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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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2
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Ho L, Kwong MH, Li ASC, Nilsen P, Ho FF, Zhong CCW, Wong CHL, Lin WL, Chung VCH. Developing implementation strategies for promoting integrative oncology outpatient service delivery and utilisation: a qualitative study in Hong Kong. Front Public Health 2024; 12:1414297. [PMID: 39281081 PMCID: PMC11392861 DOI: 10.3389/fpubh.2024.1414297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/20/2024] [Indexed: 09/18/2024] Open
Abstract
Purpose Current evidence supports the use of integrative oncology (IO) interventions in cancer supportive care. The demand for outpatient IO services in Hong Kong is expected to soar following the surge in cancer incidence due to population ageing. This study identified the factors influencing the delivery and utilisation of outpatient IO from local stakeholders' perspectives and developed corresponding implementation strategies. Methods This study involved two sequential stages. First, with individual semi-structured interviews guided by the Theoretical Domains Framework (TDF), we explored stakeholders' views on the barriers to and facilitators for implementing IO. Second, guided by a TDF-based qualitative data analysis of interview transcripts, we performed intervention mapping to develop Behaviour Change Wheel-based implementation strategies that may overcome the barriers and strengthen the facilitators. Results We interviewed 31 stakeholders, including traditional Chinese medicine (TCM) practitioners (n = 8), biomedically-trained doctors (n = 7), nurses (n = 6), administrators (n = 4), caregivers (n = 4), and pharmacists (n = 2). The key local factors influencing outpatient IO are (1) lacking nursing and administrative workforce supporting IO service delivery, (2) lacking awareness of IO services among healthcare professionals, administrators, patients, and caregivers, and (3) lacking knowledge among healthcare professionals of herb-drug interaction and herbal toxicities. Conclusion We recommended a multi-faceted implementation strategies package that included arranging funding to train, recruit, and retain nursing and administrative staff, devolving resources into promoting interprofessional collaborations and evidence on IO effectiveness and safety, integrating evidence on herb-drug interactions and herbal toxicities into automated electronic health record systems monitored by pharmacists with dual qualifications in TCM and conventional pharmacy.
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Affiliation(s)
- Leonard Ho
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ming Hong Kwong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Angus S C Li
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Per Nilsen
- Department of Medicine, Health and Caring Sciences, Linköping University, Linköping, Sweden
| | - Fai Fai Ho
- School of Chinese Medicine, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Claire C W Zhong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Charlene H L Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wai Ling Lin
- School of Chinese Medicine, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Vincent C H Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Rajendran V. Practice recommendations for physiotherapists in Canada managing adverse events associated with acupuncture. Acupunct Med 2024; 42:155-165. [PMID: 38706181 DOI: 10.1177/09645284241248468] [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] [Indexed: 05/07/2024]
Abstract
In Canada, acupuncture is a regulated medical practice that involves inserting thin needles at specific points on the body to alleviate pain and other health conditions. Acupuncture is a controlled act in physiotherapy practice. Therefore, physiotherapists who incorporate acupuncture into their practice should have the necessary education and roster this controlled act with the regulatory college in their province. Although acupuncture can be helpful, potential complications can arise, ranging from minor bruising to life-threatening conditions such as pneumothorax and cardiac tamponade. This article provides information on the potential adverse effects of acupuncture and provides recommendations for physiotherapists regarding prevention and management of any incidents that may arise during treatment.
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Affiliation(s)
- Venkadesan Rajendran
- Acute Stroke and Internal Medicine Unit, Health Sciences North, Sudbury, ON, Canada
- Northern Ontario School of Medicine University, Sudbury, ON, Canada
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4
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Xiang SR, Ma Q, Dong J, Ren YF, Lin JZ, Zheng C, Xiao P, You FM. Contrasting Effects of Music Therapy and Aromatherapy on Perioperative Anxiety: A Systematic Review and Meta-Analysis. Complement Med Res 2024; 31:278-291. [PMID: 38560980 DOI: 10.1159/000538425] [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: 05/16/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Music therapy and aromatherapy have been demonstrated effective for perioperative anxiety. However, the available studies have indicated discordant results about which adjunct treatment is better for perioperative anxiety. Therefore, we conducted this meta-analysis to explore the contrasting effects between them. METHODS Six electronic databases were searched for clinical trials evaluating the efficacy of music therapy compared with aromatherapy in alleviating perioperative anxiety. The primary outcome was the postintervention anxiety level. Secondary outcomes included differences in blood pressure and heart rate before and after the intervention as well as pain scores at intraoperative and postoperative time points. The study protocol was registered on PROSPERO (CRD42021249737). RESULTS Twelve studies (894 patients) were included. The anxiety level showed no statistically significant difference (SMD, 0.28; 95% CI: -0.12, 0.68; p = 0.17). The analysis of blood pressure and heart rate also did not identify statistically significant differences. Notably, the pain scores at the intraoperative time point suggested that aromatherapy was superior to music therapy (WMD, 0.29 cm; 95% CI: 0.05, 0.52; p = 0.02), while those at 4 h after surgery indicated the opposite results (WMD, -0.48 cm; 95% CI: -0.60, -0.36; p < 0.001). CONCLUSION Low-to-moderate quality evidence suggests that music therapy and aromatherapy have similar potential to relieve perioperative anxiety. The potential data indicate that the two therapies have different benefits in intervention duration and age distribution. More direct high-quality comparisons are encouraged in the future to verify this point. Einleitung Musik- und Aromatherapie haben sich bei perioperativen Angstzuständen als wirksam erwiesen. Die verfügbaren Studien zeigten jedoch widersprüchliche Ergebnisse zur Frage, welche adjuvante Therapie bei perioperativen Angstzuständen besser ist. Daher führten wir die vorliegende Metaanalyse durch, um die unterschiedlichen Effekte der beiden Therapien zu untersuchen. Methoden Sechs (6) elektronische Datenbanken wurden nach klinischen Studien zur Wirksamkeit von Musiktherapie im Vergleich zur Aromatherapie bei der Linderung perioperativer Angstzustände durchsucht. Primäres Zielkriterium war das Angstniveau nach der Intervention. Die sekundären Zielkriterien umfassten die Unterschiede bei Blutdruck und Herzfrequenz vor und nach der Intervention sowie die Schmerz-Scores zu intra- und postoperativen Zeitpunkten. Das Studienprotokoll wurde auf PROSPERO (CRD42021249737) registriert. Ergebnisse Zwölf (12) Studien (894 Patienten) wurden eingeschlossen. Das Angstniveau zeigte keinen statistisch signifikanten Unterschied (SMD, 0,28; 95%-KI: −0,12, 0,68, p = 0,17) und auch die Analyse von Blutdruck und Herzfrequenz ergab keine statistisch signifikanten Unterschiede. Insbesondere die Schmerz-Scores zum intraoperativen Zeitpunkt sprachen dafür, dass die Aromatherapie gegenüber der Musiktherapie überlegen war (WMD, 0,29 cm; 95%-KI: 0,05, 0,52; p = 0,02), während die Werte 4 Stunden nach der Operation gegenteilige Ergebnisse zeigten (WMD, −0,48 cm; 95%-KI: −0,60, −0,36, p < 0,001). Schlussfolgerung Evidenzen von geringer bis mässiger Qualität deuten darauf hin, dass Musik- und Aromatherapie ein vergleichbares Potenzial bei der Linderung perioperativer Ängste besitzen. Die potenziellen Daten zeigen, dass die beiden Therapien unterschiedliche Vorteile hinsichtlich Interventionsdauer und Altersverteilung haben. Künftig sollten mehr direkte und qualitativ hochwertige Vergleiche durchgeführt werden, um diesen Aspekt zu überprüfen.
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Affiliation(s)
- Si-Rui Xiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiong Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Dong
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi-Feng Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun-Zhi Lin
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chuan Zheng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Xiao
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng-Ming You
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Malfait I, Gijsbers S, Smeets A, Hanssen B, Pick A, Peers K, Schillebeeckx F. Safety of dry needling in stroke patients: a scoping review. Eur J Phys Rehabil Med 2024; 60:225-232. [PMID: 38502557 PMCID: PMC11114159 DOI: 10.23736/s1973-9087.24.08224-8] [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: 09/06/2023] [Revised: 12/20/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Spasticity is a common problem in stroke patients. Treatments of spasticity often have side effects or are insufficiently effective. Dry needling (DN) has been proposed as a potential additional option to consider in the multimodal treatment of post-stroke spasticity, although questions about its safety remain. The goal of this study is to assess the safety of DN in stroke patients. EVIDENCE ACQUISITION A systematic search in Medline, Embase, The Cochrane Library, Web of Science, CIHNAL and PEDro was conducted in June 2023. Two reviewers independently screened abstracts according to the eligibility criteria. EVIDENCE SYNTHESIS Twenty-five articles were included in this review. Only six studies reported adverse events, all of which were considered minor. None of the included studies reported any serious adverse events. In four of the included studies anticoagulants were regarded as contra-indicative for DN. Anticoagulants were not mentioned in the other included studies. CONCLUSIONS There is a paucity of literature concerning the safety of DN in stroke patients. This review is the first to investigate the safety of DN in stroke patients and based on the results there is insufficient evidence regarding the safety of DN in stroke patients. CLINICAL REHABILITATION IMPACT Although DN could be a promising treatment in post-stroke spasticity, further research is indicated to investigate its mechanism of action and its effect on outcome. However, before conducting large clinical trials to assess outcome parameters, the safety of DN in stroke patients must be further investigated.
