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Acupuncture
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ramonmercadoOffline
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PostPosted: 08-05-2010 18:25    Post subject: Reply with quote

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I usually treat alternative medicine with a dose of skepticism however I have to admit that I am willing to give acupuncture the benefit of the doubt.


Same here. Accupuncture works very well for a friend of mine. Much better than heavy painkillers.
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PostPosted: 01-06-2010 14:13    Post subject: Reply with quote

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Acupuncture's Molecular Effects Pinned Down
31 May 2010

Scientists have taken another important step toward understanding just how sticking needles into the body can ease pain.

In a paper published online May 30 in Nature Neuroscience, a team at the University of Rochester Medical Center identifies the molecule adenosine as a central player in parlaying some of the effects of acupuncture in the body. Building on that knowledge, scientists were able to triple the beneficial effects of acupuncture in mice by adding a medication approved to treat leukemia in people.

The research focuses on adenosine, a natural compound known for its role in regulating sleep, for its effects on the heart, and for its anti-inflammatory properties. But adenosine also acts as a natural painkiller, becoming active in the skin after an injury to inhibit nerve signals and ease pain in a way similar to lidocaine.

In the current study, scientists found that the chemical is also very active in deeper tissues affected by acupuncture. The Rochester researchers looked at the effects of acupuncture on the peripheral nervous system - the nerves in our body that aren't part of the brain and spinal cord. The research complements a rich, established body of work showing that in the central nervous system, acupuncture creates signals that cause the brain to churn out natural pain-killing endorphins.

The new findings add to the scientific heft underlying acupuncture, said neuroscientist Maiken Nedergaard, M.D., D.M.Sc., who led the research. Her team is presenting the work at a scientific meeting, Purines 2010, in Barcelona, Spain.

"Acupuncture has been a mainstay of medical treatment in certain parts of the world for 4,000 years, but because it has not been understood completely, many people have remained skeptical," said Nedergaard, co-director of the University's Center for Translational Neuromedicine, where the research was conducted.

"In this work, we provide information about one physical mechanism through which acupuncture reduces pain in the body," she added.

To do the experiment, the team performed acupuncture treatments on mice that had discomfort in one paw. The mice each received a 30-minute acupuncture treatment at a well known acupuncture point near the knee, with very fine needles rotated gently every five minutes, much as is done in standard acupuncture treatments with people.

The team made a number of observations regarding adenosine:

* In mice with normal functioning levels of adenosine, acupuncture reduced discomfort by two-thirds.
* In special "adenosine receptor knock-out mice" not equipped with the adenosine receptor, acupuncture had no effect.
* When adenosine was turned on in the tissues, discomfort was reduced even without acupuncture.
* During and immediately after an acupuncture treatment, the level of adenosine in the tissues near the needles was 24 times greater than before the treatment.

Once scientists recognized adenosine's role, the team explored the effects of a cancer drug called deoxycoformycin, which makes it harder for the tissue to remove adenosine. The compound boosted the effects of acupuncture treatment dramatically, nearly tripling the accumulation of adenosine in the muscles and more than tripling the length of time the treatment was effective.

"It's clear that acupuncture may activate a number of different mechanisms," said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health. "This carefully performed study identifies adenosine as a new player in the process. It's an interesting contribution to our growing understanding of the complex intervention which is acupuncture," added Briggs, who is the spouse of co-author Jurgen Schnermann.

The paper includes three first co-authors: Nanna Goldman, technical associate Michael Chen, and post-doctoral associate Takumi Fujita. Other authors from Rochester include Qiwu Xu; medical student Tina Jensen; former student Wei Liu and former post-doctoral associate Yong Pei; assistant professors Takahiro Takano and Kim Tieu; and research assistant professors Weiguo Peng, Fushun Wang, Xiaoning Han, and Lane Bekar. Also contributing were Jiang-Fan Chen from Boston University and Jürgen Schnermann from the National Institute of Diabetes and Digestive and Kidney Diseases.

Funding for the work came from the New York State Spinal Cord Injury Program and the National Institutes of Health.

Source:
Tom Rickey
University of Rochester Medical Center

Article URL: http://www.medicalnewstoday.com/articles/190394.php
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PostPosted: 09-07-2010 12:42    Post subject: Reply with quote

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The Effectiveness Of Acupuncture For Exercise Tolerance In Heart Failure
03 Jul 2010

Acupuncture can improve exercise tolerance in patients suffering from chronic heart failure. This was determined in a clinical pilot study by the team headed by Dr. Johannes Backs, physician and study director at the Department of Internal Medicine III (Cardiology, Angiology, and Pneumology - Medical Director: Professor Dr. Hugo Katus) of Heidelberg University Hospital. The needles do not increase the heart's pump function, but they seem to have an influence on skeletal muscle strength and thus can increase the walk distance that heart patients can cover. The results of the clinical study, which was conducted with a comparison group treated with placebo acupuncture using dull needles, have been published in the prestigious medical journal Heart.

Acupuncture influences the autonomic nervous system

Chronic weakness of the heart muscle is one of the most frequent diseases and causes of death in Europe. Patients with this disease suffer in particular from a reduction in work capacity. Shortness of breath and fatigue brought on by physical exercise are signs of the disease.

The disease is much more complex than previously assumed. It is not only the weakening pump function of the heart muscle that is responsible for the symptoms. What is known as the autonomic or vegetative nervous system and various nerve transmitter substances become imbalanced, which further worsens the course of the disease. This is precisely where acupuncture may intervene, by bringing these processes back into balance- it influences the autonomic sympathetic nervous system (excitation), boosts the parasympathetic nervous system (relaxation), and also has an anti-inflammatory affect. Thus far there have been hardly any studies of whether acupuncture can thus influence such life-threatening diseases such as heart failure.

