bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser Acupuncture for Migraine and Muscle Tension Headache: A Double-Blind Controlled Trial
Authors: Lavies Nicholas G
Published: April 2009

Twelve patients with chronic migraine recruited from a neurology clinic or a self-help group were randomly allocated to receive either 6 weeks active laser acupuncture or 6 weeks dummy laser acupuncture. Patients completed headache diaries for the 6 weeks prior to treatment and for 6 weeks following. They were then crossed over to receive the alternative treatment for a further 6 weeks. Neither patients nor operator knew which unit was the active one. There was a reduction in mean total headache score (combining duration and severity) of 18% in the active group and 43% in the control group following the first treatment period. This difference was not significant. Following the second treatment period, mean scores increased by 50% in the active group and 5% in the control group but again this difference was not significant due to inconsistent responses by some patients. When active and placebo treatments were computed for all patients, there were still no significant differences. It is concluded that laser acupuncture does not have an important clinical effect in migraine over and above the expected placebo response.
High Frequency Ozone Therapy Based on Acupuncture Systematics
Authors: Umlauf Richard
Published: April 2009

After witnessing a dramatic demonstration of pain relief following High Frequency Ozone Therapy (HFOT) at a medical conference in Germany the author reports on his use of the treatment in 500 cases. Pain relief was the reason for 76.4% of treatments. The condition of no patient in the 500 worsened following therapy, and 18 patients suffering from malignant disease all obtained beneficial symptomatic relief.

The High Frequency Ozone Therapy apparatus uses a variety of electrodes ranging from simple probes to elaborate brush or comb devices for application directly on the skin surface or aerially above it. Treatment is most effective if given through a layer of natural textile (wool or cotton). Stimulation through synthetic material, however, may provoke pain.
Aetiology and Treatment of Some Common Cephalalgias
Authors: Baldry Peter
Published: April 2009

Reasons are advanced for believing that migraine and tension-type headaches are a continuum and that whether migraine or tension-type headache develops at any particular time is dependent on the relative vascular nociceptive, myofascial nociceptive and supraspinal (emotional) inputs that converge on and are integrated by the subnucleus caudalis (medullary dorsal horn).

The prophylaxis of both these two types of headache involves reducing each of these various inputs and therefore a polytherapeutic approach is essential. The measures required include pharmacotherapy, psychotherapy and acupuncture.

The aetiology and treatment of primary myofascial trigger point cephalaigia is also discussed.
The Substrate and Properties of Meridians: A Review of Modern Research
Authors: Wei Haifeng , Huang Lawrence Chung-Long , Kong Jian
Published: April 2009

Meridians are regarded as the base upon which traditional acupuncture theory is built but, although much research time has been spent on their investigation, no coherent scientific theory has emerged to explain their structure or mode of action. There have been several hypotheses that offer sufficient evidence for a partial explanation for certain meridians. This paper suggests that there is indeed no single answer, but that the various hypotheses should be combined, accepting that different explanations are likely for different meridians or parts of the body.

The most useful tool for investigation seems to be the phenomenon of propagated sensation along meridians. Experiments indicate that physical transmission occurs most generally through the interstitial space, specifically along the neurovascular bundles, rather than through vascular channels. The mechanism of meridian activity is likely to be via neuro-transmitters, found particularly along meridian lines, and by ionic movement.

This review of research literature, much of which has emanated from China, concludes that there is a real structural basis for the meridians, but that this structure is the orderly arrangement of normal tissues along the line of meridians rather than any special histological feature.
A Study of Acupuncture Treatment for Enuresis in Children with Mental and Physical Handicap
Authors: Floares Iuliu
Published: April 2009

At a hospital for children with severe mental and physical handicap where the incidence of nocturnal enuresis exceeds 88%, a group of 128 children between the ages of 5 and 19 years (65% of those resident) were treated with acupuncture. The overall response showed good or very good benefit for 29% of patients, while 44% had none. The most responsive age group was the 10 to 14 year olds with 50% success; there was no difference between boys and girls. Children with the most severe mental retardation and those with day time faecal and urinary incontinence responded less well. The benefit felt by the whole hospital community at the reduction of bed wetting was substantial. The author believes that acupuncture for enuresis in mentally and physically handicapped children is an effective and worthwhile treatment.
Clinical Applications of the Zulinqi Acupuncture Point
Authors: Jun Pang , Yu-shun Li , Bo-ling Huang , Yu-yan Zhou , Zhi-yong Han , Richardson Faye
Published: April 2009

The Zulinqi acupuncture point (GB.41), on the dorsal surface of the foot, is reported traditionally to be effective for treating disorders that occur along the course of the Gall bladder channel. The authors describe its beneficial use in five, widely differing indications and give supporting case histories. The indications discussed are: metatarsal fracture, bruised finger, headache, pain in the hypochondrium, and abdominal Herpes zoster. Its use in these cases is shown to illustrate four important principles of treatment: select lower points for upper diseases, use points on the right for symptoms on the left and vice versa, restrict needling to few but effective points, and apply one point to many purposes.
Is Acupuncture for Pain Relief in General Practice Cost-Effective?
Authors: Lindall Steven
Published: April 2009