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Affiliation(s)
- Iris Malfait
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Sabien Gijsbers
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Annemie Smeets
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, KU Leuven, Leuven, Belgium
| | - Britta Hanssen
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, KU Leuven, Leuven, Belgium
| | - Anton Pick
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Koen Peers
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium
| | - Fabienne Schillebeeckx
- Unit of Physical Medicine and Rehabilitation, Department of Development and Regeneration, University Hospital of Leuven, Leuven, Belgium -
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6
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Bontinck JS, Lyphout C, Malfait TL. Pneumothorax as a complication of dry needling technique. ERJ Open Res 2024; 10:00156-2024. [PMID: 38623313 PMCID: PMC11017104 DOI: 10.1183/23120541.00156-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/17/2024] Open
Abstract
Post-dry needling pneumothorax is not extremely rare. Patients and referring doctors should be aware of this. Informed consent should mention pneumothorax as a considerable risk of dry needling procedures in the neck, shoulder or chest region. https://bit.ly/49YYNR8.
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Wang L, Zhang P, Zhang X, Wang W, Huang F. Letter to the Editor: Diagnosis of Purulent Spondylitis Was Confirmed After Acupuncture. Surg Infect (Larchmt) 2024; 25:175-176. [PMID: 38330427 DOI: 10.1089/sur.2023.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
- Lei Wang
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Pengxin Zhang
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xin Zhang
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Weiyang Wang
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Fuli Huang
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Jeon H, Lee S, Kim SA, Lee U, Lee S. Effect of Korean Medicine Treatment on Patients with Postherpetic Neuralgia: A Retrospective Chart Review. Healthcare (Basel) 2024; 12:256. [PMID: 38275536 PMCID: PMC10815056 DOI: 10.3390/healthcare12020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/05/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Evidence regarding Korean medicine treatment (KMT) for neuropathic pain is lacking. We aimed to identify the effects of integrative KMT in patients with postherpetic neuralgia (PHN). We retrospectively analyzed the electronic medical records of patients with PHN who received KMT at Kyung Hee University Korean Medicine Hospital between August 2021 and July 2022. We evaluated the effects of KMT-comprising acupuncture, pharmacopuncture, herbal medicine, cupping, and moxibustion-on pain intensity using the numerical rating scale (NRS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale-Anxiety (HADS-A), Hospital Anxiety and Depression Scale-Depression (HADS-D), Daily Sleep Interference Scale (DSIS), Fatigue Severity Scale (FSS), and EuroQol-5D. Among 53 patients with PHN, 13 were included. The NRS score for worst pain over 1 week decreased from 6.54 ± 0.64 at baseline to 3.85 ± 0.63 at 8 weeks (41% reduction, p < 0.01), while that for average pain over 1 week decreased from 4.93 ± 0.67 at baseline to 3.08 ± 0.46 at 8 weeks (37% reduction, p < 0.01). From baseline to 8 weeks, there were significant reductions in the SF-MPQ, HADS-A, FSS, and EuroQol-5D scores. No adverse events were reported after KMT. Therefore, KMT may be an effective treatment option for patients with PHN.
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Affiliation(s)
- Hyoseung Jeon
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea (S.L.)
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Suji Lee
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea (S.L.)
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Sung-A Kim
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea (S.L.)
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Unhyung Lee
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea (S.L.)
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul 02453, Republic of Korea
| | - Seunghoon Lee
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea (S.L.)
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul 02453, Republic of Korea
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Magee B, Smith KR. Infertility clinics and acupuncture: a qualitative web-based study. J Assist Reprod Genet 2023; 40:2367-2373. [PMID: 37526808 PMCID: PMC10504127 DOI: 10.1007/s10815-023-02898-6] [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: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
The increasing demand for fertility treatments has led to the rise of private clinics offering complementary and alternative medicine (CAM) treatments. The most frequently offered CAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility. This study evaluates the scope of information provided by CAM fertility clinics in the UK. A content analysis was conducted on 200 websites of CAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on the efficacy, risks and success rates of acupuncture for infertility. This has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment.
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Affiliation(s)
- Bethany Magee
- Division of Health Science, School of Applied Sciences, Abertay University, Dundee, DD1 1HG, UK
| | - Kevin Richard Smith
- Division of Health Science, School of Applied Sciences, Abertay University, Dundee, DD1 1HG, UK.
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Garrett B, Caulfield T, Musoke R, Murdoch B, Tang X, Lam JST. Demographic and psychometric predictors associated with engagement in risk-associated alternative healthcare behaviours. PLoS One 2023; 18:e0291016. [PMID: 37733748 PMCID: PMC10513319 DOI: 10.1371/journal.pone.0291016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
This paper builds on prior work exploring the use of risk-associated alternative healthcare (RAAH) in Canada. RAAH uptake was surveyed to explore the characteristics of adult RAAH users and the value of established psychometric instruments previously used in alternative healthcare studies in predicting RAAH behaviours: the Control Beliefs Inventory (CBI), the Reward Responsiveness Behavioural Activation System (RBAS) scale, the Positive Attitudes to Science (PAS) scale, the Satisfaction with Orthodox Medicine (SOM) scale, and the brief version of the Susceptibility to Persuasion-II (StP-II-B) scale. Findings suggest RAAH is influenced by gender, age, income, education, employment, chronic illness status, and ethnicity. Engagement in some form of RAAH was common (around 40%) and the most common types of RAAH use reported were physical manipulation and herbal/nutritional supplement use. Other higher-risk AH activities (such as use of toxins and physically invasive procedures) were also reported by about 5% of respondents. The StP-II-B and PAS instruments were predictive of the likelihood of engagement in RAAH behaviours, as illustrated by higher risk tolerance, desire for novelty, positive attitude to advertising and social influence, and positive beliefs about science. The CBI, RBAS, and SOM instruments were not predictive overall. However, the CBI and SOM instruments were predictive of engagement with physical manipulative RAAH activities, while the RBAS was predictive of herbal/nutritional RAAH engagement. These findings can help inform health professionals' understanding of public health-seeking behaviours with respect to risk.
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Affiliation(s)
- Bernie Garrett
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy Caulfield
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Musoke
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Blake Murdoch
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Xuyan Tang
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joyce S. T. Lam
- Pacific Parkinson’s Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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Shahdad A, Fadaee Aghdam N, Goli S, Binesh E, Nourian J, Khajeh M. Effect of transcutaneous electrical nerve stimulation of acupoints on respiratory outcomes of COVID-19 patients with moderate pulmonary involvement: A parallel randomized clinical trial. Health Sci Rep 2023; 6:e1427. [PMID: 37492271 PMCID: PMC10363792 DOI: 10.1002/hsr2.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023] Open
Abstract
Background and aims Experiencing respiratory symptoms, especially dyspnea and decreased oxygen saturation (SpO2) level in patients with coronavirus disease 2019 (COVID-19) is associated with increased mortality. The present study was conducted to investigate the effect of transcutaneous electrical nerve stimulation of acupoints (Acu-TENS) on the respiratory outcomes of COVID-19 patients with moderate pulmonary involvement. Methods In these three-blind parallel randomized clinical trials, 84 patients with COVID-19 admitted to a referral hospital were selected by the convenience sampling method. Participants were randomly assigned to Acu-TENS (n = 42) and control (n = 42) groups. The Acu-TENS group received Acu-TENS over the EX-B1 (Dingchuan) acupuncture point for 45 min for four consecutive days, while participants in the control group received no intervention. Participants' respiratory outcomes, including oxygen saturation, vital signs, and the severity of dyspnea, were evaluated before and after each intervention on four consecutive days. In addition, the need for mechanical ventilation on Days 4, 8, and 12 and the disease's outcome (death or survival) were recorded in SPSS software version 16, and finally, data were analyzed using an independent samples t-test. Results SpO2, the number of patients without the need for mechanical ventilation, and patient survival after the intervention were significantly higher in the Acu-TENS group compared with the control group (<0.001). However, respiratory rate, heart rate, and the severity of dyspnea after the intervention were not significantly different between the two groups (p > 0.05). Conclusion The use of Acu-TENS could improve SpO2 as a respiratory outcome of patients with COVID-19 with moderate pulmonary involvement and it can be used as a therapeutic intervention.
