Dr. Yanhui Qi says some people are skeptical when they first bring their animals in for acupuncture treatments at his Calgary clinic. Qi says he enjoys helping dogs, cats and horses using holistic veterinary techniques.
Acupuncture reduces intestinal inflammation in patients with Crohn’s disease, reverses tissue damage, and improves the quality of life. Until now, how acupuncture achieves these results has gone unanswered. Researchers sought to solve this mystery and came up with concrete answers. With the help of immunohistochemistry, researchers discovered how acupuncture works for these patients.
Crohn’s disease is an inflammatory bowel disease (IBD) characterized by abdominal pain, diarrhea, intestinal obstructions, abdominal masses, fatigue, nausea, mouth ulcers, and many other disruptions of the gastrointestinal system. Demographically, it disproportionately affects Scandinavians and Ashkenazim Jewish people. Crohn’s disease often affects the colon, anus, and terminal ileum (the distal aspect of the small intestine connecting to the cecum). Deep intestinal ulcerations with a patchy distribution throughout the gastrointestinal system help to distinguish Crohn’s disease from ulcerative colitis. Crohn’s disease has a serpiginous distribution of inflammation whereas ulcerative colitis has a contiguous distribution of inflammation.
Acupuncture and moxibustion have been shown to improve CDAI (Crohn’s Disease Activity Index) scores in modern research. CDAI scores are a method of measuring clinical responses to medicine and medical procedures by quantifying responses and remissions of Crohn’s disease. The researchers note that studies show that acupuncture improves CDAI scores, quality of life, increases hemoglobin levels, and reduces CRP levels for Crohn’s disease patients.
CRP (C-reactive protein) is determined by a blood test and quantifies inflammation levels. High levels indicate inflammation, often due to infections and chronic disease. The research demonstrates that acupuncture significantly lowers CRP levels for Crohn’s disease patients. With the help of an Olympus flourescent microscope, the researchers learned how acupuncture and moxibustion induce a powerful anti-inflammatory response in human patients with Crohn’s disease.
A confirmation of acupuncture and moxibustion’s benefits became apparent in a before and after intestinal biopsy comparison. Prior to acupuncture and moxibustion, patients had a significantly elevated level of giant, multinucleated cells in granulomas. Inflammatory and necrotic cells infiltrated the center of the granulomas. The mucosa epithelium was either damaged or completely absent. Lymphocytes infiltrated the lamina propria and intestinal glands were damaged. The glands contained necrotic, inflammatory, and multinucleated giant cells. After acupuncture and moxibustion, significant improvements were documented. The researchers note that the “intestinal mucosal epithelium was intact, the intestinal glands were reorganized, and less inflammatory cells infiltrated.”
The researchers carefully mapped the biological mechanisms regulated by acupuncture and moxibustion that achieved successful clinical results. What they discovered was that acupuncture and moxibustion induce a homeostatic response on the cellular level. Acupuncture and moxibustion relieved intestinal inflammation by regulating the ratio of inflammatory response cells. Proinflammatory Th17 cells and anti-inflammatory Treg cells were restored to normal levels and intestinal inflammation subsequently reduced. The researchers note this “study shows that moxibustion and acupuncture can reduce the number of Th17 cells and downregulate the expression of Th17-related molecules IL-17 and RORγt and increase the number of Treg cells and upregulate the expression of Treg transcription factor FOXP3 in the intestinal mucosa of CD (Chron’s disease) patients.” They add, “The present study showed that moxibustion and acupuncture can regulate and restore the balance between Th17 and Treg cells in intestinal mucosa of patients with CD."
The randomized study compared the results of acupuncture and moxibustion against a sham-placebo control group to ensure the validity of the results. Imaging, endoscopy, and histopathological exams confirmed the results. The research team shared the exact acupuncture and moxibustion procedures used to achieve clinical success. First, let’s look at the cellular changes induced by acupuncture and moxibustion. Next, we go over the exact acupuncture and moxibustion treatment protocol that helped the patients.
Citing Hovhannisyan et al., the researchers note, “An imbalance between Th17 and Treg cells constituted a key step in the disruption of intestinal homeostasis and is one of the major contributors to the development and progression of CD (Crohn’s disease).” TH17 (T helper 17) cells exert proinflammatory responses while Tregs (regulatory T cells, suppressor T cells) exert anti-inflammatory responses, especially in the case of auto-immune disorders. Crohn’s disease, which is often understood as an autoimmune disease, is characterized by unregulated proinflammatory responses. The study documents that acupuncture and moxibustion regulate the cells thereby balancing proinflammatory and anti-inflammatory responses.
The RORγt protein promotes differentiation of cells into proinflammatory Th17 cells. TH17 cells secrete proinflammatory cytokines including IL-17, which creates powerful proinflammatory responses. This causes neutrophils to migrate towards infections as part of the inflammatory cascade. Acupuncture and moxibustion downregulate IL17, RORγt, and TH17 cells.
The researchers add that “Th17 cells are the major contributor to inflammation in CD (Crohn’s disease)” and IL-17 is positively correlated with Crohn’s disease severity. This study demonstrates that acupuncture and moxibustion “reduced the number of TH17 cells and inhibited the expression of TH17-related molecules IL-17 and RORγt in the intestinal mucosa. It also increased the number of Treg cells and the expression of Treg-specific transcription factor FOXP3, thus restoring the ratio of the two cell types."