Sixty-five selected patients with pain, mainly of musculo-skeletal origin, were offered treatment by a qualified medical acupuncturist in his general practice surgery as an alternative to hospital outpatient referral. The patients assessed their own outcomes on a digital scale: there were 46 successful treatments and 14 failures, with 5 being lost to follow up. The cost of acupuncture treatment was compared to that of the referral that would have been made if acupuncture had not been offered. The acupuncture was found to have cost £10,943 against a minimum likely cost for hospital referrals of £26,783. A minimum total saving for all 60 patients of £13,916 was determined, giving an average saving per patient of £232. Additional hidden savings through avoiding further hospital procedures and expenditure on medication were not taken into account. It is concluded that acupuncture in selected patients and when used by an appropriately qualified practitioner appears to be a cost-effective therapy for use in general practice, reducing the need for more expensive hospital referrals.
Tender Point Injection of Corticosteroid in the Treatment of Backache
Authors: Bourne IHJ
Published: April 2009

The cost of back pain in terms of morbidity and fall in income to patients, and loss of manpower to industry is remarkably high: it has been estimated that half the population has or has had backache. Thus a simple and efficacious treatment has been much sought after.

A series of 115 patients with chronic backache seen in general practice over a period of 10 years was reviewed. They had all been treated with injection of corticosteroid in lignocaine to tender spots on the back. The men showed a progressive incidence of backache to their fifties, with reducing incidence in retirement, while the women had an even spread through all ages from puberty. The proportion responding to treatment was similar for all age groups and was unrelated to length of history. A good response to injection was reported by 54% of patients overall, but this was reduced to 41% if prolapsed disc had been diagnosed on x-ray.

A second series of 57 patients with backache was investigated on a single-blind, randomised, controlled basis. Three groups were compared: lignocaine injection only, lignocaine with triamcinolone acetonide, and lignocaine with methylprednisolone acetate. There was no statistical difference between the two forms of corticosteroid, but there was a significantly greater benefit (p=0.001) from corticosteroid injection to tender spots in the back than from lignocaine injection alone.
Acupuncture Therapy for Stroke: Approaches from the Acupuncture Literature
Authors: Erickson Russell J
Published: April 2009

Acupuncture therapy for rehabilitation following stroke is very popular in China and has also been investigated in the West, notably in Scandinavia. The traditional method is body acupuncture using yang meridian points. Yin meridians are probably more beneficial when treatment has been delayed for some months after the stroke. Scalp acupuncture, either the Japanese Yamamoto New Scalp Acupuncture, a microsystem which requires great accuracy, or a Chinese variety such as the Zhu approach or the Shanghai scalp technique, has become very popular and published work has demonstrated superiority to traditional body acupuncture. Additionally, a new technique, Xingnao Kaiqiao, has been developed that uses strongly stimulated body points to induce twitching in the affected limbs. This method seems to have given good results in large-scale usage and is not difficult to learn. However, all of these acupuncture techniques require many sessions of treatment and are thus, with perhaps the exception of Yamamoto scalp acupuncture, heavily labour intensive. None the less, the benefits in terms of cost savings as well as effective return to an independent life-style are clear.
Three Months in China
Authors: Slark Hollie
Published: April 2009

An eight week period of study was undertaken at Shanghai Medical University as a student elective from Manchester University Medical School. During this time the student was taught elements of the traditional theory of acupuncture and was given clinical training in acupuncture, electroacupuncture, moxibustion, cupping and herbal injection. A good variety of medical problems were seen being treated. The process of selecting a suitable venue for a student elective in China is discussed, as is the teaching routine in an acupuncture clinic.
Unilateral versus Bilateral Acupuncture on Knee Function in Advanced Osteoarthritis of the Knee – a Prospective Randomised Trial
Authors: Tillu Abhay , Roberts Chris , Tillu Sumedha
Published: April 2009

We report a prospective randomised trial of acupuncture given to 44 patients with advanced osteoarthritis (OA) of the knee awaiting total knee joint replacement. Patients were randomly allocated into two groups, group A receiving acupuncture to the most affected knee only and group B receiving acupuncture to both knees. Acupuncture was given to four local points around the knee and one distal point. The local points were Spleen 9 (Yinlinquan, SP9), Spleen 10 (Xuehai, SP10), Stomach 34 (Liangqui, ST34), and Stomach 36 (Zusanli, ST36). The distal point was Large Intestine 4 (Hegu, LI4) on the first web space of the ipsilateral hand. A blinded observer assessed knee function before starting treatment, and at the end of two and six months. Analysis of the results showed a significant reduction in symptoms in both groups, and this improvement was sustained for six months. There was no statistically significant difference between the groups.