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Affiliation(s)
- Amin Shahdad
- Student Research Committee, Nursing and Midwifery SchoolShahroud University of Medical SciencesShahroudIran
| | - Nasrin Fadaee Aghdam
- Department of Nursing, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| | - Shahrbanoo Goli
- Department of Epidemiology, School of Public HealthShahroud University of Medical SciencesShahroudIran
| | - Ehsan Binesh
- Clinical Research Development Unit, Imam Hossein HospitalShahroud University of Medical SciencesShahroudIran
| | - Javad Nourian
- Clinical Research Development Unit, Imam Hossein HospitalShahroud University of Medical SciencesShahroudIran
| | - Mahboobeh Khajeh
- Department of Nursing, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
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Xu M, Yang C, Nian T, Tian C, Zhou L, Wu Y, Li Y, Deng X, Li X, Yang K. Adverse effects associated with acupuncture therapies: An evidence mapping from 535 systematic reviews. Chin Med 2023; 18:38. [PMID: 37038228 PMCID: PMC10088157 DOI: 10.1186/s13020-023-00743-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/01/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Considering that physicians and patients widely use acupuncture, it is necessary to explore its adverse effects during treatment. Herein, an evidence map was generated based on published studies to identify acupuncture-induced adverse effects and assess their severity, with the overarching goal of providing references for safe and effective implementation. METHODS A comprehensive literature search was performed in four public databases (PubMed, Embase, Web of science, and the Cochrane Library) to identify relevant studies published up to 15th June 2022. In addition, relevant studies were explored in the Epistemonikos database and reference lists were retrieved as a supplement. A MeaSurement Tool to Assess systematic Reviews, Version 2 (AMSTAR-2) quality assessment tool was applied to determine the methodological quality of included systematic reviews (SRs) and/or meta-analysis (MAs), whereas Microsoft Excel 2019 tool was used for data extraction and coding. Heatmaps were generated to display disease type, countries of origin for the first authors, and the sample sizes of original studies. Moreover, bubble charts comprehensively presented intervention categories, adverse reaction types, and evidence levels. RESULTS A total of 535 SRs involving 33 adverse reactions were included. Among them, 22 studies were rated as high quality, 28 as moderate, 106 as low, and the rest were of critically-low quality. Numerous adverse effects were described in the studies, including syncope (86 SRs), organ or tissue injury (233 SRs), systemic reactions (113 SRs), infection (19 SRs), and other adverse events (373 SRs). Importantly, these adverse reactions were mainly associated with 19 acupuncture techniques, including electroacupuncture (n = 67), manual acupuncture (n = 47) and acupoint catgut embedding (n = 41). Furthermore, the 535 SRs described 23 diseases, among which symptoms, signs or clinical findings (83 SRs), mental, behavioral or neurodevelopmental disorders (67 SRs), and diseases of the nervous system (66 SRs) had the highest incidence. CONCLUSION This evidence mapping explores the adverse effects of acupuncture, showing that there are multiple types of adverse reactions to acupuncture, with milder symptoms. The methodological assessment revealed that most of the included studies were of low- or critically low-quality. Therefore, there is a need for future randomized controlled trials and SRs to comprehensively analyze acupuncture-related adverse events in order to provide reliable and credible evidence.
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Affiliation(s)
- Meng Xu
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Chaoqun Yang
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Tao Nian
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Chen Tian
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
| | - Liying Zhou
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Yanan Wu
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Yanfei Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xinxin Deng
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiuxia Li
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| | - Kehu Yang
- Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
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13
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Chamo M, Kull C, Khani H. [Acupuncture with an Aftermath]. PRAXIS 2023; 112:239-241. [PMID: 36919318 DOI: 10.1024/1661-8157/a004023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Acupuncture with an Aftermath Abstract. A 70-year-old female patient presents with a 6-hour history of left sided thoracic pain and acutely exacerbated cough in the emergency department. Earlier in the morning she had undergone acupuncture therapy. The clinical examination revealed tachypnea with diminished breath sounds on the left side and hyperresonance to percussion. The laboratory findings revealed elevated D-Dimer and NT-proBNP. Due to the clinical presentation and the laboratory results, a CT scan of the chest was made, which confirmed the suspected left-side pneumothorax. The chest radiograph showed complete resolution of the pneumothorax within two days after chest tube placement.
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Affiliation(s)
- Michael Chamo
- Medizinische Universitätsklinik, Kantonsspital Baselland, Laufen, Schweiz
| | - Christof Kull
- Klinik für Gefäss- und Thoraxchirurgie, Kantonsspital Baselland, Liestal, Schweiz
| | - Hamid Khani
- Medizinische Universitätsklinik, Kantonsspital Baselland, Laufen, Schweiz
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14
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Ochi JW. Pneumothorax After Acupuncture: Medicolegal Consequences and Prevention. Med Acupunct 2022. [DOI: 10.1089/acu.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- James W. Ochi
- Division of Otolaryngology, Sharp Rees-Stealy Medical Group, San Diego, CA, USA
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15
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Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis. Pain Res Manag 2022. [DOI: 10.1155/2022/2551591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25,
) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46,
), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07,
) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61,
). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85,
), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36,
). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complications
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16
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Hong J, Sun J, Zhang L, Tan Z, Chen Y, Chen Q, Zhu Y, Liu Y, Zhu L, Zeng L, Kong Y, Li B, Liu L. Neurological mechanism and treatment effects prediction of acupuncture on migraine without aura: Study protocol for a randomized controlled trial. Front Neurol 2022; 13:981752. [PMID: 36158972 PMCID: PMC9492888 DOI: 10.3389/fneur.2022.981752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAcupuncture is an effective treatment in migraine without aura (MWoA), but the neurological mechanism has not been investigated using multimodal magnetic resonance imaging (MRI). This trial will combine functional MRI, structural MRI, and diffusion tensor imaging to explore the potential neural mechanism of acupuncture on MWoA, and will use machine learning approach to predict acupuncture treatment effects.MethodsIn this multimodal neuroimaging randomized controlled trial, a total of 60 MWoA participants will be randomly allocated to two groups: the real acupuncture treatment group and the sham acupuncture control group. This trial will include a 4-week baseline phase, a 4-week treatment phase, and a 12-week follow-up phase. Participants will undergo 12 acupuncture or sham acupuncture sessions during the treatment phase. The Headache Diary, Migraine-Specific Quality of Life Questionnaire, Headache Impact Test, Beck Depression Inventory-II, and Beck Anxiety Inventory will be utilized to evaluate the clinical efficacy. Multimodal MRI scans will be employed to investigate the mechanism of acupuncture at baseline, at the end of treatment, and after follow-up. Multimodal MRI data will be used to predict acupuncture treatment effects using machine learning technology.DiscussionThis study hypothesized that acupuncture therapy may treat MWoA by restoring the neuropathological alterations in brain activity. Our finding should provide valuable scientific proof for the effects of acupuncture and demonstrate the usefulness of acupuncture in the treatment of MWoA. Moreover, acupuncture response prediction might decrease healthcare expenses and time lags for patients.Trial registration number[ChiCTR2100044251].
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Affiliation(s)
- Jiahui Hong
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Jingqing Sun
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Liping Zhang
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Ying Chen
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Qiuyi Chen
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Yupu Zhu
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuhan Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Liying Zhu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Lin Zeng
- Peking University Third Hospital, Research Centre of Clinical Epidemiology, Beijing, China
| | - Yazhuo Kong
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Lu Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
- *Correspondence: Lu Liu
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An Observational Study Using Ultrasound to Assess Allowable Needle Insertion Range of Acupoint CV12. Healthcare (Basel) 2022; 10:healthcare10091707. [PMID: 36141319 PMCID: PMC9498562 DOI: 10.3390/healthcare10091707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Abdominal organ injuries are a rarely reported complication when deep acupuncture needling is applied to the abdomen. In order to ascertain the allowable needle insertion range (ANIR) of the abdomen region, we selected acupoint CV12, which is commonly used for treating gastric disease, and ANIR was measured with an ultrasound device. Method: Eighty-five healthy volunteers were recruited, of which 83 cases of ultrasound images were obtained. To investigate the prediction factor of ANIR, we also measured several anthropometric factors. Results: The average ANIR was 25.3 ± 10.2; generally, the ANIRs of females were thicker than those of males; and the liver was observed in 62.7% subjects’ ultrasound images. The non-observed group showed thicker ANIR and higher BMI than the liver-observed group. Conclusion: There are reliable variables that make it possible to predict the ANIR. It is advised to refer to anthropometric factors in needling acupoint CV12 to avoid complications with the acupuncture treatment. However, individual differences are not negligible when applying deep needling. Thus, if the risk is not judged before or during the procedure, practitioners could consider the patient’s ANIR on CV12 when applying acupuncture by examining the individual anatomical structures using ultrasound and considering internal organ positions to prevent adverse events due to acupuncture.
