Influence of acupuncture on neural movement function in rats with middle cerebral artery occlusion--a randomized controlled trial

Objectives

To observe recovery in movement function in rats with middle cerebral artery occlusion (MCAO) after acupuncture treatment.

Methods

According to the randomized and controlled principle 1384 rats were divided into the basic control group (including the normal, sham, model control, model without intervention, Nimodipine, and para-Renzhong groups) and the acupuncture group (including the Neiguan (PC 6), Weizhong (BL 40), Sanyinjiao (SP 6), Chize (LU 5), Renzhong (GV 6) and non-acupoint groups). MCAO was modeled by Zea-longa's thread ligation and rats with scores of 1–3, as assessed by Zausinger's six-point method, were used in this study. Moreover, in the acupuncture group each acupoint was set with 12 different parameters by the orthogonal intersection method, resulting in 78 groups with 18 rats per group. The rats were treated by acupuncture once every 12 h for a total of six sessions and neurobehavioral scores were measured after each session. The neurobehavioral scores were compared by one-way ANOVA using the statistical software SPSS 17.0.

Results

After acupuncture therapy the mean neurobehavioral scores in MCAO rats increased gradually at each time point with a significant difference among the six scores, but with no significant differences between the fourth (48 h) and the fifth score (60 h), and between the fifth (60 h) and the sixth (72 h) score (P> 0.05).

Conclusions

MCAO rats gradually recovered movement function over multiple acupuncture sessions. After the fouth acupuncture session (48 h), the neurobehavioral scores of rats with cerebral infarction remained stable. Acupuncture treatment had a reliable curative effect on movement function in cerebral infarction rats.     

Effect of acupuncture on hippocampal mitochondrial proteome expression in SAMP8 mouse model with Alzheimer disease

Objective

To observe the effect of acupuncture on the expression of mitochondrial proteome in hippocampus of senescence-accelerated mouse prone 8 (SAMP8) mice models with Alzheimer disease (AD), and to explore the possible protective mechanism of acupuncture on mitochondria.

Methods

Sixty 6-month-old male SAMP8 mice were randomly divided into an acupuncture at acupoint group, an acupuncture at non-acupoint group and a model group, 20 mice in each group. The 20 male senescence-accelerated mouse/resistance 1 (SAMR1) mice of the same age were used as a normal control group. Shenshu (BL 23), Baihui (GV 20), Xuehai (SP 10) and Geshu (BL 17) were selected for acupuncture intervention in acupuncture at acupoint group. After an 8-week intervention, mitochondrial tissues were extracted from the hippocampus. Differentially expressed proteins were identified by subcellular organelle proteomics. Western blot was used to verify the expressions of some related proteins in hippocampal mitochondria.

Results

Compared with the model group, there were 13 differentially expressed protein spots in the acupuncture at acupoint group, of which, 9 were up-regulated, including neurofilament light polypeptide (NFL), actin (cytoplasmic 1, database ID: ACTB), tubulin beta-2A chain (TBB2A), tropomodulin-2 (TMOD2), pyruvate dehydrogenase E1 component subunit beta (PDHE1-β), NADH-ubiquinone oxidoreductase 75 kDa subunit (database ID: NDUS1), heat shock cognate 71 kDa protein (HSC71), pyruvate dehydrogenase E1 component subunit alpha (PDHE1-α) and ATP synthase beta subunit (ATP-β); 4 were down-regulated, including glial fibrillary acidic protein (GFAP), pyruvate dehydrogenase phosphatase 1 (PDP1), mitochondrial-processing peptidase subunit alpha (MMP-α) and adenosine kinase (ADK). According to the information provided in the protein database, most of the differentially expressed proteins involve the regulation of mitochondrial function and structure. The expression levels of NFL and TBB2A in the normal control group and the acupuncture at acupoint group were significantly higher than those in the acupuncture at non-acupoint group (P<0.05). ATP-β and NDUS1 expression levels were significantly higher in the acupuncture at acupoint group than those in the acupuncture at non-acupoint group (P<0.05); there was no significant difference between the acupuncture at non-acupoint group and the model group (P>0.05).

Conclusion

Acupuncture may achieve the potential therapeutic effect on AD by regulating the structure and functional proteins of hippocampal mitochondria.

