Medical Acupuncture最新文献

Introduction: Acupuncture has emerged as an effective adjunctive therapy for polycystic ovary syndrome (PCOS) with concern on the higher rate of adverse events (AE). In addition, timing of intervention, specific acupoints, and stimulation strength are concerning, as high-stimulation electroacupuncture (EA) may increase miscarriage risk. This review aims to systematically evaluate the safety profile of acupuncture in PCOS.

Materials and methods: PubMed, ScienceDirect, and Scopus were searched prior to September 8, 2024. This study included randomized controlled trials (RCTs) comparing acupuncture with "control" (sham/no acupuncture) or active drugs. Study quality was assessed using RoB 2.0. Meta-analyses were conducted with R Studio.

Results: From 1,041 articles, 13 RCTs were included. There was no significant serious or life-threatening AE occurred in all trials. In acupuncture versus control groups, mild to moderate AEs were similar overall, except bruising, which was significantly more frequent at needle insertion sites with acupuncture (OR = 3.34; 95% CI: 1.76-6,37; p < 0.01). In acupuncture versus active drugs, there were no significantly higher mild to moderate AEs in the acupuncture group. Miscarriage rates were comparable with acupuncture versus controls or ovulation-induction drugs, particularly with low-frequency (2 Hz) EA applied prepregnancy. Collectively, the findings support acupuncture's safety profile, including no significant increase in miscarriage risk when administered prior to pregnancy.

Conclusions: Acupuncture has emerged as a safe option for complementary therapy in PCOS. Further research is needed to refine acupuncture protocols, which further position it as a preferred adjunctive treatment in PCOS.

Background: The safety of acupuncture treatments is crucial for patients. Although acupuncture is generally considered a relatively safe therapeutic modality, acupuncture-related adverse events cannot be entirely avoided. The development and implementation of effective preventive strategies are essential for enhancing clinical safety.

Objective: This article focuses on the acupuncture safety strategies implemented within Taiwan's medical system, aiming to address the multifaceted and complex nature of acupuncture-related adverse events and to propose practical approaches for risk reduction.

Methods: This article emphasizes the application of preventive strategies tailored to known risk factors. A structured, phased educational model has been adopted to reinforce both theoretical knowledge and clinical proficiency. In addition, improvements in the use of acupuncture instruments and the standardization of procedural workflows have strengthened adherence to safety protocols. The integration of modern technologies with traditional medical knowledge has further advanced innovation in clinical safety.

Conclusion: Taiwan's comprehensive approach to promoting acupuncture safety offers valuable insights and a practical reference for enhancing acupuncture safety in global settings.

Acupuncture, an integral part of traditional Chinese medicine, has been practiced for over 2,500 years. Dr. William Osler, a renowned physician in Canada and the United States during the late 1800s, was also an acupuncturist. He learned acupuncture from Dr. Sydney Ringer, a prominent British physiologist and medical doctor. Osler developed a method for treating lower back pain that focused on local acupoints, utilizing long hatpins. He advocated for acupuncture in his teaching for four decades and included it in his seminal textbook The Principles and Practice of Medicine: Designed for the Use of Practitioners and Students of Medicine. In 1879, Osler experienced a failed case in his acupuncture practice. A wealthy patient's severe lower back pain was aggravated after treatment, leading to public criticism and professional humiliation. This incident caused some scholars to undervalue acupuncture and speculate that Osler ceased practicing it thereafter. The reasons for such painful experiences in acupuncture are generally attributed to four factors: The first is poor needle quality and size: The needles used by Osler were rigid and had a diameter of ∼1.00 mm, which is significantly larger than modern acupuncture needles. The second is inadequate needling technique: Proper training and precision are crucial for painless acupuncture. The third is improper needle placement: Inserting needles into subcutaneous vessel walls or skin follicles can cause discomfort. The fourth is patient-specific reactions: Conditions such as hyperalgesia may increase sensitivity, requiring the use of distal acupoints rather than local ones. To minimize pain and adverse effects, effective communication with patients is essential. It is worth noting that the rate of severe pain caused by acupuncture is only 0.007%, and the risk of other adverse effects is very low.

Background: Acupuncture is a widely recognized complementary therapy with proven therapeutic benefits; however, concerns regarding patient safety persist due to adverse events ranging from minor complications to severe outcomes like pneumothorax and nerve injury.

Objective: This study aims to identify common adverse events in acupuncture, propose innovative risk mitigation strategies, establish standardized best practices, enhance practitioner training, and examine global disparities in safety protocols.

Design: Comprehensive review of existing literature, clinical case studies, and international safety guidelines.

Setting: Global acupuncture practice environments, including clinical and wellness settings.

Patients or subjects: Analysis of patient populations receiving acupuncture treatments across various international settings and case reports of adverse events.

Intervention: Analysis of emerging technologies, training methodologies, and preventive strategies including real-time monitoring tools, ultrasound-assisted acupuncture, and digital patient records.

Main outcome measures: Adverse event rates, safety protocol effectiveness, practitioner competency measures, and global safety standard variations.

