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Gao Q, Liu Q, Zhang G, Lu Y, Li Y, Tang M, Liu S, Zhang H, Hu X. Identification of pathogen composition in a Chinese population with iatrogenic and native vertebral osteomyelitis by using mNGS. Ann Med 2024; 56:2337738. [PMID: 38590185 PMCID: PMC11005868 DOI: 10.1080/07853890.2024.2337738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/19/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Early antimicrobial therapy is crucial regarding the prognosis of vertebral osteomyelitis, but early pathogen diagnosis remains challenging. OBJECTIVE In this study, we aimed to differentiate the types of pathogens in iatrogenic vertebral osteomyelitis (IVO) and native vertebral osteomyelitis (NVO) to guide early antibiotic treatment. METHODS A total of 145 patients, who had confirmed spinal infection and underwent metagenomic next-generation sequencing (mNGS) testing, were included, with 114 in the NVO group and 31 in the IVO group. Using mNGS, we detected and classified 53 pathogens in the 31 patients in the IVO group and 169 pathogens in the 114 patients in the NVO group. To further distinguish IVO from NVO, we employed machine learning algorithms to select serum biomarkers and developed a nomogram model. RESULTS The results revealed that the proportion of the Actinobacteria phylum in the NVO group was approximately 28.40%, which was significantly higher than the 15.09% in the IVO group. Conversely, the proportion of the Firmicutes phylum (39.62%) in the IVO group was markedly increased compared to the 21.30% in the NVO group. Further genus-level classification demonstrated that Staphylococcus was the most common pathogen in the IVO group, whereas Mycobacterium was predominant in the NVO group. Through LASSO regression and random forest algorithms, we identified 5 serum biomarkers including percentage of basophils (BASO%), percentage of monocytes (Mono%), platelet volume (PCT), globulin (G), activated partial thromboplastin time (APTT) for distinguishing IVO from NVO. Based on these biomarkers, we established a nomogram model capable of accurately discriminating between the two conditions. CONCLUSION The results of this study hold promise in providing valuable guidance to clinical practitioners for the differential diagnosis and early antimicrobial treatment of vertebral osteomyelitis.
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Affiliation(s)
- Qile Gao
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qianfei Liu
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guang Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yingqing Lu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanbing Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, China
| | - Mingxing Tang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Shaohua Liu
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hongqi Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojiang Hu
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Lin CL, Chern A, Wang MJ, Lin SK. Incidence of nerve injury following acupuncture treatments in Taiwan. Complement Ther Med 2024; 80:103007. [PMID: 38040097 DOI: 10.1016/j.ctim.2023.103007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE Acupuncture, a widely employed traditional therapeutic modality known for its efficacy in pain alleviation and diverse condition management, may inadvertently result in mechanical nerve injury due to its invasive nature. This research aimed to ascertain the incidence of nerve injuries post-acupuncture, identify associated risk factors, and map the distribution of nerve injury sites. METHODS A case-control study nested in the National Health Insurance Research Database (NHIRD) 2000-2018 two million cohort was conducted. Patients previously diagnosed with nerve injury, surgery, or degeneration before acupuncture were excluded. Cases were defined as patients receiving acupuncture and seeking medical attention for nerve injury (ICD9-CM code 950-957) within 14 days post-procedure, while control groups comprised patients undergoing acupuncture without subsequent adverse events. Invasive treatments prior to adverse events and adverse events occurring more than 14 days post-acupuncture were excluded. To ensure case-control comparability, factors such as age, gender, socioeconomic status, and medical facility environment were controlled using propensity score matching. RESULTS The study encompassed 14,507,847 acupuncture treatments administered to 886,753 patients, with 8361 instances of post-acupuncture nerve injury identified, representing an incidence rate of approximately 5.76 per 10,000 procedures. Age emerged as a significant risk factor, with the adjusted odds ratios escalating with age. Several comorbidities including diabetes, hypothyroidism, liver cirrhosis, chronic kidney disease, herpes zoster, hepatitis virus, rheumatoid arthritis, systemic lupus erythematosus, dementia, and cerebrovascular accidents were associated with an elevated risk of nerve injury post-acupuncture. CONCLUSION This study underscores the importance of meticulous patient profiling and cautious therapeutic approach in acupuncture, considering the evident influence of various demographic, systemic, and treatment-related factors on the incidence of nerve injuries.
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Affiliation(s)
- Chia-Lin Lin
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
| | - Andy Chern
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Jen Wang
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shun-Ku Lin
- Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; University of Taipei, Taipei, Taiwan, ROC
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3
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Kayo T, Suzuki M, Mitsuma T, Suzuki M, Ikeda S, Sukegawa M, Tsunoda S, Ohta M. Bleeding Risk of Acupuncture for Patients with Hematological Malignancies Accompanying Thrombocytopenia: A Retrospective Chart Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:77-84. [PMID: 37405736 DOI: 10.1089/jicm.2022.0710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Introduction: In recent years, it has been reported that acupuncture is useful for alleviating the symptoms of patients with hematological malignancies, but the safety of acupuncture for such patients has not been established. This study evaluated the risk of bleeding from acupuncture in patients with hematological malignancies accompanying thrombocytopenia. Methods: The authors performed a retrospective investigation of the medical records of patients with hematological malignancies who received acupuncture during hospitalization at the hematology department of a single medical center in Japan. The bleeding risk at the acupuncture site was evaluated in the following four groups according to the platelet count measured on the day of acupuncture treatment: (1) <20 × 103/μL, (2) 20-49 × 103/μL, (3) 50-99 × 103/μL, and (4) 100 × 103/μL or more. Occurrence of grade 2 or higher bleeding according to the Common Terminology Criteria for Adverse Events, version 5.0, within 24 h from the acupuncture session or before the next session was defined as an event, and the risk of occurrence of bleeding was examined in each group. Results: Of 2423 acupuncture sessions conducted on 51 patients with hematological malignancies, 815 were included in the analysis. Ninety sessions were performed in the <20 × 103/μL platelet count group, 161 in the 20-49 × 103/μL group, 133 in the 50-99 × 103/μL group, and 431 in the 100 × 103/μL or more group. No bleeding event according to the authors' definition occurred in any of these groups. Conclusions: This study is the largest to date to assess the bleeding risk of acupuncture in patients with hematological malignancies accompanying thrombocytopenia. The authors considered that acupuncture could be safely performed without causing serious bleeding for patients with hematological malignancies accompanying thrombocytopenia.
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Affiliation(s)
- Takumi Kayo
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masao Suzuki
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Manabu Suzuki
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Shohei Ikeda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Saburo Tsunoda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masatsugu Ohta
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
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Chen HT, Kuo CF, Hsu CC, Lai LC, Cheng AC, Sun CK, Hung KC. Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis. Front Med (Lausanne) 2023; 9:1100014. [PMID: 36698826 PMCID: PMC9868182 DOI: 10.3389/fmed.2022.1100014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background This meta-analysis aimed at investigating the efficacy of acupuncture for relieving renal colic and reducing the risk of analgesic-related complications. Methods Randomized controlled trials (RCTs) comparing the efficacy of acupuncture (acupuncture group) with conventional interventions (control group) were screened from MEDLINE, EMBASE, Cochrane library databases, China Knowledge Network (CNKI), and Airiti Library till July 15, 2022. The primary outcome was the rate of effective pain relief (response rate), while secondary outcomes included the time of onset of pain relief, visual analog scale (VAS) at 30-60 min and risk of side effects. Results Thirteen eligible studies involving 1,212 participants published between 1992 and 2021 were analyzed. Compared with the control group, patients receiving acupuncture had a higher overall response rate [risk ratio (RR) = 1.12, 95% CI: 1.05-1.19, p = 0.0002, I 2 = 41%, 1,136 patients] (primary outcome) and a faster pain relief [MD = -10.74 min, 95% CI: -12.65 to -8.82, p < 0.00001, I 2 = 87%, 839 patients]. Patients receiving acupuncture had a lower pain score [MD = -0.65, 95% CI: -1.09 to -0.21, p = 0.21, I 2 = 55%, 327 patients] and risk of side effects (RR = 0.11, 95% CI: 0.04-0.26, p < 0.00001, I 2 = 0, 314 patients) compared to those receiving conventional interventions. Results from trial sequence analysis revealed sufficient evidence supporting the beneficial effects of acupuncture on response rate, time to pain relief, and pain score at 30-60 min. Conclusion Compared with conventional analgesic-based interventions, acupuncture can more efficiently relieve renal colic with fewer adverse effects. The limited number and quality of included studies warrant more clinical RCTs to support our findings. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022346714.
