Acupuncture Research
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Acupuncture Research
Research on acupuncture, collated and presented by acupuncturist Helen Smallwood at Shaftesbury Clinic, Bedford, UK www.shaftesburyclinic.com
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Acupuncture efficacy in the treatment of persistent primary nocturnal enuresis. [Arab J Nephrol Transplant. 2013] - PubMed - NCBI

Acupuncture efficacy in the treatment of persistent primary nocturnal enuresis. [Arab J Nephrol Transplant. 2013] - PubMed - NCBI | Acupuncture Research | Scoop.it

Arab J Nephrol Transplant. 2013 Sep;6(3):173-6.Acupuncture efficacy in the treatment of persistent primary nocturnal enuresis.El Koumi MA1, Ahmed SA, Salama AM.Author information AbstractINTRODUCTION:

This study aimed to assess the therapeutic efficacy of traditional Chinese acupuncture in the treatment of persistent primary nocturnal enuresis (PNE).

METHODS:

Fifty children and adolescents suffering from persistent PNE were recruited from the Pediatrics and Urology Outpatient Clinic of Zagazig University Hospital during the year 2010. They included 31 boys and 19 girls, with a mean age of 116 ± years (range 9-17 years). The children and their parents underwent thorough counseling followed by two courses of treatment, each course administered over 10 consecutive days. Patients were instructed to continue regular follow-up, every three months, after starting the therapy. The response rate (cure, improvement, or failure) was monitored by recording dry nights and the number of spontaneous arousals to void per week on a calendar. Children who showed partial or no response after six months of observation received another two courses of acupuncture therapy, and were followed up for a further six months period.

RESULTS:

After the initial two courses of treatment, the cure rate at six months was 76% with an additional 18% achieving partial improvement. Twelve children needed another two courses of treatment. After one year of follow-up, 92% of patients showed complete cure and 8% showed failure of acupuncture therapy.

CONCLUSION:

Acupuncture treatment in patients with PNE appears effective in increasing the percentage of dry nights, with stable results even after the end of treatment courses. Further controlled studies are needed to confirm these results and to elucidate the therapeutic mechanism of acupuncture. Keywords: Acupuncture Therapy; Nocturnal Enuresis; Traditional Medicine.

PMID: 24053744 [PubMed - in process] Free full text

 

PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.


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prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP) - including #acupuncture

prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP) - including #acupuncture | Acupuncture Research | Scoop.it

Abstract

OBJECTIVE: The aim of this study was to examine the prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP).

DESIGN: We analyzed data from the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives, a prospective cohort study of women seeking care for noncancerous pelvic problems with intact uteri at enrollment. Among a subset of 699 participants who reported having CPP, we analyzed the prevalence of complementary health approaches used and associated patient sociodemographic and clinical characteristics, health-related quality of life, attitudes and beliefs, and conventional health care practices.

RESULTS: At baseline, slightly over one-half (51%) of women with CPP used at least one complementary health approach in the past year, including acupuncture (8%), special foods or diets (22%), herbs (27%), and vitamins and minerals (29%). During follow-up surveys conducted annually for 4 years, a substantial proportion of women (44.8%) used complementary health approaches at more than half of the assessments. Users of complementary health approaches were more likely to undergo a hysterectomy or oophorectomy or to use gonadotropin-releasing hormone agonists or opioids during the study compared with nonusers. Women with CPP who used complementary health approaches also had more optimal health-related quality of life measured by the Pelvic Problem Impact Questionnaire (31.6 vs 25.6, P < 0.001).

CONCLUSION(S): Many women with CPP consistently use complementary health approaches. The substantial interest in and high prevalence of complementary health approaches used alongside conventional medical approaches highlight the need for better understanding of multimodal approaches to address the complex condition of CPP.

Wiley Periodicals, Inc.PMID 25279935 [PubMed - as supplied by publisher]


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Mechanisms of Action of Acupuncture

Mechanisms of Action of Acupuncture | Acupuncture Research | Scoop.it

MECHANISMS OF ACTION OF ACUPUNCTURE

Acupuncture is increasingly being used as a complementary therapeutic approach, but its efficacy remains controversial and the physiological mechanisms determining its actions are largely unknown.

To explain the existence of the acupoints there were published a lot of studies, searching a visual method to explain the meridians. In 1984 Dung observed that there were no particular structures under the acupoints, but he saw that nerve bundles were involved in almost all such locations. In 1996, with a study based on histological analysis, Croley showed that in the area of acupuncture points there were high concentration of dermal papillae containing capillary loops with sympathetic nerve endings. Helene Langevin has also shown, by the histochemical examination, how subtle differences in acupuncture-needle manipulation techniques can affect cellular responses in mouse subcutaneous connective tissue.

The recent neuroimaging trials found altered functional brain responses to acupuncture in sensory, affective, cognitive, and inhibitory regions, often including neural networks for pain perception and transmission. These discoveries have allowed a better understanding of the functioning of acupuncture against diseases. Napadow in 2010 monitored the acupuncture effects on human brain with functional MRI, and he showed how acupuncture mobilizes a limbic-paralimbic-neocortical network and its anti-correlated sensorimotor/paralimbic network at multiple levels of the brain.

Furthermore, it's now sure that acupuncture has numerous endocrine and neurotransmitter effects. After Han's work, many authors have reported activation of endogenous opioid peptide related antinociceptive pathways during acupuncture, which involves the arcuate nucleus, the peri-aqueductal gray, the nucleus raphe magnus, and the descending inhibitory pathways. In 2014, Wu localized ATP release at acupoints after acupuncture, demonstrating that acupuncture is related to neural regulation based on ATP.

Thomas in 2008 showed how acupuncture can reduce the oxidative damage in pathological conditions, Wang discovered that it can exert an antiapoptotic effect through regulating the expression of genes Bax and Bcl-2. All these and some more recent studies confirmed that acupuncture has local and systemic effects mediated by nervous and neuro-endocrine-immune systems, but its mechanisms are still far from being fully understood.

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Knowledge, attitude and practice among Chinese acupuncturists receiving sham and/or placebo acupuncture: a cross-sectional survey -- Jin et al. -- Acupuncture in Medicine

Knowledge, attitude and practice among Chinese acupuncturists receiving sham and/or placebo acupuncture: a cross-sectional survey -- Jin et al. -- Acupuncture in Medicine | Acupuncture Research | Scoop.it
Abstract

Background Placebo and sham acupuncture are common control strategies in acupuncture studies. However, the perception and practice of these approaches in acupuncturists are poorly documented.

Objective To investigate knowledge of, attitude towards and practice of sham and/or placebo acupuncture among Chinese acupuncturists.

Method A cross-sectional survey conducted in six different tertiary care hospitals of traditional Chinese medicine in Beijing, China. A total of 92 licensed acupuncturists were asked to complete a predesigned and structured questionnaire on-site.

Results A response rate of 92.4% (n=85) was achieved. Almost all participants (99%, n=84) had moderate knowledge about sham and/or placebo acupuncture, but only a minority (27%, n=23) reported an excellent understanding. The general attitude towards sham and/or placebo acupuncture was positive. Most respondents (99%, n=84) thought such controls were necessary and the majority (81%, n=69) believed they were feasible in acupuncture research. More than two-thirds of participants (71%, n=60) had applied sham and/or placebo acupuncture, but only a few (8%, 5/60) used it as the most common control strategy in clinical trials.

Conclusions The result of our survey suggests that Chinese acupuncturists have a moderate knowledge of, and a positive attitude towards, sham and/or placebo acupuncture. Research into sham and/or placebo acupuncture is limited in comparison with other control strategies. Therefore, an in-service education programme for acupuncturists and standardisation of sham and/or placebo acupuncture need to be developed.

