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Roth LU, Maret-Maric A, Adler RH, Neuenschwander BE. Acupuncture Points Have Subjective (Needing Sensation) and Objective (Serum Cortisol Increase) Specificity. Acupunct Med 2018. [DOI: 10.1136/aim.15.1.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This randomised, controlled trial was to determine if blinded subjects are able to discriminate between needle stimulation at traditional acupuncture points and sham points, based on the appreciation of needling sensation (de qi); and if needling at traditional points is related to the objective parameter of serum cortisol increase. Manual acupuncture at traditional and sham points was applied to 20 healthy male students in a single-blind crossover design. Needle sensation (de qi) was reported as significantly stronger with traditional needling than with sham acupuncture. Needling at traditional acupuncture points moderately, but significantly, increased serum cortisol values at 5, 25 and 45 minutes after cessation of stimulation. Needle sensation did not correlate with serum cortisol levels. Experience of pain did not show a difference between traditional and sham needling, nor did it correlate with serum cortisol levels. We conclude that acupuncture points show subjective (needling sensation) and objective (serum cortisol increase) specificity.
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Affiliation(s)
- LU Roth
- Chirurgische Abt., Bezirksspital, Herzogenbuchsee
| | | | - RH Adler
- Med Abt CL Lory-Haus, Inselspital, Bern
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Neri I, Pignatti L, Fontanesi F, Facchinetti F. Acupuncture in Postdate Pregnancy Management. J Acupunct Meridian Stud 2018; 11:332-336. [PMID: 29890286 DOI: 10.1016/j.jams.2018.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/08/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Pharmacological labor induction is obtained through prostaglandins application and/or oxytocin infusion; however, the use seems to be related to fetal and maternal side effects. Traditional Chinese Medicine advocates the use of acupuncture to soften the cervix and induce uterine contractions. at which presented for The primary outcome was the rate of women admitted for labour induction in case of prolonged pregnancy at 41 + 5 weeks, and the secondary outcome was the rate of induction planning for other indications. METHODS After obtaining informed consent, 375 undelivered women after 40 + 2 gestational age were enrolled for the study: 112 women received acupuncture and 263, routine care. Acupuncture was applied every odd day starting from 40 + 2 weeks up to 41 + 4 weeks. Women allocated to the control group received standard care. At 41 + 5 weeks, a pharmacological induction was planned. RESULTS The rate of labor induction significantly differed between acupuncture and observation groups (19.6% vs. 38%; p < 0.01); in particular, women receiving acupuncture showed a lower rate of induction, indicating prolonged pregnancy (5.3% vs. 10.1%; p < 0.01). As far as the pharmacological device is concerned, no differences were observed with regard to the prostaglandins use, whereas oxytocin infusion rate was lower in the acupuncture group than in the observation group. CONCLUSIONS The present study suggested that acupuncture applied at term of pregnancy seems to be effective in reducing the rate of labor induction which is performed for prolonged pregnancy at 41 + 5 weeks. Moreover, acupuncture also seems to be able to reduce oxytocin use; such a "saving" effect could play a role in childhood, considering that a recent study underlined the adverse effect of oxytocin on birth outcomes.
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Affiliation(s)
- Isabella Neri
- Obstetrics and Gynecology Department, University of Modena and Reggio Emilia, Modena, Italy.
| | - Lucrezia Pignatti
- Obstetrics and Gynecology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Fontanesi
- Obstetrics and Gynecology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Obstetrics and Gynecology Department, University of Modena and Reggio Emilia, Modena, Italy
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Abstract
BACKGROUND This is one of a series of reviews of methods of cervical ripening and labour induction. The use of complementary therapies is increasing. Women may 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. Acupressure is using the thumbs or fingers to apply pressure to specific points. The limited observational studies to date suggest acupuncture for induction of labour 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, from the best available evidence, the effectiveness and safety of acupuncture and acupressure for third trimester cervical ripening or induction of labour. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2016), PubMed (1966 to 25 November 2016), ProQuest Dissertations & Theses (25 November 2016), CINAHL (25 November 2016), Embase (25 November 2016), the WHO International Clinical Trials Registry Portal (ICTRP) (3 October 2016), and bibliographies of relevant papers. SELECTION CRITERIA Randomised controlled trials comparing acupuncture or acupressure, used for third trimester cervical ripening or labour induction, with placebo/no treatment or other methods on a predefined list of labour induction methods. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked them for accuracy. The quality of the evidence was assessed using GRADE. MAIN RESULTS This updated review includes 22 trials, reporting on 3456 women. The trials using manual or electro-acupuncture were compared with usual care (eight trials, 760 women), sweeping of membranes (one trial, 207 women), or sham controls (seven trials, 729 women). Trials using acupressure were compared with usual care (two trials, 151 women) or sham controls (two trials, 239 women). Many studies had a moderate risk of bias.Overall, few trials reported on primary outcomes. No trial reported vaginal delivery not achieved within 24 hours and uterine hyperstimulation with fetal heart rate (FHR) changes. Serious maternal and neonatal death or morbidity were only reported under acupuncture versus sham control. Acupuncture versus sham control There was no clear difference in caesarean sections between groups (average risk ratio (RR) 0.80, 95% confidence interval (CI) 0.56 to 1.15, eight trials, 789 women; high-quality evidence). There were no reports of maternal death or perinatal death in the one trial that reported this outcome. There was evidence of a benefit from acupuncture in improving cervical readiness for labour (mean difference (MD) 0.40, 95% CI 0.11 to 0.69, one trial, 125 women), as measured by cervical maturity within 24 hours using Bishop's score. There was no evidence of a difference between groups for oxytocin augmentation, epidural analgesia, instrumental vaginal birth, meconium-stained liquor, Apgar score < 7 at five minutes, neonatal intensive care admission, maternal infection, postpartum bleeding greater than 500 mL, time from the trial to time of birth, use of induction methods, length of labour, and spontaneous vaginal birth. Acupuncture