Medical Acupuncture最新文献

Introduction: This study explores laser auricular acupuncture as a potential solution for nicotine dependence, comparing it to conventional counseling. With a death every 6.5 s due to tobacco, the systematic review aims to assess the efficacy of laser acupuncture versus counseling or placebo, offering insights into innovative strategies for combating tobacco addiction.

Methods: A systematic search across scientific databases yielded 2537 articles (2000-2021), reduced to 1294 after deduplication. Abstract screening narrowed it down to eight articles; after a full-text assessment based on inclusion/exclusion criteria, four were selected. Inter-rater reliability between coders (Z.A., M.R.K.) was strong at each screening stage, with perfect agreement at the full text (κ = 1.0), abstract (κ = 0.99), and title (κ = 0.89) stages, all with a 95% confidence interval.

Results: In the meta-analysis of two studies on post-intervention nicotine dependence using the Fagerstrom scale, the laser group showed significantly lower scores (p = 0.002, mean difference = -0.60). Examining subjects who failed to quit smoking immediately after therapy, the laser group had 53.8% continuation compared to 83.0% in the comparison group (non-significant difference). At the 3-month mark, the continuation rates were 60.8% for the laser group and 86.6% for the comparison group (non-significant difference).

Conclusion: Potential superiority of laser auricular acupuncture over behavioral counseling in tobacco cessation, with reported safety. However, the limited trials and sample size warrant cautious interpretation. Laser therapy emerges as a promising modality, but further extensive trials, especially in combination with other interventions, are crucial to solidify its efficacy in facilitating successful tobacco cessation.

Background: Acupuncture is a popular modality for treating shoulder pain and dysfunction. However, its reproducibility in shoulder-related clinical studies has been inconsistent. Several discrepancies were found between the systematic classical (Jia Yi Jing [JYJ]) and a modern standardized acupuncture text for the location of points on the shoulder girdle.

Objective: To define the neuroanatomical target of acupoint with respect to the shoulder girdle.

Methods: Transliteration of the location of shoulder girdle-related acupuncture points from the JYJ. Point locations from the JYJ were compared to the textbook Chinese Acupuncture and Moxibustion. A review of surgical literature, cadaver dissection, and response from electrical stimulation on healthy volunteers was used to propose new neuroanatomical targets for each acupuncture point.

Results: Acupuncture points of the shoulder girdle corresponded to the following: dorsal scapular, spinal accessory, long thoracic, thoraco-dorsal, suprascapular, axillary, and pectoral nerves.

Conclusions: The present research verified the relationship between acupuncture points of the shoulder girdle and their corresponding neuroanatomical targets. This information increases the precision of acupuncture point stimulation and aids in the standardization of acupuncture point locations. It is expected to improve the interpretation of acupuncture studies on shoulder rehabilitation and future research design.

Introduction: Long COVID, or post-COVID syndrome, refers to signs, symptoms, and conditions that persist or emerge following an acute coronavirus disease (COVID-19) infection. The most frequent symptoms are fatigue and dyspnea, with approximately 10-20% of patients recovering from COVID-19. Currently, there are no specific medical recommendations, except for symptomatic treatment.

Objective: To evaluate the use of transcutaneous electrical acupoint stimulation (TEAS) for the treatment of post-COVID severe dyspnea.

Methodology: This is a case report of successful treatment using TEAS in a patient with severe dyspnea after recovery from COVID-19.

Results: A female adult patient experienced progressive dyspnea after recovering from COVID-19 a year prior. One session of TEAS successfully relieved severe dyspnea. No adverse effects or recurrence of dyspnea were reported at the 6-month follow-up.

Conclusion: TEAS is a safe, simple, and effective treatment for overcoming post-COVID severe dyspnea.

Background: Preeclampsia is a leading cause of maternal mortality, puerperal ICU admission, and iatrogenic preterm delivery. Some small studies suggest that acupuncture and acupressure may improve blood pressure, but few studies have examined the impact of these treatments on outcomes in patients with preterm preeclampsia with severe features.