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Acupuncture accelerates recovery after general anaesthesia: prospective RCT

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"ABSTRACT BACKGROUND: Acupuncture anesthesia was created in the 1950’s in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain, heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery. OBJECTIVE: This randomized prospective study aims at comparing the effect of two acupoints (Yongquan, KI1 and Renzhong, DU26) with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor (BIS). DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 (group A), DU26 (groups B), both KI1 and DU26 (group C), and sham points (group D), and one had no acupuncture (group E). MAIN OUTCOME MEASURES: Bispectral Index (BIS), time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures. RESULTS: Time to spontaneous eye opening differed among groups (P=0.002), as well as time to tracheal extubation (P<0.000 1) and time to following commands (P=0.000 6). BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia (P<0.000 1 and P=0.000 4, respectively). BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 min after the end of anesthesia, although the difference among groups was not significant at these time points (P=0.164 and P=0.104, respectively). CONCLUSION: Acupuncture on DU26 and KI1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature."

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Acupuncture research and resources

The twitch in horses: a variant of acupunctureE Lagerweij, PC Nelis, VM Wiegant, and JM van ReeScience 14 September 1984: 1172-1174. [DOI:10.1126/science.6089344]The twitch in horses: a variant of acupuncture 10.1126/science.6089344 E Lagerweij...pain and may resemble that of classicalacupuncture. BAYER, J, OPERATIONSLEHRE ( 1896...HAN, J.S., NEUROCHEMICAL BASIS OF ACUPUNCTUREANALGESIA, ANNUAL REVIEW OF PHARMACOLOGY...Abstract References Full Text (PDF)Select this articleAcupuncture: Fertile Ground for Faddists and Serious NIH ResearchBarbara J. CullitonScience 18 August 1972: 592-594. [DOI:10.1126/science.177.4049.592]Acupuncture: Fertile Ground for Faddists and Serious...177.4049.592 Barbara J. Culliton Acupuncture: Fertile Ground for Faddists and Serious NIH Research. | Journal Article Acupuncture: Fertile Ground for Faddists and Serious...Extract Full Text (PDF)Thumbs Up for AcupunctureScience 14 November 1997: 1231. [DOI:10.1126/science.278.5341.1231a]Thumbs Up for Acupuncture 10.1126/science.278.5341...the U.S. medical establishment, acupuncture seems to be getting respectable. Last...the “experimental” label off acupuncture needles as medical devices. And...Full TextThumbs Down on AcupunctureArthur TaubScience 9 January 1998: 155. [DOI:10.1126/science.279.5348.155f]Thumbs Down on Acupuncture 10.1126/science.279.5348...Health (NIH) consensus statement on acupuncture (Random Samples, 14 Nov., p. 1231 ) should not prompt physicians to use acupuncture or to refer patients to acupuncturists...Full TextSelect this articleLetter: Acupuncture, pain, and signal detection theoryScience 4 July 1975: 65-68. [DOI:10.1126/science.1135629]Letter: Acupuncture, pain, and signal detection theory 10.1126/science.1135629 Letter: Acupuncture, pain, and signal detection theory. | Journal Article | Acupuncture Therapy Analgesia Differential Threshold Humans Pain Physical Stimulation...Extract Full Text (PDF)5200-Year-Old Acupuncture in Central Europe?Leopold Dorfer, Maximilian Moser, Konrad Spindler, Frank Bahr, Eduard Egarter-Vigl, and Gottfried DohrScience 9 October 1998: 239. [DOI:10.1126/science.282.5387.239f]5200-Year-Old Acupuncture in Central Europe? 10.1126/science...uibk.ac.at German Academy of Acupuncture, D-81247 Munich, Germany. E-mail...puncture seem to be located on Chinese acupuncture points. The tattoos were therefore...Full TextAcupuncture AnesthesiaTsung O. ChengScience 9 February 1973: 521. [DOI:10.1126/science.179.4073.521]Acupuncture Anesthesia 10.1126/science.179.4073.521 Tsung...ENGLAND JOURNAL OF MEDICINE 287 : 259 ( 1972 ). TAUB, A, ACUPUNCTURE, SCIENCE 178 : 9 (
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Acupuncture Point Anatomy Found

Acupuncture Point Anatomy Found | Acupuncture Research | Scoop.it

on 03 January 2015.

 

 

Researchers have discovered an anatomical structure located at acupuncture points. Wang, et. al., have identified a “vessel-like structure” made of “calcitonin gene related peptide (CGRP)-positive neurofibers in local tissues” at acupuncture points. The researchers discovered that “CGRP-positive nerve fibers were found to distribute in the dermis and subcutaneous layers of local tissues of acupoint ST 44, ST 36 and ST 32, mainly concentrating around the vessel-like structure.” They add, “CGRP-positive neurofibers are an important element in the local tissues of acupoint ST 44, ST 36 and ST 32 regions….”

Miyauchi, et. al., note, “The calcitonin gene-related peptide (CGRP) plays important roles as a neurotransmitter/neuromodulator in the central nervous system, and as a potent vasodilator when secreted from peripheral, perivascular nerves through its specific receptors.” Wang, et. al,. used a laser confocal microscope to make the discovery of CGRP positive nerve fibers at acupuncture points. This research solves one piece of the biological mystery behind the structure and mechanism of acupuncture’s effective actions on human health.

CGRP is a type of neurotransmitter. Nerve fibers that are positive for the presence of CGRP play many roles in human physiology. For example, Hara-Irie, et. al., note that “CGRP-positive nerve fibers could be a crucial element in bone metabolism during bone growth and development.” Kunst, et. al., from the Yale School of Medicine (New Haven, Connecticut) note that CGRP is “a wake-promoting neuropeptide that regulates sleep maintenance at night.” Evans, et. al., from the University of Miami School of Medicine (Miami, Florida) note that CGRP is “a potent vasodilator neuropeptide.” The density of nerve fibers containing CGRP located at acupuncture points may correlate to the ability of acupuncture to stimulate signal conduction and induce health benefits.

Hongbao Ma of the Department of Medicine, Michigan State University (East Lansing) notes, “Calcitonin gene-related peptide (CGRP) is a 37 amino acid vasoactive neuropeptide that is widely distributed in central and peripheral nervous systems in mammals. CGRP was discovered in 1982 by molecular cloning of calcitonin (CT) gene.” Ma adds, “CGRP is secreted by primary afferents and causes primary hyperalgesia, and its expression increases in (the) dorsal horn under sensitization conditions. CGRP plays (an) important role in blood pressure system.” Given the discovery of CGRP in 1982, it is not unusual that the vessel-like physical structures of CGRP associated with acupuncture points have only recently been discovered.

Russell, et. al. note, “CGRP is a highly potent vasodilator and, partly as a consequence, possesses protective mechanisms that are important for physiological and pathological conditions involving the cardiovascular system and wound healing. CGRP is primarily released from sensory nerves and thus is implicated in pain pathways. The proven ability of CGRP antagonists to alleviate migraine has been of most interest in terms of drug development, and knowledge to date concerning this potential therapeutic area is discussed.”

Ling Zhao et. al., conclude that acupuncture is effective in the treatment of migraines and reduces pain intensity levels. Zhou et. al., find acupuncture effective in the prevention of migraines and links acupuncture’s therapeutic benefits to its ability to stimulate MLCK expression. The expression of myosin light-chain kinase (MLCK) is involved in the regulation of smooth muscle contraction. The researchers document a correlation between acute migraine attacks and decreases of MLCK via the CGRP signal system. The researchers discovered that applying acupuncture to acupoint GB20 (Fengchi) successfully upregulates MLCK expression and has “preventative and curative” effects for migraine patients.

In another investigation, Morry Silberstein, et. al., conclude that acupuncture points are related to both unmyelinated and myelinated afferent nerve fibers in a unique neuroanatomical structure not found in other areas of the body. The researchers used light microscopy on silver stained sections of acupuncture point P6 (silver stained human cadaver sample) and used confocal light microscopy on a live subject for acupuncture points GB20 and SP6. Control sites were compared with the acupuncture points.

At acupuncture points, it was discovered that a nerve bundle extended to the dermal-epidermal junctions. Each bundle branched into 2 sections perpendicular to each other. This anatomical phenomenon was not observed at the control sites. The researchers concluded that this acupoint neuroanatomical finding suggests that, “acupuncture may incise afferent unmyelinated axonal branch points, disrupting both neural transmission to the spinal cord and crosstalk along meridians, while simultaneously stimulating larger, myelinated afferents, thus explaining both the immediate and long-lasting effects of acupuncture.”

