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Niruthisard S, Ma Q, Napadow V. Recent advances in acupuncture for pain relief. Pain Rep 2024; 9:e1188. [PMID: 39285954 PMCID: PMC11404884 DOI: 10.1097/pr9.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/20/2024] [Indexed: 09/19/2024] Open
Abstract
Introduction Acupuncture therapy has achieved global expansion and shown promise for health promotion and treatment of acute/chronic pain. Objectives To present an update on the existing evidence base for research and clinical practice supporting acupuncture analgesia. Methods This Clinical Update elaborates on the 2023 International Association for the Study of Pain Global Year for Integrative Pain Care "Factsheet Acupuncture for Pain Relief" and reviews best evidence and practice. Results Acupuncture is supported by a large research evidence base and growing utilization. Mechanisms of acupuncture analgesia include local physiological response at the needling site, suppression of nociceptive signaling at spinal and supraspinal levels, and peripheral/central release of endogenous opioids and other biochemical mediators. Acupuncture also produces pain relief by modulating specific brain networks, integral for sensory, affective, and cognitive processing, as demonstrated by neuroimaging research. Importantly, acupuncture does not just manage pain symptoms but may target the sources that drive pain, such as inflammation, partially by modulating autonomic pathways. Contextual factors are important for acupuncture analgesia, which is a complex multifaceted intervention. In clinical practice, historical records and many providers believe that acupuncture efficacy depends on specific acupoints used, the technique of needle placement and stimulation, and the person who delivers the procedure. Clinical research has supported the safety and effectiveness of acupuncture for various pain disorders, including acupuncture as a complementary/integrative therapy with other pain interventions. Conclusion Although the quality of supportive evidence is heterogeneous, acupuncture's potential cost-effectiveness and low risk profile under standardized techniques suggest consideration as a neuromodulatory and practical nonpharmacological pain therapy.
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Affiliation(s)
- Supranee Niruthisard
- Pain Management Research Unit, Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Qiufu Ma
- Center of Bioelectronic Medicine, School of Life Sciences, Westlake University, Hangzhou, China
| | - Vitaly Napadow
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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Jin B, Han Y, Jiang Y, Zhang J, Shen W, Zhang Y. Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis. Complement Ther Med 2024; 85:103079. [PMID: 39214380 DOI: 10.1016/j.ctim.2024.103079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/21/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Pregnant women commonly experience challenging nausea and vomiting, which significantly affect their general well-being and daily life. Although medication is often used for relief, it may not alleviate symptoms completely, emphasizing the need for complementary therapies. Acupuncture is one of the complementary treatments for nausea and vomiting of pregnancy (NVP). Studying the outcomes of acupuncture for NVP can shed light on this issue and inform treatment guidelines. Therefore, we systematically evaluated the effectiveness and safety of acupuncture in managing NVP, considering the traditional meridian and acupoint theories. METHODS PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, ClinicalTrials.gov, and the Chinese Clinical Trial Registry were searched on May 1, 2024. Randomized controlled trials (RCTs) that compared acupuncture for NVP with sham acupuncture, placebo, and Western medicine (WM) or acupuncture plus WM with WM alone were included. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was conducted using RevMan 5.4.1, and the quality of evidence for each outcome was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Twenty-four RCTs (with 26 publications) involving 2390 women were included. Acupuncture plus WM significantly led to a reduction in Pregnancy-Unique Quantification of Emesis (PUQE) scores and ineffective rates compared with WM alone (PUQE: mean difference [MD] -1.95, 95 % confidence interval [CI] -3.08 to -0.81, P = 0.0008, I2 = 90 %, six studies; ineffective rates: risk ratio [RR] 0.27, 95 % CI 0.19 to 0.39, P < 0.00001, I2 = 7 %, 16 studies). It also resulted in a greater improvement in ketonuria, shorter length of stay, and lower scores on the NVP Quality of Life and Chinese Medicine Syndrome Scale. Acupuncture was superior to WM in terms of reduction in ineffective rates (RR 0.50, 95 % CI 0.30 to 0.81, P = 0.006, I2 = 0 %, five studies). Acupuncture and WM had comparable results in improvement in PUQE scores (MD -0.80, 95 % CI -3.06 to 1.46, P = 0.49, I2 = 89 %, three studies) and ketonuria negative rates. The evidence is not clear regarding the impact of acupuncture on depression and anxiety compared with that of sham acupuncture. The incidence of severe adverse events was not significantly different between acupuncture and WM or sham acupuncture. Evidence certainty ranged from moderate to very low. Of the 24 RCTs, 19 used the Neiguan (PC6) acupoint, 16 used the Zusanli (ST36) acupoint, and 13 used the Zhongwan (CV12) acupoint. CONCLUSION According to the current systematic review and meta-analysis, acupuncture combined with WM may be a more effective treatment for NVP than WM alone. Furthermore, acupuncture may be as effective as WM. PC6, ST36, and CV12 are the most commonly used acupoints. Although more robust and larger studies are required, the current evidence supports the use of acupuncture in NVP treatment, as it has been demonstrated to be safe.
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Affiliation(s)
- Bao Jin
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yanhua Han
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yue Jiang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiao Zhang
- Department of Acupuncture and Moxibustion, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wenjuan Shen
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuehui Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
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Jansen LAW, Shaw V, Grooten IJ, Koot MH, Dean CR, Painter RC. Diagnostic et traitement de l’hyperémèse gravidique. CMAJ 2024; 196:E734-E743. [PMID: 38830681 PMCID: PMC11142033 DOI: 10.1503/cmaj.221502-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Larissa A W Jansen
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Victoria Shaw
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Iris J Grooten
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Marjette H Koot
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Caitlin R Dean
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
| | - Rebecca C Painter
- Institut de recherche sur la reproduction et le développement d'Amsterdam (Jansen, Dean, Painter), Amsterdam; Département d'obstétrique et de gynécologie (Jansen), Centre médical Érasme, Rotterdam, Pays-Bas; École des sciences infirmières et de sagesfemmes, Faculté de santé (Shaw), Université de Plymouth, R.-U.; Département d'obstétrique et de gynécologie (Grooten), Centre médical universitaire d'Amsterdam, Université d'Amsterdam; Département d'épidémiologie et de science des données (Koot), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays-Bas; Soutien aux nausées gravidiques (Dean), R.-U.; Département d'obstétrique et de gynécologie (Painter), Centre médical universitaire d'Amsterdam, Université libre d'Amsterdam, Amsterdam, Pays Bas
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Kyung D, Park KS, Koo JE, Kim S, Park J, Bae JH, Bae J, Kim S, Lee YJ, Ha IH. Safety and effectiveness of integrative Korean medicine for the management of patients sustaining injuries in traffic accidents during pregnancy: A retrospective chart review and questionnaire survey. Medicine (Baltimore) 2024; 103:e38250. [PMID: 38787995 PMCID: PMC11124594 DOI: 10.1097/md.0000000000038250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
The number of traffic accidents (TAs) is rising each year, and the severity of injuries can vary. Many people experience limitations in activities of daily living following TAs, affecting their quality of life. In pregnant women, even simple injuries caused by a TA could lead to unfavorable obstetric outcomes. Thus, we conducted a retrospective chart review and follow-up questionnaire survey to assess the safety and effectiveness of integrative Korean medicine (KM) treatment for pregnant women injured in TAs. To assess integrative KM effectiveness, the numeric rating scale (NRS) for TA-related symptoms, neck disability index (NDI) score, Oswestry disability index (ODI) score, shoulder pain and disability index score, Western Ontario and McMaster Universities Arthritis Index score, EuroQol 5-dimension 5-level (EQ-5D-5L) score, and patient global impression of change score were investigated for pregnant women injured in TAs. Additionally, for safety evaluation, obstetric and neonatal outcomes, as well as symptoms related to pregnancy, were assessed. At the end of treatment and follow-up, there were significant reductions in NDI and ODI scores, as well as NRS for neck pain, lower back pain, and headache, compared to scores at baseline. EQ-5D-5L scores significantly increased. A follow-up of 50 patients showed no major differences in obstetric and neonatal outcomes compared to the typical outcomes that occur in pregnant women and neonates. Major improvements were observed in the symptoms of patients who underwent integrative KM treatment after being injured in TAs. The symptoms occurred at a rate similar to those in typical pregnant women, while causality with integrative KM treatment was assessed to be unlikely or unclear. Therefore, integrative KM treatment may be considered an alternative treatment option for pregnant women who currently have limited treatment options.