versus usual care There was no clear difference in caesarean sections between groups (average RR 0.77, 95% CI 0.51 to 1.17, eight trials, 760 women; low-quality evidence). There was an increase in cervical maturation for the acupuncture (electro) group compared with control (MD 1.30, 95% CI 0.11 to 2.49, one trial, 67 women) and a shorter length of labour (minutes) in the usual care group compared to electro-acupuncture (MD 124.00, 95% CI 37.39 to 210.61, one trial, 67 women).There appeared be a differential effect according to type of acupuncture based on subgroup analysis. Electro-acupuncture appeared to have more of an effect than manual acupuncture for the outcomes caesarean section (CS), and instrumental vaginal and spontaneous vaginal birth. It decreased the rate of CS (average RR 0.54, 95% CI 0.37 to 0.80, 3 trials, 327 women), increased the rate of instrumental vaginal birth (average RR 2.30, 95%CI 1.15 to 4.60, two trials, 271 women), and increased the rate of spontaneous vaginal birth (average RR 2.06, 95% CI 1.20 to 3.56, one trial, 72 women). However, subgroup analyses are observational in nature and so results should be interpreted with caution.There were no clear differences between groups for other outcomes: oxytocin augmentation, use of epidural analgesia, Apgar score < 7 at 5 minutes, neonatal intensive care admission, maternal infection, perineal tear, fetal infection, maternal satisfaction, use of other induction methods, and postpartum bleeding greater than 500 mL. Acupuncture versus sweeping if fetal membranes One trial of acupuncture versus sweeping of fetal membranes showed no clear differences between groups in caesarean sections (RR 0.64, 95% CI 0.34 to 1.22, one trial, 207 women, moderate-quality evidence), need for augmentation, epidural analgesia, instrumental vaginal birth, Apgar score < 7 at 5 minutes, neonatal intensive care admission, and postpartum bleeding greater than 500 mL. Acupressure versus sham control There was no evidence of benefit from acupressure in reducing caesarean sections compared to control (RR, 0.94, 95% CI 0.68 to 1.30, two trials, 239 women, moderate-quality evidence). There was no evidence of a clear benefit in reduced oxytocin augmentation, instrumental vaginal birth, meconium-stained liquor, time from trial intervention to birth of the baby, and spontaneous vaginal birth. Acupressure versus usual care There was no evidence of benefit from acupressure in reducing caesarean sections compared to usual care (RR 1.02, 95% CI 0.68 to 1.53, two trials, 151 women, moderate-quality evidence). There was no evidence of a clear benefit in reduced epidural analgesia, Apgar score < 7 at 5 minutes, admission to neonatal intensive care, time from trial intervention to birth of the baby, use of other induction methods, and spontaneous vaginal birth. AUTHORS' CONCLUSIONS Overall, there was no clear benefit from acupuncture or acupressure in reducing caesarean section rate. The quality of the evidence varied between low to high. Few trials reported on neonatal morbidity or maternal mortality outcomes. Acupuncture showed some benefit in improving cervical maturity, however, more well-designed trials are needed. Future trials could include clinically relevant safety outcomes.
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Affiliation(s)
- Caroline A Smith
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797SydneyNew South WalesAustralia2751
| | - Mike Armour
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797SydneyNew South WalesAustralia2751
| | - Hannah G Dahlen
- Western Sydney UniversitySchool of Nursing and MidwiferyLocked Bag 1797PenrithNSWAustralia2751
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Asadi N, Maharlouei N, Khalili A, Darabi Y, Davoodi S, Raeisi Shahraki H, Hadianfard M, Jokar A, Vafaei H, Kasraeian M. Effects of LI-4 and SP-6 Acupuncture on Labor Pain, Cortisol Level and Duration of Labor. J Acupunct Meridian Stud 2015; 8:249-54. [DOI: 10.1016/j.jams.2015.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 08/07/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022] Open
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Goes ACADM, Pinto FMM, Fernandes GC, Barbosa JS, Correia ES, Ribeiro RA, Guimaraes SB, Lima Júnior RCP, Brito GADC, Rodrigues LV. Electroacupuncture ameliorates experimental colitis induced by TNBS through activation of interleukin-10 and inhibition of iNOS in mice. Acta Cir Bras 2014; 29:787-93. [DOI: 10.1590/s0102-86502014001900004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/11/2014] [Indexed: 11/22/2022] Open
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Neri I, Monari F, Midwife CS, Facchinetti F. Acupuncture in post-date pregnancy: a pilot study. J Matern Fetal Neonatal Med 2013; 27:874-8. [DOI: 10.3109/14767058.2013.845158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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8
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Lima LP, de Oliveira Albuquerque A, de Lima Silva JJ, Medeiros FDC, de Vasconcelos PRL, Guimarães SB. Electroacupuncture attenuates oxidative stress in random skin flaps in rats. Aesthetic Plast Surg 2012; 36:1230-5. [PMID: 22678136 DOI: 10.1007/s00266-012-9926-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 05/15/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Skin flaps may be damaged by free radicals produced during blood reflow and oxygen return to ischemic tissues. Considering that published studies have demonstrated the effects of manual acupuncture (MA) and electroacupuncture (EA) in attenuating the oxidative stress in different tissues and organs, this study aimed to investigate the possible protective effects of MA and EA in randomized skin flaps in rats. METHODS Thirty-two rats were subjected to dorsal skin flap (8 × 2.5 cm) construction and randomly divided into four groups of eight rats each: G1, surgical trauma; G2, MA; G3, EA 3 Hz; and G4, EA 100 Hz. All rats were anesthetized with ketamine (90 mg/kg) + xylazine (10 mg/kg) intraperitoneally on days 1, 3, and 7. MA (G2) and EA (G3/G4) were applied on days 3 and 7 of the experiment. G3 and G4 rats were treated with EA 3 and 100 Hz, respectively. Needles were inserted in GV-14 (Dazhui), GV-2 (Yaoshu), and L-13 (Zhangmen) acupoints and retained for 30 min. Blood and skin samples were collected at the end of the last procedure. The ANOVA/Dunnett test was used for group comparison. Values of p < 0.05 were considered significant. RESULTS Skin myeloperoxidase (MPO) activity decreased significantly in G2, G3, and G4 rats. Plasma and skin levels of reduced glutathione (GSH) increased significantly in G3 and G4 rats (p < 0.001) compared with G1 control. Malondialdehyde (MDA) plasma and skin levels increased significantly in G4 compared with G1 rats. CONCLUSIONS MA/EA decreased MPO activity in the graft, consistent with attenuated inflammation, and increased plasma and tissue GSH, indicative of reduced systemic and local oxidative stress. EA at 100 Hz enhances lipid peroxidation in plasma and skin of rats subjected to surgical stress. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article.
