bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Acupuncture for Depression – a Systematic Review of Randomised Controlled Trials
Authors: Mukaino Yoshito , Park Jongbae , White Adrian , Ernst Edzard 
Published: April 2009

Objective To summarise the existing evidence on acupuncture as a therapy for depression. Methods RCTs were included, in which either manual acupuncture or electroacupuncture was compared with any control procedure in subjects with depression. Data were extracted independently by two authors. The methodological quality was assessed. Pre and post means and SDs for depression specific measures were extracted, when available, for meta-analysis. Results Seven randomised comparative trials involving 509 patients were included. The evidence is inconsistent on whether manual acupuncture is superior to sham, and suggests that acupuncture was not superior to waiting list. Evidence suggests that the effect of electroacupuncture may not be significantly different from antidepressant medication, weighted mean difference −0.43(95% CI −5.61 to 4.76). There is inconclusive evidence on whether acupuncture has an additive effect when given as an adjunct to antidepressant drugs. Conclusion The evidence from controlled trials is insufficient to conclude whether acupuncture is an effective treatment for depression, but justifies further trials of electroacupuncture.
Laser Acupuncture for Mild to Moderate Depression in a Primary Care Setting – a Randomised Controlled Trial
Authors: Quah-Smith Joo Im , Tang Wai Mun , Russell Janice 
Published: April 2009

Objective Depression is a major public health problem. There is some evidence supporting the effectiveness of needle acupuncture in its treatment. Laser stimulation, regarded here as a modality of acupuncture, is non-invasive and therefore free of infection risk; and it is acceptable to patients with needle phobia. The technique is relatively easily learned by community-based general practitioners. It is also amenable to sham control and therefore double-blinding in clinical trials. A double-blind randomised controlled trial was conducted to test the efficacy of low level laser acupuncture in mild to moderate depression. Methods Thirty patients with depression were randomised to receive either active or inactive laser treatment. The laser unit could be switched to one of two settings. One switch position delivered active laser acupuncture and the other was inactive (sham). In the active mode, 0.5J was delivered to each of six to eight individually tailored acupuncture sites per visit. All patients were treated twice weekly for four weeks then weekly for a further four weeks. The patients and the acupuncturist were both blinded to conditions. Outcome was assessed using the Beck Depression Inventory at baseline, weeks four and eight during treatment, and at 4 and 12 weeks following the treatment. Results At the end of the treatment period, Beck Depression Inventory scores fell from baseline by 16.1 points in the intervention group and by 6.8 points in the sham control group (P<0.001). The difference showed only a trend four weeks later, but was again significant after 12 weeks (P=0.007). Laser acupuncture was well tolerated with transient fatigue as the most common adverse effect. Conclusion Laser acupuncture may be worth further investigation as a treatment for mild to moderate depression in primary care.
Short Term Reactions to Acupuncture – a Cross-Sectional Survey of Patient Reports
Authors: MacPherson Hugh , Thomas Kate 
Published: April 2009

Objective To explore the type and frequency of short term reactions associated with a single acupuncture treatment. Methods As part of recruitment to a large-scale prospective survey of the safety of acupuncture, 9408 consecutive patients each completed one survey form soon after receiving treatment with acupuncture, and returned it directly to the research centre. On this form, patients were asked to report on a range of possible short term reactions relating to their most recent acupuncture treatment using a checklist of options. Results At least one short term reaction to acupuncture during or immediately after treatment was reported by 94.6% (CI 94.2 to 95.1) of patients, an average of 1.8 reactions per patient. The most common experiences reported were feeling ‘relaxed’ (79.1%) followed by feeling ‘energised’ (32.7%). A total of 24.4% of patients reported ‘tiredness’ or ‘drowsiness’, with obvious implications for safety if the patient intended to drive after treatment. ‘Negative’ reactions, such as pain and bruising at the site of needling, were reported by 29.7% of patients who were more likely to be female patients (OR 1.58), patients under the age of 40 (OR 1.62), patients who had consulted their GP or hospital specialist beforehand (OR 1.30), patients consulting their acupuncturist for the first time (OR 1.24), and patients treated by an acupuncturist with less than two years’ experience since qualification (OR 1.24). Only 13 patients were unwilling to have acupuncture again as a result of these short term reactions. Conclusion In this large cross-sectional study, extensive patient reports showed that ‘positive’ reactions to acupuncture treatment were very common. Tiredness, drowsiness and a range of ‘negative’ reactions were also frequently reported. Almost all patients were willing to experience these reactions again.
The Acupuncture Randomised Trial (Art) for Tension-Type Headache - Details of the Treatment
Authors: Melchart Dieter , Streng Andrea , Hoppe Andrea , Brinkhaus Benno , Becker-Witt Claudia , Hammes Michael , Irnich Dominic , Hummelsberger Josef , Willich Stefan N , Linde Klaus 
Published: April 2009

