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Irnich D, Bäumler P. [Concept for integrative pain treatment of osteoarthritis of the knee based on the evidence for conservative and complementary therapies]. Schmerz 2023; 37:413-425. [PMID: 37505229 DOI: 10.1007/s00482-023-00739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/09/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Osteoarthritis of the knee (gonarthritis) represents a medical challenge. RESEARCH QUESTION What is the evidence with respect to approaches of complementary medicine and their integration into multimodal pain management concepts? MATERIAL AND METHODS Qualitative nonsystematic literature search on the epidemiology and pathophysiology as well as informative clinical trials, meta-analyses and clinical guidelines about conservative treatment including complementary therapy for gonarthritis. RESULTS Osteoarthritis of the knee is a frequent condition with biopsychosocial risks factors for chronification. The German S2k clinical guideline (k = consensus-based, not based on scientific systematic literature searches) published by the Association of the Scientific Medical Societies in Germany (AWMF) in 2017 has not yet been updated. The current guidelines of the American College of Rheumatology (ACR) date from 2020. Both guidelines recommend exercise therapy, weight reduction, short-term analgesics, topical therapy, intra-articular corticoid injections and acupuncture with variable strengths. Furthermore, transcutaneous electrical nerve stimulation (TENS), laser and other electrophysical therapies, shock waves, traction treatment, ergotherapy, comfrey poultices and mudpacks can also be used. Current research supports the benefits of tai chi/qigong and medicinal leaches. CONCLUSION Complementary treatment approaches, such as acupuncture, tai chi/qigong, topical naturopathic self-treatment and leeches (with limitations) can, in addition to behavioral changes, exercise therapy and short-term pharmacological treatment, be important evidence-based components of integrative pain management concepts, e.g. in terms of an interdisciplinary multimodal pain treatment (IMPT). Besides pain reduction and functional improvement they promote the internal control conviction through the possibility of self-treatment and self-exercise.
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Affiliation(s)
- Dominik Irnich
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland.
| | - Petra Bäumler
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland
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2
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Mohamed AA, Zhang X, Jan YK. Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review. J Back Musculoskelet Rehabil 2023; 36:3-19. [PMID: 35848010 DOI: 10.3233/bmr-210242] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown. OBJECTIVE To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions. METHODS 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis. RESULTS The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low. CONCLUSION This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.
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Affiliation(s)
- Ayman A Mohamed
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Basic Sciences, Faculty of Physical Therapy, Beni-Suef University, Beni Suef, Egypt.,Faculty of Physical Therapy, Nahda University, Beni Suef, Egypt
| | - Xueyan Zhang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Shen WC, Jan YK, Liau BY, Lin Q, Wang S, Tai CC, Lung CW. Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e32325. [PMID: 36595746 PMCID: PMC9794267 DOI: 10.1097/md.0000000000032325] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Low back pain (LBP) can significantly affect a person's quality of life. Cupping has been used to treat LBP. However, various cupping methods are typically included in evaluating the efficacy of cupping therapy. Therefore, the objectives of this study were to evaluate the evidence from the literature regarding the effects of dry and wet cupping therapy on LBP in adults. Dry and wet cupping therapy are analyzed categorically in this study. METHODS We searched for randomized clinical trials with cupping in LBP published between 2008 and 2022. In dry or wet cupping clinical studies, pain intensity was assessed using the Visual Analogue Scale and present pain intensity, and the quality of life intensity was measured using the Oswestry disability index. RESULTS The 656 studies were identified, of which 10 studies for 690 patients with LBP were included in the meta-analysis. There was a significant reduction in the pain intensity score with present pain intensity using wet cupping therapy (P < .01). In addition, both cupping therapy groups displayed significant Oswestry disability index score reduction compared to the control group (both P < .01). The patients with LBP have a substantial reduction by using wet cupping but have not shown a considerable decrease by using dry cupping (P = .19). In addition, only wet cupping therapy groups displayed a significantly improved quality of life compared to the control group. The study had a very high heterogeneity (I2 > 50%). It means there is no standardization in the treatment protocol in randomized clinical trials. In the meta-regression, there was statistically significant evidence that the number of treatment times and intercepts were related (P < .01). CONCLUSION The present meta-analysis shows that wet cupping therapy effectively reduces the pain intensity of LBP. Furthermore, both dry wet cupping therapy improved patients with LBP quality of life.
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Affiliation(s)
- Wei-Cheng Shen
- Department of Digital Media Design, Asia University, Taichung, Taiwan
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL
- Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
- Computational Science and Engineering, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Ben-Yi Liau
- Department of Biomedical Engineering, Hungkuang University, Taichung, Taiwan
| | - Quanxin Lin
- Department of Creative Product Design, Asia University, Taichung, Taiwan
| | - Song Wang
- Division of Chinese Medicine, Asia University Hospital, Taichung, Taiwan
| | - Chien-Cheng Tai
- International Ph.D. Program for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL
- Department of Creative Product Design, Asia University, Taichung, Taiwan
- * Correspondence: Chi-Wen Lung, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL (e-mail: )
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Rotter G, Ortiz M, Binting S, Tomzik J, Reese F, Roll S, Brinkhaus B, Teut M. Mindful Walking in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:474-483. [PMID: 35363058 PMCID: PMC9232228 DOI: 10.1089/jicm.2021.0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The objective of this study was to investigate the effectiveness of a mindful walking program (MWP) in patients with chronic low back pain (CLBP). Methods: The trial was a two-armed, randomized, controlled single-center open clinical trial. The study was performed in the Outpatient Clinic for Integrative Medicine of the Charité–Universitätsmedizin Berlin. The participants were adults aged 18–65 years with CLBP (≥3 months) and an average low back pain within the past 7 days measured on a visual analog scale (VAS, 0 = no pain, 100 = worst imaginable pain) of at least 40 mm. The patients received either eight weekly MWP sessions or no intervention (control). The primary outcome was the perceived pain intensity assessed with a VAS (0–100 mm) after 8 weeks. The secondary outcomes included back function assessed by the Hannover Functional Questionnaire Backache (FFbH-R) and perceived stress assessed by the 14-item Cohen's Perceived Stress Scale (PSS-14). The results were obtained by analysis of covariance adjusted for the respective baseline values. Results: In total, 55 patients were randomized (MWP: n = 29, 82.8% female, mean (±standard deviation) age: 52.5 ± 8.6 years, pain: 56.4 ± 14.1 mm; control: n = 26, 84.6% female, 54.8 ± 7.5 years, pain: 55.4 ± 13.1 mm). After 8 weeks, compared with the control conditions, the MWP was not associated with a statistically significant benefit for pain (VAS), adjusted mean − 9.6 [−22.3 to 3.1], p = 0.136, clinical benefits for back function (FFbH-R), adjusted mean 2.2 [−4.2 to 8.6], p = 0.493, or stress (PSS-14), adjusted mean − 1.6 [−4.8 to 1.6], p = 0.326. Conclusion: In conclusion, compared with no intervention, mindful walking did not significantly improve pain, back function, or perceived stress in patients with CLBP. Clinical Trial registration: ClinicalTrials.gov (NCT01893073).