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Affiliation(s)
- Dahyun Kyung
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Ji-Eun Koo
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Sujin Kim
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Jiwon Park
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Jun-Hyo Bae
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Jieun Bae
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Suna Kim
- Daejeon Jaseng Hospital of Korean Medicine, Seo-gu, Daejeon, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
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5
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Jansen LAW, Shaw V, Grooten IJ, Koot MH, Dean CR, Painter RC. Diagnosis and treatment of hyperemesis gravidarum. CMAJ 2024; 196:E477-E485. [PMID: 38621783 PMCID: PMC11019608 DOI: 10.1503/cmaj.221502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Affiliation(s)
- Larissa A W Jansen
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Victoria Shaw
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Iris J Grooten
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marjette H Koot
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Caitlin R Dean
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Rebecca C Painter
- Amsterdam Reproduction and Development Research Institute (Jansen, Dean, Painter), Amsterdam; Department of Obstetrics and Gynecology (Jansen), Erasmus MC, Rotterdam, the Netherlands; School of Nursing and Midwifery, Faculty of Health (Shaw), University of Plymouth, UK; Department of Obstetrics and Gynecology (Grooten), Amsterdam UMC, University of Amsterdam; Department of Epidemiology & Data Science (Koot), Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands; Pregnancy Sickness Support (Dean), UK; Department of Obstetrics and Gynecology (Painter), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
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Hu Y, Yang Q, Hu X. The efficacy and safety of acupuncture and moxibustion for the management of nausea and vomiting in pregnant women: A systematic review and meta-analysis. Heliyon 2024; 10:e24439. [PMID: 38298660 PMCID: PMC10828706 DOI: 10.1016/j.heliyon.2024.e24439] [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: 09/24/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Background Nausea and vomiting, which cause considerable multifaceted effects, are commonly experience in early pregnancy. Various therapeutic strategies are employed, including both conventional agents and complementary medicine. However, the effectiveness of complementary medicine remains controversial. The objective of this meta-analysis is to evaluate efficacy and safety of acupuncture and moxibustion in pregnant women. Methods We conducted a comprehensive search using electronic databases such as PubMed, Embase, ISI Web, Medline, Cochrane, clinicaltrial.gov, and several Chinese databases. A total of 21 randomized controlled trials were included in this study for quantitative analysis. Forest plots were utilized to evaluate the efficacy and safety of acupuncture and moxibustion. Egger's test was employed to assess publication bias. Results The pooled analysis revealed that the acupuncture/moxibustion group was more effective than control group in alleviating nausea and vomiting in early pregnant women (RR: 0.28; 95%CI: 0.21, 0.37). Similar results were observed when comparing the acupuncture group to traditional herbs (RR: 0.08; 95 % CI: 0.01, 0.60), conventional therapy (RR: 0.15; 95 % CI: 0.04, 0.57), and the blank control group (RR: 0.33; 95 % CI: 0.22, 0.51). Moxibustion also exhibited the ability to alleviate nausea and vomiting compared with the blank control group (RR: 0.21; 95 % CI: 0.08, 0.52). As for safety, there were no significant differences in severe adverse events between the acupuncture group and the control group (RR: 0.77; 95%CI: 0.52, 1.14), the blank control group (RR: 0.61; 95%CI: 0.34, 1.10), the sham acupuncture group (RR: 1.05; 95%CI: 0.63, 1.73), or the conventional therapy group (RR: 0.32; 95%CI: 0.06, 1.55). Conclusion Acupuncture and moxibustion might be effective for the management of nausea and vomiting in early pregnant women. Moreover, acupuncture might be a relatively safe treatment for pregnancy.
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Affiliation(s)
- Yao Hu
- Department of Traditional Chinese Medicine, Xiang He Community Healthcare Center, Chengdu, Sichuan, China
| | - Qian Yang
- Science and Education Department, Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Sichuan, China
| | - Xianjin Hu
- Department of Cardiology, West China Hospital, Sichuan University, China
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Boccino J. Auricular Acupuncture for Lowering Blood Glucose in Type 2 Diabetes: A Pilot Study. Med Acupunct 2023; 35:186-194. [PMID: 37609549 PMCID: PMC10440671 DOI: 10.1089/acu.2023.0022] [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: 08/24/2023] Open
Abstract
Objective Although type 2 diabetes mellitus (T2DM) is a major health epidemic, little research on auricular acupuncture for reducing blood glucose levels has been published. In Guatemala, where this study was conducted, the prevalence of T2DM is high and access to care is limited. The purpose of this pilot study was to determine if an auricular acupuncture protocol could be a feasible, effective treatment for reducing blood glucose, thus offering another potential accessible treatment. Materials and Methods Utilizing a self-controlled design approach, 28 participants diagnosed with T2DM were recruited and received 2 weeks of treatment consisting of a set protocol of 5 points in each ear. Pre- and post-treatment surveys were used to assess patients' health status, treatment expectations, and quality of life. Paired t-tests were used to measure pre- to post-treatment glucose levels. Results Treatment produced significant reduction in the patients' fasting and postprandial blood glucose levels, averaging 45.35 (n = 19; P = 0.014) and 109.45 points (n = 10; P = 0.008), respectively. Surveys indicated that all participants would be interested in using the treatment again to help manage their blood glucose. Conclusions An auricular protocol may provide a low-cost, effective treatment for lowering blood glucose in patients with T2DM. The results of this study are promising, suggesting that further investigation is warranted.
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Affiliation(s)
- Joan Boccino
- Department of Bioscience, Pacific College of Health and Science–New York, New York, NY, USA
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Li R, Chen L, Ren Y, Huang J, Xu Y, Lin X, Zhen R. Efficacy and safety of acupuncture for pregnancy-related low back pain: A systematic review and meta-analysis. Heliyon 2023; 9:e18439. [PMID: 37593601 PMCID: PMC10427988 DOI: 10.1016/j.heliyon.2023.e18439] [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: 11/09/2022] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/19/2023] Open
Abstract
Background Pregnancy-related low back pain (PLBP) is a common musculoskeletal disorder, affecting people's physical and psychological health. Acupuncture is widely used in clinical practice as a treatment for PLBP. This study aimed to evaluate the efficacy and safety of acupuncture or acupuncture combined with other treatments for PLBP patients. Methods The Cochrane Library, PubMed, EMBASE, Web of Science, the Chinese Biological Medicine Database, China National Knowledge Infrastructure, WanFang Database, and VIP information database were searched from inception to January 31, 2022. Randomized controlled trials (RCTs) were eligible, without blinding and language restriction. Cochrane's risk of bias tool was used to assess the methodological quality. Meta-analysis was performed using RevMan 5.3. Results Twelve randomized controlled trials involving 1302 patients were included. The results showed that compared to the control group, the VAS score was significantly decreased after acupuncture treatment. In addition, no significant difference was found in the preterm delivery rate (RR = 0.38, 95%CI: 0.24 to 0.61, P = 0.97) after acupuncture treatment. Compared with other therapies, acupuncture or acupuncture plus other therapies revealed a significant increase in the effective rate (OR: 6.92, 95%CI: 2.44 to 19.67, I2 = 0%). No serious adverse events owing to acupuncture were reported. Conclusion Acupuncture or acupuncture combined with other interventions was a safe and effective therapy for treating PLBP. However, the methodological quality of the RCTs was low. More rigorous and well-designed trials should be conducted.
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Affiliation(s)
- Rong Li
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liping Chen
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yulan Ren
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jinzhu Huang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuqi Xu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoding Lin
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Runchen Zhen
- School of Chinese Classics, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Lowe LA, Betts D. Midwifery Acupuncturists' Management of Antenatal Anxiety and Depression: Data from a Survey in Aotearoa (New Zealand). Med Acupunct 2023; 35:63-72. [PMID: 37095785 PMCID: PMC10122233 DOI: 10.1089/acu.2022.0062] [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: 02/19/2023] Open
Abstract
Objective The goal of this research was to explore how New Zealand midwifery acupuncturists manage mild-to-moderate antenatal anxiety and depression (AAD). Materials and Methods A survey (Surveymonkey®) on midwives' perceptions of acupuncture for treating AAD was distributed late in 2019 to midwives who completed a Certificate in Midwifery Acupuncture. Data were collected on referrals and on acupuncture and complementary and alternative medicine use for AAD and associated symptoms of concern (SoC), such as low-back and pelvic pain (LBPP), sleep issues, stress, other pain, and pregnancy issues. Descriptive analysis was used to report data. Results Of 119 midwives, 66 responded (55.5%). For AAD and SoC, midwives mostly referred patients to general practitioners and counselors, and administered acupuncture themselves. Acupuncture was most accessed for LBPP (n = 38; 70.4%), sleep (n = 31; 57.4%), anxiety (n = 27; 50.0%); stress (n = 26; 48.1%), and other pain (n = 20, 37.0%). Massage was second most-accessed for LBPP (n = 36; 66.7%), sleep (n = 25; 46.3%), and stress (n = 24; 44.4%). For depression, treatments were herbs (n = 16; 29.6%), homeopathy (n = 14; 25.9%), and acupuncture and massage (both n = 13; 24.1%). Acupuncture was most used for other pregnancy issues: birth preparation (n = 44, 88.0%); assisted labor induction (n = 43; 86.0%): nausea and vomiting (n = 43; 86.0%); breech (n = 37; 74.0%); and headaches/migraines (n = 29; 58.0%). Conclusion Acupuncture is commonly used by midwife acupuncturists in New Zealand to treat a range of pregnancy issues, including anxiety, SoC for AAD, and other pregnancy issues. Further research would be beneficial.
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Affiliation(s)
- Lee-Ana Lowe
- Dunedin, Aotearoa (New Zealand)
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
| | - Debra Betts
- New Zealand School of acupuncture and Traditional Chinese Medicine, Auckland, Aotearoa (New Zealand)
- University Western Sydney, Sydney, Australia
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10
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Feng J, He H, Wang Y, Zhang X, Zhang X, Zhang T, Zhu M, Wu X, Zhang Y. The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review. Front Endocrinol (Lausanne) 2022; 13:1009537. [PMID: 36329891 PMCID: PMC9624472 DOI: 10.3389/fendo.2022.1009537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.