The researchers note that “a reduction in the number or function of Treg cells might be a major cause of the pathogenesis of Crohn’s disease. Tregs can suppress intestinal mucosal inflammation induced by innate or acquired immunity. FOXP3 and IL-2 promote the differentiation of Treg cells. Reduced numbers of Treg cells and deficiency in their function can cause damage in the intestinal mucosa, resulting in CD (Crohn’s disease).” Tregs can inhibit the proliferation of Th cells and subsequent production of inflammatory factors although they may differentiate into Th17 cells in other instances. Research demonstrates that reduced Tregs and FOXP3 in the bloodstream are correlated with Crohn’s disease. Moreover, the ratio of Treg to Th17 cells both in the intestinal mucosa and peripheral bloodstream is reduced in patients with Crohn’s disease. The researchers note that “restoring the balance between these cells is essential for the treatment of intestinal inflammation in CD.” Acupuncture and moxibustion restored the balance between these cells and testing also revealed significant positive patient clinical improvements. Treatment
Acupuncture was administered at the following acupoints:
Zusanli (ST36)
Shangjuxu (ST37)
Sanyinjiao (SP6)
Taixi (KI3)
Gongsun (SP4)
Taichong (LR3)
The acupuncture needles were 0.30 mm x 25 - 40 mm. Needle depth was between 20 - 30 mm and manual acupuncture techniques were used to elicit the de qi response. Needle retention time was 30 minutes. Both acupuncture and moxibustion were administered three times per week for 12 weeks for a grand total of 36 acupuncture combined with moxibustion sessions.
Moxibustion was administered at the following acupoints:
Tianshu (ST25)
Qihai (CV6)
Zhongwan (CV12)
Moxa cones of a 16 mm height and a 17 mm diameter were placed atop of an herb cake. Two moxa cones were burned on the herbal cakes place atop of each acupoint. The herbal cakes formed from a paste made from a fine herbal powder mixed with maltose and water. The paste was used to form the 28 mm diameter x 5 mm height cakes made primarily of the following herbs:
Coptis chinensis (Huang Lian)
Radix Aconiti Lateralis (Fu Zi, aconite)
Cortex Cinnamomi (Rou Gui, cinnamon bark)
Radix Aucklandiae (Mu Xiang)
Flos carthami (Hong Hua, saffron)
Salvia miltiorrhiza (Dan Shen)
Angelica sinensis (Dang Gui)
Patients with Crohn’s disease are often treated with corticosteroids, immunosuppressants, aminosalicylates, and anti-TNF-alpha medications. This research demonstrates that acupuncture combined with herb-partitioned moxibustion is another helpful treatment regime for patients with Crohn’s disease. In addition, the research has measured how acupuncture and moxibustion affect cellular responses and secretions to reduce intestinal inflammation for patients with Crohn’s disease.
Anxiety is becoming increasingly common, as are the drugs prescribed for it. Like any complex health problem, anxiety is best seen as a condition that has many causes.
It appears that while there are hereditary tendencies toward anxiety, for most of us it does not become a problem unless triggered, typically by our lifestyles. While it is quite common — 18 percent of the adult population is affected by it every year — only about 4 percent of the population is severely impacted by the disease.
Anxiety sometimes is described as an imbalance in the chemistry of the brain. The biggest influence on our brain chemistry is our diet. A healthy brain balance is supported by — this should be a surprise to no one — a healthy diet. Highly processed foods, artificial flavorings and preservatives, crops raised on chemicals instead of fertile soil and animals raised on grains instead of their natural foods all affect our brains. This especially is true of sugar, which causes a blood sugar “spike” and then a “crash” that stresses our systems, including the brain.
The dietary recommendations for anxiety are the same for diabetes, heart disease, obesity, etc. Eat whole, minimally processed, preferably organic foods and avoid or at least limit “non-foods,” such as soda, chips, ice cream and pastries.
Of course, chronic stress is a huge trigger for anxiety. Over time, the effects of stress build up in the body; if it is not released somehow, it can become a problem. Exercise is one of the best ways to address this problem; just walking 30 minutes per day helps. Doing just the opposite — sitting quietly, without the computer or TV on, for 5 minutes, then gradually working your way up to 10 minutes or more — can go a long way toward easing this build up of stress and anxiety.
On the treatment side, plenty of wellness options are available. In my experience, acupuncture is one of the most effective. There are many different approaches in acupuncture, ranging from using several needles throughout the body to using only a few select points or even treating only ear points. Auriculotherapy, acupuncture to the ears, has been increasingly used by the military with good results.
Not every patient reacts the same. Sometimes, a few styles have to be tried before the patient gets the full benefit.
There also are herbs used to control anxiety. One of the key benefits of herbals is the fact that they do not have serious side effects, like anti-anxiety medications. Their downside is poor quality control. In a recent report, the attorney general of New York had “off the shelf” herbal supplements tested from stores including Walmart, Target and GNC. A shocking 80 percent of the supplements had none of the active ingredients listed on the bottle. Contaminants also were found in the supplements. This is why I do not recommend buying herbals at a local store. I use a company that has their products extensively tested for quality and to ensure the dosage is consistent, and they provide information and training on proper usage, including drug interactions.
There is natural, drug-free help for many, if not most, anxiety sufferers. In my experience, the most severe cases seem to respond best to medication, but the majority of patients can control their symptoms naturally, with lifestyle changes and some wellness-based care.
Acupuncture speeds recovery from lumbar disc herniations. Researchers tested a protocol that increased the efficacy of electroacupuncture procedures for disc herniations by adding Chinese herbal medicine iontophoresis. They discovered that the combined therapy of electroacupuncture plus herbal iontophoresis enhances clinical efficacy with a significant synergistic effect.
Patients had greater pain relief and lumbar functional improvements with the combination therapy. The total effective rate of electroacupuncture only was 87.5%. The combined therapy approach had a total effective rate of 95.0%. McGill and Japanese Orthopedic Association assessments using a Visual Analogue Scale (VAS) were used to calculate improvements.