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18
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Lee SS. Acupuncture-induced hemopneumothorax: a case report. Acupunct Med 2022; 40:559-560. [PMID: 35983779 DOI: 10.1177/09645284221117843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Seok Soo Lee
- Department of Thoracic and Cardiovascular Surgery, College of Medicine and Yeungnam University Medical Center, Yeungnam University, Daegu, Republic of Korea
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19
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Su K, Hao W, Lv Z, Wu M, Li J, Hu Y, Zhang Z, Gao J, Feng X. Electroacupuncture of Baihui and Shenting ameliorates cognitive deficits via Pten/Akt pathway in a rat cerebral ischemia injury model. Front Neurol 2022; 13:855362. [PMID: 36062010 PMCID: PMC9437581 DOI: 10.3389/fneur.2022.855362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Cerebral ischemic stroke is a huge threat to the health and life of many people. Electroacupuncture (EA) at Baihui (GV20) and Shenting (GV24) acupoints can notably alleviate cerebral ischemia/reperfusion injury (CIRI). However, the molecular basis underlying the effectiveness of EA at the GV20 and GV24 acupoints for CIRI remains largely unknown. Our present study demonstrated that EA treatment at the GV20 and GV24 acupoints markedly alleviated middle cerebral artery occlusion/reperfusion (MCAO/R)-induced cognitive deficits and cerebral infarction in rats. Proteomics analysis revealed that 195 and 218 proteins were dysregulated in rat hippocampal tissues in the MCAO/R vs. sham group and thhhe EA vs. MCAO/R group, respectively. Moreover, 62 proteins with converse alteration trends in MCAO/R vs. sham and EA vs. MCAO/R groups were identified. These proteins might be implicated in the EA-mediated protective effect against MCAO/R-induced cerebral injury. GO enrichment analysis showed that 39 dysregulated proteins in the MCAO/R vs. sham group and 40 dysregulated proteins in the EA vs. MCAO/R group were related to brain and nerve development. Protein–protein interaction analysis of the abovementioned dysregulated proteins associated with brain and nerve development suggested that Pten/Akt pathway-related proteins might play major roles in regulating EA-mediated protective effects against MCAO/R-induced brain and nerve injury. Western blot assays demonstrated that Pak4, Akt3, and Efnb2 were expressed at low levels in the MCAO/R group vs. the sham group but at high levels in the EA group vs. the MCAO/R group. In conclusion, multiple proteins related to the protective effect of EA at the GV20 and GV24 acupoints against CIRI were identified in our study.
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Affiliation(s)
- Kaiqi Su
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenxue Hao
- Department of Rehabilitation, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuan Lv
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Mingli Wu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jieying Li
- College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanchao Hu
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zhenhua Zhang
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jing Gao
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- *Correspondence: Jing Gao
| | - Xiaodong Feng
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- Xiaodong Feng
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20
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Dry Needling and Antithrombotic Drugs. Pain Res Manag 2022; 2022:1363477. [PMID: 35035647 PMCID: PMC8759918 DOI: 10.1155/2022/1363477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 11/22/2022]
Abstract
Many clinicians increasingly use dry needling in clinical practice. However, whether patients' intake of antithrombotic drugs should be considered as a contraindication for dry needling has not been investigated to date. As far as we know, there are no publications in analyzing the intake of antiplatelet or anticoagulant agents in the context of dry needling techniques. A thorough analysis of existing medications and how they may impact various needling approaches may contribute to improved evidence-informed clinical practice. The primary purpose of this paper is to review the current knowledge of antithrombotic therapy in the context of dry needling. In addition, reviewing guidelines of other needling approaches, such as electromyography, acupuncture, botulinum toxin infiltration, and neck ultrasound-guided fine-needle aspiration biopsy, may provide specific insights relevant for dry needling. Based on published data, taking antithrombotic medication should not be considered an absolute contraindication for dry needling techniques. As long as specific dry needling and individual risks are properly considered, it does not change the risk and safety profile of dry needling. Under specific circumstances, the use of ultrasound guidance is recommended when available.
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Liu CY, Tu JF, Lee MS, Qi LY, Yu FT, Yan SY, Li JL, Lin LL, Hao XW, Su XT, Yang JW, Wang LQ. Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e052270. [PMID: 35017242 PMCID: PMC8753400 DOI: 10.1136/bmjopen-2021-052270] [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] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA. METHODS AND ANALYSIS Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched from the database inception to 1 September 2021. All randomised controlled trials related to acupuncture for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be pain intensity. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology. ETHICS AND DISSEMINATION Ethics approval is not required because individual patient data are not included. This protocol was registered in the international Prospective Register of Systematic Reviews on 25 February 2021. The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal. The findings will also be disseminated through conference presentations. TRIAL REGISTRATION NUMBER CRD42021232177.
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Affiliation(s)
- Chuan-Yang Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jian-Feng Tu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Myeong Soo Lee
- KM Science Research division, Korea Institute of Oriental Medicine, Daejon, South Korea
| | - Ling-Yu Qi
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Fang-Ting Yu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Yan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jin-Ling Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Lu Lin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Wan Hao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-Tong Su
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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22
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Tu M, Jiang Y, Yu J, Hu H, Liao B, He X, Fang J. Acupuncture for treating chronic stable angina pectoris associated anxiety and depression: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 45:101484. [PMID: 34517216 DOI: 10.1016/j.ctcp.2021.101484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Despite that acupuncture is effective in treating anxiety, depression and chronic stable angina pectoris (CSAP), it remains unclear whether acupuncture can treat CSAP, anxiety and depression simultaneously. This systematic review and meta-analysis aimed to investigate the efficacy of acupuncture on CSAP-associated anxiety and depression. METHODS Eight electronic databases were searched to identify eligible randomized controlled trials (RCTs) or controlled clinical trials (i.e. "acupuncture alone or combined with standard care" versus " sham acupuncture alone, sham acupuncture with standard care, or standard care alone") from their inception to January 2021, which included PubMed, Embase, Web of Science, the Cochrane Library, CBM, CNKI, VIP and Wanfang Database. Data were extracted and meta analyses were performed using the RevMan 5.3. Risk of bias (ROB) 2.0 was used for methodological quality assessment. GRADEprofiler 3.2.2 was used to rate the quality of evidence. RESULTS Seven trials involving 893 subjects were included. Meta-analysis results showed that acupuncture combined with standard care was more effective in relieving anxiety and depression, reducing angina attack frequency, and angina pain intensity than sham acupuncture with standard care and standard care alone. In addition, the effect remained until 16 weeks after acupuncture. The safety of acupuncture for CSAP-associated anxiety and depression was also high. Nonetheless, the quality of evidence ranged from low to moderate. CONCLUSION Acupuncture may be used as an adjunctive therapy to treat CSAP-associated anxiety and depression. However, more high-quality RCTs are required to confirm our findings.
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Affiliation(s)
- Mingqi Tu
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.
| | - Yongliang Jiang
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.
| | - Jie Yu
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China; Department of Acupuncture and Massage, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
| | - Hantong Hu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
| | - Binjun Liao
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.
| | - Xiaofen He
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.
| | - Jianqiao Fang
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, 310053, China.
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Ho L, Ke FYT, Wong CHL, Wu IXY, Cheung AKL, Mao C, Chung VCH. Low methodological quality of systematic reviews on acupuncture: a cross-sectional study. BMC Med Res Methodol 2021; 21:237. [PMID: 34717563 PMCID: PMC8557536 DOI: 10.1186/s12874-021-01437-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND While well-conducted systematic reviews (SRs) can provide the best evidence on the potential effectiveness of acupuncture, limitations on the methodological rigour of SRs may impact the trustworthiness of their conclusions. This cross-sectional study aimed to evaluate the methodological quality of a representative sample of SRs on acupuncture effectiveness. METHODS Cochrane Database of Systematic Reviews, MEDLINE, and EMBASE were searched for SRs focusing on the treatment effect of manual acupuncture or electro-acupuncture published during January 2018 and March 2020. Eligible SRs must contain at least one meta-analysis and be published in English language. Two independent reviewers extracted the bibliographical characteristics of the included SRs with a pre-designed questionnaire and appraised the methodological quality of the studies with the validated AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2). The associations between bibliographical characteristics and methodological quality ratings were explored using Kruskal-Wallis rank tests and Spearman's rank correlation coefficients. RESULTS A total of 106 SRs were appraised. Only one (0.9%) SR was of high overall methodological quality, zero (0%) was of moderate-quality, six (5.7%) and 99 (93.4%) were of low-quality and critically low-quality respectively. Among appraised SRs, only ten (9.4%) provided an a priori protocol, four (3.8%) conducted a comprehensive literature search, five (4.7%) provided a list of excluded studies, and six (5.7%) performed meta-analysis appropriately. Cochrane SRs, updated SRs, and SRs that did not search non-English databases had relatively higher overall quality. CONCLUSIONS Methodological quality of SRs on acupuncture is unsatisfactory. Future reviewers should improve critical methodological aspects of publishing protocols, performing comprehensive search, providing a list of excluded studies with justifications for exclusion, and conducting appropriate meta-analyses. These recommendations can be implemented via enhancing the technical competency of reviewers in SR methodology through established education approaches as well as quality gatekeeping by journal editors and reviewers. Finally, for evidence users, skills in SR critical appraisal remain to be essential as relevant evidence may not be available in pre-appraised formats.
