bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reproductive Medicine: Research Projects in Acupuncture
Authors: Stener-Victorin Elisabet 
Published: April 2009

Two studies are briefly reported in which electroacupuncture is found to be beneficial in aspects of infertility treatment. They are the first in a series planned to investigate acupuncture in this area of gynaecology. 1. A high impedance in the blood flow of the uterine arteries has been shown to reduce the pregnancy rate of in-vitro fertilisation treatment. So ten healthy, but infertile, women with a high uterine artery pulsatility index were treated with electroacupuncture twice a week over a period of four weeks. There was a significant reduction (p<0.0001) in pulsatility index that was maintained for a further two weeks. 2. Twenty-four women with polycystic ovary syndrome were treated with electroacupuncture over a period of three months. Ovulation patterns were observed by daily recording of basal body temperature over nine months, including three months before treatment and three after. The main outcome was that electroacupuncture induced regular ovulation in more than a third of the women. The women were found to fall into two categories: a group in whom regular ovulation was induced following electroacupuncture who were less androgenic and had less metabolic disturbance, and a group who were more affected by the syndrome and who did not respond to treatment.
Acupuncture as an Alternative to Diazepam Sedation for Diagnostic Gastrointestinal Endoscopy
Authors: Stellon Anthony , Palmer Terence 
Published: April 2009

A study was undertaken to compare the differences in ease of intubation, emotional distress and physical discomfort during oesophago-gastro-duodenoscopy in 3 groups of patients: sedated with intravenous diazepam, receiving acupuncture, or being part of a control group having neither treatment. Patients were given the option of sedation. Those that declined were randomly divided into two groups, either receiving acupuncture or acting as a control. Patient distress was measured by two independent methods: direct observation by the attending nurse and a self-report questionnaire. The observed and self-reported physical discomfort were significantly reduced in the sedation group compared to controls, but there was no significant difference in any measurement between the acupuncture and the control groups. Respiratory complications were least in the acupuncture group and there was some evidence of benefit from acupuncture in relieving emotional distress.
Somatosensory Evoked Potentials in the Investigation of Auricular Acupuncture Points
Authors: Volf Nadia 
Published: April 2009

A preliminary study correlating the wrist and gall bladder body areas with their auricular acupuncture points, through recording the somatosensory evoked potentials (SEP) at the corresponding brain localisation, showed that stimulation of the “Wrist” auricular point activates the primary cortical somatosensory area of the upper extremity on the contralateral hemisphere in a similar way to direct median nerve stimulation. A “placebo” point 5 to 8mm from the “Wrist” auricular point was used as a control: no activation in the brain area was observed. In patients with post-stroke hemiplegia, SEP traces obtained both by direct median nerve stimulation at the wrist, and by stimulation of the “wrist” auricular point, were altered in a similar manner and only on the damaged side. Similarly, “gall bladder” auricular point stimulation activates the corresponding cortical somatosensory area in the same way as direct stimulation of the T7 intercostal nerve. Again, a “placebo” point, 5 to 8mm away from the “Gall bladder” auricular point, was used as a control, and activation in the brain area was not observed. Also, in patients with cholelithiasis, both the SEP traces evoked by T7 direct intercostal nerve stimulation and those evoked by “Gall bladder” auricular point stimulation were altered in the same manner. These results demonstrate that there is correlation between the activation of specific areas of brain cortex and stimulation of their corresponding auricular acupuncture points, and indicate a convergence into the same cortical somatosensory area of nerve impulses coming from the body organ itself and from the auricular point corresponding to that organ. This might be taken as suggesting neurological support for a functional somatic relationship of auricular points.
Myofascial Trigger Points: Pathophysiology and Correlation with Acupuncture Points
Authors: Hong Chang-Zern 
Published: April 2009