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Affiliation(s)
- Jiaxing Feng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hui He
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yu Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xu Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiuying Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tiantian Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mengyi Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoke Wu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Yuehui Zhang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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11
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Shi YQ, Wang Y, Zhu XT, Yin RY, Ma YF, Han H, Han YH, Zhang YH. The Application of Complementary and Alternative Medicine in Polycystic Ovary Syndrome Infertility. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:5076306. [PMID: 36248406 PMCID: PMC9568292 DOI: 10.1155/2022/5076306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a lifelong reproductive endocrine disease, which is the most common cause of anovular infertility. Modern medicine mainly treats infertile patients with PCOS by improving living habits, ovulation induction therapy, and assisted reproductive technology (ART), but the effect is not satisfied. Complementary alternative medicine (CAM) has conspicuous advantages in the treatment of PCOS infertility due to its good clinical efficacy, wide mechanism of action, and no obvious adverse reactions, but its safety and effectiveness in the treatment of PCOS infertility have not been proved. Based on the existing clinical and experimental studies, this paper looks for the therapeutic effect and the mechanism behind it, and explores the safety and effectiveness of its treatment in PCOS infertility, in order to provide reference for future clinical treatment and experimental research.
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Affiliation(s)
- Yu-Qian Shi
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yi Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xi-Ting Zhu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Rui-Yang Yin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yi-Fu Ma
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Han Han
- The First Clinical Hospital affiliated to Harbin Medical University, Harbin, China
| | - Yan-Hua Han
- Department of Obstetrics and Gynecology, Key Laboratory and Unit of Infertility in Chinese Medicine, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yue-Hui Zhang
- Department of Obstetrics and Gynecology, Key Laboratory and Unit of Infertility in Chinese Medicine, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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12
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The safety of acupuncture for migraine prevention during pregnancy. Neurol Sci 2022; 43:5753-5755. [DOI: 10.1007/s10072-022-06201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/04/2022] [Indexed: 10/18/2022]
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13
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Daher AM, Ong SS, Krisnan D. Threat to Professional Autonomy and Physicians' Intention to Use Acupuncture: A Study From Malaysia. Front Public Health 2022; 10:820786. [PMID: 35719683 PMCID: PMC9201056 DOI: 10.3389/fpubh.2022.820786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Despite its popularity, registered medical practitioners (RMPs) are reluctant to use acupuncture in their practice. The aim of this study is to determine the impact of Threat to Professional Autonomy (TPA) on RMPs' intention to use acupuncture in Malaysia. A cross sectional study was conducted using an online survey form. The survey was distributed to 250 registered medical practitioners who are affiliated with the Malaysian Medical Association. The questionnaire followed a modified technology acceptance theoretical framework including the three main constructs of ease of use, usefulness and intention to use with addition of TPA as a predictor of physician intention. Structural equation modeling (SEM) was utilized to test the relationship between the 4 constructs. Measurement model, discriminant validity and path analysis statistics were presented. Two hundred and seventeen returned the completed questionnaire yielding a response rate of 86.8%. In the measurement model, all items within each construct were highly correlated. The minimum average variance extracted (AVE) was 0.741. All constructs achieved a minimum of 0.896 reliability estimates. Discriminant validity was ascertained with the findings that the square root of AVE is larger than the correlation between each two constructs. TPA has a significant negative impact on ease of use (p < 0.001) and perceived usefulness (p = 0.002). There was no significant direct effect of TPA on intention (p = 0.0561). Fit indices showed adequate fit. In conclusion, TPA affects the intention to use acupuncture indirectly through its negative effect on perceived ease of use and perceived usefulness of acupuncture.
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Affiliation(s)
- Aqil M Daher
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Siew Siew Ong
- Department of Chinese Medicine, Centre for Complementary and Alternative Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Devanandhini Krisnan
- Department of Chinese Medicine, Centre for Complementary and Alternative Medicine, International Medical University, Kuala Lumpur, Malaysia
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14
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da Costa N, Silva Martins E, Pinheiro AKB, Soares PRAL, de Souza Aquino P, Castro RCMB. Acupuncture for perceived stress in pregnant women: an intervention study. Rev Esc Enferm USP 2022; 56:e20210233. [PMID: 35639350 PMCID: PMC10081585 DOI: 10.1590/1980-220x-reeusp-2021-0233en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 04/01/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the effects of acupuncture in the treatment of perceived stress in pregnant women. METHOD A before-after intervention study, carried out in a primary health unit in Fortaleza-Ceará, with 56 pregnant women. The pregnant women underwent six acupuncture sessions, with two 30-minute sessions per week. Before the first session, an instrument to collect sociodemographic, clinical, and obstetric data was applied. The Global Perceived Stress Scale (PSS10) was applied weekly to monitor the progression of stress during treatment. RESULTS After the intervention, there was a significant decrease in the scores of the following scale items: being upset, inability to control, nervousness, tiredness, anger, and inability to overcome stress. (p < 0.05). There was a significant increase in the score of the item control of situations (p = 0.003). There was a significant difference in the mean perceived stress of the initial session compared to the 1st, 2nd and 3rd week sessions (p < 0.001). CONCLUSION The use of acupuncture to treat stress during pregnancy reduced the stress perceived by pregnant women.
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Affiliation(s)
- Nicolau da Costa
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, Fortaleza, CE, Brazil
| | - Eveliny Silva Martins
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, Fortaleza, CE, Brazil
| | - Ana Karina Bezerra Pinheiro
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, Fortaleza, CE, Brazil
| | | | - Priscila de Souza Aquino
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, Fortaleza, CE, Brazil
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Abstract
PURPOSE To provide updated evidence-based recommendations for the evaluation and treatment of primary and secondary headaches in pregnancy and postpartum. TARGET POPULATION Pregnant and postpartum patients with a history of or experiencing primary or new secondary headaches. METHODS This guideline was developed using an a priori protocol in conjunction with a writing team consisting of two specialists in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines-Obstetrics and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS This Clinical Practice Guideline includes recommendations on interventions to prevent primary headache in individuals who are pregnant or attempting to become pregnant, postpartum, or breastfeeding; evaluation for symptomatic patients presenting with primary and secondary headaches during pregnancy; and treatment options for primary and secondary headaches during pregnancy and lactation. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.
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16
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Wang D, Jiang Y, Feng J, Gao J, Yu J, Zhao J, Liu P, Han Y. Evidence for the Use of Complementary and Alternative Medicine for Pelvic Inflammatory Disease: A Literature Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:1364297. [PMID: 35096102 PMCID: PMC8791705 DOI: 10.1155/2022/1364297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/13/2021] [Indexed: 12/05/2022]
Abstract
Pelvic inflammatory disease (PID), a common infectious disease of the female reproductive tract, is mainly characterized by abdominal/pelvic pain and tenderness of the uterus, cervix, or adnexa on physical exam. In recent years, its incidence has gradually increased yearly due to numerous factors, including sexually transmitted diseases and intrauterine operations. Based on self-report of PID in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 survey, PID impacts approximately 2.5 million women in the US during their reproductive age. Although empiric treatments such as antibiotics or surgery could alleviate the related symptoms of PID, its unsatisfactory obstetric outcome and high relapse bring heavy physical and psychological burden to women. Complementary and alternative medicine (CAM), a complementary therapy other than Western medicine with a complete theoretical and practical system, has been attached to importance in the world due to its remarkable efficacy. More people are accepting and trying to use CAM to treat gynecological diseases, including infertility, polycystic ovary syndrome, and PID, but its efficacy and mechanism are still controversial. This article reviews the previous literature systematically focusing on the effectiveness, safety, and mechanism of CAM in the treatment of PID to provide an evidence-based basis for the clinical application of CAM in patients with PID.
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Affiliation(s)
- Dongmei Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yue Jiang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiaxing Feng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jingshu Gao
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinlan Yu
- Harbin Daoli District People's Hospital, Harbin, China
| | - Jing Zhao
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Pihong Liu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yaguang Han
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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da Costa N, Silva Martins E, Pinheiro AKB, Soares PRAL, de Souza Aquino P, Castro RCMB. Acupuntura no estresse percebido em gestantes: um estudo de intervenção. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0233pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Analisar os efeitos da acupuntura no tratamento de estresse percebido em gestantes. Método: Estudo de intervenção do tipo antes e depois, realizado em unidade básica de saúde de Fortaleza-Ceará, com 56 gestantes. As gestantes realizaram seis sessões de acupuntura, com periodicidade de duas sessões por semana e duração de 30 minutos. Antes da primeira sessão, aplicou-se instrumento de coleta de dados sociodemográficos, clínicos e obstétricos. Semanalmente, foi aplicada a Escala Global de Estresse Percebido (PSS10) para verificar a evolução do estresse durante o tratamento. Resultados: Após a intervenção, houve uma diminuição significativa na pontuação dos seguintes itens da escala: preocupação, incapacidade de controle, nervosismo, cansaço, fúria e incapacidade de superar o estresse (p < 0,05). Observou-se aumento significativo na pontuação do item controle das situações (p = 0,003). Houve diferença significativa na média de estresse percebido da sessão inicial em relação às sessões da 1ª, 2ª e 3ª semana (p < 0,001). Conclusão: O uso da acupuntura para tratamento do estresse na gestação reduziu o estresse percebido pelas gestantes.
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Abstract
Globally, headache disorders are an important cause of disability in adults. As many types of headache (eg, migraine, tension-type and medication-overuse) are more common in women and have peak incidence in reproductive years, chronic headache disorders are highly prevalent in pregnant women. Some women with a history of migraine may find that it improves during pregnancy while others may find that their migraines become more unpredictable. Ideally, women with migraine and problematic headache disorder should be offered preconception counselling to address pregnancy-related concerns and advice on the use of medicines, which should be supported by high-quality information. For women with history of headache, the use of effective non-pharmacological options should be maximised, and the smallest number of the safest medicines at the lowest effective doses should be used while preparing for pregnancy and during pregnancy. This article forms part of the series of prescribing for pregnancy and discusses the impact of headache and migraine on pregnancy, the impact of pregnancy on headache and migraine and options for prophylaxis and treatment.