     

Akupunktur bei Patienten mit allergischer Rhinitis: Analyse der Studienintervention und Syndrommuster der randomisierten Multicenter Studie (ACUSAR)

Background

Acupuncture was efficient and superior to sham acupuncture and a control group in the ACUpuncture in Seasonal Allergic Rhinitis (ACUSAR) trial. The article aims to inform about the study intervention, the underlying therapeutic ideas and clinical consequences.

Design

Three-armed, randomized, controlled multi-center-trial with a 16-week follow-up during the SAR season in the first trial year and an 8 week follow-up during the SAR season in the following year.

Setting

Outpatient or private clinics in Germany.

Intervention

422 Patients with seasonal allergic rhinitis on birch and grass pollen have been randomized to fall into 3 groups: 12 sessions of semi-standardised acupuncture plus rescue medication (RM, Cetirizine) or 12 sessions of sham acupuncture plus RM or RM alone during the initial two months of the study. Study intervention was defined in a Delphi consensus procedure including five experts from two major German acupuncture associations and three experts on trial methodology and statistics. A consensus between the need for standardisation and individualisation was defined using a semi-standardised treatment in the acupuncture group: 4 obligatory acupuncture points, ≥ 3 out of 8 facultative basic points and ≥ 3 facultative local or distant acupuncture points. Sham acupuncture consisted in superficial needling of at least 5 of 7 predefined, bilateral, distant non-acupuncture points. Needling characteristics such as point location, needling time, manipulation and achieved ‘De Qi' had to be documented after each session.

Results

CM syndrome diagnoss reported most frequently were Wind-Cold invading the lung' and ‘Wind-Heat invading the lung' (37 % each). In the acupuncture group all basic obligatory points were used in 97 % of cases (LI 4, LI 11, LI 20, EX-HN 3 Yintang). The most frequently used basic optional acupuncture points were GB 20, LIV 3, ST 36, LU 7 and SP 6. The total number of needles used was higher in the acupuncture group (15.7 ± 2.5) compared to the sham acupuncture group (10.0 ± 1.6).

Conclusions

CM syndrome diagnoses and point selection in the acupuncture group of the trial corresponded to clinical experiences in CM treatment of SAR. Point location and a higher number of needles in the acupuncture group compared to the sham acupuncture group may have influenced the positive trial results.     

Studien zum Lingshu als Beitrag zur Bewertung klinischer Akupunkturstudien: – Punktlokalisation,Stichtiefe, De Qi

Background

Clinical trials on acupuncture use a variety of control methods, such as sham acupuncture, minimal acupuncture, and placebo. Frequently, needle insertion on non-classical acupuncture points (“minimal acupuncture”) is employed for this purpose. The aim of such clinical trials is to evaluate specific effects of acupuncture. There is a controversial discussion regarding the appropriateness of comparing “true” acupuncture to “minimal acupuncture”.Minimal and verum acupuncture are distinguished by various criteria, such as “localisation”, “depth of needle insertion”, and “induction of de qi”.

Aim

This study is dedicated to the question of what information the Huang Di Neijing, specifically the Lingshu-compilation which extensively focuses on needling techniques, has to offer regarding the above mentioned criteria, and their importance for successful acupuncture. In relation to this, it will be discussed if the definition of “minimal acupuncture” as used in the German Acupuncture Trials, is feasible.

Methods

The entire original text of the Huang Di Neijing Lingshu was searched for information regarding “point localisation”, “insertion depth”, and “induction of “de qi”. The paragraphs in question were compiled and probed on statements regarding the efficacy of treatment. These subsequently were compared to the technique of “minimal acupuncture” as in the German Acupuncture Trials (ART, GERAC).

Results

The analysis of the Lingshu shows that neither a specific point localisation, nor a certain insertion depth or the induction of de qi are clearly and in all cases relevant for a successful therapy. Rather, the Lingshu offers specific indications for superficial needling. Sites of acupoint localisation aren't clearly defined and the induction of de qi is not understood as mandatory for a successful therapy.