Needles fight exhaustion

The scientists examined patients with heart failure who were treated with the conventional medications and were in stable condition. In addition, patients in the acupuncture group were given ten sessions of acupuncture focusing on the acupuncture points which boost general strength according to Traditional Chinese Medicine and are also known to influence the sympathetic and parasympathetic nervous systems and inflammation markers. The control group was treated with special placebo needles that simulate a needle prick but do not break the skin. After this therapy, the acupuncture patients could cover a greater walk distance in the time allowed than the placebo patients. They recovered more quickly and tended to feel subjectively less exhausted. However, the measurable work capacity of the heart was unchanged.

Inflammation messengers cause muscle fatigue

We already know from other studies that heart patient's ability to tolerate exercise is independent of the pump function of the heart. It appears rather that easily becoming fatigued stems primarily from the muscles. Inflammation messengers in the blood are increased in chronic heart failure and make the muscles tired. They activate what are known as ergoreceptors in the muscle that signalize to the body that the muscle cannot sustain the workload. "The blood level of a certain messenger, tumor necrosis factor alpha (TNF alpha) actually drops after the real acupuncture treatment. Since TNF alpha leads to a reduction of muscle mass and muscle strength among other things, this would explain the positive effect on skeletal muscle function," explains Dr. Arnt Kristen, one of the authors of the study.

Better long-term prognoses through acupuncture?

"Most studies on the effectiveness of acupuncture have methodological weaknesses, as there are no placebo controls and the study participants are not 'blinded'. This means that the patients know which treatment they are given and may therefore have certain expectations," according to Backs. "In our studies, all patients thought they had received 'real' acupuncture." A fascinating question for the future will be whether relatively low-cost acupuncture can improve the prognosis for cardiac patients over the long term.

References:
Arnt V. Kristen, Boris Schuhmacher, Kathrin Strych, Dirk Lossnitzer, Hans-Christoph Friederich, Thomas Hilbel, Markus Haass, Hugo A. Katus, Antonius Schneider, Konrad M. Streitberger, Johannes Backs. Acupuncture Improves Exercise Tolerance of Heart Failure Patients - a Placebo-Controlled Pilot Study.

Source:
Dr. Johannes Backs
University Hospital Heidelberg

Article URL: http://www.medicalnewstoday.com/articles/193709.php
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PostPosted: 19-08-2010 13:28    Post subject: Reply with quote

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Acupuncture Not Superior To Sham Acupuncture In Knee Osteoarthritis
18 Aug 2010

Researchers from MD Anderson Cancer Center determined patients with osteoarthritis (OA) of the knee who are treated with traditional Chinese acupuncture (TCA) do not experience any more benefit than those receiving sham acupuncture (placebo). The team did find that the communication style of the acupuncturist could have a significant effect on pain reduction and satisfaction in patients. Full findings are now online and will publish in the September print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) cites OA as the most common type of arthritis affecting 27 million Americans age 25 and older. With the aging population OA is expected to increase and NIAMS estimates that by 2030 roughly 72 million people in the U.S. will be older than 65 years and at high risk for OA. Individuals with OA experience pain, stiffness and swelling in one or more joints and some may notice a crunching sound as bones rub against one another. Many patients seek alternative treatments such as acupuncture to reduce OA symptoms.

According to the National Center for Complementary and Alternative Medicine NCCAM), acupuncture is a key part of traditional Chinese medicine where health is achieved by maintaining a "balanced state" in the body and disease is caused by an imbalance or blockage in the flow of Qi (vital energy) along pathways known as meridians. Acupuncture is used to stimulate specific points on the body in order to remove these blockages to restore and maintain health. A 2007 NCCAM survey (included with the National Health Interview Survey) estimated 3.1 million U.S. adults had used acupuncture in the prior year.

In the current study, Maria Suarez-Almazor, M.D., Ph.D., and colleagues compared the efficacy of TCA with sham acupuncture in OA of the knee. Additionally, researchers measured the effects of provider-patent interactions in the response to acupuncture. A total of 455 knee OA patients received either TCA or sham acupuncture treatments and 72 healthy controls were included. Acupuncturists were trained to interact in 1 of 2 communication styles high ("I've had a lot of success with treating knee pain") or neutral ("It may or may not work for you") expectations. Patients were then randomized and nested within 1 of 3 style groups waiting list, high, or neutral.

Researchers found no statistically significant differences between patients in the TCA and those in the sham acupuncture group. The TCA and sham groups had substantial reductions in the joint-specific multidimensional assessment of pain (J-MAP) at -1.1 and -1.0, respectively while the control group saw a reduction of -0.1. J-MAP measures the intensity, frequency, and quality of pain with response ranges from 1 to 7 where higher values indicate more pain.

"We found a small, but significant effect on pain and satisfaction with treatment, demonstrating a placebo effect related to the clinician's communications style," said Dr. Suarez-Almazor. The team found significant differences in J-MAP pain reduction (0.25) and satisfaction (0.22) for those patients in the high expectations group compared with the neutral group. "The improvement in pain and satisfaction suggests that the benefits of acupuncture may be partially mediated through placebo effects related to the behavior of the acupuncturist," concluded Dr. Suarez-Almazor.

Source: Wiley - Blackwell

Article URL: http://www.medicalnewstoday.com/articles/198017.php
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PostPosted: 05-09-2010 14:23    Post subject: Reply with quote

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Acupuncture Helps Ease Side Effects And Symptoms Of Some Cancers
05 Sep 2010

Recent studies have shown that acupuncture can help control a number of symptoms and side effects -- such as pain, fatigue, dry mouth, nausea, and vomiting -- associated with a variety of cancers and their treatments. Experts from Memorial Sloan-Kettering Cancer Center's Integrative Medicine Service, who have either conducted or reviewed many of those studies, recommend that cancer patients interested in acupuncture seek a certified or licensed acupuncturist who has training or past experience working with individuals with cancer.