A review is made of recent studies on myofascial trigger points (MTrP) and their mechanism is discussed. Clinical and basic science studies have shown that there are multiple MTrP loci in a MTrP region. A MTrP locus contains a sensory component (sensitive locus) and a motor component (active locus). A sensitive locus is a point from which tenderness or pain, referred pain, and local twitch response can be elicited by mechanical stimulation. Sensitive loci (probably sensitised nociceptors) are widely distributed in the whole muscle, but are concentrated in the endplate zone. An active locus is a site from which spontaneous electrical activity can be recorded. Active loci appear to be dysfunctional endplates since spontaneous electrical activity is essentially the same as the electrical activity reported by neurophysiologists as that recorded from an abnormal endplate. A MTrP is always found in a taut band which is histologically related to contraction knots caused by excessive release of acetylcholine in abnormal endplates. Both referred pain and local twitch response are mediated through spinal cord mechanisms, as demonstrated in both human and animal studies. The pathogenesis of MTrPs appears to be related to integration in the spinal cord of response to the disturbance of nerve endings and abnormal contractile mechanism at multiple dysfunctional endplates. There are many similarities between MTrPs and acupuncture points including their location and distribution, pain and referred pain patterns, local twitch responses (de qi), and possible spinal cord mechanism.
Skin Disinfection and Acupuncture
Authors: Hoffman Peter 
Published: April 2009

The need for skin disinfection before insertion of an acupuncture needle is controversial and there is no specific research on this topic. However research and observations on the effect of, and the need for, skin disinfection before injections forms a good analogy of acupuncture. Whilst micro-organisms present on the surface of the skin are accessible to disinfection, those located under the surface in ducts, glands and follicles are out of reach and can be inoculated into the sterile tissues below by needle insertion. Fortunately, the bacteria resident on the skin have a low potential to cause infection if host immunity is not severely impaired or compromised by the long-term presence of foreign material, such as a surgical stitch. Disinfection of clean skin before injection is not generally considered necessary and observations of lack of infection following injections without prior skin disinfection support this; however, contamination by micro-organisms not normally resident on skin can pose a higher risk of infection. If skin is visibly soiled, it should be washed and if needle insertion is near an infected or contaminated site, it should be disinfected with alcohol. Practitioner hand hygiene between patients is important, even if gloves are worn. Hands should be washed with soap or detergent and water, or an alcohol handrub can be used if hands are physically clean.
A Prospective Survey of Adverse Events and Treatment Reactions following 34,000 Consultations with Professional Acupuncturists
Authors: MacPherson Hugh , Thomas Kate , Walters Stephen , Fitter Mike 
Published: April 2009

The paper describes the type and frequency of adverse events and transient reactions following consultations with professional acupuncturists. In a postal survey, involving 1848 professional acupuncturists, all of whom were members of the British Acupuncture Council and practising in the UK, details of adverse events and transient reactions following treatment were recorded on standardised self-report forms. A sample size of 30,000 treatments was sought, and piloting indicated that a four-week period was required. Practitioners also provided information on themselves, including age, sex, length of training and years of practice. A total of 574 practitioners responded, 31% of the total population. These practitioners reported on adverse events and transient reactions associated with 34,407 treatments. No serious adverse events were reported, where these were defined as requiring hospital admission, prolonging hospital stays, permanently disabling, or resulting in death (95% CI: 0 to 1.1 per 10,000 treatments). A total of 43 significant minor adverse events were reported, a rate of 1.3 per 1,000 treatments (95% CI: 0.9 to 1.7). These included severe nausea and actual fainting (12), unexpected, severe and prolonged aggravation of symptoms (7), prolonged and unacceptable pain and bruising (5) and psychological and emotional reactions (4). There were three avoidable events: two patients had needles left in by mistake, and one patient had moxa burns to the skin, also caused by practitioner error. The acupuncturists also recorded 10,920 mild transient reactions occurring in 5136 treatments, 15% (95% CI: 14.6 to 15.3) of the 34,407 total. In terms of local reactions, there were reports of mild bruising (1.7%), pain (1.2%) and bleeding (0.4%). Practitioners reported that patients experienced an aggravation of existing symptoms after 2.8% of treatments. The most common mild transient reactions to treatment were feeling relaxed (11.9%) and feeling energised (6.6%). In this prospective survey of 34,407 treatments, practitioners reported no serious adverse events. This conclusion was based on data collected from one in three members of the British Acupuncture Council. Given that the whole membership delivers between one and a half and two million treatments a year, this is important evidence on public health and safety. When compared with medication routinely prescribed in primary care, the results suggest that acupuncture is a relatively safe treatment modality.
Superficial Dry Needling and Active Stretching in the Treatment of Myofascial Pain – a Randomised Controlled Trial
Authors: Edwards Janet , Knowles Nicola 
Published: April 2009

