A great video made for the British acupuncture awareness week
A new study published this month in the Journal of Alternative Complementary Medicine indicates that not only can abdominal acupuncture offer assistance with menstrual regulation in those with Polycystic Ovary Syndrome but also can help with weight loss and reduce BMI and Waist to Hip ratio.
Effectiveness of Abdominal Acupuncture for Patients with Obesity-Type Polycystic Ovary Syndrome: A Randomized Controlled Trial.
Zheng YH, Wang XH, Lai MH, Yao H, Liu H, Ma HX.
First Affiliated Hospital of Guangzhou Medical College , Guangzhou, China .
Abstract Objective: To assess the effectiveness of abdominal acupuncture at the endocrine and metabolic level in patients with obesity-type polycystic ovary syndrome (PCOS).
Methods: Eighty-six women from the First Affiliated Hospital of Guangzhou Medical College with a diagnosis of PCOS (body-mass index [BMI] ≥25 kg/m2) were randomly assigned to receive 6 months of abdominal acupuncture (once a day) or oral metformin (250 mg three times daily in the first week, followed by 500 mg three times daily thereafter). BMI, waist-to-hip ratio (WHR), ovarian volume, menstrual frequency, homeostasis model assessment for insulin resistance (HOMA-IR), and Ferriman-Gallwey score were measured at the beginning of the study and after 6 months of treatment. Luteotrophic hormone (LH), testosterone, follicle-stimulating hormone (FSH), fasting blood glucose, 2-hour Postprandial blood glucose, fasting insulin, 2-hour postprandial blood insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were also assessed.
Results: According to the results at baseline and 6 months, BMI, WHR, Ferriman-Gallwey score, ovarian volume, luteotrophic hormone, ratio of luteotrophic hormone to follicle-stimulating hormone, testosterone, LDL-C, triglycerides, total cholesterol, fasting blood glucose, 2-hour postprandial blood glucose, fasting insulin, 2-hour postprandial blood insulin, and HOMA-IR were reduced significantly in the two groups (p<0.05). Menstrual frequency and HDL-C (p<0.05) increased significantly in both groups; follicle-stimulating hormone also increased in both groups, but the change was not significant (p>0.05). The acupuncture group showed considerable advantages over the metformin group in terms of reduced BMI and WHR and increases in menstrual frequency (p<0.05).
Conclusion: Abdominal acupuncture and metformin improved the endocrine and metabolic function of patients with obesity-type PCOS. Abdominal acupuncture may be more effective in improving menstrual frequency, BMI, and WHR, with few adverse effects.
A Cochrane Review is considered the gold standard of research meta-analysis. The following abstract shows that Acupuncture may be useful in the treatment of chronic neck pain.
A B S T R A C T
Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. Acupuncture has been used as an alternative to more traditional treatments for musculoskeletal pain. This review summarizes the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain.
Objectives: To determine the effects of acupuncture for individuals with neck pain.
Search strategy: We searched CENTRAL (2006, issue 1) and MEDLINE, EMBASE, MANTIS, CINAHL from their beginning to February 2006. We searched reference lists and the acupuncture database TCMLARS in China.
Selection criteria: Any published trial using randomized (RCT) or quasi-randomized (quasi-RCT) assignment to the intervention groups, either in full text or abstract form, were included.
Data collection and analysis: Two reviewers made independent decisions for each step of the review: article inclusion, data abstraction and assessment of trial methodological quality. Study quality was assessed using the Jadad criteria. Consensus was used to resolve disagreements. When clinical heterogeneity was absent, we combined studies using random-effects meta-analysis models.
Main results: We did not find any trials that examined the effects of acupuncture for acute or subacute pain, but we found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodological quality had a mean of 2.3/5 on the Jadad Scale. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately post-treatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately post-treatment and at short-term follow-up (pooled standardized mean difference (SMD) -0.37, 95% confidence interval (CI) -0.61 to -0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupunctur was more effective than a wait-list control at short-term follow-up.
Authors’ conclusions: There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment.There is moderate evidence that those who received acupuncture reported less pain at short term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain post-treatment and this is maintained at short-term follow-up.