Conclusion

The criteria distinguishing „verum acupuncture” from „minimal acupuncture” as practiced in many clinical trials don't correspond to the early practice of acupuncture as documented in the Lingshu. This can be a possible explanation for the good clinical results of minimal acupuncture in a number of clinical trials.However, for further discussions of this problem the developments and the clinical evolution present-day acupuncture has undergone since the ancient times have to be held in account.     

Appetitmangel/Ernährungsstörung im Kindesalter: Klinisches Zeichen eines Milz-Qi-Mangels und seine Behandlung mit Ein-Punkt-Akupunktur

Background

Lack of appetite in young children is a symptom often encountered in pediatric practice. Acute incidents within the course of or shortly after an infection as well as chronic forms – so called “bad eaters” – are a well-known phenomenon. Chinese medicine sees these symptoms as signs of spleen qi deficiency and suggests a therapeutic approach by strengthening the spleen.

Objectives

The study investigates the impact of the acupuncture treatment of Sp 6 on the lack of appetite in young children. Results after 1-5 treatment sessions were rated by the parents subjectively describing the effect as excellent, good, moderate, or no effect.

Methods

In a multicentre trial in Germany and Switzerland children at the age of 10 weeks up to 5 years (n = 42) were treated with needle (n = 35) and laser acupuncture (n = 7) at acupoint Spleen 6. The needling technique used was tonifying at one (n = 7) or both sides (n = 28) for approx. 4 seconds and then removing the needle immediately. Laser acupuncture was applied to both sides with 630 nm and 0,1–0,2 Joule at each point which equals 20–40 seconds at 5 mW.

Results

Needle acupuncture as well as laser acupuncture at Sp 6 has a positive impact on the appetite of children, according to their parents' observations.

Discussion

Acupuncture of Sp 6 seems to be an advisable therapeutic approach in children with lack of appetite, resembling a cost and time-effective, safe option that could even be performed by non-acupuncturists, especially since there is no alternative treatment in western medicine and since the technique is easy to be acquired. The good results encourage even a single-point therapy. However, further studies are needed to confirm these findings.     

Effect of electroacupuncture at the Pericardium Meridian on the heart function of volunteers with acute hypoxia

Objective

To study the effect of electroacupuncture (EA) at the Pericardium Meridian on the heart function of volunteers with acute hypoxia, and to provide scientific evidence for the acupoints selection along the affected meridian in acupuncture-moxibustion therapy.

Methods

Based on a self-control design, eighteen healthy volunteers were recruited in the study. Points from the Pericardium Meridian [Neiguan (PC 6), Ximen (PC 4), Quze (PC 3) and Tianquan (PC 2)], non-Pericardium Meridian point [Shousanli (LI 10)], non-meridian and non-acupoint points [1.0-1.5 cm lateral to Neiguan (PC 6) and Ximen (PC 4), respectively on both sides], and a blank control (only inhaling low-oxygen gas without EA stimulation) were selected to observe, once every week, 10 sessions in total, and only 1 acupoint was observed once. The volunteers inhaled low-oxygen gas mixture (10.8% O₂ and 89.2% N₂) for 30 min to imitate acute hypoxia. EA was conducted when the gas mixture was inhaled for 10 min and then lasted for 20 min; meanwhile, hemodynamic indexes such as cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), left cardiac work (LCW), left cardiac work index (LCWI) and heart rate (HR) were recorded on a hemodynamic monitor.

Results

EA at the acupoints of Pericardium Meridian significantly down-regulated the increased CO/CI, LCW/LCWI, and HR (P<0.05), and significantly up-regulated the decreased SVR/SVRI in hypoxia (P<0.05); EA at other meridian acupoints or at non-meridian and non-acupoint points didn’t produce such effects.

Conclusion

EA at the Pericardium Meridian can obviously improve the cardiac hyper-activation caused by acute hypoxia in healthy volunteers.

     

Repeated Immediate Effect of Ear Acupoint “Sympathetic” in a Case of Peripheral Arterial Occlusive Disease (PAOD)

Aim

To investigate the effects of Chinese ear acupuncture as a palliative therapy of Peripheral Arterial Occlusive Disease (PAOD).