Acupuncture

Acupuncture treatment, a two-thousand-year-old component of traditional Chinese medicine, involves stimulating one or more predetermined points on the body, called acupoints, with needles for therapeutic effect. Heat, pressure, or electricity may be added to intensify the effect of the acupuncture needles. According to traditional Chinese medicine beliefs, energy flows throughout the body along channels, or "meridians." Specific acupoints are stimulated to increase energy flow along various channels throughout the body to a particular tissue, organ, or organ system.

Treatment is usually customized to treat each patient's particular symptoms. A typical acupuncture session, which takes about 30 minutes, involves the insertion of ten to 20 very thin, stainless steel needles. Most patients receiving acupuncture experience no pain from the insertion of the needles, and there is minimal risk of injury from acupuncture treatments, with reports of fewer than one adverse event in more than 10,000 treatments.

According to the Centers for Disease Control and Prevention, each year more than eight million Americans use acupuncture to treat different ailments. Studies have demonstrated its effectiveness in the treatment of a host of non-cancer-related health issues, such as back pain, chronic headaches, osteoarthritis, high blood pressure, infertility, and hot flashes. Its use for the treatment of symptoms and side effects of a variety of cancers has recently been investigated in a number of studies and reviews.

Acupuncture for Head and Neck Cancer

For many of the more than 100,000 individuals diagnosed with head and neck cancer each year in the United States, the cancer spreads from its primary location to lymph nodes in the neck. When this occurs, nerves known as spinal accessory nerves must also be removed along with the affected lymph node, which can lead to shoulder function problems.

A study conducted by Memorial Sloan-Kettering investigators and published in the April 2010 issue of the Journal of Clinical Oncology sought to determine if acupuncture could reduce pain and dysfunction in individuals with cancer of the head or neck who had received a surgical dissection of lymph nodes in their neck. The study evaluated 58 patients who were suffering from chronic pain or dysfunction as a result of neck dissection. For four weeks, study participants were randomly assigned into one of two groups: those receiving weekly acupuncture sessions and those receiving standard care, which included physical therapy, as well as pain and antiinflammatory medication.

The study found that individuals in the group receiving acupuncture experienced significant reductions in pain and dysfunction when compared with individuals receiving standard care. Individuals in the acupuncture group also reported significant improvement in xerostomia, a condition in which patients receiving adjuvant radiation therapy experience extreme dry mouth.

Acupuncture and Leukemia

Many people with leukemia try additional treatments outside their standard care, hoping to manage symptoms and, in some cases, to improve their treatment outcome. In a commentary on the subject in the September 2009 issue of Expert Reviews Anticancer Therapies, Memorial Sloan-Kettering investigators examined the results from available studies testing the effectiveness of such approaches. They report that among the complementary therapies used to decrease symptoms and side effects, acupuncture is very beneficial for symptom management.

For some leukemia patients, cancer chemotherapy drugs can damage the peripheral nervous system (a condition known as peripheral neuropathy), causing pain, numbness, tingling, swelling, and muscle weakness in various parts of the body, especially in the hands and feet. In some cases, doctors must reduce the chemotherapy dose in order to prevent the neuropathy from progressing further. Acupuncture has been found to decrease these difficult neuropathy symptoms, allowing the maximum amount of chemotherapy to be used, thereby increasing the patient's chance for a successful outcome.

Acupuncture is also known to reduce the effects of nausea caused by a variety of chemotherapy agents used to treat leukemia. Research has shown that timing the acupuncture sessions one to two days before chemotherapy infusion and continued weekly throughout the chemotherapy regimen produces the best results. In addition, the authors note that acupuncture has been proven safe for patients receiving the anticoagulation drugs Coumadin® or heparin during their leukemia treatment.

The review's authors note that, in general, it is important to distinguish between complementary therapies -- including acupuncture, self-hypnosis, yoga, meditation, and therapeutic massage -- and alternative therapies, which are unproven and ineffective, and may interfere with mainstream cancer treatments.

Acupuncture and Breast Cancer

A significant number of breast cancers have receptors for the hormone estrogen. These receptor-positive breast tumors are more likely to respond to therapy with anti-estrogen medications, which take advantage of the cancer cells' dependence on hormones for growth. Women with these tumors are often given treatment that blocks the production of estrogen, which is meant to slow the growth of the tumor. These treatments can induce early menopause, leading to symptoms such as hot flashes, fatigue, and excessive sweating. Because these women cannot receive hormone replacement therapy, which is usually used to treat such symptoms, doctors typically prescribe antidepressants such as the drug venlafaxine (Effexor).

A recent study examined whether acupuncture reduces some of these common side effects and produces fewer adverse effects than antidepressants. In the study, published in the February 2010 issue of the Journal of Clinical Oncology, 50 women with hormone-receptor positive breast cancer were assigned into one of two groups. The first group received 12 weeks of acupuncture, and the second group received treatment with venlafaxine.

Both groups experienced significant decreases in hot flashes, depressive symptoms, and other quality-of-life symptoms. However, women in the group taking venlafaxine began to re-experience their symptoms about two weeks after stopping drug therapy. In comparison, it took 15 weeks for the symptoms to return for women in the group receiving acupuncture. In addition, women in the acupuncture group reported no significant side effects during treatment, while the group taking venlafaxine experienced 18 incidences of adverse effects, including nausea, dry mouth, dizziness, and anxiety.

Finding the Right Acupuncturist for Cancer Patients

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) provides a list of practitioners who are nationally certified in Oriental medicine, acupuncture, Chinese herbology, and Asian bodywork therapy. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center has trained thousands of acupuncturists from across the United States and many other countries. Its previously face-to-face, three-day courses were replaced in April 2010 with Internet-based courses to facilitate international requests. The Integrative Medicine Service also maintains a list of cancer-trained acupuncturists. Our integrative medicine specialists stress the importance of using an acupuncturist who is NCCAOM certified or licensed and who has training in working with cancer patients.

