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Chia KL, Lam RPK, Lam CK, Tsui SH. Acupuncture in the emergency department: a systematic review of randomised controlled trials. Acupunct Med 2018; 36:183-192. [PMID: 29581138 DOI: 10.1136/acupmed-2017-011547] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A comprehensive review of both English and Chinese language literature to inform acupuncture practice in emergency department (ED) settings is lacking. Accordingly, we aimed to conduct a systematic review of English and Chinese randomised controlled trials (RCTs) of acupuncture use in the ED. METHODS Four English databases (Embase, PubMed, AMED and CENTRAL) and two Chinese databases (CNKI and Wanfang) were systematically searched using the keywords 'acupuncture' and 'emergency department', followed by a bibliographic search of references. The data were extracted and assessed by two independent authors. RCTs were selected based on pre-defined criteria. Data were extracted and a risk of bias assessment was performed using the Cochrane risk of bias tool. The quality of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS In total, 1461 articles were screened and six RCTs involving 651 patients were included. For various acute pain conditions, acupuncture was superior to sham acupuncture, more effective than intravenous morphine, comparable to conventional ED treatment, and superior to standard ED care alone when used on an adjuvant basis; however, the overall level of evidence was low. Studies that applied acupuncture in hypertension and cardiac arrest were deemed to be at high risk of bias, and the level of evidence for these outcomes was very low. No major adverse events were reported in the included studies. CONCLUSION There is a lack of high-quality evidence to support the use of acupuncture in the ED. Multicentre RCTs with rigorous designs are warranted.
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Affiliation(s)
- Kwan Leung Chia
- St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Rex Pui Kin Lam
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chung Kwun Lam
- Hong Kong Association for Integration of Chinese-Western Medicine, Hong Kong SAR, China
| | - Sik Hon Tsui
- Department of Accident and Emergency, Queen Mary Hospital, Hong Kong SAR, China
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He BS, Li Y, Gui T. Preliminary Clinical Evaluation of Acupuncture Therapy in Patients With Postpartum Sciatica. J Midwifery Womens Health 2018; 63:214-220. [DOI: 10.1111/jmwh.12681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/11/2022]
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Soliday E, Betts D. Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. J Acupunct Meridian Stud 2018; 11:25-30. [PMID: 29482798 DOI: 10.1016/j.jams.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 11/18/2017] [Accepted: 11/28/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Clinic-based acupuncturists, midwives, and physiotherapists have reported using acupuncture to treat lumbopelvic pain in pregnancy, a common condition that may affect functioning and quality of life. To contribute to the emerging evidence on treatment outcomes, we collected patient-reported pain reduction data from women treated during pregnancy in a no-pay, hospital-based acupuncture service in New Zealand. METHODS Observational study of patient-reported symptom reduction.The main outcome measure was the MYMOP (Measure Your Medical Outcome Profile), a brief, validated self-report instrument. Open-ended questions on treatment experiences and adverse events were included. RESULTS Of the 81 women on whom we had complete treatment data, the majority (N = 72, 89%) reported clinically meaningful symptom reduction. Patient-reported adverse events were infrequent and mild. DISCUSSION Patient-reported and treatment-related lumbopelvic pain symptom reduction findings provide further evidence that acupuncture in pregnancy is safe and beneficial in a field setting. We discuss this study's unique contributions in providing guidance for clinicians who practice acupuncture in pregnancy, including midwives, physiotherapists, and physicians.
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Affiliation(s)
- Elizabeth Soliday
- Department of Human Development, Washington State University Vancouver, Vancouver, WA, USA.
| | - Debra Betts
- National Institute of Complementary Medicine at University of Western Sydney, Sydney, Australia; Postgraduate Programmes, New Zealand School of Acupuncture and Traditional Chinese Medicine, Wellington, New Zealand
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Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z. Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e9838. [PMID: 29465566 PMCID: PMC5841968 DOI: 10.1097/md.0000000000009838] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/06/2017] [Accepted: 01/19/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients' health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs. METHODS We independently searched 9 databases from beginning to August 15, 2017. Two writers extracted data at the same time independently. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs) and mean difference (MD) with 95% CIs. RESULTS Ten randomized controlled trials (RCTs) with 794 patients were included in this systematic review. The combined results showed that electroacupuncture (EA) may be more effective than sham electroacupuncture (sham EA) in improving the 24-hour nocturia episodes and EA may enhance tolterodine for relieving voiding symptoms and enhancing patients' quality of life. However, more trials with high quality and larger sample sizes will be needed in the future to provide sufficient evidence. Only 15 of 794 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, acupuncture is safe for treating OAB. CONCLUSION Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.