Materials and Methods

One patient with a particularly complicated case history, affected by grade IV PAOD of his left lower limb, was treated with ear acupuncture. The main ear acupoint selected was Sympathetic (Jiaogan-AH6a). Auxiliary acupoints selected were Ankle, Heel, Toes and Shenmen. Single-use 0.25 × 13.0 needles were used; stimulation was carried out with reducing method, 1 minute rotation.

Results

Immediately after treatment the patient experienced the restoration of systolic-diastolic blood flow in the ventral and dorsal regions of the lower left leg, which could be confirmed by pulse-doppler. A week later and after a relapse of the PAOD this result was reproduced.

Conclusions

Sympathetic (Jiaogan-AH6a) is an important ear acupoint with a wide range of functions, mainly associated with the treatment of visceral pain and spasm soothing. In medical literature it is reported that Sympathetic (Jiaogan-AH6a) can also induce blood vessel dilation. Therefore, this case report is an important confirmation of the previously described sympatholytic kind of action, supported by pre- and post-treatment evidence.     

Effects of acupuncture on the number of associated protein phosphorylation in brain tissues of MCAO rats based on protein microarray technique

Objective

To investigate the effects of acupuncture on the number of associated phosphorylated proteins in brain tissues of middle cerebral artery occlusion (MCAO) rats, based on the protein microarray technique.

Methods

The MCAO model was prepared according to the modified occlusion method using occlusion lines. Forty healthy Sprague-Dawley (SD) rats were randomly divided into 4 groups using the lottery method: a sham operation group, a model group, a control point group and an acupoint group, with 10 rats in each group. Rats in the sham operation group and the model group only received binding without acupuncture. Rats in the acupoint group received acupuncture at Dazhui (GV 14), Baihui (GV 20) and Shuigou (GV 25); rats in the control point group received acupuncture at non-acupoint control points. The needle was twisted once for 1 min after insertion and another time in the middle of the 30 min needle retaining. Acupuncture was conducted once every 12 h for 6 consecutive times. At the end of the experiment, the neurological impairment score was collected, and cells of the ischemic brain tissues were extracted. The protein phosphorylation of the related signaling was detected using the 720 phosphorylated antibody microarray technique, and the differentially expressed proteins between groups were screened.

Results

The neurological impairment scores after 72 h of treatment: compared with the sham operation group, the scores of the model group, the control point group and the acupoint group were significantly increased (P<0.01); compared with the model group, the scores of the acupoint group and the control point group were significantly decreased (P<0.01, P<0.05); the score of the acupoint group was better than that of the control point group (P<0.05). The results of the protein microarray: compared with the sham operation group, 48 proteins showed up-regulated phosphorylation (≥1.5 times) in the model group and the down-regulated was 28; compared with the model group, 35 proteins showed up-regulated phosphorylation in the control point group, and the down-regulated was 24. There were 29 proteins showing up-regulated phosphorylation in the acupoint group and the down-regulated was 51. The numbers of proteins involved in the function and signal transduction pathways were also different.

Conclusion

Acupuncture at Dazhui (GV 14), Baihui (GV 20) and Shuigou (GV 25) can effectively repair brain injury. The ischemic injury of brain tissue may be caused by imbalance of a variety of proteins, and acupuncture can promote brain tissue repair by multi-functional and multi-channel regulation of the protein disorders.

     

Trigger Points and Classical Acupuncture Points: Part 2: Clinical Correspondences in Treating Pain and Somatovisceral Disorders

Background

Anatomic comparisons of the locations of myofascial trigger points (mTrPs) to those of classical acupuncture points in the first part of this study showed that at least 238 (93.3 %) of 255 “common” mTrPs described by the Trigger Point Manual have proximate, anatomically corresponding classical acupoints that anatomy references document enter the same muscle regions of those mTrPs.

Objectives

To determine whether these correlated common mTrP–classical acupoint pairs have similar indications for treating pain and somatovisceral disorders.

Methods

The clinical indications of the 238 anatomically corresponding classical acupoints were examined in acupuncture references to determine whether they include indications for treating pain and/or somatovisceral disorders that are comparable to those described for their correlated common mTrPs by the Trigger Point Manual.

