Acupuncture and Related Therapies最新文献

Background

GV26 is well known as an emergency and a revival acupoint. It has been most commonly used for acute neurological conditions and acute low back strain (ALBS). This systematic review evaluates the effectiveness and occurrence of adverse effects of using GV26 for a variety conditions; and to determine the appropriate parameters to inform its use in practice.

Methods

Randomized controlled trials evaluating stimulation of GV26 as a sole or as an adjunct to treatment for any condition were included. Quality of reporting and methodology were assessed using STRICTA and the Cochrane risk of bias tool. Meta-analysis was pooled with RevMan 5.2 software (Protocol ID: CRD42013006528).

Results

Fifteen trials investigated conditions which included shock, epilepsy, vascular dementia, febrile seizures in children, post general anesthesia, acute low back strain, functional enuresis, and intractable hiccups. The reporting quality and methodological quality of all included trials was limited. Data from eleven trials were pooled. Significant favorable improvements were shown for GV26 used in addition to other common acupoints as measured by efficacy rate; GV26 in addition to usual care as measured by blood pressure. No study reported any adverse effects.

Conclusions

There appears to be evidence on the use of GV26 for improving efficacy rate in ALBS, functional enuresis and intractable hiccups, and it appears to be effective in increasing blood pressure and reducing heart rate during revival. However, the findings should be interpreted with caution due to the limited methodological quality of included trials.

Objective

To investigate the effectiveness of acupuncture in addition to routine care, compared with routine care alone, in the treatment of patients with pain, nauseas and vomiting due to cesarean section (CS).

Methods

In a randomized controlled trial, 56 patients post CS were randomly allocated to undergo up to 1 session of real acupuncture or to a control group receiving sham acupuncture with no penetrating needling immediately after spinal anesthesia. All patients were allowed to receive usual medical care for pain, nauseas and vomiting. A satisfaction questionnaire was also applied to puerperal mothers in the first 48 h after the procedure.

Results

The patient characteristics were similar in both groups. No significant difference was found in the incidence of nausea and vomiting and the antiemetic use between groups during the first 24 h and 48 h post-CS. The sham group showed better VAS pain scores at rest in the first 24 h. In the assessment of pain in 48 h there was no difference between acupuncture group and sham group.

Conclusion

This clinical trial using a single session of acupuncture showed no effectiveness of acupuncture in the prevention of pain, nauseas and vomiting after CS. More well-designed studies are needed to define the role of acupuncture on post-CS.

Acupuncture is an emerging therapy being utilised by those with eating disorders. Little is known about acupuncture and eating disorders. The aim of this paper is to present some TCM insight into the eating disordered patient who seeks acupuncture treatment such as how they present according to TCM principles and how acupuncturists are treating these patients. Three experienced acupuncturists contributed 46 cases studies (eighteen outpatients, twenty six inpatients) of patients with eating disorders who sought acupuncture treatment. Help with their eating disorder was not what the majority of patients in this study sought acupuncture for. The majority of in-patients wanted help for digestive and mood concerns. Our collective cases provide an insight into how eating disorders present and how they are treated by TCM acupuncture. How these insights may help clinicians and researchers is discussed.

A group of seven patients received neurostimulation (Stimpod) post-tennis or golfer's elbow surgery as their sole treatment to relieve acute post-operative pain, improve mobility and function. Patients undergoing the above-mentioned surgery have had chronic pain with and without neuropathic symptoms for a prolonged period. There is usually severe injury with active inflammatory processes due to the surgery. It was thought that treating these patients aggressively early post-operatively may expedite pain relief and the healing process.

Method

After their surgery, seven patients were given neurostimulation for three treatments of 20 min each on the brachial plexus during the 10 days before the splint was removed. This was followed by 6 treatments, twice weekly of 20 min each after the splint was removed. At each of these treatments 5-min stimulation were administered to four areas: the nerve supply (1) superior and (2) inferior to the elbow and (3 and 4) on either end of the wound. Patients were evaluated for pain with the visual analogue scale, movements of flexion and extension measured with a goniometer, strength and flexibility with a 12-movement activity scale, status of the wound and satisfaction with treatment, mobility and function. These measures were re-evaluated telephonically at one, three and six months after the last treatment.

Results

Significant pain relief was achieved by all of the seven patients before the splint was removed at the 4th treatment. Pain relief, range of movement and function was greatly improved at the final (9th) treatment by six of the seven patients and this was maintained with nearly full improvement of the above parameters for most of the participants at one month after the last treatment. Two patients had to have re-operation due to requiring more extensive surgery in the one patient and falling and injuring the original surgical site in the other patient. At three and six months after the last treatment full improvement in all the parameters above was maintained in the remaining five patients who also had excellent wound healing and satisfaction with their treatment, mobility and function.

Conclusion

It appears that the neurostimulation (Stimpod) has the capacity to improve acute post-surgical pain and reduce pain, improve mobility, function and stimulate wound healing once the splint was removed. This treatment is relatively cost effective, is non-invasive and of short duration. Positive effects were all maintained at 6 months.

