle, has been recently developed in China. The objective of this study was to evaluate the effectiveness of the MSN release treatment versus that of traditional steroid injection for plantar fasciitis. Patients with plantar fasciitis were randomly assigned to 2 groups and followed up for 12 months, with 29 receiving MSN treatment and 25 receiving steroid injection treatment. The results showed that visual analog scale scores for morning pain, active pain, and overall heel pain all were decreased significantly in the MSN group from 1 to 12 months after treatment. In contrast, treatment with steroid injection showed a significant effect only at the 1-month follow-up but not at 6 or 12 months after treatment. Moreover, the MSN group achieved more rapid and sustained improvements than the steroid group throughout the duration of this study. No severe side effects were observed with MSN treatment. Our data suggest that the MSN release treatment is safe and has a significant benefit for plantar fasciitis compared to steroid injection.

Acupuncture for acute stroke: study protocol for a multicenter, randomized, controlled trial

BACKGROUND

Acupuncture has been widely used as a treatment for stroke in China for more than 3,000 years. However, previous research has not yet shown that acupuncture is effective as a stroke treatment. We report a protocol for a multicenter, randomized, controlled, and outcome assessor-blind trial to evaluate the efficacy and safety of acupuncture on acute ischemic stroke.

METHODS/DESIGN

In a prospective trial involving three hospitals in the Zhejiang Province (China) 250 patients with a recent (less than 1 week previous) episode of ischemic stroke will be included. Patients will be randomized into two groups: an acupuncture group given scalp acupuncture and electroacupuncture, and a control group given no acupuncture. Eighteen treatment sessions will be performed over a three-week period. The primary outcome will be measured by changes in the National Institutes of Health Stroke Scale score at the one, three, and four-week follow-up. Secondary outcome measures will be: 1) the Fugl-Meyer assessment scale for motor function; 2) the mini-mental state examination and Montreal cognitive assessment for cognitive function; 3) the video-fluoroscopic swallowing study for swallowing ability; and 4) the incidence of adverse events.

DISCUSSION

This trial is expected to clarify whether or not acupuncture is effective for acute stroke. It will also show if acupuncture can improve motor, cognitive, or swallowing function.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR-TRC-12001971.

Acupuncture and traditional Chinese medicine for hot flushes in menopause: a randomized trial

OBJECTIVE

To evaluate the effect of acupuncture on hot flushes and other menopause-related symptoms used in an integrated system, including such therapeutic techniques as diet therapy and Tuina self-massage.

DESIGN

Randomized trial.

SETTING

Outpatient center.

PARTICIPANTS

One hundred women in spontaneous menopause with at least three episodes of hot flushes daily were randomly allocated to two treatment groups (50 per group): Women in group A were given diet, self-massage training, and treatment with acupuncture, and women in group B (the control group) were given the same diet and self-massage training, but treatment with acupuncture started 6 weeks after they were enrolled into the study.

INTERVENTION

Acupuncture treatments were scheduled twice weekly for 6 consecutive weeks.

OUTCOME MEASURES

Mean change in frequency and/or intensity in menopause-related symptoms were estimated by questionnaire after treatment at week 4.

RESULTS

Treatment with acupuncture significantly reduced the occurrence of hot flushes and sudden sweating (p<.001). Other symptoms (sleep disorders, tightness in the chest, irritability, bone pain, feeling depressed) significantly improved.

CONCLUSIONS

Acupuncture in an integrated system that includes therapeutic techniques such as diet therapy and Tuina self-massage can be used to treat hot flushes and selected symptoms in postmenopausal women.