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Affiliation(s)
- Hsiao-Tien Chen
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Cheng-Feng Kuo
- Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chin-Chia Hsu
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Li-Chun Lai
- Department of Nursing, Chi Mei Medical Center, Tainan City, Taiwan
| | - Ai-Chin Cheng
- Division of Respiratory Therapy, Department of Internal Medicine, Chi Mei Medical Center, Tainan City, Taiwan,Department of Medical Sociology and Health Care Bachelor’s Degree Program, College of Health Sciences, Chang Jung Christian University, Tainan City, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan,*Correspondence: Kuo-Chuan Hung,
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Won J, Lee JH, Bang H, Lee H. Safety of acupuncture by Korean Medicine Doctors: a prospective, practice-based survey of 37,490 consultations. BMC Complement Med Ther 2022; 22:300. [DOI: 10.1186/s12906-022-03782-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
To evaluate safety of acupuncture treatment by Korean Medicine Doctors (KMDs), a prospective, practice-based survey on adverse events (AEs) associated with acupuncture was conducted.
Methods
From July 2016 to October 2017, KMDs were invited to participate in an online survey. Frequency was calculated as the number of AEs per 10,000 treatments; severity was assessed with the Common Terminology Criteria for Adverse Events Grading (Severity) Scale; and causality was evaluated using the World Health Organisation-Uppsala Monitoring Centre system for standardised case causality assessment. Associations between AE occurrence and KMDs’ type of practice/clinical experience and patient age/gender/current medication(s) were analysed.
Results
Data on 37,490 acupuncture treatments were collected from 222 KMDs. At least one AE was reported from 4,518 acupuncture treatments, giving a frequency rate of 1,205 per 10,000 acupuncture treatments; this increased to 4,768 treatments when administrative problems related to defective devices or medical negligence were added, for a rate of 1,272 per 10,000 acupuncture treatments. Commonly reported AEs were bleeding, needle site pain, and bruising. Approximately 72.9% of AEs/administrative problems were assessed as they certainly occurred by acupuncture treatment in causality assessment. Most AEs/administrative problems were considered mild in severity and two life-threatening AEs were resolved with no sequelae. Compared to males, female patients were more likely to experience AEs and KMDs’ clinical experience was not associated with reported AE occurrence.
Conclusions
Although acupuncture-associated AEs occur commonly, they are largely transient and mild. Acupuncture performed by qualified KMDs may serve as a reliable medical treatment with acceptable safety profiles.
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Yoon SH, Kwon CY, Jo HG, Sul JU, Lee H, Won J, Jeong SJ, Lee JH, Leem J. Safety of acupotomy in a real-world setting: A prospective pilot and feasibility study. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:514-523. [PMID: 36050272 DOI: 10.1016/j.joim.2022.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/11/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Acupotomy is a modern acupuncture method that includes modern surgical methods. Since acupotomy is relatively more invasive than filiform acupuncture treatment, it is important to establish the safety profile of this practice. To justify further large-scale prospective observational studies, this preliminary study was performed to assess the feasibility of the approach and investigate the safety profile and factors potentially associated with adverse events (AEs). METHODS This was a prospective pilot study that assessed the feasibility of a large-scale forthcoming safety study on acupotomy treatment in a real-world setting. The feasibility (call response rate, drop-out rate, response rate for each variable and recruitment per month) and safety profile (incidence, type, severity and causality of AEs, and factors potentially associated with AEs) were measured. RESULTS A total of 28 participants joined the study from January to May 2018. A follow-up assessment was achieved in 258 (1185 treatment points) out of 261 sessions (1214 treatment points). The response rate via telephone on the day after treatment was 87.3%. There were 8 systemic AEs in all the sessions (8/258; 3.11%) and 27 local AEs on the total points treated (27/1185; 2.28%). Severe AEs did not occur. Total AE and local AE occurrence were associated with blade width and the number of needle stimulations per treatment point. CONCLUSION The findings suggest that it could be feasible to analyze the safety of acupotomy in a real-world setting. Moreover, the primary data on some relevant AEs could be determined. We are planning large-scale prospective studies based on these findings. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0002849 (https://cris.nih.go.kr/cris/search/detailSearch.do/11487).
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Affiliation(s)
- Sang-Hoon Yoon
- Chung-Yeon Korean Medicine Clinic, Gangnam-gu, Seoul 06224, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busanjin-gu, Busan 47340, Republic of Korea
| | - Hee-Geun Jo
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
| | - Jae-Uk Sul
- Department of Korean Rehabilitation Medicine, Dongshin University Korean Medicine Hospital, Gwangju 61619, Republic of Korea
| | - Hyangsook Lee
- Acupuncture and Meridian Science Research Center, Kyung Hee University, Dongdaemun-gu, Seoul 02447, Republic of Korea; Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Jiyoon Won
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Su Jin Jeong
- Department of Statistics Support, Medical Science Research Institute, Kyung Hee University Medical Center, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon 34054, Republic of Korea; Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon 34054, Republic of Korea.
| | - Jungtae Leem
- College of Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do 54538, Republic of Korea.
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Uehara A, Yoshimoto T, Kaneko Y, Ochiai H, Shirasawa T, Minoura A, Den H, Sakamoto A, Kokaze A. Patient- and Therapist-Related Risk Factors for Adverse Events in Acupuncture and Moxibustion in Japan: Multicenter Survey of Acupuncture and Moxibustion Teaching Clinics. Med Acupunct 2021; 33:435-442. [PMID: 34976277 PMCID: PMC8716478 DOI: 10.1089/acu.2021.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background/Objective: To investigate the patient- and therapist-related factors underlying adverse events (AEs) in acupuncture and moxibustion (A&M). Design: Retrospective study using data from medical records. Subjects: Patients who underwent A&M therapy in 4 clinics providing A&M over a 6-month period and their therapists. Main Outcome Measures: Survey items included the number of patients, age, sex, number of sessions, number and type of AEs, patients' underlying disease, and the therapist's years of clinical experience. The chi-squared test was used for intergroup comparisons. Spearman's rank correlation coefficient was used to analyze the correlations between the number of sessions and AEs. Logistic regression analysis was performed with AEs as the objective variable to investigate the relationships between the various parameters and AEs. Results: The analysis included 615 patients and 113 therapists. A total of 421 AEs occurred in a total of 4,369 sessions (9.6%). The number of sessions and number of AEs were significantly and positively correlated with patients (r = 0.47, P < 0.001) and therapists (r = 0.65, P < 0.001). Logistic analysis identified patient sex (adjusted odds ratio: 1.78, 95% confidence interval: [1.39-2.30]), liver disease (0.40, [0.19-0.84]), and years of clinical experience (to a cutoff of 2 or fewer years, 2-4 years: 0.65, [0.48-0.88], 5-9 years: 0.62, [0.44-0.87], 10 years or more: 0.50, [0.37-0.68]) as significant variables. Conclusions: Female sex and fewer years of clinical experience were factors that increased the risk of AEs, and underlying liver disease was a factor that decreased the risk of AEs.
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Affiliation(s)
- Akihito Uehara
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
- Kuretake College of Medical Arts and Sciences, Oriental Medicine Clinical Institute, Shinjuku-ku, Tokyo, Japan
- Address correspondence to: Akihito Uehara, MNR, LAc, Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku 142-8555, Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yasuhisa Kaneko
- Kuretake College of Medical Arts and Sciences, Oriental Medicine Clinical Institute, Shinjuku-ku, Tokyo, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Hiroki Den
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Ayumi Sakamoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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Bäumler P, Zhang W, Stübinger T, Irnich D. Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open 2021; 11:e045961. [PMID: 34489268 PMCID: PMC8422480 DOI: 10.1136/bmjopen-2020-045961] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Overview on risks of acupuncture-related adverse events (AEs). DESIGN Systematic review and meta-analyses of prospective studies. DATA SOURCES PubMed, Scopus and Embase from inception date to 15 September 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective studies assessing AEs caused by needle acupuncture in humans as primary outcome published in English or German. DATA EXTRACTION AND SYNTHESIS Two independent researchers selected articles, extracted the data and assessed study quality. Overall risks and risks for different AE categories were obtained from random effects meta-analyses. MAIN OUTCOMES Overall risk of minor AEs and serious adverse events (SAEs) per patients and per treatments. RESULTS A total of 7679 publications were identified. Twenty-two articles reporting on 21 studies were included. Meta-analyses suggest at least one AE occurring in 9.31% (95% CI 5.10% to 14.62%, 11 studies) of patients undergoing an acupuncture series and in 7.57% (95% CI 1.43% to 17.95%, 5 studies) of treatments. Summary risk estimates for SAEs were 1.01 (95% CI 0.23 to 2.33, 11 studies) per 10 000 patients and 7.98 (95% CI 1.39 to 20.00, 14 studies) per one million treatments, for AEs requiring treatment 1.14 (95% CI 0.00 to 7.37, 8 studies) per 1000 patients. Heterogeneity was substantial (I2 >80%). On average, 9.4 AEs occurred in 100 treatments. Half of the AEs were bleeding, pain or flare at the needle site that are argued to represent intended acupuncture reaction. AE definitions and assessments varied largely. CONCLUSION Acupuncture can be considered among the safer treatments in medicine. SAEs are rare, and the most common minor AEs are very mild. AEs requiring medical management are uncommon but necessitate medical competence to assure patient safety. Clinical and methodological heterogeneity call for standardised AE assessments tools, clear criteria for differentiating acupuncture-related AEs from therapeutically desired reactions, and identification of patient-related risk factors for AEs. PROSPERO REGISTRATION NUMBER CRD42020151930.