In conclusion, unilateral acupuncture is as effective as bilateral acupuncture in increasing function and reducing the pain associated with OA of the knee. This trial is not able to distinguish the specific from the non-specific effects of the treatment.
Rare but Serious Complications of Acupuncture: Traumatic Lesions
Authors: Peuker Elmar , Grönemeyer Dietrich
Published: April 2009

Acupuncture has a reputation among the public of being safe. Although recently performed prospective studies on the frequency of adverse effects of acupuncture found no severe complication, since 1965 many case reports of serious or even life-threatening incidents caused by acupuncture have appeared in the scientific literature.

The most frequently reported complications are pneumothorax and lesions of the spinal cord. Severe injuries of peripheral nerves and blood vessels due to acupuncture seem to be very rare.

Although case reports do not produce reliable data on the frequency of adverse events, information on sources of application errors can be extracted to increase the quality of acupuncture in education and therapy.

All traumatic injuries described in this article could be avoided if practitioners had better anatomical knowledge, applied existing anatomical knowledge better, or both.
Management of Myofascial Trigger Point Pain
Authors: Baldry Peter
Published: April 2009

Successful management of myofascial trigger point (MTrP) pain depends on the practitioner finding all of the MTrPs from which the pain is emanating, and then deactivating them by one of several currently used methods. These include deeply applied procedures, such as an injection of a local anaesthetic into MTrPs and deep dry needling (DDN), and superficially applied ones, including an injection of saline into the skin and superficial dry needling (SDN) at MTrP sites. Reasons are given for believing that DDN should be employed in cases where there is severe muscle spasm due to an underlying radiculopathy. For all other patients SDN is the treatment of choice. Following MTrP deactivation, correction of any postural disorder likely to cause MTrP reactivation is essential, as is the need to teach the patient how to carry out appropriate muscle stretching exercises. It is also important that the practitioner excludes certain biochemical disorders.
Acupuncture for Carpal Tunnel Syndrome
Authors: Freedman Jonathan
Published: April 2009

Acupuncture was used to treat a 51-year-old ‘lollipop lady’ (school crossing patrol officer), with severe carpal tunnel syndrome (CTS) affecting her dominant hand, and co-existing cervical spondylosis. I postulate that her symptoms were work related. She responded well to acupuncture, which provided good symptomatic treatment rather than cure and allowed her to continue working whilst she awaited surgical release.
Validating a New Non-Penetrating Sham Acupuncture Device: Two Randomised Controlled Trials
Authors: Park Jongbae , White Adrian , Stevinson Clare , Ernst Edzard , James Martin
Published: April 2009

For clinical trials of acupuncture, it would be desirable to have a sham procedure that is indistinguishable from the real treatment, yet inactive. A sham needle has been designed which telescopes instead of penetrating the skin. The Park Sham Device involves an improved method of supporting the sham needle and requires validation. The objective of these studies was to test whether the sham procedure using the new device was 1) indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and 2) inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. The studies were designed as subject and assessor blind, randomised controlled trials. Study 1) included 58 patients enrolled in a clinical trial of acupuncture for acute stroke. Study 2) included 63 healthy, acupuncture naïve, adult volunteers. The interventions used were real or sham acupuncture using the Park Sham Device. Study 1) was set in a district general hospital, and study 2) in a university laboratory. The outcome measure in study 1) was the form of treatment that patients believed they had received. In study 2) the outcome measure was experience of de qi, as judged by three acupuncture experts. No patient in either group(study 1) believed he or she had been treated with the sham needle. In 40 volunteers (study 2) for whom experts achieved consensus, the relative risk of experiencing de qi with real acupuncture to that with sham acupuncture was 15.38 (95% CI 2.26 to 104.86). The inter-rater reliability of all 13 experts (study 2), calculated from their judgements on 10 subjects selected by randomisation, was 0.52 (95% CI 0.19 to 0.61). In conclusion, the results suggest that the procedure using the new device is indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and is inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. It is therefore a valid control for acupuncture trials. The findings also lend support to the existence of de qi, a major concept underlying traditional Chinese acupuncture.
Acupuncture in a Rehabilitation Setting: Wu Visits Wuhan
Authors: Wu Kit
Published: April 2009

This paper reports the personal experiences encountered by the author (a medical student) on an elective period at a large rehabilitation unit of Tongji Hospital in Wuhan, China. The author had the opportunity to learn the principles of traditional Chinese medicine and practise blunt needling under careful supervision. This elective experience illustrated, for the author, how acupuncture can be used alongside western medicine to restore patients to their optimum state of health.
Can Acupuncture Reduce the Induction Time of a Local Anaesthetic? - a Pilot Study
Authors: Rosted Palle , Bundgaard Mads
Published: April 2009

We report on a pilot study we undertook to investigate if segmental acupuncture treatment, given two minutes prior to a regional inferior dental block (ID) with Prilocaine Hydrochloride, would reduce the onset time of a local anaesthetic.