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Saputra K, Sutrisno TC. Electroacupuncture Treatment in Osteoarthritis Pain of the Knee for Geriatric Patients. Med Acupunct 2012. [DOI: 10.1089/acu.2011.0869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Koosnadi Saputra
- Acupuncture Research Laboratory in Health Services, Ministry of Health of Republic Indonesia, East Java, Indonesia
- Academy Acupuncture of Surabaya, East Java, Indonesia
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Longhurst JC. Defining Meridians: A Modern Basis of Understanding. J Acupunct Meridian Stud 2010; 3:67-74. [PMID: 20633518 DOI: 10.1016/s2005-2901(10)60014-3] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 03/30/2010] [Indexed: 11/17/2022] Open
Affiliation(s)
- John C Longhurst
- Samueli Center for Integrative Medicine, Departments of Medicine, Physiology and Biophysics, Pharmacology and Biomedical Engineering, Schools of Medicine and Engineering, University of California, Irvine, USA.
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Lim CED, Wilkinson JM, Wong WSF, Cheng NCL. Effect of Acupuncture on Induction of Labor. J Altern Complement Med 2009; 15:1209-14. [DOI: 10.1089/acm.2009.0100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chi Eung Danforn Lim
- Division of Chinese Medicine, Royal Melbourne Institute of Technology University, Bundoora Campus, Victoria, Australia
| | - Jenny M. Wilkinson
- School of Biomedical Sciences, Faculty of Science, Charles Sturt University, Boorooma, New South Wales, Australia
| | - Wu Shun Felix Wong
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Nga Chong Lisa Cheng
- Sydney Children's Hospital, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Ferreira AS. Prophylactic effects of short-term acupuncture on Zusanli (ST36) in Wistar rats with lipopolysaccharide-induced acute lung injury. ACTA ACUST UNITED AC 2009; 7:969-75. [DOI: 10.3736/jcim20091011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
OBJECTIVE To estimate the clinical effectiveness of acupuncture to induce labor. METHODS This study was a randomized controlled trial of acupuncture compared with sham acupuncture. Women who were scheduled for a postterm induction with a singleton pregnancy and cephalic presentation were eligible for the study. Women received two acupuncture or sham acupuncture sessions over a 2-day period before the planned medical/pharmacological induction. The principal primary outcomes related to the need for induction methods and time from the administration of the intervention to delivery. RESULTS Three hundred sixty-four women were randomly assigned to the trial (treatment n=181 and control n=183). Women did not differ in their need for induction methods between groups: prostaglandin induction: relative risk (RR) 1.20, 95% confidence interval (CI) 0.96-1.51, P=.11; artificial rupture of membranes only: RR 0.93, 95% CI 0.72-1.20, P=.57; oxytocin only: RR 0.89, 95% CI 0.60-1.32, P=.55; artificial rupture of membranes plus oxytocin: RR 0.87, 95% CI 0.57-1.33, P=.52; prostaglandins, artificial rupture of membranes, and oxytocin: RR 0.84, 95% CI 0.37-1.91, P=.68. The median time from acupuncture to delivery was 68.6 hours (interquartile range 53.9-79.5) compared with 65 hours (interquartile range 49.3-76.3) for women in the control group. CONCLUSION Two sessions of manual acupuncture, using local and distal acupuncture points, administered 2 days before a scheduled induction of labor did not reduce the need for induction methods or the duration of labor for women with a postterm pregnancy. CLINICAL TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, www.anzctr.org.au, ACTRN12606000494538 LEVEL OF EVIDENCE I.
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Li A, Zhang RX, Wang Y, Zhang H, Ren K, Berman BM, Tan M, Lao L. Corticosterone mediates electroacupuncture-produced anti-edema in a rat model of inflammation. Altern Ther Health Med 2007; 7:27. [PMID: 17697336 PMCID: PMC1976320 DOI: 10.1186/1472-6882-7-27] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Accepted: 08/14/2007] [Indexed: 11/16/2022]
Abstract
Background Electroacupuncture (EA) has been reported to produce anti-edema and anti-hyperalgesia effects on inflammatory disease. However, the mechanisms are not clear. The present study investigated the biochemical mechanisms of EA anti-inflammation in a rat model. Methods Three experiments were conducted on male Sprague-Dawley rats (n = 7–8/per group). Inflammation was induced by injecting complete Freund's adjuvant (CFA) subcutaneously into the plantar surface of one hind paw. Experiment 1 measured plasma corticosterone (CORT) levels to see if EA regulates CORT secretion. Experiment 2 studied the effects of the adrenal gland on the therapeutic actions of EA using adrenalectomy (ADX) rats. Experiment 3 determined whether a prototypical glucocorticoid receptor antagonist, RU486, affects EA anti-edema. EA treatment, 10 Hz at 3 mA and 0.1 ms pulse width, was given twice, for 20 min each, once immediately after CFA administration and again 2 h post-CFA. Plasma CORT levels, paw thickness, indicative of the intensity of inflammation, and paw withdrawal latency (PWL) were measured 2 h and 5 h after the CFA injection. Results EA significantly increased plasma corticosterone levels 2 h (5 folds) and 5 h (10 folds) after CFA administration compared to sham EA control, but EA alone in naive rats and CFA alone did not induce significant increases in corticosterone. Adrenalectomy blocked EA-produced anti-edema, but not EA anti-hyperalgesia. RU486 (15 μl, 15 μg/μl), a prototypical glucocorticoid receptor antagonist, also prevented EA anti-edema. Conclusion The data demonstrate that EA activates the adrenals to increase plasma corticosterone levels and suppress edema and suggest that EA effects differ in healthy subjects and in those with pathologies.
