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.     

Patient mit Fersensporn

Background

Pain in the heel due to a calcaneal spur, verified in X-ray, often leads to a reduction of quality of life. A calcaneal spur is not as common as other problems an orthopaedic surgeon might encounter in practice, such as vertebral pain or pain in joints. However, pain associated with a calcaneal spur often is resistant to treatment and for this reason poses a challenge to the specialists. Seldom acupuncture is the first option although meanwhile it has become a well-accepted treatment for pain of the locomotor system.

Objectives

to determine whether acupuncture could be an option in the treatment of pain associated with a calcaneal spur.

Method

A male patient with a calcaneal spur was treated with semi-permanent needles in the ear, and low-level laser therapy. Previously, he had received all appropriate therapies western medicine currently has to offer in the treatment of this diagnosis.

Results

Already after the first treatment, a significant reduction of pain was reported. After four sessions, the patient was able to go running again. No further treatment has been necessary ever since.

Conclusion

Trials to prove the effectiveness of acupuncture in patients with calcaneal spurs should follow to vindicate the regular application of acupuncture in this diagnosis. Case reports show that pain due to a calcaneal spur can be influenced by ear acupuncture and laser therapy.     

Therapie eines chronischen Colon irritabile

Background

A 66 year old female patient has been suffering from irritable bowel syndrome for ten years. Allopathic therapy has not been successful. Moreover, she complains of chronic lumbar and cervical pain.

Aim

To relieve the patient of discomfort.

Method

Within two months, acupuncture sessions were carried out twice a week at first, subsequently once a week.

Result

Significant lasting improvement of all symptoms.

Conclusion

Acupuncture has proved to be an effective treatment of the symptoms of irritable bowel syndrome in this patient.     

Patient mit Fettstoffwechselstörung und Kryptozoospermie

Background

Acupuncture is mainly known as a therapy for functional disorders. Although hereditary lipometabolic disorders usually don't belong into this category, we wanted to find out if acupuncture in addition to conventional statin therapy could help reduce hyperlipidaemia. The patient in this case report additionally suffered from cryptozoospermia, so acupuncture was used to treat both diagnoses.

Aim

To significantly reduce blood lipoprotein levels. Second-line aim was an improvement of spermiography results.

Methods

Therapy was started using micro acupuncture systems exclusively until a complete check-up according to conventional medicine was performed. After that, body acupuncture was applied as well.

Results

At the beginning of acupuncture therapy, the level of triglyceride was up to 946 mg/dl, nine weeks after the beginning of treatment the level was 768, six months later the result was 490 mg/dl. A spermiography to monitor the effect on the fertility disorder was not necessary as the couple expected a baby soon after the end of treatment.

Conclusion

A general recommendation to use acupuncture as a treatment for lipometabolic disorders cannot be based solely on a single case report. However, in cases of failure of dietary as well as pharmacological therapy, acupuncture may be helpful.     

Ear therapy and massage therapy in elderly people with dementia a pilot study

Objective

To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients.

Methods

We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format questions done by an occupational therapist not involved in the study.

Results

There was a statistically significant positive effect of massage and ear acupuncture (P<0.001) on measured variables in the third month of intervention, which were maintained at two months after completing the treatment (P<0.021), when compared to the control group.

Conclusions

Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients.     

Cephalea,Lumbago und Tinnitus als psychosomatische Manifestation

Background

For three years, a 40 year-old male patient had been suffering from headache after having lost his job. His permanent pain could not be influenced by analgetic drugs. Additionally, he suffered from lower back pain and tinnitus (ringing in both ears). All these problems affected his general condition in a way that he didn't feel capable of looking for a new job.

Objectives

Improvement of pain and reduction of tinnitus, to enable the patient to find a new employment.

Methods

YNSA, ear and body acupuncture

Results

After ten treatments, there was no significant improvement of the headache and the lower back pain. There was also no change in general condition and regarding the tinnitus. The patient quit acupuncture after the tenth session, as he felt he could not relax in the busy surroundings of the outpatient service of the hospital. Within the following weeks the patient felt better little by little without any further treatment. Finally, the ringing in the ears only reoccurred in stressful situations. He found a new job and needed no consultations for 4 years until after an argument with his son, the headache reappeared.