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Affiliation(s)
- Petra Bäumler
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
| | - Wenyue Zhang
- School of Acupuncture, Moxibustion and Tuina, Beijing Rehabilitation Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Theresa Stübinger
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
| | - Dominik Irnich
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University Hospital LMU Munich, Munich, Germany
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9
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Yamaguchi R, Makino Y, Torimitsu S, Chiba F, Kihara Y, Iwase H. Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review. J Forensic Sci 2021; 67:377-383. [PMID: 34435369 DOI: 10.1111/1556-4029.14874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
Acupuncture is practiced as a complementary medicine worldwide. Although it is considered a safe practice, pneumothorax is one of its most common serious complications. However, there have been few reports of deaths due to pneumothorax after acupuncture treatment, especially focused on electroacupuncture. We report an autopsy case of a man in his 60s who went into cardiopulmonary arrest and died immediately after receiving electroacupuncture. Postmortem computed tomography (PMCT) showed bilateral pneumothoraces, as well as the presence of numerous gold threads embedded subcutaneously. An autopsy revealed two ecchymoses in the right thoracic cavity and a pinhole injury on the lower lobe of the right lung, suggesting that the needles had penetrated the lung. There were marked emphysematous changes in the lung, suggesting that rupture of bullae might also have contributed to bilateral pneumothoraces and fatal outcome. The acupuncture needles may have been drawn deeper into the body than at the time of insertion due to electrical pulses and muscle contraction, indicating the need for careful determination of treatment indications and technical safety measures, such as fail-safe mechanisms. This is the first case report of fatal bilateral pneumothoraces after electroacupuncture reported in the English literature. This case sheds light on the safety of electroacupuncture and the need for special care when administering it to patients with pulmonary disease who may be at a higher risk of pneumothorax. This is also the first report of three-dimensional reconstructed PMCT images showing the whole-body distribution of embedded gold acupuncture threads, which is unusual.
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Affiliation(s)
- Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Suguru Torimitsu
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Fumiko Chiba
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Yuko Kihara
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
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10
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Huang JJ, Liang JQ, Xu XK, Xu YX, Chen GZ. Safety of Thread Embedding Acupuncture Therapy: A Systematic Review. Chin J Integr Med 2021; 27:947-955. [PMID: 33893986 DOI: 10.1007/s11655-021-3443-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the safety of thread embedding acupuncture therapy (TEAT) and discuss the prevention and treatment of some adverse events (AEs). METHODS Review of databases, including China National Knowledge Infrastructure (CNKI), CBMdisc, Wanfang, VIP databases and English literature published in PubMed, MEDLINE, EMBASE and Web of Science, were searched from their inception to January 2020, randomized controlled trials (RCTs) and case reports in which AEs with TEAT were included. Cochrane Collaboration's tool and RevMan V.5.3.3 software were used to evaluate the quality of the studies. RESULTS A total of 61 studies (45 RCTs and 16 case reports) with 620 cases of AEs were included in this review. These studies were published in two countries: China and South Korea. Twenty eight kinds of AEs were summarized. The most common AEs were induration, bleeding and ecchymosis, redness and swelling, fever, and pain. They were accounted for 75.35% (425/564) in the review, and most of them were mild. The rarest AEs were epilepsy, irregular menstruation, skin ulcer, thread malabsorption, and fat liquefaction, with 1 case each. But not all of them had clear causal relationship with TEAT. Most of the AEs were local reactions [with incidence of 9.83% (480/4,882)] and systemic reactions accounted for only 1.27% (62/4,882). Although the included studies showed that AEs were very commonly encountered (11.09%), only 5 cases of severe AEs reported from 2013 to 2017 (0.1%) by using catgut thread, which are rarely seen nowdays with the wide use of new absorbable surgical suture. All of the severe AEs were recovered after symptomatic treatment with no sequelae. CONCLUSIONS The evidence showed that TEAT is a relatively safe and convenient therapy especially since application of new absorbable surgical suture. Improving practitioner skills, regulating operations, and paying attention to the patients' conditions may reduce the incidence of AEs and improve safety of TEAT.
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Affiliation(s)
- Jia-Jia Huang
- Clinical Medical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jun-Quan Liang
- Clinical Medical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Xiao-Kang Xu
- Clinical Medical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Yun-Xiang Xu
- Clinical Medical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
| | - Gui-Zhen Chen
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, The Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, 518101, China.
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Effectiveness and Safety of Moxibustion Robots on Primary Dysmenorrhea: A Randomized Controlled Pilot Trial. Chin J Integr Med 2021; 27:578-584. [PMID: 33837481 DOI: 10.1007/s11655-021-3287-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To conduct a pilot trial to explore the effectiveness and safety of moxibustion robots in treating primary dysmenorrhea (PD) and evaluate its feasibility in clinic. METHODS A total of 70 participants with PD were allocated to either moxibustion robot (MR) group (35 cases) or manual moxibustion (MM) group (35 cases) using computer-generated randomization. One acupoint Guanyuan (CV 4) was selected to receive moxa heat stimulation. Two groups of participants were given 3 menstrual cycles of MM and MR treatment respectively (once a day, 5 days a session) and received another 3 menstrual cycles follow-up. The degree of pain was evaluated by short-form McGill pain questionnaire (SF-MPQ) and the symptoms of dysmenorrhea were evaluated by Cox Menstrual Symptom Scale (CMSS). The safety was measured by the occurrence rate of adverse events (AEs), including burns (blisters, red and swollen), itching, bowel changes, menstrual cycle disorder, menorrhagia and fatigue, etc. RESULTS: A total of 62 patients completed the trial, 32 in MR group and 30 in MM group. Compared with baseline, scores of SF-MPQ and CMSS significantly decreased in both groups (P<0.05), and no significant difference was observed between the two groups in the 3rd and 6th menstrual cycles (P>0.05). The total occurrence rate of AEs in MR group was 2.1%, which was significantly lower than MM group (7.2%, P<0.05). CONCLUSIONS MR has the same effect as MM at SF-MPQ and CMSS in patients with PD. However, MR is safer than MM (Trial registration No. ChiCTR1800018236).
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12
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Joo HS, Lee SJ, Sung KY. Moxibustion burns: wound characteristics and clinical manifestation. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-020-01717-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Lin SK, Liu JM, Hsu RJ, Chuang HC, Wang YX, Lin PH. Incidence of iatrogenic pneumothorax following acupuncture treatments in Taiwan. Acupunct Med 2019; 37:332-339. [DOI: 10.1136/acupmed-2018-011697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Pneumothorax is a rare complication of acupuncture and the risk factors are unclear. Objective: This study analysed the incidence of post-acupuncture pneumothorax requiring hospitalisation in a one-million-sample cohort derived from Taiwan’s National Health Insurance Research Database. Methods: We tracked this cohort between 1997 and 2012 and recorded all medical insurance information. Subjects were categorised according to gender, insurance amount, comorbidities, residential area, and number of acupuncture treatments. Pneumothorax risk was evaluated according to different demographic and medical variables by logistic regression analysis using an adjusted odds ratio (aOR) with a 95% confidence interval (95% CI). Results: Overall, 411 734 patients undergoing 5 407 378 acupuncture treatments were identified with data collected over the first 7 days after acupuncture. The incidence rates of iatrogenic pneumothorax were 0.87 per 1 000 000 acupuncture treatments overall and 1.75 per 1 000 000 acupuncture treatments in “at-risk” anatomical areas. Multivariate logistic regression demonstrated that a history of thoracic surgery (aOR 7.85, 95% CI 3.49 to 9.25), chronic bronchitis (aOR 2.61, 95% CI 1.03 to 6.87), emphysema (aOR 4.87, 95% CI 1.03 to 7.96), pneumonia (aOR 2.09, 95% CI 1.44 to 2.72), tuberculosis (aOR 3.65, 95% CI 1.39 to 9.56), and lung cancer (aOR 3.85, 95% CI 1.53 to 9.73) may increase the post-acupuncture risk of iatrogenic pneumothorax. Men had a higher risk of pneumothorax than women (aOR 3.41, 95% CI 1.36 to 8.57). The number of treatments was not associated with risk of pneumothorax. Conclusions: Patients with a history of lung disease including chronic bronchitis, emphysema, tuberculosis, lung cancer and pneumonia, and a history of thoracic surgery, might have an increased post-acupuncture risk of pneumothorax. This information may possibly help physicians avoid post-acupuncture pneumothorax.