Interaction of acupuncture and electroacupuncture on the pharmacokinetics of aspirin and the effect of brain blood flow in rats

Acupuncture and electroacupuncture have been used to improve the brain and motor functions of poststroke patients, and aspirin is used for the prevention of stroke recurrence. Our hypothesis is that acupuncture and electroacupuncture treatments may interact with aspirin in terms of pharmacokinetics via affecting the brain blood flow. The aim of this study is to investigate the potential interactions of acupuncture and electroacupuncture on the pharmacokinetics of aspirin. The effects of acupuncture treatments on brain blood flow were measured by the laser Doppler blood flow imager. The parallel pharmacokinetic study design included three groups: control, acupuncture, and electroacupuncture groups. Two acupoints, namely, Quchi (LI 11) and Zusanli (ST 36), were needled and stimulated electronically in anaesthetized rats. The concentrations of aspirin and its metabolite, salicylic acid were determined by microdialysis and HPLC analysis after aspirin administration (30 mg/kg, i.v.). The brain blood flow responded to electroacupuncture treatments, but the pharmacokinetic parameters of aspirin and salicylic acid in blood and brain were not significantly changed by acupuncture and electroacupuncture treatments. This study may, in part, offer some evidence to support the contention that there is no significant interaction for the combination of aspirin with acupuncture or electroacupuncture.

Specificity of Sensory and Motor Neurons Associated with BL40 and GB30 in the Rat: A Dual Fluorescent Labeling Study

The purpose of this study is to investigate the specific innervations on “Weizhong” (BL40) and “Huantiao” (GB30) by using a dual neural tracing technique. After Alexa Fluor 488 and 594 conjugates of cholera toxin subunit B (AF488/594-CTB) were, respectively, injected into BL40 and GB30 in the same rat, the labeled sensory and motor neurons were examined in the rat's dorsal root ganglia (DRGs) and spinal cord at thoracic (T) and lumbar (L) segments with a laser scanning confocal microscope. In the cases of BL40 injection, AF488-CTB labeled sensory and motor neurons were located in L_2–6 DRGs and on the mediolateral part of spinal ventral horn from L₃ to L₅ segments, respectively. By contrast, in the cases of GB30 injection, AF594-CTB labeled sensory and motor neurons were distributed in T₁₃-L₆ DRGs and on the anterolateral part of spinal ventral horn from L₁ to L₅ segments, respectively. These results indicate that the sensory and motor neurons associated with BL40 and GB30 are located in different spinal segments and regions in the nervous system, providing the neuroanatomical evidence to serve the specificity of acupoints.

Hemodynamic changes in the brachial artery induced by acupuncture stimulation on the lower limbs: a single-blind randomized controlled trial

Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups; they received stimulation at 3 different points located on the lower limbs: ST36, LR3, and a non-acupoint. Stimulation was performed bilaterally with manual rotation of the needles. Using ultrasonography, BFV was measured continuously from rest to 180 seconds after stimulation. LR3 stimulation significantly increased BFV compared to that before needle insertion. Meanwhile, stimulation at ST36 and the non-acupoint significantly decreased BFV compared to that before needle insertion. Stimulation at LR3 elicited a significant increase in BFV compared to that at ST36 and the non-acupoint. The results suggest that the stimulation of different points on the lower limbs causes distinct physiological effects on BFV in the BA.

Efficacy of Electro-Acupuncture in Chronic Plantar Fasciitis: A Randomized Controlled Trial

The aim of the study was to investigate the efficacy of electro-acupuncture coupled with conventional treatments and compare it with the efficacy of conventional treatments alone in patients with chronic plantar fasciitis. Thirty patients with chronic refractory plantar fasciitis were randomly assigned to two groups. Subjects in the control group received five weeks of conventional treatments, including stretching exercise, shoe modification and rescue analgesics. Subjects in the acupuncture group received the same treatments plus ten sessions of electro-acupuncture twice weekly. Endpoints included a success rate determined by a minimum of a 50% decrease in Visual Analog Scale (VAS) and Foot Function Index (FFI). At the end of treatment, VAS decreased significantly from 6.00 ± 1.69 to 1.89 ± 1.59 and from 6.27 ± 2.34 to 5.40 ± 2.26 in the acupuncture and control groups, respectively. FFI decreased significantly only in the acupuncture group (p < 0.05). Subjects in the acupuncture group obtained higher success rates than those in control group (80% and 13.3%, respectively). FFI in the acupuncture group was better than those in the control group (p < 0.001). At the sixth week follow-up, subjects in the acupuncture group showed a better FFI and success rate for pain during the day than those in the control group (p < 0.05). Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone. The effects lasted for at least six weeks.