Results

93 % (221/238) of the correlated common mTrPs have pain indications described by the Trigger Point Manual. Of their anatomically corresponding classical acupoints, 208/221 (94 %) have similar regional pain indications described, and another 6 (3 %) of these acupoints have indications for painful conditions in the distributions of their correlated mTrPs' described referred-pain. Only 7 classical acupoints that anatomically corresponded to common mTrPs had no comparable pain indications. The Trigger Point Manual describes somatovisceral effects for 60 (24 %) of its common mTrPs. Of their anatomically corresponding classical acupoints, 82 % (49/60) have “definite” and another 11 % (7/60) have “probable” clinical correspondences of their somatovisceral effects.

Conclusions

The marked correspondences of the pain indications (up to 97 %) and somatovisceral indications (up to 93 %) of anatomically corresponding common mTrP-classical acupoint pairs provide a second, clinical line of evidence that trigger points and acupuncture points likely describe the same physiologic phenomena.     

Placebokontrollierte Untersuchung zerebraler und vegetativer Effekte von Akupunktur an Di 4

Background and Aims

Many neurophysiologic effects have been observed during acupuncture. So far there is no placebo-controlled trial studying the correlation between changes in the central nervous system and vegetative effects. In consideration of a reliable blinding of the volunteers, the aim of this study was to examine specific cerebral and vegetative effects of verum-acupunture (VA) compared to placebo-acupuncture (PA).

Methods

Healthy volunteers received either VA at LI 4 (Hegu) with a verum-needle or PA at a non-acupuncture point with a placebo needle. EEG and ECG recordings were performed in parallel followed by an evaluation of pain, skin penetration and vegetative effects.

Results

The feeling of skin penetration was not significantly different (p = 0.057). Vegetative effects and Deqi occurred significantly more often during VA (p = 0.022). Pain was increased during VA-stimulation compared to PA (p > 0.01). Verum stimulation markedly increased occipital EEG power (p < 0.03). The increase in the fast alpha1 waves was accompanied by a decrease in the theta frequencies and the ratio alpha1/theta was shifted to the benefit of alpha1 (p < 0.04). This was paralleled by a short increase of the ECG ratio between low frequency (LF) and high frequency (HF) (p < 0.02), followed by an increase of HF-power (p < 0.04).

Conclusions

Volunteers were unable to distinguish between VA and PA. The EEG and ECG changes measured during VA stimulation are pointing towards a modulation of cerebral functions by vegetative acupuncture effects compared to PA.     

Trigger Points and Classical Acupuncture Points: Part 3: Relationships of Myofascial Referred Pain Patterns to Acupuncture Meridians

Background

In the first part of this study, myofascial trigger point regions were demonstrated to have strong (93.3%) anatomic correspondences with classical acupuncture points. The second portion of this study examined the clinical correspondences of trigger point regions and classical acupuncture points in the treatment of both pain and somatovisceral disorders, and found they had ∼ 97% correlation for treating pain conditions and over 93% correlation in treating somatovisceral conditions.

Objective

To examine the relationships of myofascial trigger point regions' referred-pain patterns to the meridian distributions of their anatomically corresponding classical acupuncture points.

Methods

The 238 anatomically corresponding trigger point region – classical acupuncture point pairs in part one of this study were analyzed to compare the distributions of their myofascial referred-pain patterns and acupuncture meridians in order to determine if their distributions correlated.

Results

Seventeen of the 238 anatomically corresponding trigger point regions had no described myofascial referred-pain. In the remaining 221 trigger point region-classical acupuncture point pairs, 180 (81.5%) demonstrated complete or near-complete correlation, and another 9.5% of point pairs partially showed correlations regarding the distributions of their myofascial referred-pain patterns and associated acupuncture meridians. Only 9% of point pairs showed little or no consistency of their referred-pain patterns and acupuncture meridians.

Conclusions

The strong (up to 91%) consistency of the distributions of trigger point regions' referred pain patterns to acupuncture meridians provides a fourth line of evidence that trigger points most likely represent the same physiological phenomenon as acupuncture points in the treatment of pain disorders.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

Objective

To observe capillary blood flow at acupoints during acupuncture treatment of primary dysmenorrhea and gain new insights into its analgesic mechanism.