Source: Memorial Sloan-Kettering Cancer Center

Article URL: http://www.medicalnewstoday.com/articles/199981.php
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PostPosted: 01-12-2010 13:20    Post subject: Reply with quote

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Acupuncture Changes Brain's Perception And Processing Of Pain
30 Nov 2010

Using functional magnetic resonance imaging (fMRI), researchers have captured pictures of the brain while patients experienced a pain stimulus with and without acupuncture to determine acupuncture's effect on how the brain processes pain. Results of the study, which the researchers say suggest the effectiveness of acupuncture, were presented today at the annual meeting of the Radiological Society of North America (RSNA).

"Until now, the role of acupuncture in the perception and processing of pain has been controversial," said lead researcher Nina Theysohn, M.D., from the Department of Diagnostic and Interventional Radiology and Neuroradiology at University Hospital in Essen, Germany. "Functional MRI gives us the opportunity to directly observe areas of the brain that are activated during pain perception and see the variances that occur with acupuncture."

fMRI measures the tiny metabolic changes that take place in an active part of the brain, while a patient performs a task or is exposed to a specific external stimulus.

In the study, conducted in close collaboration with the Department of Complementary and Integrative Medicine at University of Duisburg-Essen, 18 healthy volunteers underwent fMRI while an electrical pain stimulus was attached to the left ankle. Acupuncture needles were then placed at three places on the right side, including between the toes, below the knee, and near the thumb. With the needles in place, fMRI was repeated while electrical currents were again directed at the left ankle. The researchers then compared the images and data obtained from the fMRI sessions with no acupuncture to those of the fMRI sessions with acupuncture.

"Activation of brain areas involved in pain perception was significantly reduced or modulated under acupuncture," Dr. Theysohn said.

Specifically, fMRI revealed significant activation in the contralateral supplementary motor area, somatosensory cortex, precuneus bilateral insula and ipsilateral somatomotor cortex during electrical pain stimulation without acupuncture. During acupuncture, activation in most of these pain-processing areas of the brain was significantly reduced.

According to Dr. Theysohn, in addition to the assumed specific effects on the pain signal, acupuncture also affected brain activation in areas governing the patients' expectations of pain, similar to a placebo analgesic response.

The anterior insula, for example, plays a role in transforming pain sensation to cognition and represents a subjective component of pain sensation. The reduction in activation of the primary somatosensory cortex and the insula during acupuncture indicates an acupuncture-induced modulation of the sensory encoding of the painful stimulus.

"Acupuncture is supposed to act through at least two mechanisms-nonspecific expectancy-based effects and specific modulation of the incoming pain signal," Dr. Theysohn said. "Our findings support that both these nonspecific and specific mechanisms exist, suggesting that acupuncture can help relieve pain."

Coauthors are Kyung-Eun Choi, M.Sc., Elke Gizewski, M.D., Ph.D., Thomas Rampp, M.D., Gustav Dobos, M.D., Ph.D., Michael Forsting, M.D., Ph.D., and Frauke Musial, Ph.D.

Source:
Radiological Society of North America

Article URL: http://www.medicalnewstoday.com/articles/209596.php
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PostPosted: 29-03-2011 18:46    Post subject: Reply with quote

Some contrary news.

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Acupuncture For Pain No Better Than Placebo And Not Without Harm
24 Mar 2011

Although acupuncture is commonly used for pain control, doubts about its effectiveness and safety remain. Investigators from the Universities of Exeter & Plymouth (Exeter, UK) and the Korea Institute of Oriental Medicine (Daejeon, South Korea) critically evaluated systematic reviews of acupuncture as a treatment of pain in order to explore this question. Reporting in the April 2011 issue of PAIN®, they conclude that numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain, and serious adverse effects continue to be reported.

"Many systematic reviews of acupuncture for pain management are available, yet they only support few indications, and contradictions abound," commented lead investigator Professor Edzard Ernst, MD, PhD, Laing Chair in Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, UK. "Acupuncture remains associated with serious adverse effects. One might argue that, in view of the popularity of acupuncture, the number of serious adverse effects is minute. We would counter, however, that even one avoidable adverse event is one too many. The key to making progress would be to train all acupuncturists to a high level of competency."

Researchers carefully identified and critically examined systematic reviews of acupuncture studies for pain relief and case reviews reporting adverse effects. Reviews were defined as systematic if they included an explicit Methods section describing the search strategy and inclusion/exclusion criteria. Systematic reviews had to focus on the effectiveness of any type of acupuncture for pain. Of the 266 articles found, 56 were categorized as acceptable systematic reviews.

The authors observe that recent results from high-quality randomized controlled trials have shown that various forms of acupuncture, including so-called "sham acupuncture," during which no needles actually penetrate the skin, are equally effective for chronic low back pain, and more effective than standard care. In these and other studies, the effects were attributed to such factors as therapist conviction, patient enthusiasm or the acupuncturist's communication style.

If even sham acupuncture is as good as or better than standard care, then what is the harm? The answer lies in the adverse effect case studies. These studies were grouped into three categories: Infection (38 cases), trauma (42 cases) and other adverse effects (13 cases). Many of these adverse side effects are not intrinsic to acupuncture, but rather result from malpractice of acupuncturists. The most frequently reported complications included pneumothorax, (penetration of the thorax) and bacterial and viral infections. Five patients died after their treatment.

In an accompanying commentary, Harriet Hall, MD, states her position forcefully: "Importantly, when a treatment is truly effective, studies tend to produce more convincing results as time passes and the weight of evidence accumulates. When a treatment is extensively studied for decades and the evidence continues to be inconsistent, it becomes more and more likely that the treatment is not truly effective. This appears to be the case for acupuncture. In fact, taken as a whole, the published (and scientifically rigorous) evidence leads to the conclusion that acupuncture is no more effective than placebo."