A lumbar intervertebral disc herniation is a rupture of the annulus fibrosus that causes extrusion of the nucleus pulposus from the center of the disc. This often causes low back pain, weakness, or numbness that may radiate to the legs and feet. The researchers confirmed disc herniations for participants with diagnostic tests including CT scans, MRIs, and a positive Lasegue’s or Bragard’s sign. Patients were also evaluated with X-rays and an assessment of range of motion restrictions and pain levels. A total of 80 patients from the rehabilitation center at the Second Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine (TCM) participated in the study. Acupuncture Points
The researchers used the following acupuncture points:
GB34 (Yanglingquan, affected side for L4-5 herniations)
BL40 (Weizhong, affected side for L5-S1 herniations)
Acupuncture Techniques
Disposable, single-use, sterile filiform needles of 0.30 mm diameter and a 40-75 mm length were used. Jiaji points were needled with 50 mm needles to a depth of approximately 40 mm. Needles were angled slightly towards the spine. Manual acupuncture was subsequently applied with an even reinforcing-reducing technique. The researchers note that the optimal response is if the patient reported a sensation radiating downwardly towards the buttocks and leg on the affected side. Electroacupuncture was then applied to the Jiaji points of the affected vertebral level. A sparse-dense setting was used with a 2 - 100 Hz frequency. Intensity was set to patient comfortability levels.
GB30 was needled using 75 mm needles and the remaining points were needled with 40 mm needles perpendicularly with the addition of the even reinforcing-reducing technique. The treatment duration was thirty minutes per acupuncture session. Acupuncture treatments were applied once per day for 10 days followed by a three day break from treatments. Next, another course of ten acupuncture treatments over ten days was applied for a total of two courses of care. Chinese Herbs
Iontophoresis is the administration of a substance through the skin by using a direct electric current. An LD-AE thermal treatment device was used to apply the current to the Chinese medicinal herbs. The herbs used in the iontophoresis procedure were:
Qiang Huo (Rhizoma et Radix Notopterygii)
Du Huo (Radix Angelicae Pubescentis)
Xuan Shen (Radix Scrophulariae)
Bi Xie (Rhizoma Dioscoreae Hypoglaucae)
Sheng Di Huang (Radix Rehmanniae)
Shu Di Huang (Radix Rehmanniae preparata)
Dang Gui (Radix Angelicae Sinensis)
Du Zhong (Cortex Eucommiae)
Fang Feng (Radix Saposhnikoviae)
Rou Gui (Cortex Cinnamomi)
Gui Zhi (Ramulus Cinnamomi)
Bai Zhi (Radix Angelicae Dahuricae)
Ru Xiang (Olibanum)
Mo Yao (Myrrha)
Tian Ma (Rhizoma Gastrodiae)
A decoction was made of the herbal formula and cotton pads were soaked in it. The cotton was squeezed dry and placed over the electrodes. The positive electrodes were bilateral to the affected disc and the negative electrodes were placed distally on the side of the radiated pain or tender points on the buttocks. Sand packets were placed over the electrodes with cotton to compress and immobilize the cotton pads. The treatment was administered for thirty minutes per session. Findings
The researchers reviewed current studies and commented on a few aspects of acupuncture therapy. Citing Zhao et al., they note that Jiaji electroacupuncture improves microcirculation to affected regions, speeds cell metabolism, transforms or reduces inflammatory substances, and reduces edema. Citing Yan et al., the researchers note that electroacupuncture “can alleviate pain by inhibiting the pathological reaction in the cerebral cortex through increasing opioid peptide release of periphery inflammatory tissues.”
Citing several studies (Yang et al., Yuan et al., Li et al.), the researchers note that electroacupuncture “at contralateral Jiaji (EX-B2) points can help to eliminate aseptic inflammation in intervertebral space through the current impulse, alleviate inflammatory irritation, and relieve compression to the nerve root.” Citing Chen et al., they add that electroacupuncture accelerates tissue metabolism, nurtures tissues, and reduces edema by stimulating rhythmic muscle contractions. Citing Cai et al., the researchers note that iontophoresis of Chinese herbal medicine increases blood circulation, relaxes muscles, and increases the efficacy of electrotherapy. Evaluation
The researchers note that “EA (electroacupuncture) at lumbar Jiaji (EX-B2) points combined with iontophoresis of Chinese medicine can obtain better analgesic effect than EA alone. In addition, the effect tends to increase with time.” They add that the combined therapeutic approach speeds recovery, improves lumbar functions, and improves the pain relief therapeutic efficacy.
Acupuncture was shown to lessen pain and reduce the underlying inflammation in pediatric patients with a diagnosis of acute appendicitis, according to a study published in The Journal of Alternative and Complementary Medicine, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers (http://www.liebertpub.com). The article is available free on The Journal of Alternative and Complementary Medicine website until June 12, 2015.
Alan L. Nager, MD, MHA and coauthors from Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California assessed subjective pain among pediatric patients immediately before and 20 minutes after treatment by a licensed acupuncturist. The researchers also measured two biomarkers of inflammation in blood samples taken before, during, and 30 minutes after needle placement.
In the article "Effects of Acupuncture on Pain and Inflammation in Pediatric Emergency Department Patients with Acute Appendicitis: A Pilot Study," the authors report that the patients' subjective pain decreased, likely due to the acupuncture treatment.. Furthermore, one of the inflammatory biomarkers (white blood cell count) "showed a modest and noticeable drop," suggesting "that the effectiveness of acupuncture may have a biophysiological basis."
Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic - Abstract
Published: 08 May 2015
OBJECTIVE: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief.
METHODS: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes.
RESULTS: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P = .001). After 60 minutes, mean VAS scores of groups I and III (P = .753) were similar. The mean VAS score of group III was lower than that of group II (P = .013). After 120 minutes, the difference in the VAS scores was (P = .000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P = .488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS.
CONCLUSIONS: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality.
Written by:
Kaynar M, Koyuncu F, Buldu İ, Tekinarslan E, Tepeler A, Karatağ T, İstanbulluoğlu MO, Ceylan K.
Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey; Department of Emergency Medicine, Beyhekim State Hospital, Konya, Turkey; Department of Urology, Mevlana University, Faculty of Medicine, Konya, Turkey; Department of Urology, Konya Education and Research Hospital, Konya, Turkey; Department of Urology, Bezmialem Vakıf University, Faculty of Medicine, Istanbul,Turkey. mekaynar@gmail.com
Reference: Am J Emerg Med. 2015 Feb 25. pii: S0735-6757(15)00122-9. doi: 10.1016/j.ajem.2015.02.033
Acupuncture Effective for Post-Tonsillectomy Pain in Children
Last Updated: May 06, 2015.
Less pain, analgesic drug consumption for children treated with acupuncture, standard analgesics
Acupuncture, in addition to conventional analgesic treatment, is an effective treatment for post-tonsillectomy pain in children, according to a study published in the June issue of Pediatric Anesthesia.
WEDNESDAY, May 6, 2015 (HealthDay News) -- Acupuncture, in addition to conventional analgesic treatment, is an effective treatment for post-tonsillectomy pain in children, according to a study published in the June issue of Pediatric Anesthesia.
Peter Gilbey, M.D., from the Ziv Medical Center in Safed, Israel, and colleagues examined whether acupuncture, in addition to conventional analgesic treatment, would be effective for post-tonsillectomy pain in children. Sixty children, aged 3 to 12 years, undergoing tonsillectomy were randomized to receive conventional postoperative analgesic treatment or the same regimen plus acupuncture.
The researchers found that the children assigned to the acupuncture group had less pain and less analgesic drug consumption. In addition, the acupuncture group reported higher patient/parent satisfaction with analgesic treatment scores. There were no adverse effects recorded.
"Acupuncture is a safe treatment, well tolerated by children aged 3 to 12 years and by their parents," the authors write. "Additional studies are warranted to further evaluate the efficacy of acupuncture for postoperative and perhaps other pain relief. There is a need for further research regarding intraoperative acupuncture and the long-term analgesic effect of acupuncture."
Acupuncture reduces cholesterol. Researchers measured the effects of needling acupuncture point ST40 (Fenglong) on plasma cholesterol levels.
In a laboratory experiment, electroacupuncture successfully downregulated LDL cholesterol. Simultaneously, electroacupuncture downregulated several proinflammatory macrophages linked to dyslipidemia: MCP-1, ICAM-1, IL-1gamma. The researchers conclude that electroacupuncture at ST40 downregulates plasma total cholesterol, LDL cholesterol and proinflammatory macrophages in cases of hyperlipidemia.
A related laboratory experiment reveals similar findings. Zhang, et. al., conclude that electroacupuncture lowers levels of cholesterol and triglycerides in cases of high cholesterol. Acupuncture points LI11 (Quchi), CV12 (Zhongwan) and ST40 effectively lowered LDL cholesterol, total cholesterol and triglycerides.
Nitric Oxide Ling Li, et. al., concur that acupuncture lowers both cholesterol and triglycerides. The laboratory research measured biochemical responses to electroacupuncture at acupoint ST40 to map the mechanisms by which acupuncture reduces hyperlipidemia. The study documents that electroacupuncture induces expression of nNOS and Mt1. The NNOS enzyme mediates nitric oxide signaling and plays an important role in cellular signaling, vascular tone, blood pressure, insulin secretion, airway tone, angiogenesis and peristalsis. Mt1 plays an important role in the protection against oxidative stress. Based on these findings, the researchers conclude that electroacupuncture and its effect on nitric oxide signaling transduction is physiologically related to its cholesterol and triglyceride lowering effects.
St 40 (By KVDP/Wikimedia Commons)
Foam Cells
Y. F. Chen, et. al., conclude that acupuncture prevents and reverses dangerous cellular accumulations of fatty materials in cases of high cholesterol. The laboratory research confirms that needling ST40 prevents and reverses the formation of foam cells. This type of cell forms at the site of fatty streaks and is the beginning of atherosclerotic plaque formation in blood vessels. The presence of foam cells is indicative of an increased risk of heart attacks and strokes. Based on the research, the investigators note that acupuncture could “play an essential role in treating hyperlipidemia and stopping it from developing into a further level.”
Oxidized LDL cholesterol creates inflammation within blood vessels. Macrophages are attracted to the site of inflammation and consume the LDL cholesterol. Ordinarily, macrophages defend against bacteria and other pathogens. However, macrophages may become engulfed in fatty materials when attempting to eliminate excess cholesterol. Under a microscope, one can see that the macrophages become overrun with cholesterol and other fatty materials. The damaged macrophages take on a foamy appearance, hence the name foam cell. Foam cells indicate that dangerous plaques are beginning to form within the vessels. The researchers conclude that electroacupuncture at acupuncture point ST40 “prevents and reverse(s) the formation of foam cell(s).” In this way, acupuncture helps to fight hyperlipidemia and prevent heart disease.
The research demonstrates that electroacupuncture at ST40 “significantly prohibits the transformation of macrophage(s) into foam cell(s).” The researchers measured sharp reductions in foam cells as a result of acupuncture. Stimulation of acupoint ST40 was shown to decrease the cholesterol content of macrophages.
Cells decrease cholesterol levels can in two ways. The first way is to convert cholesterol into cholesterol esters. This method is limited because it may overrun cells with esters and consequent toxicity. Needling acupuncture point ST40 accomplishes cholesterol reduction by another method that is completely non-toxic. ST40 stimulation increases the rate of cholesterol efflux from macrophages. Cholesterol efflux is a process of eliminating cholesterol from cells that is regulated by intracellular transporters including ATP proteins A1, G1 and B1. Unlike the cholesterol ester process, the efflux process has a virtually unlimited capacity to reduce cholesterol because there is no danger of building up excess cellular cholesterol esters. Needling ST40 with electroacupuncture activates an important, safe and powerful method for cells to reduce excess cholesterol content.