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Affiliation(s)
- Yuwei Zhao
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
- Beijing University of Chinese Medicine, Beijing
| | - Jing Zhou
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Qian Mo
- Guiyang College of Traditional Chinese Medicine, Guiyang, China
| | - Yang Wang
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Jinna Yu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
| | - Zhishun Liu
- Department of Acupuncture, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
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Buchberger B, Krabbe L. Evaluation of outpatient acupuncture for relief of pregnancy-related conditions. Int J Gynaecol Obstet 2018; 141:151-158. [PMID: 29355951 DOI: 10.1002/ijgo.12446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/15/2017] [Accepted: 01/17/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Acupuncture is a non-pharmacological option to relieve pregnancy-related complaints. OBJECTIVES To critically appraise the best available evidence for the use of acupuncture in outpatient care. SEARCH STRATEGY The MEDLINE, Cochrane Library, and Centre for Reviews and Dissemination databases were searched for English-language and German-language papers published from January 1980 to March 2017 using search terms related to pregnancy combined with 'acupuncture'. SELECTION CRITERIA Systematic reviews and randomized controlled trials (RCTs) comparing non-pharmacological treatments in unselected or low-risk pregnant women. DATA COLLECTION AND ANALYSIS Quality was assessed using a checklist (A Measurement Tool to Assess Systematic Reviews) and the Cochrane risk of bias tool. Meta-analyses were also performed. MAIN RESULTS High-quality systematic reviews (n=5) and RCTs with low risk of bias (n=3) were identified. The systematic reviews were based on single studies, with small sample sizes, that showed a benefit of acupuncture for evening pelvic pain; pelvic and low-back pain; nausea; functional disability; and sleep quality. Contradictory results were found in the RCTs regarding cesarean delivery; time to delivery; spontaneous labor; fetal distress; and Apgar score. Data pooling emphasized the heterogeneity of results. CONCLUSIONS Evidence to support the use of acupuncture for relief of pregnancy-related conditions was limited.
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Affiliation(s)
- Barbara Buchberger
- Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Essen, Germany
| | - Laura Krabbe
- Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Essen, Germany
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Reyhan AÇ, Dereli EE, Çolak TK. Low back pain during pregnancy and Kinesio tape application. J Back Musculoskelet Rehabil 2017; 30:609-613. [PMID: 28035911 DOI: 10.3233/bmr-160584] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Low back pain is a common problem during pregnancy. Although the pain usually occurs in the third trimester, it might be seen in the first trimester, too. There are various types of applications for the treatment of low back pain during pregnancy. However, there is a lack of evidence for the effectiveness of each method. If there is not an obvious deficit, bed rest, exercise, conventional physiotherapy, using protective principles for the lumbar area are recommended, since the main and the only complaint is low back pain. It is aimed in the current review to investigate the use of Kinesio tape in the low back pain seen during pregnancy and to review the literature related to this subject. CONCLUSION There are only a few studies investigating the effect of Kinesio tape during pregnancy in the literature and they mostly did not aim to study the low back pain, further evidence and studies are needed to investigate the use of Kinesio tape for the low back pain seen during pregnancy as there is not evidence strong enough. Kinesiotape application aims to increase circulation and mobility, and regarding these gains decreased pain and increased performance are expected.