The article is "Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews" by E. Ernst, Myeong Soo Lee and Tae-Young Choi (DOI: 10.1016/j.pain.2010.11.004). The accompanying commentary is "Acupuncture's claims punctured: Not proven effective for pain, not harmless" by Harriet Hall, MD (DOI: 10.1016/j.pain.2011.01.039). Both appear in PAIN®, Volume 152, Issue 4 (April 2011) published by Elsevier.

Source: Elsevier


Article URL: http://www.medicalnewstoday.com/articles/220037.php
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PostPosted: 05-06-2011 16:52    Post subject: Reply with quote

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Unexplained Symptoms Eased By Acupuncture

30 May 2011

Attending frequently with medically unexplained symptoms is distressing for both patient and doctor and effective treatment or management options are limited: one in five patients have symptoms that remain unexplained by conventional medicine. Studies have shown that the cost to the NHS of managing the treatment of a patient with medically unexplained symptoms can be twice that of a patient with a diagnosis.

A research team from the Institute of Health Services Research, Peninsula Medical School, University of Exeter, has carried out a randomised control trial and a linked interview study regarding 80 such patients from GP practices across London, to investigate their experiences of having five-element acupuncture added to their usual care. This is the first trial of traditional acupuncture for people with unexplained symptoms.

The results of the research are published in the British Journal of General Practice. They reveal that acupuncture had a significant and sustained benefit for these patients and consequently acupuncture could be safely added to the therapies used by practitioners when treating frequently attending patients with medically unexplained symptoms.

The patient group was made up of 80 adults, 80 per cent female with an average age of 50 years and from a variety of ethnic backgrounds who had consulted their GP at least eight times in the past year. Nearly 60 per cent reported musculoskeletal health problems, of which almost two-thirds had been present for a year.

In the three months before taking part in the study, the 80 patients had accounted for the following NHS experiences: 21 patient in-days; 106 outpatient clinic visits; 52 hospital clinic visits (for treatments such as physiotherapy, chiropody and counselling); 44 hospital visits for investigations (including 10 magnetic resonance imaging - MRI - scans); and 75 visits to non-NHS practitioners such as opticians, dentists and complementary therapists.

The patients were randomly divided into an acupuncture group and a control group. Eight acupuncturists administered individual five-element acupuncture to the acupuncture group immediately, up to 12 sessions over 26 weeks. The same numbers of treatments were made available to the control group after 26 weeks.

At 26 weeks the patients were asked to complete a number of questionnaires including the individualised health status questionnaire "Measure Yourself Medical Outcome Profile."

The acupuncture group registered a significantly improved overall score when compared with the control group. They also recorded improved wellbeing but did not show any change in GP and other clinical visits and the number of medications they were taking. Between 26 and 52 weeks the acupuncture group maintained their improvement and the control group, now receiving their acupuncture treatments, showed a 'catch up' improvement.

The associated qualitative study, which focused on the patients' experiences, supported the quantitative work.

This element identified that the participating patients had a variety of longstanding symptoms and disability including chronic pain, fatigue and emotional problems which affected their ability to work, socialise and carry out everyday tasks. A lack of a convincing diagnosis to explain their symptoms led to frustration, worry and low mood.

Participating patients reported that their acupuncture consultations became increasingly valuable. They appreciated the amount of time they had with each acupuncturist and the interactive and holistic nature of the sessions - there was a sense that the practitioners were listening to their concerns and, via therapy, doing something positive about them.

As a result, many patients were encouraged to take an active role in their treatment, resulting in cognitive and behavioural lifestyle changes, such as: a new self-awareness about what caused stress in their lives, and a subsequent ability to deal with stress more effectively; and taking their own initiatives based on advice from the acupuncturists about diet, exercise, relaxation and social activities.

Comments from participating patients included: "the energy is the main thing I have noticed. You know, yeah, it's marvellous! Where I was going out and cutting my grass, now I'm going out and cutting my neighbour's after because he's elderly"; "I had to reduce my medication. That's the big help actually, because medication was giving me more trouble...side effects"; and "It kind of boosts you, somehow or another."

Dr. Charlotte Paterson, who managed the randomised control trial and the longitudinal study of patients' experiences, commented: "Our research indicates that the addition of up to 12 five-element acupuncture consultations to the usual care experienced by the patients in the trial was feasible and acceptable and resulted in improved overall well-being that was sustained for up to a year.

"This is the first trial to investigate the effectiveness of acupuncture treatment to those with unexplained symptoms, and the next development will be to carry out a cost-effectiveness study with a longer follow-up period. While further studies are required, this particular study suggests that GPs may recommend a series of five-element acupuncture consultations to patients with unexplained symptoms as a safe and potentially effective intervention."

She added: "Such intervention could not only result in potential resource savings for the NHS, but would also improve the quality of life for a group of patients for whom traditional biomedicine has little in the way of effective diagnosis and treatment."

Source:
Andrew Gould
The Peninsula College of Medicine and Dentistry

Article URL: http://www.medicalnewstoday.com/releases/226866.php
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PostPosted: 06-06-2011 12:43    Post subject: Reply with quote

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Acupuncturists show that acupuncture doesn’t work, but conclude the opposite: journal fails

One wonders about the standards of peer review at the British Journal of General Practice. The June issue has a paper, "Acupuncture for ‘frequent attenders’ with medically unexplained symptoms: a randomised controlled trial (CACTUS study)". It has lots of numbers, but the result is very easy to see. Just look at their Figure.

There is no need to wade through all the statistics; it’s perfectly obvious at a glance that acupuncture has at best a tiny and erratic effect on any of the outcomes that were measured.

But this is not what the paper said. On the contrary, the conclusions of the paper said

Conclusion

The addition of 12 sessions of five-element acupuncture to usual care resulted in improved health status and wellbeing that was sustained for 12 months.