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Affiliation(s)
- Caroline Ovadia
- Department of Women and Children's Health, King's College London, London, UK
- Obstetrics and Gynaecology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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19
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The Efficacy of Complementary and Alternative Medicine in the Treatment of Female Infertility. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6634309. [PMID: 33986820 PMCID: PMC8093064 DOI: 10.1155/2021/6634309] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/13/2021] [Accepted: 04/17/2021] [Indexed: 11/29/2022]
Abstract
Female infertility is a state of fertility disorder caused by multiple reasons. The incidence of infertility for females has significantly increased due to various factors such as social pressure, late marriage, and late childbirth, and its harm includes heavy economic burden, psychological shadow, and even marriage failure. Conventional solutions, such as hormone therapy, in vitro fertilization (IVF), and embryo transfer, have the limitations of unsatisfied obstetric outcomes and serious adverse events. Currently, complementary and alternative medicine (CAM), as a new treatment for infertility, is gradually challenging the dominant position of traditional therapies in the treatment of infertility. CAM claims that it can adjust and harmonize the state of the female body from a holistic approach to achieve a better therapeutic effect and has been increasingly used by infertile women. Meanwhile, some controversial issues also appeared; that is, some randomized controlled trials (RCTs) confirmed that CAM had no obvious effect on infertility, and the mechanism of its effect could not reach a consensus. To clarify CAM effectiveness, safety, and mechanism, this paper systematically reviewed the literature about its treatment of female infertility collected from PubMed and CNKI databases and mainly introduced acupuncture, moxibustion, and oral Chinese herbal medicine. In addition, we also briefly summarized psychological intervention, biosimilar electrical stimulation, homeopathy, hyperbaric oxygen therapy, etc.
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20
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Nielsen A, Gereau S, Tick H. Risks and Safety of Extended Auricular Therapy: A Review of Reviews and Case Reports of Adverse Events. PAIN MEDICINE 2021; 21:1276-1293. [PMID: 32430505 DOI: 10.1093/pm/pnz379] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Auricular acupuncture (AA) and extended auricular therapy (AT) are a part of acupuncture practice shown to benefit patients with pain, anxiety, and other conditions, with cost-effective access enhanced when given in a group setting. Yet there are safety concerns and risks, perhaps unnecessary risks, that attend embedded, indwelling needles applied to the ear as a means of extended AT. METHODS Electronic searches were conducted in PubMed, MEDLINE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) for "auriculotherapy," "auricular acupuncture" or "auricular acupressure," "safety," "adverse events," "chondritis," and "perichondritis," with additional manual review of titles, links, and reference lists. Individual auricular therapy adverse event (AE) case reports were included, as well as systematic reviews and or meta-analyses if they evaluated AEs associated with AT. RESULTS Nineteen auricular AE case reports and nine safety reviews of or including auriculotherapy were included. Ten systematic reviews of AT with eight specific reviews of auricular acupressure (AP) were also included. CONCLUSIONS The primary AE risks is infection, perichondritis, and chondritis stemming from embedded or indwelling needles or potential inadvertent needlesticks from contaminated roaming sharps. Extended AP i.e., application of spheres, preferably seeds (natural, nontoxic botanical Vaccaria seeds) provides clinical benefit without the risks associated with embedded needles. More research is needed to establish if embedded needles at the ear are even necessary or have any advantage over in-session auricular acupuncture for immediate pain relief followed by ear acupressure.
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Affiliation(s)
- Arya Nielsen
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Heather Tick
- Department of Family Medicine, Anesthesiology and Pain Medicine, University of Washington School of Medicine, Washington, USA
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21
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Zhang NM, Vesty G, Zheng Z. Healthcare Professionals' Attitudes to Integration of Acupuncture in Western Medicine: A Mixed-Method Systematic Review. Pain Manag Nurs 2021; 22:684-693. [PMID: 33962872 DOI: 10.1016/j.pmn.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/13/2020] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acupuncture is practiced in many Western countries with increasing evidence supporting its use across the healthcare system. However, this nonpharmacological intervention is yet to be widely integrated into hospitals. Fundamental to the integration of any innovation into healthcare systems is the attitudes of healthcare professionals. AIMS To explore healthcare professionals' attitudes towards acupuncture and identify the enablers and barriers to integration in the hospital setting. DESIGN This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines; we conducted a mixed-method systematic review following Joanna Briggs Institute Reviewer's Manual 2017. DATA SOURCES PubMed, CINAHL, AMED, EMBASE, Cochrane Library, and SCOPUS were searched from their inception to December 2019 using different combination of keywords. METHODS Attitude and perception data were extracted from the articles and constructs were categorized as barriers and enablers. A convergent integrated approach was adopted whereby qualitative data themes were integrated with quantitative data constructs to generate descriptive codes around enablers and barriers at intrapersonal, interpersonal, and environmental levels according to the framework proposed by Manias et al. (2014). RESULTS Twenty-six studies comprising 19 survey and seven interview studies were identified, with 24 articles (92%) reporting positive attitudes, supporting the integration of acupuncture into Western medicine. Enablers identified were prior positive experience, belief in the treatment's efficacy, and patient demand. Barriers were lack of evidentiary knowledge or experience; lack of resources such as time, providers, and funding; and paradigm differences. Twenty studies (77%) focused on medical doctors or medical student perceptions. A conceptual framework for implementing and integrating acupuncture into Western medicine is proposed. CONCLUSION Healthcare professionals' attitudes to acupuncture are positive. Barriers to integrating acupuncture into the hospital system exist at intrapersonal, interpersonal, and external levels, with lack of resources being the key barrier. Nurses' role in facilitating integration into Western medical pain management practice provides an avenue for future research. The proposed conceptual framework provides guidance for nursing researchers interested in the role of acupuncture and integrated medicine in patient-centric, value-based healthcare.
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Affiliation(s)
- Nancy Ming Zhang
- School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Australia.
| | - Gillian Vesty
- School of Accounting, Information Systems and Supply Chain, RMIT University, Melbourne, Australia
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora West Campus, Australia
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Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021. [DOI: 10.1155/2021/5589116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Threatened miscarriage is one of the most common complications causing pregnancy loss, and it affects approximately 20% of confirmed pregnancies. More and more women are seeking treatment with complementary and alternative medicine (CAM) for this common complication, and it has been reported that women have had successful pregnancies after threatened miscarriage when being treated with CAM, which mainly includes Chinese herbal medicines, acupuncture, and nutritional supplements as well as psychological interventions and other approaches. However, many experts are concerned about the safety and adverse events of certain CAM approaches in women with threatened miscarriage. Therefore, this review focuses on the status of CAM for threatened miscarriage and presents the potential therapeutic efficacy and safety of CAM based on some clinical and experimental studies. We thus hope to provide some instructive suggestions for the application of CAM for treating threatened miscarriage in the future.
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Abstract
Irritable bowel syndrome (IBS) affects a significant percentage of the general population and is more common in women. A large proportion of women affected with IBS are of childbearing age; however, there is a paucity of studies and guidelines to specifically address the epidemiology, course, maternal/fetal prognosis, or management of IBS in pregnancy. This scarcity of literature on IBS and pregnancy poses significant challenges to healthcare providers in counseling and managing patients. In this comprehensive review, we summarize the current literature and knowledge gaps regarding the effects of pregnancy on IBS and vice versa, along with the efficacy and safety profiles of commonly used IBS diets and medications in pregnancy. The management of pregnant women with IBS should be multidisciplinary, with emphasis on education and judicious use of dietary modifications and pharmacologic options that are deemed relatively safe during pregnancy.
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Bai L, Zhang D, Cui TT, Li JF, Gao YY, Wang NY, Jia PL, Zhang HY, Sun ZR, Zou W, Wang L. Mechanisms Underlying the Antidepressant Effect of Acupuncture via the CaMK Signaling Pathway. Front Behav Neurosci 2020; 14:563698. [PMID: 33343309 PMCID: PMC7746547 DOI: 10.3389/fnbeh.2020.563698] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
The CaMK pathway has been proven to play an important role in regulating cognitive function and emotional response. Acupuncture through the CaMK pathway improves depression-like behavior and the molecular mechanism related to its antidepressant remains to be explored. In this study, we aimed to determine whether the ability of acupuncture at Baihui (GV20) and Shenting (GV24) points to treat depression is related to the regulation of key proteins in the CaMK pathway. A rat model of depression was induced by chronic unpredicted mild stress (CUMS). Model rats in the electroacupuncture group were subjected to acupuncture at the Baihui (GV20) and Shenting (GV24) acupoints once a day for 20 min. Model rats in the fluoxetine group were gavaged with fluoxetine (1.8 mg/kg). Immunohistochemistry and Western blotting assays were used to evaluate immunoreactivity for and the protein expression levels of CaMKII, CaMKIV, and CaM. The results showed that electroacupuncture had a significant effect in rats with depression. Electroacupuncture and fluoxetine regulated the expression of key proteins in the CaMK signaling pathway, which is related to depression, in the hippocampi of rats. This indicates that acupuncture at Baihui (GV20) and Shenting (GV24) may alleviate depressive symptoms and reduce work- and life-related burdens and stress by regulating the CaMK signaling pathway.