Thirty healthy people, who needed a regional inferior dental block (ID) as part of dental treatment in the lower jaw, were randomly allocated to three groups. They received segmental acupuncture, heterosegmental superficial acupuncture, or standard treatment (regional inferior dental block) without acupuncture. In the segmental acupuncture group, acupuncture was given within the innervation of the trigeminal nerve. The needles were left in for two minutes, followed by a regional inferior dental block (ID). In the second group, acupuncture needles were inserted superficially in extra-segmental points and left in for two minutes without stimulation, followed by the regional inferior dental block. A control group received standard treatment only, of a regional inferior dental block.

The concept ‘pain free for dental work’ was defined as ‘patients reporting pins and needles in the lower lip’ and measured by a drilling test. Patients who reported no pain during the drilling test were included in the study. The time from administration of the injection to the patients’ reporting pins and needles was recorded by an independent dental nurse.

All tested patients reported sufficient anaesthesia during the drilling test. In the segmental acupuncture group, anaesthesia was achieved after 62 seconds, compared to the heterosegmental superficial acupuncture group, who took 115 seconds and the control group, who received standard treatment only, and took 119 seconds. The difference between the segmental acupuncture group and the heterosegmental superficial acupuncture group was statistically significant (p<0.015); the difference between the segmental acupuncture group and the control, who received a regional inferior dental block only, was also significant (p<0.032). No significant difference was found between the heterosegmental superficial acupuncture group and the control group who received a regional inferior dental block only (p<0.84).

It appears from this pilot study that the onset time of local anaesthesia is reduced if segmentally administered acupuncture is given prior to the regional inferior dental block. However, it needs to be reproduced including objective measurements.
Comparison of Transient Heart Rate Reduction Associated with Acupuncture Stimulation in Supine and Sitting Subjects
Authors: Imai Kenji , Kitakoji Hiroshi
Published: April 2009

We investigated the difference in transient heart rate reduction associated with brief acupuncture in 20 healthy subjects at rest in a supine and in a sitting position. After the subjects had been at rest for about 20 minutes, acupuncture needling using the sparrow-pecking method, in which the needle is moved vertically lifting and thrusting, was performed for one minute at the Shousanli point on the right forearm (LI10). The procedure was carried out with the subjects in a supine position and in a sitting position. The position for stimulation of each subject, either supine or sitting, was selected at random, and on different days. The results showed that the average heart rate reduction associated with stimulation in supine subjects was 3.6±0.19 (mean ± standard error {SE}) beats per minute (bpm), while that for sitting subjects was about 7.0±1.07 (mean ± SE) bpm, indicating that stimulation reduces heart rate to a greater degree in subjects who are sitting (p<0.05, Mann-Whitney test). These results would be consistent with a mechanism involving reduced sympathetic drive to the heart, as sympathetic nerve activity has more influence on the heart rate in the sitting than in the supine position.
Guidelines for Case Reports of Adverse Events Related to Acupuncture
Authors: Peuker Elmar , Filler Timm
Published: April 2009

Numerous case reports of adverse events of acupuncture have been published, mostly in journals which are not related to acupuncture. The authors usually have no training in acupuncture. In principle, case reports on adverse events are of value as an aid for learning. They can only achieve this effect if useful information is provided. In the case of acupuncture related adverse events and complications, basic information about the patient and the therapist as well as the treated acupuncture points and topographical regions and the needling technique are desirable. This article offers suggestions on what details should be included in a case report on adverse events related to acupuncture.
Towards Greater Safety in Acupuncture Practice - a Systems Approach
Authors: White Adrian
Published: April 2009

Everyone wants safe medicine. The traditional approach to adverse events has developed within a culture of blaming the individual practitioner. Such an approach is likely to be damaging to individuals and possibly counterproductive by creating an atmosphere of defensiveness and denial. Industries such as airlines have developed an alternative culture using a systems approach. This approach concentrates on assessing and improving the systems of working rather than blaming an individual's performance. Frameworks have been developed for applying this approach to investigating and avoiding medical accidents. These form the basis of a check-list for acupuncture practice that is presented here, and may be useful for individuals and organisations who are concerned to reduce the risk of adverse events.
Acupuncture for Low Back Pain in Pregnancy – a Prospective, Quasi- Randomised, Controlled Study
Authors: Guerreiro da Silva João Bosco , Nakamura Mary Uchiyama , Cordeiro José Antonio , Kulay Luiz
Published: April 2009