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Affiliation(s)
- Aycan Çakmak Reyhan
- Department of Ergotherapy, Faculty of Health Sciences, İstanbul Bilgi University, Istanbul, Turkey
| | - Elif Elçin Dereli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İstanbul Bilgi University, Istanbul, Turkey
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Turkey
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Seto MT, Cheung KW, Lo TK, Ng EH. Pregnancy outcomes of women randomized to receive real versus placebo acupuncture on the day of fresh or frozen-thawed embryo transfer. Eur J Obstet Gynecol Reprod Biol 2017; 218:119-122. [DOI: 10.1016/j.ejogrb.2017.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/16/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
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Jo J, Lee YJ. Effectiveness of Acupuncture in Women with Polycystic Ovarian Syndrome Undergoing in Vitro Fertilisation Or Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis. Acupunct Med 2017; 35:162-170. [DOI: 10.1136/acupmed-2016-011163] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 12/13/2022]
Abstract
Objectives The aim of this systematic review was to assess the evidence from randomised controlled trials (RCTs) on the efficacy, effectiveness and safety of acupuncture in women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Methods We searched a total of 15 databases through October 2015. The participants were women with PCOS (diagnosed using the Rotterdam criteria) undergoing IVF or ICSI. Eligible trials were those with intervention groups receiving manual acupuncture (MA) or electroacupuncture (EA), and control groups receiving sham acupuncture, no treatment or other treatments. Outcomes included the clinical pregnancy rate (CPR), live birth rate (LBR), ongoing pregnancy rate (OPR) and incidence of ovarian hyperstimulation syndrome (OHSS) and adverse events (AEs). For statistical pooling, the risk ratio (RR) and its 95% (confidence interval) CI was calculated using a random effects model. Results Four RCTs including 430 participants were selected. All trials compared acupuncture (MA/EA) against no treatment. Acupuncture significantly increased the CPR (RR 1.33, 95% CI 1.03 to 1.71) and OPR (RR 2.03, 95% CI 1.08 to 3.81) and decreased the risk of OHSS (RR 0.63, 95% CI 0.42 to 0.94); however, there was no significant difference in the LBR (RR 1.61, 95% CI 0.73 to 3.58). None of the RCTs reported on AEs. Conclusions Acupuncture may increase the CPR and OPR and decrease the risk of OHSS in women with PCOS undergoing IVF or ICSI. Further studies are needed to confirm the efficacy and safety of acupuncture as an adjunct to assisted reproductive technology in this particular population.
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Affiliation(s)
- Junyoung Jo
- Department of Korean Gynecology, Conmaul Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Department of Korean Gynecology, Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
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CHEN S, XUAN LH, LIU S. Warm needling moxibustion at Xià guān ( ST 7) plus shallow Puncture for Bell's palsy in pregnancy. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2017. [DOI: 10.1016/s1003-5257(17)30121-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Patil S, Sen S, Bral M, Reddy S, Bradley KK, Cornett EM, Fox CJ, Kaye AD. The Role of Acupuncture in Pain Management. Curr Pain Headache Rep 2016; 20:22. [PMID: 26896946 DOI: 10.1007/s11916-016-0552-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Acupuncture is a traditional Chinese practice of medicine that has gained popularity in Western culture and around the world. It involves the insertion of thin needles into the skin to stimulate nerves, muscles, and connective tissues throughout the body with the goal of alleviating pain, tension, and stress. More broadly, acupuncture is actually a family of different procedures. Conceptually, it is believed to stimulate the body's meridians, or energy-carrying channels, in an attempt to correct imbalances and to restore health. These benefits are thought to be derived from the proximity of acupoints with nerves through intracellular calcium ions. This lesson outlines a brief history of acupuncture and how it may be used to treat various types of physical and emotional pain and specific conditions, including overactive bladder and psoriasis. Acupuncture has been demonstrated to enhance endogenous opiates, such as dynorphin, endorphin, encephalin, and release corticosteroids, relieving pain and enhancing the healing process. There are associated risks; however, serious side effects are rare. When compared to traditional methods of pain management, more studies are warranted in order to establish the efficacy of acupuncture and its place in pain management.