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Affiliation(s)
- Shun-Ku Lin
- Department of Chinese Medicine, Taipei City Hospital, RenAi Branch, Taipei City, Taiwan
- Institute of Public Health, National Yangming University, Taipei, Taiwan
| | - Jui-Ming Liu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ren-Jun Hsu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Pathology and Graduate Institute of Pathology and Parasitology, The Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Heng-Chang Chuang
- Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Ying-Xue Wang
- Department of Nursing, Taipei City Hospital, RenAi Branch, Taipei, Taiwan
- Department of Health, Taipei City Government, Taipei, Taiwan
| | - Po-Hung Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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14
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Wang CC, Tan JY, Williams A. Safety and side effects of acupuncture therapy in Australia: A systematic review. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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16
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Ball AM, Finnegan M, Koppenhaver S, Freres W, Dommerholt J, Mayoral Del Moral O, Bron C, Moore R, Ball EE, Gaffney EE. The relative risk to the femoral nerve as a function of patient positioning: potential implications for trigger point dry needling of the iliacus muscle. J Man Manip Ther 2019; 27:162-171. [PMID: 30935326 DOI: 10.1080/10669817.2019.1568699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objectives: Prudent dry needling techniques are commonly practiced with the intent to avoid large neurovascular structures, thereby minimizing potential excessive bleeding and neural injury. Patient position is one factor thought to affect the size of the safe zone during dry needling of some muscles. This study aimed to compare the size of the needle safe zone of the iliacus muscle during two different patient positions using ultrasound imaging. Methods: The distance from the anterior inferior iliac spine (AIIS) to the posterior pole of the femoral nerve was measured in 25 healthy participants (11 male, 14 female, mean age = 40) in both supine and sidelying positions using a Chison Eco1 musculoskeletal ultrasound unit. The average distance was calculated for each position and a two-tailed, paired t-test (α < 0.05) was used to examine the difference between positions. Results: The mean distance from the AIIS to the posterior pole of the femoral nerve was statistically greater with participants in the sidelying position (mean[SD] = 35.7 [6.2] mm) than in the supine position (mean[SD] = 32.1 [7.3] mm, p < .001). Discussion: Although more study is needed, these results suggest that patient positioning is one of several potential variables that should be considered in the optimization of patient safety/relative risk when performing trigger point dry needling. Level of Evidence: Level 4 (Pre-Post Test).
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Affiliation(s)
- Andrew M Ball
- a Atrium Health , Carolinas Rehabilitation , Charlotte , NC , USA.,b NxtGen Institute of Physical Therapy , Atlanta , GA , USA.,c Myopain Seminars , Bethesda , MD , USA
| | - Michelle Finnegan
- c Myopain Seminars , Bethesda , MD , USA.,d ProMove PT Pain Specialists , Bethesda , MD , USA
| | - Shane Koppenhaver
- e Department of Physical Therapy , Baylor University , Dallas , TX , USA.,f Department of Physical Therapy , South College , Knoxville , TN , USA
| | - Will Freres
- a Atrium Health , Carolinas Rehabilitation , Charlotte , NC , USA.,c Myopain Seminars , Bethesda , MD , USA
| | - Jan Dommerholt
- c Myopain Seminars , Bethesda , MD , USA.,d ProMove PT Pain Specialists , Bethesda , MD , USA
| | - Orlando Mayoral Del Moral
- g Hospital Provincial de Toledo , Physical Therapy Unit , Toledo , Spain.,h Orlando Mayoral Clinica de fisiotherapia , Madrid , Spain.,i Seminarios Travell y Simons® , Toledo , Spain
| | - Carel Bron
- j Physical therapy practice for disorders of neck, shoulder and upper extremity , Groningen , Netherlands
| | - Randy Moore
- k MSK Masters , Cincinnati , OH , USA.,l General Musculoskeletal Imaging, Inc , Cincinnati , OH , USA
| | - Erin E Ball
- c Myopain Seminars , Bethesda , MD , USA.,m Novant Health , Charlotte , NC , USA
| | - Emily E Gaffney
- n USA MEDDAC Guthrie Ambulatory Health Care Clinic , Fort Drum , NY , USA
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Abstract
Everyone wants safe medicine. The traditional approach to adverse events has developed within a culture of blaming the individual practitioner. Such an approach is likely to be damaging to individuals and possibly counterproductive by creating an atmosphere of defensiveness and denial. Industries such as airlines have developed an alternative culture using a systems approach. This approach concentrates on assessing and improving the systems of working rather than blaming an individual's performance. Frameworks have been developed for applying this approach to investigating and avoiding medical accidents. These form the basis of a check-list for acupuncture practice that is presented here, and may be useful for individuals and organisations who are concerned to reduce the risk of adverse events.
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18
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Abstract
Background Patients are attracted to acupuncture partly by its reputation for having low risks. The safety of acupuncture should be established by positive evidence. Methods Two prospective surveys were conducted among different groups of professionals in the UK, including doctors, physiotherapists and practitioners primarily trained in acupuncture. Participants monitored adverse events over a defined period of time, and reported minor and significant events on purpose designed forms. Results A total of 652 acupuncturists reported 6733 adverse reactions including tiredness in 66 229 patients, an adverse event rate of 10.2%. The most common events were tiredness (3%) bleeding or bruising (3%), aggravation of symptoms (2%) and pain at the needling site (1%). There were no serious adverse events. A total of 86 (0.1%) of the treatments was associated with an event that the practitioner judged to be significant though without persistent consequences for the patient's health. Conclusion The risks associated with acupuncture can be classified as negligible, and acupuncture is a very safe treatment in the hands of competent practitioners.
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19
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Yamashita H, Masuyama S, Otsuki K, Tsukayama H. Safety of Acupuncture for Osteoarthritis of the Knee – a Review of Randomised Controlled Trials, Focusing on Specific Reactions to Acupuncture. Acupunct Med 2018. [DOI: 10.1136/aim.24.suppl.49] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In order to assess how many reported adverse reactions to acupuncture are truly associated with the physiological mechanisms of acupuncture, we performed a literature review of published RCTs of acupuncture for osteoarthritis of the knee. We searched for reports of RCTs using two data sources: PubMed and Japana Centra Revuo Medicina (Igaku Chuo Zasshi). Of the twelve RCTs located, seven included information on adverse events. No serious adverse events were reported. Joint swelling, local inflammation, haematoma and back pain occurred more frequently in the dummy electroacupuncture or minimal acupuncture group. We confirmed the possibility that many adverse reactions to acupuncture treatment reported in RCTs, at least for the knee OA, are non-specific, and that not all reported events should be attributed to the mechanism of action of acupuncture. It is likely this is also true for RCTs of acupuncture in other conditions, and for prospective surveys on adverse events of acupuncture.
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Affiliation(s)
- Hitoshi Yamashita
- Department of Acupuncture, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
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20
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White A. A Cumulative Review of the Range and Incidence of Significant Adverse Events Associated with Acupuncture. Acupunct Med 2018; 22:122-33. [PMID: 15551936 DOI: 10.1136/aim.22.3.122] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarise the range and frequency of significant adverse events associated with acupuncture in order to provide evidence on which to base continuing efforts to improve the safety of acupuncture practice. Methods Searches were conducted of computerised databases, previous reviews of case reports, population surveys, prospective surveys of acupuncture practice and relevant sections of textbooks for primary and secondary reports to indicate the range of significant adverse events associated with acupuncture. Data from prospective surveys of acupuncture were combined to estimate the incidence of serious adverse events. Results A total of 715 adverse events was included. There were 90 primary reports of trauma, and 186 secondary reports; the most common were pneumothorax and injury to the central nervous system. Infection accounted for 204 primary reports and 91 secondary reports. Over 60% of these cases were hepatitis B. The next most common infection was of the external ear, as a complication of auricular acupuncture. The 144 miscellaneous events mainly comprised seizures and drowsiness judged severe enough to cause a traffic hazard. There were 12 primary reports of deaths. According to the evidence from 12 prospective studies which surveyed more than a million treatments, the risk of a serious adverse event with acupuncture is estimated to be 0.05 per 10 000 treatments, and 0.55 per 10 000 individual patients. Conclusions The risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. The range of adverse events reported is wide and some events, specifically trauma and some episodes of infection, are likely to be avoidable.
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Abstract
A 50 year old woman experienced an episode of vertigo and nystagmus about 10 minutes after receiving her first treatment with acupuncture for shoulder pain. The nystagmus was confirmed by several health professionals. She had no previous history of nystagmus, and the symptom was not associated with feelings of faintness. Her blood pressure was 90/50 at the onset of symptoms but returned to normal while the symptoms continued. She recovered spontaneously after about five hours. Nystagmus after acupuncture has not been unequivocally reported before, though dizziness associated with hypotension is common. In this case the association may be coincidental, or a focal neurological response to needling; if the latter, then it should be regarded as an unavoidable idiosyncratic reaction.