Source: Cochrane Library
Acupuncture for the alleviation of lateral epicondyle pain: a systematic review
Objectives: Lateral epicondyle pain is a common complaint in North America. In the past 10 yr acupuncture has become increasingly recognized as an alternative treatment for pain, including epicondyle pain. This review evaluates the effectiveness of acupuncture as a treatment for lateral epicondylitis using the appropriate analysis.
Methods: Online bibliographic database searches in any language from Medline, PsychINFO, CINAHL, Healthstar, PMID, CAM, EMBASE, Cochrane Database of Systematic Review (3rd quarter 2003), articles listed in reference lists of key articles and the author's personal files were performed. Randomized and quasi-randomized controlled trials examining the effects of acupuncture on lateral epicondyle pain were selected. From the six studies that met inclusion criteria, the first author, year of publication, population studied, dropout rate, treatment plan, assessment scale and outcome measures were extracted. Study quality was determined by using the Jadad scale, in which all studies were rated as high quality. A best evidence synthesis approach was used to analyse the data presented in the six studies.
Results: All the studies suggested that acupuncture was effective in the short-term relief of lateral epicondyle pain. Five of six studies indicated that acupuncture treatment was more effective compared to a control treatment.
Conclusions: There is strong evidence suggesting that acupuncture is effective in the short-term relief of lateral epicondyle pain.
Source: Rheumatology Journal
STUDY ANALYSIS SHOWS ACUPUNCTURE EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN
Millions of people suffer with low back pain in the UK, and it is one of the top reasons people seek medical treatment. Back problems are also, by far, the primary reason for appointments with acupuncturists. But does acupuncture really help these patients? Researchers from the University of Maryland School of Medicine and the Peninsula Medical School, Plymouth, U.K., analyzed dozens of studies from around the world on acupuncture for low back pain. The study results will be published in the April 19 issue of the Annals of Internal Medicine.
“For people with chronic low back pain, this analysis shows that acupuncture is clearly effective in providing considerable pain relief,” says Eric Manheimer, study author and director of database and evaluation for the University of Maryland Center for Integrative Medicine. “The research also showed that acupuncture provided true pain relief. The benefit was not just due to the placebo effect.”
The reviewers scoured the medical literature for all studies involving acupuncture for treating low back pain. To minimize bias, the American and British teams developed explicit criteria for evaluating the studies and did the evaluations independently. Their analysis included only randomized controlled trials, the gold standard study design for evaluating medical procedures.
Thirty-three studies covering more than 2,100 patients met the criteria for review. In the end, the researchers used 22 of these studies for their analysis. All 22 evaluated Chinese-style acupuncture for chronic low back pain, defined as pain that has been on-going for more than three months. The other 11 studies were excluded because they either only reported data that could not be combined statistically, they only included patients with acute back pain or pregnancy-related back pain or they involved forms of acupuncture other than traditional Chinese acupuncture.
Manheimer says, “We wanted the studies for the analysis to meet the highest scientific standards. As a way to account for a possible placebo effect, we looked at many studies that used ‘sham acupuncture’ as a control group, where acupuncture needles were inserted only superficially or in the wrong place.”
The sham acupuncture studies were double-blinded, meaning neither the researchers nor the participants knew who was receiving the real or the sham treatment. When looking at those studies, the reviewers found the differences in pain ratings showed a significant difference between the real acupuncture and the sham acupuncture groups, indicating that the benefit was not just due to the placebo effect.
“From our analysis, the message for people with chronic low back pain is that acupuncture is a truly effective therapy that provides significant pain relief,” says Manheimer. “Patients with low back pain have many options for treatment including medication, chiropractic care, physical therapy and back exercises. However, these treatments do not always help, and scientific evidence indicates that they have only modest effectiveness.”
The researchers evaluated the effects of acupuncture both in the short-term (defined as three weeks after the last acupuncture treatment) as well as in the longer term. They found acupuncture provided definite pain relief in the short-term, and this relief appeared to be sustained over the longer term. However, they say it’s too early to be certain of longer term effects, and more studies are underway.