The recent foam cell research on the beneficial effects of acupuncture on macrophages comes at a time when other remarkable research has emerged. Recently, an investigation published in Molecular Neurobiology reveals that acupuncture reduces inflammation and muscle pain by downregulating M1 macrophages (proinflammatory cells) and upregulating M2 macrophages (antiinflammatory cells). The study measured responses in muscle tissues and confirms that M1 to M2 macrophage phenotype switching is triggered by acupuncture stimulation. Acupuncture stimulates biological actions wherein inflammatory responses are reduced and cellular healing responses are initiated. About HealthCMi: The Healthcare Medicine Institute (HealthCMi) publishes news, research and acupuncture continuing education courses online for acupuncture CEU and PDA credit. Learn more at www.healthcmi.com *Image of “acupuncture needle” via Shutterstock
Acupuncture relieves Parkinson’s disease symptoms. Researchers document the ability of acupuncture to reduce pain, anxiety, depression, hot flashes and abnormal sweating in a clinical case history. The patient responded with significant positive patient outcomes after a 2 week regime of acupuncture treatments given at a rate of five days per week.
Parkinson’s disease is a progressive nervous system disorder affecting movement. Changes include the onset of tremors, slowness of movements, shuffling, difficulty swallowing, fainting, reduced arm sway, rigidity and dysfunction of speech and gait. There is no known biomedical cure but medications including levodopa, COMT inhibitors, MAO-B inhibitors, dopamine agonists and other medications are used to control symptoms. Surgical interventions include the implantation of deep brain stimulators.
Acupuncture successfully reduces pain, autonomic nervous system dysfunction, and mental illness in Parkinson’s disease patients. Researchers from the Aizu Medical Center (Fukushima Medical University) delivered the patient care and collected the data. Additional support and came from an investigator at the Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (Yamagata University).
The case history documents acupuncture’s ability to address specific concerns of an 81 year old female patient suffering from Parkinson’s disease. Complications included a history of hypertension and lumbar fracture. The patient had been prescribed medications including anti-inflammatory and psychiatric drugs. Her symptoms persisted and acupuncture was initiated.
Manual acupuncture was applied at acupuncture points: LR3, LI4, KI5, KI7, SP6, GB34, BL18, BL15, GB20. Needles were retained for ten minutes per session. Electroacupuncture at 1 Hz for 7 minutes was applied to: KI10, LR9, BL23, BL25. The researchers note that the electroacupuncture was applied to relax the muscle tension. Seirin brand acupuncture needles of 40 – 50 mm length and 0.14 – 0.18 diameter were used. The researchers note that Traditional Chinese Medicine (TCM) theory guided the needle selection process. UB15, LR3, and SP6 were chosen for their ability to treat both depression and anxiety. LR3, KI7, BL18, and GB34 were chosen for their ability to treat hot flashes and paroxysmal sweating.
The researchers note that the patient’s lower leg pain decreased. (Shutterstock)
The researchers note that the patient’s lower leg pain decreased. Hot flashes and paroxysmal sweating incidences reduced. The patient showed very significant reductions in depression and anxiety scores. In addition, her “steps became larger” and there was a significant reduction in bradykinesia, a complication often correlated with Parkinson’s disease characterized by slowness and impairment of movements and reflexes.
In related research, University of Arizona doctors find acupuncture effective for the treatment of balance and gait disorders in Parkinson’s disease patients. The research team from the surgery and neurology departments measured significant clinical improvements in overall balance, gait speed and stride length. The results were published in Neurology, the official journal of the American Academy of Neurology.
Patients were randomly assigned to an acupuncture group or a control group. The acupuncture group received electroacupuncture. The control group received sham acupuncture to rule out variables including the placebo effect. Patients received one treatment per week for three weeks and each treatment duration lasted a total of 30 minutes.
Objective measurements were taken from various positions and during many types of activities. Balance measurements included assessment of the relationship between the mediolateral center of mass sway with the anteroposterior sway. These measurements were taken with the eyes open, closed and during multitasking. Gait measurements were taken during fast walking, postural transitions and related activities.
The researchers tabulated the results and measured an overall improvement in balance by 31% in the acupuncture group. Gait speed improved by 10% and stride length increased by 5% for patients receiving true acupuncture. Control group patients showed no improvements.
Balance, gait and stride length significantly improved due to the application of electroacupuncture. Use of a sham acupuncture control group eliminated the possibility of the placebo effect in the final results. As a result, the University of Arizona doctors conclude, “EA (electroacupuncture) is an effective therapy in improving certain aspects of balance and gait disorders in PD (Parkinson’s disease).”
Herbal medicine research reveals benefits for Parkinson’s disease patients. (Shutterstock)
Herbal medicine research reveals benefits for Parkinson’s disease patients. That the herbal formula Yi Gan San exhibits neuroprotective effects and rescues dopaminergic neurons from toxicity. The Acupuncture & Meridian Science Research Center at Kyung Hee University conducted research showing that Yi Gan San is correctly used for the management of neurodegenerative disorders. Yi Gan San showed significant neuroprotection in an induced Parkinsonian mouse model. The study notes that “in the mouse Parkinson’s disease model, treatment with Yi-Gan San also significantly improved motor functioning and prevented dopaminergic loss.”