The whole story at:

http://www.dcscience.net/?p=4439
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PostPosted: 07-07-2011 12:57    Post subject: Reply with quote

You know the minor op done on knees, where they open up and poke about inside, sometimes trimming off bits of adhesions or loose cartilage? Well, truth is no one really knows why that works half the time, they just know it works to relieve pain, so they do it. The only difference between arthroscopy (the knee op) and acupuncture is that one is viewed as scientific and the other isn't. But that distinction is pretty random and anti-scietific of itself. So, go figure.
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PostPosted: 06-01-2012 23:28    Post subject: Reply with quote

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Acupuncture Reduces Protein Linked To Stress In First Of Its Kind Animal Study

21 Dec 2011

Acupuncture significantly reduces levels of a protein in rats linked to chronic stress, researchers at Georgetown University Medical Center (GUMC) have found. They say their animal study may help explain the sense of well-being that many people receive from this ancient Chinese therapy.

Published online in December in Experimental Biology and Medicine, the researchers say that if their findings are replicated in human studies, acupuncture would offer a proven therapy for stress, which is often difficult to treat.

"It has long been thought that acupuncture can reduce stress, but this is the first study to show molecular proof of this benefit," says the study's lead author, Ladan Eshkevari, Ph.D., an assistant professor at Georgetown's School of Nursing & Health Studies, a part of GUMC.

Eshkevari, who is also a nurse anesthetist as well as a certified acupuncturist, says she conducted the study because many of the patients she treats with acupuncture in the pain clinic reported a "better overall sense of wellbeing - and they often remarked that they felt less stress."

While traditional Chinese acupuncture has been thought to relieve stress - in fact, the World Health Organization states that acupuncture is useful as adjunct therapy in more than 50 disorders, including chronic stress - Eshevari says that no one has biological proof that it does so.

So she designed a study to test the effect of acupuncture on blood levels of neuropeptide Y (NPY), a peptide that is secreted by the sympathetic nervous system in humans. This system is involved in the "flight or fight" response to acute stress, resulting in constriction of blood flow to all parts of the body except to the heart, lungs, and brain (the organs most needed to react to danger). Chronic stress, however, can cause elevated blood pressure and cardiac disease.

Eshevari used rats in this study because these animals are often used to research the biological determinants of stress. They mount a stress response when exposed to winter-like cold temperatures for an hour a day.

Eshevari allowed the rats to become familiar with her, and encouraged them to rest by crawling into a small sock that exposed their legs. She very gently conditioned them to become comfortable with the kind of stimulation used in electroacupuncture - an acupuncture needle that delivers a painless small electrical charge. This form of acupuncture is a little more intense than manual acupuncture and is often used for pain management, she says, adding "I used electroacupuncture because I could make sure that every rat was getting the same treatment dose."

She then selected a single acupuncture spot to test: Zuslanli (ST 36 on the stomach meridian), which is said to help relieve a variety of conditions including stress. As with the rats, that acupuncture point for humans is on the leg below the knee.

The study utilized four groups of rats for a 14-day experiment: a control group that was not stressed and received no acupuncture; a group that was stressed for an hour a day and did not receive acupuncture; a group that was stressed and received "sham" acupuncture near the tail; and the experimental group that were stressed and received acupuncture to the Zuslanli spot on the leg.

She found NPY levels in the experimental group came down almost to the level of the control group, while the rats that were stressed and not treated with Zuslanli acupuncture had high levels of the protein.

In a second experiment, Eshevari stopped acupuncture in the experimental group but continued to stress the rats for an additional four days, and found NPY levels remained low. "We were surprised to find what looks to be a protective effect against stress," she says.

Eshevari is continuing to study the effect of acupuncture with her rat models by testing another critical stress pathway. Preliminary results look promising, she says.

The study was funded by the American Association of Nurse Anesthetists doctoral fellowship award to Eshevari, and by a grant from the National Institutes of Health's National Center for Complementary and Alternative Medicine. Co-authors include Georgetown researchers Susan Mulroney, Ph.D., Rupert Egan, Dylan Phillips, Jason Tilan, Elissa Carney, Nabil Azzam, Ph.D., and Hakima Amri, Ph.D. The authors disclose no conflicts of interest.
Article URL: http://www.medicalnewstoday.com/releases/239469.php
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PostPosted: 25-04-2012 10:42    Post subject: Reply with quote

Using acupuncture methods to deliver new reliefs.

Quote:
Pain Relief That Can Last 100 Times Longer Than A Traditional Acupuncture Treatment

25 Apr 2012

Scientists at the University of North Carolina at Chapel Hill have identified a new way to deliver long-lasting pain relief through an ancient medical practice.

In an article published in Molecular Pain, UNC researchers describe how exploiting the molecular mechanism behind acupuncture resulted in six-day pain relief in animal models. They call this new therapeutic approach PAPupuncture.

Principal investigator Mark J. Zylka, PhD, associate professor in the Department of Cell and Molecular Physiology and the UNC Neuroscience Center, said this is a promising study that moves his lab's work with prostatic acid phosphatase, known as PAP, towards translational research.

Several years ago, Zylka and members of his lab documented how injecting PAP into the spine eased chronic pain for up to three days in rodents. The only problem was PAP's delivery.

"Spinal injections are invasive and must be performed in a clinical setting, and hence are typically reserved for patients with excruciating pain," said Zylka. Though he had never received acupuncture or researched traditional Chinese medicine, Zylka said recent research showing how acupuncture relieved pain caught his eye.

"When an acupuncture needle is inserted into an acupuncture point and stimulated, nucleotides are released. These nucleotides are then converted into adenosine," said Zylka. Adenosine has antinociceptive properties, meaning adenosine can decrease the body's sensitivity to pain. The release of adenosine offers pain relief, but for most acupuncture patients that relief typically lasts for a few hours.

"We knew that PAP makes adenosine and lasts for days following spinal injection, so we wondered what would happen if we injected PAP into an acupuncture point?" Zylka said. "Can we mimic the pain relief that occurs with acupuncture, but have it last longer?"