This study was undertaken to investigate the effects of acupuncture in low back and pelvic pain during pregnancy under real life conditions, as compared with patients undergoing conventional treatment alone. A total of 61 conventionally treated pregnant women were allocated randomly into two groups to be treated or not by acupuncture. Twenty-seven patients formed the study group and 34 the control group. They reported the severity of pain using a Numerical Rating Scale from 0 to 10, and their capacity to perform general activities, to work, and to walk. We also assessed the use of analgesic drugs. Women were followed up for eight weeks and interviewed five times, at two-week intervals. All women completed the study. In the study group the average pain during the study period showed a larger reduction (4.8 points) than the control group (−0.3 points) (P<0.0001). Average pain scores decreased by at least 50% over time in 21 (78%) patients in the acupuncture group and in five (15%) patients in the control group (P<0.0001). Maximum pain and pain at the moment of interview were also less in the acupuncture group compared with the control group. The capacity to perform general activities, to work and to walk was improved significantly more in the study group than in the control group (P<0.05). The use of paracetamol was lower in the acupuncture group (P<0.01). These results indicate that acupuncture seems to alleviate low back and pelvic pain during pregnancy, as well as to increase the capacity for some physical activities and to diminish the need for drugs, which is a great advantage during this period.
Acupuncture Treatment of Phantom Limb Pain and Phantom Limb Sensation in Amputees
Authors: Bradbrook David
Published: April 2009

Three case histories are presented in which amputees with acute or chronic phantom limb pain and phantom limb sensation were treated with Western medical acupuncture, needling the asymptomatic intact limb. Two out of the three cases reported complete relief of their phantom limb pain and phantom limb sensation. Acupuncture was successful in treating phantom phenomena in two of these cases, but a larger cohort study would be needed to provide more evidence for the success rate of this treatment technique for this indication.
Acupuncture for Chronic Neck Pain - a Cohort Study in An Nhs Pain Clinic
Authors: Blossfeldt Patrick
Published: April 2009

The study investigates the outcome of acupuncture for chronic neck pain in a cohort of patients referred to an NHS chronic pain clinic. One hundred and seventy two patients were selected for acupuncture over a period of 6.5 years. Treatment was given by a single acupuncturist and consisted of a course of needle acupuncture for an average of seven sessions per patient. Treatment outcome was measured by an oral rating scale of improvement at the end of treatment and at follow up six months and one year after treatment. Nineteen patients were withdrawn from treatment for various reasons, two for adverse events. One hundred and fifty three patients were evaluated, of whom 68% had a successful outcome from acupuncture, reporting an improvement in pain of at least 50%. The success rate was higher in patients with a short duration of pain: 85% in patients with pain for up to three months and 78% with pain for up to six months. Long-term follow up showed that 49% of the patients who completed treatment had maintained the benefit after six months, and 40% at one year. The results indicate that acupuncture can be an effective treatment for selected patients with chronic neck pain.
Unilateral Septic Arthritis of a Lumbar Facet Joint Secondary to Acupuncture Treatment - a Case Report
Authors: Daivajna Sachin , Jones Alwyn , O’Malley Michael , Mehdian Hossein
Published: April 2009

This report describes a case of septic arthritis of the lumbar facet joint probably as a result of acupuncture treatment. A 48 year old man with a long history of back pain presented with a two week history of increasing pain following a third session of acupuncture. Examination revealed tenderness in the right lumbosacral area and laboratory investigations revealed raised inflammatory markers with negative blood cultures. A bone scan and MRI scan showed evidence of septic arthritis of the right L5/S1 facet joint. An x ray computed tomography guided biopsy was carried out which isolated staphylococcus aureus. The patient was initially treated with intravenous antibiotics. A repeat MRI scan demonstrated persistent septic arthritis with adjacent early abscess formation. Surgical debridement of the facet joint was therefore performed. The patient had resolution of his symptoms and the inflammatory markers returned to normal. He regained a full range of movement of the lumbar spine. Very few cases have been reported of lumbar facet joint septic arthritis and this condition is rare in association with acupuncture treatment. A high index of suspicion needs to be maintained and if conservative management fails then debridement can result in an acceptable outcome.
Perceptions of Complementary and Alternative Medicine Amongst Medical Students in Singapore – a Survey
Authors: Yeo Angela SH , Yeo Jonathan CH , Yeo Colin , Lee Chau Hung , Lim Lan Fern , Lee Tat Leang
Published: April 2009

Background

In view of the current upsurge of interest in, practice of, and research into, complementary and alternative medicine (CAM) worldwide and locally, a survey was conducted to gauge the understanding, interest and knowledge of CAM amongst medical students in a local university.

Methods

A total of 555 first to fifth year medical students completed a questionnaire (54% response rate) designed to assess their knowledge, beliefs and attitudes to CAM in general and 16 common CAM therapies.

Results

Acupuncture was the best known therapy, with 57% claiming to know at least something about it. No students claimed they knew a lot about chiropractic, osteopathy, Ayuverdic medicine, homeopathy and naturopathy, and many had not ever heard of these therapies. Knowledge of commonly held beliefs about the 16 CAM modalities was generally poor, even for modalities which students claimed to know most about. A significant number of students had knowledge about CAM that was erroneous. Lack of scientific support was considered to be the main barrier to implementation of CAM. Attitudes to CAM were positive, with 92% believing that CAM includes ideas and methods from which conventional medicine can benefit, 86% wishing to know more about CAM and 91% stating that CAM would play an important role in their future medical practice.