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Affiliation(s)
- Aihui Li
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201 USA
| | - Rui-Xin Zhang
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201 USA
| | - Yi Wang
- Shanghai University of Traditional Chinese Medicine, Yueyang Affiliated Hospital, Shanghai, China
| | - Haiqing Zhang
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201 USA
| | - Ke Ren
- Dept. of Biomedical Sciences, Dental School, University of Maryland, Baltimore, MD 21201 USA
| | - Brian M Berman
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201 USA
| | - Ming Tan
- Division of Biostatistics, University of Maryland Greenebaum Cancer Center, Baltimore, MD 21201 USA
| | - Lixing Lao
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201 USA
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Huang CL, Tsai PS, Wang TY, Yan LP, Xu HZ, Huang CJ. Acupuncture stimulation of ST36 (Zusanli) attenuates acute renal but not hepatic injury in lipopolysaccharide-stimulated rats. Anesth Analg 2007; 104:646-54. [PMID: 17312224 DOI: 10.1213/01.ane.0000255288.68199.eb] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND We sought to determine the effects of ST36 acupuncture on sepsis-induced kidney and liver injuries. METHODS A total of 120 rats were randomized into 10 groups: 1) lipopolysaccharide (LPS), 2) normal saline (N/S), 3) LPS + ST36, 4) ST36, 5) LPS + P-ST36, 6) P-ST36, 7) LPS + Sham, 8) Sham, 9) LPS + P-Sham, and 10) P-Sham groups. Rats in the LPS + ST36, ST36, LPS +Sham, and Sham groups received ST36 (designated as "ST36") or a nonacupoint (designated as "Sham") acupuncture for 30 min followed by LPS or N/S injection. Rats in the LPS + P-ST36, P-ST36, LPS + P-Sham, and P-Sham groups received LPS or N/S injection for 3 h followed by a 30 min of ST36 or a "nonacupoint" acupuncture. Rats were killed at 6 h after LPS injection. RESULTS LPS caused prominent kidney and liver injuries. The renal and hepatic nitric oxide (NO) concentrations and inducible NO synthase (iNOS) expression were also increased by LPS. ST36 acupuncture pretreatment significantly attenuated the LPS-induced kidney injury and the increases in renal NO concentration and iNOS expression. However, ST36 acupuncture pretreatment did not affect the LPS-induced liver injury and increases in hepatic NO concentration or iNOS expression. Furthermore, ST36 acupuncture performed after LPS did not affect the LPS-induced organ injuries or increases in NO concentration and iNOS expression. CONCLUSIONS ST36 acupuncture pretreatment significantly attenuated sepsis-induced kidney, but not liver, injury in rats, whereas ST36 acupuncture performed after sepsis induction had no protective effects against sepsis-induced organ injuries.
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Affiliation(s)
- Chin-Liang Huang
- Acupuncture and Moxibustion Institute, Nanjing University of Traditional Chinese Medicine, Nanjing, China
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Moon PD, Jeong HJ, Kim SJ, An HJ, Lee HJ, Yang WM, Park SK, Hong SH, Kim HM, Um JY. Use of electroacupuncture at ST36 to inhibit anaphylactic and inflammatory reaction in mice. Neuroimmunomodulation 2007; 14:24-31. [PMID: 17700037 DOI: 10.1159/000107285] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 02/17/2007] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Electroacupuncture (EA) has been used to treat myalgia, allergy and gastroenteropathy in Korea. To determine whether EA can treat anaphylactic and inflammatory reactions, the effect of EA was investigated in a murine model. METHODS EA stimulation of the ST36 acupoint was performed for 10 min. Using a passive cutaneous anaphylaxis (PCA) model, the antianaphylactic effects of EA were examined. Interleukin-6 and tumor necrosis factor-alpha were measured using the ELISA method. The level of nuclear factor (NF)-kappaB/RelA protein and NF-kappaB DNA-binding activity was determined using the Western blot analysis and the transcription factor enzyme-linked immunoassay method. RESULTS EA inhibits PCA and beta-hexosaminidase release, IL-6 secretion on the PCA, and in addition, EA reduces NF-kappaB DNA-binding activity. CONCLUSION These results indicate that EA may possess antianaphylactic and antiinflammatory properties.
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Affiliation(s)
- Phil-Dong Moon
- Department of Pharmacology, College of Oriental Medicine, Institute of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
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An HJ, Lee JH, Lee HJ, Yang WM, Park SK, Hong SH, Kim HM, Um JY. Electroacupuncture protects against CCK-induced acute pancreatitis in rats. Neuroimmunomodulation 2007; 14:112-8. [PMID: 17804915 DOI: 10.1159/000107793] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2007] [Accepted: 06/26/2007] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Electroacupuncture (EA) has been used to treat myalgia, adiposis and gastroenteropathy in Korea. EA as a complementary and alternative medicine has been accepted worldwide mainly for the treatment acute and chronic pain and inflammation. The aim of this study was to investigate the effects of EA on acute pancreatitis induced by cholecystokinin octapeptide (CCK) in rats. METHODS Animals were divided into four groups: (1) a normal group; (2) a CCK-induced acute pancreatitis group; (3) a CCK-induced acute pancreatitis group treated with 100-Hz EA, and (4) a CCK-induced acute pancreatitis group treated with 2-Hz EA. High-frequency (100-Hz) and low-frequency EA (2-Hz) stimulations were applied to an acupoint equivalent to Zusanli (ST36) in rats, followed by 75 microg/kg CCK subcutaneously three times, after 1, 3 and 5 h. The entire procedure was repeated over 5 days. Repeated CCK treatment resulted in typical laboratory and morphological changes in experimentally induced pancreatitis. RESULTS EA significantly decreased the pancreatic weight/body weight ratio in CCK-induced acute pancreatitis, increased the pancreatic levels of HSP60 and HSP72, and decreased the beta-amylase and lipase levels associated with CCK-induced acute pancreatitis. Furthermore, the release of ACTH was increased in the blood serum of the EA-treated group. CONCLUSION EA may have protective effects against CCK-induced acute pancreatitis through the release of ACTH.