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Affiliation(s)
- Leonard Ho
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Fiona Y T Ke
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Charlene H L Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, 5/F, 238 Shang-Ma-Yuan-Ling Alley, Kai-Fu District, Changsha, Hunan, China.
| | - Andy K L Cheung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Vincent C H Chung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Acupuncture-Induced Tension Pneumothorax Presenting as Acute Heart Failure. Case Rep Cardiol 2021; 2021:9986300. [PMID: 34650818 PMCID: PMC8510795 DOI: 10.1155/2021/9986300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/25/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022] Open
Abstract
Takotsubo syndrome (TSS) is a reversible, acute cardiomyopathy with transient heart failure, often secondary to other disorders. A 64-year-old woman, with no history of ischemic heart disease, was admitted to the emergency department after developing sudden-onset dyspnea after a planned acupuncture treatment for back pain. Acute echocardiography showed decreased left ventricular function with basal hypercontraction and apical akinesia and was interpreted, and treated, as acute heart failure. When the attending cardiologist arrived, the patient still had dyspnea with a declining blood pressure (97/65 mmHg) and tachycardia (111/minute). The cardiologist suspected a tension pneumothorax induced by the penetration of an acupuncture needle to the apex of the lung, as well as secondary TSS cardiomyopathy. An acute chest X-ray was performed, which showed a large left-sided rim pneumothorax. The attending surgeon placed a chest tube in the left 6th intercostal space in the midaxillary line, and the patient reported immediate pain relief and improvement in her dyspnea. The patient's clinical condition improved, and a control X-ray showed that the lung was fully expanded. The chest tube was removed, but after a few minutes, the patient developed a massive subcutaneous emphysema in the upper chest and in the face and her clinical condition deteriorated rapidly. A new chest tube was inserted, and the patient's tachycardia diminished, with her clinical condition improving immediately. The patient remained hospitalized for the next seven days. After three continuous days without any escaped air in the chest tube, the tube was removed, and the patient was observed for another 48 hours. This time, the removal was without any complications and within two days, the patient was ready for discharge. The follow-up echocardiography showed complete recovery of left ventricular function.
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Bäumler P, Zhang W, Stübinger T, Irnich D. Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open 2021; 11:e045961. [PMID: 34489268 PMCID: PMC8422480 DOI: 10.1136/bmjopen-2020-045961] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/29/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Overview on risks of acupuncture-related adverse events (AEs). DESIGN Systematic review and meta-analyses of prospective studies. DATA SOURCES PubMed, Scopus and Embase from inception date to 15 September 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German. DATA EXTRACTION AND SYNTHESIS Two independent researchers selected articles, extracted the data and assessed study quality. Overall risks and risks for different AE categories were obtained from random effects meta-analyses. MAIN OUTCOMES Overall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments. RESULTS A total of 7679 publications were identified. Twenty-two articles reporting on 21 studies were included. Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was substantial (I2 >80%). On average, 9.4 AEs occurred in 100 treatments. Half of the AEs were bleeding, pain or flare at the needle site that are argued to represent intended acupuncture reaction. AE definitions and assessments varied largely. CONCLUSION Acupuncture can be considered among the safer treatments in medicine. SAEs are rare, and the most common minor AEs are very mild. AEs requiring medical management are uncommon but necessitate medical competence to assure patient safety. Clinical and methodological heterogeneity call for standardised AE assessments tools, clear criteria for differentiating acupuncture-related AEs from therapeutically desired reactions, and identification of patient-related risk factors for AEs. PROSPERO REGISTRATION NUMBER CRD42020151930.
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Affiliation(s)
- Petra Bäumler
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
| | - Wenyue Zhang
- School of Acupuncture, Moxibustion and Tuina, Beijing Rehabilitation Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Theresa Stübinger
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
| | - Dominik Irnich
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
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26
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Shapiro JM, Deutsch JK. Complementary and Alternative Medicine Therapies for Irritable Bowel Syndrome. Gastroenterol Clin North Am 2021; 50:671-688. [PMID: 34304794 DOI: 10.1016/j.gtc.2021.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Complementary and alternative medicine (CAM) is a term used to define a broad range of therapies, most commonly grouped into natural products, mind-body medicine, and traditional systems of medicine. Patients with irritable bowel syndrome (IBS) commonly use CAM therapies, although there are many barriers that may keep patients and providers from talking about a patient's CAM use. Despite limited quantity and quality of evidence of CAM for IBS, providers can better counsel patients on CAM use by understanding pitfalls related to CAM use and by learning what is known about CAM.
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Affiliation(s)
- Jordan M Shapiro
- Section of Gastroenterology and Hepatology, Baylor College of Medicine, 7200 Cambridge Street, A8.172, MS:BCM901, Houston, TX 77030, USA.
| | - Jill K Deutsch
- Section of Gastroenterology and Hepatology, Yale New Haven Hospital, 40 Temple Street, Suite 1A, New Haven, CT 06510, USA. https://twitter.com/GIJill
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Na J, Jung J, Park J, Song PH, Song C. Therapeutic effects of acupuncture in typical dry eye: a systematic review and meta-analysis. Acta Ophthalmol 2021; 99:489-498. [PMID: 33124107 DOI: 10.1111/aos.14651] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/03/2020] [Accepted: 09/25/2020] [Indexed: 12/01/2022]
Abstract
Acupuncture is a treatment option for dry eye syndrome (DES), but its efficacy remains still controversial. We assessed the effectiveness of this treatment for typical DES without specific aetiologies. Eight databases up through June 2018 were searched for randomized clinical trials (RCTs) comparing treatments of acupuncture with artificial tears. The risk of bias was assessed using Cochrane criteria, and a random effects model was used for meta-analyses on tear-film breakup time (BUT), Schirmer test, corneal fluorescein staining (CFS), ocular surface disease index, visual analogue scale and score of symptoms (SOS). Subgroup and sensitivity analyses were conducted to explore the heterogeneity, and publication bias was assessed by funnel plot using Egger's test. Twenty-one RCTs in 19 studies (n = 1542 eyes) met our eligible criteria. The results demonstrated the superiority of acupuncture in improving the symptoms of BUT, Schirmer test, CFS and SOS, compared to artificial tears acting alone. The BUT and Schirmer test were also more improved in acupuncture combination with artificial tears than artificial tears alone. Further subgroup analyses suggest that acupuncture applied at 2.0-3.0 times per week for 21-30 days may be optimal for treating typical DES. This provides useful information for guiding acupuncture in the clinical trials.
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Affiliation(s)
- Ji‐Ho Na
- College of Korean Medicine Daegu Haany University Gyeongsan Korea
| | - Ji‐Hyeo Jung
- College of Korean Medicine Daegu Haany University Gyeongsan Korea
| | - Joon‐Gon Park
- College of Korean Medicine Daegu Haany University Gyeongsan Korea
| | - Phil Hyun Song
- Department of Urology College of Medicine Yeungnam University Daegu Korea
| | - Chang‐Hyun Song
- College of Korean Medicine Daegu Haany University Gyeongsan Korea
- Department of Anatomy and Histology College of Korean Medicine Daegu Haany University Gyeongsan Korea
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Digestion-Specific Acupuncture Effect on Feeding Intolerance in Critically Ill Post-Operative Oral and Hypopharyngeal Cancer Patients: A Single-Blind Randomized Control Trial. Nutrients 2021; 13:nu13062110. [PMID: 34205461 PMCID: PMC8234819 DOI: 10.3390/nu13062110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022] Open
Abstract
Malnourishment is prevalent in patients suffering from head and neck cancer. The postoperative period is crucial in terms of nutritional support, especially after composite resection and reconstruction surgery. These patients present with a number of risk factors that aggravate feeding intolerance, including postoperative status, prolonged immobility, decreased head elevation, mechanical ventilation, and applied sedative agents. Routine management protocols for feeding intolerance include prokinetic drug use and post-pyloric tube insertion, which could be both limited and accompanied by detrimental adverse events. This single-blind clinical trial aimed to investigate the effects of acupuncture in postoperative feeding intolerance in critically ill oral and hypopharyngeal cancer patients. Twenty-eight patients were randomized into two groups: Intervention group and Control group. Interventions were administered daily over three consecutive postoperative days. The primary outcome revealed that the intervention group reached 70% and 80% of target energy expenditure (EE) significantly earlier than the control group (4.00 ± 1.22 versus 6.69 ± 3.50 days, p = 0.012), accompanied by higher total calorie intake within the first postoperative week (10263.62 ± 1086.11 kcals versus 8384.69 ± 2120.05 kcals, p = 0.004). Furthermore, the intervention group also needed less of the prokinetic drug (Metoclopramide, 20.77 ± 48.73 mg versus 68.46 ± 66.56 mg, p = 0.010). In conclusion, digestion-specific acupuncture facilitated reduced postoperative feeding intolerance in oral and hypopharyngeal cancer patients.