Conclusion

As the public's use of various healing practices outside conventional medicine accelerates, ignorance about these practices by the country's future medical practitioners risks broadening the communication gap between the public and the profession that serves them. The majority of medical students recognise this risk and are keen to bridge this gap.
Acupuncture for Insomnia in Pregnancy – a Prospective, Quasi-Randomised, Controlled Study
Authors: Guerreiro da Silva João Bosco , Nakamura Mary Uchiyama , Cordeiro José Antonio , Kulay Luiz
Published: April 2009

Objective

This study was undertaken to test the effects of acupuncture on insomnia in a group of pregnant women under real life conditions, and to compare the results with a group of patients undergoing conventional treatment alone (sleep hygiene).

Methods

A total of 30 conventionally treated pregnant women were allocated at random into groups with or without acupuncture. Seventeen patients formed the study group and 13 the control group. The pregnant women scored the severity of insomnia using a Numerical Rating Scale from 0 to 10. Women were followed up for eight weeks and interviewed five times, at two-week intervals.

Results

Eight women dropped out, five in the study group and three in the control group. The study group reported a larger reduction on insomnia rating (5.1) than the control group (0.0), a difference which was statistically significant (P=0.0028). Average insomnia scores decreased by at least 50% over time in nine (75%) patients in the study group and in three (30%) of the control group.

Conclusion

The results of this study suggest that acupuncture alleviates insomnia during pregnancy and further research is justified.
Acupuncture for Acute Postoperative Pain Relief in a Patient with Pregnancy-Induced Thrombocytopenia – a Case Report
Authors: Oomman Susmita , Liu David , Cummings Mike
Published: April 2009

A 39 year old woman, scheduled for elective caesarean section in her second pregnancy, developed thrombocytopenia. Therefore, at the time of surgery, spinal anaesthesia and non-steroidal analgesic drugs were avoided and she was given a standard general anaesthetic procedure including fentanyl 100μg and morphine 10mg. In the early postoperative period she received tramadol 100mg and a further 10mg of morphine. These drugs did not control her pain, but caused side effects - in particular nausea and retching. Acupuncture to LI4 and PC6 on the right side produced dramatic pain relief within minutes.
Introducing Voluntary Donations to Fund Primary Care Acupuncture – a User Survey
Authors: Freedman Jonathan , Richardson Marion
Published: April 2009

An acupuncture clinic has been running in general practice without any funding for nine years. However, reorganisation of the health service meant that it had to become self-funding. A scheme for voluntary donations was introduced, with a target of £15 per treatment. In the first six months, the scheme covered the clinic's costs. A user survey was undertaken to elicit patients’ views on the scheme. The majority of patients thought that the scheme was a good idea, and the amount about right. However, a few patients found payment difficult, and stated that they would be less likely to use the service for that reason, or feel guilty about using it without paying. This information should be used to try to obtain public funding through public funds in the future.
Acupuncture-Induced Galactorrhoea – a Case Report
Authors: Campbell Anthony , Macglashan Janette
Published: April 2009

A case of acupuncture-induced galactorrhoea in a healthy subject is described. The acupuncture was performed at a non-traditional site using a periosteal technique and galactorrhoea occurred on two separate occasions. Galactorrhoea following acupuncture has been reported on one previous occasion.
Acupuncture Prior to and at Embryo Transfer in An Assisted Conception Unit – a Case Series
Authors: Johnson David
Published: April 2009

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P>0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.
The Clinical Effectiveness of Acupuncture for Pain Relief – you can be Certain of Uncertainty
Authors: Johnson Mark I
Published: April 2009

Nowadays the volume of published research is so overwhelming that practitioners are turning to expert groups to interpret and summarise research for them. This paper critically reviews the processes used to establish one-sentence statements about the effectiveness of acupuncture for pain relief. Some one-sentence statements claim that acupuncture is not clinically effective because systematic reviews of clinical trials find similar amounts of pain relief between sham acupuncture and real acupuncture. However, these one-sentence statements fail to account for shortcomings in clinical trials such as inadequate doses and inappropriate acupuncture technique. Establishing the physiological intention of acupuncture and developing criteria to assess whether this has been achieved in trials will help to overcome some of these problems in future trials. In addition, shortcomings in systematic review methodology such as imprecise inclusion criteria, comparisons of heterogeneous study populations and imprecise definitions of acupuncture have resulted in discrepancies in vote counting of outcomes between review groups. Recognition of these issues has produced a shift in favour of acupuncture in recent systematic reviews and meta-analyses. It is hoped that this will be reflected in a reappraisal of some of the negative one-sentence statements about the effectiveness of acupuncture for pain relief.
Use of Acupuncture in Female Infertility and a Summary of Recent Acupuncture Studies Related to Embryo Transfer
Authors: Stener-Victorin Elisabet , Humaidan Peter
Published: April 2009

During the last five years the use of acupuncture in female infertility as an adjuvant to conventional treatment in assisted reproductive technology (ART) has increased in popularity.