Conclusion

For a positive reaction to manifest, chronic disease sometimes needs more than 10 treatments with acupuncture. Still, it may be justified to stop therapy, especially if the patient doesn't feel comfortable with it and longs for the end of the treatment series. A sudden improvement may as well happen within the weeks following the termination of therapy. There can be a delayed reaction causing the desired effect to manifest in a period of “no treatment”.     

Akupunktur bei idiopathischer peripherer Fazialisparese beidseits

Background

A 45 year old patient was hospitalized with a case of bilateral idiopathic Bell's palsy and initially received high-dose steroid therapy. After four days, the Patient was discharged without any detectable improvement in status. He then received acupuncture.

Objectives

As the patient was unable to make telephone calls, an improvement of articulation had top priority. The therapy also aimed at the restoration of lid occlusion to prevent desiccation of the eyes and enable the patient to take off the watch glass bandage.

Method

: Initially, the patient received two treatments per day followed by a pause of two days due to the weekend. During the following week, the patient received one treatment per day from Monday to Friday. The treatment consisted of acupuncture as well as cupping.

Results

After seven therapy sessions, the symptoms had completely disappeared.

Conclusion

Early-onset therapy of idiopathic Bell's palsy by means of acupuncture and cupping can lead to successful results even under continued use of steroids.     

Akupunktur und Schmerz – eine Historie in 3 Teilen: Teil 2: Der Weg der Akupunktur in die moderne Schmerztherapie

Background

In modern pain therapy, a more integral view on the patient has become prevalent. Interdisciplinary approaches for diagnosis and treatment have become established, especially regarding patients suffering from chronic pain. Besides the application of conventional pain medicine, alternative therapy options are being implemented. Here, especially acupuncture has become important since it emphasizes the unity of body, mind, and soul.

Aim

The historical evolution of the integration of acupuncture into pain therapy as well as the scientific knowledge regarding this therapeutic approach will be explained.

Methods

Extant literature about the development of pain therapy, acupuncture techniques, as well as results of basic research was interpreted in the context of daily clinical practice.

Results

Considering the changes that pain therapy experienced over the last century, the integration of acupuncture into increasingly important interdisciplinary treatment approaches appears almost as a logical consequence. The bio-psycho-social model representing the basis of modern pain therapy emphasizes the interrelation of pain syndromes and purely physical factors, the patient's life situation, and social background, in the same way as done in acupuncture therapy. In this context, the development of western acupuncture styles besides the traditional Chinese techniques is of special interest.

Discussion

The summary of the historical and scientific background of acupuncture and pain medicine reveals that interdisciplinary therapy and, especially the integral point of view represent relatively new approaches. Thus, further progress in the treatment of chronic pain patients can be expected.     

Klimakterische Beschwerden nach Mammakarzinom und antihormoneller Behandlung

Background

A female Patient, born 7/1953, suffers from menopausal discomfort after a history of breast cancer which was treated with surgery, radiochemotherapy and antihormonal drugs.

Aim

To relieve the patient of menopausal discomfort.

Method

Due to the lack of allopathic therapy options, the patient received ambulant body- and ear-acupuncture initially twice, later on once a week.

Result

After the initial two treatment sessions, the patient reported improved symptoms. Therapy was interrupted after 15 sessions, but complaints recurred. Therefore, we resumed biweekly acupuncture treatment and were able to keep the condition under control.

Conclusion

Acupuncture proved to be an effective method for menopausal discomfort, even after antihormonal treatment for breast cancer, and should be considered as a therapy option.     

Implementation des NADA-Protokolls in der Psychosomatik : Eine begleitende Untersuchung

Background

In 2011, the NADA protocol was introduced in the department of psychosomatic medicine, psychotherapy, and psychosomatic rehabilitation of the Diana hospital in Bad Bevensen.

Objective

In view of the paucity of data with respect to indications outside of substance dependency, data were collected concomitantly to the introduction of the NADA protocol. Along with the routine data collection using the SCL-90-R, the group of NADA ear acupuncture patients was examined with the WHO 5 questionnaire before and after treatment.