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22
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Kwon S, Jung WS, Yang S, Jin C, Cho SY, Park SU, Moon SK, Park JM, Ko CN, Cho KH, Park MJ. Safety of Acupuncture in Patients Taking Newer Oral Anticoagulants: A Retrospective Chart Review Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8042198. [PMID: 30405744 PMCID: PMC6199863 DOI: 10.1155/2018/8042198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/02/2018] [Indexed: 11/17/2022]
Abstract
Anticoagulant therapy is used to reduce the risk of thromboembolic events in patients with atrial fibrillation. Warfarin has been the traditional anticoagulant but is difficult to use because of its narrow therapeutic window. Recently, newer oral anticoagulants (NOACs) have been developed. However, bleeding continues to be a significant complication. The objective of this study was to assess the safety of acupuncture in patients taking NOACs. The medical records in the Stroke Center at Kyung Hee University Korean Medicine Hospital were retrospectively reviewed to identify patients who had received acupuncture between January 2017 and September 2017. The patients were divided into groups according to whether they were taking an NOAC, an antiplatelet agent, or no anticoagulant therapy. Bleeding-related side effects that occurred immediately after removal of acupuncture needles were recorded. Three hundred and sixteen patients underwent 10,177 acupuncture sessions during the study period. Microbleeding (bleeding that ceased within 30 s) occurred at a rate of 3.9% in the NOAC group, 5.6% in the antiplatelet group, and 5.1% in the control group. There were no between-group differences in the microbleeding rate. No serious adverse events, including major bleeding, were detected. These findings indicate that acupuncture is safe in patients taking NOACs.
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Affiliation(s)
- Seungwon Kwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Woo-Sang Jung
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seungbo Yang
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chul Jin
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seung-Yeon Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Uk Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Kwan Moon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Mi Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Nam Ko
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ki-Ho Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Jeong Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Yoon SH, Lee H, Kwon CY, Jeon D, Kim H, Jo HG, Shin A, Yun Y, Sul JU, Lee GM, Lee JH, Leem J. Development of a survey form through Delphi study about adverse events associated with the miniscalpel needle, for application in prospective observational studies regarding safety of miniscalpel needles: Study protocol. Medicine (Baltimore) 2018; 97:e12736. [PMID: 30313076 PMCID: PMC6203508 DOI: 10.1097/md.0000000000012736] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite the wide usage of miniscalpel-needles (MSNs), information about MSN treatment-related adverse events (AEs) is insufficient. As the definition of AE might vary among physicians, without an exact definition for pain and hemorrhage, it is difficult to provide accurate information about AEs in MSN treatment to physicians, researchers, and patients. The aim of our study is to reach a consensus about the items and definitions of AEs that should be included in the survey form for prospective observational multicenter studies to record MSN treatment-related AEs. We will especially focus on obtaining a consensus on the definition of pain and hemorrhage caused by MSN treatment. METHODS Our study protocol is composed of 6 steps. First, we will identify the aim of the study. Next, we will conduct a systematic review to investigate MSN treatment-related AEs reported till date in Korea. Third, we will conduct a pilot observational prospective single-center study on AEs in MSN treatment. We will develop a standardized case report form to record MSN treatment-related AEs, including the causality, severity, and details of the MSN procedure at every site. Next, based on the pilot study, the Delphi study questionnaire will be developed by a panel composed of 13 physicians. The Delphi study will have 4 rounds with open questions and 4-point Likert-scale closed questions. Through these rounds, we will develop a consensus about the items and definitions of AEs that should be included in the survey form for future multicenter studies about MSN treatment-related AEs. Following this, a face-to-face consensus meeting will be held for a final agreement of survey form. The final survey form will then be approved by the related academic society for dissemination. DISCUSSION The aim of this protocol is to develop a survey form for future prospective observational multicenter studies on MSN treatment-related AEs. This protocol will present the research methodology for developing a survey form, which will improve consistency and reliability between MSN treatment studies. We believe that this protocol can evaluate the safety of MSN treatment. TRIAL REGISTRATION Clinical Research Information Service: KCT0002849.
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Affiliation(s)
- Sang-Hoon Yoon
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | - Haebeom Lee
- Department of Human Informatics of Korean Medicine, Interdisciplinary Programs, Kyung Hee University
- Inae Korean Medicine Clinic, Seongdong-gu
| | - Chan-Young Kwon
- Chung-Yeon Medical Institute
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu
| | | | - Hyunho Kim
- Chung-Yeon Medical Institute
- Dongshin Korean Medicine Hospital, Yangcheon-gu
| | - Hee-Geun Jo
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | | | - Younghee Yun
- Chung-Yeon Medical Institute
- Research and Development Institute, CY Pharma Co, Gangnam-gu
| | - Jae-Uk Sul
- Chung-Yeon Medical Institute
- Chung-Yeon Korean Medicine Hospital, Gwangju
| | - Geon-Mok Lee
- Lee-Geonmok Wonli Korean Medicine Hospital, Seocho-gu, Seoul
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine
- Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jungtae Leem
- Chung-Yeon Medical Institute
- Dongshin Korean Medicine Hospital, Yangcheon-gu
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Effect of Different Dosages of ST36 Indirect Moxibustion on the Skin Temperature of the Lower Legs and Feet. MEDICINES 2018; 5:medicines5020057. [PMID: 29914073 PMCID: PMC6023346 DOI: 10.3390/medicines5020057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 12/12/2022]
Abstract
Background: Indirect moxibustion (IM) has been previously performed between the spinous process while recording skin temperature of the trunk. However, moxibustion is often applied not only to acupuncture points on the back, but also to points located on the limbs. Thus, there is a need to investigate skin temperature (ST) responses following IM applied to the limbs. Methods: In Experiment 1 (Exp 1), subjects were randomly assigned to three groups: the left IM stimulation, right IM stimulation and control groups. In Experiment 2 (Exp 2), the subjects underwent two experimental sessions consisting of a single stimulation of IM or triple stimulations of IM. The IM stimulation was administered to the ST36 acupuncture point. A thermograph was used to obtain the ST on the lower limbs. Results: In Exp 1, the ST of the lower limbs increased in the stimulation groups whereas there was no increase in the non-stimulation group. In Exp 2, no significant response occurred between the single and triple stimulation of IM groups for all observed sites except for the left ankle ST. Conclusions: Lower limb ST increased following IM application to the ST36 point. No difference was observed between the dosage of the stimulation and ST responses.
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Furuse N, Shinbara H, Uehara A, Sugawara M, Yamazaki T, Hosaka M, Yamashita H. A Multicenter Prospective Survey of Adverse Events Associated with Acupuncture and Moxibustion in Japan. Med Acupunct 2017; 29:155-162. [PMID: 28736592 PMCID: PMC5512321 DOI: 10.1089/acu.2017.1230] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: There have been only a few prospective surveys on adverse events (AEs) in Japanese-style acupuncture practice, and these surveys were conducted only in a single college acupuncture clinic. Objective: The goal of this research was to assess the safety of acupuncture and moxibustion performed in educational facilities in Japan. Materials and Methods: This was a multicenter prospective survey, using paper reporting forms. It was conducted in eight acupuncture clinics affiliated with educational institutions. The subjects were outpatients attending the clinics. The main outcome measure was the number of reported adverse events. The study was conducted for 5-7 months at each facility between October 2014 and June 2015. Participating acupuncture practitioners were instructed to self-report AEs observed during and after treatment; patients were interviewed upon treatment completion. For returning patients, treatment was preceded by an interview survey regarding the AEs identified after the previous treatment session. A specialized 4-sheet questionnaire was used. Results: Two hundred and thirty-two acupuncture practitioners participated, 2180 patients received treatment, and there were 14,039 sessions, overall. In total, 847 (6.03%) AEs were reported. The most common AEs included subcutaneous bleeding and hematomas (370, 2.64%), followed by discomfort (109, 0.78%) and residual pain at insertion points (94, 0.67%). No infections or serious AEs were reported. Conclusions: Acupuncture and moxibustion performed in educational facilities in Japan were safe because most of the AEs reported were mild and transient. However, the risk cannot be defined definitely because the survey sample size was too small.