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Affiliation(s)
- Lu Bai
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Di Zhang
- The Second Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tao-Tao Cui
- The Second Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ji-Fei Li
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yang-Yang Gao
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Nan-Yi Wang
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Peng-Li Jia
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hui-Yuan Zhang
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Zhong-Ren Sun
- Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wei Zou
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Long Wang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Wei TH, Hsieh CL. Effect of Acupuncture on the p38 Signaling Pathway in Several Nervous System Diseases: A Systematic Review. Int J Mol Sci 2020; 21:E4693. [PMID: 32630156 PMCID: PMC7370084 DOI: 10.3390/ijms21134693] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 12/16/2022] Open
Abstract
Acupuncture is clinically used to treat various diseases and exerts positive local and systemic effects in several nervous system diseases. Advanced molecular and clinical studies have continually attempted to decipher the mechanisms underlying these effects of acupuncture. While a growing understanding of the pathophysiology underlying several nervous system diseases shows it to be related to inflammation and impair cell regeneration after ischemic events, the relationship between the therapeutic mechanism of acupuncture and the p38 MAPK signal pathway has yet to be elucidated. This review discusses the latest advancements in the identification of the effect of acupuncture on the p38 signaling pathway in several nervous system diseases. We electronically searched databases including PubMed, Embase, and the Cochrane Library from their inception to April 2020, using the following keywords alone or in various combinations: "acupuncture", "p38 MAPK pathway", "signaling", "stress response", "inflammation", "immune", "pain", "analgesic", "cerebral ischemic injury", "epilepsy", "Alzheimer's disease", "Parkinson's disease", "dementia", "degenerative", and "homeostasis". Manual acupuncture and electroacupuncture confer positive therapeutic effects by regulating proinflammatory cytokines, ion channels, scaffold proteins, and transcription factors including TRPV1/4, Nav, BDNF, and NADMR1; consequently, p38 regulates various phenomena including cell communication, remodeling, regeneration, and gene expression. In this review article, we found the most common acupoints for the relief of nervous system disorders including GV20, GV14, ST36, ST37, and LI4. Acupuncture exhibits dual regulatory functions of activating or inhibiting different p38 MAPK pathways, contributing to an overall improvement of clinical symptoms and function in several nervous system diseases.
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Affiliation(s)
- Tzu-Hsuan Wei
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
- Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
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Cheng FK. Using Acupuncture in Labor Pain and Childbirth-Related Issues: A Narrative Review. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-19-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDLatent threats, such as prolonged labor duration and postpartum hemorrhage, endanger women and newborns during and post childbirth, which produce burdens on natal care and public health expenditures. Acupuncture, a traditional Chinese medical practice, has increasingly been used for labor delivery in various countries to cope with these problems.METHODThis narrative review searched 29 English and Chinese electronic databases. Thirty-one empirical studies, carried out in Asia, America, Africa, the Middle East, Europe, and Australia were reviewed according to inclusion and exclusion criteria.RESULTSAcupuncture is adopted with positive signs toward labor pain relief, delivery mode, labor duration, postpartum hemorrhage, APGAR score (an evaluation for a neonatal evaluation), and birth weight.DISCUSSIONWith support of earlier studies, the satisfactory effects of acupuncture on labor delivery reviewed in this research have been noted by obstetric researchers and scholars, physicians, nurses, and midwives.CONCLUSIONThis review recommends the use of acupuncture in obstetric profession with respect to maternal-related healthcare.
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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.
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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
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Wu AW, Gettelfinger JD, Ting JY, Mort C, Higgins TS. Alternative therapies for sinusitis and rhinitis: a systematic review utilizing a modified Delphi method. Int Forum Allergy Rhinol 2020; 10:496-504. [DOI: 10.1002/alr.22488] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Arthur W. Wu
- Division of Otolaryngology–Head and Neck SurgeryCedars‐Sinai Medical Center Los Angeles CA
| | - John D. Gettelfinger
- Department of Otolaryngology–Head and Neck SurgeryIndiana University School of Medicine Indianapolis IN
| | - Jonathan Y. Ting
- Department of Otolaryngology–Head and Neck SurgeryIndiana University School of Medicine Indianapolis IN
| | | | - Thomas S. Higgins
- Rhinology, Sinus and Skull BaseKentuckiana Ear, Nose, & Throat Louisville KY
- Department of Otolaryngology–Head & Neck SurgeryUniversity of Louisville Louisville KY
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29
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Qu Z, Liu L, Yang Y, Zhao L, Xu X, Li Z, Zhu Y, Jing X, Wang X, Zhang CS, Fisher M, Li B, Wang L. Electro-acupuncture inhibits C-fiber-evoked WDR neuronal activity of the trigeminocervical complex: Neurophysiological hypothesis of a complementary therapy for acute migraine modeled rats. Brain Res 2020; 1730:146670. [PMID: 31953213 DOI: 10.1016/j.brainres.2020.146670] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/07/2020] [Accepted: 01/11/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Acupuncture has become a relevant complementary and alternative treatment for acute migraine; however, the neurophysiological mechanism (C-fibers) underlying this effect remains unclear. C-fibers play a crucial role for diffuse noxious inhibitory controls (DNIC) at wide dynamic range (WDR) neurons in the trigeminocervical complex (TCC) in migraine attacks, and we supposed that this may be the mechanism of acupuncture analgesia. This study aimed to examine the neurophysiology of acupuncture intervention in an acute migraine rat model. METHODS Inflammatory soup (IS) or saline was injected into the dura mater to establish a migraine and control model in rats. To explore the neurobiological mechanism of acupuncture for migraine, we implemented electro-acupuncture (EA), non-electric-stimulation acupuncture, and no-acupuncture in IS and saline injected rats, and recorded the single-cell extraneural neurophysiology of the atlas (C1) spinal dorsal horn neurons in the TCC. RESULTS Our research shows that electro-acupuncture at GB8 (Shuaigu), located in the periorbital region receptive field of the trigeminal nerve, may rapidly reduce the C-fiber evoked WDR neuronal discharges of the TCC within 60 s. DISCUSSION This study provides pioneering evidence of a potential neurobiological mechanism for the analgesic effect on migraine attacks achieved by electro-acupuncture intervention via DNIC. The data indicates that EA may become a crucial supplementary and alternative therapy for migraineurs that failed to respond to acute medications, e.g., fremanezumab, which achieves its analgesic effect via modulating Aσ-fibers, not C-fibers.
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Affiliation(s)
- Zhengyang Qu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Lu Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Yang
- Department of History, University College London, London, UK
| | - Luopeng Zhao
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China; Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
| | - Xiaobai Xu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Zhijuan Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Yupu Zhu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Xianghong Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoyu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Claire Shuiqing Zhang
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Marc Fisher
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Bin Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Linpeng Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China.
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Qu Z, Liu L, Zhao L, Xu X, Li Z, Zhu Y, Zhang C, Jing X, Wang X, Li B, Zhang CS, Fisher M, Wang L. Prophylactic Electroacupuncture on the Upper Cervical Segments Decreases Neuronal Discharges of the Trigeminocervical Complex in Migraine-Affected Rats: An in vivo Extracellular Electrophysiological Experiment. J Pain Res 2020; 13:25-37. [PMID: 32021392 PMCID: PMC6960663 DOI: 10.2147/jpr.s226922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/24/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose This rat experiment aims to demonstrate the efficacy of electrical acupuncture in preventing migraine attacks by stimulating the acupoint GB20. Introduction Migraine, which takes 2ed at level four causes of GBD’s disease hierarchy, becomes a public health issue. It is important for physicians to supplement their knowledge of its treatment and consider alternative methods of therapy, such as acupuncture. However, the neurobiological and pathophysiological mechanisms of this prophylactic effect were unclear. The trigeminocervical complex is thought to be an important relay station in migraine pathophysiology as the key nuclei of the trigeminovascular system and the brainstem descending pain modulation system. Methods There were six groups involved in this study: control, model, electroacupuncture, non-acupoint electroacupuncture, saline+electroacupuncture and saline+non-acupoint electroacupuncture. We injected saline or inflammatory soup into dura mater to induce control or migraine in the rats. The mechanical pain threshold and the single-cell extraneural neurophysiology of the C1 spinal dorsal horn neurons in the trigeminocervical complex were detected. Results Pre-electroacupuncture could significantly increase the mechanical pain threshold of the periorbital region receptive field of the trigeminal nerve and decrease the discharges of neurons in the trigeminocervical complex. Acupuncture also reversed the abnormal skin pain response of the periorbital region receptive field of the trigeminal nerve caused by low-intensity stimulation. Discussion We believe that our study makes a significant contribution to the literature because it is the first of its kind to use GB20 to provide relief from migraine attacks and mechanical cephalic cutaneous hypersensitivity by regulating the neuronal discharge from trigeminocervical complex.