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Affiliation(s)
- Hyo-Jin An
- Department of Pharmacology, College of Oriental Medicine, Oriental Medical Science, Institute of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
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Huang CL, Huang CJ, Tsai PS, Yan LP, Xu HZ. Acupuncture stimulation of ST-36 (Zusanli) significantly mitigates acute lung injury in lipopolysaccharide-stimulated rats. Acta Anaesthesiol Scand 2006; 50:722-30. [PMID: 16987368 DOI: 10.1111/j.1399-6576.2006.01029.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND We sought to investigate the potential therapeutic effects of acupuncture stimulation of ST-36 (Zusanli) on endotoxemia-induced acute lung injury in lipopolysaccharide (LPS)-stimulated rats. METHODS Sixty rats were randomized into six groups (n = 10): (i) lipopolysaccharide (LPS) control group, (ii) normal saline (N/S) control group, (iii) LPS plus ST-36 group, (iv) N/S plus ST-36 group, (v) LPS plus sham point (Sham) group, and (vi) N/S plus Sham group. Manual acupuncture stimulation of ST-36 (designated as 'ST-36') or a 'non-acupoint' (designated as 'Sham') was performed in lightly immobilized rats for 30 min. Then, LPS injection was employed to induce sepsis. Rats were killed at 6 h after LPS injection and lung injury, nitric oxide (NO) biosynthesis and inducible NO synthase (iNOS) expression were assayed. RESULTS Significant lung injury, pulmonary iNOS expression and systemic and pulmonary NO biosynthesis were noted in the LPS groups. Rats in the LPS plus Sham group had lung injury, pulmonary iNOS expression, systemic and pulmonary NO biosynthesis similar to those observed in the LPS group. However, the degree of lung injury, pulmonary iNOS expression and pulmonary NO biosynthesis, but not systemic NO biosynthesis, were significantly attenuated in the LPS plus ST-36 group as compared with those in both the LPS group and the LPS plus Sham group. CONCLUSION Acupuncture stimulation of ST-36 may be effective as a prophylaxis measure against sepsis. However, results from this study do not support the use of acupuncture for the treatment of sepsis.
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Affiliation(s)
- C-L Huang
- Acupuncture and Moxibustion Institute, Nanjing University of Traditional Chinese Medicine, Nanjing, China
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Zhang RX, Lao L, Wang X, Fan A, Wang L, Ren K, Berman BM. Electroacupuncture Attenuates Inflammation in a Rat Model. J Altern Complement Med 2005; 11:135-42. [PMID: 15750372 DOI: 10.1089/acm.2005.11.135] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acupuncture has traditionally been used in China and is being increasingly applied in Western countries to treat a variety of conditions, including inflammatory disease. However, clinical trials investigating the effectiveness of the anti-inflammatory effects of acupuncture have yielded inconsistent results, and the underlying mechanisms of acupuncture-produced anti-inflammation are unclear. OBJECTIVE To evaluate the effectiveness of electroacupuncture (EA) on inflammation in a rat model. MATERIALS AND METHODS Four experiments were conducted on male Sprague-Dawley rats (n = 8-9 per group). Inflammation was induced by injecting complete Freund's adjuvant (CFA) subcutaneously into the plantar surface of one hind paw of the rat. Experiment 1: To determine the effect of EA (10 and 100 Hz) versus sham treatment on inflammation. Experiment 2: To investigate the involvement of the adrenal glands on the effect of EA treatment using adrenalectomized (ADX) rats. Experiment 3: To determine the effects of EA on plasma levels of corticosterone. Experiment 4: To determine the effects of EA treatment versus immobilization on such stress indicators as heart rate and blood pressure. RESULTS At 10 Hz EA significantly reduced CFA-induced hind paw edema. The effect was partially blocked in the ADX rats. EA significantly increased plasma levels of corticosterone but produced no noticeable signs of stress. CONCLUSION At 10 Hz but not 100 Hz, EA suppresses inflammation by activating the hypothalamus-pituitary-adrenal axis (HPA) and the nervous system.
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Affiliation(s)
- Rui-Xin Zhang
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
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20
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Lao L, Zhang RX, Zhang G, Wang X, Berman BM, Ren K. A parametric study of electroacupuncture on persistent hyperalgesia and Fos protein expression in rats. Brain Res 2004; 1020:18-29. [PMID: 15312783 DOI: 10.1016/j.brainres.2004.01.092] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2004] [Indexed: 11/17/2022]
Abstract
We previously reported the anti-hyperalgesia of electroacupuncture (EA) on persistent inflammatory pain in an unrestrained, unsedated, and conscious rat model. Using this model, induced by injecting complete Freund's adjuvant (CFA) into one hind paw, we systematically evaluated the anti-hyperalgesia of EA stimulation parameters (frequency, intensity, treatment duration, and pulse width). We assessed hyperalgesia by paw withdrawal latency (PWL) to a noxious thermal stimulus and found that 10- and 100-Hz EA frequencies at a current intensity of 3 mA produced the greatest anti-hyperalgesia, when compared to other parameters. Both frequencies significantly increased PWL in the early phases of hyperalgesia (2.5 and 24 h; p < 0.05), and 10 Hz EA also significantly increased PWL in later phases (5 to 7 days; p < 0.05). A sufficient but tolerable intensity of 3 mA was more effective than lower intensities (1-2 mA). A 20-min treatment produced better anti-hyperalgesia than longer and shorter (10 and 30 min) treatments. Acupoint specificity study demonstrated that GB30 produced significant EA anti-hyperalgesia, while Waiguan (TE5) and sham points, an abdominal point and a point at the opposite aspect of GB30, did not. The spinal Fos protein expression study demonstrated that the optimal EA selectively suppressed Fos expression in superficial laminae (I/II) and activated it in deeper laminae (III/IV) of the spinal dorsal horn. The results suggest that the EA anti-hyperalgesia is parameter-dependent and point-specific, and they provide important information for designing further clinical acupuncture research on persistent inflammatory pain.
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Affiliation(s)
- Lixing Lao
- Center For Integrative Medicine, School of Medicine, University of Maryland, 3rd Floor, James Kernan Hospital Mansion, 2200 Kernan Drive, Baltimore, MD 21201, USA.
