Phasen der Stressbewältigung: Traumaverarbeitung und Akupunktur

After trauma, people accomplish several stages of coping which require certain mental abilities: Fear, aggression, insight, grief, and hope. Traumas are usually coped with in a physiological sense. However, they may also lead to a trauma disorder if the coping is blocked at one or more stages. The stages of stress coping correspond to the metaphoric terms of TCM characterizing the five mento-psycho-somatic abilities acting together in forming a cycle of reaction.In addition to the therapies of post-trauma-disorders, as well as in order to prevent their arising after traumatic life events, non-verbal forms of therapy are suitable. The NADA protocol, devised in the 1980s by Michael Smith et al. in New York is also successful in the treatment of trauma patients. It represents a low-threshold, non-confrontative and non-verbal method of therapy.     

Nachweis einer Entspannungsfähigkeit bei verschiedenen Qigong-Übungen mittels Messung der Herz-Raten-Variabilität (HRV)

Introduction

The effects of qigong are changes in concentration and relaxation, following a dual principle, which will be demonstrated by measurement of heart rate variability (HRV).

Methods

HRV was measured in 4 female qigong teachers and 17 quigong practitioners (12 women and 5 men, mean age 47,9 years, SD 9,4 yrs), employing an ECG recorder (HeartMan®, Heart Balance Corp., Vienna). The sessions comprised exercises of daoistic qigong (n = 10) or chan mi gong (n = 11) and lasted for one to three hours.

Results

In different persons our HRV measurements showed identical phases of concentration and relaxation during the exercises as well as during intervals. While attentively listening to instructions as well as during Intervals all participants showed emotional and mental tension.

Conclusions

In this study, inter-individual differencesof relaxation could be demonstrated by HRV measurements In various subjects. Superior „competence” in Qigong did not matter. In fact specific qigong exercises may be applied as targeted tools for individual relaxation and as therapeutic options as well.     

Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.     

Fallbericht: Patientin mit Schlafstörung

Background

Since the onset of her menopause about ten years ago, a sixty-year old patient has been suffering from hot flashes and sleep disorders causing her to become increasingly anxious and nervous. As the patient's mother had died of breast cancer, substitution of hormones was not advisable. Relaxation methods such as Yoga and Autogenic Training could only mildly alleviate the symptoms.

Objective

To effectively treat the sleep disorder, improve quality of life, lessen frequency and severity of hot flashes

Methods

Weekly sessions with ear- and body acupuncture for ten weeks

Results

After the third acupuncture session the patient reported a decrease of nightly waking episodes but suffered from acute pain in the neck as well as shoulder region. After nine therapy sessions, the patient reported a 50% decrease of nightly waking episodes. The hot flashes, however, remained unchanged.

Discussion

In this case, acupuncture significantly improved the patient's sleeping disorder. It also reduced the symptoms of anxiety and nervousness. Other menopausal symptoms such as hot flashes and dryness of mucous tissues, could not be influenced.     

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.     

Akupunktur bei Kindern und Jugendlichen mit Asthma bronchiale: Eine randomisierte kontrollierte Studie

Background

During rehabilitation children and adolescents with bronchial asthma suffer from physical and mental stress in spite of receiving their asthma medication, or demonstrate poor therapy compliance. The randomized controlled trial evaluates the effectiveness of acupuncture in the course of inpatient rehabilitation of children and adolescents with mild to severe persistent bronchial asthma.

Patients and methods

In a longitudinal study design (pre-, post-, 4 month-follow-up) the effects of additional acupuncture on symptom frequency and severity, lung function, medication, quality of life (PAQLQ), general and asthma specific level of anxiety (STAIK) were examined in 43 acupuncture and 42 control patients. Apart from asthma sport, climate therapy and behavioural training, the acupuncture group was given acupuncture treatment according to a standardized needle pattern (12 × 30′).

Results

After acupuncture the frequency of morning breathlessness and inhalation difficulty decreased significantly (p < .05) with equal or reduced medication. Patients treated with acupuncture also showed a tendency towards reduced anxiety levels . Patients of the acupuncture group with moderately persistent asthma demonstrated an additional decline of workload-induced obstruction (FEV₁ Diff. %).