In another study, The Journal of Brain Disease reported that Yi Gan San may be helpful in treating schizophrenia and many neuropsychological disorders because it has been shown to restore glutathione levels in the brain. In yet another study published in Progress in Neuro-Psychopharmacology and Biological Psychiatry, the Shimane School of Medicine concluded that Yi Gan San is a serotonin modulator and is a “safe and useful” formula for treating behavioural and psychological symptoms of dementia and borderline personality disorder. That study also shows a statistically significant improvement in tardive dyskinesia, psychosis, schizophrenia,
Yi Gan San (Restrain the Liver Powder) contains Dang Gui, Fu Ling, Bai Zhu, Gou Teng, Chuan Xiong, Chai Hu, and Gan Cao. The formula is often used for headaches, dizziness, anxiety, panic attacks, teeth grinding, chills & fever, seizures, palpitations, infantile epilepsy, disturbed dreams, insomnia, and spasms. Traditionally, this formula quells rebellious Liver Qi and treats Liver Blood deficiency. Biomedical and traditional perspectives agree that Yi Gan San has neuroprotective benefits. About HealthCMi: The Healthcare Medicine Institute (HealthCMi) publishes news, research and acupuncture continuing education courses online for acupuncture CEU and PDA credit. Learn more at www.healthcmi.com. *Image of “acupuncture points“via Shutterstock
Acupuncture is safe and effective for the relief of migraine headaches. Researchers conducted a randomized-controlled investigation and determined that acupuncture reduces the frequency and intensity of migraines. The results were confirmed by comparing a real acupuncture study group with a sham acupuncture study group. The RMIT University and Royal Melbourne Hospital researchers conclude, “Acupuncture can be used as alternative and safe prophylaxis for frequent migraine. Our recommendation is that practitioners treat migraine sufferers twice per week for at least eight weeks.”
The research team made several important discoveries. They note that the total number of days with a migraine reduced for patients receiving real acupuncture. Real acupuncture improved quality of life scores and produced significant reductions in the need for migraine medication consumption. The researchers note “more participants in the RA (real acupuncture) group used less pain killers as relief medication than in the SA (sham acupuncture) group” at the end of the treatment regime. Sham acupuncture did not produce the significant positive patient outcomes as did real acupuncture. The relief from migraine frequency and intensity using real acupuncture was confirmed in a three month follow-up investigation. In addition, the real acupuncture group had significant improvements in pressure pain thresholds.
The total number of days with a migraine significantly reduced in the real acupuncture group over and above results in the sham acupuncture group. The researchers applied a further measure of clinical results in what they termed a “responder.” This is an individual whose clinical improvements were at least a 50% reduction in the total number of days with a migraine. Both at the end of the twenty week acupuncture treatment period and in a three month follow-up investigation, the real acupuncture group had an overwhelmingly significant number of responders when compared with the sham acupuncture group. Approximately 73% of real acupuncture patients had a 50% or greater reduction in the number of days with a migraine. The sham acupuncture group had an approximately 29% reduction. In addition, the real acupuncture group had a faster onset of pain relief from migraine attacks than the sham acupuncture group.
The researchers detailed issues concerning providing a valid sham control protocol for the study. They reported concern that some sham techniques involve needle penetration of the skin and, although the needles are not placed at acupuncture points, they activate spinal gate control system that stimulates pain reduction in spinal nerve segments by diffuse noxious inhibitory control. The research team used a hybrid technique of combining shallow insertion sham acupuncture needle stimulation on body acupoints while scalp sham acupuncture involved only non-insertion of needles. The researches comment that the “procedure seems to have been successful in this study.”
The researchers note, "The present trial showed that acupuncture was effective in reducing migraine days, as well as effecting a reduction of medication consumption and improvement in quality of life, when compared with sham acupuncture." They add that the “results demonstrated that manual acupuncture can be an effective and a safe prophylaxis for frequent migraine sufferers.” The positive patient outcomes were achieved using a semi-standardised treatment protocol.
Patients received a twenty week treatment period of acupuncture. Initially patients received acupuncture two times per week for four weeks followed by once per week for an additional four weeks. Next, acupuncture was administered once every two weeks for another four weeks. Finally, acupuncture was applied one time per month for two months. In total, patients received sixteen acupuncture treatments.
The researchers devised a protocol in two parts. The first part involved a set of mandatory acupuncture points to be applied to all patients in the real acupuncture group. The second part allowed for the addition of supplementary acupuncture points based in Traditional Chinese Medicine (TCM) differential diagnostics. The total number of needles needed to be in the range of nine to twelve. All participants in the real and sham acupuncture groups had needles that were 0.25 mm in diameter. Needle length ranged between thirty to forty millimeters. The Hwato brand of needles made in the Suzhou Medical Instrument Factory (China) were used.
The mandatory acupuncture points were:
Fengchi (GB20)
Taiyang (Ex-HN5)
Shuai Gu (GB8)
Hegu (LI4)
The supplementary acupuncture points were:
Baihui (DU20)
Xingjian (LR2)
Taichong (LR3)
Taixi (KI3)
Xuanzhong (GB39)
Sanyinjiao (SP6)
Shang Xing (DU23)
Zusanli (ST36)
Feng Long (ST40)
Zhongwan (CV12)
Yinlingquan (SP9)
Xuehai (SP10)
Ashi point
Supplementary point selections were based on the following differential diagnostic patterns within the TCM system: ascending hyperactivity of liver yang, deficiency of qi and blood, wind-phlegm blocking the channels, and blood stasis. For the real acupuncture group, the needles were inserted transversely, obliquely, or perpendicularly. The depth of needling ranged from ten to thirty millimeters. The de qi sensation was induced by manual acupuncture. Needle retention time was twenty-five minutes with the addition of manual needle stimulation every ten minutes.
The researchers designed the study with careful control models and close attention to inclusion and exclusion criteria. The researchers documented design protocols for statistical analyses, sham controls, randomizing procedures, and ensuring the validity of clinical protocols. The inclusion of mandatory acupuncture points combined with supplemental points provided both standardization and customization. The researchers commented that allowing for customized secondary acupuncture point choices based on individual diagnostics is a more accurate reflection of an acupuncture treatment than allowing for only one set of mandatory points per patient.
Reference: Wang, Yanyi, Charlie Changli Xue, Robert Helme, Cliff Da Costa, and Zhen Zheng. "Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up." Evidence-Based Complementary and Alternative Medicine 2015 (2015).