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Affiliation(s)
| | - Sudipta Sen
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Matthew Bral
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Shanthi Reddy
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | | | | | - Charles J Fox
- Department of Anesthesiology, LSUHSC, Shreveport, LA, USA
| | - Alan David Kaye
- Department of Anesthesiology, Louisiana State University Health Science Center, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
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Mallory MJ, Do A, Bublitz SE, Veleber SJ, Bauer BA, Bhagra A. Puncturing the myths of acupuncture. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2016; 14:311-4. [PMID: 27641603 DOI: 10.1016/s2095-4964(16)60269-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acupuncture is a widely practiced system of medicine that has been in place for thousands of years. Consumer interest and use of acupuncture are becoming increasingly popular in the United States, as it is used to treat a multitude of symptoms and disease processes as well as to maintain health and prevent illness. A growing body of evidence increasingly validates the practice of acupuncture. Further developing scientific data will play an important role in the future of acupuncture and other complementary and alternative medicines in public health. Acupuncture is commonly used concurrently with conventional medicine. Although acupuncture is embraced by consumers and medical professionals, misconceptions abound. We have explored and dispelled ten misconceptions common to the practice of acupuncture, utilizing an evidence-based approach. As the trend of merging conventional medical care with acupuncture treatment grows, it is important to develop a conceptual model of integrative medicine. Using a scientific evidence approach will create a structure from which to begin and grow confidence among conventional medical providers. Acupuncture is a safe and effective modality when performed properly by trained professionals. Educating both the consumer and medical community is important to enable appropriate and evidence-based applications of acupuncture and integration with conventional medicine for high-quality patient care.
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Affiliation(s)
- Molly J Mallory
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Alexander Do
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Sara E Bublitz
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Susan J Veleber
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Brent A Bauer
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Anjali Bhagra
- Complementary and Integrative Medicine, Division General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Wells RE, Turner DP, Lee M, Bishop L, Strauss L. Managing Migraine During Pregnancy and Lactation. Curr Neurol Neurosci Rep 2016; 16:40. [PMID: 27002079 DOI: 10.1007/s11910-016-0634-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
While over half of women with migraine report improvement during pregnancy, having a history of migraine may increase the chance of negative health outcomes. The state of pregnancy increases the risk of several dangerous secondary headache disorders, especially those associated with hypertensive disorders of pregnancy, and providers need to know the red flags to diagnose and treat emergently. Non-pharmacological migraine treatments can be instituted in advance of pregnancy as many are considered the safest options during pregnancy, but understanding the safety of medications and dietary supplements ensures appropriate care for the refractory migraine patient. New controversy exists over the safety of several historically routine and safe migraine treatment options in pregnancy, such as magnesium, acetaminophen, ondansetron, and butalbital. While it is not clear if breastfeeding decreases the postpartum recurrence of migraine, understanding safe treatment options during lactation can allow women to continue breastfeeding while achieving migraine relief.
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Affiliation(s)
- Rebecca Erwin Wells
- Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Dana P Turner
- Department of Anesthesiology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Michelle Lee
- Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Laura Bishop
- Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Lauren Strauss
- Department of Neurology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA
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Ormsby SM, Smith CA, Dahlen HG, Hay PJ, Lind JM. Evaluation of an antenatal acupuncture intervention as an adjunct therapy for antenatal depression (AcuAnteDep): study protocol for a pragmatic randomised controlled trial. Trials 2016; 17:93. [PMID: 26887958 PMCID: PMC4758005 DOI: 10.1186/s13063-016-1204-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 01/28/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depressed pregnant women face difficulty navigating a course between the potentially serious consequences of leaving depression untreated and significant limitations associated with conventional therapies, such as foetal toxicity and teratogenicity. Preliminary evidence is suggestive that acupuncture may provide a safe and effective alternative treatment option for antenatal depression; however, additional research is required. The purpose of this study is to further investigate this treatment possibility, with an additional examination of a potential biomechanistic acupuncture effect. METHODS/DESIGN In this pragmatic randomised controlled trial, we will compare individually tailored, flexible antenatal depression-oriented acupuncture with equivalent attention progressive muscle relaxation and routine antenatal depression hospital care. Eligible women at 24 weeks of gestation with Edinburgh Postnatal Depression Scale scores of 13 or more will be recruited from 2 antenatal clinics in South Western Sydney, Australia. The recruitment goal of 96 is powered to demonstrate a significant difference in Edinburgh Postnatal Depression Scale score severity between acupuncture and usual care, with intervention groups receiving weekly 1-h treatments for 8 weeks from 24 to 31 weeks of gestation. Mental health and quality-of-life assessments will occur at study commencement, intervention weeks 4 and 8 and 6 weeks post-natally via the collection of completed Edinburgh Postnatal Depression Scale scores, Depression, Stress and Anxiety Scale scores and World Health Organisation Quality of Life Scale scores. Adjustment to mothering will also be evaluated at 6 weeks post-natally using the Being a Mother Scale. A putative biomechanistic effect of acupuncture on the oxytocinergic system will additionally be examined by comparing baseline salivary hormone levels with those measured at intervention weeks 4 and 8, as well as leucocyte oxytocin receptor expression at baseline and intervention week 8. DISCUSSION Ethical approval was received in February 2015, and recruitment is underway and expected to be completed in July 2016. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12615000250538, Registered on 19 March 2015.