Conclusion

Add-on acupuncture was able to achieve significant improvements in lung function, especially in severe asthma, as well as a sustained reduction of anxiety scores.     

Chinesische Orthopädie: Teil 2: Behandlungskonzepte für die obere und die untere Halswirbelsäule

The locomotor system as a major field of acupuncture therapy offers a number of good indications for acupuncture outside the range of the large national acupuncture studies funded by German Health Insurances. Looking at the upper and the lower cervical spine the layers of the problem and a hierarchy of therapeutic goals are defined to match the effects of acupuncture, related techniques and further therapeutic modalities. The manual of acupuncture focuses on therapeutic effects and objectives first, and then goes on to sketch therapeutic strategies and finally complex approaches of acupuncture within the cervical region.     

Patientin mit chronisch rezidivierenden Gelenks- und Wirbelsäulenschmerzen

Background

Acupuncture as a regulative therapy is well-suited for the treatment of functional, reversible disorders. Additionally, the WHO recommends its application for pain therapy in cases of arthritis and back pain due to various causes. This case study should clarify which paths to take in the case of a multi-morbid patient suffering from chronic pains due to polyarthrosis.

Objective

Pain reduction and improvement of quality of life as well as improvement of sleep quality.

Methods

Annual treatment series consisting of 10 sessions each, one session per week.

Results

short-term pain reduction before undergoing endoprosthetic surgery; considerable improvement of general status and sleep.

Conclusions

Acupuncture may bring temporal relief in cases of chronic pain due to osteoarthritis and should therefore be applied in combination with western medicine. Acupuncture is particularly well-suited to treat the co-emergent vegetative symptoms.     

Vergleich verschiedener Repräsentationspunkte der großen Beingelenke in der Ohrakupunktur

Contributing to the current discussion on differences in ear-acupuncture between the ‘French school’ and ‘Chinese school’ with regard to the localization of therapeutic regions corresponding to the major articulations of the leg, I investigated the therapeutic effect of ear-acupuncture on pressure-pain in the lower limb, both in the fossa triangularis and the crus superius anthelicis. Both regions proved to be therapeutically most effective with pressure pain. The rationale of differences in therapeutic effective regions is discussed.     

Einfluss der Akupunktur auf den Augendruck und die Compliance bei Patienten mit okulärer Hypertension oder primärem Offenwinkelglaukom: Erste Ergebnisse einer prospektiven kontrollierten Langzeitbeobachtung

Background and Aims

Primary wide-angle glaucoma (the most common form of glaucoma) is a multi-factorial disease of the optic nerve marked by the preceding loss of retinal ganglion cells, eventually leading to the atrophy of the optic nerve. Intraocular pressure (IOP) makes up the most important and most treatable risk factor.

Methods

The study examined the effect of acupuncture therapy on eye pressure and the compliance in patients suffering from primary wide-angle glaucoma (n = 21) and ocular hypertension (n = 13) against a group of test subjects not suffering from any eye complaint (n = 16). Before commencing therapy, corneal thickness was determined by 4Optics-Pachymeter. Before and after acupuncture treatment, an ophthalmologic determination of visual acuity according to DIN 58220 and a computer-aided visual field analysis were done. The IOP was measured before and immediately after acupuncture as well as 30 minutes after therapy. Changes in compliance were documented with a standardized questionnaire completed by each patient having received this treatment.

Results

It was shown that for patients with primary wide-angle glaucoma and ocular hypertension, acupuncture is able to significantly lower intraocular pressure. According to the questionnaire analysis, a subjective improvement of quality of life and better compliance of using anti-glaucomatous medication was achieved.

Conclusions

Acupuncture is an appropriate method to treat patients with primary wide-angle glaucoma in addition to lowering eye pressure by anti-glaucomatous pharmacological therapy. In patients suffering from ocular hypertension, acupuncture can significantly lower intraocular pressure and therefore reduce the rate of conversion into a manifest glaucoma. Therefore this treatment can be suggested for ocular hypertension patients with contraindications against local anti-glaucomatous medicine (e. g. beta-blocker). However, it is absolutely necessary in this treatment that patients are continuously monitored regarding visual field, retinal nerve fibre thickness and micro-morphological alterations of the disc in order to detect tissue damage of the optic nerve and functional loss caused by the onset of glaucoma.     