To find out, Zylka and his lab injected PAP into the popliteal fossa, the soft tissue area behind the knee. This also happens to be the location of the Weizhong acupuncture point. Remarkably, they saw that pain relief lasted 100 times longer than a traditional acupuncture treatment. What's more, by avoiding the spine the researchers could increase the dose of PAP. A single injection was also effective at reducing symptoms associated with inflammatory pain and neuropathic pain.

"Pinning down the mechanisms behind acupuncture, at least in animal models, was critical," said Zylka. "Once you know what chemicals are involved, you can exploit the mechanism, as we did in our study."

The next step for PAP will be refining the protein for use in human trials. UNC has licensed the use of PAP for pain treatment to Aerial BioPharma, a Morrisville, N.C.-based biopharmaceutical company.

Zylka said PAP could be applicable to any area where regional anesthesia is performed to treat pain. And PAP has the potential to last longer than a single injection of local anesthetic - the class of drugs used in regional anesthesia.

"When it comes to pain management, there is a clear need for new approaches that last for longer periods of time," said Julie Hurt, PhD, a postdoctoral fellow in Zylka's lab.

References:

Zylka co-authored the paper with Hurt. The research was undertaken at UNC and was supported by the National Institute of Neurological Disorders and Stroke, a component of the National Institutes of Health.
University of North Carolina School of Medicine


http://www.medicalnewstoday.com/releases/244515.php.
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PostPosted: 08-09-2012 22:30    Post subject: Reply with quote

Another contrary report.

Quote:
Acupuncture treatment is not as safe as advertised
http://www.newscientist.com/article/dn22247-acupuncture-treatment-is-not-as-safe-as-advertised.html
18:44 06 September 2012 by Deborah MacKenzie

The first ever study of the adverse effects of acupuncture in state-funded acupuncture clinics in the UK has found that the procedure is largely safe, but not as safe as advertised. In extreme cases, it could even put lives at risk.

Despite this, claims that acupuncture is completely safe could soon lead to the procedure being funded by Medicare, the US government-funded medical benefits programme. Acupuncture is already government-funded in much of Europe.

Investigators from the National Patient Safety Agency, part of the UK's government-funded National Health Service, assembled all reports of adverse events following acupuncture treatment in NHS clinics between 2009 and 2011. In these clinics, acupuncture is provided by conventionally qualified doctors and therapists, who are also trained to perform acupuncture. This is offered in several NHS hospitals, GP's surgeries and nearly all NHS pain clinics.

The investigators found 325 reports of adverse effects. There is no data for the total number of acupuncture treatments given, so the frequency of these events cannot be calculated. But other studies in Germany and the UK have found adverse effects following some 10 per cent of treatments.

Some of the reports were merely of sloppy practice. In 100 cases, patients were left with needles still in them, sometimes hours longer than intended or even after they or the staff went home. Some needles subsequently had to be surgically removed.

Definition of harm

Of the 325 adverse reports, 309 were rated as involving little or no harm. This included 162 people experiencing dizziness and fainting when the needle was inserted.

Five people experienced lung collapse, or pneumothorax, caused by the needle puncturing the pleural membranes around the lung.

The fact that only one of these collapses was reported as "severe" – and one was listed as "no harm" even though lung collapse can be fatal – rings alarm bells for Edzard Ernst of the University of Exeter, a leading expert on the evidence-based evaluation of alternative medicine, who helped conduct the study.

"Clearly this is not a highly risky treatment," he says. "But acupuncturists are adamant that it is devoid of risk, and that is not the case." If a patient has trouble breathing after treatment and the acupuncturist does not suspect lung collapse, they could send the patient home, where, if both lungs go, the patient can die. "They are in denial. They don't realise there's a potential problem, and that is the problem."

Ernst says that studies of acupuncture in other countries and in the UK outside the NHS have revealed 86 deaths after acupuncture between 1965 and 2009, most of them from lung collapse. Another risk, he says, is to the 6 per cent of people who naturally have a hole in their breastbone, near an acupuncture point. The hole is covered with ligaments, so a doctor cannot feel it. "Acupuncture needles go right through and penetrate the membranes around the heart," with lethal effect, says Ernst.

The British Acupuncture Council, a professional association, cites two studies "showing the risk of a serious adverse reaction to acupuncture is less than 1 in 10,000. This is far less than many orthodox medical treatments".

Any such risk assessment, however, must be weighed against the treatment's benefits says Ernst. "Critical analysis of existing evidence shows acupuncture might help in back pain, osteoarthritis and nausea," he says. "That's about it. But the NHS uses it for just about anything, even smoking cessation." This means that even though the risks are small, "they could well outweigh the benefit, which is next to non-existent".

Leading US acupuncturist Phil Veneziano writing in the Huffington Post, says acupuncturists "provide a safe, side effect-free method of recovery" from post-operative pain and nausea, constipation, urinary difficulties, hypertension, anxiety and insomnia. He predicts that by 2014, the US health care laws could "formally recognise acupuncture as a profession, opening the door to Medicare coverage for acupuncture."

Journal reference: International Journal of Risk & Safety in Medicine, DOI: 10.3233/JRS-2012-0569
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PostPosted: 12-09-2012 14:10    Post subject: Reply with quote

And we bounce back to the plus side.

Quote:
Acupuncture Provides Relief For Chronic Pain, Say Researchers
http://www.medicalnewstoday.com/articles/250009.php
10 Sep 2012

Acupuncture for the treatment of chronic pain is better than placebo acupuncture (sham acupuncture) or no acupuncture at all, researchers from the Memorial Sloan-Kettering Cancer Center, New York, wrote in the JAMA journal Archives of Internal Medicine. This was their conclusion after gathering and analyzing data from 29 randomized controlled human studies.

The authors explained that acupuncture is used extensively for the treatment of chronic pain. However, its acceptance is mixed and there is controversy regarding its efficacy and value.

Several studies have shown that acupuncture can have a pain-lowering effect when administered by a qualified practitioner. In 2011, a German pain specialist, Dr. Winfried Meissner, found that acupuncture can help reduce pain in patients after surgery.