Results

Individual pre- and post-testing data were obtained from 53 patients. Patients predominantly received NADA acupuncture in a group setting. Compared to pre-data, patients improved significantly in terms of WHO 5 scores (t = 19.54, p < 0.001) and showed high satisfaction with the NADA treatment. Side effects were rare and mild. The patients strongly opted for a repetition of the treatment.

Discussion

The data here presented demonstrate a strong treatment effect with very small side effects” along with a high degree of patient acceptance of the NADA protocol in the setting of a psychosomatic rehabilitation clinic.     

“Qufeng Tongluo” acupuncture prevents the progression of glomerulonephritis by decreasing renal sympathetic nerve activity

Ethnopharmacological relevance

Although the exact mechanism(s) underlying acupuncture remain unknown, acupuncture and acupuncture-like somatic nerve stimulation have been used to treat different kidney diseases and several complications related to them.The aim of this preliminary study was to assess the effectiveness of acupuncture on glomerulonephritis (GN) according to the theory of “Wind-hided renal collaterals” previously proposed.

Material and methods

We used a New Zealand white rabbit model of cationized bovine serum albumin (cBSA)-induced glomerulonephritis and then administered them metoprolol, irbesartan or acupuncture to evaluate the effectiveness of acupuncture treatment and preliminarily explore its potential mechanism.

Results

After immunization, our results showed that compared to the cBSA+MET and cBSA+IRB medication groups, “Qufeng Tongluo” significantly lowered parameters of renal function and improved podocyte injury in the 3rd, 6th and 8th weeks of treatment. Moreover, acupuncture increased the protein expression of phosphorylated ERK1/2.

Conclusions

Our study suggests that a potential mechanism by which acupuncture has an antihypertensive effect and can significantly halt deteriorating renal function due to cBSA GN might be mediated by inhibiting the Erk1/2 MAPK pathway to reduce renal sympathetic nerve activity (RSNA).     

Relative specificity of acupuncture reinforcing and reducing methods

Objective

To probe the effects of acupuncture reinforcing and reducing methods on the human body.

Methods

Studied acupuncture reinforcing and reducing actions in the ancient literature, based on modern clinical and experimental studies, in combination with experience of acupuncture teaching and clinical treatment.

Results

The key to the generation of reinforcing and reducing actions is not the acupuncture reinforcing and reducing methods themselves, but instead the functional state of the patient during the acupuncture. When reinforcing and reducing methods act on the human body, a reinforcing-reducing effect is produced through regulation of Qi, indicating that the production of the reinforcing-reducing effect requires a certain condition. Specifically, acupuncture does not produce the reinforcing-reducing effect under all conditions, but can produce a reinforcing effect in patients with deficiency syndrome and a reducing effect in patients with excess syndrome.

Conclusion

Reinforcing and reducing methods each have therapeutic effects on both deficiency syndrome and excess syndrome, but a reinforcing method should be selected first for deficiency syndrome and a reducing method should be selected first for excess syndrome.     

Patientin mit klimakterischen Beschwerden

Background

Hormone substitution in the treatment of perimenopausal symptoms should be regarded with caution due to possible side effects. Patients with a family history of breast cancer as well as patients suffering from fibroadenoma are not eligible for hormone substitution and therefore need alternative options without side effects.

Objective

To determine if and how acupuncture can improve the quality of life in women with perimenopausal symptoms, using the present case report as well as data base literature research.

Method

The patient received 12 weekly sessions of acupuncture combined with ear-acupuncture.

Results

After 10 weeks of treatment, the patient reported a slight improvement of symptoms, but was still far from showing satisfactory results. Therefore, she received two more treatment sessions. A breakthrough improvement only occurred after the series of 12 sessions was discontinued. The visual analogue scale (VAS) showed a reduction from 10 to 4.5 within 6 months after the first session. However, the improvement didn't last – 12 months later, the patient reported an aggravation of symptoms (VAS 8), which lead to another treatment series.

Discussion

Acupuncture may be able to alleviate perimenopausal symptoms such as sleep disorders or hot flashes, but has to be repeated on a regular (at least yearly) basis.     

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.     

A review of Omics research in acupuncture: the relevance and future prospects for understanding the nature of meridians and acupoints

Relevance

Acupuncture is an intrinsic part of traditional Chinese medicine. The current understanding of the acupuncture meridian system, acupoints and the potential utilizing Omics technologies are summarized in this review.