For patients with acute back pain (defined as lasting less than three months), the reviewers found the data to be sparse and inconclusive. The evidence comparing acupuncture to other therapies was also inconclusive.
Previous attempts to synthesize information on acupuncture and chronic low back pain provided mixed results. But since 1999, the publication of five high quality, large-scale studies has added new evidence for the analysis. The current analysis includes these newer studies as well as earlier research not included in previous reviews.
In all, this analysis contains more than twice as many studies as earlier reviews and includes reports in English, Chinese, Japanese, Korean as well as Germanic and Romance languages. For this study, the reviewers received funding from the National Center for Complementary and Alternative Medicine, a part of the National Institutes of Health.
Source: University of Maryland Press release
Background: Low back pain limits activity and is the second most frequent reason for physician visits. Previous research shows widespread use of acupuncture for low back pain.
Purpose: To assess acupuncture's effectiveness for treating low back pain.
Data Sources: Randomized, controlled trials were identified through searches of MEDLINE, Cochrane Central, EMBASE, AMED, CINAHL, CISCOM, and GERA databases through August 2004. Additional data sources included previous reviews and personal contacts with colleagues.
Study Selection: Randomized, controlled trials comparing needle acupuncture with sham acupuncture, other sham treatments, no additional treatment, or another active treatment for patients with low back pain.
Data Extraction: Data were dually extracted for the outcomes of pain, functional status, overall improvement, return to work, and analgesic consumption. In addition, study quality was assessed.
Data Synthesis: The 33 randomized, controlled trials that met inclusion criteria were subgrouped according to acute or chronic pain, style of acupuncture, and type of control group used. The principal measure of effect size was the standardized mean difference, since the trials assessed the same outcome but measured it in various ways. For the primary outcome of short-term relief of chronic pain, the meta-analyses showed that acupuncture is significantly more effective than sham treatment (standardized mean difference, 0.54 [95% CI, 0.35 to 0.73]; 7 trials) and no additional treatment (standardized mean difference, 0.69 [CI, 0.40 to 0.98]; 8 trials). For patients with acute low back pain, data are sparse and inconclusive. Data are also insufficient for drawing conclusions about acupuncture's short-term effectiveness compared with most other therapies.
Limitations: The quantity and quality of the included trials varied.
Conclusions: Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies.
Source: Annals of Internal Medicine April 2005
ACUPUNCTURE PROVIDES ADDED BENEFIT FOR PEOPLE WITH OSTEOARTHRITIS OF THE KNEE
Study by University of Maryland doctors is one of the largest ever for acupuncture
Researchers at the University of Maryland School of Medicine have found that traditional Chinese acupuncture significantly reduces pain and improves function for patients with osteoarthritis of the knee who have moderate or more severe pain despite taking pain medication. Those are the results of a four-year study published in the December 21 issue of the Annals of Internal Medicine.
"Our study shows that acupuncture can be a safe and effective complementary therapy for people with osteoarthritis of the knee," explains Brian Berman, M.D., the principal investigator who is director of the University of Maryland Center for Integrative Medicine and a professor of family medicine at the University of Maryland School of Medicine. "Before taking part in our study, many of the patients were taking anti-inflammatory medicine but they still experienced a lot of pain. When we added acupuncture to their treatment, the majority reported significant improvement."
"Osteoarthritis is the most common form of arthritis, affecting more than 20 million Americans," says Marc Hochberg, M.D., M.P.H., a co-investigator of the study. Dr. Hochberg is a professor of medicine and head of the Division of Rheumatology at the University of Maryland School of Medicine and head of rheumatology at the University of Maryland Medical Center.
According to Dr. Hochberg, "Many people with osteoarthritis live with debilitating pain, which forces them to limit their activities. This research shows that acupuncture, when used along with medication, can help to relieve symptoms and improve people's ability to participate in their usual activities."
The Phase III randomized controlled trial followed 570 participants the largest group ever for an acupuncture study. Researchers divided participants into three groups. One group received education about arthritis, another group received traditional Chinese acupuncture and the third received sham acupuncture, where practitioners tapped the needles on the skin but they did not go through. The stainless steel needles are about the width of a human hair and are not painful when inserted correctly.