Das alternde Immunsystem und chronische Erkrankungen: Akupunktur, extrazelluläre Matrix und die Pflanzenformel Padma 28 im Rahmen eines strukturierten Präventions- und Therapiekonzepts

The natural process of aging leads to changes in the immune system, the so-called immunosenescence. One characteristic among others is a shift of the immune response towards cellular defense. Endogenous and exogenous triggers and lifestyle factors with pro-inflammatory effects increase oxidative stress, and through long-time accumulation lead to a chronic, low-level inflammatory status called inflammaging.Inflammaging is the basis for a range of chronic inflammatory diseases of the later part of life and thus constitutes the common denominator of diseases such as atherosclerosis, diabetes mellitus type 2, chronic periodontitis and different cancers. Inflammaging is aggravated or accelerated by an impairment of the functionality and the ability for regulation of the extracellular matrix (ECM). This may be caused e.g. by oxidative and pro-inflammatory processes, by a disturbed acid-base homeostasis or by an increased formation of advanced glycation endproducts (AGEs).Therefore, a structured three-armed prevention and therapy concept is proposed for the spectrum of chronic inflammatory diseases, in which different methods from the field of complementary medicine with a regulative, modulating mode of action can be used. Different acupuncture and acupressure methods as well as herbal multicompound formulations from Asian medicine systems can regenerate and protect the ECM and trigger the body's own anti-inflammatory mechanisms. With the example of Padma 28, a pharmaceutical composition based on Tibetan Medicine, the anti-inflammatory, cytoprotective and anti-oxidative potential of herbal remedies is illustrated.In the context of a matrix-based, structured treatment concept such remedies can make an important contribution to the prevention and therapy of chronic, inflammatory, age-related diseases.     

Ernährungstherapie nicht nur bei kindlichen Kopfschmerzen

Food intolerance is a well-known factor in functional headache in children. Severe migraine in children can be significantly mitigated by a strict diet. But in the long term, a simpler nutritional change seems to be more appropriate in order to achieve a long-lasting influence on children's headache. A nutritional change of at least 6 weeks' duration should reduce the headache frequency and intensity in the range of 50 % or more in order to be defined as successful. Not only migraine, but also tension-type headache respond in a relevant dimension to nutritional treatment. In case of higher migraine frequency combined with allergic comorbidity, the efficacy of the nutritional regime seems to be even more pronounced. In daily counselling, a combination of written information and a short personal explanation seems to represent a practicable procedure.     

Diätetische Kopfschmerzbehandlung bei Kindern

During the past 30 years, the prevalence of headache in children in the western world has significantly increased. Although food intolerance is a well known factor influencing headache in children, the dimensions of this have not been clearly evaluated yet. Severe migraine in children can be mitigated by strict dietary treatment in about 90 % of the cases. But in the long-term, such strict dietary regimes - especially according to Chinese medicine - are hardly practicable. Thus, a simplified nutritional change seems to be more appropriate in order to achieve a long-lasting influence on school children's headache.

Methods

Therefore, a randomized study was started to investigate the efficacy of a longer lasting nutritional intervention in children with headache, comparing the effects of a self-help brochure to those of individual nutritional advice. Children (7-18 years) with migraine, tension-type headache or a combination of both were randomized into two groups: “self-help program with a brochure” or “individual nutritional advice”. Nutritional change according to Traditional Chinese Medicine as well as state of the art in modern nutritional chemistry included avoidance of milk, curd cheese, wheat flour, white sugar, chocolate, preservatives, coloring and other food additives. After 12 weeks of nutritional change, mitigation of headache was checked in a control appointment. A reduction of headache frequency and intensity in the range of 50 % or more as revealed in headache calendars was defined as success.

Results

Out of 117 randomized participants, 32 (27 %) suffered from lactose malabsorption. 25 patients failed to fulfil the introduction criteria or broke off, showing a slightly higher but not significant dropout rate in the self-help group. 76 of the remaining participants changed their nutritional habits. 59 (83 %) reported subjective improvement, 56 of which fulfilled the success criteria with no statistically significant difference between the two groups. No significant difference was found between tension type headache and migraine.