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Park JE, Kang S, Jang BH, Shin YC, Ko SG. Adverse events from pharmacopuncture treatment in Korea: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e25107. [PMID: 33725988 PMCID: PMC7982247 DOI: 10.1097/md.0000000000025107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pharmacopuncture is a combination of acupuncture and herbal medicine, which involves the injection of herbal extracts into acupuncture points (acupoints). Pharmacopuncture has become one of the major therapeutic tools used in Korea; however, safety is one of the major concerns associated with it. We aim to systematically review clinical studies on the adverse events of pharmacopuncture in Korea. METHODS To collect data on the incidence and characteristics of adverse events (AEs) and to evaluate pharmacopuncture safety, 2 or more researchers will conduct a comprehensive search of pertinent English and Korean databases using the keywords "pharmacopuncture" and "adverse events." Regardless of the participants' conditions or treatment types, we will include clinical studies on the AEs of pharmacopuncture. Studies that were not conducted in Korea, and acupoint injections containing Western medications, vitamins, or autologous serum will be excluded from this study. The severity of AEs will be classified using the common terminology criteria for adverse events, and the causality between pharmacopuncture and AEs will be assessed using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) causality scale. The quality of identifying and reporting the AEs will be assessed using the McHarm scale. The risk of selection bias will be assessed using the Cochrane risk of bias and the risk of bias for non-randomized studies tools. Studies will be assessed for heterogeneity utilizing Higgins's I2 statistics, and the risk of publication bias will be assessed and expressed in the form of a contour-enhanced funnel plot. RESULTS AND CONCLUSION Comprehensive investigation of all types of clinical studies in Korea will provide clearer evidence of the safety of pharmacopuncture. The results of this study will be useful for traditional medical doctors and patients who use such treatments and interventions.Systematic Review Registration: Open Science Foundation (osf.io/umhyz).
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Affiliation(s)
- Jae Eun Park
- Department of Global Public Health and Korean Medicine Management, Graduate School
| | - Sohyeon Kang
- Department of Global Public Health and Korean Medicine Management, Graduate School
| | - Bo-Hyoung Jang
- Department of Global Public Health and Korean Medicine Management, Graduate School
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Cheol Shin
- Department of Global Public Health and Korean Medicine Management, Graduate School
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Global Public Health and Korean Medicine Management, Graduate School
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Nishie M, Masaki K, Kayama Y, Yoshino T. Bilateral pneumothorax after acupuncture treatment. BMJ Case Rep 2021; 14:14/3/e241510. [PMID: 33649032 PMCID: PMC7929814 DOI: 10.1136/bcr-2020-241510] [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: 11/04/2022] Open
Abstract
A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior history of respiratory disease or smoking. Acupuncture needles may easily reach the pleura around the end of the suprascapular angle of the levator scapulae muscle where the subcutaneous tissue is anatomically thin. In our patient, the thickness between the epidermis and the visceral pleura in this area was only 22 mm as confirmed by an ultrasound scan. Although she felt chest discomfort 30 min after the procedure, she assumed the symptom to be a reaction to the acupuncture. In light of our case, we advise practitioners to select appropriate acupuncture needles for patients based on the site of insertion and counsel them regarding the appearance of symptoms such as chest pain and dyspnoea immediately after the procedure.
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Affiliation(s)
- Miyuki Nishie
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yohei Kayama
- Center for Kampo Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tetsuhiro Yoshino
- Center for Kampo Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Dan A, Attias S, Woitiz R, Arnon Z, Keshet Y, Ben-Arye E, Schiff E. Patterns of patient reluctance to receive complementary-medicine treatments in a hospital setting: A cross-sectional study. Complement Ther Med 2021; 58:102694. [PMID: 33639252 DOI: 10.1016/j.ctim.2021.102694] [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: 11/06/2020] [Revised: 02/03/2021] [Accepted: 02/20/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE We aim to characterize the patient population that exhibits reluctance to undergo complementary medicine (CM) treatments in a hospital setting. METHODS We conducted a cross-sectional prospective study among patients prior to hospitalization using structured questionnaires in a single center in Israel. Participants were asked to rate their degree of consent to receiving CM treatments during hospitalization. RESULTS The CM-reluctant group was 7.1 % of the study cohort. The CM modalities most commonly refused were spiritual guidance, acupuncture, and energy and healing therapies. The CM-reluctant population showed a weaker relation to spiritual content and tended to value complementary medicine's effectiveness less in comparison to the CM-consenting group. The main reason for reluctance was skepticism of the perceived effectiveness of CM. CONCLUSIONS With skepticism playing a major role in decision making, we should question whether the Stakeholders in the field of CM and public health services are succeeding in explaining the benefits and risks of CM treatments.
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Affiliation(s)
- Asaf Dan
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel.
| | - Samuel Attias
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; School of Public Health, University of Haifa, Haifa, Israel.
| | - Rachel Woitiz
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel.
| | - Zahi Arnon
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; Yezreel Valley Academic College, Emek Yezreel, Israel.
| | - Yael Keshet
- Yezreel Valley Academic College, Emek Yezreel, Israel.
| | - Eran Ben-Arye
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Lin and Carmel Medical Centers, Clalit Health Services.
| | - Elad Schiff
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; Internal Medicine Department B, Bnai-Zion Medical Center, Haifa, Israel.
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Smith B, Lew S, Manes P. Traumatic Pneumothorax in a 58-Year-Old Man: A Case Report of a Rare Post-Acupuncture Adverse Event. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e928094. [PMID: 33486502 PMCID: PMC7841691 DOI: 10.12659/ajcr.928094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patient: Male, 58-year-old Final Diagnosis: Pneumothorax Symptoms: Chest pain Medication: — Clinical Procedure: Chest tube Specialty: General and Internal Medicine• Pulmonology
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Affiliation(s)
- Brittany Smith
- Saint George's University School of Medicine, True Blue, Grenada.,Department of Family Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA
| | - Sungyub Lew
- Saint George's University School of Medicine, True Blue, Grenada.,Department of Family Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA
| | - Prabhjot Manes
- Saint George's University School of Medicine, True Blue, Grenada.,Department of Family Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA
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Mesaik MA, Mirghani HO, Elfakki F. Alternative Medicine in the Management of Diabetic Foot Ulcers/Infections. DIABETIC FOOT ULCER 2021:269-280. [DOI: 10.1007/978-981-15-7639-3_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2024]
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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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Liew SK, Teh KK. Flexor pollicis longus rupture following acupuncture for trigger thumb: a case report. Acupunct Med 2020; 39:398-399. [PMID: 33256436 DOI: 10.1177/0964528420959085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Siew Khei Liew
- Department of Orthopaedics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Kok Kheng Teh
- Hand & Microsurgery Division, Sunway Medical Centre, Sunway City, Malaysia
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Fan AY, He D, Gu S, Tian H, Ouyang H, Wei H, Gong C, Alemi SF, Zhao X. Estimated Number of Acupuncture Practitioners in Mainland China in 2018: Multiperspectives. Med Acupunct 2020; 32:310-319. [PMID: 33101576 PMCID: PMC7583322 DOI: 10.1089/acu.2020.1439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Objective: Acupuncture and Oriental medicine are widespread, practiced in >183 countries and regions. As such, it has played an important role in the world health care system. However, there are no official statistics available on the number of acupuncture practitioners in China. The aim of this study is to calculate the number ranges of acupuncture practitioners in China in 2018. Materials and Methods: In total, 33.708 million was used as the total number of patient visits for acupuncture in 2018 in China. This number was calculated using the data released by the National Administration of Traditional Chinese Medicine (China), in which the average daily workload of all acupuncture practitioners in China was 134,832 patient visits. Acupuncture practitioners in China are part of Chinese Medicine doctors (CMDs) at the physician level, called "acupuncture doctors." This number 134,832 was divided by the workload of a single doctor of acupuncture, which was 19.4 or 7.0 patient visits per day. These numbers were from a survey by the authors. There are also the numbers 16.0 or 9.4 patient visits per day; these numbers were calculated from the salary level of acupuncture practitioners at 10,000 Yuan per month (providing the doctor's net income was 30% or 50% in his/her gross income). From these 2 sources, the authors then obtained 2 sets of ranges of acupuncture practitioners in China in 2018. There were 9,927 CMDs in 49 big hospitals, of which 619 were acupuncture practitioners; the ratio of acupuncture practitioners to the whole of all CMDs was 6.23%. Using this ratio multiplied by the whole number of CMDs in 2018, then the number of acupuncture practitioners in China in 2018 could be obtained as well. Results: Calculating based on the workload, the range of acupuncture practitioners in China in 2018 was from 6,950 to 19,262. Calculating based on the salary level, the range was 10,618 to 17,697. Calculating based on the ratio of the number of acupuncture practitioners to the whole population of CMDs, the number was 28,360. Conclusions: The reasonable range of acupuncture practitioners in China in 2018 was 10,618 to 17,697, with a median of 14,157. Considering that some acupuncture practitioners are also engaged in teaching, research, and management, the mentioned number is enlarged by 30% to produce 18,404, which would be reasonable. It was also concluded that the density of acupuncture practitioners was 1.31 per 100,000 residents.