Methods

Patients with primary dysmenorrhea were enrolled and randomly assigned to a treatment or control group. Subjects' symptoms were differentiated into various Traditional Chinese Medicine (TCM) syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu (LI 4), adding other acupoints based on syndrome. Laser speckle was used to compare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu (LI 4) before and during the treatment. Each subject was required to finish the period pain symptoms observation form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxiety scale, and numerical rating scale before and after treatments.

Results

After 10 sessions, the symptom scores, pain index (PI), and visual analog scale (VAS) decreased significantly in treatment group. The volume of blood flow in Hegu (LI 4) declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vasomotor amplitude at Hegu (LI 4) increased remarkably.

Conclusion

Acupuncture can increase the capillary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

Effect of electroacupuncture on expressions of VEGF and CD31 in MCAO model rats

Objective

To investigate the effect of electroacupuncture (EA) at Ganshu (BL 18) and Shenshu (BL 23) on vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1)/CD31 around the cerebral infarction focus in middle cerebral artery occlusion (MCAO) rats and the possible mechanism, thus to provide a new strategy for the treatment of cerebral ischemic stroke by acupuncture.

Methods

A total of 180 healthy male Sprague-Dawley (SD) rats were randomly divided into a sham operation group, a model group, an acupoint group and a non-acupoint group, 45 rats in each group. MCAO model was established using the modified line-embolus method in all rats except for those in the sham operation group; rats in the acupoint group were treated with EA at Ganshu (BL 18) and Shenshu (BL 23); rats in the non-acupoint group were treated with EA at the control points; rats in other 2 groups were only subjected to bundling without treatment. Ten rats in each group were randomly selected on the 3rd day, the 14th day and the 21st day after acupuncture stimulation to test the neurological function impairment. The expression levels of CD31 and VEGF were also detected.

Results

Compared with the model group and non-acupoint group, the neurological function score of the acupoint group was decreased at each time point, and the differences were statistically significant (P<0.05, P<0.01). The expressions of VEGF and CD31 in each group were the lowest on the 3rd day, reached the peak on the 14th day and still remained at high level on the 21st day. And the differences among groups were statistically significant both on the 14th day and the 21st day (P<0.05, P<0.01). Compared with the model group and the non-acupoint group, the expressions of VEGF and CD31 in the acupoint group were increased, and the differences were statistically significant (all P<0.05).

Conclusion

EA at Ganshu (BL 18) and Shenshu (BL 23) can significantly improve the neurological function score of MCAO model rats, and shows protective effect on cerebral ischemia. The protective mechanism may be related to the up-regulation of CD31 and VEGF expression around the cerebral infarction focus in the MCAO model rats and induction of angiogenesis.

     

Clinical application of the second metacarpal bone lateral needling

Objective

To explore the rules of the second metacarpal bone lateral needling in clinical application and its characteristics so as to provide the guidance to clinical practice.

Correlation analysis on clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation

Objective

To investigate the relationship between clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation.

Methods

A total of 120 elderly patients with sensorineural deafness were randomly divided into a comprehensive treatment group, an acupuncture group and a Western medicine group, with 40 cases in each group. The acupuncture group received acupuncture treatment, the Western medicine group received oral mecobalamin tablets and the comprehensive treatment group received acupuncture plus acupoint injection and auricular acupoint sticking. The values of pure tone hearing threshold test of the three groups were observed before and after treatment, and the relationship between clinical effects and ear distending sensation was compared.

Results

The total effective rate of the comprehensive treatment group was 82.5% versus 67.0% in the acupuncture group and 62.5% in the Western medicine group. The inter-group comparisons showed statistically significant differences in the comprehensive treatment group versus the Western medicine group (P<0.01) and the acupuncture group (P<0.05). In the comprehensive treatment group, there were 23 cases (57.5%) with ear distending sensation, the clinical total effective rate was 86.9%; there were 17 cases (42.5%) without the sensation, the clinical total effective rate was 76.5%. In the acupuncture group, there were 24 cases (60.0%) with ear distending sensation, the clinical total effective rate was 71.0%; there were 16 cases (40.0%) without the sensation, the clinical total effective rate was 63.0%. In the Western medicine group, there were 21 cases (52.5%) with ear distending sensation, the clinical total effective rate was 66.7%; there were 19 cases (47.5%) without the sensation, the clinical total effective rate was 57.9%. The total effective rate of patients with ear distending sensation were higher than the rates of those without ear distending sensation in the three groups, but the differences were insignificant (all P>0.05).