Conclusion

Not only migraine but also tension-type headache responded in a relevant dimension to nutritional treatment. In case of higher migraine frequency combined with allergic comorbidity the efficacy of the nutritional regime seems to be even more pronounced. Personal counseling shows only a trend towards better clinical results. The lacking statistical difference between the two treatment groups excludes a significant importance of personal influence as explanation of headache improvement. In daily counselling, a combination of written information and a short personal explanation seems to be a practicable procedure.     

Rückenschmerzen,hyperaktive Blase und Angststörung: Kombination von Akupunktur,Neuraltherapie und Psychotonik Glaser®/Körpertherapie

In a case of low back pain, hyperactive urinary bladder and generalized anxiety disorder, a combination of acupuncture, Psychotonik Glaser® and neural therapy according to Huneke was helpful, working as a kind of trauma therapy after appendectomy at the age of 5 years.     

Gibt es eine Beziehung zwischen Qigong und Moderner Physik?

Based on the principle of completeness, Qigong is described as a method uniting external and internal paths to insight, and this can be perceived while practicing it. The common principle which we approach in every Qigong exercise is named the Dao. In quantum physics, there are also phenomena showing an underlying unity: entanglement of atomic systems.     

Sekundäre Enuresis nocturna

Beside the indication as pain therapy, acupuncture is well-known to be effective in the treatment of functional disorders. Nocturnal enuresis without a structural cause belongs to the group of such dysfunctions and should be accessible to successful treatmend with acupuncture. However, an example from experience shows the treatment of secondary nocturnal enuresis nocturna to be more difficult than one would expect. Neither laser nor acupuncture was successful as a therapy for a ten year old boy with secondary enuresis. Trials in literature are inconsistent and unable to prove the impact of different acupuncture techniques. One could imagine that an experimental design comparing various techniques should be able to give additional safety regarding the selection of the best procedure.     

Patientin mit Migräne und fünf Jahre Follow up

There are a lot of clinical trials proving the therapeutic effect of acupuncture in headache and migraine. These studies do not show how long the effect will last. This clinician's corner will introduce a patient who has been suffering from a hormone related migraine for more than thirty years. A pharmacologically induced menopause did not show a reduction of symptoms. The effect of acupuncture lasted for five years.     

Patientin mit Migräne und Cervicalsyndrom nach Hysterektomie

Background

In 2005, Mrs ES, a 54 year-old patient, consulted our acupuncture outpatient service for the first time, having suffered from intense headaches and permanent tensions in the shoulder and neck region for 7 years. The clinical symptoms were exacerbated by all kinds of stress. Although the patient had worked the same stressful job for years, the headaches only first manifested after she'd had a hysterectomy.

Aim

Pain reduction and improvement of stress tolerance at the work place

Methods

acupuncture, analysis of life style, means of stress prophylaxis

Results

Between the 4th and 10th treatment session, only one migraine episode occurred which was related to the consumption of red wine. For the following three years, the patient remained free of symptoms. Then tensions and headache attacks returned.

Discussion

According to TCM, long-term exposure to emotional stress situations can lead to the stagnation of liver qi. 7 years ago, this manifested as a blood stagnation of the lower heater (myomatous uterus). From the point of view of western medicine, the problem was solved by hysterectomy – however, stagnation now came to appear elsewhere in the body, this time, in the head. In this case, western medicine could offer only symptom-oriented therapeutic interventions whereas TCM enabled us to work on the underlying problem and reach, if only temporarily, an improvement of the clinical situation.     

Akupunktur in Sucht und Psyche – ein Update

In recent years, acupuncture has come to play an integral role in the treatment provided by many inpatient- as well as outpatient facilities throught Germany. It has been widely acknowledged to offer a versatile and rewarding, yet at the same time simple approach in the treatment of dependency disorders. This article will focus on ear acupuncture according to the NADA protocol, a method combining high efficacy with conceptual simplicity. NADA is the abbreviation for “National Acupuncture Detoxification Association”, an organization founded in New York in 1985, originally aimed at the promotion of a standardized, out-patient ear acupuncture detoxification concept. The protocol combines many useful aspects in the treatment of five ear points named according to Chinese Medicine (Vegetative I/sympagthetic, Shen men, kidney, liver, lung), representing a non-confrontative mode of therapy.