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Affiliation(s)
- Simone M Ormsby
- PhD Candidate, National Institute of Complementary Medicine, Western Sydney University, Building 5, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Caroline A Smith
- Professor of Complementary Medicine, National Institute of Complementary Medicine, Western Sydney University, Building 5, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Hannah G Dahlen
- Professor of Midwifery, Western Sydney University, Building EB, Parramatta Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Phillipa J Hay
- Chair of Mental Health, Western Sydney University, Building 30, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Joanne M Lind
- Associate Professor, Molecular Biology and Genetics, Western Sydney University, Building 30, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Jiang QY, Wang MY, Li L, Mo HX, Song JL, Tang QL, Feng XT. Electroacupuncture relieves labour pain and influences the spinal dynorphin/κ-opioid receptor system in rats. Acupunct Med 2016; 34:223-8. [PMID: 26732307 DOI: 10.1136/acupmed-2015-010951] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND The dynorphin (DYN)/κ-opioid receptor (KOR) system plays a key role in the control of labour pain. Our previous clinical study reported that electroacupuncture (EA) provided intrapartum analgesia, but the underlying mechanisms of action have not been fully elucidated. AIMS To observe the effect of EA on labour pain and to explore the underlying mechanisms of action in a rat model. METHODS Copulation-confirmed pregnant rats (n=120) were given castor oil to induce labour. Rats remained untreated (control group, n=20) or received either meperidine (an opioid that is commonly used to treat labour pain, n=20) or EA at SP6, LI4, SP6+LI4 or SP10 (four groups, n=20 each). Labour pain was evaluated by the warm water tail-flick test. Serum DYN values were measured by ELISA. Protein and mRNA expression of prodynorphin (PDYN, the precursor protein of DYN) and KOR were analysed by Western blotting and real-time PCR, respectively. RESULTS EA treatment at all acupuncture point combinations studied significantly relieved labour pain and increased serum DYN concentrations, to a degree similar to that achieved with meperidine. EA notably enhanced protein expression of KOR and PDYN and mRNA expression in the lumbar spinal cord but not in the cerebral cortex. The size of effect varied by EA group in the order: SP6>LI4>SP6+LI4>SP10 for all parameters measured, indicating differential effects relating to acupuncture point selection/combination. CONCLUSIONS The present study indicates that EA relieves labour pain, at least in part, by regulation of the spinal DYN/KOR system in a rat model.
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Affiliation(s)
- Qiu-Yan Jiang
- The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Meng-Ying Wang
- The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Li Li
- The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Hai-Xia Mo
- The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Jin-Ling Song
- The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
| | - Qian-Li Tang
- Scientific Experimental Center, Youjiang Medical University for Nationalities, Baise, Guangxi, China
| | - Xiao-Tao Feng
- Guangxi Scientific Experimental Center of Traditional Chinese Medicine, Guangxi University of Chinese Medicine, Nanning, Guangxi, China
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Zeng Y, Liu B, Luo T, Chen Y, Chen G, Chen D. Effects of acupuncture on preeclampsia in Chinese women: a pilot prospective cohort study. Acupunct Med 2015; 34:144-8. [PMID: 26516136 DOI: 10.1136/acupmed-2015-010893] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the acceptability and feasibility of acupuncture treatment as an adjunct to usual care in Chinese women with preeclampsia. METHODS This was a pilot prospective cohort study. Pregnant women with a diagnosis of preeclampsia were offered acupuncture and allocated into groups based on their choice: the acupuncture group (n=11) comprised women electing to receive treatment (up to 10 sessions over 2 weeks). The control group (n=11) was made up of women who declined and was matched for age, gestation at diagnosis, and parity. All women received usual care and underwent measurement of blood pressure (BP) at four time points: at baseline, at the end of the intervention, immediately before delivery, and postpartum (within 24 h). RESULTS Patients in the acupuncture group had significantly lower BP at time of delivery, and postpartum, than patients in the control group (p<0.05). The individual change in BP between baseline and the end of treatment was significantly greater in the acupuncture group versus the control group for both systolic BP (median (IQR) -8 (-3 to -14) vs +1 (-7 to +9) mm Hg, p=0.007) and diastolic BP (-3 (-1 to -3) vs +2 (-2 to +7) mm Hg, p=0.013). There were no significant differences between the groups in perinatal outcomes and no adverse effects of treatment. CONCLUSIONS Acupuncture plus usual care was associated with a greater reduction in BP than usual care alone. Further studies are needed to clarify the role of acupuncture in the treatment of preeclampsia.
