bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concomitant Sympathetically Mediated Pain and Myofascial Trigger Point Pain
Authors: Baldry Peter 
Published: April 2009

It is not sufficiently well recognised that the reflex sympathetic dystrophy syndrome (RSDS) and the myofascial pain syndrome (MPS) may develop concomitantly. This happens because they have similar aetiological factors, with trauma being by far the commonest. Everyone is liable to develop nociceptor pain as a result of trauma-induced activation and sensitisation of C afferent skin and Group IV muscle nociceptors; also A-β mediated pain as a result of the sensory afferent barrage produced by these nociceptors giving rise to sensitisation of dorsal horn transmission neurones. With most people these neural changes lead only to the development of MPS. In a minority of people, possibly those with a genetically determined predisposition, this sensory afferent barrage also causes changes to take place in the sympathetic nervous system, with the development of a characteristic burning type of sympathetically mediated pain. This may develop alone or in association with myofascial trigger point pain. There is much controversy concerning the mechanisms for development of RSDS pain. One theory is that the pain develops as a result of the nociceptor-induced sensory afferent barrage setting up aberrant sympathetic efferent activity. This results in the release of noradrenaline which binds to α-1 adrenoreceptors in the walls of the nociceptors, exciting them further. Much research, however, still has to be done before the development of sympathetically maintained pain can be adequately explained. It is stressed that for the successful treatment of RSDS early diagnosis is essential. Treatment involves sympathetic blockade either by the injection of local anaesthetic into a sympathetic ganglion, or by the regional infusion of a catecholamine depleting drug. Sympathetically maintained pain is morphine resistant and is therefore unlikely to be relieved by acupuncture, the analgesic effect of which is mediated by opioid peptides. The main place for acupuncture is in the treatment of concomitant myofascial trigger point pain. It is emphasised that in all cases of RSDS it is essential to search for myofascial trigger points and, when present, to deactivate these by means of acupuncture stimulation of A-δ nerve fibres present in the skin and subcutaneous tissues at the trigger point sites.
Towards a Dose of Acupuncture
Authors: Marcus Paul 
Published: April 2009

Although it would be quite unacceptable to attempt most forms of treatment without defining the dose, acupuncture has so far remained without any means of quantification. Electrical and deep manual needling probably rely for their main effect on direct nerve and muscle stimulation. It is suggested that superficial needling acts by producing a cone of tissue damage, with release of inflammatory mediators which increase the sensitivity of local nerve endings so that trivial, incidental stimulation continues to induce CNS inhibitory effects for a prolonged period. The degree of local inflammatory effect can easily be recorded by measuring the area of skin flare. A simple formula is offered to determine the dose of acupuncture, based on skin flare recordings after experimental needling and theoretical considerations of tissue damage. Needles of varying shaft radius were inserted to a number of depths in the abdominal dermis and subjected to specific degrees of stimulation. The experimental data correlate well with the theoretical model. Needle response increases with depth of insertion, and with needle thickness although this is outweighed by the effects of manipulation if carried out. The formula derived for determining the dose of acupuncture which correlates with inflammatory response, as measured by skin flare, is (r + 0.1 l)K, where r is the radius of the needle shaft, l is the depth of insertion and K is 10 for unmanipulated insertions or 12.4 if the needle is manipulated.
Hay Fever Prophylaxis Using Single Point Acupuncture: A Pilot Study
Authors: Williamson Lyn 
Published: April 2009

To determine whether single point, Liver 3 (Taichong), acupuncture is effective for hay fever prophylaxis in a dedicated general practice clinic setting, 30 patients suffering from long-standing, moderate to severe hay fever were randomised to acupuncture or conventional therapy. Three, ten minute acupuncture treatments were given at weekly intervals during April 1993. Four of the fifteen acupuncture patients had complete remission of symptoms compared with none from the control group. The rest of the acupuncture group had a variable response, but a small, significant improvement in overall symptom score was demonstrated, as was a shortening of duration of hay fever symptoms. The start of the hay fever season for some patients was later than expected, which may have resulted in reduced effectivity of the acupuncture, thus treatment may be better starting at the beginning of May to cover the peak of symptoms in early June. The results of this pilot study have shown that single point (Liver 3) acupuncture given for hay fever prophylaxis in a clinic setting was effective, safe, easily reproducible, acceptable and inexpensive (the material cost of the treatment was less than 50p per patient). The study merits repeating on a larger scale.
Conjuctivitis Sicca: A Comparison of Traditional Chinese and Western Medical Symptoms
Authors: Nepp Johannes , Wedrich A 
Published: April 2009