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Affiliation(s)
- Nobutatsu Furuse
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Osaka Minami Prefectural Special Needs Education School for the Visually Impaired, Osaka, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
| | - Hisashi Shinbara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Acupuncture and Moxibustion Therapy, Faculty of Health Promotional Sciences, Tokoha University, Shizuoka, Japan
| | - Akihito Uehara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Oriental Medicine Clinical Laboratory, Kuretake College of Medical Arts & Sciences, Tokyo, Japan
| | - Masaaki Sugawara
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Toshiya Yamazaki
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Department of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Masayoshi Hosaka
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
| | - Hitoshi Yamashita
- Committee for Safe Acupuncture, Academic & Research Department, Japan Society of Acupuncture and Moxibustion, Tokyo, Japan
- Morinomiya University of Medical Sciences Acupuncture Information Center, Osaka, Japan
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Liao Y, Ota E, Cheng K, Mori R. Alternative prophylactic therapies (acupuncture and/or moxibustion) for reducing blood loss in the third stage of labour. Hippokratia 2016. [DOI: 10.1002/14651858.cd012259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yi Liao
- Graduate School of Medicine, The University of Tokyo; Department of Health Policy; 7-3-1 Hongo Bunkyo-ku Tokyo Japan 113-0033
| | - Erika Ota
- St. Luke's International University, Graduate School of Nursing Sciences; Global Health Nursing; 10-1 Akashi-cho Chuo-Ku Tokyo Japan 104-0044
| | - Ke Cheng
- Shanghai University of Traditional Chinese Medicine; School of Acupuncture-Moxibustion and Tuina; 1200, Cailun RD Shanghai China 201203
| | - Rintaro Mori
- National Center for Child Health and Development; Department of Health Policy; 2-10-1 Okura Setagaya-ku Tokyo Tokyo Japan 157-0074
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Epidemiology of burns caused by moxibustion in Korea. Burns 2016; 42:1588-1592. [PMID: 27156790 DOI: 10.1016/j.burns.2016.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/07/2016] [Accepted: 04/22/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Moxibustion, a traditional Chinese treatment that uses dried Artemisia argyi, is a common cause of burns treated in Korean hospitals. We aimed to examine the characteristics of moxibustion-induced burns. METHODS This retrospective study examined the records of 59 patients who were treated for moxibustion-induced burns (April 2014-October 2015). All patients completed a questionnaire regarding their general characteristics and moxibustion use. RESULTS The patients included 16 men and 43 women (average age: 49.1 years, 68 burn sites). Superficial second-degree burns were present at 21 sites, deep second- or third-degree burns at 44 sites, and unknown burns at 3 sites. The most common sites were the lower extremities, abdomen, and upper extremities. The most common practitioners were the patients (27/59, 45.7%) and Oriental medicine practitioners (23/59, 38.9%). The most common locations were the patient's home, Oriental medicine clinic, and moxibustion clinic. The most common reason for moxibustion was pain. Only the burn site was significantly associated with burn depth, and non-abdominal sites were 9.37-fold more likely to involve deep burns (vs. abdominal sites). CONCLUSION Korean patients routinely undergo moxibustion, and care must be taken when using moxibustion at non-abdominal sites, due to the risk of deep burns.
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The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0150367. [PMID: 26959661 PMCID: PMC4784927 DOI: 10.1371/journal.pone.0150367] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 02/12/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Postoperative pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects. OBJECTIVE This systematic review and meta-analysis evaluated the effectiveness of acupuncture and acupuncture-related techniques in treating postoperative pain. DATA SOURCE MEDLINE, Cochrane Library, and EMBASE databases were searched until Sep 30, 2014. STUDY ELIGIBILITY CRITERIA Randomized controlled trials of adult subjects (≥ 18 years) who had undergone surgery and who had received acupuncture, electroacupuncture, or acupoint electrical stimulation for managing acute post-operative pain were included. RESULTS We found that patients treated with acupuncture or related techniques had less pain and used less opioid analgesics on Day 1 after surgery compared with those treated with control (P < 0.001). Sensitivity analysis using the leave-one-out approach indicated the findings are reliable and are not dependent on any one study. In addition, no publication bias was detected. Subgroup analysis indicated that conventional acupuncture and transcutaneous electric acupoint stimulation (TEAS) were associated with less postoperative pain one day following surgery than control treatment, while electroacupuncture was similar to control (P = 0.116). TEAS was associated with significantly greater reduction in opioid analgesic use on Day 1 post surgery than control (P < 0.001); however conventional acupuncture and electroacupuncture showed no benefit in reducing opioid analgesic use compared with control (P ≥ 0.142). CONCLUSION Our findings indicate that certain modes of acupuncture improved postoperative pain on the first day after surgery and reduced opioid use. Our findings support the use of acupuncture as adjuvant therapy in treating postoperative pain.
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Lau CHY, Wu X, Chung VCH, Liu X, Hui EP, Cramer H, Lauche R, Wong SYS, Lau AYL, Sit RWS, Ziea ETC, Ng BFL, Wu JCY. Acupuncture and Related Therapies for Symptom Management in Palliative Cancer Care: Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016; 95:e2901. [PMID: 26945382 PMCID: PMC4782866 DOI: 10.1097/md.0000000000002901] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Available systematic reviews showed uncertainty on the effectiveness of using acupuncture and related therapies for palliative cancer care. The aim of this systematic review and meta-analysis was to summarize current best evidence on acupuncture and related therapies for palliative cancer care. Five international and 3 Chinese databases were searched. Randomized controlled trials (RCTs) comparing acupuncture and related therapies with conventional or sham treatments were considered. Primary outcomes included fatigue, paresthesia and dysesthesias, chronic pain, anorexia, insomnia, limb edema, constipation, and health-related quality of life, of which effective conventional interventions are limited. Thirteen RCTs were included. Compared with conventional interventions, meta-analysis demonstrated that acupuncture and related therapies significantly reduced pain (2 studies, n = 175, pooled weighted mean difference: -0.76, 95% confidence interval: -0.14 to -0.39) among patients with liver or gastric cancer. Combined use of acupuncture and related therapies and Chinese herbal medicine improved quality of life in patients with gastrointestinal cancer (2 studies, n = 111, pooled standard mean difference: 0.75, 95% confidence interval: 0.36-1.13). Acupressure showed significant efficacy in reducing fatigue in lung cancer patients when compared with sham acupressure. Adverse events for acupuncture and related therapies were infrequent and mild. Acupuncture and related therapies are effective in reducing pain, fatigue, and in improving quality of life when compared with conventional intervention alone among cancer patients. Limitations on current evidence body imply that they should be used as a complement, rather than an alternative, to conventional care. Effectiveness of acupuncture and related therapies for managing anorexia, reducing constipation, paresthesia and dysesthesia, insomnia, and limb edema in cancer patients is uncertain, warranting future RCTs in these areas.
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Affiliation(s)
- Charlotte H Y Lau
- From the Faculty of Medicine (CHL); Hong Kong Institute of Integrative Medicine (XW, VCC, EPH, SYW, AYL, RWSS, JCW); Jockey Club School of Public Health and Primary Care (XW, VCC, XL, SYW, RWSS); Comprehensive Cancer Trials Unit (EPH), The Chinese University of Hong Kong, Hong Kong, China; Department of Internal and Integrative Medicine (HC), Faculty of Medicine, Kliniken Essen-MitteUniversity of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) (HC), Faculty of Health, University of Technology Sydney, Sydney, Australia; Department of Medicine and Therapeutics (AYL, JCW), The Chinese University of Hong Kong; and Chinese Medicine Department (ETZ, BFN), Hong Kong Hospital Authority, Hong Kong, China
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Özmert S, Salman N, Sever F, Akın M, Saydam S, Keskin G, Akcan F, Kurt DT. Acupuncture as an Antiemetic in Children who Underwent Adenoidectomy and/or Tonsillectomy. Turk J Anaesthesiol Reanim 2016; 44:7-12. [PMID: 27366548 DOI: 10.5152/tjar.2016.05902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 10/07/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Postoperative vomiting (POV) is one of the most common problems following general anaesthesia, and many factors, either solely or in combination, may play a role in aetiology. Acupuncture is a technique that the World Health Organization has accepted as a complementary treatment. This study presents our experience with acupuncture for POV treatment in a study of paediatric tonsillectomy cases. METHODS The study included ASA I-II patients (n=70) aged 2-14 years who underwent tonsillectomy and/or adenoidectomy under general anaesthesia. The patients were randomly divided into the following two groups: control and study group. In the study group, an acupuncture needle was intraoperatively applied to the P6 acupuncture point for 20 min. Antiemetics were not administered to either group because of the standard applications in the preoperative period. The patients were postoperatively evaluated by nurses who were unaware about the techniques used in either group. RESULTS No statistically significant difference was determined between the groups with regard to age, sex, nature of the operation, duration of anaesthesia, duration of the operation, surgical method and ASA scores. A statistically significant difference was determined between the groups with respect to vomiting rates. The acupuncture group presented with 0.28-times fewer vomiting episodes than the control group. CONCLUSION The results of the study demonstrate that acupuncture has an apparent antiemetic efficacy in POV. Its routine use for POV may improve postoperative comfort and reduce drug use for prophylactic or therapeutic purposes.
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Affiliation(s)
- Sengül Özmert
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Nergis Salman
- Clinic of Otorhinolaryngology Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Feyza Sever
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Mine Akın
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Sibel Saydam
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Gülsen Keskin
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Fatih Akcan
- Clinic of Otorhinolaryngology Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Devrim Tanıl Kurt
- Clinic of Anesthesiology and Reanimation, Ankara Childrens Haematology, Oncology Education and Research Hospital, Ankara, Turkey
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Ji GY, Oh CH, Choi WS, Lee JB. Three cases of hemiplegia after cervical paraspinal muscle needling. Spine J 2015; 15:e9-13. [PMID: 25459742 DOI: 10.1016/j.spinee.2014.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 09/22/2014] [Accepted: 11/08/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Muscle needling therapy is common for chronic pain management, but the development of unusual complications such as hemiplegia is not well understood. PURPOSE We report on three cases with hemiplegia after cervical paraspinal muscle needling and propose possible explanations for these unusual complications. STUDY DESIGN Case report. METHODS The authors retrospectively reviewed the medical charts from a decade (2002-2013) at Korea University Hospital. The records were systematically searched, and the cases with hemiplegia (grade<3) after needing therapy were collected. No conflict of interest reported. No funding received. RESULTS A 54-year-old woman, a 38-year-old woman, and a 60-year-old man with hemiplegia by cervical subdural or epidural hematoma after cervical posterior paraspinal muscle needling without direct invasion (intramuscular stimulation, acupuncture, or intramuscular lidocaine) were observed. All patients were taken for emergent decompressive laminectomy, and their postoperative motor function improved substantially. CONCLUSION Spinal hematoma after muscle needling is unusual but was thought to result after a rupture of the epidural or subarachnoid veins by a sharp increase in blood pressure delivered in the intraabdominal or intrathoracic areas after needling therapy.