The present paper briefly discusses clinical and experimental data on the effect of acupuncture on uterine and ovarian blood flow, as an analgesic method during ART, and on endocrine and metabolic disturbances such as polycystic ovary syndrome (PCOS).

Further it gives a summary of recent studies evaluating the effect of acupuncture before and after embryo transfer on pregnancy outcome. Of the four published RCTs, three reveal significantly higher pregnancy rates in the acupuncture groups compared with the control groups. But the use of different study protocols makes it difficult to draw definitive conclusions. It seems, however, that acupuncture has a positive effect and no adverse effects on pregnancy outcome.
Osteoarthritis of the Knee – An Introduction
Authors: White Adrian
Published: April 2009

Osteoarthritis of the knee is common, and a major cause of disability in older people that is likely to increase over time. Some patients progress rapidly to needing surgery, whereas others will have persistent pain for many years. The aims of conservative treatment are to reduce pain and disability.

There is evidence that several non-pharmacological therapies such as exercise, education and weight loss can have an effect in patients with knee pain, though the effect is usually only modest. Ultrasound and short wave diathermy are widely available, but not supported by evidence. Particular preparations of topical treatments are effective, as too is oral paracetamol (acetaminophen). Glucosamine is popular but not all trials have found it to have any effect.

Non-steroidal anti-inflammatory drugs (NSAIDs) are effective, though their effect is modest and their longterm value is not established. They are associated with significant adverse events, particularly gastrointestinal haemorrhage, which has a substantial mortality. They are particularly dangerous in the elderly. Cyclooxygenase-2 (COX-2) inhibitors cause fewer gastrointestinal problems but increase the risk of vascular events including myocardial infarction and stroke. Herbal therapies have only sparse evidence in support. Intra-articular injections of steroids may be effective, at least for a short period, but hyaluronan has a longer duration of action.

Patients prefer treatments that are safe, and are willing to forgo some effectiveness in favour of safety. In this context, acupuncture is a potentially valuable treatment for OA knee, and the evidence on effectiveness, safety and cost should be considered carefully.
Efficacy, Effectiveness, Safety and Costs of Acupuncture for Chronic Pain – Results of a Large Research Initiative
Authors: Witt Claudia M , Brinkhaus Benno , Reinhold Thomas , Willich Stefan N
Published: April 2009

Background

The aim of the ‘Acupuncture Model Project of the Techniker Krankenkasse’ was to determine efficacy, effectiveness, safety and cost effectiveness of acupuncture treatment in standard medical care.

Methods

We evaluated a total of 304 674 patients (34.5% men, aged 53.1?13.8 and 65.5% women, aged 49.5±14.2) who were in the care of over 10 000 physicians and received on average 10?3 acupuncture treatments for chronic pain (osteoarthritis of the hip or knee, low back pain, neck pain, headache) during a period of three months.

Results and conclusions

Our findings demonstrate that for the diagnoses examined, acupuncture in addition to usual care was an effective and safe treatment. Whether the effects of acupuncture can be attributed primarily to specific or nonspecific mechanisms appeared to depend on the diagnosis, and should be investigated in further studies. Using acupuncture as an adjunctive treatment was more expensive than usual care alone, but was cost-effective according to internationally accepted threshold values.
The Evidence on Acupuncture for Knee Osteoarthritis – Editorial Summary on the Implications for Health Policy
Authors: White Adrian , Kawakita Kenji
Published: April 2009

Decisions on whether a health service should provide a particular treatment are based on the evidence on three questions: 1) whether the treatment can work, ie it is biologically active; 2) whether the treatment is safe and effective in daily practice; and 3) whether it is economically worthwhile. Evidence presented at the Kyoto conference shows that acupuncture for osteoarthritis of the knee has a biological effect, has a large clinical effect in practice, has negligible risk, and has a cost effectiveness which is well within the usual acceptable limit. On the present evidence, acupuncture is likely to offer an alternative to treatment with non-steroidal anti-inflammatory drugs (NSAIDs).
Auricular Acupuncture to Resolve the Exacerbations in Ocular Myasthenia – a Case Report
Authors: Crestati Francesco , Shaladi Ali , Preteroti Salvatore , Tartari Stefano
Published: April 2009

Ocular myasthenia is a neuromuscular autoimmune disorder in which the clinical symptoms are restricted to the external ocular muscles with either ptosis or diplopia, or both. The condition may follow a relapsing and remitting course. Conventional therapy consists of anticholinergic drugs, corticosteroids and immunosuppressants. We report a case in which auricular acupuncture was used as an adjunct to pharmacological treatment. The time course of the response suggests that acupuncture appeared to help resolve the current relapse.
Acupuncture for Mild to Moderate Emotional Complaints in Pregnancy – a Prospective, Quasi-Randomised, Controlled Study
Authors: Guerreiro da Silva Joao Bosco
Published: April 2009

Background

The aim of this study was to describe the effects of acupuncture under real life conditions, in the treatment of emotional complaints during pregnancy.