Other studies, however, have had unfavorable findings. In 2011, researchers from the Universities of Exeter & Plymouth, UK, and the Korea Institute of Oriental Medicine, found that there was very little compelling evidence that acupuncture reduces pain. They added that acupuncture was associated with some serious adverse events.

Andrew J. Vickers, D.Phil., and team carried out individual data meta-analyses, using information from several published randomized control studies from the USA, UK, Germany, Sweden and Spain involving 17,922 patients. Their aim was to find out what effect acupuncture has on some chronic pain conditions.

The authors wrote:

"We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain. Although the data indicate that acupuncture is more than a placebo, the differences between true and sham acupuncture are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to therapeutic effects."



An acupuncturist inserting needles into a patient's skin Placebo acupuncture involved pretending to stick needles into the patient with retractable needles that did not really perforate the skin, or ones that just went slightly into the surface, rather than penetrating deeper as occurs in proper acupuncture. Proper acupuncture was also compared to deactivated electrical simulation or detuned laser.

The people who were administered real acupuncture had pain scores 0.23, 0.16 and 0.15 lower (SDs, standard deviations) than those receiving the pretend acupuncture for back and neck pain.

The scientists concluded:

"Our results from individual patient data meta-analyses of nearly 18,000 randomized patients in high-quality RCTs provide the most robust evidence to date that acupuncture is a reasonable referral option for patients with chronic pain."
Accompanying Commentary in the Same Journal

In the same journal, Andrew L. Avins, M.D., M.P.H., of Kaiser-Permanente, Northern California Division of Research, Oakland, wrote that there is still an ambiguous relationship between conventional allopathic medical care and alternative and complementary medicine.

Dr. Avins wrote:

"At the end of the day, our patients seek our help to feel better and lead longer and more enjoyable lives. It's ideal to understand the mechanism of action, which carries the potential for developing more and better interventions. But the ultimate questions is: does this intervention work (or, more completely, do its benefits outweigh its risks and justify its costs)?.

"At least in the case of acupuncture, Vickers et al have provided some robust evidence that acupuncture seems to provide modest benefits over usual care for patients with diverse sources of chronic pain. Perhaps a more productive strategy at this point would be to provide whatever benefits we can for our patients, while we continue to explore more carefully all mechanisms of healing."
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PostPosted: 16-03-2013 13:20    Post subject: Reply with quote

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Understanding The Molecular Underpinnings Of Acupuncture's Success Could Increase Its Acceptance By Mainstream Medicine
http://www.medicalnewstoday.com/releases/257668.php

16 Mar 2013

While acupuncture is used widely to treat chronic stress, the mechanism of action leading to reported health benefits are not understood. In a series of studies at Georgetown University Medical Center (GUMC), researchers are demonstrating how acupuncture can significantly reduce the stress hormone response in an animal model of chronic stress.

The latest study was published in the April issue of Journal of Endocrinology.

"Many practitioners of acupuncture have observed that this ancient practice can reduce stress in their patients, but there is a lack of biological proof of how or why this happens," says the study's lead author, Ladan Eshkevari, PhD, an associate professor of nursing at Georgetown University School of Nursing & Health Studies, a part of GUMC. "We're starting to understand what's going on at the molecular level that helps explain acupuncture's benefit."

Eshkevari, a physiologist, nurse anesthetist and certified acupuncturist, designed a series of studies in rats to test the effect of electronic acupuncture on levels of proteins and hormones secreted by biologic pathways involved in stress response.

Eshkevari used rats because these animals are often used to research the biological determinants of stress. They mount a stress response when exposed to winter-like temperatures for an hour a day.

"I used electroacupuncture because I could make sure that each animal was getting the same treatment dose," she explains.

The spot used for the acupuncture needle is called "Zusanli," which is reported to help relieve a variety of conditions including stress. As with rats, that acupuncture point for humans is on the leg below the knee.

The study utilized four groups of rats for a 10-day experiment: a control group that was not stressed and received no acupuncture; a group that was stressed for an hour a day and did not receive acupuncture; a group that was stressed and received "sham" acupuncture near the tail; and the experimental group that were stressed and received acupuncture to the Zusanli spot on the leg.

The researchers then measured blood hormone levels secreted by the hypothalamus pituitary adrenal (HPA) axis, which includes the hypothalamus, the pituitary gland and the adrenal gland. The interactions among these organs control reactions to stress and regulate digestion, the immune system, mood and emotions, sexuality and energy storage and expenditure.

They also measured levels of NPY, a peptide secreted by the sympathetic nervous system in rodents and humans. This system is involved in the "flight or fight" response to acute stress, resulting in constriction of blood flow to all parts of the body except the heart, lungs and brain (the organs most needed to react to danger). Chronic stress, however, can cause elevated blood pressure and cardiac disease.

"We found that electronic acupuncture blocks the chronic, stress-induced elevations of the HPA axis hormones and the sympathetic NPY pathway," Eshkevari says. She adds that the rats receiving the sham electronic acupuncture had elevation of the hormones similar to that of the stress-only animals.

Eshkevari says this research complements her earlier reported work that focused only on NPY. In that study, Eshkevari and her team found that NPY levels were reduced in the experimental group almost to the level of the control group, while the rats that were stressed and not treated with Zusanli acupuncture had high levels of NPY (Experimental Biology and Medicine Dec. 2011).

"Our growing body of evidence points to acupuncture's protective effect against the stress response," she continues. Eshkevari says additional research is needed to examine if acupuncture would be effective in reducing hormone levels after the animals are exposed to the stress of cold temperatures, and whether a similar observation can be made in humans.
References:

The study was funded by the American Association of Nurse Anesthetists doctoral fellowship award to Eshkevari.

Co-authors include Georgetown researchers Susan Mulroney, PhD, and Eva Permaul. The authors disclose no conflicts of interest.
Georgetown University Medical Center
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