"The participants really couldn't tell whether they were receiving the real or the sham acupuncture," explains Lixing Lao, M.D., Ph.D., a licensed acupuncturist and a study investigator who is an associate professor of family medicine at the University of Maryland School of Medicine. "We chose specific places for the needles to be inserted based on traditional Chinese medicine. Those who received the sham acupuncture may have felt the edge of the guide tube, but the actual needle did not go in."
The acupuncturists placed a screen over the participants' stomachs so they did not know whether they were receiving the true acupuncture. Also, when electrical stimulation was supposed to be used, people receiving the sham acupuncture saw machines with flashing lights even though there was no electricity going through.
Patients in the acupuncture and sham acupuncture groups received 24 "treatments" over a 26-week period. At first, the treatments were given twice a week and they were gradually reduced to once a month. People in the education group took a 12-week self-help course involving two-hour group sessions. Researchers assessed the participants at the beginning of the study and then at four weeks, eight weeks, 14 weeks and 26 weeks.
"At the end of the 26 weeks, patients receiving traditional Chinese acupuncture had more improvement in both pain relief and function when compared to the sham acupuncture and the education groups," says Dr. Berman.
But the benefits were not evident right away. Among those who received real acupuncture, their pain was not significantly reduced compared to the sham acupuncture group until week 14. On the function score, researchers saw a difference after eight weeks of real acupuncture compared to the sham acupuncture.
Overall, patients receiving the true acupuncture reported a 40 percent improvement in both pain and function from their baseline scores. Participants rated their pain and function using a standard arthritis measurement: the Western-Ontario McMaster (WOMAC) Index.
Dr. Hochberg adds, "Study participants were allowed to continue whatever drug and non-drug therapies they were already using. With the addition of the acupuncture therapy, the participants did not report any significant side effects. So it proved to be a safe and effective treatment."
During the trial, seven acupuncturists treated participants at three sites: The University of Maryland Center for Integrative Medicine at Kernan Hospital in Baltimore, the Innovative Medical Research Center in Towson, Maryland, and the Hospital for Special Surgery in New York City. Participants had to be at least 50 years old with a diagnosis of osteoarthritis and had to experience at least moderate knee pain on most days of the prior month. They could not have had any previous experience with acupuncture.
"For the first time, a clinical trial with sufficient rigor, size and duration has shown that acupuncture reduces the pain and functional impairment of osteoarthritis of the knee," says Stephen E. Straus, M.D., director of the National Center for Complementary and Alternative Medicine.
The National Center for Complementary and Alternative Medicine and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, both components of the National Institutes of Health, provided funding for the study.
Source: University of Maryland Press Release
A recent pilot study published in the European Journal of Obstetric Gynaecology and Reproductive Biology in March found that acupuncture was as effective in treating primary dysmenorrhea as were common painkillers.
A randomized pilot study of acupuncture treatment for primary dysmenorrhea.
Kiran G, Gumusalan Y, Ekerbicer HC, Kiran H, Coskun A, Arikan DC.
Source: Kahramanmaras Sutcu Imam University School of Medicine, Department of Obstetrics and Gynecology, Kahramanmaras, Turkey. Electronic address: firstname.lastname@example.org.
OBJECTIVE: To compare the therapeutic effect of acupuncture and non-steroidal anti-inflammatory drug (NSAID) therapy in primary dysmenorrhea patients.
STUDY DESIGN: Thirty-five young women with a diagnosis of primary dysmenorrhea were recruited for the study. Their dysmenorrhea severity was rated by visual analog scale (VAS) immediately prior to entry into the study. They were randomly divided into two groups; and the following month they were given NSAID (group 1, n=24) or acupuncture treatment (group 2, n=11). Pain was rated again using VAS during menstruation in both groups.
RESULTS: After one month's treatment, pain scores were significantly lower in both groups (p<0.05). Mean pain scores decreased by 52.2% and 69.5% in the NSAID and acupuncture groups, respectively.
CONCLUSION: Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea. Since this was a pilot study with a small sample size and short follow-up period, larger studies are needed to clarify the effect of acupuncture in the treatment of primary dysmenorrhea.
Chinese Medicine Blog
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