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Affiliation(s)
- Zhengyang Qu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
| | - Lu Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China.,Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
| | - Luopeng Zhao
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China.,Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, People's Republic of China
| | - Xiaobai Xu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
| | - Zhijuan Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
| | - Yupu Zhu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
| | - Chen Zhang
- Acupuncture and Moxibustion Department, Beijing Massage Hospital, Beijing, People's Republic of China
| | - Xianghong Jing
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
| | - Xiaoyu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People's Republic of China
| | - Bin Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
| | - Claire Suiqing Zhang
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Marc Fisher
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Linpeng Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, People's Republic of China
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Foroughinia S, Hessami K, Asadi N, Foroughinia L, Hadianfard M, Hajihosseini A, Pirasteh N, Vossoughi M, Vafaei H, Faraji A, Kasraeian M, Doroudchi M, Rafiee Monjezi M, Roozmeh S, Bazrafshan K. Effect of Acupuncture on Pregnancy-Related Insomnia and Melatonin: A Single-Blinded, Randomized, Placebo-Controlled Trial. Nat Sci Sleep 2020; 12:271-278. [PMID: 32494210 PMCID: PMC7231755 DOI: 10.2147/nss.s247628] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/27/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of the current study is to evaluate the efficacy and safety of acupuncture on sleep quality and overnight melatonin secretion, measured as urinary 6-sulfatoxymelatonin, in pregnant women. PATIENTS AND METHODS This randomized, parallel, single-blinded (participant), controlled trial was conducted on 72 pregnant women with insomnia. Study participants were randomly assigned to either the intervention, 10 sessions of acupuncture treatment over a 3-week period, or control group by block randomization (1:1). Patients in both groups were evaluated at baseline and post-treatment (third week) using the Pittsburgh Sleep Quality Index (PSQI) score (as the primary outcome) and urinary 6-sulfatoxymelatonin. RESULTS Fifty-five of 72 participants completed the study. There was no statistically significant difference regarding PSQI score and 6-sulfatoxymelatonin level between intervention and control groups at the baseline (P=0.169 and P=0.496). At the end of the study period, treatment with acupuncture significantly improved the PSQI score (P<0.001) with a large effect size of 3.7, as well as 6-sulfatoxymelatonin level (P=0.020) with a medium effect size of 0.6 as compared to the control group. No adverse effects were noted during acupuncture sessions and follow-up visits. CONCLUSION Acupuncture was shown to significantly improve the sleep quality in pregnant women, possibly through increasing melatonin secretion, and could be recommended as a low-cost and low-risk alternative treatment to pharmacological therapies.
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Affiliation(s)
- Saeedeh Foroughinia
- Obstetrics and Gynecology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Hessami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammadjavad Hadianfard
- Physical Medicine and Rehabilitation Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Hajihosseini
- Physical Medicine and Rehabilitation Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Pirasteh
- Physical Medicine and Rehabilitation Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Vossoughi
- Oral and Dental Disease Research Center, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azam Faraji
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrnoosh Doroudchi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Shohreh Roozmeh
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadije Bazrafshan
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Levett KM, Sutcliffe KL, Betts D. Using Forbidden Points in Pregnancy: Adverse Outcomes and Quality of Evidence in Randomized Controlled Trials-A Systematic Narrative Review. Med Acupunct 2019; 31:346-360. [PMID: 31871522 DOI: 10.1089/acu.2019.1391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: Pregnancy is a complex physical and hormonal condition. Many women experience back and pelvic pain, reflux, and headaches during pregnancy. There has been a significant rise in the popularity of acupuncture for pain conditions in pregnancy, wherein nonpharmacologic options are important. Concerns have been raised by both traditional and medical acupuncturists about using "forbidden points" during pregnancy and the risk of preterm contractions (PTC), as this could limit women's and practitioners' willingness to continue treatment during pregnancy. There is also a risk of bias introduced into clinical trials when participants are highly selected or they drop out of studies due to adverse outcomes. This review examined randomized controlled trials (RCTs) of acupuncture using forbidden points prior to 37 weeks of pregnancy to treat pain conditions, with the primary outcome of PTC. Methods: A database search identified RCTs, including trials of penetrating acupuncture that used forbidden points in their protocols to treat pregnancy-related pain conditions. STRICTA [Standards for Reporting Interventions in Clinical Trials of Acupuncture] and GRADE [Grades of Recommendation, Assessment, Development, and Evaluation] criteria were used to assess the quality of evidence. This review includes 8 RCTs reporting on 713 women. Results: Only 2 studies reported on the primary outcome of PTC, and there were insufficient data to perform a primary analysis. In these 2 studies, 6 participants withdrew due to PTC. No study was at a low risk of bias for all GRADE domains, and 3 studies were at high or unclear risk of bias in all domains. Conclusions: PTC is an important clinical outcome and should be reported routinely. The strength of evidence to date is insufficient to recommend using forbidden points prior to 37 weeks of pregnancy. Highly selected patient populations, risk of bias in study design, and participant withdrawal rates, suggest that high-quality trials are required.
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Affiliation(s)
- Kate M Levett
- School of Medicine Sydney, University of Notre Dame Australia, New South Wales, Australia.,NICM Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia
| | - Kerry L Sutcliffe
- School of Medicine Sydney, University of Notre Dame Australia, New South Wales, Australia
| | - Debra Betts
- NICM Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia.,New Zealand School of Acupuncture, Wellington, New Zealand
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How Do You Treat Pregnancy, Fertility, Labor and Delivery, and Postpartum Issues in Your Practice? Part II. Med Acupunct 2019; 31:416-425. [DOI: 10.1089/acu.2019.29129.cpl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Madsen C, Banaag A, Koehlmoos TP. Trends in Use of Acupuncture During Pregnancy for the Military Health System, 2006-2016. Med Acupunct 2019; 31:366-371. [PMID: 31871524 DOI: 10.1089/acu.2019.1376] [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: 11/13/2022] Open
Abstract
Objective: Acupuncture is recognized as safe for use in pregnancy when correctly performed and has been provided at military healthcare facilities since 2005. Previous research identified a number of pregnant patients receiving acupuncture within the Military Health System (MHS). This study was conducted to describe trends in usage from 2006 to 2016 including patient and provider characteristics. Materials and Methods: This study utilized TRICARE claims from the MHS Data Repository (MDR). Analysis was performed through the MDR for women ages 18 years and older, who had acupuncture treatments at military treatment facilities related to pregnancy, from 2006 to 2016. Descriptive statistics were collected on patient demographics, clinic types and provider specialties, major diagnostic categories associated with acupuncture, number of visits per patient, and utilization over time. Results: Less than 0.3% of pregnant women in the MHS received acupuncture. The greatest usage was among patients who were white, ages 25-34, dependents of active duty personnel, and in the Army service. The most common diagnoses were for musculoskeletal system and connective tissue disorders (41.9%). Approximately 79% of care was delivered by physicians. The trend over time rose from 11 visits in 2006 to 130 visits in 2016. Conclusions: Provision of acupuncture in pregnancy grew ∼12-fold between 2006 and 2016, although usage remains low overall. This greater proportion of physician-provided care in pregnant women versus the general patient population may reflect a cautionary attitude toward use in pregnancy. This research is expected to inform discussions for people seeking to increase access to acupuncture during pregnancy.
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Affiliation(s)
- Cathaleen Madsen
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Amanda Banaag
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Tracey Pérez Koehlmoos
- Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine; Bethesda, MD
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Betts D, Armour M, Robinson N. U.K. Support Network for Maternity Acupuncture: Survey of Acupuncturists on the Acupuncture (for Conception to) Childbirth Team. Med Acupunct 2019; 31:274-280. [PMID: 31624526 DOI: 10.1089/acu.2019.1386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: In the United Kingdom, a professional acupuncture network, the Acupuncture (for Conception to) Childbirth Team (ACT), provides education and support for practitioners using maternity acupuncture. However, the nature of treatments their members provide has been unknown. The aim of this survey was to explore how ACT members used acupuncture for maternity care within their women's health practices. Materials and Methods: An anonymous self-completion questionnaire, hosted by Survey Monkey, was completed by practitioners from 10 ACT branches. Questions covered demographic information, type and frequency of treatment provided in the previous year, and referral networks. Descriptive statistics were used to report the data. Results: Of 114 survey forms sent, 99 replies were received, a response rate of 86.8%. In addition to fertility and menstrual conditions, the majority of the practitioners (87 [87.8%]) had treated at least 1 pregnant woman each. The most-common maternity situations encountered were: birth preparation (84 [96.5%]); nausea & vomiting (82 [94.2%]); and inducing labor (79 [90.8%]). More than 50% of the practitioners were also treating lower-back and pelvic pain (77 [88.5%]), breech presentations (74 [85.0%]), threatened miscarriages (55 [63.2%]), and headaches/migraines (46 [52.8%]). Only a minority (8 [9.1%]) attended births. A greater number of referrals were received from medical health professionals for pregnancy (54 [65.8%]) than for fertility (16 [19.5%]) or menstrual conditions (8 [9.7%]). Conclusions: ACT practitioners were treating a wide range of maternity conditions. Referrals from Western medical practitioners were more common for maternity acupuncture than for fertility or menstrual health. It may be that this professional network approach would be beneficial in other countries to support practitioners interested in providing maternity acupuncture.