Results: Most adverse events are linked to practitioner errors, patient-specific factors, or inadequate safety protocols, with major complications remaining rare but requiring structured safety measures. Risk mitigation strategies significantly improve treatment precision and safety. Countries with rigorous certification processes report fewer adverse events.

Conclusions: Improving acupuncture safety requires a multifaceted approach integrating technological advancements, evidence-based best practices, and enhanced professional training. Strengthening international collaboration and regulatory oversight will ensure acupuncture remains a trusted, risk-free, and effective therapeutic modality.

Introduction: This review evaluates the safety protocols for acupuncture, emphasizing the need for stringent measures due to the procedure's invasive nature.

Discussion: It discusses the necessity of global safety standards, including mandatory accreditation and licensing for practitioners to mitigate risks such as needle contamination and improper technique. The study advocates for extensive training and continuous education programs to ensure practitioners master both theoretical and practical aspects of acupuncture. The review highlights the use of sterilized, single-use needles and regular equipment checks to maintain high safety standards. It also underscores the importance of pretreatment assessments, informed consent, and posttreatment monitoring to enhance patient safety. Furthermore, it suggests the implementation of robust surveillance systems and the use of case studies to learn from adverse events. Finally, the review identifies research gaps and recommends focusing on innovative techniques and fostering international cooperation to advance acupuncture's safety and efficacy.

Conclusion: This approach aims to strengthen safety protocols, thereby improving patient outcomes and aiding acupuncture's integration into mainstream health care.

Introduction: Acupuncture has gained recognition in modern health care for its effectiveness in managing chronic pain, reducing stress, and enhancing well-being.

Discussion: Despite this, the acupuncture profession in the United States faces significant challenges, including the disconnect between education and job markets, the encroachment of other health professionals such as physical therapists, preference for medical doctors over licensed acupuncturists in medical establishments, and inconsistent entry standards that affect care quality. Fragmented regulations and public misconceptions further undermine the profession's credibility.

Conclusion: To ensure its future, a unified professional body, standardized education, and collaborative efforts among stakeholders are essential to promote rigorous standards and enhance public trust in acupuncture.

Introduction: Pain after rotator cuff surgery is prolonged. This has led to the need for opioids and the risk of developing opioid use disorder. This study was designed to investigate the role that active auriculotherapy treatment (AT) may play in reducing opioid consumption following rotator cuff surgery.

Methods: Fifty patients who underwent a primary ambulatory unilateral rotator cuff surgery participated in this randomized, placebo-controlled study. Each patient was randomized to either the AT group or the placebo group (P group). The primary endpoint was overall opioid consumption (oral morphine equivalent in mg) in the first five days after surgery. Secondary endpoints included pain at rest and with movement, non-narcotic analgesic consumption, functional recovery, time to discharge from the recovery room and hospital, patient satisfaction, and the number of patients readmitted to the hospital because of pain.

Results: The use of AT (n = 20) significantly decrease by 35% opioid consumption (p = 0.0307). The pain with movement in the AT group was significantly lower compared to the P group at 14 days (4.47 ± 2.12 vs. 5.84 ± 2.39, respectively; p = 0.0394). No differences in time to discharge from the recovery room and the hospital and functional recovery were recorded. The use of AT was also associated with an increase in satisfaction at 90 days compared to the P group (5.9 ± 0.3 vs. 4.9 ± 1.9, respectively; p = 0.0267).

Discussion: Our data, based on a randomized, placebo-controlled study, demonstrated that AT using cryogenic needles and nine ear points is an effective technique to reduce postoperative opioid requirement in opioid-naïve patients following rotator cuff surgery.

Conclusion: Our data suggest that the use of AT may help reduce opioid consumption following ambulatory rotator-cuff surgery.

Introduction: Acupuncture clinical research has gone through a stage of exponential growth since the NIH consensus statement published in 1998 with over 21,000 articles indexed in PubMed. However, there is still uncertainty about the scientific or biological basis of an acupuncture point. This adversely affects research making it impossible to defend what is a real or verum acupuncture point versus a sham or non-acupuncture point that could be used in a randomized controlled study as a control group. Even more problematic is related lack of certainty about the anatomic target of the inserted needle.

Discussion: The scientific community has proposed a number of possible tissue targets based on the physiological response to acupuncture stimulation from motor end points in the muscle to nerve plexuses and trunks to the fascia. Complicating this discussion is the fact that within acupuncture traditions across the world, there are many different needling styles from Japanese approaches that tend to be more superficial, to deep needle stimulation styles from China, to cutaneous needling methods developed in Germany called the Very Point technique. A subset of this debate revolves around the use of acupuncture needles to treat myofascial trigger points.

Conclusion: This article will discuss some of the leading theories especially as they relate to acupuncture and propose a model that focuses on fascial stimulation. An acupuncture needle technique called Fascial Nodal Point^© stimulation will be discussed and contrasted with many non-acupuncture styles of stimulating myofascial trigger points.