In traditional Chinese medicine (TCM) three syndromes are said to be associated with conjunctivitis sicca: Liver-Yin deficiency, Liver-Yang excess and Liver fire. The diagnosis of one of these syndromes requires the use of a specific combination of points for acupuncture. We used an extensive questionnaire of autonomic nervous system disturbances to suggest points that should be treated on a western medical basis. This prospective study was performed to answer two questions: i. Is it possible to associate the complaints of our patients with a TCM syndrome? ii. Is there any difference between the results using a TCM combination of points and those selected with our western method? Thirty seven patients with conjunctivitis sicca were enrolled in the study and asked to complete two questionnaires. In one, autonomic nervous system complaints were evaluated; in the second, the symptoms of the three relevant TCM syndromes were specifically asked for. The results of both questionnaires were compared. Our “western medical” combination of points for therapy consisted of local points, and points related to the autonomic nervous system complaints and to the five Chinese elements. In total we recorded 29 different symptoms associated with conjunctivitis sicca. According to the TCM questionnaire, 21 patients had a deficit of Liver-Yin, 5 had a Liver-Yang excess and 10 suffered from Liver fire. One patient had symptoms of Liver-Yin and Liver-Yang. Yet all patients had symptoms of more than one Chinese syndrome. Only 4 out of 37 patients seemed to belong clearly to only one TCM syndrome. So the evaluation of symptoms according to the TCM system proved to be inadequate compared with the western “autonomic” system. Points for therapy resulting from the western system were similar to the points proposed by the TCM system. We conclude that the points proposed by both methods are similar for the treatment of conjunctivitis sicca, but we believe that for western medical doctors it is easier to find a successful combination of points with the western method asking about complaints of the autonomic nervous system.
Koryo Hand Acupuncture: A Versatile and Potent Acupuncture Microsystem
Authors: Magovern Patrick 
Published: April 2009

Koryo Hand Acupuncture (KHA) is an acupuncture microsystem analogous to ear acupuncture. Unlike other acupuncture microsystems, however, there is a full meridian system including the Conception Vessel and Governing Vessel and also the extraordinary meridians. Each of the KHA micromeridians are lettered and correspond to one of the body meridians (Figure 1). One can treat a wide range of problems using this modality and it is possible in many cases to administer treatment without use of needles.
A Comparison of Acupuncture with Intra-Articular Steroid Injection as Analgesia for Osteoarthritis of the Hip
Authors: McIndoe AK , Young K , Bone ME 
Published: April 2009

This controlled trial used a prospective, randomised open design to compare the effectiveness of acupuncture and intra-articular injections in reducing chronic pain associated with osteoarthritis of the hip. Thirty two patients awaiting hip arthroplasty with chronic pain of more than twelve months duration were included. Group A received acupuncture using a standardised technique of periosteal needling to the greater trochanter of the femur with three acupuncture needles. The treatment was repeated on three occasions at weekly intervals. Group B received an intra-articular/peri-articular hip injection of 20ml of 1% lignocaine + 80mg Depo-Medrone. Patients were assessed for pain intensity, mobility and pattern of analgesia usage pre-treatment and at one, two and four week intervals thereafter. Both groups experienced a decrease in pain intensity and analgesic usage following treatment. This decrease was greater in the acupuncture group. However, mobility remained unchanged in both groups. From the results of this study, periosteal acupuncture appears to be as effective as an intra-articular injection in relieving the pain associated with osteoarthritis of the hip. However, due to the small numbers involved, statistical significance was not achieved.
Introduction of a New Therapy Method: Music Sound Electroacupuncture Stimulation
Authors: Tekeoğlu İbrahim 
Published: April 2009