Material and methods

A systematic search for acupuncture involving Omics technologies was carried out using multiple online literature databases. The records retrieved were from the full collections of each database dated to September 2011. Data produced from functional genomic technologies were extracted from the collected acupuncture/moxibustion studies and subjected to evaluation. Analyses and comments were summarized on the advances in experimental research in acupuncture/moxibustion-related studies, and the future for strategies and approaches in the era of functional genomics highlighted.

Results

An overview of articles indicated that several diseases or symptoms with evidence of effectiveness had been piloted for using functional genomic technologies, such as Parkinson's disease, allergic disorders, pain, and spinal cord injury, most of which are chronic “difficult diseases”. High-throughput genomic and proteomic profiling of gene expression in tissues has been able to identify potential candidates for the effects of acupuncture and provide valuable information toward understanding the possible mechanisms of the therapy. However, without further holistic and sophisticated analyses in the context of metabolomics and systems biology, the current attempts and the foreseeable developments appear to be insufficient to produce firm conclusions. Noticeably, the recent rapid advances in functional molecular imaging targeting specific metabolites have shown great promise and if combined with other post-genomic technologies, could be extremely helpful for the acupuncture studies in human subjects.

Conclusion

This review suggest that disease-oriented studies using the approach of multi-indexed high-throughput technologies and systems biology analyses will be a preferred strategy for future acupuncture/moxibustion research.     

Efficacy of acupuncture during post-acute phase of rehabilitation after total knee arthroplasty

Objective

The purpose of this study was to determine whether acupuncture is effective in reducing pain and swelling around the knee and improving range of motion (ROM) during the post-acute phase of rehabilitation after total knee arthroplasty (TKA).

Methods

Following TKA, 80 knees in 80 patients were randomly assigned to either an acupuncture treatment group (Group A) or a control group (Group C). In Group A, the complementary treatment of acupuncture was performed three times/week from postoperative day 7 until postoperative day 21. Outcome measures were: i) pain as assessed by a visual analog scale; ii) reduction of swelling around the knee as indicated by its circumference at the center of the patella; and iii) ROM of the affected knee.

Results

Group A patients had significantly reduced pain and swelling around the knees and earlier recovery of ROM than did those in Group C.

Conclusion

Acupuncture provides effective treatment during the post-acute phase of rehabilitation after TKA with respect to pain relief, reduction of swelling around the knee, and early recovery of ROM.     

Patientin mit diversen vegetativen Beschwerden seit der Strumektomie

Background

Since her strumectomy two years ago, a 56 year old female patient has suff ered from sleep disorder, exhaustion, fl uctuation of blood pressure and palpitations. Family problems constitute an additional burden for the patient. The substitution of thyroxin and additional psychotherapy has not been able to improve the patient's status.

Objective

Improvement of sleep and stress tolerance, dehabituation from nicotine

Methods

Beside drugs and psychotherapy we used needle acupuncture. In the acupuncture outpatient service, patients usually receive one treatment per week over a period of ten weeks. Following this period, the patient received an ear acupuncture treatment with permanent needles to help her stop smoking.

Results

Improvement of the patient's general condition after the 4th treatment, VAS (0–10) before acupuncture 9,3. VAS at the end of treatment: 2,8.

Discussion

The improvement of her general condition gave the patient the feeling of “being reborn”. After considerable reluctance at the beginning of therapy, she gladly accepted the off ering of an additional intervention to help her stop smoking after the tenth treatment.     

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.     

Therapeutic effects of acupuncture for neurogenic dysphagia--a randomized controlled trial

Objective

To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.

Methods

Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture (experimental group) or sham acupuncture (control group 1) for approximately one and a half months. A third group (control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards. The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), as well as by the consistencies of ingested food and fluid.

Results

A total of 87 subjects (experimental group, n= 20; control group 1, n=19; control group 2, n=48) were recruited into the trial. The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2. The average levels of food and fluid consistencies displayed greater improvement in the experimental group than in the two control groups.

Conclusions

This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia. However, due to an insufficient sample size and the lack of follow-up for control group 2, multi-centre trials employing a larger sample size may be required to draw concrete conclusions.