Methods

A group of 51 conventionally treated pregnant women (with counselling by their physicians and nurses) was allocated by chance into two groups to be either treated or not by acupuncture. Both groups (28 in the study group and 23 in the control group) presented emotional complaints such as anxiety, depression and irritability. They reported the severity of symptoms using a Numerical Rating Scale (NRS) from 0 to 10; and they rated how much the symptoms disturbed five aspects of their lives: mood, sleep, relationships, social activities, sexual life and joy of living. Traditional acupuncture was used. In order to facilitate protocols we used pre-programmed points. Up to four points were permitted as optional points.

Results

Three women from the acupuncture group and four from the control group dropped out of the study. Over the study period, the NRS scores of intensity of emotional distress decreased by at least half in 15/25 (60%) of patients in the study group and in 5/19 (26%) of those in the control group (P=0.013). The impact of the distress on three out of the five aspects of life was significantly less in the acupuncture group when compared with the control group (P<0.05).

Conclusion

Emotional complaints are very common in pregnancy and medication is always a risk. In this study, acupuncture seems to be an efficacious means of reducing symptoms and improving the quality of life of women with emotional complaints during pregnancy. Large randomised studies are recommended to confirm these results.
Are Auricular Maps Reliable for Chronic Musculoskeletal Pain Disorders?: A Double-Blind Evaluation
Authors: Andersson Elisabeth , Persson Ann L , Carlsson Christer PO
Published: April 2009

Aim

To examine the proposed somatotopic relation between the regions in which patients report musculoskeletal pain and tender points located on the external ears according to a map based on commonly used auricular acupuncture maps.

Methods

Twenty-five patients (16 women) from a chronic pain clinic were included. Patients were asked, before examination of the external ears, if they had past or present musculoskeletal pain in any of 11 body regions. An ear map, collapsed into 11 zones representing the musculoskeletal system, was used. The ear examiner was blinded to the patients’ pain conditions, medical history and ongoing treatment. Patients communicated with the examiner only to express if tenderness was present in the external ear on palpation using a spring-loaded pressure stylus commonly used for auricular acupuncture. The degree of tenderness was registered on a 5-point scale and dichotomised (no tenderness or tenderness). Agreements between the patients’ painful body regions and tenderness in the external ear zones were presented as percentage, kappa values, sensitivity and specificity.

Results

The 25 patients reported 116 past or present musculoskeletal pain regions and had 110 tender ear zones. No statistically significant agreements were found between the painful body regions and the corresponding tender ear zones.

Conclusions

Our results did not show agreements between patients’ reported musculoskeletal pain regions and tender zones in the external ears assessed according to commonly used maps in auricular acupuncture using a pressure stylus. However, very tender points occur on the external ear in a population with chronic musculoskeletal pain.
Effect of Varying Frequency and Duration of Electroacupuncture Stimulation on Carrageenan-Induced Hyperalgesia
Authors: Taguchi Tatsuki , Taguchi Reina
Published: April 2009

Objective

Although electroacupuncture (EA) therapy is used to relieve various kinds of pain, the optimal frequency and duration of EA remain unclear. We investigated the effect of varying frequency and duration of EA during hyperalgesia elicited by carrageenan-induced inflammation.

Methods

Carrageenan was administered by subcutaneous intraplantar injection to induce inflammation. Nociceptive thresholds were measured using the paw pressure threshold (PPT) (Randall-Selitto Test). EA was applied at 3, 15, or 100Hz to the left anterior tibial muscles for 1, 15, or 60 minutes. Intensities used were chosen within the known tolerance of the animal, and increased up to 3mA for 3Hz, and up to 1.5mA for 15 and 100Hz. EA was started three hours after carrageenan injection.

Results

Three hours after carrageenan injection, a marked ipsilateral inflammatory response appeared and PPT decreased significantly. This decrease persisted for at least 24 hours after carrageenan injection. EA at 3Hz (60 minutes) resulted in significant increases of PPT which persisted for 24 hours after injection. EA at 3Hz (15 minutes) also induced PPT elevations immediately and for one hour after EA compared to the control group. However, no other variety of EA significantly increased PPT.

Conclusion

These results show that EA produces electroacupuncture analgesia of carrageenan-induced hyperalgesia. These findings also suggest that, among the frequencies and durations tested, EA at 3Hz (60 minutes) is the most suitable frequency and duration for carrageenan-induced inflammation. It seems that EA has different analgesic effects and mechanisms according to the parameters of stimulation. For EA in the clinical induction of analgesia, it is especially important that an effective frequency and duration are selected.