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Juliane Tomzik
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Frauke Reese
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
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Peluso R, Hesson J, Aikens J, Bullock M. An Update on Physical Therapy Adjuncts in Orthopedics. Arthroplast Today 2022; 14:163-169. [PMID: 35330664 PMCID: PMC8938198 DOI: 10.1016/j.artd.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 02/13/2022] [Indexed: 11/24/2022] Open
Abstract
Physical therapy is a necessary part of the recovery process after most orthopedic procedures. Effective treatment, patient satisfaction, and financial reimbursement hinge on the successful implementation of both surgical and nonsurgical interventions. Evidence-based practice and open communication between therapists and orthopedic surgeons continue to form the foundation of patient care. The aim of this paper is to familiarize orthopedic surgeons with the relevant data behind some of the recent advances in rehabilitation adjuncts to better address the needs of our patients. Although each intervention has been found to be relatively safe, high-quality evidence is still sparse. Opportunities exist for improved outcomes with further well-designed studies to investigate the role of these therapy modalities among orthopedic patients.
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Affiliation(s)
- Richard Peluso
- Department of Orthopaedics, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Jacob Hesson
- Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Jordan Aikens
- Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Matthew Bullock
- Department of Orthopaedics, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
- Corresponding author. 1600 Medical Center Drive Suite G500, Huntington, WV 25701, USA. Tel.: +1 724 825 6766.
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Pressure Changes During Layer Cupping in a Skin Model. JOURNAL OF ACUPUNCTURE RESEARCH 2021. [DOI: 10.13045/jar.2020.00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Cupping is widely used in Korean medicine, but there is a risk of bacterial infection if the suction pump (used for inducing negative pressure) and the patients’ skin are not separated. This study aimed to investigate the effect of layer cupping by comparing the pressure changes between layer cupping and conventional cupping.Methods: To evaluate pressure changes the study was designed with 3 types of conditions applied to a skin model: (1) a Dongbang cup with a manual or motor suction pump (conventional cupping); (2) layer cupping with 2 Dongbang cups; and (3) layer cupping with a cup made by 3D printing and a Dongbang cup.Results: When a manual suction pump was used (conventional cupping), the pressure did not decrease steadily, and in 1 section there was an increase in pressure. When layer cupping was used, the pressure in the lower cup (which would be directly applied to the patient’s skin), decreased steadily.Conclusion: In the pressure change graph for layer cupping in this skin model, the pressure in the lower cup (which would be placed on the patient’s skin) steadily decreased, and reached equilibrium. Therefore, the layer cupping model may help to reduce the risks of bacterial infection.
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Evidence Map of Cupping Therapy. J Clin Med 2021; 10:jcm10081750. [PMID: 33920643 PMCID: PMC8073851 DOI: 10.3390/jcm10081750] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Abstract
This study aimed to describe and assess the current evidence in systematic reviews on cupping therapy for various conditions. We searched PubMed, EMBASE, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure, and six Korean databases for systematic reviews of trials on cupping treatments for any condition published prior to March 2021. We used a bubble plot to graphically display the clinical topics, the number of articles, the number of participants in the total population, confidence, and effectiveness. Thirteen systematic reviews that met the inclusion criteria were included in the evidence map, and 16 bubbles were created. The findings from six reviews showed potential benefits of cupping for conditions such as low back pain, ankylosing spondylitis, knee osteoarthritis, neck pain, herpes zoster, migraine, plaque psoriasis, and chronic urticaria. Cupping has been applied in a variety of clinical areas, and systematic reviews in a few of these areas have demonstrated statistically significant benefits. The evidence map provides a visual overview of cupping research volume and findings. Evidence mapping can facilitate the transfer of knowledge from researchers to policymakers and promote research on musculoskeletal pain (such as low back pain, neck pain, and knee osteoarthritis) and skin disease (plaque psoriasis).
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Pontes NS, Barbosa GM, Almeida Silva HJ, Scattone Silva R, Souza CG, Lins CADA, de Souza MC. Effects of dry cupping on pain, function and quality of life in women with knee osteoarthritis: a protocol for a sham-controlled randomised trial. BMJ Open 2020; 10:e039857. [PMID: 33361075 PMCID: PMC7768956 DOI: 10.1136/bmjopen-2020-039857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is the most common cause of pain and disability worldwide. Dry cupping has been used as non-pharmacological approach to control pain and improve physical function. However, there is a lack of high-quality scientific evidence regarding its effects on this condition. This protocol describes a sham-controlled, randomised and simple blind study that aims to evaluate the effect of dry cupping on pain, function and quality of life in women with KOA. METHODS AND ANALYSIS Sixty-two women diagnosed with KOA, based on American College of Rheumatology clinical criteria, and aged from 50 to 75 years, will be randomly distributed into two groups (31 per group): real and sham dry cupping. Both applications will occur with acrylic cups around the knee. The intervention will last 15 min, two times a week over six consecutive weeks, for a total of 12 sessions. Both groups will be assessed at four different times: before the intervention (T0), after 3 weeks intervention (T3), at the end of the protocol (T6) and 4 weeks after the interventions (follow-up: T10). The primary outcome will be pain intensity (Numerical Pain Rating Scale), and secondary outcomes will be knee-related health status (Western Ontario and McMaster Universities Osteoarthritis Index), functional capacity (8-step stair climb test, 40-metre fast-paced walk test and 30-second chair stand test), quality of life (Short-Form 36) and global perceived effect. ETHICS AND DISSEMINATION This protocol was approved by the UFRN/FACISA Ethics Committee (number 3.737.688). The study results will be disseminated to the participants and submitted to a peer-reviewed journal and scientific meetings. TRIAL REGISTRATION NUMBER NCT04331158.
