Medical Acupuncture最新文献

Background: A patient with severe COVID-19 pneumonia had adjunctive acupuncture to improve respiration and facilitate weaning off prolonged mechanical ventilation (MV).

Case: A man in his 40s with COVID-19 was in an advanced critical-care center on symptom day 5 for respiratory failure due to pneumonia requiring MV therapy. He received high-dose corticosteroid pulse therapy, antiviral agents, and multiple antibiotics for complicated bacterial pneumonia and bacteremia. Repeated MV weaning attempts failed, although his pneumonia gradually improved. Then, acupuncture 4 times per week was started to improve his respiration and facilitate MV weaning from day 49 of his symptoms' onset.

Results: His weaning-related indices improved, including reductions in respiratory rate and Rapid Shallow Breath Index. His O₂ saturation increased immediately after each acupuncture treatment. The day after the first acupuncture treatment, his MV support was reduced by changing ventilation mode from synchronized intermittent mandatory ventilation mode to continuous positive airway pressure (CPAP) mode during the day without exacerbation of respiratory status. After 3 days of acupuncture, this patient was on CPAP support alone. MV therapy was discontinued completely after 8 days of acupuncture (6th acupuncture treatment).

Conclusions: Acupuncture improved respiration and facilitated MV weaning in a patient with respiratory failure secondary to COVID-19. Adjunctive acupuncture may benefit such patients and others after severe pneumonia. Large cohort studies are needed.

Introduction: Patients with chronic pain and high-level catastrophic thoughts often do not respond to acupuncture. This may be related to hypofunctioning of the dorsolateral prefrontal cortex and the descending pain inhibitory system. Therefore, we examined the relationship between the level of catastrophic thinking and the analgesic effect of electroacupuncture using the pain catastrophizing scale (PCS). We also evaluated the descending pain inhibitory system using conditioned pain modulation (CPM) and offset analgesia (OA). The relationship between catastrophic thinking and the descending pain inhibitory system was also examined.

Materials and methods: After testing the hospital anxiety and depression scale and the PCS in 14 healthy adults, the current pain threshold (CPT), CPM, and OA were measured, in order, before the intervention. Thereafter, electroacupuncture was applied to 3 limbs (the dominant hand and both lower extremities) at 4 Hz, and to the scalp at 100 Hz, for 30 minutes, and the CPT was measured again immediately after the intervention. The difference in the CPT before and after the intervention was taken as the analgesic effect.

Results: The participants were divided into 2 groups, the H-PCS group (≥16 points) and the L-PCS group (≤15 points), according to the PCS score, and the analgesic effects of electroacupuncture were significantly different (P = 0.04). However, no relationship was found between the PCS score and the CPM (r = -0.02, P = 0.94) and OA effects (r = -0.19, P = 0.49).

Conclusion: It was suggested that people with high-level catastrophic thinking may find it difficult to obtain the analgesic effects of electroacupuncture.

Background: Bell's palsy is an acute idiopathic paralysis of lower motor neurons on only 1 side of the face without any identifiable etiology. The condition affects a patient's physical, social, and psychologic health. It is important for the patient to recover quickly and minimize the risk of long-term sequelae. Therefore, researchers recommend a combination of several therapeutic modalities to shorten the disease's course and improve curative effects.

Case: A 34-year-old woman had with right facial weakness. She was diagnosed with House-Brackmann grade III Bell's palsy and received medical therapy. She was also given manual acupuncture at GB-20, BL-2, ST-36, LI-4, TE-5 bilateral, and GV-20. Penetrating needling was given at GB-14 toward Ex-HN-3, ST-7 toward SI-18, SI-18 toward LI-20, ST-6 toward ST-4, and ST-5 toward ST-4 on the affected area, with a 30-minute needle retention. Electroacupuncture (EA) was delivered at ST-7-SI-18, ST-6-ST-5, GB-14-Ex-HN-5, and ST-4-CV-24, with a dense-disperse wave, at a frequency of 10/50 Hz for 20 minutes. She had treatment sessions twice per week, for a total of12 sessions.

Results: From her 7th to 12th visit, this patient had reached House-Brackmann grade I. No adverse effects occurred.

Conclusions: In this patient, a combination of acupuncture penetrating needling technique and EA played a role to shorten her recovery time and minimize the risk of sequelae of Bell's palsy. The treatment combination used in this case report can be considered in other clinical cases.

Background: Trigger finger (TF; a type of stenosing tenosynovitis) is common, affecting the flexor tendons of the hand, often causing significant pain and functional impairment. Treatment can include splinting, corticosteroid injection, or surgical release. There is little published research on the role of electroacupuncture (EA) for treating TF.

Case: After more than 1 year of pain and triggering, a 58 year-old male had locking of his left, fourth ring finger requiring painful manual reduction. EA was performed with 4-6 needles in a rectangular pattern along the radial and ulnar aspects of the A1 pulley of the fourth digit, with 10 Hz delivered in a daisy-chain formation for 45 minutes. Nodule size, frequency of triggering and locking, and severity of pain were assessed before and after 4 treatments over ∼1.5 months.

Results: This patient's frequency of locking and severity of pain decreased significantly by 50% after his first treatment. Additional clinically significant reductions of locking, pain, and nodule-size were evident after each treatment along with substantial functional gains between visits. After his fourth treatment, he reported 100% resolution of his symptoms with no further pain or triggering. Throughout this time, he continued his usual activities.

Conclusions: EA alone directed at the A1 pulley may be an effective treatment modality for patients with TF. The authors hypothesize that EA may reduce pain enabling a return to normal function and compression of the nodule, thus eliminating triggering. Further research evaluating the efficacy of EA for TF may help substantiate these results.