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Affiliation(s)
- Yingchun Zeng
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bing Liu
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Taizhen Luo
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yun Chen
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guangen Chen
- Department of Rehabilitation Sciences, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dunjin Chen
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Abstract
Background/aim Although the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic. Main findings There is no objective evidence of harm following needling at forbidden points, summarised by the following four lines of evidence. (1) In 15 clinical trials (n=823 women receiving n=4549–7234 acupuncture treatments at one or more forbidden points) rates of preterm birth (PTB) and stillbirth following are equivalent to those in untreated control groups and consistent with background rates of these complications in the general population. (2) Observational studies, including a large cohort of 5885 pregnant women needled at forbidden points at all stage of pregnancy, demonstrate that rates of miscarriage, PTB, preterm prelabour rupture of membranes (PPROM), and preterm contractions (preterm labour (PTL) or threatened PTL) are comparable with untreated controls and/or consistent with their anticipated incidence. (3) There is no reliable evidence that acupuncture/electroacupuncture (EA) can induce miscarriage/labour, even under otherwise favourable circumstances such as post-dates pregnancy or intrauterine fetal death. (4) Laboratory experiments using pregnant rats have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption. Conclusions These findings are reassuring and will help individualised risk:benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment.
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Affiliation(s)
- David John Carr
- Institute for Medical and Biomedical Education, St George's University of London, London, UK Royal London Hospital for Integrated Medicine, University College London Hospitals NHS Trust, London, UK
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68
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Millwala F, Chen S, Tsaltskan V, Simon G. Acupuncture and postpartum pyogenic sacroiliitis: a case report. J Med Case Rep 2015; 9:193. [PMID: 26358565 PMCID: PMC4566364 DOI: 10.1186/s13256-015-0676-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/17/2015] [Indexed: 11/15/2022] Open
Abstract
Introduction Pyogenic sacroiliitis, a rare form of septic arthritis, occurs in patients following trauma, intravenous drug use, genitourinary infections and pregnancy. Here we report a rare case where both acupuncture and pregnancy served as predisposing risk factors to the development of this infection. Case presentation A 33-year-old white woman received several sessions of acupuncture treatment during her gestation at the site of her sacroiliac joint for sciatica; she developed biopsy-confirmed sacroiliitis with methicillin-sensitive Staphylococcus aureus during the immediate postpartum period. The diagnosis, medical management and treatment course are described. Conclusions Low back and pelvic pain are common conditions during pregnancy and postpartum. Acupuncture is a common modality of medication-free treatment used by many patients. Recognition of the potential complications of such therapies can lead to early diagnosis, accurate treatment, decreased morbidity and increased chances for a successful outcome.
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Affiliation(s)
- Farida Millwala
- Department of Internal Medicine, George Washington University Hospital, 900 23rd St NW, Washington, DC, 20037, USA.
| | - Shuo Chen
- Department of Internal Medicine, George Washington University Hospital, 900 23rd St NW, Washington, DC, 20037, USA.
| | - Vladislav Tsaltskan
- Department of Internal Medicine, George Washington University Hospital, 900 23rd St NW, Washington, DC, 20037, USA.
| | - Gary Simon
- Department of Internal Medicine, George Washington University Hospital, 900 23rd St NW, Washington, DC, 20037, USA.