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Affiliation(s)
- Nayara Silva Pontes
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Germanna Medeiros Barbosa
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Hugo Jário Almeida Silva
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Rodrigo Scattone Silva
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Clécio Gabriel Souza
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Caio Alano de Almeida Lins
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
| | - Marcelo Cardoso de Souza
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN/FACISA), Santa Cruz, Brazil
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Abstract
This is a systematic review of the clinical use of cupping therapy. Four domestic databases and 2 foreign databases were searched. Studies that reported the cupping pressure used during cupping therapy were included in this study. The types of cupping, cupping site, pressure, and duration of cupping were the main parameters analyzed. A total of 27 studies, including 24 experimental studies were analyzed. There were 12 constant negative pressure (domestic) studies with a range between 60 mmHg and 600 mmHg. There were 5 maximum negative pressure (domestic) studies and the maximum negative pressure was 620 mmHg. Three studies used a maximum negative pressure of 600 mmHg. There were 4 constant negative pressure (foreign) studies with a range between 75 mmHg to 750 mmHg. There were 3 maximum negative pressure (foreign) studies with a maximum pressure of 420 mmHg. The studies differed with regards to the materials used and the amount of pressure applied. Many studies had limited information and therefore generalizability of the results in this review is limited. Further experimental studies are required to establish the correlation between cupping pressure and treatment effects so that cupping therapy can be standardised.
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Xing M, Yan X, Yang S, Li L, Gong L, Liu H, Xu R, Chen J, Ying L, Zhao Y, An Y, Liu Y, Huang G, Guo F, Yin Q, Wang R, Li B, Li X. Effects of moving cupping therapy for plaque psoriasis: study protocol for a randomized multicenter clinical trial. Trials 2020; 21:229. [PMID: 32102679 PMCID: PMC7045603 DOI: 10.1186/s13063-020-4155-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 02/10/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It is difficult to achieve a balance among safety, efficacy, and cost for the clinical treatment of plaque psoriasis. The current treatment of psoriasis often involves comprehensive therapy such as topical plasters, internal medicine, and phototherapy, which are expensive, and some of the drugs have serious side effects. Moving cupping is a type of cupping that has been used clinically for thousands of years in China. It has the advantage of being inexpensive and easy to perform. Therefore, it is widely used in public hospitals in China for psoriasis treatment. However, a comprehensive evaluation of the current clinical evidence of its efficacy is lacking. In this study, we aimed to evaluate the efficacy and safety of moving cupping to treat plaque psoriasis. METHODS A multicenter, two-arm parallel group, single-blind, randomized, controlled trial will be conducted at six hospitals in China between August 1, 2019 and December 31, 2021. A total of 122 adult patients (aged 18-65 years) who meet the inclusion criteria are being recruited. Participants will receive either basic treatment combined with moving cupping therapy or basic treatment combined with moving cupping placebo. The treatment cycle will be 4 weeks, and the efficacy of treatment will be assessed weekly by the Psoriasis Area and Severity Index during the treatment period and follow-up visits at weeks 6 and 8. The body surface area, physician's global assessment, Dermatology Life Quality Index, patient-reported quality of life, visual analog scale, Traditional Chinese Medication syndrome scoring scale, combined medication, and adverse events will also be recorded and compared to the relative baseline values. DISCUSSION The findings of this trial may lead to better decisions regarding the treatment of plaque psoriasis. If the trial outcomes are considered favorable, this ancient Chinese medical therapy may be worthy of widespread use because of its convenience and low cost. TRIAL REGISTRATION This study was registered on May 15,2019 at ClinicalTrials.gov with the identifier number NCT03952676.
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Affiliation(s)
- Meng Xing
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Xiaoning Yan
- Department of Dermatology, Shaanxi Traditional Chinese Medicine Hospital, Shaanxi, 710003 China
| | - Suqing Yang
- Department of Dermatology, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040 Heilongjiang China
| | - Linge Li
- Department of Dermatology, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang, 050051 China
| | - Liping Gong
- Department of Dermatology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330006 China
| | - Hongxia Liu
- Department of Dermatology, Hospital of Traditional Chinese Medicine, Xinjiang Medicine University, Xinjiang, 830000 China
| | - Rong Xu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Jie Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Luo Ying
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Yiding Zhao
- Department of Dermatology, Shaanxi Traditional Chinese Medicine Hospital, Shaanxi, 710003 China
| | - Yuepeng An
- Department of Dermatology, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040 Heilongjiang China
| | - Yang Liu
- Department of Dermatology, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang, 050051 China
| | - Gang Huang
- Department of Dermatology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330006 China
| | - Fei Guo
- Department of Dermatology, Hospital of Traditional Chinese Medicine, Xinjiang Medicine University, Xinjiang, 830000 China
| | - Qingfeng Yin
- Jiangsu Famous Medical Technology Co. Ltd, Nanjing University of Traditional Chinese Medicine, Nanjing, 210029 China
| | - Ruiping Wang
- Office of Clinical Medical Research Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Department of Dermatology, Shaanxi Traditional Chinese Medicine Hospital, Shaanxi, 710003 China
- Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203 China
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Zhang X, Tian R, Lam WC, Duan Y, Liu F, Zhao C, Wu T, Shang H, Tang X, Lyu A, Bian Z. Standards for reporting interventions in clinical trials of cupping (STRICTOC): extending the CONSORT statement. Chin Med 2020; 15:10. [PMID: 32021646 PMCID: PMC6995163 DOI: 10.1186/s13020-020-0293-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The standards for reporting interventions in clinical trials of cupping (STRICTOC), in the form of a checklist and explanations for users, were designed to improve reporting of cupping trials, particularly the interventions, and thereby facilitating their interpretation and replication. METHODS A group of clinical experts, methodologists, epidemiologists, and editors has developed this STRICTOC checklist through a comprehensive process, including registration of this guideline, literature review, solicitation of comments, consensus meeting, revision, and finalization. RESULTS The STRICTOC checklist includes 6 items and 16 sub-items, namely cupping rationale, details of cupping, treatment regimen, other components of treatment, treatment provider background, and control or comparator interventions. Illustrative examples of each item are also provided. CONCLUSIONS It is intended that the STRICTOC, in conjunction with both the main Consolidated Standards of Reporting Trials (CONSORT) Statement and extension for nonpharmacologic treatment, will raise the reporting quality of clinical trials of cupping.Trial registration We have registered this study on the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network: http://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-clinical-trials/#STRICTOC.