Acupuncture Points of the Horse's Distal Thoracic Limb: A Neuroanatomic Approach to the Transposition of Traditional Points

Veterinary acupuncture charts were developed based on the concept of transpositional points whereby human acupuncture maps were adapted to animal anatomy. Transpositional acupuncture points have traditionally been placed in specific locations around the horse's coronet and distal limb believed to be the closest approximation to the human distal limb points. Because the horse has a single digit and lacks several structures analogous to the human hand and foot, precisely transposing all of the human digital points is not anatomically possible. To date there is no published research on the effect of acupuncture treatment of the equine distal limb points. This paper presents a modified approach to equine distal limb point selection based on what is known from research on other species about the neuroanatomic method of acupuncture. A rationale is presented for modification of traditional equine ting points as well as additional points around the hoof and distal limb that do not appear in the standard textbooks of equine acupuncture. The anatomy and physiology of the equine foot likely to be affected by acupuncture are briefly reviewed. Modified neuroanatomic points are proposed that may be more accurate as transpositional points. As an example of clinical application, a neuroanatomic approach to acupuncture treatment of equine laminitis is presented.

Evaluation of the effects of acupuncture on blood flow in humans with ultrasound color Doppler imaging

Color Doppler imaging (CDI) can be used to noninvasively create images of human blood vessels and quantitatively evaluate blood flow in real-time. The purpose of this study was to assess the effects of acupuncture on the blood flow of the peripheral, mesenteric, and retrobulbar arteries by CDI. Statistical significance was defined as P values less than 0.05. Blood flow in the radial and brachial arteries was significantly lower during needle stimulation on LR3 than before in healthy volunteers, but was significantly higher after needle stimulation than before. LR3 stimulation also resulted in a significant decrease in the vascular resistance of the short posterior ciliary artery and no significant change of blood flow through the superior mesenteric artery (SMA) during acupuncture. In contrast, ST36 stimulation resulted in a significant increase in blood flow through the SMA and no significant change in the vascular resistance of the retrobulbar arteries. Additionally, acupuncture at previously determined acupoints in patients with open-angle glaucoma led to a significant reduction in the vascular resistance of the central retinal artery and short posterior ciliary artery. Our results suggest that acupuncture can affect blood flow of the peripheral, mesenteric, and retrobulbar arteries, and CDI can be useful to evaluate hemodynamic changes by acupuncture.

Haemodynamic changes in the superior mesenteric artery induced by acupuncture stimulation on the lower limbs

Acupuncture is commonly performed on acupoints. A comparison of quantitative physiological alterations induced by stimulation on different acupoints has never been performed in the superior mesenteric artery (SMA) in humans. Therefore, we investigated changes in blood flow volume (BFV) in the SMA as an indicator of physiological effects induced by stimulation on 3 points. Thirty healthy participants aged 29 ± 10 years (mean ± SD) were enrolled. All participants underwent stimulations on 3 points located in the lower legs: ST36, LR3, and a non-acupoint. Control pertains to a condition with no-stimulation. Stimulation was performed bilaterally with manual rotation of the needles. BFV was measured by ultrasonography before insertion and 10, 20, 30, and 60 minutes after stimulation. Following acupuncture on ST36, BFV increased significantly 20 and 30 minutes after stimulation, compared to BFV before insertion (P < 0.05). Following stimulation on LR3 and the non-acupoint, no significant differences in BFV could be found. Relative to the no-stimulation group, stimulation on LR3, and the non-acupoint, stimulation on ST36 elicited a significant increase in BFV (P < 0.05). The results suggest that stimulation on the different points causes distinct physiological effects in BFV in the SMA.