Conclusion

The comprehensive therapy is one of the effective methods to treat elderly patients with sensorineural deafness. In the three groups of elderly patients with sensorineural deafness, the relief of ear distending sensation and the hearing loss were basically simultaneous, and the hearing recovery in the patients with ear distending sensation may be slightly better than that in those without ear distending sensation. Nevertheless, further research is needed.

     

Unerwünschte Wirkungen und Komplikationen bei Akupunkturbehandlung: Ergebnisse der großen Beobachtungsstudie im Rahmen des Modellvorhabens der Ersatzkassen

Background and objective

Within a large research and reimbursement program by German social health insurance the effectiveness and safety of acupuncture for the treatment of patients suffering from chronic pain was investigated. We provide here the results regarding safety aspects from a large observational study.

Methods

Safety aspects were investigated in three ways: Physicians were asked to make a global assessment of safety and to report adverse effects for all 503,397 treatment cycles documented between July 2001 and June 2003. Serious adverse effects had to be reported directly to the research center and were collected up to December 2004. In addition, a sample of 6,140 patients was asked about the side effects they had experienced.

Results

Physicians documented at least one adverse effect in 7.8% of all patients, the most frequent being needling pain in 3.9%. Serious adverse events were reported in 17 cases, the most frequent event being pneumothorax (5 cases). 9.3% of patients reported side effects, a quarter of these were considered as truly bothersome. The most frequent side effects reported by patients were pain, fatigue and circulatory disturbances.

Conclusions

Serious adverse effects of acupuncture are very rare; however, minor side effects occur frequently. Overall, acupuncture provided by trained physicians is a comparably safe therapy.     

Observation on clinical effects of Zhu Lian’s type I excitation needling technique for postpartum urinary retention

Objective

To observe the clinical effects of Zhu Lian’s type I excitation needling technique for postpartum urinary retention.

Methods

A total of 60 cases with postpartum urinary retention were recruited and divided randomly into an observation group and a control group, 30 cases in each group. The control group was treated with routine acupuncture, and stimulated with sparse and dense wave of electric acupuncture for 15 min after arrival of needling sensation, and then the needles were taken out. The observation group was treated with Zhu Lian’s type I excitation needling technique, by inserting the needles with the quick inserting method, swift and temporary lifting and thrusting technique for shallow insertion for 5 times, by an in-and-out technique, without retaining the needles.

Results

The total effective rate was 96.7% in the observation group and 83.3% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). After the treatment, the first urination time was shorter in the observation group than that in the control group, with a statistical significance (P<0.01). After the treatment, the volume of residual urine after the first urination was less in the observation group than that in the control group (P<0.01).

Conclusion

Zhu Lian’s type I excitation needling technique can effectively promote the voluntary urination and bladder emptying in patients with postpartum urinary retention, and it takes effect faster.

     

Diagnose: Stottern

Background

Stuttering in childhood is a well-known and common problem which responds well to logopedic treatment. If the opportunity for speech therapy is missed or turns out a failure, stuttering will remain a constant problem for adults, reducing quality of life and lacking possibilities to cure.

Objective

In this case report of a 34 year-old woman who has stuttered since childhood it will be discussed if acupuncture can sufficiently improve this speech impairment.

Methods

In literature, there are only a few reports of successful treatment of stuttering in adults. In this case report, classic TCM acupuncture was administered in combination with Japanese Yamamoto's New Scalp Acupuncture (YNSA).

Results

For professional reasons, the patient had to take an oral test which would have been an impossible task before acupuncture. After 25 sessions of acupuncture once a week she underwent her exam and passed with almost no speech difficulties. On the visual analogue scale (from 0 to 10) she showed improvement of more then 70 percent (8,0 before acupuncture, 2,8 afterwards).

Conclusions

Stuttering in adulthood is a rare, but grave problem. In this individual case, acupuncture administered according to the tenets of TCM in combination with YNSA could improve the condition and subsequently, the patient's quality of life.