In another body of research by Chenglin, et. al., CT scans reveal unique anatomical structures of acupuncture points. A CT (computerized tomography) scan is a series of X-rays used to create cross-sectional images. In a study published in the Journal of Electron Spectroscopy and Related Phenomena, researchers used in-line phase contrast CT imaging with synchrotron radiation on both non-acupuncture points and acupuncture points. The CT scans revealed clear distinctions between the non-acupuncture point and acupuncture point anatomical structures. Acupuncture points have a higher density of micro-vessels and contain a large amount of involuted microvascular structures. The non-acupuncture points did not exhibit these properties.

The researchers note that the state-of-the-art CT imaging techniques used in this study allow for improved three-dimensional (3D) imaging of a large field of view without artifacts. This greatly improves imaging of soft tissue and allowed the researchers to view this important finding.

The acupuncture points ST36 (Zusanli) and ST37 (Shangjuxu) were shown to have distinct structural differences from surrounding areas. At the acupuncture points, microvascular densities with bifurcations “can be clearly seen around thick blood vessels” but non-acupuncture point areas showed few thick blood vessels and none showed fine, high density structures. The acupuncture points contained fine structures with more large blood vessels that are several dozen micrometers in size plus beds of high density vascularization of vessels 15-50 micrometers in size. This structure was not found in non-acupuncture point areas. 

The researchers note that the size of an acupuncture point “can be estimated by the diameter of microvascular aggregations….” They also commented that other research has identified unique structures of acupuncture points and acupuncture meridians using MRI (magnetic resonance imaging), infrared imaging, LCD thermal photography, ultrasound and other CT imaging methods. The researchers commented that many studies using these technological approaches have already demonstrated that physical structures exist at acupuncture points. They note that “the high brightness, wide spectrum, high collimation, polarization and pulsed structure of synchrotron radiation” facilitated their discovery. They concluded, “Our results demonstrated again the existence of acupoints, and also show that the acupoints are special points in mammals.”

In another study, researchers used an amperometric oxygen micro-sensor to detect partial oxygen pressure variations at different locations on the anterior aspect of the wrist. The researchers concluded that partial oxygen pressure is significantly higher at acupuncture points. Below are images from the study measuring the increase of partial oxygen pressure combined with an overlay of the local acupuncture point locations. The images map the lung, pericardium and heart channels and their associated local points. Acupuncture points P7 and P6 clearly show high oxygen pressure levels as do the other acupuncture points in the region.

 

These measurements were not taken at needled acupuncture points. They were taken at the natural resting states of acupuncture points absent stimulation. A truly unique finding, acupuncture points exhibit special oxygen characteristics. Acupuncture points and acupuncture channels are scientifically measurable phenomena in repeated experiments. High oxygen pressure levels indicate the presence of pericardium, lung and heart acupuncture points and channels.


References:
Wang, C., W. J. Xie, M. Liu, J. Yan, J. L. Zhang, Z. Liu, and L. N. Guo. "[Distribution of calcitonin gene related peptide positive neurofibers in local skin tissues of" Neiting"(ST 44)," Zusanli"(ST 36) and" Futu"(ST 32) regions in the rat]." Zhen ci yan jiu= Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji] 39, no. 5 (2014): 377-381.

Kunst, Michael, Michael E. Hughes, Davide Raccuglia, Mario Felix, Michael Li, Gregory Barnett, Janelle Duah, and Michael N. Nitabach. "Calcitonin Gene-Related Peptide Neurons Mediate Sleep-Specific Circadian Output in Drosophila." Current Biology (2014).

Ma, Hongbao. "Calcitonin gene-related peptide (CGRP)." Nat Sci 2 (2004): 41-47.

Russell, F. A., R. King, S-J. Smillie, X. Kodji, and S. D. Brain. "Calcitonin Gene-Related Peptide: Physiology and Pathophysiology." Physiological reviews 94, no. 4 (2014): 1099-1142.

Miyauchi, K., N. Tadotsu, T. Hayashi, Y. Ono, K. Tokoyoda, K. Tsujikawa, and H. Yamamoto. "Molecular cloning and characterization of mouse calcitonin gene-related peptide receptor." Neuropeptides 36, no. 1 (2002): 22-33.

Evans, Bornadata N., Mark I. Rosenblatt, Laila O. Mnayer, Kevin R. Oliver, and Ian M. Dickerson. "CGRP-RCP, a novel protein required for signal transduction at calcitonin gene-related peptide and adrenomedullin receptors." Journal of Biological Chemistry 275, no. 40 (2000): 31438-31443.

Hara-Irie, F., N. Amizuka, and H. Ozawa. "Immunohistochemical and ultrastructural localization of CGRP-positive nerve fibers at the epiphyseal trabecules facing the growth plate of rat femurs." Bone 18, no. 1 (1996): 29-39.

Zhao, Ling, Ji-xin Liu, Ying Li, Wei Qin, and Fan-rong Liang. "EFFECTS OF LONG-TERM ACUPUNCTURE TREATMENT ON RESTING-STATE BRAIN ACTIVITY IN MIGRAINE PATIENTS: A COMPARATIVE STUDY ON ACTIVE ACUPOINTS AND INACTIVE ACUPOINTS." Journal of Integrative Medicine 3 (2014): 234.

ZHOU Pei-juan, LI Bai, WANG Ai-cheng, LIU Chun-yan, WANG Yu, [Effect of Fengchi Point on the Expression of Myosin Light Chain Kinase on Middle Meningeal Artery of Migraine Model rats,] Acta Chinese Medicine and Pharmacology, 2014,(5), R285.5.

Morry Silberstein, Katharine Adcroft, Aston Wan, and Masimilliano Massi. Medical Acupuncture. Afferent Neural Branching at Human Acupuncture Points: Do Needles Stimulate or Inhibit?, doi:10.1089/acu.2011.0823. Department of Chemistry, Curtin University, Perth, Western Australia, Australia. Department of Pain Management, St. Vincent's Hospital Melbourne, Victoria, Fitzroy, Victoria, Australia.

Chenglin, Liu, Wang Xiaohu, Xu Hua, Liu Fang, Dang Ruishan, Zhang Dongming, Zhang Xinyi, Xie Honglan, and Xiao Tiqiao. "X-ray phase-contrast CT imaging of the acupoints based on synchrotron radiation." Journal of Electron Spectroscopy and Related Phenomena (2013).
Author Affiliations:

Minyoung Hong, Sarah S. Park, Yejin Ha, et al., “Heterogeneity of Skin Surface Oxygen Level of Wrist in Relation to Acupuncture Point,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 106762, 7 pages, 2012. doi:10.1155/2012/10a6762.

Zhang Y, Yan X H, Liu C L, et al. Photoluminescence of acupuncture points “Waiqiu” in human superficial fascia [J]. J Lumin. 2006, 119-120:96-99.

Julia J. Tsuei, Scientific Evidence in Support of Acupuncture and Meridian Theory: I. Introduction. IEEE Engineering in Medicine and Biology Magazine. 1996, 15(3):58-63.

Song X J, Zhang D. Study on the manifestation of facial infrared thermography induced by acupuncturing Guangming (GB 37) and Hegu (LI 4) [J]. Chinese Acupuncture & Moxibustion. 2010, 30(1):51-54.

Liu P, Zhou G Y, Zhang Y, et al. The hybrid GLM‒ ICA investigation on the neural mechanism of acupoint ST36: An fMRI study [J]. Neuroscience Letters, 2010, 479: 267-271.

Fei L, Cheng H S, et al. The experimental exploration and the research prospects about the material basis and the functional characteristics of the meridian [J]. Chinese Science Bulletin, 1998, 439(6):658-672.