'Forbidden points' in pregnancy: no plausible mechanism for risk

It has been suggested that acupuncture may pose particular risks during pregnancy: by enhancing oxygenation to the developing embryo (presumably via increasing blood flow to the uterus); by affecting the level of maternal progesterone in early pregnancy; or by stimulating uterine contractions. This article examines the proposed risks and fails to find any plausible physiological mechanism for them.

Local thermal therapy effects on menopausal symptoms and bone mineral density

OBJECTIVES

The aim of this study was to evaluate the effects of local thermal therapy with far-infrared rays (FIR) on menopausal symptoms and bone mineral density (BMD) in postmenopausal women.

SUBJECTS AND METHODS

A prospective randomized, controlled trial was conducted in female volunteers from communities in Northern Taiwan. The intervention group (n=22) received local thermal therapy with the help of FIR from an FIR emitter, for approximately 20 minutes per day, twice a week, for 20 sessions. They received the therapy on their backs while lying in a supine position. The control group (n=21) received no treatment. The primary outcome was the change in the Perceived Perimenopausal Disturbances Scale, designed for the measurement of menopause-related symptoms (MRS) before and after completion of treatment in a 10-week period. Secondary outcome parameters included serum levels of estradiol (E2) with osteocalcin (OC), and calcaneal BMD by quantitative ultrasound.

RESULTS

After 10 weeks of intervention, MRS determined by the scale decreased in mean total scores and mean scores for vasomotor, musculoskeletal, urologic, reproductive, and psychologic domains (p<0.05), except for reproductive (sexuality-related) symptoms. In the control group, mean total scores and scores of each domain had no significant difference between baseline and follow-up examination after 10 weeks. There was no significant difference between the quantitative ultrasound parameters in the calcaneus, serum E2, and OC levels either at the baseline or in the changes from the baseline between the intervention and control groups of women (p>0.05).

CONCLUSIONS

Local thermal therapy with FIR results in a significant reduction of MRS in postmenopausal women. Serum E2, OC levels, and calcaneal BMD showed no significant changes between the two groups. These results suggest that FIR local thermal therapy may be a potential alternative for the management of postmenopausal symptoms.

Assessing the effects of acupuncture by comparing needling the hegu acupoint and needling nearby nonacupoints by spectral analysis of microcirculatory laser Doppler signals

We aimed to assess the effects of acupuncture by analyzing the frequency content of skin blood-flow signals simultaneously recorded at the Hegu acupoint and two nearby nonacupoints following acupuncture stimulation (AS). Laser Doppler flowmetry (LDF) signals were measured in male healthy volunteers in two groups of experiments: needling the Hegu acupoint (n = 13) and needling a nearby nonacupoint (control experiment; n = 10). Each experiment involved recording a 20 min baseline-data sequence and two sets of effects data recorded 0–20 and 50–70 min after stopping AS. Wavelet transform with Morlet mother wavelet was applied to the measured LDF signals. Needling the Hegu acupoint significantly increased the blood flow, significantly decreased the relative energy contribution at 0.02–0.06 Hz and significantly increased the relative energy contribution at 0.4–1.6 Hz at Hegu, but induced no significant changes at the nonacupoints. Also, needling a nearby nonacupoint had no effect in any band at any site. This is the first time that spectral analysis has been used to investigate the microcirculatory blood-flow responses induced by AS, and has revealed possible differences in sympathetic nerve activities between needling the Hegu acupoint and its nearby nonacupoint. One possible weakness of the present design is that different De-Qi feelings following AS could lead to nonblind experimental setup, which may bias the comparison between needling Hegu and its nearby nonacupoint. Our results suggest that the described noninvasive method can be used to evaluate sympathetic control of peripheral vascular activity, which might be useful for studying the therapeutic effects of AS.

Acupuncture for treating dry eye: a systematic review

PURPOSE

The objective of this review was to assess the effectiveness of acupuncture as a treatment option for treating the condition of dry eye.