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Engelhardt PF, Daha LK, Zils T, Simak R, König K, Pflüger H. Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study. Int J Impot Res 2004; 15:343-6. [PMID: 14562135 DOI: 10.1038/sj.ijir.3901021] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In a prospective study, we investigated the potentially curative effect of acupuncture in patients with psychogenic erectile dysfunction (pED). A total of 22 patients with pED were randomized into two groups. They were either treated with acupuncture specific against ED (treatment group) or acupuncture specific against headache (placebo group). Nonresponders of the placebo group were crossed over to the treatment group. Prior to acupuncture, serum sexual hormone levels, IIEF score, nocturnal penile tumescence testing for three nights (Rigiscan) and the erectile response to 50 mg sildenafil were evaluated. Out of 21 patients, 20 completed the study, including 10 patients after crossover. A satisfactory response was achieved in 68.4% of the treatment group and in 9% of the placebo group (P=0.0017). Another 21.05% of the patients had improved erections, that is, sufficient rigidity under simultaneous treatment with 50 gm sildenafil. The results of our pilot study indicate that acupuncture can be an effective treatment option in more than two-thirds of patients with psychogenic erectile dysfunction.
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Affiliation(s)
- P F Engelhardt
- Department of Urology and Ludwig-Boltzmann-Institute of Andrology and Urology, Lainz Hospital, Vienna, Austria.
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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 teratogenic effects, and may be effective. The evidence regarding the clinical effectiveness of this technique is limited. OBJECTIVES To determine the effects of acupuncture for third trimester cervical ripening or induction of labour. SEARCH STRATEGY The Cochrane Pregnancy and Childbirth Group trials register (February 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), PubMed (1966 to present), CISCOM (1960 to present), EMBASE (1980 to present) 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 A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. MAIN RESULTS One trial of 56 women was included in the review. Data were not in a form that could be included in the meta-analysis. REVIEWER'S CONCLUSIONS 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)
- C A Smith
- School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, South Australia, Australia
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Medici TC, Grebski E, Wu J, Hinz G, Wüthrich B. Acupuncture and bronchial asthma: a long-term randomized study of the effects of real versus sham acupuncture compared to controls in patients with bronchial asthma. J Altern Complement Med 2002; 8:737-50; discussion 751-4. [PMID: 12614526 DOI: 10.1089/10755530260511748] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acupuncture has traditionally been used in China in the treatment of bronchial asthma and is being increasingly applied in Western countries. Although there are many published studies on acupuncture and asthma, few meet the scientific criteria necessary to prove the effectiveness of acupuncture. OBJECTIVE To examine the short- and long-term effects of real versus sham or no acupuncture in patients with bronchial asthma. DESIGN Randomized partially blinded study with three parallel groups. SUBJECTS Sixty-six (66) patients of both genders (mean age, 39 years) with mild-to-moderate persistent bronchial asthma. INTERVENTIONS After 2 weeks of run-in, the patients with asthma were randomized to receive either real (23 patients) or sham acupuncture (23 patients) or no acupuncture (20 patients). Two acupuncture periods (each 4 weeks) within the first 4 months were followed by a 6-month observation. MEASUREMENTS Primary outcome was the change of peak expiratory flow (PEF) variability at the end of the two treatment periods. Secondary outcomes were changes in forced expiratory volume in 1 second (FEV1), airway responsiveness, symptoms of asthma, the use of asthma drugs, and patients' well-being. Moreover, the effect of the intervention on eosinophils and eosinophil cationic protein (ECP) in blood and sputum was assessed. RESULTS PEF variability decreased in all groups. In a subgroup of patients whose asthma medication remained fairly unchanged, PEF variability decreased significantly after needling of real as well as sham points at month 4 and 5 compared to controls (p < or = 0.005). However, there was no difference in the decrease of PEF variability between patients who had the blinded treatment with real or sham acupuncture. Most of the other functional and clinical variables did not differ from those obtained in controls. Eosinophils and ECP in blood and sputum decreased in all groups, but the only significant differences were found in blood eosinophil count at 4 months between sham acupuncture and the control group (p < 0.05) and at 10 months between real and sham acupuncture (p < 0.05) suggesting a possible effect on eosinophilic inflammation. CONCLUSIONS In view of the fact that the effects after real and sham acupuncture compared to controls who had no needling at all were small, in all likelihood clinically irrelevant, our data do not seem to support the use of acupuncture in the management of pharmacologically well-treated patients with mild-to-moderate persistent asthma.
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Affiliation(s)
- Tullio C Medici
- Department of Internal Medicine, University Hospital Zurich, Switzerland.
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24
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Gruber W, Eber E, Malle-Scheid D, Pfleger A, Weinhandl E, Dorfer L, Zach MS. Laser acupuncture in children and adolescents with exercise induced asthma. Thorax 2002; 57:222-5. [PMID: 11867825 PMCID: PMC1746279 DOI: 10.1136/thorax.57.3.222] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Laser acupuncture, a painless technique, is a widely used alternative treatment method for childhood asthma, although its efficacy has not been proved in controlled clinical studies. METHODS A double blind, placebo controlled, crossover study was performed to investigate the possible protective effect of a single laser acupuncture treatment on cold dry air hyperventilation induced bronchoconstriction in 44 children and adolescents of mean age 11.9 years (range 7.5-16.7) with exercise induced asthma. Laser acupuncture was performed on real and placebo points in random order on two consecutive days. Lung function was measured before laser acupuncture, immediately after laser acupuncture (just before cold dry air challenge (CACh)), and 3 and 15 minutes after CACh. CACh consisted of a 4 minute isocapnic hyperventilation of -10 degrees C absolute dry air. RESULTS Comparison of real acupuncture with placebo acupuncture showed no significant differences in the mean maximum CACh induced decrease in forced expiratory volume in 1 second (27.2 (18.2)% v 23.8 (16.2)%) and maximal expiratory flow at 25% remaining vital capacity (51.6 (20.8)% v 44.4 (22.3)%). CONCLUSIONS A single laser acupuncture treatment offers no protection against exercise induced bronchoconstriction in paediatric and adolescent patients.