- See more at: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1415-acupuncture-point-anatomy-found#sthash.4ajNI0nQ.dpuf

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Dr Elisabet Stener-Victorin - Fysiologi, Göteborgs universitet

Dr Elisabet Stener-Victorin - Fysiologi, Göteborgs universitet | Acupuncture Research | Scoop.it

Dr Elisabet Stener-VictorinA Molecular Link between Androgen Excess and Development of Polycystic Ovary Syndrome? 
Effect and mechanisms of non-pharmacological treatment


Background: With a prevalence of 8–17%, PCOS is the most common endocrine and metabolic disorder in women1. PCOS is usually diagnosed during the early reproductive years, and clinical and biochemical signs include hyperandrogenism, ovulatory dysfunction, and polycystic ovaries2. The main metabolic phenotype is hyperinsulinemia and insulin resistance, which often preceed the development of type 2 diabetes (T2D), and these occur independently of body weight although obesity worsens all symptoms3. PCOS is also associated with affective symptoms and reduced health related quality of life (HRQoL). Therefore, if ovulation can be induced, hyperandrogenism decreased, and insulin sensitivity maintained in these women then the symptoms of PCOS and development of T2D can be prevented. 
The etiology of PCOS is poorly understood. The heterogeneity of the syndrome may reflect multiple underlying mechanisms, and both genetic and environmental factors have been implicated in the occurrence and progression of PCOS. Current treatment options are symptom oriented and, although effective, they often result in multiple pregnancies and can have severe metabolic and gastrointestinal side effects. Thus, PCOS places a large burden on these women, their families, and the healthcare system and the costs of PCOS exceed several billion Euros annually not even counting PCOS-associated morbidities in menopause. Because women with PCOS require long-term treatment, an important goal is to evaluate the effects and possible mechanisms of action of treatment strategies with few side effects, such as acupuncture.
The overarching aim of Stener-Victorin’s groups research is to yield new key information on the pathophysiology of PCOS with specific focus on metabolic dysfunction. A further aim is to elucidate if new treatment strategies such as acupuncture and physical exercise can improve PCOS related symptoms with main focus on metabolic dysfunction but also reproductive function.
A central hypothesize is that hyperandrogenism, the central feature of PCOS, contributes to the development of PCOS and metabolic disturbances via epigenetic changes to the genomic DNA in adipose and skeletal tissue and that acupuncture treatment can modify these epigenetic changes and reverse insulin resistance via restoration of key signaling molecules.

 

Fig. 1. Schematic presentation of hypotheses and aims. LH, luteinizing hormone; SNS, sympathetic nervous system.



Ongoing Projects:

Mechanisms of acupuncture with low-frequency electrical stimulation on insulin sensitivity in female rats with dihydrostestosterone-induced PCOS (rat)
 Does acupuncture improve insulin sensitivity in women with PCOS? This study will be the first to study the effect and possible mechanisms of acupuncture on insulin sensitivity in overweight and obese women with PCOS compared with controls.
The primary outcome measure is insulin sensitivity i.e. glucose disposal rate measured by euglycemic hyperinsulinemic clamp.Secondary outcome measures are health related quality of life, and symptoms of anxiety and depression. Exploratory outcome measures include molecular mechanistic studies in fat and muscle biopsies, anthropometrics, body fat distribution, circulating sex steroids, adipokines, lipids and inflammatory markers.
 Determine if hyperandrogenism in women with PCOS induces epigenetic alterations in adipose and skeletal muscle tissue and contributes to insulin resistance (human). This study will be the first to determine genome-wide methylation profiles as a way of detecting epigenetic modifications to the genomic DNA in adipose and skeletal muscle tissue in women with and without PCOS.
Project 1: Differences in genome-wide DNA methylation profiles in adipose and skeletal muscle tissue between women with and without PCOS 
Project 2: Determine if acupuncture treatment modifies genome-wide methylation patterns in adipose and skeletal muscle tissue of women with and without PCOS
 Impact of maternal androgen excess and polycystic ovary syndrome (PCOS) on placental metabolic pathways and long-term health effects on their female offspring (rat and human)
 Continuous Administration of a P450 Aromatase Inhibitor Induces PCOS with a Metabolic and Endocrine Phenotype in Female Rats at Adult Age – Effect of cyclic estrogen treatment, propranolol or acupuncture (rat)
 To estimate the prevalence of PCOS in obese premenopausal women and elucidate how they respond to a weight reduction treatment program (human)
 To assess the efficacy of acupuncture with or without clomiphen citrate (CC) in achieving live births among 1000 infertile Chinese women with PCOS (human)
 Sex steroids and symptoms of depression and anxiety in women in the transition into menopause – from Q56 population (human)


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Inpatient treatment for severe atopic dermatitis [Complement Ther Med. 2013] - PubMed - NCBI

Inpatient treatment for severe atopic dermatitis [Complement Ther Med. 2013] - PubMed - NCBI | Acupuncture Research | Scoop.it

Complement Ther Med. 2013 Jun;21(3):200-6. doi: 10.1016/j.ctim.2012.12.002. Epub 2013 Jan 11.Inpatient treatment for severe atopic dermatitis in a Traditional Korean Medicine hospital: introduction and retrospective chart review.Yun Y1, Lee S, Kim S, Choi I.Author information AbstractOBJECTIVES:

Patients with atopic dermatitis increasingly seek complementary and alternative medical treatment. A number of studies have demonstrated the efficacy of herbs and acupuncture in the treatment of atopic dermatitis. Some patients with extensive disease, outpatient treatment failure, acute deterioration or highly impaired everyday functioning require inpatient care. The aim of this study was to introduce and evaluate inpatient treatments for severe atopic dermatitis patients at a Traditional Korean Medicine hospital.

DESIGN AND SUBJECTS:

We performed a retrospective chart review of inpatients with severe atopic dermatitis between March 2008 and October 2011. Eligibility criteria for inclusion were: (1) a diagnosis of atopic dermatitis according to the criteria established by Hanifin and Rajka and (2) hospitalisation because of severe atopic dermatitis (objective scoring atopic dermatitis (SCORAD) score ≥ 40).

MAIN OUTCOME MEASUREMENT:

The SCORAD score was assessed by trained investigators at admission and discharge.

RESULTS:

Among 37 inpatients, there were 29 patients who met the criteria. Patients received treatments including acupuncture, herbal medicine and herbal wet wrap dressings. The mean total scoring SCORAD decreased from 60.63 to 37.37 during hospitalisation. Despite the relatively small sample size, these findings were statistically significant.

CONCLUSION:

In atopic dermatitis, Traditional Korean Medicine effectively decreased clinical disease severity. This study's weaknesses include the relatively small number of patients, some aspects of the study design, lack of follow-up assessment and lack of second measurement.

Copyright © 2012 Elsevier Ltd. All rights reserved.

PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.


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Can Acupuncture Treat Depression?

Can Acupuncture Treat Depression? | Acupuncture Research | Scoop.it
The alternative practice may be able to replace medication or alleviate its side effects

 

A growing number of people are seeking alternatives to antidepressant medications, and new research suggests that acupuncture could be a promising option. One new study found the traditional Chinese practice to be as effective as antidepressants, and a different study found that acupuncture may help treat the medications' side effects.

In acupuncture, a practitioner inserts needles into the skin at points of the body thought to correspond with specific organs (right). Western research suggests the needles may activate natural painkillers in the brain; in traditional Chinese medicine, the process is believed to improve functioning by correcting energy blocks or imbalances in the organs.

A study published last fall in the Journal of Alternative and Complementary Medicinefound that electroacupuncture—in which a mild electric current is transmitted through the needles—was just as effective as fluoxetine (the generic name of Prozac) in reducing symptoms of depression. For six weeks, patients underwent either electroacupuncture five times weekly or a standard daily dose of fluoxetine. The researchers, the majority of whom specialize in traditional Chinese medicine, assessed participants' symptoms every two weeks and tracked their levels of glial cell line–derived neurotrophic factor (GDNF), a neuroprotective protein. Previous studies have found lower amounts of GDNF among patients with major depressive disorder, and in other research levels of the protein rose after treatment with antidepressant medication.

After six weeks, both groups showed a similar improvement in symptoms, and both treatments restored GDNF to a normal concentration. But the acupuncture began to work faster, reducing symptoms more dramatically at weeks two and four than the drug did. Among the patients who got better, a higher percentage of the acupuncture recipients showed “great improvement.”