Objective: This retrospective chart review study assessed if acupuncture/acupressure (AQ/AP) in conjunction with routine care is associated with longer time from admission to delivery or gestational age at delivery in hospitalized patients with preterm preeclampsia compared to routine care alone. Secondary outcomes included breakthrough antihypertensive use, mean arterial pressure (MAP), postpartum length of stay, ICU admission, measures of hepatic and renal function, platelet counts, birthweights, and 5-min Apgar scores.

Study design: This was a retrospective matched cohort study (2010-2020) of patients with preterm preeclampsia with severe features admitted for expectant management. Patients receiving AQ/AP were matched with controls who received only routine care.

Results: The final sample of 100 matched pairs found the mean latency period from admission to delivery was 2.5 days longer in the AQ/AP group (95% CI: 0.81-4.26, p = 0.004). Breakthrough antihypertensive medication use, changes in MAP, and other biomarkers did not differ significantly.

Conclusion: Among patients hospitalized for preeclampsia with severe features, those who received acupuncture and/or acupressure treatment had a longer time to delivery than matched controls, but AQ/AP treatment was not significantly associated with MAP or use of breakthrough antihypertensive medication.

Background: Yamamoto New Scalp Acupuncture (YNSA) uses microsystems in the body for various treatments. In YNSA diagnosis, Hoku is important for determining the treatment side. The A-point is used for treating neck and shoulder symptoms, and the D-point for low back pain; however, no studies support this.

Aim: To investigate the site specificity of stimulation at the A-point and the usefulness of Hoku diagnosis.

Methods: Nineteen healthy adults with no previous acupuncture experience were included. Participants randomly received three sessions of A-point, D-point, or no stimulation, followed by a 1-week minimum washout period. The visual analog scale (VAS) of shoulder stiffness, pressure pain threshold (PPT), and muscle hardness were evaluated at the bilateral shoulder region before, during, and 20 min after the stimulation, with the observer blinded to group allocation.

Results: No significant differences were found in PPT between the three groups. Significant differences in VAS were observed between the three groups and in the comparison between the A-point and the control group. Intragroup analysis showed a significant improvement in the A-point and none in the D-point group. In subjects who had tenderness and induration on the right side of Hoku, the VAS score was significantly improved between the groups and multiple comparisons between the A-point and the control. The effect size was greater when limited by the Hoku diagnosis.

Conclusion: The stimulation point selected according to the diagnosis point information might be more effective in YNSA. However, the results of this study were based on healthy adults, so the effect size was small. In the future, large-scale studies on patients with symptoms are needed.

Background: Point detection is a pillar for auriculotherapy diagnosis. However, the pressure probes' accuracy is yet to be established.

Objective: To assess the accuracy of commercially available pressure probes for auriculotherapy's diagnosis.

Methods: Four probes were tested against a semi-analytic bubble level and calibrated precision pressure scale. Forty peaks of pressure from each device were recorded. The raw and the normalized peaks (by probes' length and diameter) were analyzed.

Results: The absolute and the relative trials consistency were considered reliable, but inter-device differences were found for all pairwise comparisons among devices. The ideal preset pressure of 250 g was not achieved by any device, with effect sizes ranging from moderate to huge.

Conclusions: All devices showed higher values compared with 250 g. The device's results disagree compared to each other, impairing the reliability and the diagnosis. Aside from the within-device absolute and relative consistency, the results suggest there is still no gold-standard device to assertively assess the auricular tender points.

Introduction: The Japan Society of Acupuncture and Moxibustion (JSAM) and experts on the safety of acupuncture and moxibustion (AM) in Japan have focused on safety improvement among acupuncturists, moxibustionists (AMists), and AM-practicing physicians. This article provides an overview of the activities conducted by academic experts in AM safety, primarily from the JSAM, to improve AM safety.