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Affiliation(s)
- W Gruber
- Respiratory and Allergic Disease Division, Paediatric Department, University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria
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25
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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 rising 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 teratogenic effects, and may be effective. The evidence regarding the clinical effectiveness of this technique is limited. OBJECTIVES To determine the effects of acupuncture for third trimester cervical ripening or induction of labour. SEARCH STRATEGY The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and bibliographies of relevant papers. SELECTION CRITERIA The criteria for inclusion included the following: (1) 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; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions. DATA COLLECTION AND ANALYSIS A strategy has been developed to deal with the large volume and complexity of trial data relating to labour induction. This involves a two-stage method of data extraction. The initial data extraction is done centrally, and incorporated into a series of primary reviews arranged by methods of induction of labour, following a standardised methodology. The data will then be extracted from the primary reviews into a series of secondary reviews, arranged by category of woman. To avoid duplication of data in the primary reviews, the labour induction methods have been listed in a specific order, from one to 25. Each primary review includes comparisons between one of the methods (from two to 25) with only those methods above it on the list. MAIN RESULTS No trials met the inclusion criteria for the systematic review. REVIEWER'S CONCLUSIONS There is a need for a well designed randomised controlled trial to evaluate the role of acupuncture to induce labour.
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Affiliation(s)
- C A Smith
- Clinical Trials Unit, Department of Obstetrics and Gynaecolygy, Adelaide University, Women's and Children's Hospital, 72 King William Road, North Adelaide, Australia, SA 5006.
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Han SH, Yoon SH, Cho YW, Kim CJ, Min BI. Inhibitory effects of electroacupuncture on stress responses evoked by tooth-pulp stimulation in rats. Physiol Behav 1999; 66:217-22. [PMID: 10336147 DOI: 10.1016/s0031-9384(98)00276-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mechanism of electroacupuncture (EA) on the stress responses induced by tooth-pulp stimulation was investigated in anesthetized adult female Sprague-Dawley rats. The Hoku point in the Chinese meridian was used for acupuncture stimulation. Constant rectangular current (1 mA) pulses of 5-ms duration were delivered at 3 Hz through a pair of needles for 15 min. As for stress response indexes, we have monitored changes in arterial blood pressure and the levels of blood catecholamines, corticosterone, and ACTH. Arterial blood pressure was increased by high frequency stimulation (0.1 mA, 0.5 ms, 100 Hz for 15 s) of tooth-pulp in the control condition. After EA, we did not observe the same responses of the arterial blood pressure changes with the same stimuli. The tooth-pulp stimulation increased the concentrations of plasma norepinephrine (NE), epinephrine (E), dopamine (DA), corticosterone, and ACTH significantly from the levels of those before stress. After treatment with EA, the stress-induced increase in NE, DA, corticosterone, and ACTH but not the rise in E, were inhibited. When naloxone, an opioid antagonist, was administered intraperitoneally before EA, the effects of EA on stress responses were reduced. In this study, it can be suggested that EA has not only an analgesic effect but also suppressive effects on the stress responses primarily through the mediation of an endogenous opioid.
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Affiliation(s)
- S H Han
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, South Korea
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Jobst KA. Acupuncture in asthma and pulmonary disease: an analysis of efficacy and safety. J Altern Complement Med 1997; 2:179-206; discussion 207-10. [PMID: 9395653 DOI: 10.1089/acm.1996.2.179] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- K A Jobst
- Oxford Project to Investigate Memory and Aging (OPTIMA), Radcliffe Infirmary Trust, United Kingdom
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Jobst KA. A critical analysis of acupuncture in pulmonary disease: efficacy and safety of the acupuncture needle. J Altern Complement Med 1995; 1:57-85. [PMID: 9395603 DOI: 10.1089/acm.1995.1.57] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Criteria for therapeutic efficacy and safety include significant amelioration of symptoms and, ideally, cure (i.e., patients' belief in effective improvement of symptoms and quality of life, durable impact on symptoms, verifiable subjective and objective changes); improved patient management (e.g., diminishing, or ceasing medication, physiotherapy, and other interventions); safety for patient and practitioner and an acceptable side effect profile; cost-effectiveness of the therapy in practice and to teach to others. There is evidence that in bronchial asthma, chronic bronchitis, and chronic disabling breathlessness the use of acupuncture fulfills these to varying degrees. It can facilitate reducing pharmacologic medication and is safe, suggesting that acupuncture as an adjuvant in the treatment of respiratory disease might be safer than prolonged pharmaceutical maintenance therapy alone. Its cost-effectiveness has yet to be adequately researched. Twenty-one papers in English were obtained and 16 were further evaluated; eight were double-blind, five single-blind, and three unblinded. The remaining five, and most of the Chinese literature, were excluded on account of their poor quality. Acupuncture was effective in four of eight of the double-blind, three of five single-blind, and three of three unblinded studies (i.e., 10 of 16 [62.5%] overall). A previously unreported confounding variable was identified and concerned the designation of sham points. Most sham points were believed to be inactive but, according to traditional Chinese principles, many are active in pulmonary disease. Reappraised accordingly, the unequivocally positive studies were summed with those in which "real" and "sham" acupuncture were not significantly different but in which the combined effect of all acupuncture (i.e., real + sham) on breathlessness was significantly different from baseline. This yielded 13 of 16 (81%) [corrected] studies in which acupuncture led to significant improvement. In most studies, current pharmacologic treatment had a greater effect than acupuncture alone. However, in the 11 studies in which it was evaluated, medication could be significantly reduced by acupuncture in 10 (91%). Twenty-three of the 320 patients in the 16 studies (7%) reported minimal side effects, none requiring intervention. Current published evidence reveals no reason to withhold acupuncture as a safe and potentially effective treatment in patients with bronchial asthma and chronic obstructive lung disease. Further, more appropriately designed studies are urgently required. This would be facilitated in the United States by licensing the acupuncture needle as a therapeutic agent and might lead to important new insights and therapeutic opportunities.