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Affiliation(s)
- Xuan Zhang
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Ran Tian
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Wai Ching Lam
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Yuting Duan
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Fan Liu
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Taixiang Wu
- Chinese Cochrane Centre, West China Hospital, Sichuan University, China Trial Registration Center, Chengdu, Sichuan China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xudong Tang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Aiping Lyu
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Zhaoxiang Bian
- Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
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Cramer H, Klose P, Teut M, Rotter G, Ortiz M, Anheyer D, Linde K, Brinkhaus B. Cupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2020; 21:943-956. [PMID: 31982686 DOI: 10.1016/j.jpain.2020.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/25/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
There is a growing interest in nonpharmacological pain treatment options such as cupping. This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for randomized controlled trials on effects of cupping on pain intensity and disability in patients with chronic pain. Risk of bias was assessed using the Cochrane risk of bias tool. Of the 18 included trials (n =1,172), most were limited by clinical heterogeneity and risk of bias. Meta-analyses found large short-term effects of cupping on pain intensity compared to no treatment (standardized mean difference [SMD] = -1.03; 95% confidence interval [CI] = -1.41, -.65), but no significant effects compared to sham cupping (SDM = -.27; 95% CI = -.58, .05) or other active treatment (SMD = -.24; 95% CI = -.57, .09). For disability, there were medium-sized short-term effects of cupping compared to no treatment (SMD = -.66; 95% CI = -.99, -.34), and compared to other active treatments (SMD = -.52; 95% CI = -1.03, -.0028), but not compared to sham cupping (SMD = -.26; 95% CI = -.57,.05). Adverse events were more frequent among patients treated with cupping compared to no treatment; differences compared to sham cupping or other active treatment were not statistically significant. Cupping might be a treatment option for chronic pain, but the evidence is still limited by the clinical heterogeneity and risk of bias. Perspective: This article presents the results of a meta-analysis aimed to assess the effectiveness and safety of cupping with chronic pain. The results suggest that cupping might be a treatment option; however, the evidence is still limited due to methodical limitations of the included trials. High-quality trials seem warranted.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Klose
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Teut
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Klaus Linde
- Institute of General Practice, Technical University of Munich, TUM Medical School, Munich, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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The Evidence for Common Nonsurgical Modalities in Sports Medicine, Part 2: Cupping and Blood Flow Restriction. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2020; 4:e1900105. [PMID: 32672728 PMCID: PMC7028774 DOI: 10.5435/jaaosglobal-d-19-00105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There are a number of nonsurgical modalities used by athletes in attempts to improve performance or prevent, treat, and rehabilitate musculoskeletal injuries. A concise review of available evidence on common nonsurgical modalities used today is necessary, so that practitioners may appropriately counsel patients.
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A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther 2019; 23:539-546. [DOI: 10.1016/j.jbmt.2019.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 12/13/2022]
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Brinkhaus B, Dobos GJ. The Crisis of Medicine and the Benefits of Complex Pain Therapy Procedures Such As Cupping: More Research Needed. Complement Med Res 2019; 26:145-147. [PMID: 31132767 DOI: 10.1159/000500466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Benno Brinkhaus
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Projektbereich Komplementäre und Integrative Medizin, Charité - Universitätsmedizin Berlin, Berlin, Germany,
| | - Gustav J Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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AlKhadhrawi N, Alshami A. Effects of myofascial trigger point dry cupping on pain and function in patients with plantar heel pain: A randomized controlled trial. J Bodyw Mov Ther 2019; 23:532-538. [PMID: 31563366 DOI: 10.1016/j.jbmt.2019.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of dry cupping on calf muscle myofascial trigger points (MTrPs) on pain and function in patients with plantar heel pain. METHODS Seventy-one patients were randomly divided into an intervention group or control group. Both groups performed stretching exercises for the calf muscle and plantar fascia and ankle dorsiflexion exercises. The intervention group also received dry cupping. The primary outcome measures were visual analogue scale (VAS), pressure pain threshold (PPT), and patient-specific functional scale (PSFS). The secondary outcomes were ankle dorsiflexion range of motion (ROM) and ankle plantar flexor strength. These measurements were performed at baseline, immediately after intervention, and after 2 days. RESULTS Current VAS significantly decreased immediately in the intervention group (p = 0.002), but not in the control group (p ≥ 0.220). Morning VAS decreased significantly in both groups (p < 0.001) after 2 days, but decreased more in the intervention group (p = 0.006). Trigger point PPT significantly improved immediately in the intervention group (p = 0.003), but not in the control group (p = 0.112). Both groups improved significantly in PSFS (p < 0.001) and ankle dorsiflexion ROM (p < 0.001). Plantar flexor strength significantly increased immediately in the intervention group (p < 0.001), but not in the control group (p = 0.556). CONCLUSION Adding dry cupping on calf MTrPs to self-stretching and ankle dorsiflexion exercises for patients with plantar heel pain was superior to only self-stretching and active ankle dorsiflexion exercises in pain, ankle dorsiflexion ROM, and plantar flexor strength.