METHODS

We searched the literature using 14 databases from their inceptions to 3 December 2009, without language restrictions. We included randomized clinical trials (RCTs) comparing acupuncture with conventional treatment. Their risk of bias was assessed using Cochrane criteria.

RESULTS

Six RCTs met all the inclusion criteria. Three RCTs compared the effects of acupuncture with artificial tears in patients with xerophthalmia or Sjögren syndrome. A meta-analysis of these data showed that acupuncture improved tear break-up times (p < 0.0001), Schirmer test scores (p < 0.00001), response rates (p = 0.002) and the region of cornea fluorescent staining (p = 0.0001) significantly more than artificial tears did. The other three RCTs compared the effects of acupuncture plus artificial tears with artificial tears alone. Two of these studies failed to show significant effects of acupuncture, while one reported significant effects. For Schirmer test scores and frequency of artificial tear usage, two RCTs reported superior effects of acupuncture plus artificial tears, while one RCT failed to do so.

CONCLUSION

These results provide limited evidence for the effectiveness of acupuncture for treating dry eye. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions.

Changes of blood flow volume in the superior mesenteric artery and brachial artery with abdominal thermal stimulation

In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physician's experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD) for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA) and brachial artery (BA), the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (P < .01), as well as at 10 min (P < .01) and 20 min (P < .05) after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (P < .01). In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.

Acupuncture reduces symptoms of dry eye syndrome: a preliminary observational study

OBJECTIVE

The aim of this study was to evaluate the effect of acupuncture treatment on dry eye syndrome.

DESIGN

This was a prospective observational study.

SETTING

The study was conducted at a clinical evaluation center for acupuncture and moxibustion of the Korean Institute of Oriental Medicine, Republic of Korea.

SUBJECTS

The subjects were patients with dry eye disease (N = 36), defined by Schirmer test scores of <10 mm/5 min and tear film break-up times (BUTs) of <10 seconds.

TREATMENTS

Participants were treated with acupuncture three times per week for 4 weeks. MEASURE OF EFFECTIVENESS: Schirmer test scores, BUTs, symptom scores, ocular surface disease index (OSDI) scores and dry eye symptom questionnaires were compared before and after treatment to evaluate the efficacy of acupuncture treatment.

RESULTS

After treatment, symptom scores, OSDI scores and the number of dry eye symptoms were all significantly lower (p < 0.0001). Although tear wettings were significantly higher (left: p < 0.0001, right: p = 0.0012), there were no significant differences in BUTs.

CONCLUSIONS

This study suggests that acupuncture treatment can effectively relieve the symptoms of dry eye and increase watery secretion.

Acupuncture's Effects in Treating the Sequelae of Acute and Chronic Spinal Cord Injuries: A Review of Allopathic and Traditional Chinese Medicine Literature

Each year, there are an estimated 12 000 individuals who sustain a spinal cord injury (SCI) in the United States. Improved understanding of the pathophysiology of SCI and its sequelae has over the past 50 years led to the development of medical treatments (especially urologic) that have enhanced short- and long-term survival from these injuries. The prevalence of individuals with SCI in this country is ~250 000 individuals; and beyond the incalculable personal consequences of these devastating neurologic injuries, substantial direct and indirect societal costs result from the sequelae of SCI including paralysis, sensory loss, chronic pain, decubiti and bladder and/or bowel incontinence. The purpose of this treatise is to review the allopathic and traditional Chinese medicine (TCM) literature available through MEDLINE, PubMed and eCAM search engines that discuss the potential uses of acupuncture to treat acute and chronic spinal cord injuries and their sequelae, and present the neurophysiologic mechanisms for acupuncture's beneficial effects. There is evidence that use of electroacupuncture in acute SCI may significantly improve long-term neurologic recovery from these injuries both in terms of motor, sensory and bowel/bladder function with essentially no risk. Acupuncture may even improve neurourologic function in individuals with chronic SCI, and help with management with chronic pain associated with these injuries.