Another study suggests that acupuncture may help with one particularly difficult aspect of depression treatment: the sexual side effects of some medications. Twelve weeks of acupuncture helped both men and women with several aspects of sexual functioning, according to the work, also in the Journal of Alternative and Complementary Medicine. These findings add to a growing body of research suggesting acupuncture may be useful for a variety of ailments, including chronic pain, anxiety and nausea. — Tori Rodriguez

... But Will the Results Hold Up?
Strong studies should include a convincing control group, account for the placebo effect and be properly blinded so that neither the clinicians nor the participants know whether they are taking part in real or sham treatment. The results should also be successfully replicated in labs at numerous locations. Acupuncture researchers have struggled to comply for several reasons.

Placebo effect: One major hurdle is crafting a good fake acupuncture technique to act as a control condition. The first study described above did not attempt to use a true control, so it is impossible to know whether the needle placement, the electric current or some other aspect of the treatment accounted for the results. Further, acupuncture is associated with a robust placebo effect—simply being seen and touched by a practitioner makes most people feel significantly better, which could make acupuncture seem more effective than it really is. On the flip side, this large placebo component can overshadow a small but real difference between the treatment and placebo groups, potentially masking acupuncture's true usefulness.

Blinding: Another concern is the difficulty in creating a double-blinded experiment. Observers and participants alike can skew the results when they know whether they are participating in a real treatment rather than a sham procedure. The acupuncturist involved would almost certainly know whether he or she is engaged in the real thing, and that knowledge could subtly alter the acupuncturist's behavior. The first study above was partially blinded, in that the doctors who evaluated the patients' symptoms did not know what treatment they had received.

Reporting bias: Several studies have shown a systematic bias in the medical literature. When researchers reviewed randomized controlled trials performed in China, Japan, Russia and Taiwan, they found that these studies almost always showed positive results for acupuncture. Studies in the rest of the world were much more likely to find no benefit. The bias is further compounded by the “file drawer problem,” or the tendency to publish positive results but confine negative or inconclusive findings to the so-called file drawer. Overall the evidence for acupuncture's effectiveness has been ambiguous or outright contradictory, and most results have been difficult to reproduce. — Victoria Stern

This article was originally published with the title "Acupuncture for Depression."

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Acupuncture for nausea, current trials Complementary and alternative therapy research : Cancer Research UK : CancerHelp UK

Acupuncture for nausea, current trials Complementary and alternative therapy research : Cancer Research UK : CancerHelp UK | Acupuncture Research | Scoop.it
Acupressure for nausea

Results from a recent study looking at acupressure to help relieve sickness due to chemotherapyshowed that overall acupressure did not help. The research team were able to analyse the results of 372 out of the 500 people who took part. Everyone who took part had standard care to relieve sickness. Some people also wore an acupressure wrist band or a dummy wrist band (placebo). The people who wore either wrist band did feel less sick than those who didn't wear a wrist band, but the difference between the groups could have happened by chance (they were not statistically significant). When looking at how many people had been sick or felt anxious and how they rated theirquality of life, the researchers found no difference between the groups. Although the researchers couldn't recommend the use of acupressure wrist bands to help with sickness after chemotherapy, they felt that some people may benefit from them and this would be useful to look at in other trials.


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Study finds acupuncture can prevent radiation-induced chronic dry mouth

Study finds acupuncture can prevent radiation-induced chronic dry mouth | Acupuncture Research | Scoop.it

When given alongside radiation therapy for head and neck cancer, acupuncture has shown for the first time to reduce the debilitating side effect of xerostomia, according to new research from The University of Texas MD Anderson Cancer Center and Fudan University Shanghai Cancer Center.

The study, published in the journal Cancer, reported findings from the first randomized controlled trial of acupuncture for the prevention of xerostomia.

Xerostomia, or severe dry mouth, is characterized by reduced salivary flow, which commonly affects patients receiving radiotherapy for head and neck cancer. Most current treatments are palliative and offer limited benefit, according to Lorenzo Cohen, Ph.D., professor in MD Anderson's Departments of General Oncology and Behavioral Science and director of the Integrative Medicine Program.

 

The condition impairs quality of life for patients, as it creates difficulties eating, speaking and sleeping, while also increasing the risk for oral infections.

"There have been a number of small studies examining the benefits of acupuncture after xerostomia develops, but no one previously examined if it could prevent xerostomia," said Cohen, who is also the study's principal investigator. "We found incorporating acupuncture alongside radiotherapy diminished the incidence and severity of this side effect."

Cohen and his colleagues examined 86 patients with nasopharyngeal carcinoma, treated at Fudan University Shanghai Cancer Center. Forty patients were randomized to acupuncture and 46 to the standard of care. Those in the treatment arm received acupuncture therapy three times per week during the seven-week course of radiotherapy. Patients were evaluated before radiotherapy, weekly during radiotherapy, and then again one and six months later.

The results were based on data derived from two self-report questionnaires and measuring actual saliva flow. Patients completed the Xerostomia Questionnaire (XQ), an eight-item survey which assessed symptoms consistent with the condition. XQ scores under 30 corresponded to mild or no symptoms of xerostomia.

The second measure, MD Anderson Symptom Inventory Head and Neck (MDASI-HN), ranked the severity of cancer-related symptoms, other than xerostomia, and their interference with quality of life. The team also measured saliva flow rates using standardized sialometry collection techniques.

Benefits Noticed Quickly

"What was quite remarkable was that we started to see group differences as early as three weeks into radiotherapy for the development of xerostomia, cancer-related symptoms that interfere with quality of life, and saliva flow rates - an important objective measure," said Zhiqiang Meng, M.D., Ph.D., co-principle investigator of the study and deputy chair of the Department of Integrative Oncology, Fudan University Shanghai Cancer Center.

The largest group differences in XQ scores were seen by the end of radiotherapy, but the differences persisted over time. By one month after the end of radiotherapy, 54.3 percent of the acupuncture group reported XQ scores greater than 30, compared to the control group at 86.1 percent. By six months after radiotherapy, the numbers dropped to 24.1 percent in the acupuncture group and 63.6 percent of the control group still reporting symptoms of xerostomia. Saliva flow rates were also greater in the acupuncture group, starting at three weeks into radiotherapy and persisting through the one and six month follow-up.

Acupuncture also helped cancer-related symptoms, other than xerostomia, as measured by the MDASI-HN questionnaire, with differences that emerged in week three and continued through six months.

"The medical implications are quite profound in terms of quality of life, because while chronic dry mouth may sound benign, it has a significant impact on sleeping, eating and speaking," Cohen said. "Without saliva, there can be an increase in microbial growth, possible bone infection and irreversible nutritional deficits."

Additional studies are needed to determine the mechanisms for the benefits of acupuncture, and while the study didn't examine this issue, Cohen said it may have an impact on local blood flux, specifically at the parotid gland.

Further research is planned, including a large trial conducted at MD Anderson in collaboration with Fudan University Shanghai Cancer Center. Both centers will enroll 150 patients undergoing radiotherapy for head and neck cancer: 50 will receive acupuncture, 50 sham acupuncture and 50 will be enrolled in a control group. Researchers will also examine saliva constituents and a number of other measures to better determine the mechanisms of acupuncture.


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Acupuncture Effect on Inflammatory Markers in Pediatric Otitis Media With Effusion: A Pilot Study - myTomorrows

Acupuncture Effect on Inflammatory Markers in Pediatric Otitis Media With Effusion: A Pilot Study - myTomorrows | Acupuncture Research | Scoop.it

Objective: to evaluate acupunctures effect on inflammatory markers in pediatric Otitis Media
with Effusion Methods: 100 Children with otitis media with effusion (OME) diagnosis, who are
in watchful waiting for 3 month, will be randomized in two groups: acupuncture and control.
50 Children in the acupuncture group will receive standard treatment combined with
acupuncture for 3 months. 50 Children in the control group will receive standard treatment
only, for the same time period. After 3 months, both groups will be reassessed for OME.
Children with no improvement from both groups will be assigned for tympanostomy.