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Affiliation(s)
- Debra Betts
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Nicola Robinson
- Allied Health Sciences, School of Health and Social Care, London South Bank University, London.,Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Moon HY, Kim MR, Hwang DS, Jang JB, Lee J, Shin JS, Ha I, Lee YJ. Safety of acupuncture during pregnancy: a retrospective cohort study in Korea. BJOG 2019; 127:79-86. [PMID: 31483927 DOI: 10.1111/1471-0528.15925] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The present study aimed to analyse the Korean National Health Insurance Service (NHIS) cohort data to examine the safety of acupuncture therapy during pregnancy. DESIGN Retrospective cohort. SETTING Korea. POPULATION OR SAMPLE Women with confirmed pregnancy between 2003 and 2012 from the 2002-13 NHIS sample cohort (n = 20 799). METHODS Women with confirmed pregnancy were identified and divided into acupuncture or control group for comparison of their outcomes. Differences in other factors such as age, and rate of high-risk pregnancy and multiple pregnancy were examined. In the acupuncture group, the most frequent acupuncture diagnosis codes and the timing of treatment were also investigated. MAIN OUTCOME MEASURES Incidence of full-term delivery, preterm delivery and stillbirth by pregnancy duration and among the high-risk and multiple pregnancy groups. RESULTS Of 20 799 pregnant women analysed, 1030 (4.95%) and 19 749 were in the acupuncture and control groups, respectively. Both overall (odds ratio [OR] 1.23; 95% CI 0.98-1.54), and in the stratified analysis of high-risk pregnancies (OR 1.09; 95% CI 0.73-1.64), there was no significant difference between acupuncture and control groups in preterm deliveries. No stillbirths occurred in the acupuncture group and 0.035% of pregnancies resulted in stillbirths in the control group. CONCLUSION No significant difference in delivery outcomes (preterm delivery and stillbirth) was observed between confirmed pregnancies in the acupuncture and control groups. Therefore, in pregnancy, acupuncture therapy may be a safe therapeutic modality for relieving discomfort without an adverse delivery outcome. TWEETABLE ABSTRACT In pregnancy, acupuncture therapy may be a safe therapeutic modality for relieving discomfort without an adverse outcome.
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Affiliation(s)
- H-Y Moon
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - M-R Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | - D-S Hwang
- College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - J-B Jang
- College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - J Lee
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - J-S Shin
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - I Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | - Y J Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
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Mak TC, Chen HY, Cho WC. Acupuncture for overactive bladder in adults: a systematic review and meta-analysis. Acupunct Med 2019; 37:321-331. [PMID: 31433197 DOI: 10.1136/acupmed-2017-011528] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Overactive bladder is prevalent in adults over 40 years of age and its prevalence increases with age. The use of acupuncture in adults with overactive bladder is increasing globally. However, its effectiveness/efficacy and safety have not yet been confirmed. Objective: To determine the effectiveness/efficacy and safety of acupuncture and to identify the pattern of commonly used traditional acupuncture points in the management of overactive bladder in adults. Methods: Ten electronic English and Chinese language databases were systematically searched and two English together with four Chinese journals relevant to acupuncture were manually searched in libraries for randomised controlled trials (RCTs) of acupuncture for overactive bladder in adults from their inception to March 2017. The Cochrane risk of bias tool was used to assess the methodological quality of the RCTs. RevMan v.5.3 software was employed for data analysis. Results: Seven eligible trials involving 695 participants were included. Meta-analysis showed that acupuncture was comparable to drugs (tolterodine tartrate/solifenacin) in the reduction of micturition episodes over 24 hours (pooled standardised mean difference (SMD) 0.36, 95% CI −0.23 to 0.95; I2=83%), increase in voided volume of each micturition episode (pooled SMD −0.15, 95% CI −0.36 to 0.05; I2=0%), and reduction of overactive bladder symptom score (pooled SMD −0.23, 95% CI −1.30 to 0.85; I2=91%). In addition, acupuncture was not significantly different compared with placebo in the reduction of overactive bladder symptom score (pooled SMD −2.36, 95% CI −5.64 to 0.93; I2=97%). No serious adverse events were reported. Conclusions: No significant differences in effectiveness or efficacy were found between acupuncture and drug or between verum and sham acupuncture, respectively. Further high-quality studies are required.
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Affiliation(s)
- Tony C Mak
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Hai Yong Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong
| | - William C Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong
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Signal Transduction Pathways of Acupuncture for Treating Some Nervous System Diseases. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2909632. [PMID: 31379957 PMCID: PMC6657648 DOI: 10.1155/2019/2909632] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/23/2019] [Indexed: 12/14/2022]
Abstract
In this article, we review signal transduction pathways through which acupuncture treats nervous system diseases. We electronically searched the databases, including PubMed, MEDLINE, clinical Key, the Cochrane Library, and the China National Knowledge Infrastructure from their inception to December 2018 using the following MeSH headings and keywords alone or in varied combination: acupuncture, molecular, signal transduction, genetic, cerebral ischemic injury, cerebral hemorrhagic injury, stroke, epilepsy, seizure, depression, Alzheimer's disease, dementia, vascular dementia, and Parkinson's disease. Acupuncture treats nervous system diseases by increasing the brain-derived neurotrophic factor level and involves multiple signal pathways, including p38 MAPKs, Raf/MAPK/ERK 1/2, TLR4/ERK, PI3K/AKT, AC/cAMP/PKA, ASK1-JNK/p38, and downstream CREB, JNK, m-TOR, NF-κB, and Bcl-2/Bax balance. Acupuncture affects synaptic plasticity, causes an increase in neurotrophic factors, and results in neuroprotection, cell proliferation, antiapoptosis, antioxidant activity, anti-inflammation, and maintenance of the blood-brain barrier.
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Xie ZY, Peng ZH, Yao B, Chen L, Mu YY, Cheng J, Li Q, Luo X, Yang PY, Xia YB. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:131. [PMID: 31200701 PMCID: PMC6570865 DOI: 10.1186/s12906-019-2523-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 05/15/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effects of acupuncture on in vitro fertilization (IVF) outcomes remain controversial. And the variation in participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. METHODS We searched digital databases for relevant studies, including Embase, PubMed, Cochrane Library and some Chinese databases up to December 2018, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF. We included studies with intervention groups using needling, and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of eight pre-specified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. RESULTS Twenty-seven studies with 6116 participants were included. The pooled clinical pregnancy rate (CPR) from all of acupuncture groups was significantly greater than that of control groups (RR 1.21, 95% CI: 1.07-1.38), whereas the pooled live birth rate (LBR) was not. Meta-regression subgroup analysis showed a more significant benefit of acupuncture for repeated IVF cycle proportion (number of women with a history of prior unsuccessful IVF attempt divided by number of women included in each trial) ≥ 50% group (CPR: RR 1.60, 95% CI: 1.28-2.00; LBR: RR 1.42, 95% CI: 1.05-1.92), and this covariate explained most of the heterogeneity (CPR and LBR: adjusted R2 = 100 and 87.90%). Similar results were found between CPR and number of acupuncture treatments (CPR: p = 0.002, adjusted R2 = 51.90%), but not LBR. CONCLUSIONS Our analysis finds a benefit of acupuncture for IVF outcomes in women with a history of unsuccessful IVF attempt, and number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings.
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Affiliation(s)
- Zheng-yun Xie
- Nanjing Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-hang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bing Yao
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Li Chen
- Center of Reproductive Medicine, Nanjing Jinling Hospital, Nanjing University School of Medical, Nanjing, China
| | - Yan-yun Mu
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Cheng
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Li
- The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xi Luo
- Changzheng Hospital of the Second Military Medical University, Nanjing branch, Nanjing, China
| | - Peng-yan Yang
- Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing, China
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Vas J, Cintado MC, Aranda-Regules JM, Aguilar I, Rivas Ruiz F. Effect of ear acupuncture on pregnancy-related pain in the lower back and posterior pelvic girdle: A multicenter randomized clinical trial. Acta Obstet Gynecol Scand 2019; 98:1307-1317. [PMID: 31034580 DOI: 10.1111/aogs.13635] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/14/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Ear acupuncture carried out in primary care by trained midwives, with no specialist training in acupuncture, may be effective in alleviating pregnancy-related lower back and/or posterior pelvic girdle pain (LBPGP). The objective of this study was to assess the effect of ear acupuncture associated with standard obstetric care, in the primary-care setting, on LBPGP experienced by pregnant women. MATERIAL AND METHODS This four-group, multicenter, randomized controlled trial was conducted at 18 public primary care centers in three regions in Spain, with the participation of 220 pregnant women at 24-36 weeks of gestation, aged 18 years or more, diagnosed with pregnancy-related LBPGP and who had not previously received ear acupuncture. The trial was conducted from March 2014 to December 2016. Participants were randomly assigned (1:1:1:1) to receive standard obstetric care plus two sessions (over 2 weeks) of verum ear acupuncture, or nonspecific ear acupuncture, or placebo ear acupuncture, or standard obstetric care alone. The primary outcome was change in pain intensity, assessed using a visual analog scale (0-100 mm) from baseline to the end of treatment (T2). Secondary outcomes included change or presence of pain at 3 months (T3) and at 1 year (T4) postpartum, and changes in responses to the Roland-Morris disability questionnaire (RMDQ) and Short Form-12 Health Survey (SF-12) at the end of treatment. RESULTS A total of 55 women were randomized to each group, and 205 completed the study. With respect to baseline values, the reduction in pain intensity among the verum ear acupuncture group vs standard obstetric care was significantly greater, both at T2 (65.8%, 95%CI 56.2-75.3 vs 25.1%, 95%CI 15.3-34.9) and at T3 (93.8%, 95%CI 88.7-99.0 vs 67.9%, 95%CI 55.3-80.5). Moreover, significant changes were found in the verum ear acupuncture group vs standard obstetric care at T2, in reduced RMDQ scores (70.9%, 95%CI 61.8-80.1 vs 21.2%, 95%CI 8.6-33.7) and in increased SF-12 scores on the physical scale (40.5%, 95%CI 31.5-49.4 vs 8.1%, 95%CI 0.8-15.5). CONCLUSIONS After 2 weeks of treatment, ear acupuncture applied by midwives and associated with standard obstetric care significantly reduces lumbar and pelvic pain in pregnant women, improves quality of life and reduces functional disability.