Music is an increasingly popular means of enhancing pain relief and suppression of anxiety in a variety of painful situations. The author has used a device that delivers an electrical stimulation to acupuncture needles (electroacupuncture) that is frequency modulated by the sound of classical music being played to the patient. In a randomised controlled trial, patients with migraine or cervical tension headache were divided into two groups (25 each). One group received standard electroacupuncture at 100Hz while the other had music sound electroacupuncture stimulation. Pain levels were scored by the patients on a five point scale. Analgesia obtained by the standard electroacupuncture group was statistically significant (P<0.01). That obtained by the music sound electroacupuncture group was highly significant (P<0.001).
Hay Fever Treatment in General Practice: A Randomised Controlled Trial Comparing Standardised Western Acupuncture with Sham Acupuncture
Authors: Williamson L , Yudkin P , Livingstone R , Prasad K , Fuller A , Lawrence M 
Published: April 2009

The effect of standardised, Western acupuncture on hay fever symptoms was investigated in a randomised, controlled, single-blind trial in comparison with “sham” acupuncture. Three general practices, in Oxfordshire (rural), Lincolnshire (semi-rural), and Peterborough (urban), recruited 102 patients aged 16 or over with long-standing, moderate or severe hay fever symptoms that had required continuous therapy for at least one month of the year for three or more consecutive years. The patients were asked to keep a diary to record: the amount of medication used daily; a daily symptom score (using a ten-point scale), from which was derived a weekly remission of symptoms score; and their assessment of the effect of acupuncture on the hay fever symptoms. Symptom scores and use of medication were similar in the two groups. In the four-week period following each patient's first treatment, remission of symptoms was reported by 39.0% in the active treatment group and 45.2% in the sham group; mean weekly symptom scores were 18.4 and 17.6 respectively; and mean units of medication used were 4.1 and 5.0 respectively. Sixteen out of 43 patients in the active treatment group and 14 out of 43 in the sham group felt that the acupuncture had had an excellent or very good effect on their hay fever. The treatments were simple, safe, reproducible and perceived as equally effective. Whether this represented an acupuncture effect, a placebo effect, or natural variation in a fluctuating condition, is not clear.
Overeating: Treatment of Obesity and Anxiety by Auricular Acupuncture, An Analysis of 800 Cases
Authors: Apostolopoulos A , Karavis M 
Published: April 2009

Auricular acupuncture (placement of press needles) was applied at the stomach point (according to Nogier) and sometimes at the point of psychological balance (Shenmen) for the control of anxiety and for help in weight loss in 800 patients over a two year period. Press needles were inserted and left in for 10 to 15 days at the auricular acupuncture point and resited again after 4 to 5 days. At the same time, instructions were given for the standard treatment of obesity (information leaflet, low calorie diet, aerobic exercise, behaviour modification, psychological support, etc.). The patients were followed up for a period of one year. The participants were 683 women and 117 men aged between 15 and 76 years. The Body Mass Index (weight/height) was used to determine the degree of obesity, and cases were divided into three groups according to the number of acupuncture sessions as follows: 468 patients (Group A) had one acupuncture session, 278 (Group B) 2 to 4 sessions, and 54 (Group C) had over 4 sessions, all conducted at 15 to 20 day intervals. A reduction in overeating was reported by 81.1% of patients, and 46.7% of the 697 patients who had noted anxiety symptoms claimed that treatment had helped in the reduction of anxiety. Regular exercise was encouraged, and started by 43.4% of the 703 who had no such habit. There was no significant weight loss in 35.2% of patients. During the first 3 months there was an overall significant weight loss in 64.8% and 35.5% at 6–12 months. The percentage weight loss was higher in Groups B and C and remained higher at six months and one year after the start of acupuncture treatment. Group B presented a good six month result in 61.2% of patients and a good annual result in 39.1%. In Group C results were 88.9% and 77.8% respectively. The control of overeating and anxiety using auricular acupuncture al the stomach and Shenmen points in this audit has been beneficial. Its correct use in an integrated obesity control programme may prove of significant long tem help.
Semi-Permanent Acupuncture Needles in the Prevention of Post-Operative Nausea and Vomiting
Authors: Andrzejowski J , Woodward D 
Published: April 2009