A pragmatic, single blind, randomised, controlled trial was conducted to test the hypothesis that superficial dry needling (SDN) together with active stretching is more effective than stretching alone, or no treatment, in deactivating trigger points (TrPs) and reducing myofascial pain. Forty patients with musculoskeletal pain, referred by GPs for physiotherapy, fulfilled inclusion / exclusion criteria for active TrPs. Subjects were randomised into three groups: group 1 (n=14) received superficial dry needling (SDN) and active stretching exercises (G1); group 2 (n=13) received stretching exercises alone (G2); and group 3 (n=13) were no treatment controls (G3). During the three-week intervention period for G1 and G2, the number of treatments varied according to the severity of the condition and subject/clinician availability. Assessment was carried out pre-intervention (M1), post-intervention (M2), and at a three-week follow up (M3). Outcome measures were the Short Form McGill Pain Questionnaire (SFMPQ) and Pressure Pain Threshold (PPT) of the primary TrP, using a Fischer algometer. Ninety-one per cent of assessments were blind to grouping. At M2 there were no significant inter-group differences, but at M3, G1 demonstrated significantly improved SFMPQ versus G3 (p=0.043) and significantly improved PPT versus G2 (p=0.011). There were no differences between G2 and G3. The mean PPT and SFMPQ scores correlated significantly in G1 only, though no significant inter-group differences were demonstrated. Numbers of patients requiring further treatment following the trial were: 6 (G1); 12 (G2); 9 (G3). Conclusion: SDN followed by active stretching is more effective than stretching alone in deactivating TrPs (reducing their sensitivity to pressure), and more effective than no treatment in reducing subjective pain. Stretching without prior deactivation may increase TrP sensitivity.
The Use of Acupuncture and Attitudes to Regulation among Doctors in the Uk – a Survey
Authors: Price Julian , White Adrian 
Published: April 2009

Objective To assess the usage of acupuncture by members of British Medical Acupuncture Society (BMAS) in their daily work, in the course of a survey of attitudes to regulation of the acupuncture profession. Methods A brief questionnaire survey of all members was conducted in December 2002. Results After a single mailing, 1112 members responded (a response rate of 48%). Seventy-five percent of these were general practitioners. The majority were in support of a regulatory process. Ninety percent of respondents indicated that they use acupuncture in their practice, giving an average of about eight treatments per week. Sixty-one percent of these treatments are given within the National Health Service (NHS) at no cost to the patient. Conclusion It is estimated that BMAS members provide a total of about one million acupuncture treatments each year, of which well over half a million are given within the NHS.
The Use of Acupuncture in the Treatment of Temporomandibular Dysfunction – An Audit
Authors: Rosted Palle , Bundgaard Mads , Pedersen Anne Marie Lynge 
Published: April 2009