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69
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Waterfield J, Bartlam B, Bishop A, Holden MA, Barlas P, Foster NE. Physical Therapists' Views and Experiences of Pregnancy-Related Low Back Pain and the Role of Acupuncture: Qualitative Exploration. Phys Ther 2015; 95:1234-43. [PMID: 25929530 PMCID: PMC4556954 DOI: 10.2522/ptj.20140298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 04/19/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Low back pain is often accepted as a "normal" part of pregnancy. Despite research suggesting that quality of life for women who are pregnant is adversely affected, most are advised to self-manage. Although the use of acupuncture for the management of persistent nonspecific low back pain has been recommended in recent UK national guidelines, its use in the management of pregnancy-related low back pain remains limited. OBJECTIVES This study aimed to explore the perceptions and experiences of physical therapists involved in treating women who are pregnant and have low back pain with the objective of informing the pretrial training program for a pilot randomized trial (Evaluating Acupuncture and Standard care for pregnant womEn with Back pain [EASE Back]). DESIGN A qualitative phenomenological method with purposive sampling was used in the study. METHODS Three focus groups and 3 individual semistructured interviews were undertaken, and an iterative exploratory thematic analysis was performed. To ensure transparency of the research process and the decisions made, an audit trail was created. RESULTS Twenty-one physical therapists participated, and emergent issues included: a lack of experience in treating pregnancy-related complaints, mixed messages from previous acupuncture education, a mistrust of the current evidence for acupuncture safety and effectiveness, and personal and professional fear of causing harm. CONCLUSIONS The findings suggest that UK physical therapists are reluctant to use acupuncture in the management of pregnancy-related low back pain. The explanations for these findings include perceived lack of knowledge and confidence, as well as a pervasive professional culture of caution, particularly fears of inducing early labor and of litigation. These findings have been key to informing the content of the training program for physical therapists delivering acupuncture within the pilot EASE Back trial.
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Affiliation(s)
- Jackie Waterfield
- J. Waterfield, EdD, MSc, School of Health and Rehabilitation and Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom.
| | - Bernadette Bartlam
- B. Bartlam, PhD, MA, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University
| | - Annette Bishop
- A. Bishop, PhD, MSc, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University
| | - Melanie A Holden
- M.A. Holden, PhD, BSc(Hons), Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University
| | - Panos Barlas
- P. Barlas, DPhil, BSc, School of Health and Rehabilitation and Institute for Primary Care and Health Sciences, Keele University
| | - Nadine E Foster
- N.E. Foster, DPhil, BSc, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University
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70
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Does acupuncture increase the risk of bleeding in patients taking warfarin? Integr Med Res 2015; 4:119-121. [PMID: 28664117 PMCID: PMC5481786 DOI: 10.1016/j.imr.2015.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 03/25/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022] Open
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71
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Clarkson CE, O'mahony D, Jones DE. Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review. Acta Obstet Gynecol Scand 2015; 94:453-64. [DOI: 10.1111/aogs.12587] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Carl E. Clarkson
- Department of Sport, Exercise and Rehabilitation; Faculty of Health and Life Sciences; Northumbria University; Newcastle upon Tyne UK
| | | | - Diana E. Jones
- Department of Sport, Exercise and Rehabilitation; Faculty of Health and Life Sciences; Northumbria University; Newcastle upon Tyne UK
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72
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Mo Q, Wang Y, Ye Y, Yu J, Liu Z. Acupuncture for adults with overactive bladder: a systematic review protocol. BMJ Open 2015; 5:e006756. [PMID: 25573525 PMCID: PMC4289716 DOI: 10.1136/bmjopen-2014-006756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/25/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Overactive bladder (OAB) is a symptom syndrome defined by the International Continence Society (ICS) as 'the presence of urinary urgency (both daytime and nighttime), usually accompanied by increased frequency and nocturia with or without urge urinary incontinence in the absence of a urinary tract infection or other obvious pathology'. Clinical studies indicate that acupuncture could reduce micturition over 24 h, urgency episodes over 24 h, and improve quality of life among people with OAB. This systematic review protocol details the proposed methods for evaluating the effectiveness and safety of acupuncture for OAB. METHODS AND ANALYSIS The following databases will be searched for relevant studies: the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Incontinence Group Trials Register, MEDLINE, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), Chinese Scientific Journal Database (VIP database), Wan-Fang Data, and China National Knowledge Infrastructure (CNKI) and will hand search a list of medical journals as a supplement. Any randomised controlled trials in English or Chinese without restriction of publication status will be included with treatment of OAB. Outcomes will mainly include number of micturition episodes over 24 h, number of urgency episodes over 24 h and number of incontinence episodes over 24 h. Two reviewers will independently screen the titles, abstracts or even full texts, and extract data. Two other reviewers will assess study quality. Revman 5.1 software will be used to conduct meta-analysis and calculate the risk ratio for dichotomous data. Weighted mean difference or standard mean difference will be calculated for continuous data. The Cochrane collaboration's tool will be used to assess the risk of bias. DISSEMINATION This systematic review protocol will provide information on acupuncture therapy for OAB. The results will be disseminated through peer-reviewed publication or conference presentations. PROTOCOL REGISTRATION PROSPERO CRD42014010181.