Discussion: The JSAM formed the Safety Committee in 1998 to collect data regarding AM-related adverse events, provide relevant information to members, and conduct educational activities to prevent malpractice. Early literature reviews on AM-related adverse events in Japan published by the committee significantly shifted the paradigm regarding the awareness of AM safety among Japanese AMists and AM-practicing physicians. The committee has been holding educational workshops on safe clinical AM practices at the annual conferences of the JSAM, managing a website on AM safety strategies, conducting various surveys on AM safety, and performing periodic literature reviews of AM-related adverse events. In recent years, the committee has focused on publishing guidelines and manual books. This article briefly describes the guidelines published in 2020, as well as a practical manual based on these guidelines that was published in 2024.

Conclusion: Despite extensive efforts in this area, further enhancement of safety management education in Japan is essential. The information provided herein is expected to stimulate the exchange of ideas, discussions, and innovations for improving AM safety worldwide.

Background: Any injury to the diabetic limbs may portent disastrous consequences. However, it is not uncommon for diabetics to also seek complementary and alternative medicine for treatment, such as acupuncture. There are limited data on infective or ulcerative adverse events regarding acupuncture in diabetic limbs.

Objective: This scoping review served to survey and map out the current literature landscape on infective or ulcerative complications, if any, of acupuncture in diabetic limbs and to also identify key gaps in the current literature.

Methods: A scoping review was conducted based on the five-step framework by Arskey and O'Malley. The review included a comprehensive search of three databases (PubMed, Medline, and Embase) regarding any reports of adverse events after acupuncture in diabetic limbs.

Results: Eight articles were analyzed. Four were case reports, three were clinical trials, and one was a review article. Most of the articles mentioned qualifications for practitioners (except for two articles). Clean needle technique was mentioned only in one article. Three articles highlighted adverse events and possible dangers related to needling in diabetic limbs. The other five articles highlighted no serious adverse events in using acupuncture/needling in diabetic limbs.

Conclusions: While there are risks of ulceration and poor healing after acupuncture in diabetic feet, there are also likely benefits like improving neuropathy symptoms and ulcer healing. It is important to optimize safety risk factors such as procedural sterility, avoiding concomitant heat modalities, and ensuring qualified practitioners. Only then can patients benefit from acupuncture treatment for diabetic feet while minimizing complication rates.

Background: Acupuncture and moxibustion (AM) are effective for pain relief and chronic disease management but carry risks of adverse events (AEs). Japan prioritizes AM safety, and Hiroshima University Hospital Kampo Clinical Center (HUHKCC) follows strict professional standards to ensure both safety and efficacy.

Objectives: The study analyzes AM-related AEs in Japan over the past decade, compares them with HUHKCC practices, and proposes risk mitigation strategies.

Methods: AM-related AEs from 2013 to 2024 were reviewed using case reports from the Ichushi-Web, CiNii, and Accident Information Data Bank System (AIDBS) databases, alongside data from HUHKCC (October 2023-2024). Patient information and AEs were collected from electronic medical records and a survey of six acupuncturists. Data analysis was performed using bibliometric methods in Excel and BioVenn.

Results: An analysis of 55 studies and 153 AEs showed a fluctuating trend, with insertion needle technique (INT) accounting for 89.1%. Common AEs included internal injuries (32.7%) and infections (21.8%). AIDBS data indicated 12 AEs annually, with 66% from INT and 33% from moxibustion. Conversely, HUHKCC's 568 sessions reported no adverse effects; however, side effects such as fatigue or localized pain were reported in 10 cases. One reason for less AEs is that contact needle technique (CNT) was used in 96.8% of sessions.

Conclusions: Despite Japan's emphasis on AM safety, AM-related AEs remain consistent. Although effectiveness of each technique requires evaluation, the HUHKCC model, with its focus on CNT, diagnostics, and practitioner training, might effectively mitigate AEs and offer a valuable framework for improving AM safety.