Objective Temporomandibular dysfunction often represents a major therapeutic problem in a dental practice. Evidence from clinical studies suggests that acupuncture may be useful in the treatment of temporomandibular dysfunction. However, most studies have been performed in university settings. The aims of this study were to determine if the results of acupuncture treatment of temporomandibular dysfunction in general dental practice are comparable to the results obtained in previous studies in university clinics, and whether the treatment approach differs from that used in previous studies. Methods The case reports submitted by 15 dentists applying for the diploma of the British Dental Acupuncture Society were combined into one audit. All dentists were informed before submitting the forms that the data might be used for scientific purposes. The criteria for Pain Syndrome Dysfunction were used as inclusion criteria. A visual analogue scale (VAS) was used to assess the pain intensity before and after acupuncture treatment. The acupuncture points and technique used were recorded for each treatment. Results A total number of 70 case reports were received. Ten patients were excluded, as they did not fulfil the criteria. The remaining 60 patients (50 female) fulfilled an average of 3.2 of the Pain Syndrome Dysfunction criteria, out of a possible five. Their mean age was 40.6 years (range 14–68). The average duration of temporomandibular dysfunction was 32 months (range 1–180). The patients received a mean of 3.4 treatments, each treatment lasting on average 12 minutes. The dentists used only manual stimulation, and mainly acupuncture points over the temporomandibular joint and in the masticatory muscles, points on the neck, and additional relaxing points. The mean pain scores were 7.35 (SD 1.52) before treatment and 2.67 (SD 0.58) after treatment (P<0.001). A beneficial effect was observed in 85% with an average reduction in the pain intensity of 75%. Conclusion This audit shows that the results of using acupuncture in the treatment of temporomandibular dysfunction in a general dental practice are comparable to those obtained in clinical studies in university settings. Also the therapeutic approach of using acupuncture is similar. Thus, acupuncture is a simple, relatively safe and potentially efficacious and useful technique in the management of temporomandibular dysfunction in a general dental practice.
Acupuncture Treatment for Chemotherapy-Induced Peripheral Neuropathy – a Case Series
Authors: Wong Raimond , Sagar Stephen 
Published: April 2009

Chemotherapy induced peripheral neuropathy (CIPN) occurs in 10 to 20% of cancer patients treated with neurotoxic chemotherapy. A mixture of sensory, sensorimotor and autonomic nervous system dysfunction can occur, resulting in deterioration in function and worsened quality of life. A major feature is discomfort and pain. Early termination of treatment and dose reduction of chemotherapy may be necessary. The clinical course is variable and depends on the chemotherapy agents and their cumulative dose. Although symptoms can resolve completely, in most patients CIPN is either only partially reversible or completely irreversible. Current management for CIPN is symptomatic using membrane stabilising medications and antidepressants. The use of nerve growth factors is still experimental. Dysaesthesia and pain involving the feet and hands are described in both traditional Chinese medicine (TCM) and Western biomedicine. In TCM, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. Acupuncture is moderately effective in treating diabetic neuropathy. However, to date, there is no report of the usefulness of acupuncture for CIPN. We report the result of a pilot prospective case series of five patients treated with an acupuncture protocol that aims to correct Qi, Blood and Yang deficiencies and directs Qi and Blood to the extremities, with the goal of improving the symptoms of CIPN. The responses were encouraging, and cannot be easily explained by the known neurophysiological mechanisms of acupuncture.
Mechanisms of Action of Acupuncture for Chronic Pain Relief – Polymodal Receptors Are the Key Candidates
Authors: Kawakita Kenji , Okada Kaoru 
Published: April 2009