This study evaluated the efficacy of Adjunct Laser therapy compared to self-management topical agents among acne vulgaris patients. A parallel randomized controlled trial involving 40 volunteer age ranged 17–28 years (22 ± 4). 35 participants who completed the study were sampled from the stratified 6 faculties’ population of the campus who were screened after meeting the selection criteria and giving the sorted individual consents. Both participants and assessors (physician) were parallel, block and blinded randomized. The outcome measures included distribution and severity of facial acne, counts of baseline lesion of comedones, papule, pustule and nodule, Estimate nos. of face acne eruptions; Mean density of acne calculated and recorded at base line prior each 8 RX sessions in 4 weeks [Density = n/25 cm² (Initial Density − Present Density = Level of Clearance)]. 2 × 4 × weeks R_x (laser group-invisible infrared non-ablative laser therapy supine lying via 905 nm pulsed single probe [Operation frequency: 2000 Hz ± 10%; Pulse Width: 160 ns ± 10%; Dosage = 5 J/cm² × 12 min duration]. 10 min Post-RX monitor. Results showed significant improvement in clearance rate of acne (post-laser therapy) relative to their counterparts in control group (54.98% vs. 17.97%, t = 9.773, p = <0.0001, CI = 95%). Conclusively, laser was observed significant adjunct therapy in improving acne clearance rate compared to self-administered topical agent approach only.

This study aimed to investigate the effects of percutaneous acupuncture stimulation on the viscoelasticity of human tendon structures during isometric contraction. Nine healthy men participated. The experimental order was pre-test, acupuncture stimulation, and post-test. Real and sham acupuncture applications were used at the stimulus site of the medial gastrocnemius muscle (MG), and a crossover trial was performed on the same subjects at a later date. Before and after acupuncture stimulation, tendon elongation and MG aponeurosis were directly measured by ultrasonography while the subjects performed isometric plantar flexions up to the maximum voluntary contraction (MVC) followed by relaxation. The relationship between the estimated MG muscle force (Fm) and tendon elongation (L) during the ascending phase was fitted to a linear regression, the slope of which was defined as the stiffness of the tendon structures. Additionally, the ratio (%) of the area within the Fm–L loop to the area under the curve during contraction and relaxation was calculated and defined as hysteresis. Stiffness rate of change (RC) in real and sham acupuncture was 137.5 ± 116.5% and 55.0 ± 10.4%, respectively (p < 0.05). Thus, real acupuncture demonstrated significantly higher values than sham acupuncture. The hysteresis measurement results in real acupuncture indicated a downward tendency (pre-treatment: 25.6 ± 5.1%, post-treatment: 16.1 ± 13.0%), while sham acupuncture indicated an upward tendency (pre-treatment: 26.5 ± 10.9%, post-treatment: 28.4 ± 6.9%). These results indicated that percutaneous acupuncture stimulation reduces hysteresis, enhances stiffness, and improves the viscoelasticity of tendon structures.

Acupuncture has recently gained increased attention in the world as an alternative treatment for diseases, but its metabolism pathways remain understood. Here we use proteomic technology to determine subtle protein changes and link proteins to metabolism pathways. iTRAQ-based quantitative proteomics was used to identify key proteins for acupuncture at ‘Zusanli’ acupoint (ST-36) in subjects. A total of seven related proteins were identified, and these candidates may be useful to clarify the biological mechanism of acupuncture at ST-36. Pathway analysis further revealed that most of these proteins were found to play a pivotal role in the regulation of multiple metabolism pathways.

A case of a 31 years-old woman with complex regional pain syndrome type I (CRPS) of the left arm is described. Brachial plexus block (BPB) has been cited as a treatment modality for CRPS. This report is based on the retrospective observations of the outcome and effects of axillary BPB in a patient with CRPS. 31 Years-old woman suffered from CRPS of the left upper limb after trauma for 5 months. Symptoms over the left upper limb were not alleviated under conventional pharmacological treatment and rehabilitation and severe painful swelling of the left wrist persisted. Axillary BPB with 30 ml Naropaine 0.2% was performed and 12 h later resulted in significant reduction of pain and improvement of function of the left wrist.

Cluster headache (CH) is a trigeminal autonomic cephalalgia and the most painful of the primary headaches. The medical therapy of CH includes both acute therapy for individual attacks and prophylactic therapy to prevent recurrent attacks during the cluster period. Although most patients can be treated effectively, some remain poorly responsive to therapy. The objective of this report is to describe a low cost technique that can be applied in office by a doctor trained in neurofunctional acupuncture and can bring good results for patients with this debilitating disease.

Objective

Our previous case study introduced combination acupuncture (manual, auricular and electro-acupuncture) as a treatment for radiation-induced xerostomia. The present retrospective study evaluates the effect of combination acupuncture on the severity of dry mouth and activities of daily living as related to radiation-induced xerostomia.

Design

Data was retrospectively collected from twenty-two patients with xerostomia related to radiotherapy for head and neck cancer (HNC). Sixteen patients who met the inclusion and exclusion criteria were analyzed for this report. The intervention was weekly 20 min sessions of combination acupuncture. Upon reaching a plateau in symptom improvement the length in time between treatments was increased as tolerated without return of symptoms. Outcome measures included a self-reported quality of life xerostomia questionnaire completed prior to each acupuncture session and quantitative data from documented Modified Schirmer's tests.

Results

Significant improvement in dry mouth and pain occurred during the initial six weeks of treatment (p < 0.05). During this period, the mean severity of dry mouth and pain decreased by 35% and 50%, respectively (p < 0.001). After six weeks, the improvement in dry mouth and pain symptoms plateaued. This effect was maintained with intermittent acupuncture treatments.

Conclusions

Combination acupuncture significantly decreases the severity of dry mouth and pain with long lasting effects, up to six months (at the end of data collection), in patients with radiation-induced xerostomia.