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Affiliation(s)
- Nazar AlKhadhrawi
- Department of Physical Therapy, Qatif Central Hospital, P.O.Box: 3718 Qudaih, Unit No. 1, Qatif, 32661, Saudi Arabia.
| | - Ali Alshami
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Saudi Arabia.
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Yang Y, Ma LX, Niu TL, Niu X, Yang XZ, Wang JX, Lu Y, Gao LJ, Chen TY, Zhang YJ, Wu YJ, Song Y. Effects of Pulsatile Cupping on Body Pain and Quality of Life in People with Suboptimal Health:A Randomized Controlled Exploratory Trial. Med Acupunct 2018; 30:326-335. [PMID: 30671153 DOI: 10.1089/acu.2018.1313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective: The curative effect of pneumatic pulsatile cupping on pain has been shown. This study was conducted to investigate effects of the pulsating frequency of pneumatic pulsatile cupping, compared with traditional cupping (TC), on body pain and quality of life (QoL) in people with suboptimal health status (SHS). Materials and Methods: Ninety-six participants with SHS were randomized to low-frequency (LF; n = 24) or high-frequency (HF; n = 24) pulsating cupping, traditional cupping (TC; n = 24), or wait-list (WL; n = 24) groups. The LF, HF, and TC groups received 4 sessions of cupping over 2 weeks. Visual analogue scale (VAS; 0-100 mm) pain level and Short-Form-36 (SF-36) QoL measurements were taken before and after the intervention. Results: Both LF and HF reduced pain significantly (VAS: -28.26; 95% confidence interval [CI] -36.18 to -20.34; and -31.88, 95% CI -39.81 to -23.96; both P = 0.000) and improved QoL more than WL (SF-36, Bodily Pain dimension: 1.46, 95% CI: 0.85 to 2.07; and 1.75, 95% CI: 1.14 to 2.36, both P = 0.000). Compared to TC, LF and HF significantly reduced pain (VAS: -7.92, 95% CI: -15.75 to -0.08, P LT = 0.048; and -11.54, 95% CI: -19.38 to -3.70, P HT = 0.004) and improved QoL (SF-36, Bodily Pain dimension: 0.61, 95% CI: 0.01 to 1.21, P LT = 0.046; and 0.90, 95% CI: 0.30 to 1.50, P HT = 0.004). There was no significant difference between LF and HF. Conclusions: This study showed that, in patients with SHS, pulsatile cupping therapy could have a more-favorable effect to relieve body pain, compared to TC. LF and HF pulsation produced equivalent pain relief. Further studies investigating the underlying mechanism are needed. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR-INR-16009345).
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Affiliation(s)
- Yang Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ting-Li Niu
- Affiliated Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Niu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xue-Zhi Yang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jun-Xiang Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Lu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Jiao Gao
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tian-Yu Chen
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yu-Jing Zhang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Jing Wu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Moura CDC, Chaves ÉDCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem 2018; 26:e3094. [PMID: 30462793 PMCID: PMC6248735 DOI: 10.1590/1518-8345.2888.3094] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/17/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. METHOD systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. RESULTS 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). CONCLUSION cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.
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Yang Y, Ma L, Niu T, Wang J, Song Y, Lu Y, Yang X, Niu X, Mohammadi A. Comparative pilot study on the effects of pulsating and static cupping on non-specific neck pain and local skin blood perfusion. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Wang YL, An CM, Song S, Lei FL, Wang Y. Cupping Therapy for Knee Osteoarthritis: A Synthesis of Evidence. Complement Med Res 2018; 25:249-255. [PMID: 30007978 DOI: 10.1159/000488707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND This systematic review was aimed to evaluate the efficacy and safety of cupping therapy for treating patients with knee osteoarthritis (KOA). METHODS The following databases were searched from their inception until June 2017: the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and 4 Chinese databases (Wan Fang Data, Chinese Biomedical Literature Database (CBM), VeiPu, and China National Knowledge Infrastructure (CNKI)). Randomized controlled trials (RCTs) assessing the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of the RCTs was conducted using RevMan 5.3 software. Study selection and data extraction and validation were performed independently by 2 reviewers. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials. RESULTS A total of 5 studies met our inclusion criteria. We analyzed the data from these 5 RCTs involving 535 participants. All included studies were judged to be at high risk for bias. Dry cupping therapy plus Western medicine therapy was more effective than Western therapy alone in reducing the pain scores (mean difference (MD) = -1.79, 95% confidence interval (CI) -2.40 to -1.18; p < 0.01). In addition, the study participants in the dry cupping therapy plus Western medicine therapy group showed significantly greater improvements in the pain (MD = -0.73, 95% CI -1.61 to -0.41; p < 0.01), stiffness (MD = -0.94, 95% CI -1.30 to -0.58; p < 0.01), and physical function (MD = -10.07, 95% CI -13.45 to -6.69; p < 0.01) domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group. Moreover, when compared with Western medicine therapy alone, a meta-analysis of 4 RCTs suggested statistically significant favorable effects of wet cupping therapy plus Western medicine on the Lequesne Algofunctional Index (LAI) (MD = -3.44, 95% CI -4.21 to -2.68; p < 0.01). CONCLUSION There is weak evidence to support the hypothesis that cupping therapy has beneficial effects on reducing the pain intensity and improving the physical function in patients with KOA.