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Affiliation(s)
- Qian Mo
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Graduates, Beijing University of Chinese Medicine, Beijing, China
| | - Yang Wang
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yongming Ye
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinna Yu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhishun Liu
- Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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73
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Betts D, Smith CA, Dahlen HG. “Well I'm Safe Because…” — Acupuncturists Managing Conflicting Treatment Recommendations When Treating Threatened Miscarriage: A Mixed-Methods Study. J Altern Complement Med 2014; 20:838-45. [DOI: 10.1089/acm.2014.0139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Debra Betts
- The National Institute of Complementary Medicine, University of Western Sydney, Penrith, Australia
| | - Caroline A. Smith
- The National Institute of Complementary Medicine, University of Western Sydney, Penrith, Australia
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, University of Western Sydney, Australia
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Kwon S, Shin K, Jung W, Moon S, Cho K. Acupuncture therapy for fever induced by viral upper respiratory tract infection (URTI) in military medical service: a case series. Acupunct Med 2014; 32:509-11. [PMID: 25267729 DOI: 10.1136/acupmed-2014-010629] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. All patients were treated immediately after diagnosis with classical acupuncture (GV14, GB20, TE8 points) and a new type of acupuncture, equilibrium acupuncture (Feibing and Ganmao points). After one treatment session (20 min), reduction of body temperature was confirmed in all patients. Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported.
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Affiliation(s)
- SeungWon Kwon
- Department of Cardiovascular and Neurologic Diseases, College of Korean Medicine, KyungHee University, Seoul, Korea Medical Service Room, Service Support Group, Ministry of National Defence, Seoul, Korea
| | - KyoungHo Shin
- Medical Service Room, Service Support Group, Ministry of National Defence, Seoul, Korea
| | - WooSang Jung
- Department of Cardiovascular and Neurologic Diseases, College of Korean Medicine, KyungHee University, Seoul, Korea
| | - SangKwan Moon
- Department of Cardiovascular and Neurologic Diseases, College of Korean Medicine, KyungHee University, Seoul, Korea
| | - KiHo Cho
- Department of Cardiovascular and Neurologic Diseases, College of Korean Medicine, KyungHee University, Seoul, Korea
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75
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Abstract
BACKGROUND A placenta is considered to be retained when it remains undelivered 30 or 60 min after the birth of the baby following active or physiological management of the third stage of labour, respectively. It can be life threatening for the mother. METHODS We retrospectively examined the influence of acupuncture on the delivery of retained placentas in the third stage of labour in 70 women. In all cases the third stage of labour was actively managed, and acupuncture was provided 30 min after delivery at points KI16 and SP6 for 15 min. RESULTS After acupuncture 77% of placentas separated successfully. In 10% of cases some retained placental tissue was detected and manual removal of the avulsed cotyledon was performed, while in 13% the entire placenta was retained and manual removal of the placenta under general anaesthesia was necessary. CONCLUSIONS Acupuncture may help to facilitate placental separation but further controlled trials are needed.
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Affiliation(s)
- Ivka Djakovic
- Department of Gynecology and Obstetrics, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - Nada Bilic
- Department of Anesthesiology and Intensive Care, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
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