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Affiliation(s)
- Arthur Yin Fan
- American TCM Association (ATCMA), Vienna, VA, USA
- McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA, USA
| | - Deguang He
- American TCM Association (ATCMA), Vienna, VA, USA
- New England School of Acupuncture, MCPHS University, Worcester, MA, USA
| | - Sherman Gu
- Federation of Chinese Medicine and Acupuncture Societies of Australia Ltd (FCMA), Melbourne, Australia
- Knox Chinese Healing and Myotherapy, Wantirna South, Australia
| | - Haihe Tian
- American TCM Association (ATCMA), Vienna, VA, USA
- Chinese Acupuncture and Herbs Center, Largo, FL, USA
| | - Hui Ouyang
- American TCM Association (ATCMA), Vienna, VA, USA
- YIN and YANG Healthcare, Friendswood, TX, USA
| | - Hui Wei
- American TCM Association (ATCMA), Vienna, VA, USA
- Wei's Chinese Medical Center, Lake Worth, FL, USA
| | - Changzhen Gong
- American TCM Association (ATCMA), Vienna, VA, USA
- American Academy of Acupuncture and Oriental Medicine, Roseville, MN, USA
| | - Sarah Faggert Alemi
- American TCM Association (ATCMA), Vienna, VA, USA
- Eastern Roots Wellness, PLC, McLean, VA, USA
| | - Xiaoyin Zhao
- Nanjing University of Chinese Medicine The Third Hospital, Nanjing, China
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Ribeiro BMDSS, da Silva VA, Boaretto JP, Freitas IRS, Dalri RDCDMB, Martins EAP. Reflections on biosafety in acupuncture. Rev Bras Med Trab 2020; 18:109-112. [PMID: 32783012 DOI: 10.5327/z1679443520200456] [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: 06/13/2019] [Accepted: 03/11/2020] [Indexed: 11/05/2022] Open
Abstract
Background Acupuncture is an integrative and complementary practice for which biosafety standards are essential. Objective To elicit a reflection on biosafety in acupuncture to reduce occupational hazards associated with infection as adverse effect for both provider and patient. Methods The present theoretical essay is grounded on references intentionally selected from June through October 2019. Results Infection is the adverse effect most frequently reported for acupuncture practice, which involves considerable risk of microorganism inoculation. Provider awareness should be raised to comply with biosafety principles and thus ensure their and patient safety without any negative implications for the effectiveness of treatment. Conclusion We recommended providers to adopt universal biosafety practices during acupuncture procedures.
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Affiliation(s)
| | - Vladimir Araujo da Silva
- Nursing, Universidade Federal de Santa Catarina - Curitibanos (SC), Brazil. Universidade Federal de Santa Catarina Nursing Universidade Federal de Santa Catarina Brazil
| | - Jucelei Pascoal Boaretto
- Nursing, Universidade Estadual de Londrina - Londrina (PR), Brazil. Universidade Estadual de Londrina Nursing Universidade Estadual de Londrina Brazil
| | - Iria Roberta Staut Freitas
- Nursing, Universidade Estadual de Londrina - Londrina (PR), Brazil. Universidade Estadual de Londrina Nursing Universidade Estadual de Londrina Brazil
| | | | - Eleine Aparecida Penha Martins
- Nursing, Universidade Estadual de Londrina - Londrina (PR), Brazil. Universidade Estadual de Londrina Nursing Universidade Estadual de Londrina Brazil
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Park JH, Lee JH, Lee S, Shin JY, Kim TH. Adverse events related to electroacupuncture: a systematic review of single case studies and case series. Acupunct Med 2020; 38:407-416. [PMID: 32418438 DOI: 10.1177/0964528420920287] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Electroacupuncture (EA) is used in the treatment of various diseases through the use of electrical stimulation. Reports of adverse events (AEs) associated with acupuncture are relatively consistent, but the safety of EA has been less well reported. In this systematic review, we provide a summary of the types of AEs related to EA in clinical practice. METHODS Twelve electronic databases, including those in English (PubMed, Ovid-EMBASE, CENTRAL), Korean (KMbase, KISS, NDSL, KISTI, OASIS), Chinese (CNKI, Wanfang, Weipu) and Japanese (J-STAGE), were systematically searched for single case studies and case series through April 2018. There were no language restrictions. We included clinical studies in which EA was used as a key intervention and in which AEs that may have been causally related to EA were reported. RESULTS Thirty-seven studies, including 27 single case studies and 10 case series, were evaluated. The most frequently reported AEs were pallor (eight cases), skin pigmentation (eight cases), vertigo (seven cases), chest tightness (six cases), vomiting (six cases) and unconsciousness (five cases). Thirty-one cases (62%) achieved full recovery and three cases (6%) achieved partial recovery. There were also three cases of death (6%). CONCLUSION AEs related to EA included acupuncture-related AEs and serious AEs induced by electrical stimulation. Currently, specific stimulation conditions associated with EA-specific AEs are not identifiable due to inappropriate reporting. However, skin pigmentation, syncope or spasm, implantable cardioverter-defibrillator shock, cardiac emergencies, electrical burns, and potential internal organ injury are potential EA-specific AEs regarding which physicians should be cautious in clinical practice.
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Affiliation(s)
- Jeong Hwan Park
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sanghun Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jae-Young Shin
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Tae-Hun Kim
- Korea Medicine Clinical Trial Center, Korea Medicine Hospital, Kyung Hee University, Seoul, South Korea
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Godson DR, Wardle JL. Accuracy of acupuncture point location among first-year acupuncture students: A pilot study evaluating the impact of training and use of an adjustable ruler. Acupunct Med 2020; 39:126-134. [PMID: 32403998 DOI: 10.1177/0964528420920302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The proportional method of acupuncture point location (APL) currently taught at Endeavor College of Natural Health and advocated by the World Health Organization Regional Office for the Western Pacific (WPRO) was found to be imprecise and/or inaccurate in previous student studies. The ruler and elastic methods of APL were identified as more accurate or precise than the proportional method of APL but were not well received by student participants. Use of an adjustable ruler may overcome barriers to uptake of the more accurate APL methods. This pilot study was the first to evaluate the comparative accuracy of the adjustable ruler and the proportional methods of APL in first-year students at a major Australian acupuncture training college. METHODS After 10 weeks of in-class instruction in both proportional and adjustable ruler methods of APL, student participants (n = 14) attempted location of three acupuncture points (LI10, SP6 and ST38) on a volunteer using both APL methods of interest. A self-administered questionnaire and lecturer field notes elucidated attitudes to implementation of both APL methods. RESULTS Points marked using the adjustable ruler were closer to the correct location than those marked using the proportional method across all three acupuncture points. Students and lecturers rated the adjustable ruler more highly than the proportional method for ease of learning and ease of use. CONCLUSION Encouraging results with the adjustable ruler method warrant further larger scale studies. Use of the adjustable ruler method of APL should be considered for use in point location training at educational institutions teaching traditional acupuncture.
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Affiliation(s)
- Debra R Godson
- Academic Department, Endeavour College of Natural Health, Office of the Director of Education, Brisbane, QLD, Australia.,Department of Chinese Medicine, Endeavour College of Natural Health, Brisbane, QLD, Australia
| | - Jonathan L Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Cardiac tamponade and right ventricle perforation after an acupuncture procedure. Med Clin (Barc) 2020; 154:416-417. [DOI: 10.1016/j.medcli.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/27/2018] [Accepted: 01/10/2019] [Indexed: 11/19/2022]
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Iatrogenic Bilateral Pneumothorax Due to Acupuncture. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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A review of acute responses, after-effects and chronic complications related to microneurography. Clin Neurophysiol 2019; 130:1781-1788. [DOI: 10.1016/j.clinph.2019.06.228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/07/2019] [Accepted: 06/11/2019] [Indexed: 12/17/2022]
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Ben-Arie E, Kao PY, Ho WC, Lee YC. Acupuncture effect on digestion in critically ill postoperative oral and hypopharyngeal cancer patients: A protocol for double-blind randomized control trial. Medicine (Baltimore) 2019; 98:e16944. [PMID: 31464933 PMCID: PMC6736481 DOI: 10.1097/md.0000000000016944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Head and neck cancer patients are at a high risk to suffer from malnourishment, a risk that increases in postoperative condition and with the use of enteral nutrition (EN). Until now patients who are suffering from indigestion in the intensive care unit (ICU) received treatment in the form of prokinetic drugs, drugs that can lead to serious side effects and only can partially improve digestion functions. Acupuncture was used successfully in several clinical trials to improve postoperative indigestion in cancer patients without any reported adverse events. The study aims are to investigate acupuncture effect in combination with prokinetic drugs in the treatment of indigestion in postoperative oral and hypopharyngeal cancer patients in the ICU. METHODS Single-center, double-blind randomized control trial will compare between 2 equal groups. A total of 28 patients that will meet the inclusion criteria: age 30 to 80, postplastic surgery for oral cancer or hypopharyngeal cancer, developed feeding intolerance 2 times in the first postoperative day, Apache score <20, and needed EN. Patients will be randomly divided (1:1) into treatment group or control group for 3 treatments in 3 days along with routine ICU treatment. The main outcome measurement will be the number of days a patient needs to reach his total energy expenditure. EXPECTED OUTCOME The results will shed light on the effectiveness and safety of acupuncture in a double-blind design treating postoperative ICU cancer patients. In addition, the study presents a revolutionary double-blind design that if, will prove as successful might influence the way double-blind acupuncture studies are performed today. OTHER INFORMATION The study will be conducted in the surgical ICU department, of China medical university hospital, Taichung 404, Taiwan. The study is conducted on stable ICU patients and is anticipated to have minimum risk for adverse events. Patients enrollment and data collection will start from May 15, 2019. The study expected completion time: June 2021.