Objective The goal of this paper is to describe the characteristics of physicians and their interventions in a large, multicentre randomised trial of acupuncture for tension-type headache known as ARTTTH, in order to enable acupuncturists to assess the study interventions. Methods Participating physicians were recruited whose qualifications met or surpassed those of physicians currently accredited for providing acupuncture by state health funding agencies in Germany. Semi-standardised treatment strategies for acupuncture and minimal acupuncture were developed in a consensus process with acupuncture experts. A total of 270 patients suffering from episodic or chronic tension-type headache were randomised to 12 sessions of semi-standardised acupuncture (three predefined ‘basic’ points, recommendations for additional points given, but individual choice of additional points possible), standardised minimal acupuncture (superficial needling of at least 5 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list. Forty two physicians, trained and experienced in acupuncture, from 28 centres in Germany participated in the trial. Results The median duration of acupuncture training of trial physicians was 500 hours (range 140 to 1350 hours). Physicians had 10 (<1 to 25) years acupuncture experience. The three ‘basic’ points (GB20, GB21 and LR3) were treated in 96%, 82% and 97% of sessions, respectively. Frequently treated optional points included LI4 (67%), SP6 (50%) and ST36 (46%). Ten of the 42 physicians stated that they would have treated patients differently outside the trial. The trial found a significant effect of acupuncture over waiting list but not over minimal acupuncture. Conclusions In general, trial physicians complied well with the predefined interventions. A relevant minority of participating trial physicians stated that they would have treated patients differently outside the trial.
Effects of Lumbar Acupuncture Stimulation on Blood Flow to the Sciatic Nerve Trunk - An Exploratory Study
Authors: Inoue Motohiro , Hojo Tatsuya , Yano Tadashi , Katsumi Yasukazu 
Published: April 2009

Introduction Acupuncture may have a role in the treatment of intermittent claudication of the cauda equina due to lumbar spinal canal stenosis. The aim of this study was to explore the possible physiological mechanisms. Methods In a laboratory experiment, manual acupuncture was performed at a point adjacent to the sixth lumbar vertebra of 13 animals and its effect on sciatic nerve blood flow was measured using a laser Doppler flowmetry. Simultaneously, changes in blood pressure and cardiac rate were observed. Each animal was stimulated four to eight times, making a total of 58 experiments. Results Acupuncture stimulation did not produce consistent changes in sciatic nerve blood flow, with increased and decreased blood flow as well as no change in blood flow observed. Among the 58 individual experiments, sciatic nerve blood flow was increased in 33, reduced in 12, and unchanged in 13. Approximately half of the stimulations showed a correlation between blood flow and blood pressure change. Conclusion Our results indicate that lumbar acupuncture stimulation can have an influence on sciatic nerve blood flow. The effect is dependent not only on blood pressure but also other factors, for example vasodilator and vasoconstrictor nerve activity. This mechanism may contribute to a clinical effect on intermittent claudication of the cauda equina.
Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm
Authors: Filshie Jacqueline , Bolton Tara , Browne Doreen , Ashley Sue 
Published: April 2009

Introduction Since hormone replacement therapy given for long periods is now recognised to produce serious side effects, patients with troublesome vasomotor symptoms are increasingly using non-hormonal treatment including acupuncture. Several randomised controlled trials have shown that acupuncture reduces menopausal symptoms in patients experiencing the normal climacteric. It may have this effect by raising serotonin levels which alter the temperature set point in the hypothalamus. Vasomotor symptoms can be extreme in breast cancer patients and patients with prostate cancer who are undergoing anticancer therapy. The safety of some herbal medicines and phytoestrogens has been questioned, as they could potentially interfere adversely with the bioavailability of tumouricidal drugs. A previous study reports short term benefit from acupuncture, and the aim of this report is to describe our approach to long term treatment. Acupuncture Approach After piloting several approaches, six weekly treatments were given initially at LI4, TE5, LR3 and SP6 and two upper sternal points, but avoiding any limb with existing lymphoedema or prone to developing it. If there were no contraindications, patients were given clear instructions on how to perform self acupuncture using either semi-permanent needles or conventional needling at SP6, weekly for up to six years, for long term maintenance. Audit Methods and Results A retrospective audit of electronic records was carried out by a doctor not involved in treatment. A total of 194 patients were treated, predominantly with breast and prostate cancer. One hundred and eighty two patients were female. The number of pre-treatment hot flushes per day was estimated by the patient: in the 159 cases providing adequate records, the mean was 16 flushes per day. Following treatment, 114 (79%) gained a 50% or greater reduction in hot flushes and 30 (21%) a less than 50% reduction. Treatment was abandoned in those who responded poorly or not at all. The duration of treatment varied from one month to over six years with a mean duration of nine months. Seventeen patients (9%) experienced minor side effects over the six year period, mostly minor rashes; one patient described leg swelling but this was likely to be due to a concurrent fracture. Conclusion Acupuncture including self acupuncture is associated with long term relief of vasomotor symptoms in cancer patients. Treatment is safe and costs appear to be low. An algorithm is presented to guide clinical use. We recommend the use of self acupuncture with needles at SP6 in preference to semi-permanent needles in the first instance, but poor responders use indwelling studs if they fail to respond adequately to self acupuncture with regular needles. Point location may be of less importance than the overall ‘dose’, and an appropriate minimum dose may be required to initiate the effect.
A Review of Acupuncture Clinical Trials Indexed during 2005
Authors: White Adrian , Tough Elizabeth , Cummings Mike 
Published: April 2009