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Affiliation(s)
- Gyu Yeul Ji
- Depatment of Neurosurgery, Spine and Spinal Cord Research Institute, Yonsei University, College of Medicne, 50 Yonsei-ro, Seodamun-gu, 120-752 Seoul, Korea; Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Chang Hyun Oh
- Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Won-Seok Choi
- Department of Neurosurgery, Guro Teun Teun Hospital, 547 Siheungdae-ro, Guro-gu, 152-880 Seoul, Korea
| | - Jang-Bo Lee
- Department of Neurosurgery, Korea University Anam Hospital, College of Medicine, 73, Inchon-ro, Seongbuk-gu, 136-705 Seoul, Korea.
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An evidence-informed review of the current myofascial pain literature – January 2015. J Bodyw Mov Ther 2015; 19:126-37. [DOI: 10.1016/j.jbmt.2014.11.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Adverse events of auricular therapy: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:506758. [PMID: 25435890 PMCID: PMC4241563 DOI: 10.1155/2014/506758] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient's safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved.
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McDowell JM, Johnson GM. Acupuncture Needling Styles and Reports of Associated Adverse Reactions to Acupuncture. Med Acupunct 2014. [DOI: 10.1089/acu.2014.1060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Gillian Margaret Johnson
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Brady S, McEvoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther 2014; 22:134-40. [PMID: 25125935 DOI: 10.1179/2042618613y.0000000044] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Trigger point dry needling (TrP-DN) is commonly used to treat persons with myofascial pain, but no studies currently exist investigating its safety. The aim of this study was to determine the incidence of Adverse Events (AEs) associated with the use of TrP-DN by a sample of physiotherapists in Ireland. METHODS A prospective survey was undertaken consisting of two forms recording mild and significant AEs. Physiotherapists who had completed TrP-DN training with the David G Simons Academy (DGSA) were eligible to take part in the study. Data were collected over a ten-month period. RESULTS In the study, 39 physiotherapists participated and 1463 (19.18%) mild AEs were reported in 7629 treatments with TrP-DN. No significant AEs were reported giving an estimated upper risk rate for significant AEs of less than or equal to (≤) 0.04%. Common AEs included bruising (7.55%), bleeding (4.65%), pain during treatment (3.01%), and pain after treatment (2.19%). Uncommon AEs were aggravation of symptoms (0.88%), drowsiness (0.26%), headache (0.14%), and nausea (0.13%). Rare AEs were fatigue (0.04%), altered emotions (0.04%), shaking, itching, claustrophobia, and numbness, all 0.01%. DISCUSSION While mild AEs were very commonly reported in this study of TrP-DN, no significant AEs occurred. For the physiotherapists surveyed, TrP-DN appeared to be a safe treatment.
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Affiliation(s)
- Sarah Brady
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Ireland
| | | | | | - Catherine Doody
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Ireland
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Safety of acupuncture treatments for patients taking warfarin or antiplatelet medications: Retrospective chart review study. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2014.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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White A, Boon H, Alraek T, Lewith G, Liu JP, Norheim AJ, Steinsbekk A, Yamashita H, Fønnebø V. Reducing the risk of complementary and alternative medicine (CAM): Challenges and priorities. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2013.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Xu J, Deng H, Shen X. Safety of moxibustion: a systematic review of case reports. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:783704. [PMID: 24976851 PMCID: PMC4058265 DOI: 10.1155/2014/783704] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/26/2014] [Accepted: 05/09/2014] [Indexed: 11/17/2022]
Abstract
Moxibustion is a traditional medical treatment originating in China. It involves using the heat of burning moxa to stimulate acupoints. It is considered safe and effective and is widely used throughout the world. The increasing use of moxibustion has drawn attention to the procedure's adverse events (AEs). This review covers a total of 64 cases of AEs associated with moxibustion in 24 articles, reported in six countries. Some evidence of the risks of moxibustion has been found in these cases. AEs include allergies, burns, infection, coughing, nausea, vomiting, fetal distress, premature birth, basal cell carcinoma (BCC), ectropion, hyperpigmentation, and even death. The position, duration, distance between moxa and skin, proficiency of the practitioners, conditions of the patients, presence of smoke, and even the environment of treatment can affect the safety of moxibustion. Improving practitioner skill and regulating operations may reduce the incidence of adverse reactions and improve the security of moxibustion.
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Affiliation(s)
- Ji Xu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hongyong Deng
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xueyong Shen
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Shanghai Research Center of Acupuncture & Meridian, Shanghai 201203, China
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Cho YH, Kim CK, Heo KH, Lee MS, Ha IH, Son DW, Choi BK, Song GS, Shin BC. Acupuncture for acute postoperative pain after back surgery: a systematic review and meta-analysis of randomized controlled trials. Pain Pract 2014; 15:279-91. [PMID: 24766648 PMCID: PMC4409074 DOI: 10.1111/papr.12208] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 03/01/2014] [Indexed: 12/23/2022]
Abstract
Objectives Acupuncture is commonly used as a complimentary treatment for pain management. However, there has
been no systematic review summarizing the current evidence concerning the effectiveness of
acupuncture for acute postoperative pain after back surgery. This systematic review aimed at
evaluating the effectiveness of acupuncture treatment for acute postoperative pain (≤1 week)
after back surgery. Methods We searched 15 electronic databases without language restrictions. Two reviewers independently
assessed studies for eligibility and extracted data, outcomes, and risk of bias. Random effect
meta-analyses and subgroup analyses were performed. Results Five trials, including 3 of high quality, met our inclusion criteria. The meta-analysis showed
positive results for acupuncture treatment of pain after surgery in terms of the visual analogue
scale (VAS) for pain intensity 24 hours after surgery, when compared to sham acupuncture (standard
mean difference −0.67 (−1.04 to −0.31), P = 0.0003),
whereas the other meta-analysis did not show a positive effect of acupuncture on 24-hour opiate
demands when compared to sham acupuncture (standard mean difference −0.23 (−0.58 to
0.13), P = 0.21). Conclusion Our systematic review finds encouraging but limited evidence for the effectiveness of acupuncture
treatment for acute postoperative pain after back surgery. Further rigorously designed clinical
trials are required.
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Affiliation(s)
- Young-Hun Cho
- School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
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McCutcheon L, Yelland M. Iatrogenic pneumothorax: safety concerns when using acupuncture or dry needling in the thoracic region. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kuge H, Mori H, Tanaka TH, Hanyu K, Morisawa T. Difference between the effects of one-site and three-site abdominal hot-stone stimulation on the skin-temperature changes of the lower limbs. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2013; 11:314-9. [PMID: 24063778 DOI: 10.3736/jintegrmed2013044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine whether any difference exists in the skin-temperature responses of the lower limbs to hot-stone application relative to one-site and three-site abdominal application. METHODS Twenty-five female students participated in experimental sessions after a random allocation: 14 participants received a hot-stone application on the umbilicus, superior-umbilicus, and inferior-umbilicus regions (hereafter referred to as the three-site stimulation group); and 11 participants received the hot-stone application on the umbilicus region only (hereafter referred to as the one-site stimulation group). Heated stones were applied for 9 min to participants in both groups. Four arbitrary frames (the lower leg, ankle, proximal foot, and distal foot regions) were created in order to observe and analyze the skin temperature of a lower limb using a thermograph. Observation periods were as follows: before hot-stone stimulation, immediately after stimulation, and 5, 10, 15, and 20 min after stimulation. RESULTS There was a significant offset interaction of distal foot skin temperature between the groups. The left-side distal foot skin temperature increased at 15 and 20 min following the three-site abdominal hot-stone stimulation. The right-side distal foot skin temperature increased immediately and at 5, 10, 15, and 20 min following the three-site abdominal hot-stone stimulation. No significant change in distal foot skin temperature was observed following the one-site stimulation. CONCLUSION Lower-limb skin temperature was altered following hot-stone stimulation applied to the abdomen, and the one-site stimulation and three-site stimulation yielded different distal foot skin-temperature reactions.