Data collection: in children undergoing tympanostomy, middle ear effusion (MEE) will be
collected, analyzed and evaluated for group differences.


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[Clinical research on bedsores treated with fire needle therapy]. - PubMed - NCBI

[Clinical research on bedsores treated with fire needle therapy]. - PubMed - NCBI | Acupuncture Research | Scoop.it

Zhongguo Zhen Jiu. 2010 Oct;30(10):819-21. English Abstract; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

 

Zhongguo Zhen Jiu. 2010 Oct;30(10):819-21.[Clinical research on bedsores treated with fire needle therapy].[Article in Chinese]Yan CL1, Liu QJ, Yang P, Fu AJ, Zhu J, Wang HH.Author information AbstractOBJECTIVE:

To discuss the clinical efficacy of fire needle therapy on bedsores.

METHODS:

Fifty-four cases of bedsores were divided randomly into a fire needling group and a filiform needling group, 27 cases in each one. In fire needling group, fire needle therapy was applied. In fifliform needling group, common needling technique with filiform needle was adopted. The wound surface and Ashi points around the sores were punctured in either group. The efficacy and the treatment session required in different phases were observed in two groups.

RESULTS:

The satisfactory rate of the efficacy was 91.4% (53/58) in fire needling group and was 75.9% (41/54) in common needling group, indicating statistical significant difference in comparison (P < 0.05). The sessions in the phases III and IV of bedsores increased significantly as compared with those in the phase II of two groups (both P < 0.05), of which, the sessions in phases III and IV of fire needling group were shortened apparently as compared with those of filiform needling group (P < 0.05).

CONCLUSION:

The efficacy of the fire needling therapy is superior to that of common needling on bedsores, and it is an effective approach to bedsores.

PMID: 21058478 [PubMed - indexed for MEDLINE]


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Can Acupuncture Treatment Be Double-Blinded? An Evaluation of Double-Blind Acupuncture Treatment of Postoperative Pain

Can Acupuncture Treatment Be Double-Blinded? An Evaluation of Double-Blind Acupuncture Treatment of Postoperative Pain | Acupuncture Research | Scoop.it
Blinding protects against bias but the success of blinding is seldom assessed and reported in clinical trials including studies of acupuncture where blinding represents a major challenge. Recently, needles with the potential for double-blinding were developed, so we tested if acupuncture can be double-blinded in a randomized study of sixty-seven patients with acute pain ≥ 3 (0-10 scale following third molar removal) who received active acupuncture with a penetrating needle or placebo acupuncture with a non-penetrating needle. To test if acupuncture was administered double-blind, patients and acupuncturists were asked about perceived treatment allocation at the end of the study. To test if there were clues which led to identification of the treatment, deep dull pain associated with needle application and rotation (termed “ de qi ” in East Asian medicine), and patients’ pain levels were assessed. Perceived treatment allocation depended on actual group allocation (p < 0.015) for both patients and acupuncturists, indicating that the needles were not successful in double-blinding. Up to 68% of patients and 83% of acupuncturists correctly identified the treatment, but for patients the distribution was not far from 50/50. Also, there was a significant interaction between actual or perceived treatment and the experience of de qi (p = 0.027), suggesting that the experience of de qi and possible non-verbal clues contributed to correct identification of the treatment. Yet, of the patients who perceived the treatment as active or placebo, 50% and 23%, respectively, reported de qi . Patients’ acute pain levels did not influence the perceived treatment. In conclusion, acupuncture treatment was not fully double-blinded which is similar to observations in pharmacological studies. Still, the non-penetrating needle is the only needle that allows some degree of practitioner blinding. The study raises questions about alternatives to double-blind randomized clinical trials in the assessment of acupuncture treatment.
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Acupuncture: York Clinic Director Hugh MacPherson giving keynote lecture at international acupuncture symposium

Acupuncture: York Clinic Director Hugh MacPherson giving keynote lecture at international acupuncture symposium | Acupuncture Research | Scoop.it

international acupuncture symposium

 

21/02/2015 13:32:01

 

 

On 21st March Clinic Director Hugh MacPherson is giving a keynote lecture at the 17th International Acupuncture Research Resource Centre Symposium at King's College London. Hugh's lecutre is on acupuncture for chronic neck pain.

For more information about the symposium see www.arrcsymposium.org.uk

- See more at: http://www.yorkclinic.com/news/clinic-director-hugh-macpherson-giving-keynote-lecture-at-international-acupuncture-symposium.aspx#sthash.kjE9K71A.dpuf

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Discover World acupuncture lasers industry 2014 and 2019 forecast - WhaTech

Discover World acupuncture lasers industry 2014 and 2019 forecast - WhaTech | Acupuncture Research | Scoop.it
The report provides key statistics on the market status of the Acupuncture Lasers manufacturers and is a valuable source of guidance and direction for companies and individuals interested in the industry.

 

Discover World acupuncture lasers industry 2014 and 2019 forecast inShare1   WhaTech Channel: Medical Market Research ReportsPublished on Monday, 02 February 2015 07:15Submitted by RNR Market Research. WhaTech AgencyNews from: RnR Market ResearchRead: 68 times

The report provides key statistics on the market status of the Acupuncture Lasers manufacturers and is a valuable source of guidance and direction for companies and individuals interested in the industry.

The ‘Global and Chinese Acupuncture Lasers Industry, 2009-2019 Market Research Report’ is a professional and in-depth study on the current state of the global Acupuncture Lasers industry with a focus on the Chinese market.

Firstly, the report provides a basic overview of the industry including its definition, applications and manufacturing technology. Then, the report explores the international and Chinese major industry players in detail. 

In this part, the report presents the company profile, product specifications, capacity, production value, and 2009-2014 market shares for each company. Through the statistical analysis, the report depicts the global and Chinese total market of Acupuncture Lasers industry including capacity, production, production value, cost/profit, supply/demand and Chinese import/export. 

The total market is further divided by company, by country, and by application/type for the competitive landscape analysis.

The report then estimates 2014-2019 market development trends of Acupuncture Lasers industry. Analysis of upstream raw materials, downstream demand, and current market dynamics is also carried out. 

In the end, the report makes some important proposals for a new project of Acupuncture Lasers Industry before evaluating its feasibility. Overall, the report provides an in-depth insight of 2009-2019 global and Chinese Acupuncture Lasers industry covering all important parameters.

 

Table of Contents

Chapter One Introduction of Acupuncture Lasers Industry
1.1 Brief Introduction of Acupuncture Lasers
1.2 Development of Acupuncture Lasers Industry
1.3 Status of Acupuncture Lasers Industry

Chapter Two Manufacturing Technology of Acupuncture Lasers
2.1 Development of Acupuncture Lasers Manufacturing Technology
2.2 Analysis of Acupuncture Lasers Manufacturing Technology
2.3 Trends of Acupuncture Lasers Manufacturing Technology

 

Chapter Four 2009-2014 Global and Chinese Market of Acupuncture Lasers
4.1 2009-2014 Global Capacity, Production and Production Value of Acupuncture Lasers Industry
4.2 2009-2014 Global Cost and Profit of Acupuncture Lasers Industry
4.3 Market Comparison of Global and Chinese Acupuncture Lasers Industry
4.4 2009-2014 Global and Chinese Supply and Consumption of Acupuncture Lasers
4.5 2009-2014 Chinese Import and Export of Acupuncture Lasers

Chapter Five Market Status of Acupuncture Lasers Industry
5.1 Market Competition of Acupuncture Lasers Industry by Company
5.2 Market Competition of Acupuncture Lasers Industry by Country (USA, EU, Japan, Chinese etc.)
5.3 Market Analysis of Acupuncture Lasers Consumption by Application/Type

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The Art and Science of Traditional Medicine : acupuncture

In this second of three special supplements, herbal genomics as a novel approach for revolutionizing research on, and ultimately use of, traditional herbal medicines and other materia medica, as well as advances in their quality control and standardization, is highlighted. A prominent focus is the U.S. Food and Drug Administration’s practical framework for developing botanicals (including traditional medicines) into new drugs based on the same standards as small molecule drugs. The application of mechanistic studies to drug discovery and development from traditional therapies is discussed, with an emphasis on preclinical toxicology assessments, pharmacovigilance, comparative effectiveness research, and the practice of "P4" medicine, particularly in the context of influenza, ischemic heart disease, stroke, and cancer.