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Affiliation(s)
- Jorge Vas
- Pain Treatment Unit, Doña Mercedes Primary Health Care Center, Dos Hermanas, Spain
| | - María Carmen Cintado
- Hospital Valle Del Guadalhorce, Pizarra, Málaga, Spain.,Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | | | - Inmaculada Aguilar
- Pain Treatment Unit, Doña Mercedes Primary Health Care Center, Dos Hermanas, Spain
| | - Francisco Rivas Ruiz
- Support Research Unit, Costa del Sol Hospital, Marbella, Spain.,Research Network for Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
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Smith CA, Armour M, Shewamene Z, Tan HY, Norman RJ, Johnson NP. Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online 2019; 38:364-379. [PMID: 30658892 DOI: 10.1016/j.rbmo.2018.12.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/05/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
This was a systematic review and meta-analysis to examine the efficacy, effectiveness and safety of acupuncture as an adjunct to embryo transfer compared with controls to improve reproductive outcomes. The primary outcome was clinical pregnancy. Twenty trials and 5130 women were included in the review. The meta-analysis found increased pregnancies (risk ratio [RR] 1.32, 95% confidence interval [CI] 1.07-1.62, 12 trials, 2230 women), live births (RR 1.30, 95% CI 1.00-1.68, 9 trials, 1980 women) and reduced miscarriage (RR 1.43, 95% CI 1.03-1.98, 10 trials, 2042 women) when acupuncture was compared with no adjunctive control. There was significant heterogeneity, but no significant differences between acupuncture and sham controls. Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate. The findings suggest acupuncture may be effective when compared with no adjunctive treatment with increased clinical pregnancies, but is not an efficacious treatment when compared with sham controls, although non-specific effects may be active in both acupuncture and sham controls. Future research examining the effects of acupuncture for women with poorer IVF outcomes is warranted.
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Affiliation(s)
- Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia.
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Zewdneh Shewamene
- NICM Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
| | - Hsiewe Ying Tan
- School of Science and Health, Western Sydney University, Penrith NSW 2751, Australia
| | - Robert J Norman
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia
| | - Neil P Johnson
- Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide SA 5000, Australia; Repromed Auckland, 105 Remuera Road, Auckland 1050, New Zealand
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Safe acupuncture and dry needling during pregnancy: New Zealand physiotherapists’ opinion and practice. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:30-37. [DOI: 10.1016/j.joim.2018.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/13/2018] [Indexed: 02/08/2023]
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Ormsby SM, Dahlen HG, Smith CA. Women’s experiences of having depression during pregnancy and receiving acupuncture treatment—A qualitative study. Women Birth 2018; 31:469-478. [DOI: 10.1016/j.wombi.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/17/2017] [Indexed: 12/21/2022]
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Yoon SH, Lee H, Kwon CY, Jeon D, Kim H, Jo HG, Shin A, Yun Y, Sul JU, Lee GM, Lee JH, Leem J. Development of a survey form through Delphi study about adverse events associated with the miniscalpel needle, for application in prospective observational studies regarding safety of miniscalpel needles: Study protocol. Medicine (Baltimore) 2018; 97:e12736. [PMID: 30313076 PMCID: PMC6203508 DOI: 10.1097/md.0000000000012736] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite the wide usage of miniscalpel-needles (MSNs), information about MSN treatment-related adverse events (AEs) is insufficient. As the definition of AE might vary among physicians, without an exact definition for pain and hemorrhage, it is difficult to provide accurate information about AEs in MSN treatment to physicians, researchers, and patients. The aim of our study is to reach a consensus about the items and definitions of AEs that should be included in the survey form for prospective observational multicenter studies to record MSN treatment-related AEs. We will especially focus on obtaining a consensus on the definition of pain and hemorrhage caused by MSN treatment. METHODS Our study protocol is composed of 6 steps. First, we will identify the aim of the study. Next, we will conduct a systematic review to investigate MSN treatment-related AEs reported till date in Korea. Third, we will conduct a pilot observational prospective single-center study on AEs in MSN treatment. We will develop a standardized case report form to record MSN treatment-related AEs, including the causality, severity, and details of the MSN procedure at every site. Next, based on the pilot study, the Delphi study questionnaire will be developed by a panel composed of 13 physicians. The Delphi study will have 4 rounds with open questions and 4-point Likert-scale closed questions. Through these rounds, we will develop a consensus about the items and definitions of AEs that should be included in the survey form for future multicenter studies about MSN treatment-related AEs. Following this, a face-to-face consensus meeting will be held for a final agreement of survey form. The final survey form will then be approved by the related academic society for dissemination. DISCUSSION The aim of this protocol is to develop a survey form for future prospective observational multicenter studies on MSN treatment-related AEs. This protocol will present the research methodology for developing a survey form, which will improve consistency and reliability between MSN treatment studies. We believe that this protocol can evaluate the safety of MSN treatment. TRIAL REGISTRATION Clinical Research Information Service: KCT0002849.
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Affiliation(s)
- Sang-Hoon Yoon
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | - Haebeom Lee
- Department of Human Informatics of Korean Medicine, Interdisciplinary Programs, Kyung Hee University
- Inae Korean Medicine Clinic, Seongdong-gu
| | - Chan-Young Kwon
- Chung-Yeon Medical Institute
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu
| | | | - Hyunho Kim
- Chung-Yeon Medical Institute
- Dongshin Korean Medicine Hospital, Yangcheon-gu
| | - Hee-Geun Jo
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | | | - Younghee Yun
- Chung-Yeon Medical Institute
- Research and Development Institute, CY Pharma Co, Gangnam-gu
| | - Jae-Uk Sul
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | - Geon-Mok Lee
- Lee-Geonmok Wonli Korean Medicine Hospital, Seocho-gu, Seoul
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine
- Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jungtae Leem
- Chung-Yeon Medical Institute
- Dongshin Korean Medicine Hospital, Yangcheon-gu
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Scherman A, Tolosa JE, McEvoy C. Smoking cessation in pregnancy: a continuing challenge in the United States. Ther Adv Drug Saf 2018; 9:457-474. [PMID: 30364850 PMCID: PMC6199686 DOI: 10.1177/2042098618775366] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
Despite significant population level declines, smoking during pregnancy remains a major public health issue in the United States (US). Approximately 360,000-500,000 smoke-exposed infants are born yearly, and prenatal smoking remains a leading modifiable cause of poor birth outcomes (e.g. birth < 37 gestational weeks, low birth weight, perinatal mortality). Women who smoke during pregnancy are more likely to be younger and from disadvantaged socioeconomic and racial and ethnic groups, with some US geographic regions reporting increased prenatal smoking rates since 2000. Such disparities in maternal prenatal smoking suggests some pregnant women face unique barriers to cessation. This paper reviews the current state and future direction of smoking cessation in pregnancy in the US. We briefly discuss the etiology of smoking addiction among women, the pathophysiology and effects of tobacco smoke exposure on pregnant women and their offspring, and the emerging issue of electronic nicotine delivery systems. Current population-based and individual smoking cessation interventions are reviewed in the context of pregnancy and barriers to cessation among US women. Finally, we consider interventions that are on the horizon and areas in need of further investigation.
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Affiliation(s)
- Ashley Scherman
- Oregon Health & Science University, 3181 SW
Sam Jackson Park Rd, Portland, OR 97239, USA
| | | | - Cindy McEvoy
- Oregon Health & Science University,
Portland, OR, USA
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Martins ES, Tavares TMCL, Lessa PRA, Aquino PDS, Castro RCMB, Pinheiro AKB. Tratamento com acupuntura: avaliação multidimensional da dor lombar em gestantes. Rev Esc Enferm USP 2018; 52:e03323. [DOI: 10.1590/s1980-220x2017040303323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Avaliar os efeitos da acupuntura no tratamento da dor lombar em gestantes no segundo e terceiro trimestre de gravidez. Método Estudo quase-experimental, antes e depois, realizado com gestantes de idade gestacional entre 14 e 37 semanas, que apresentavam queixa de dor lombar. Foram realizadas sessões de acupuntura, com a aplicação de pontos sistêmicos e auriculares. Para avaliação da dor, utilizou-se do questionário McGill, além do instrumento de identificação do perfil sociodemográfico, clínico e obstétrico. Resultados A técnica de acupuntura realizada em até seis sessões, em 56 gestantes com dor lombar referida, proporcionou efeitos positivos favoráveis à saúde das participantes. Segundo a avaliação de mensuração da dor, houve redução estatisticamente significante na dor lombar das gestantes logo a partir da segunda sessão e diminuição gradativa com os avançar do número de sessões. Não houve eventos adversos graves relacionados à acupuntura. Conclusão A acupuntura ofereceu significativos efeitos para a redução ou o alívio da dor nas gestantes. As participantes denotaram satisfação e bem-estar ao sair de cada sessão.
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Carr DJ. In this Issue. Acupunct Med 2018. [DOI: 10.1136/acupmed-2018-011771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- David John Carr
- Department of Obstetrics, Gynecology and Reproductive Sciences, The Robert Larner, M.D. College of Medicine, The University of Vermont, Burlington, Vermont, USA
- Department of Maternal and Fetal Medicine, UCL EGA Institute for Women's Health, University College London, London, UK
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Ormsby SM, Dahlen HG, Ee CC, Keedle H, Smith CA. ‘Acupuncture for antenatal depression: It’s worth giving it a go’ — A qualitative study. Women Birth 2018; 31:166-176. [DOI: 10.1016/j.wombi.2017.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 12/18/2022]
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