This past
Tuesday, I found myself lying on my back in a Union Square healing center with
nearly two dozen needles in my face. It was a remarkable experience for a
number of reasons. Mostly because I am terrified of needles. To get my blood
drawn, or even my ears pierced, I require the kind of coddling and hand-holding
usually reserved for toddlers. So how exactly did I end up volunteering to
become a human pincushion? With the Met Gala just weeks
away, I’ve narrowed my focus to getting my complexion in prime glowing order,
and research has told me that, in addition to giving me the kind of temporary
facelift usually provided by lymphatic drainage facials and microcurrent
machines, an acupuncture facial (otherwise known as an acufacial) would also
fine-tune my emotional and physical state. In other words, in a mere eighty
minutes, I would be getting an appointment with a therapist, doctor, and
aesthetician all in one. And for that kind of time-saving, I would endure
almost any form of torture.
So, at the
recommendation of an editor friend, I booked an evening acufacial with
NYC-based acupuncturist Soo-Mi Hwang. Borrowing
from the traditional Chinese medicine technique that’s used for treating
everything from osteoarthritis to back pain and stress, the skin treatment
targets acupoints to stimulate the body’s regenerative process. I arrived early
in hopes of calming my nerves before going under the needles. Instead, after
being asked to remove my shoes, I was just as swiftly handed an informational
packet that was more thorough than my 2014 taxes. Inquiring about everything
from my family’s medical history, to my mental health and my dietary
inclinations, the form was meant to create a 360-degree view of my hopes,
fears, pores, organs, and 4:00 p.m. sugar cravings.
Why? Hwang
explained that my face and skin are essentially mirrors of everything happening
inside my body and mind. After setting to work painlessly placing hair-thin
pins along my frown lines, my temples, jaw, and on my head, Hwang addressed the
blockages in my body, referring to a kind of damming of my energy meridians.
“Your stomach is very tight—that’s not a good thing,” she informed me, before
putting a pin into each of my purlicues (the skin between the thumb and the
index finger), which caused a brief charley horse in my hands, then released
tension in my whole body and made me feel a little light-headed. “See?” said
Hwang, “That’s your stomach. You hold too much stress there.”
She also placed
needles in my shins (“For your chi,” she said), and one on the top of my head.
Almost instantly, I felt energized. Before I knew it, the needles were removed,
and Hwang was painting a skin-tightening herbal mask onto my face (“secret
family recipe,” she told me when I inquired about its contents). After what
felt like seconds but was actually twenty minutes, she washed it off and
performed a circulation-stimulating massage, including a vigorous rubdown of
the knots in my jaw and along the base of my skull.
As promised, I
emerged from her studio with a radiant complexion—as well as feeling more
relaxed, and with much more energy than when I arrived. In the days that followed,
my sleep was sounder, and I was surprised by how loose and lucid my body felt.
If that’s not the ultimate pre-party appointment, I don’t know what is. And one
thing is for certain: I’ll be booking another for the morning of the Met Gala.
Acne is a common inflammatory disease of the pilosebaceous units in the skin, which often occurs in the facial, chest and back region. It is due to over secretion of androgen, dyskeratosis of conduits of the sebaceous gland and microbial infection.
Several preliminary studies have suggested that acupuncture may be effective in patients with acne. The exact mechanisms of acupuncture in acne are unclear and may involve at least three key components—the hypothalamus-pituitary-adrenal axis, the autonomic nervous system and brain-derived neurotrophic factor. Additionally, acupuncture may act as a modulator of the immune system as he has been supported by a number of observations.
‘Ah Shi’ point acupuncture involves inserting needles at painful or pathological sites and was traditionally used for lancing furuncles. Therefore, a study was aimed at finding out the effects of ‘Ah Shi’ point acupuncture on papules and nodules of acne vulgaris.
Researchers Young-Hee Yun, Byeong-Kook Son and In-Hwa Choi carried out a research to observe the effects of acupuncture on acne vulgaris.
The study was conducted at the department of Oriental Dermatology, Kyung Hee University, East-West Neo Medical Center in Seoul. Participants were invited through announcements on the website of east-west Neo Medical Centre and newspapers. After a thorough explanation of the procedure, informed consent was obtained from the patients who were 18 years old or more. From July to December 2009, they screened 68 applicants and enrolled 36 who met the criteria for the study.
In this study, we found that acupuncture treatment of moderate acne vulgaris was associated with reduction of inflammatory lesions and improvement of the quality of life. Excessive sebum production secondary to sebaceous gland hyperplasia is the first abnormality to occur in acne. Subsequent hyperkeratinisation of the hair follicle prevents normal shedding of the follicular keratinocytes, which then obstruct the follicle and form an apparent microcomedon.
Lipids and cellular debris soon accumulate within the blocked follicle. This microenvironment encourages colonisation of propionibacterium acne, which provokes an immune response through the production of numerous inflammatory mediators. Inflammation is further enhanced by follicular rupture and subsequent leakage of lipids, bacteria and fatty acids into the dermis Overall, they came to the conclusion that the traditional diagnoses of wind, heat, damp and insufficiency of lung, spleen or stomach are related to acne treatment, so one can treat acne using these meridians.
In conclusion, acupuncture treatment of moderate acne vulgaris was associated with reduction of inflammatory lesions and improvement of the quality of life. kapuracu@kapuracu.com http://www.newindianexpress.com/lifestyle/health/Clearing-Acnes-For-Good/2015/04/26/article2779654.ece
Several important changes to acupuncture laws and rules have recently been enacted. A 45th state in the USA has legalized acupuncture. Insurance billing requirements have changed and will see more changes before the year is out. In addition, the NCCAOM has changed acupuncture continuing education PDA (professional development activity) requirements.