Background Clinical trials in acupuncture are published in a variety of journals, and it is useful to summarise them in one place. Methods We conducted a search of PubMed and Embase for clinical trials of acupuncture with date of entry 2005, and selected randomised controlled trials with clinical outcomes for review. Where possible, the original report was read for full details. Results Thirty-eight RCTs were found from databases, and one more during the process of the study. Ten of the trials included about 100 patients or more. Five showed acupuncture to be superior to usual care in back pain, knee pain and headache. Acupuncture was superior to placebo for chronic knee pain, but not for fibromyalgia, or post-stroke rehabilitation. Acupuncture was not as good as conventional analgesia for oocyte collection. Conclusion The role of acupuncture is becoming more precisely established in treatment of chronic knee pain, back pain and headache. Acupuncture for chronic back pain is more cost-effective than many other medical interventions.
Effects of Trigger Point Acupuncture on Chronic Low Back Pain in Elderly Patients – a Sham-Controlled Randomised Trial
Authors: Itoh Kazunori , Katsumi Yasukazu , Hirota Satoko , Kitakoji Hiroshi 
Published: April 2009

Introduction There is some evidence for the efficacy of acupuncture, but it remains unclear whether trigger point acupuncture is effective. Our objective was to evaluate the effects of trigger point acupuncture on pain and quality of life in chronic low back pain patients compared with sham acupuncture. Methods Twenty-six consecutive out-patients (17 women, 9 men; age range: 65–91 years) from the Department of Orthopaedic Surgery, Meiji University of Oriental Medicine, with non-radiating low back pain for at least six months and normal neurological examination, were randomised to two groups. Each group received one phase of trigger point acupuncture and one of sham acupuncture with a three week washout period between them, over 12 weeks. Group A (n=13) received trigger point acupuncture in the first phase and sham acupuncture in the second. Group B (n=13) received the same interventions in the reverse order. Outcome measures were pain intensity (visual analogue scale, VAS) and Roland Morris Questionnaire. Results Nineteen patients were included in the analysis. At the end of the first treatment phase, group A receiving trigger point acupuncture scored significantly lower VAS (P<0.001) and Roland Morris Questionnaire scores (P<0.01) than the sham control group. There were significant within-group reductions in pain in both groups during the trigger point acupuncture phase but not in the sham treatment phase. However, the beneficial effects were not sustained. Conclusion These results suggest that trigger point acupuncture may have greater short term effects on low back pain in elderly patients than sham acupuncture.
Lack of Effect of Acupuncture on Electromyo-Graphic (Emg) Activity – a Randomised Controlled Trial in Healthy Volunteers
Authors: Tough Liz 
Published: April 2009

Background Acupuncture is used clinically to treat muscle spasticity and flaccidity. Claims have been made that acupuncture can affect muscle EMG activity, though there is some doubt about the reliability of these studies. This study's aim was to examine the immediate effects of acupuncture on the EMG activity of the common wrist extensor muscles. Methods Thirty five right-handed healthy volunteers, 17 male and 18 female, aged 18-70 years were recruited from a convenience sample. Five subjects provided reliability data, and the remaining 30 took part in the main study. The study was a crossover, within-subject design, with the interventions counterbalanced. The three conditions were genuine acupuncture to LI4 ( Hegu) and LI10 ( Shousanli) for 20 minutes, with de qi; inappropriate acupuncture to PC3 ( Quze) and PC6 ( Neiguan) for 20 minutes; and 20 minutes of a no intervention control. All participants received each condition in random order. The outcome measure was surface EMG activity recorded over the common wrist extensor muscles during a 10 second, sub-maximal, isometric contraction. The average of three readings was used. The reliability of the outcome measurement was assessed in five volunteers selected at random who received repeated EMG recordings without acupuncture. Results The reliability tests showed the EMG procedure was highly reliable, with an intraclass correlation coefficient (ICC 2,1) of 0.9996 and a standard error of measurement of 0.014mV. In the main study, paired t tests for the effect of the order of the first two interventions showed no detectable carry-over effect. Freidman analysis of variance found no difference between the three conditions (P=0.573). Conclusion No meaningful change was detected in EMG activity following acupuncture interventions, but this study provides a sound protocol and normative values on which to plan future research.
Needle Electromyographic Activity of Myofascial Trigger Points and Control Sites in Equine Cleido-Brachialis Muscle – An Observational Study
Authors: Macgregor Joanne , von Schweinitz Dietrich Graf 
Published: April 2009