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Soliman Y, Hamed N, Khachemoune A. Cupping in dermatology: a critical review and update. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [DOI: 10.15570/actaapa.2018.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Aboushanab TS, AlSanad S. Cupping Therapy: An Overview from a Modern Medicine Perspective. J Acupunct Meridian Stud 2018; 11:83-87. [DOI: 10.1016/j.jams.2018.02.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 11/25/2017] [Accepted: 02/01/2018] [Indexed: 12/25/2022] Open
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Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Cree M, Lotz F, Roll S, Brinkhaus B. Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial. Altern Ther Health Med 2018; 18:115. [PMID: 29609566 PMCID: PMC5879872 DOI: 10.1186/s12906-018-2187-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 01/13/2023]
Abstract
Background We aimed to investigate the effectiveness of two different forms of dry pulsatile cupping in patients with chronic low back pain (cLBP) compared to medication on demand only in a three-armed randomized trial. Methods 110 cLBP patients were randomized to regular pulsatile cupping with 8 treatments plus paracetamol on demand (n = 37), minimal cupping with 8 treatments plus paracetamol on demand (n = 36) or the control group with paracetamol on demand only (n = 37). Primary outcome was the pain intensity on a visual analogue scale (VAS, 0–100 mm) after 4 weeks, secondary outcome parameter included VAS pain intensity after 12 weeks, back function as measured with the ‘Funktionsfragebogen Hannover Rücken’ (FFbH-R) and health related quality of life questionnaire Short form 36 (SF-36) after 4 and 12 weeks. Results The mean baseline-adjusted VAS after 4 weeks was 34.9 mm (95% CI: 28.7; 41.2) for pulsatile cupping, 40.4 (34.2; 46.7) for minimal cupping and 56.1 (49.8; 62.4) for control group, resulting in statistically significant differences between pulsatile cupping vs. control (21.2 (12.2; 30.1); p < 0.001) and minimal cupping vs. control (15.7 (6.9; 24.4); p = 0.001). After 12 weeks, mean adjusted VAS difference between pulsatile cupping vs. control was 15.1 ((3.1; 27.1); p = 0.014), and between minimal cupping vs. control 11.5 ((− 0.44; 23.4); p = 0.059). Differences of VAS between pulsatile cupping and minimal cupping showed no significant differences after 4 or 12 weeks. Pulsatile cupping was also better (− 5.8 (− 11.5;-0.1); p = 0.045) compared to control for back function after 4 weeks, but not after 12 weeks (− 5.4 (− 11.7;0.8); p = 0.088), pulsatile cupping also showed better improvements on SF-36 physical component scale compared to control at 4 and 12 weeks (− 5.6 (− 9.3;-2.0); p = 0.003; − 6.1 (− 9.9;-2.4); p = 0.002). For back function and quality of life minimal cupping group was not statistically different to control after 4 and 12 weeks. Paracetamol intake did not differ between the groups (cupping vs. control (7.3 (− 0.4;15.0); p = 0.063); minimal cupping vs. control (6.3 (− 2.0;14.5); p = 0.133). Conclusions Both forms of cupping were effective in cLBP without showing significant differences in direct comparison after four weeks, only pulsatile cupping showed effects compared to control after 12 weeks. Trial registration The study was registered at ClinicalTrials.gov (identifier: NCT02090686).
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Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.60508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bridgett R, Klose P, Duffield R, Mydock S, Lauche R. Effects of Cupping Therapy in Amateur and Professional Athletes: Systematic Review of Randomized Controlled Trials. J Altern Complement Med 2017; 24:208-219. [PMID: 29185802 DOI: 10.1089/acm.2017.0191] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Despite the recent re-emergence of the process of cupping by athletes, supporting evidence for its efficacy and safety remains scarce. This systematic review aims to summarize the evidence of clinical trials on cupping for athletes. METHODS SCOPUS, Cochrane Library, PubMed, AMED, and CNKI databases were searched from their inception to December 10, 2016. Randomized controlled trials on cupping therapy with no restriction regarding the technique, or cointerventions, were included, if they measured the effects of cupping compared with any other intervention on health and performance outcomes in professionals, semi-professionals, and leisure athletes. Data extraction and risk of bias assessment using the Cochrane Risk of Bias Tool were conducted independently by two pairs of reviewers. RESULTS Eleven trials with n = 498 participants from China, the United States, Greece, Iran, and the United Arab Emirates were included, reporting effects on different populations, including soccer, football, and handball players, swimmers, gymnasts, and track and field athletes of both amateur and professional nature. Cupping was applied between 1 and 20 times, in daily or weekly intervals, alone or in combination with, for example, acupuncture. Outcomes varied greatly from symptom intensity, recovery measures, functional measures, serum markers, and experimental outcomes. Cupping was reported as beneficial for perceptions of pain and disability, increased range of motion, and reductions in creatine kinase when compared to mostly untreated control groups. The majority of trials had an unclear or high risk of bias. None of the studies reported safety. CONCLUSIONS No explicit recommendation for or against the use of cupping for athletes can be made. More studies are necessary for conclusive judgment on the efficacy and safety of cupping in athletes.
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Affiliation(s)
- Rhianna Bridgett
- 1 Endeavour College of Natural Health , Fortitude Valley, Australia
| | - Petra Klose
- 2 Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen , Essen, Germany
| | - Rob Duffield
- 3 Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney , Sydney, NSW, Australia
| | - Suni Mydock
- 1 Endeavour College of Natural Health , Fortitude Valley, Australia
| | - Romy Lauche
- 4 Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney , Sydney, NSW, Australia
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Al Jaouni SK, El-Fiky EA, Mourad SA, Ibrahim NK, Kaki AM, Rohaiem SM, Qari MH, Tabsh LM, Aljawhari AA. The effect of wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital. Saudi Med J 2017; 38:53-62. [PMID: 28042631 PMCID: PMC5278066 DOI: 10.15537/smj.2017.1.15154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: To assess the effect of wet cupping on health-related quality of life (HRQOL) of adult patients with chronic medical conditions, who were referred to the Cupping Clinic of King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. Methods: A controlled, quasi-experimental study design was carried out among 629 patients referred for cupping from the KAUH Specialty Clinics, during the period from January to December 2014. Patients in the intervention group (309 patients) completed a pre-test included WHO quality of life-BREF, received one wet-cupping session, and filled-out the post-test (1 month later). Patients in the control group (320 patients) completed the pre-test during their enrollment in the study and post-test one month later. Both groups received their ordinary treatment. Descriptive and inferential statistics were performed. Results: Pain was the most common cause for cupping referral. After cupping intervention, the mean scores of most of the HRQOL domains, especially the physical domain, improved significantly among patients in the intervention group. The mean total score of physical HRQOL domain was 61.6 ± 13.6 before cupping, and reached 69.7 ± 12.6 after intervention (paired t-test=11.3, p=0.000). Improvements in HRQOL were noticed for almost all types of pain and other medical conditions. Conclusion: There are promising effects in favor of using wet cupping for improving HRQOL of patients with chronic conditions. Cupping is recommended as a complementary treatment modality for chronic medical conditions, especially pain.