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Affiliation(s)
- Eyal Ben-Arie
- Graduate Institute of Acupuncture Science (Collage of Chinese Medicine) China Medical University
| | - Pei-Yu Kao
- Division of Thoracic Surgery, Department of Surgery
- Surgical Intensive Care Unit
| | - Wen-Chao Ho
- Department of Public Health, China Medical University
- Department of Nursing and Graduate Institute of Nursing, Asia University, Taichung, Taiwan
| | - Yu Chen Lee
- Graduate Institute of Acupuncture Science (Collage of Chinese Medicine) China Medical University
- Department of Acupuncture, China Medical University Hospital
- Chinese Medicine Research Center, China Medical University
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Priola SM, Moghaddamjou A, Ku JC, Taslimi S, Yang VX. In Reply to the Letter to the Editor Regarding “Acupuncture-Induced Cranial Epidural Abscess: Case Report and Review of the Literature”. World Neurosurg 2019; 127:655. [DOI: 10.1016/j.wneu.2019.03.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 10/26/2022]
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Abstract
Acupuncture is a well-known form of complementary medicine that is increasingly being used worldwide. Despite being rare, pneumothorax is the most common serious complication described in acupuncture. A 79-year-old woman was admitted to the emergency department with a pneumothorax. Two days before, she had undergone an acupuncture treatment for chronic back pain. She felt a sharp right shoulder pain as needles were inserted in the interscapular area. As the pain did not resolve, she consulted her general practitioner and had a chest radiography done, revealing a right-sided pneumothorax. At the hospital, a right chest tube was inserted with relief of the symptoms and lung expansion. The chest tube was removed on the second day of admission, and she was discharged on the third day. Both acupuncturists and clinicians need to be aware of the possibility of adverse events following acupuncture, especially in those who develop symptoms.
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Affiliation(s)
- Sofia Costa Corado
- Serviço de Cirurgia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | | | - Luísa Quaresma
- Serviço de Cirurgia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
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46
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Safety and Effectiveness of Fluoroscopy-Guided Acupotomy for Carpal Tunnel Syndrome: Protocol for a Pilot Randomized, Patient-Assessor Blind, Parallel Clinical Trial. JOURNAL OF ACUPUNCTURE RESEARCH 2019. [DOI: 10.13045/jar.2019.00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Snyder DD. Acupuncture gone awry: a case report of a patient who required surgical removal of two single-use filament needles following acupuncture treatment. J Man Manip Ther 2019; 27:180-184. [PMID: 31023177 DOI: 10.1080/10669817.2019.1608010] [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: 10/26/2022] Open
Abstract
Background: Acupuncture and dry needling are increasingly popular treatment modalities used to treat pain around the world. This case report documents the clinical history of a patient who presented to an outpatient physical therapy clinic following surgical removal of two single-use filament needles that fractured in the patient's neck during acupuncture treatment. Case Description: The purpose of this case report was to highlight a rare adverse event following acupuncture treatment. The patient received the acupuncture treatment from a practitioner licensed in acupuncture, while on an international business trip. Following the acupuncture treatment, the practitioner realized that a needle had fractured and remained in the patient's neck. After failing to retrieve the needle, the patient was sent for imaging. Radiograph revealed that the patient had two needle fragments located in his cervical tissue. After determining that the needles did not pose an immediate threat, the patient boarded a flight home to the United States. Following his flight, the patient presented to an American hospital where it was discovered that the needle fragments had migrated during the flight, with one needle now located 2 mm from the patient's vertebral artery. Surgical intervention was required to retrieve the needles, resulting in the patient needing physical therapy to increase cervical range of motion and mediate pain relief. Outcomes: The patient suffered a setback in his treatment of chronic neck pain that resulted in decreased cervical range of motion and increased pain. Discussion: Clinicians utilizing single-use filiform needles in their practice, whether for acupuncture or dry needling, should be aware of the potential for this type of adverse event. Further, to minimize the risk of similar adverse events occurring in the future, clinicians should make sure that they are using high quality needles and make a habit of counting in and counting out the needles that they use to verify that all needles are accounted for.
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Affiliation(s)
- Drew D Snyder
- a Youngstown State University , Youngstown , OH , USA
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48
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Priola SM, Moghaddamjou A, Ku JC, Taslimi S, Yang VXD. Acupuncture-Induced Cranial Epidural Abscess: Case Report and Review of the Literature. World Neurosurg 2019; 125:519-526.e1. [PMID: 30743042 DOI: 10.1016/j.wneu.2019.01.189] [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: 01/04/2019] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Acupuncture is a common form of alternative medicine that is used for pain control among other modalities of treatment. It is a relatively safe procedure, but complications, including those of infectious etiology, may still occur. CASE DESCRIPTION A 47-year-old immunosuppressed woman presented with fever, altered level of consciousness, dysphasia, and a left occipital subgaleal fluctuant mass after acupuncture for headaches in the same area. Imaging demonstrated subgaleal and epidural collection localized in the left occipital region. She underwent urgent surgical evacuation of both collections. Cultures from intraoperative specimens grew Streptococcus anginosus. The patient started targeted antibiotic treatment leading to complete recovery. CONCLUSIONS To our knowledge, this is the first report of intracranial abscess after acupuncture. Given the worldwide application of this alternative treatment, physicians, acupuncturists, and the general public should be aware of the possibility of this rare but serious complication.
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Affiliation(s)
- Stefano Maria Priola
- Sunnybrook Health Sciences Centre, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
| | - Ali Moghaddamjou
- Sunnybrook Health Sciences Centre, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Jerry C Ku
- Sunnybrook Health Sciences Centre, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Shervin Taslimi
- Sunnybrook Health Sciences Centre, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Victor X D Yang
- Sunnybrook Health Sciences Centre, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
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Kwan YH, Fong W, Ang XL, Tan CS, Tai BC, Huang Y, Bilger M, Phang JK, Tan HC, Lee JV, Sun L, Tan CT, Dong BQ, Koh HL, Leung YY, Lui NL, Yeo SI, Ng SC, Fong KY, Thumboo J, Østbye T. Traditional Chinese medicine (TCM) collaborative care for patients with axial spondyloarthritis (AcuSpA): protocol for a pragmatic randomized controlled trial. Trials 2019; 20:46. [PMID: 30642381 PMCID: PMC6332567 DOI: 10.1186/s13063-018-3117-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/08/2018] [Indexed: 11/24/2022] Open
Abstract
Background Axial spondyloarthritis (AxSpA) is a chronic disease which results in fatigue, pain, and reduced quality of life (QoL). Traditional Chinese medicine (TCM), especially acupuncture, has shown promise in managing pain. Although a TCM collaborative model of care (TCMCMC) has been studied in cancer, there are no randomized controlled trials investigating TCM in AxSpA. Therefore, we will conduct a pragmatic trial to determine the clinical effectiveness, safety, and cost-effectiveness of TCMCMC for patients with AxSpA. We define TCMCMC as standard TCM history taking and physical examination, acupuncture, and TCM non-pharmacological advice and communications with rheumatologists in addition to usual rheumatologic care. The purpose of this paper is to describe the rationale for and methodology of this trial. Methods/design This pragmatic randomized controlled trial will recruit 160 patients who are diagnosed with AxSpA and have inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs). Simple randomization to usual rheumatologic care or the intervention (TCMCMC) with a 1:1 allocation ratio will be used. Ten 30-min acupuncture sessions will be provided to patients assigned to the TCMCMC arm. All participants will continue to receive usual rheumatologic care. The primary endpoint — spinal pain — will be evaluated at week 6. Secondary endpoints include clinical, quality of life, and economic outcome measures. Patients will be followed up for up to 52 weeks, and adverse events will be documented. Discussion This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of a TCMCMC for patients with AxSpA. Trial registration ClinicalTrials.gov, NCT03420404. Registered on 14 February 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3117-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiang Ling Ang
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Youyi Huang
- Internal Medicine Residency, SingHealth, Singapore, Singapore
| | - Marcel Bilger
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Hui Chin Tan
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Jia Ven Lee
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Limin Sun
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Choy Tip Tan
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Bao Qiang Dong
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, People's Republic of China
| | - Hwee Ling Koh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Siaw Ing Yeo
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Swee Cheng Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. .,Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Schulz P, Hede V. Alternative and complementary approaches in psychiatry: beliefs versus evidence. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 30581290 PMCID: PMC6296392 DOI: 10.31887/dcns.2018.20.3/pschulz] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
While the legitimacy of medical treatments is more and more questioned, one sees a paradoxical increase in nonconventional approaches, notably so in psychiatry. Over time, approaches that were considered valuable by the scientific community were found to be inefficacious, while other approaches, labelled as alternative or complementary, were finally discovered to be useful in a few indications. From this observation, we propose to classify therapies as orthodox (scientifically validated) or heterodox (scientifically not validated). To illustrate these two categories, we discuss the place, the role, the interest, and also the potential risks of nonconventional approaches in the present practice of psychiatry.
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Affiliation(s)
- Pierre Schulz
- Former Head, Unit of Clinical Psychopharmacology, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Vincent Hede
- Mood Disorders Unit, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
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