Therapeutic benefits of acupuncture for chronic pain patients have been clearly identified in recent clinical trials. Underlying mechanisms of acupuncture action mediated by endogenous opioids have been well demonstrated. The existence of pain inhibitory systems in the central nervous system has also been clarified and acupuncture seems to be a potent stimulus for activating the analgesic systems, although the pain mechanisms in acute and chronic states are essentially different. On the other hand, the exact nature of the acupuncture point still remains unclear. Here, we propose a key role of polymodal receptors (PMR) in acupuncture and moxibustion and offer a rational explanation of the acupuncture point as a sensitised PMR. Moxibustion (burning of moxa) therapy has been shown by medical historians to predate the use of acupuncture, and the meridian theory developed in association with moxibustion treatment. A variety of sensory receptors are activated by acupuncture and/or moxibustion, but there are very few that can be excited by both stimuli. PMRs are one of the most promising candidates. The functional characteristics of PMRs correspond with those of acupuncture action in the periphery; and tender or trigger points, one of the primitive features of acupuncture points, are assumed to be the sites of sensitised PMRs. Diffuse noxious inhibitory control (DNIC) is proposed as a possible mechanism of immediate action of acupuncture, and inputs for the development of DNIC seem to be the PMRs. In our experimental model, repeated eccentric contractions of muscle produced local tenderness at the palpable band and induced a typical referred pain pattern on application of pressure. Repeated indomethacin injections inhibited the production of the experimental trigger point. These lines of evidence suggest that the acupuncture points are the sites where the PMRs are sensitised and that such conditions might be repeatedly produced by various biomechanical stressors, insufficient blood supply and metabolic products.
The Characteristics of Middle Aged Australian Women who Consult Acupuncturists
Authors: Sibbritt David , Adams Jon , Young Anne F 
Published: April 2009

Background Although an increase in the use of acupuncture in recent years has been identified, there are few studies that focus attention upon the characteristics of acupuncture users. This survey aimed at providing a first step towards addressing this significant research gap. Methods This study was conducted as part of the Australian Longitudinal Study on Women's Health, and examined the characteristics of acupuncture users among middle aged Australian women between 50 and 55 years old. Data were collected on demographic measures, health status and health service use. Results The paper reports on 11 202 middle aged women, surveyed in 2001. We estimate that 4.5% of middle aged women consult an acupuncturist. Women who consult an acupuncturist are less likely to be married or living in a de facto relationship, are more likely to have had a major personal illness in the previous year, to have suffered from a variety of symptoms or have significantly lower scores (ie poorer health) on all eight dimensions of the SF-36 health-related quality of life scale. Women who use acupuncture are also higher users of ‘conventional’ health services. Conclusion While the development of a research base and clinical applications for acupuncture are ongoing, health professionals should be aware that acupuncture is currently being used by large numbers of middle aged women. In addition, given the relatively higher prevalence of acupuncture use reported in our study, it is important that further research explores acupuncture use in more detail and the relationship between women's health issues and their use and experience of acupuncture.
Are Reviews Based on Sham Acupuncture Procedures in Fibromyalgia Syndrome (Fms) Valid?
Authors: Lundeberg Thomas , Lund Iréne 
Published: April 2009

In recent reviews regarding the efficacy of acupuncture in fibromyalgia syndrome (FMS) it has been concluded that acupuncture has no specific effect since the control procedure (superficial needling and/or needling away from ‘specific’ points) had similar effects. These conclusions may be questioned since superficial needling and/or needling away from specific trigger points is not inert. Also, manual acupuncture or mild electroacupuncture (EA) may not be sufficient to activate the endogenous pain inhibiting system.Patients with FMS suffer from allodynia, fatigue and muscle ache, which is partly explained by peripheral and central sensitisation. Sensitisation results in augmented and altered stimulus responses whereby light stimulation of the skin has as strong an effect as regular needling on the pain inhibitory system in FMS.Central sensitisation in FMS is also associated with expanded receptive fields of central neurons resulting in a larger topographic distribution of the pain. This would suggest that control procedures using needling away from the ‘specific site’ might have as strong an effect as needling within the most painful area. Also, repeated nociceptive input from muscles (as obtained by de qi) results in expansion of receptive fields which in turn may result in activation of descending pain inhibition outside the stimulated myotome.Sensitisation to pain, such as in FMS, may also be related to abnormalities in descending efferent pathways. As there is likely to be an imbalance between excitatory and inhibitory systems in FMS, stronger stimulation may therefore be needed to activate the descending pain inhibitory system. In studies using mild manual acupuncture or weak EA stimulation optimal pain inhibition may therefore not have been obtained.When conducting studies on acupuncture, the clinical condition or syndrome needs to be taken into account and the control procedure designed accordingly.