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Affiliation(s)
- Soad K Al Jaouni
- Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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Kordafshari G, Ardakani MRS, Keshavarz M, Esfahani MM, Nazem I, Moghimi M, Zargaran A, Kenari HM. Cupping therapy can improve the quality of life of healthy people in Tehran. J TRADIT CHIN MED 2017. [DOI: 10.1016/s0254-6272(17)30164-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Li JQ, Guo W, Sun ZG, Huang QS, Lee EY, Wang Y, Yao XD. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2017; 28:152-160. [PMID: 28779923 DOI: 10.1016/j.ctcp.2017.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Cupping therapy is widely used in East Asia, the Middle East, or Central and North Europe to manage the symptom of knee osteoarthritis (KOA). The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of cupping therapy for treating patients with KOA. METHODS The following databases were searched from their inception until January 2017: PubMed, Embase, the Cochrane Central Register of Controlled Trials and four Chinese databases [WanFang Med Database, Chinese BioMedical Database, Chinese WeiPu Database, and China National Knowledge Infrastructure (CNKI)]. Only the RCTs related to the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS Seven RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the dry cupping therapy plus the Western medicine therapy group showed significantly greater improvements in the pain [MD = -1.01, 95%CI (-1.61, -0.41), p < 0.01], stiffness [MD = -0.81, 95%CI (-1.14, -0.48), p < 0.01] and physical function [MD = -5.53, 95%CI (-8.58, -2.47), p < 0.01] domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group, with low heterogeneity (Chi2 = 0.00 p = 1.00, I2 = 0% in pain; Chi2 = 0.45 p = 0.50, I2 = 0% in stiffness; Chi2 = 1.09 p = 0.30, I2 = 9% in physical function). However, it failed to do so on a Visual Analog Scale (VAS) [MD = -0.32, 95%CI (-0.70, 0.05), p = 0.09]. In addition, when compared with Western medicine therapy alone, meta-analysis of four RCTs suggested favorable statistically significant effects of wet cupping therapy plus western medicine on response rate [MD = 1.06, 95%CI (1.01, 1.12), p = 0.03; heterogeneity: Chi2 = 1.13, p = 0.77, I2 = 0%] and Lequesne Algofunctional Index (LAI) [MD = -2.74, 95%CI (-3.41, -2.07), p < 0.01; heterogeneity: Chi2 = 2.03, p = 0.57, I2 = 0% ]. CONCLUSION Only weak evidence can support the hypothesis that cupping therapy can effectively improve the treatment efficacy and physical function in patients with KOA.
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Affiliation(s)
- Jin-Quan Li
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Wen Guo
- Department of Endocrinology, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Ze-Gan Sun
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Qing-Song Huang
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - En Yeong Lee
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Ying Wang
- Department of First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210023, China
| | - Xiao-Dong Yao
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China.
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Ge W, Leson C, Vukovic C. Dry cupping for plantar fasciitis: a randomized controlled trial. J Phys Ther Sci 2017; 29:859-862. [PMID: 28603360 PMCID: PMC5462687 DOI: 10.1589/jpts.29.859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/13/2017] [Indexed: 12/19/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of dry cupping on pain
and function of patients with plantar fasciitis. [Subjects and Methods] Twenty-nine
subjects (age 15 to 59 years old, 20 females and 9 males), randomly assigned into the two
groups (dry cupping therapy and electrical stimulation therapy groups), participated in
this study. The research design was a randomized controlled trial (RCT). Treatments were
provided to the subjects twice a week for 4 weeks. Outcome measurements included the
Visual Analogue Pain Scale (VAS) (at rest, first in the morning, and with activities), the
Foot and Ankle Ability Measure (FAAM), the Lower Extremity Functional Scale (LEFS), as
well as the pressure pain threshold. [Results]The data indicated that both dry cupping
therapy and electrical stimulation therapy could reduce pain and increase function
significantly in the population tested, as all the 95% Confidence Intervals (CIs) did not
include 0 except for the pressure pain threshold. There was no significant difference
between the dry cupping therapy and electrical stimulation groups in all the outcome
measurements. [Conclusion] These results support that both dry cupping therapy and
electrical stimulation therapy could reduce pain and increase function in the population
tested.
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Affiliation(s)
- Weiqing Ge
- Department of Physical Therapy, Youngstown State University, USA
| | - Chelsea Leson
- Department of Physical Therapy, Youngstown State University, USA
| | - Corey Vukovic
- Department of Physical Therapy, Youngstown State University, USA
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History of cupping ( Hijama ): a narrative review of literature. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 15:172-181. [DOI: 10.1016/s2095-4964(17)60339-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. J Bodyw Mov Ther 2016; 20:173-178. [DOI: 10.1016/j.jbmt.2015.11.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/06/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
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Mehta P, Dhapte V. Cupping therapy: A prudent remedy for a plethora of medical ailments. J Tradit Complement Med 2015; 5:127-34. [PMID: 26151023 PMCID: PMC4488563 DOI: 10.1016/j.jtcme.2014.11.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/28/2014] [Accepted: 11/21/2014] [Indexed: 12/17/2022] Open
Abstract
Since ancient times, complementary and alternative medicine (CAM; bǔ chōng yǔ tì dài yī xué) have played an important role in human health and welfare. Many therapeutic approaches in healthcare outside the realm of conventional medicine persist in various parts of the world. There is considerable scientific and commercial potential in CAM, which needs to be explored precisely. Cupping therapy ( bá guàn liáo fǎ), one of the CAM, is practiced across the world. This therapy is believed to act by correcting imbalances in the internal bio field, such as by restoring the flow of "Qi (qì)". Cupping involves applying a heated cup to generate a partial vacuum that mobilizes the blood flow and promotes effective healing. This review outlines various tools and techniques of cupping therapy.