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Acupuncture Holds Promise for Treating Inflammatory Disease | Media Relations

Acupuncture Holds Promise for Treating Inflammatory Disease | Media Relations | Acupuncture Research | Scoop.it

Acupuncture Holds Promise for Treating Inflammatory DiseaseRutgers-led study suggests pathways to alleviating inflammation in disorders such as sepsis, arthritisSunday, February 23, 2014
  

When acupuncture first became popular in the Western Hemisphere it had its doubters. It still does. But over time, through detailed observation, scientists have produced real evidence that ancient Chinese practitioners of the medical arts were onto something. 

Now new research documents a direct connection between the use of acupuncture and physical processes that could alleviate sepsis, a condition that often develops in hospital intensive care units, springs from infection and inflammation, and takes an estimated 250,000 lives in the United States every year. 

 

Photo: Rob FormanLuis Ulloa of Rutgers New Jersey Medical School says there may be future treatments for deadly inflammation that use either acupuncture or medications.High Res“Sepsis is the major cause of death in the hospital,” says Luis Ulloa of Rutgers New Jersey Medical School's Center for Immunity and Inflammation, who led the study, which has been published by the journal Nature Medicine. “But in many cases patients don’t die because of the infection. They die because of the inflammatory disorder they develop after the infection. So we hoped to study how to control the inflammatory disorder.”

 

The researchers already knew that stimulation of one of the body’s major nerves, the vagus nerve, triggers processes in the body that reduce inflammation, so they set out to see whether a form of acupuncture that sends a small electric current through that and other nerves could reduce inflammation and organ injury in septic mice. Ulloa explains that increasing the current magnifies the effect of needle placement, and notes that electrification is already FDA-approved for treating pain in human patients.   

When electroacupuncture was applied to mice with sepsis, molecules called cytokines that help limit inflammation were stimulated as predicted, and half of those mice survived for at least a week. There was zero survival among mice that did not receive acupuncture.

Ulloa and his team then probed further, to figure out exactly why the acupuncture treatments had succeeded. And they made a discovery that, on its face, was very disappointing. They found that when they removed adrenal glands – which produce hormones in the body – the electroacpuncture stopped working.

 

 Evidence that acupuncture produces beneficial effects continues to grow. That discovery presented a big potential roadblock to use of acupuncture for sepsis in humans, because most human cases of sepsis include sharply reduced adrenal function. In theory, electroacupuncture might still help a minority of patients whose adrenal glands work well, but not many others.

 

So the researchers dug even deeper – to find the specific anatomical changes that occurred when electroacupuncture was performed with functioning adrenal glands. Those changes included increased levels of dopamine, a substance that has important functions within the immune system. But they found that adding dopamine by itself did not curb the inflammation. They then substituted a drug called fenoldopam that mimics some of dopamine’s most positive effects, and even without acupuncture they succeeded in reducing sepsis-related deaths by 40 percent.

Ulloa considers the results a double triumph. 

On the one hand, he says, this research shows physical evidence of acupuncture’s value beyond any that has been demonstrated before. His results show potential benefits, he adds, not just for sepsis, but treating other inflammatory diseases such as rheumatoid arthritis, osteoarthritis and Crohn’s disease.   

On the other hand, by also establishing that a drug reduced sepsis deaths in mice, he has provided an innovative road map toward developing potential drugs for people. That road map may be crucial, because no FDA-approved drug to treat sepsis now exists. 

“I don’t even know whether in the future the best solution for sepsis will be electroacupuncture or some medicine that will mimic electroacupuncture,” Ulloa concludes. The bottom line, he says, is that this research has opened the door to both.


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BMJ AIM: Identification of determinants of the utilisation of acupuncture treatment using Andersen's behavioural model -- Lee et al. -- Acupuncture in Medicine

BMJ AIM: Identification of determinants of the utilisation of acupuncture treatment using Andersen's behavioural model -- Lee et al. -- Acupuncture in Medicine | Acupuncture Research | Scoop.it
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Published Online First 24 November 2014Abstract

Objectives The utilisation of healthcare services is the result of a complex decision-making process with different determinants. This study aims to identify the determinants of the utilisation of acupuncture treatment using Andersen's behavioural model and quality of life.

Methods In this study we reviewed Korean Health Panel data, a nationally representative set of data, and analysed the utilisation of outpatient acupuncture services during 2011. A two-part model, which included predisposing, enabling and need factors of Andersen's behavioural model in model 1 and the additional factor of health-related quality of life (HRQOL, EQ-5D Korean index) in model 2, was analysed by logistic analysis to identify determinants of acupuncture service usage among subjects who visited traditional Korean medical clinics.

Results The higher frequency of acupuncture service usage among patients who visited traditional Korean medical clinics was associated with gender, age, number of chronic diseases, physical disabilities and HRQOL of the subjects.

Conclusions This study shows that the important determinants of the frequency of acupuncture treatment utilisation are gender, age, number of chronic diseases and the presence of physical disabilities. Our findings contribute to understanding the characteristics of patients who use acupuncture treatment and may be used as a basic resource for related policy making by government officials and medical professionals.

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Repeated electroacupuncture in obese diabetic ZDF rats - YouTube

We provide a protocol for repeated electroacupuncture in male obese diabetic ZDF rats and report a hypoglycemic effect observed via blood sampling at a basel...


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An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in Korea

An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in Korea | Acupuncture Research | Scoop.it

Park EJ, et al. J Korean Med Sci. 2010 May;25(5):772-775. http://dx.doi.org/10.3346/jkms.2010.25.5.772

 

J Korean Med Sci. 2010 May;25(5):772-775. English.
Published online April 16, 2010.  http://dx.doi.org/10.3346/jkms.2010.25.5.772 ©; 2010 The Korean Academy of Medical Sciences.  An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in KoreaEun Jung Park, Kyung Ream Han, Ho Choi, Do Wan Kim and Chan KimHyperhidrosis Center, Ajou University Hospital, Suwon, Korea.
Address for Correspondence: Chan Kim, M.D. Department of Anesthesiology and Pain Medicine, Ajou University Hospital, 164 Worldcup-ro, Yeongtong-gu, Suwon 443-721, Korea. Tel: +82.31-219-5689, Fax: +82.31-219-6656, Email: dreunjung@paran.com  Received March 30, 2009; Accepted September 24, 2009.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 This article has been cited by 1 article in  
 This article has been cited by Google Scholar.

Go to:Abstract

Hyperhidrosis is a disorder of perspiration in excess of the body's physiologic need and significantly impacts one's occupational, physical, emotional, and social life. The purpose of our study was to investigate the characteristics of primary hyperhidrosis in 255 patients at Ajou University Hospital Hyperhidrosis Center from March 2006, to February 2008. Information collected from the medical records was: sex, sites of hyperhidrosis, age at visit, age of onset, aggravating factors, hyperhidrosis disease severity scale (HDSS) rank, family history, occupation, and past treatment. A total of 255 patient records were reviewed; 57.6% were male. Patients with a family history (34.1%) showed a lower age of onset (13.21±5.80 yr vs. 16.04±9.83 yr in those without family history); 16.5% had previous treatment, most commonly oriental medicine. Palmar and plantar sites were the most commonly affected, and 87.9% of patients felt their sweating was intolerable and always interfered with their daily activities. Our study provides some original information on the Korean primary hyperhidrosis population. Patients who have a family history show signs of disease in early age than those without family history.

  

 

Keywords: Epidemiology, Primary Hyperhidrosis.

 

Go to:INTRODUCTION

Hyperhidrosis is a condition characterized by excessive sweating and can be focal (primary) or generalized (secondary) (1). Secondary hyperhidrosis is caused by an underlying condition such as infection, endocrine or metabolic disorders, neoplastic diseases, neurologic conditions, spinal cord injuries, cardiovascular or respiratory disorders, anxiety, or stress (2,3).