North Dakota has recently passed its first law regulating acupuncture. The CEO of the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) indicates that this will help attract quality licensed acupuncturists and raise the standards of care in North Dakota. Strong efforts to legalize acupuncture in North Dakota were led by members of the North Dakota Association of Acupuncture and Oriental Medicine.
The acupuncturist scope of practice defined by North Dakota law includes patient education, botanical medicine, qi gong, tai qi, dietetics, physical forces, manual acupuncture, electroacupuncture, and thermal stimulation of acupuncture needles. All needles must be sterile, disposable, filiform needles. All acupuncturists must have completed approved graduate level training.
The NCCAOM has made a few changes to acupuncture continuing education requirements. The California Acupuncture Board has one major change for acupuncture CEUs expected later in the year. For all NCCAOM diplomates re-certifying their diplomate status as of 2016, there are changes to the safety and ethics PDA requirements. Diplomates will need two safety and two ethics category PDAs instead of four safety and/or ethics PDAs. The Healthcare Medicine Institute offers both two hour safety and two hour ethics courses online for NCCAOM PDAs.
The NCCAOM will soon institute a CPR certification requirement. This is a shift from the CPR education requirement to the official certification process. The NCCAOM notes that in 2016, “CPR is required as a stand-alone requirement in addition to 60 PDA points.” Another subtle change is to the biomedicine category. Biomedicine, as it relates to clinical practice, is now part of the core medicine category. This lifts the limit on the number of biomedicine hours an acupuncturist can accrue for diplomate renewal as long as the hours are preapproved by the NCCAOM. All biomedicine hours at the Healthcare Medicine Institute are preapproved for core category PDAs. Also, the NCCAOM has reduced the number of tai chi (taiji) and qi gong hours that may be submitted for PDAs. The 10 PDA limit has been reduced to 4 PDA points.
The California Acupuncture Board will soon require California licensed acupuncturists to obtain continuing education CEUs in the category of ethics. The specifics of the new requirements will be posted on the California Acupuncture Board website once they have been finalized. A board representative states that this may occur in the fall. Once the ethics process has been finalized, the Healthcare Medicine Institute will offer courses meeting this acupuncture CEU requirement.
Insurance Billing Last year saw a change in acupuncture insurance billing in California. The 97800 and 97801 acupuncture and electroacupuncture billing codes used for workers’ compensation cases have been retired. The CPT (current procedural technology) acupuncture workers’ compensation billing codes have been updated to the industry standard including: 97810, 97811, 97813, 97814. Another big change to affect all medical professionals is the retirement of the ICD-9 diagnosis codes in favor of ICD-10 codes. Enactment of the new diagnosis codes is planned for the fall. To learn more about billing, visit the Healthcare Medicine Institute insurance article or take the acupuncture continuing education insurance billing course.
There have been some unusual changes to individual insurance policies regarding acupuncture coverage. One major insurer offers acupuncture coverage but the fine print introduces a new way to deny care. Acupuncture may be reimbursed by insurance but only if it is “in lieu of anesthesia” during surgery. Currently, this policy exclusion affects over 350,000 US citizens.
Medicare A big question is, “Will medicare cover acupuncture?” Not yet, however, monumental breakthroughs in acupuncture research will ultimately facilitate the adoption of acupuncture into the medicare system. There are two ways acupuncture becomes part of the medicare system. The first would be an act of congress. Not much happening there. The second is based on National Coverage Determinations (NCDs). NCDs are based on research and are made by the Centers for Medicare & Medicaid Services (CMS). Current NCDs are based on outdated data. Current research will ultimately need to be considered. The HealthCMi AcuNews department is a great resource for discovering the latest findings in acupuncture research. To learn about NCDs and acupuncture medicare coverage, visit the following article: First White House Acupuncture Hurdle.
California, Maryland, and More As a result of the PPACA, also known as Obamacare, many states now require acupuncture as a covered insurance benefit for all citizens with small group or individual health insurance plans. This is decided on a state-by-state basis and is not a nationwide requirement. California and Maryland were two of the earliest adopters of the new acupuncture policy requirement.
Pennsylvania The Acupuncture Licensure Act in Pennsylvania has been amended. Prior to this amendment to the Acupuncture Licensure Act, licensed acupuncturists were unable to treat patients past 60 days from the date of the first acupuncture visit without a physician, dentist or podiatrist making a patient diagnosis. The new law allows acupuncturists to treat patients for longer than 60 days without a physician, dentist or podiatrist’s diagnosis if patients are free of symptoms. As a result, patients may be able to seek long-term preventative care visits from acupuncturists without first making a trip to a doctor’s office to get a diagnosis.
- See more at: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1456-acupuncture-laws-rules-and-billing-changes#sthash.jO6CiCfx.dpuf
Researchers sought to solve this mystery and came up with concrete answers. With the help of immunohistochemistry, researchers discovered how acupuncture works for these patients.
They discovered that the combined therapy of electroacupuncture plus herbal iontophoresis enhances clinical efficacy with a significant synergistic effect.
Acupuncture treatments were applied once per day for 10 days followed by a three day break from treatments. Next, another course of ten acupuncture treatments over ten days was applied for a total of two courses of care.
The RMIT University and Royal Melbourne Hospital researchers conclude, “Acupuncture can be used as alternative and safe prophylaxis for frequent migraine. Our recommendation is that practitioners treat migraine sufferers twice per week for at least eight weeks.”
The first part involved a set of mandatory acupuncture points to be applied to all patients in the real acupuncture group. The second part allowed for the addition of supplementary acupuncture points based in Traditional Chinese Medicine (TCM) differential diagnostics. The total number of needles needed to be in the range of nine to twelve. All participants in the real and sham acupuncture groups had needles that were 0.25 mm in diameter. Needle length ranged between thirty to forty millimeters. The Hwato brand of needles made in the Suzhou Medical Instrument Factory (China) were used. 
In addition, the NCCAOM has changed acupuncture continuing education PDA (professional development activity) requirements.