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Affiliation(s)
- Hiroshi Kuge
- Department of Health, Faculty of Health Science, Tsukuba University of Technology, 4-12-7 Kasuga, Tsukuba-shi, Ibaraki, 305-8521, Japan; E-mail:
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Abstract
BACKGROUND This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. The use of complementary therapies is increasing and some women look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. The limited observational studies to date suggest acupuncture for induction of labour appears safe, has no known adverse effects to the fetus, and may be effective. However, the evidence regarding the clinical effectiveness of this technique is limited. OBJECTIVES To determine the effectiveness and safety of acupuncture for third trimester cervical ripening or induction of labour. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 November 2012), PubMed (1966 to 23 November 2012), Embase (1980 to 23 November 2012), Dissertation Abstracts (1861 to 23 November 2012), CINAHL (1982 to 23 November 2012), the WHO International Clinical Trials Registry Portal (ICTRP) (23 November 2012) and bibliographies of relevant papers. SELECTION CRITERIA Clinical trials comparing acupuncture used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, evaluated methodological quality and extracted data. MAIN RESULTS The original review included three trials and seven trials were excluded. This updated review includes 14 trials, and excludes eight trials. Three trials previously excluded due to no clinically relevant outcomes are now included. Eight new trials were included, and four new trials were excluded. We included 14 trials with data reporting on 2220 women.Trials reported on three primary outcomes only caesarean section, serious neonatal morbidity and maternal mortality. No trial reported on vaginal delivery not achieved within 24 hours; and uterine hyperstimulation with fetal heart rate (FHR) changes. There was no difference in caesarean deliveries between acupuncture and the sham control (average risk ratio (RR) 0.95, 95% confidence interval (CI) 0.69 to 1.30, six trials, 654 women), and acupuncture versus usual care (average RR 0.69, 95% CI 0.40, 1.20, six trials, 361 women). There was no difference in neonatal seizures between acupuncture and the sham group (RR 1.01, 95% CI 0.06 to 16.04, one trial, 364 women).There was some evidence of a change in cervical maturation for women receiving acupuncture compared with the sham control, (mean difference (MD) 0.40. 95%CI 0.11 to 0.69, one trial, 125 women), and when compared with usual care (MD 1.30, 95% CI 0.11 to 2.49, one trial, 67 women). The length of labour was shorter in the usual care group compared with acupuncture (average standardised mean difference (SMD) 0.67, 95% CI 0.18 to 1.17, one trial 68 women). There were no other statistically significant differences between groups. Few studies reported on many clinically relevant outcomes. One trial was at a low risk of bias on all domains. AUTHORS' CONCLUSIONS Overall, there have been few studies assessing the role of acupuncture for induction of labour. Before implications for clinical practice can be made there is a need for well-designed randomised controlled trials to evaluate the role of acupuncture to induce labour and for trials to assess clinically meaningful outcomes.
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Affiliation(s)
- Caroline A Smith
- Center for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Sydney, New South Wales, Australia, 2751
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Deng GE, Rausch SM, Jones LW, Gulati A, Kumar NB, Greenlee H, Pietanza MC, Cassileth BR. Complementary therapies and integrative medicine in lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e420S-e436S. [PMID: 23649450 DOI: 10.1378/chest.12-2364] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Physicians are often asked about complementary therapies by patients with cancer, and data show that the interest in and use of these therapies among patients with cancer is common. Therefore, it is important to assess the current evidence base on the benefits and risks of complementary therapies (modalities not historically used in modern Western medicine). METHODS A systematic literature review was carried out and recommendations were made according to the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines development methodology. RESULTS A large number of randomized controlled trials, systematic reviews, and meta-analyses, as well as a number of prospective cohort studies, met the predetermined inclusion criteria. These trials addressed many different issues pertaining to patients with lung cancer, such as symptoms of anxiety, mood disturbance, pain, quality of life, and treatment-related side effects. The available data cover a variety of interventions, including acupuncture, nutrition, mind-body therapies, exercise, and massage. The body of evidence supports a series of recommendations. An evidenced-based approach to modern cancer care should integrate complementary therapies with standard cancer therapies such as surgery, radiation, chemotherapy, and best supportive care measures. CONCLUSIONS Several complementary therapy modalities can be helpful in improving the overall care of patients with lung cancer.
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Affiliation(s)
- Gary E Deng
- Memorial Sloan-Kettering Cancer Center, New York, NY.
| | - Sarah M Rausch
- University of Florida College of Medicine, Jacksonville, FL
| | | | | | - Nagi B Kumar
- Moffitt Cancer Center and Research Institute, Tampa, FL
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Abstract
In this review we provide the updates on last years' advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.
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Affiliation(s)
- Simon Vulfsons
- Institute of Pain Medicine, Rambam Health Care Campus and Rappaport School of Medicine, Technion, Spencer Building, 6 Ephron Street, Haifa 31096, Israel.
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Lin LM, Wang SF, Lee RP, Hsu BG, Tsai NM, Peng TC. Changes in skin surface temperature at an acupuncture point with moxibustion. Acupunct Med 2013; 31:195-201. [PMID: 23598824 PMCID: PMC3686262 DOI: 10.1136/acupmed-2012-010268] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 03/16/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluates the thermographic changes associated with moxa burner moxibustion at the SP6 acupuncture point to establish an appropriate, safe distance of efficacy for moxibustion. METHODS Baseline temperature changes using a moxa burner were obtained for a paper substrate at various distances and times, and the tested with volunteers in a pilot study. A single-group trial was then conducted with 36 healthy women to monitor temperature changes on the body surface at the acupuncture point (SP6). RESULTS Based on the temperature changes seen for the paper substrate and in the pilot study, a distance of 3 cm was chosen as the intervention distance. Moxibustion significantly increased the SP6 point skin surface temperature, with a peak increase of 11°C at 4 min (p <0.001). This study also found that during moxibustion the temperature of the moxa burner's rubber layer and moxa cautery were 56.9±0.9°C and 65.8±1.2°C, as compared to baseline values of 35.1°C and 43.8°C (p<0.001). CONCLUSIONS We determined 3 cm was a safe distance between the moxa burner and acupuncture point. Moxibustion can increase the skin surface temperature at the SP6 point. This data will aid traditional Chinese medicine (TCM) practitioners in gauging safer treatment distances when using moxibustion treatments.
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Affiliation(s)
- Li-Mei Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Shu-Fang Wang
- Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan
| | - Ru-Ping Lee
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
| | - Bang-Gee Hsu
- Department of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Nu-Man Tsai
- School of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung, Taiwan
| | - Tai-Chu Peng
- Department of Nursing, Tzu Chi University, Hualien, Taiwan
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Birch S, Alraek T, Norheim AJ. Acupuncture adverse events in China: a glimpse of historical and contextual aspects. J Altern Complement Med 2013; 19:845-50. [PMID: 23544845 DOI: 10.1089/acm.2012.0639] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The article by He and colleagues, "Adverse Events Following Acupuncture: A Systematic Review of the Chinese Literature for the Years 1956-2010" is an important and timely contribution. In this commentary, the article is reviewed and issues are highlighted about how to interpret and contextualize the results of their study. While their review has been well performed, certain areas have been identified where the results may be inaccurate due to problems in the reporting of original incidents. For example, potential problems were found in the reporting of the minor adverse event (AE) of fainting and the more serious AEs of pneumothorax and hepatitis. The article by He and colleagues highlights the issue that almost all AEs associated with acupuncture in the modern period are due to the administration of the therapy rather than the therapy itself. Future prospective studies can address some of the shortcomings identified in this review.
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Affiliation(s)
- Stephen Birch
- 1 University College of Health Sciences-Campus Kristiania , Oslo, Norway
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The use of moxibustion scars in the identification of individuals in forensic medicine. Forensic Sci Int 2012; 219:e25-8. [PMID: 22281368 DOI: 10.1016/j.forsciint.2011.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 12/22/2011] [Accepted: 12/28/2011] [Indexed: 11/22/2022]
Abstract
The use of moxibustion today does not only take place in Eastern Asia, but recently also in Europe and the United States. Moxibustion scars are often seen in autopsy cases in Japan. However, no reports of the use of moxibustion in autopsy cases have been reported. This paper reports on an autopsy case in which moxibustion scars were used to extrapolate on the past symptoms of the deceased, date of therapy and the location of the moxibustion clinic which administered the moxibustion.
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MacPherson H, Hammerschlag R. Acupuncture and the emerging evidence base: contrived controversy and rational debate. J Acupunct Meridian Stud 2012; 5:141-7. [PMID: 22898062 DOI: 10.1016/j.jams.2012.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 04/25/2012] [Indexed: 10/28/2022] Open
Abstract
The rising incidence of chronic disease and stress-related illness in the West, coupled with an expanding awareness of the unwanted side effects of pharmaceutical treatment, has led to an increased utilization of acupuncture as a contemporary health care option. This increase in utilization, in turn, has paralleled a response to the call for evidence, with the result that acupuncture is now supported by a broad range of surveys of safety, clinical trials and basic science studies of physiologic action. The combined impact of these studies is linked to a growing acceptance of this traditional medical practice. The present review takes a wide-angle look at these three major areas of acupuncture research, namely: safety and the risks of serious adverse events; clinical efficacy and effectiveness; and physiologic action. We identify advances in knowledge and present a point counterpoint approach to controversial issues, with the aim of offering clarification if not a measure of resolution.
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