Primary hyperhidrosis has been associated with hyperactivity of the sympathetic nervous system and can affect the palms, soles, axillae, face, and scalp as well as other sites (2,4). This condition occurs in otherwise healthy people and can have a deeply detrimental effect on quality of life, resulting in impairment of daily activities, social interactions and occupational activities (5,6).

A pilot study of young Israelis reported an incidence of 1% (7), and hyperhidrosis prevalence in the United States is 2.8%, equivalent to 7.8 million people (2). Hyperhidrosis is uncommon but not rare. Despite many treatment modalities, research into the characteristics of hyperhidrosis patients is limited. Here, we retrospectively investigated the epidemiologic characteristics of primary hyperhidrosis patients visiting a hyperhidrosis center in Korea.

Go to:MATERIALS AND METHODS

We reviewed the medical records of patients visiting our hyperhidrosis center between March 2006, and February 2008, for diagnosis and treatment of hyperhidrosis. Information collected from the medical records included: sex, age at visit, age of onset, referral source, occupation, family history, past treatment, hyperhidrosis sites, aggravating factors and hyperhidrosis disease severity scale (HDSS) ranking. We analyzed the relationship between family history of hyperhidrosis and age of onset. Qualitative variables are expressed as percentages and compared using Pearson's chi-square test. Quantitative variables are expressed as mean±standard deviation and compared using Student's t-test. We analyzed the results with SPSS version 15.0 (SPSS, Chicago, IL, USA) and all P values less than 0.05 were considered statistically significant.

Go to:RESULTS

A total of 255 medical records were reviewed; 57.6% of the patients were male, the mean age was 28.54±13.44 yr old at the date of visit, with a mean age of onset of 15.0±8.78 yr old, and 34.1% of all patients had a positive family history of hyperhidrosis (Table 1). The mean age of onset in those with a positive family history was 13.21±5.80 yr, significantly lower than the age (16.04±9.83 yr) in those without family history of hyperhidrosis (P<0.006).

   Table 1 
Patient demographic data

 

The route to visit our center and occupation of the patients are described by frequency (Tables 2,3). The most common route of visit was "arranged by individual clinic" and the most common occupational category was "student". Previous treatment was attempted by 42 of the 255 patients (16.5%). The most common treatment modality before the visit was oriental medicine such as herbal medication and acupuncture (Table 4). The most common aggravating factors were stress or anxiety, and social relationships (Table 5).

   Table 2 
Referral source   Table 3 
Patient occupation   Table 4 
Previous treatment   Table 5 
Aggravating factors

 

Palmar and plantar sites were the most commonly affected sites (Fig. 1). We determined how hyperhidrosis affected their life using the hyperhidrosis disease severity scale. Most (87.9%) patients felt their sweating was intolerable and always interferes with their daily activities (Fig. 2).

   Fig. 1 
Sites of hyperhidrosis. Others are any combinations of excessive sweating sites except palmar/platar and palmar/plantar/axillae.   Fig. 2 
Impact of sweating on daily activities accounting by hyperhidrosis severity scale.

 

Go to:DISCUSSION

This research provides original information on primary hyperhidrosis and is the first descriptive study of Korean hyperhidrosis patients. The average age of onset is 15.0 yr old in our study, earlier than in a 2004 United States prevalence study (25.2 yr) (2). However, a more recent US study in 2007 showed a similar average age of onset to our study (14.05 yr) (8); the mean age at first visit for diagnosing and treatment of hyperhidrosis was 28.05 yr in our study and also in the recent US study (8), compared to 39.8 yr in the 2004 study (2). These studies showed that primary hyperhidrosis appeared in adolescence, but people seek medical treatment in early adulthood. Stolman suggested a genetic predisposition may exist, since 30-50% of patients have a family history of hyperhidrosis (9). A pedigree analysis by Kaufmann et al. (10) suggested that hyperhidrosis segregated independently as an autosomal dominant trait and was not inherited as a crosslinked trait. Ro et al. (11) reported a 65% incidence of positive family history in 49 patients with hyperhidrosis that had undergone thoracoscopic sympathectomy. The 2007 US study showed 47.3% of hyperhidrosis patients had a positive family history and patients who reported an onset age below 20 yr of age were more likely to have a positive family history of hyperhidrosis than those with a later age of onset (8). In line with these results, our study revealed a family history in 34.1% of primary hyperhidrosis cases; and positive family history patients had a younger onset age than those with a negative family history (13.21±5.80 yr old vs. 16.04±9.83 yr old).

Hyperhidrosis is present in 2.8% of the general population in the United States (2). This condition can have a deeply detrimental effect on a patient's quality of life, resulting in dramatic impairments of daily activities, social interactions and occupational activities (5,6). But, patients rarely seek a physician because many are unaware there are many treatments for primary hyperhidrosis (1). In this study we asked patients how they were referred to our hyperhidrosis clinic or how they got information for hyperhidrosis treatment. The most common referral mode was recommendation by individual clinics, although many patients also found information from the internet or mass media.

Lear et al. (8) reported patients had some form of treatment before the consult visit, such as topical aluminum chloride or botulinum toxin type A subcutaneous injections. However, in this study the most common treatment modality before the visit was oriental medicine such as herbal medication and acupuncture.

Hyperhidrosis can be generalized, involving the whole body, but primary focal hyperhidrosis involves limited body areas, most often palms, soles, face, axillae or a combination of them. In our study, the most commonly affected sites that had excessive sweating were palmar and plantar sites simultaneously (32.2%). Other common sites were a combination of palmar, plantar and axillae (22.4%). There are many treatment modalities for hyperhidrosis such as topical aluminum chloride, iontophoresis, botulinum toxin type A injection, endoscopic thoracic sympathectomy (ETS), axillary sweat gland removal, oral anticholinergic, and chemical lumbar sympathectomy (CLS) (12-15). Most of such treatment modalities are usually effective for focal area. But our results showed many patients suffer from excessive sweating in multiple sites. In our clinic, We are performing different procedure depending on problem area. Patients who has only palmar hyperhidrosis, we perform VATS. Patients who has only plantar hyperhidrosis, we perform CLS. Patients who has only axillary hyperhidrosis, we perform axillary sweat gland removal. We use oral anticholinergic (glycopyrrolate) for the patients who has multiple sites hyperhidrosis or refuse to have invasive procedure, contraindication to have invasive treatment, recurrence after above mentioned procedure such as ETS, CLS, and axillary sweat gland removal.

Excessive sweating of primary hyperhidrosis patients is usually triggered by anxiety, embarrassment, fear, anger, excitement, or mental stress (16). Eccrine sweat glands are innervated by cholinergic fibers from the sympathetic nervous system. Their sweat secretion function is affected by emotional and gustatory stimuli. Nearly all (95%) primary hyperhidrosis patients said their sweating was intensified when they were in stressful situations or felt anxiety, and 77.0% felt their symptoms were aggravated in social situations. Another common trigger factor was heat.

The severity and impact of hyperhidrosis was assessed using the HDSS, which provides a qualitative measure allowing tailored treatment; this validated and reliable instrument has been used in other studies of hyperhidrosis (17,18). The HDSS is used to determine the severity of sweating experienced by the respondents. A 4-point, single-item question, the HDSS asks patients to indicate which of the following best describes the impact of sweating on their daily activities: 1) never noticeable, never interferes; 2) tolerable, sometime interferes; 3) barely tolerable, frequently interferes; or 4) intolerable and always interferes. Most (87.9%) of hyperhidrosis patients have sweating that is a '4'.

In conclusion, we described the epidemiologic characteristics of primary hyperhidrosis patients in Korea for the first time. These characteristics can help physicians who treat the patients. The patients who have a family history show signs of disease in early age than those without family history. Most of hyperhidrosis patients have intolerable sweating and excessive sweating which interfered their daily activities. Since the study scope was limited to one hyperhidrosis center; a national survey should be performed to further expand the data available to assist whole Korean patients.


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