The efficacy of acupressure and acupuncture at the Pericardium 6 (PC.6) point in relieving post-operative nausea and vomiting (PONV) is well known. Lengthy manual stimulation of the needles, or electrostimulation, is inconvenient and incurs extra costs. The aim of this study was to test the effectiveness of the antiemetic action of semi-permanent acupuncture needles (SPANs), a cheap and convenient method of administering acupuncture, in the first 48 hours following gynaecological surgery. Patients (n = 36) having total abdominal hysterectomy were studied in a randomised, placebo controlled trial. Study group patients had SPANs inserted in PC.6 on both wrists. The control group had SPANs inserted into sham points on their forearms. There was no difference in the median nausea scores between the groups; however six patients suffered moderate or severe nausea during the second 24 hours in the control group, with none in the study group (p < 0.05). In addition, the nausea score between 8 and 24 hours in patients who had previously experienced PONV, was lower in the study group (median score 2) compared to the control group (median score 4) (p < 0.05). We conclude that the use of SPANs does not reduce the overall incidence of nausea and vomiting but does appear to reduce the severity of nausea in the second 24 hours, and has a greater effect on patients who had had nausea and vomiting after a previous anaesthetic.
Morphological Foundations of Acupuncture: An Anatomical Nomenclature of Acupuncture Structures
Authors: Schnorrenberger Claus C 
Published: April 2009

European mistranslations of original Chinese texts have not merely introduced incorrect concepts to Western acupuncturists, but have adversely affected treatment methods. The French diplomat Soulie de Morant published an important treatise, “L'acuponcture Chinoise”, in 1939; this has formed the basis of Westernised “traditional” Chinese acupuncture. Because he had no medical background, he was unable to interpret the medical significance of traditional Chinese concepts in the texts that he had read. More, he could not see that a firm basis of medical knowledge is necessary for the reliable practise of acupuncture, thus unwittingly introducing acupuncture as a playground for lay therapists. The two most important mistranslations were: i. the use of “point” for Xue-wei, which would be better translated as “foramen” to give the impression of a three dimensional structure; and ii. Qi, which is a particularly difficult concept to translate, but is certainly not equivalent to the Western term “energy”. These errors have now been accepted into standard usage through their transcription into modern, Western language, Chinese textbooks. Western acupuncturists are mainly unaware of the substantial anatomical basis for the nomenclature in acupuncture, and indeed of the anatomical knowledge of the ancient Chinese physicians as expressed in original Chinese medical texts, examples of which are given in this paper.
Acupuncture Studies on Pain
Authors: Thomas Moolamanil 
Published: April 2009

The relegation of acupuncture to complementary therapy ignores the history of its development and restricts possibilities for its clinical use and further research. Clinical studies with randomised, controlled trials and double blinding require reconsideration and adaptation when using acupuncture for treatment when multiple patient and treatment variables are involved. Ample experimental evidence exists for acupuncture to be considered as a modality of peripheral sensory stimulation, but present clinical research has not incontrovertibly validated the use of acupuncture on patients with chronic pain. A basic understanding of the neuro-physiology of pain and its differentiation does provide better indications for its use. More consistent results may then be obtained, as seen from a few recent studies.
A Visitor's View of Acupuncture in the Usa
Authors: Downey Paul 
Published: April 2009

A visit to the Department of Family Practice at the University of Maryland, Baltimore, where education, research and teaching is taking place in all forms of complementary medicine, provides the background to a discussion of the current status of acupuncture in the USA. Health insurers commonly reimburse for complementary therapy, forty medical schools provide modules in complementary medicine, and federal funding is available for the study of non-orthodox treatments: ten national centres for disease prevention are currently researching and evaluating the non-orthodox therapies.
Tennis Elbow: A Combined Approach Using Acupuncture and Local Corticosteroid Injection
Authors: Chilton S A 
Published: April 2009