Background Myofascial trigger points are commonly described in humans, and many studies have shown abnormal spontaneous electrical activity, spike activity and local twitch responses at these sites. Myofascial trigger points have only rarely been described in horses, and studies of their electrophysiological characteristics have not previously been published. The objective of this study was to explore the electromyographic (EMG) and other characteristics of myofascial trigger points in equine muscle, and to compare them with normal muscle tissue. Methods Four horses with chronic pain signs and impaired performance were examined. They had previously been examined at the second author's practice, and showed signs compatible with the diagnosis of myofascial trigger points in their cleidobrachialis (brachiocephalic) muscle, ie localised tender spots in a taut band of skeletal muscle which produced a local twitch response on snapping palpation. They had therefore been selected for treatment with acupuncture. Needle EMG activity and twitch responses were recorded at 25 positions at the trigger point and at a nearby control point during the course of each horse's acupuncture treatment. Results All subjects demonstrated objective signs of spontaneous electrical activity, spike activity and local twitch responses at the myofascial trigger point sites within taut bands. The frequency of these signs was significantly greater at myofascial trigger points than at control sites (P<0.05). Conclusion Equine myofascial trigger points can be identified, and have similar objective signs and electrophysiological properties to those documented in human and rabbit skeletal muscle tissue. The important differences from findings in human studies are that referred pain patterns and the reproduction of pain profile cannot be determined in animals.
Aspects of Pain, Its Assessment and Evaluation from An Acupuncture Perspective
Authors: Lund Iréne , Lundeberg Thomas 
Published: April 2009

Pain is a major clinical problem that causes great suffering for the individual and incurs costs for society. Accurate assessment and evaluation of perceived pain is necessary for diagnosis, for choice of treatment, and for the evaluation of treatment efficacy. The assessment of an individual's pain is a challenge since pain is a subjective, multidimensional experience, and assessment is based on the person's own self-report. The results are often varied, possibly due to inter-individual variation, but also in relation to gender and aetiology. A gold standard for pain assessment is still lacking, but rating scales, questionnaires, and methods derived from psychophysical concepts, such as threshold assessments and perceptual matching, are used. In the evaluation of pain and associated variables, both systematic and individual variation should be taken into account, as should pain-associated symptoms. Recommendations for pain treatment should be based on the patient's specific needs. Therefore, it is important to assess the level of perceived pain taking individual variation into account. The methods used should preferably have proved to be useful in randomised controlled trials, and analysis of pain assessment should consider its non-metric properties. In the future, the use of studies with a naturalistic protocol together with individual assessment of individual pain responses could increase the internal and external validity.
Acupuncture Vs Streitberger Needle in Knee Osteoarthritis – An Rct
Authors: Vas Jorge , Méndez Camila , Perea-Milla Emilio 
Published: April 2009

Aims To determine the effectiveness of acupuncture as a therapy complementary to the pharmacological treatment of osteoarthritis of the knee. Methods Randomised, single blind, placebo controlled trial. Patients with osteoarthritis of the knee were randomly assigned to either 12 sessions of true acupuncture or 12 sessions of placebo acupuncture (Streitberger needle), these sessions taking place once a week. A baseline measurement was carried out, followed by further observations at 4, 8, 12 and 16 weeks. The clinical variables were the WOMAC (Western Ontario and McMaster Universities Osteoarthritis) index, knee pain measured by a visual analogue scale (pain VAS), the weekly consumption of diclofenac and the Profile of the Quality of Life of the Chronically Ill (PQLC). The two groups were compared for each of the clinical variables per protocol and by intention to treat. A multiple linear regression model for the dependent variables was constructed. Results Ninety seven outpatients were selected, with 88 remaining for the per protocol analysis; the analysis of homogeneity concluded that the lost subjects were not significantly different from those that completed the study. The multivariate per protocol model for the relative pain VAS variable showed a difference in improvement of 43.7% (95% CI 29.4% to 58.0%) for acupuncture, compared with the control group. In an intention to treat analysis, the relative improvement was 32.4% (20.3% to 44.4%). In a per protocol analysis, the total WOMAC showed a relative decrease of 52.0% (34.3% to 69.6%) in favour of the acupuncture group, or 37.6% (22.4% to 52.8%) in an intention to treat analysis. Conclusions The group treated with acupuncture showed significantly better effects, both clinically and statistically, in the reduction of pain intensity as measured by pain VAS, on the WOMAC index and in decreased consumption of diclofenac.