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Affiliation(s)
- Piyush Mehta
- Department of Quality Assurance, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
| | - Vividha Dhapte
- Department of Pharmaceutics, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
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Cupping therapy for acute and chronic pain management: a systematic review of randomized clinical trials. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2014. [DOI: 10.1016/j.jtcms.2014.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chen FP, Chang CM, Hwang SJ, Chen YC, Chen FJ. Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of National Health Insurance dataset. Altern Ther Health Med 2014; 14:91. [PMID: 24606767 PMCID: PMC3973832 DOI: 10.1186/1472-6882-14-91] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/24/2014] [Indexed: 01/08/2023]
Abstract
Background Chinese herbal medicine (CHM) has been commonly used for treating osteoarthritis in Asia for centuries. This study aimed to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM used in treating osteoarthritis in Taiwan. Methods A complete database (total 22,520,776 beneficiaries) of traditional Chinese medicine (TCM) outpatient claims offered by the National Health Insurance program in Taiwan for the year 2002 was employed for this research. Patients with osteoarthritis were identified according to the diagnostic code of the International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM for treating osteoarthritis. Results There were 20,059 subjects who visited TCM clinics for osteoarthritis and received a total of 32,050 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (19.2%), followed by 50-59 years (18.8%) and 60-69 years group (18.2%). In addition, female subjects used CHMs for osteoarthritis more frequently than male subjects (female: male = 1.89: l). There was an average of 5.2 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for osteoarthritis. Du-zhong (Eucommia bark) was the most commonly prescribed Chinese single herb, while Du-huo-ji-sheng-tang was the most commonly prescribed Chinese herbal formula for osteoarthritis. According to the association rule, the most commonly prescribed formula was Du-huo-ji-sheng-tang plus Shen-tong-zhu-yu-tang, and the most commonly prescribed triple-drug combination was Du-huo-ji-sheng-tang, Gu-sui-pu (Drynaria fortune (Kunze) J. Sm.), and Xu-Duan (Himalaya teasel). Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating osteoarthritis. Conclusions This study conducted a large scale pharmaco-epidemiology survey of Chinese herbal medicine use in OA patients by analyzing the NHIRD in Taiwan in year 2002.
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Nimrouzi M, Mahbodi A, Jaladat AM, Sadeghfard A, Zarshenas MM. Hijamat in Traditional Persian Medicine. J Evid Based Complementary Altern Med 2014; 19:128-36. [DOI: 10.1177/2156587214524578] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Traditional Persian medicine is based on humoral medical concepts. In the case of abundant blood in the body, tabi’at (body nature) deals with this imbalance by elimination of the morbid substances via some controlling mechanisms. If tabi’at could not react properly, the physician should prescribe an intervention to let the extra blood out. This can be done through phlebotomy, wet cupping, and the use of leech or scarification of the ears. Cupping with scarification may eliminate the morbid substance through the scarified skin, and cupping without scarification evacuates the morbid materials from the compromised organs. Wet cupping in health state is meant to be applied for preventing the blood humor dominance in susceptible individuals. In disease condition, wet cupping is defined as a treatment in which the patients confront the abundance of blood. Wet cupping may have harmful complications in extremely thin or obese patients. Wet cupping should be postponed in patients compromised by diseases especially in the thick phlegm abundance. In Asia, Iranian people, because of religious beliefs, are very interested in cupping therapy. Many unsupervised cupping procedures are performed in Iran, whereas benefits and risks of these procedures are undetermined by providers and clients. In this study, the most important indications and contraindications of wet cupping have been reviewed based on the traditional Persian medicine resources.
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Affiliation(s)
- Majid Nimrouzi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mahbodi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir-Mohammad Jaladat
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Sadeghfard
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M. Zarshenas
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Emerich M, Braeunig M, Clement HW, Lüdtke R, Huber R. Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects. Complement Ther Med 2014; 22:148-58. [PMID: 24559830 DOI: 10.1016/j.ctim.2013.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 12/06/2013] [Accepted: 12/28/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Cupping worldwide has been part of traditional medicine systems and is in the western world used as CAM therapy mainly for treating pain syndromes. The mode of action is up to now unclear. In order to investigate its mechanism we measured in parallel metabolic changes in the tissue under the cupping glass and pressure pain thresholds. DESIGN AND INTERVENTIONS In 12 volunteers (6 healthy subjects and 6 patients with chronic neck pain) a microdialysis system was implanted subcutaneously on both sides (left and right) above the trapezius muscle. After baseline measures cupping was performed at one randomly selected side (left or right), the other side served as control. Every 20 min during baseline measures and for 280 min after cupping, microdialysis probes for detection of lactate, pyruvate, glucose and glycerin were taken. In addition, pain thresholds were measured before and after cupping with algometry. RESULTS Cupping resulted in a strong increase of lactate (beginning 160 min after cupping until the end of the measurements) and the lactate/pyruvate ratio, indicating an anaerobe metabolism in the surrounding tissue. Baseline pain thresholds were non-significantly lower in neck pain patients compared to healthy controls and slightly increased immediately after cupping (p<0.05 compared to baseline close to the area of cupping in healthy subjects and on the foot in neck pain patients). After 280 min no more significant changes of pain thresholds were detected. CONCLUSIONS Cupping induces >280 min lasting anaerobe metabolism in the subcutaneous tissue and increases immediate pressure pain thresholds in some areas.
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Affiliation(s)
- M Emerich
- Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany
| | - M Braeunig
- Department Psychosomatic Medicine, University Medical Center, 79106 Freiburg, Germany
| | - H W Clement
- Department Child and Youth Psychiatry, University Medical Center, 79106 Freiburg, Germany
| | - R Lüdtke
- Karl und Veronica Carstens-Foundation, 45276 Essen, Germany
| | - R Huber
- Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany.
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Affiliation(s)
- Arya Nielsen
- Department of Integrative Medicine, Beth Israel Medical Center, New York, New York, USA
| | - Benjamin Kligler
- Department of Integrative Medicine, Beth Israel Medical Center, New York, New York, USA
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, University of Duisburg-Essen, Essen, Germany
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