In a controlled study, a group of 16 patients in a north of England general practice received acupuncture treatment for tennis elbow, followed by a small dose of corticosteroid with lignocaine to a residual tender spot at the elbow. These patients were compared with a similar group of 19 who received a larger dose to a tender spot at the lateral epicondyle, without any initial acupuncture treatment. In the acupuncture with steroid group: 13 patients had benefited following two treatment sessions, two after three sessions and one was no better at the end of the permitted three treatments. In the steroid alone group: 13 had had benefit after two sessions, three after three and three were unsuccessful. This suggests a trend towards increased and more rapid success in the acupuncture with steroid group, but the small number of patients precluded useful statistical analysis. The physical advantage in using acupuncture before administering local corticosteroid injection is that a lower dose of steroid can be used, with consequent reduction in the risk of tissue necrosis and inflammatory reaction.
Thermographic Evidence for the Effectiveness of Acupuncture in Equine Neuromuscular Disease
Authors: von Schweinitz Dietrich G 
Published: April 2009

Thermographic scanning provides an objective method of detecting sympathetic-autonomic status of vasomotor tone in the horse by imaging thermal gradients. Through observing persistent abnormal sympathetic nervous tone causing hypothermic or hyperthermic regions the clinician is able to diagnose neuromuscular disease - a common but often unrecognised cause of chronic pain and performance problems in horses. Thermography studies at the Equine Veterinary Clinic in Guildford demonstrate that acupuncture often corrects abnormal vasomotor tone within a half to three and a half hours of needling, usually resolving vasoconstriction affecting large thermatomes. Thermal imaging can provide objective, measurable evidence of the ability of acupuncture to restore normal homoeostasis in the autonomic regulation of vasomotor tone and suggests that it may simultaneously relieve associated sensorimotor disease.
Acupuncture and the Cardiovascular System: A Scientific Challenge
Authors: Ballegaard Søren 
Published: April 2009

In acupuncture research two main issues have to be addressed. One is whether the needle has a biological effect of its own. The other is whether acupuncture is of help to patients in their daily lives. With reference to this, acupuncture is a complex form of treatment in which the needles modulate physiological mechanisms of the body and the doctor supports the patient to achieve a life-style that assists with this. To evaluate the biological effects of needling, a randomised, controlled trial group of 49 patients with angina pectoris had acupuncture while cardiological, neurophysiological and psychological observations were made in a mutually independent manner. Needling was found to improve the working capacity of the heart. In addition, acupuncture was found to activate cardiovascular autoregulatory mechanisms in 24 healthy persons. To evaluate the effect of acupuncture in daily life, a controlled trial group of 69 patients with severe angina pectoris were followed for 2 years after treatment. The incidence of cardiac death or myocardial infarction was 7%, compared to 15–21% for the control group of published results concerning invasive treatments. Due to clinical improvement, surgery was postponed in 61% of the patients. The annual number of in-hospital days was reduced by 90%, leading to a US$ 12,000 saving for each patient.
Acupuncture for Chronic Pain
Authors: Handy John L 
Published: April 2009

Seventy-four patients having acupuncture for chronic pain were asked to complete a self-appraisal questionnaire and a linear-scale pain score in order to evaluate the efficacy of their treatment. The study revealed that 75% of patients had at least moderate symptom relief in 3 out of 5 parameters. In analysing the differing response of patients with various sites of pain, it was found that 95% of patients with chronic head, neck or arm pain obtained good symptom relief, 85% with migraine or facial pain and 63% with low back pain. The response to the questionnaire was compared to the pain score for each patient, and the result was used to assess both the current response and the suitability of that patient for further treatment. It is hoped that this study will form the basis of further audits, in order that acupuncture treatment may be focused on those patients who need it most and who are getting maximum benefit from it.