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Affiliation(s)
- K A Jobst
- OPTIMA, Radcliffe Infirmary Trust, Oxford, UK
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Kaada B, Hognestad S, Havstad J. Transcutaneous nerve stimulation (TNS) in tinnitus. SCANDINAVIAN AUDIOLOGY 1989; 18:211-7. [PMID: 2609098 DOI: 10.3109/01050398909042196] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Low-frequency (2 Hz) TNS applied distally to peripheral nerves of the upper extremity is known to induce a wide-spread, non-segmental and prolonged relief of pain and an increased microcirculation due to sympatho-inhibition in a number of vascular beds. Such stimulation was administered in 29 tinnitus patients of various etiology. Reduction of tinnitus was encountered in 9 subjects in response to a 45-min TNS-session. The improvement was mainly seen in tinnitus characterized by lower frequencies (125-500 Hz). In 7 of the 9 patients, the tinnitus reduction was associated with improvement of hearing, predominantly in the low-frequency band. The effects were still present after one week following daily stimulation at home. On continued treatment, the effects were found to be transitory in 4 of the patients, whereas the remaining 5 patients are still using the stimulator after 2 to 5 years. It is suggested that the mechanism behind the beneficial effects is increased microcirculation in part of the auditory pathways.
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Affiliation(s)
- B Kaada
- Clinical Neurophysiological Laboratory, Rogaland Central Hospital, Stavanger, Norway
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31
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Kaada B, Hognestad S, Havstad J. Transcutaneous Nerve Stimulation (TNS) in Tinnitus. Int J Audiol 1989. [DOI: 10.3109/14992028909042196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Influence of transcutaneous electrical nerve stimulation on pain, range of motion, and serum cortisol concentration in females experiencing delayed onset muscle soreness. J Orthop Sports Phys Ther 1989; 11:100-3. [PMID: 18796921 DOI: 10.2519/jospt.1989.11.3.100] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
beta-Endorphin (BEP) has been implicated in the analgesic response to transcutaneous electrical nerve stimulation (TENS). The anterior pituitary gland is a source of beta-endorphin which shares the prohormone proopiomelanocortin (POMC) with adrenocorticotropin (ACTH). Current theory proposes that the stimulation-induced breakdown of POMC results in ACTH release with a subsequent elevation in blood cortisol levels. The purpose of this study was to determine the potential application and mechanism of TENS as an anti-inflammatory agent. Eight female subjects received low frequency, 300 musec pulse width TENS at four sites associated with relief of upper arm pain once when pain free and again while experiencing delayed onset muscle soreness (DOMS) of the elbow flexor muscle group. Blood samples were withdrawn 15 and 1 minute before and 1, 20, and 40 minutes after treatment. Serum was analyzed for cortisol by radioimmunoassay. TENS treatment failed to elevate serum cortisol concentration, but there was a significant reduction in perception of pain (p < 0.05) and an improvement in range of elbow extension (p < 0.05) when subjects were treated for DOMS. These results suggest that the anterior pituitary is not a source of BEP in TENS-induced analgesia. J Orthop Sports Phys Ther 1989;11(3):100-103.
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Kaada B, Romslo I. Use of transcutaneous nerve stimulation in the attacks of acute intermittent porphyria. THE INTERNATIONAL JOURNAL OF BIOCHEMISTRY 1985; 17:235-40. [PMID: 3874101 DOI: 10.1016/0020-711x(85)90120-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A 38-year-old female with acute intermittent porphyria (AIP) was having regular recurrent premenstrual severe attacks of abdominal and chest pain due to the disease. Low-frequency transcutaneous nerve stimulation (TNS) premenstrually prevented or markedly reduced the severity of clinical attacks, associated with a reduced urinary porphyrin excretion. The possible mechanisms of the TNS-induced effects are discussed. This experience suggests that TNS may be an effective and simple prophylactic method in the management of the attacks in AIP. The method can be administered easily by the patient himself as home-treatment and is free of side-effects.
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Abstract
Seventeen patients with stable bronchial asthma were randomly assigned to receive either correct acupuncture or placebo acupuncture. The study lasted 11 weeks and consisted of a pre-therapy, therapy, and post-therapy period. The patients received 10 treatments during a 5-week period. The effect of therapy on pulmonary function was assessed daily by the patients at home. Morning and evening peak expiratory flow rate, number of puffs beta 2-agonist aerosol needed, as well as subjective symptoms of asthma were recorded in a diary. The correctly treated group improved significantly throughout the study. Also, compared with the placebo group, a significant improvement was found in all assessed parameters 2 weeks after beginning therapy. Hereafter, no differences could be shown.
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Abstract
Minilaparotomy was performed using acupuncture analgesia on 78 female patients seeking voluntary sterilization to determine whether this could be used as a substitute for standard analgesic sedation. In 48 women (62%) no intravenous drug medication was required, and sterilization was successfully performed using only the local anaesthetic and acupuncture electrostimulation. These patients could be discharged within one hour of operation. For a developing country with a shortage of trained anaesthetists, acupuncture analgesia could prove to be a simple, safe and economical method, especially in a rural setting.
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36
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Kaada B, Eielsen O. In search of mediators of skin vasodilation induced by transcutaneous nerve stimulation: II. Serotonin implicated. GENERAL PHARMACOLOGY 1983; 14:635-41. [PMID: 6662343 DOI: 10.1016/0306-3623(83)90160-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Previous studies have shown that brain serotonin is increased and noradrenaline decreased in acupuncture and transcutaneous nerve stimulation (TNS). Increases in available brain serotonin and decreases in noradrenaline enhance pain suppression. The present study tests the possibility that the widespread and prolonged cutaneous vasodilation which can be produced by low-frequency TNS in patients with peripheral circulatory insufficiency is similarly dependent on a central serotonergic pathway leading to sympatho-inhibition. The serotonin receptor antagonist cyproheptadine was given to 4 patients with either Raynaud's phenomenon or diabetic polyneuropathy, who all prior to drug administration responded to TNS with marked and prolonged cutaneous vasodilation in the ischaemic limbs. Cyproheptadine almost completely blocked the vascular response. Contrary to endorphin-serotonin mediated pain inhibition, vasoconstrictor inhibition is not antagonized by conventional, low doses of naloxone (Kaada, 1982a). However, the involvement of more naloxone-resistant opioid receptors in the vascular response cannot be excluded.
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