Qi-guiding acupuncture relieves disc herniation pain and a special intensive silver acupuncture needle protocol relieves chronic lower back myofascial pain.
Researchers find acupuncture effective for the treatment of lower back pain disorders. In a protocolized study from the Shanghai Jiaotong University Sixth People’s Hospital, researchers determined that a special type of manual acupuncture therapy, known as qi-guiding acupuncture, produces significant positive patient outcomes for lumbar intervertebral disc herniation patients. In related research from Xinping Hospital of Traditional Chinese Medicine, investigators find acupuncture combined with moxibustion effective for the alleviation of lower back pain due to lumbodorsal myofascial pain syndrome. A special application of silver acupuncture needles produced superior patient outcomes. Let’s start with a look at the Shanghai Jiaotang University research and then we’ll see how the silver needle protocol boosts treatment efficacy for the treatment of lower back pain.
Acupuncture is effective for the treatment of lumbar intervertebral disc herniations. Wu et al. (Shanghai Jiaotong University Sixth People’s Hospital) investigated the treatment results of qi-guiding acupuncture with meridian differentiated acupoint selections and determined that it produces significant positive treatment outcomes for lumbar intervertebral disc herniation patients. Wu et al. also find electroacupuncture with meridian differentiated acupoint selections effective; however, qi-guiding acupuncture had a slightly higher rate of producing positive patient outcomes. Qi-guiding acupuncture had an 87.5% total treatment effective rate and electroacupuncture achieved an 86.6% total treatment effective rate. Qi-guiding acupuncture also had better outcomes for increases in nerve conduction velocity. The results are definitive given the large sample size of 549 patients with lumbar disc herniations evaluated in this study.
Lumbar disc herniation patients experience lower back pain and radiculopathy (radiating pain and numbness) as a result of anulus fibrosis damage, IVF encroachment, and other issues associated with disc damage (Hu et al.). Acupuncture, as one of the most common non-surgical treatment methods for lumbar disc herniation, has a high treatment effective rate and no significant adverse effects (Cheng).
Qi-guiding acupuncture was first documented in ancient literature, including The Systematic Classic of Acupuncture & Moxibustion by Huang-fu Mi. In qi-guiding acupuncture, needle entry and removal is controlled and slow. To direct qi upward, the acupuncture needle is oriented upward; similarly, to direct qi downward, the needle is pointed downward. Subsequently, the needle is frequently rotated, lifted, and thrust to regulate the flow of qi in the body. Additional manipulation techniques may be intermittently applied. In modern use, qi-guiding acupuncture repairs ultramicroscopic structures of damaged nerve roots and accelerates other aspects of nerve repair, thereby increasing nerve conduction.
In this study, lumbar disc herniation patients receiving qi-guiding acupuncture achieved an 87.5% total treatment effective rate. Patients receiving electroacupuncture achieved an 86.6% total treatment effective rate. Both qi-guiding acupuncture and electroacupuncture significantly increased nerve conduction velocity. Qi-guiding acupuncture had a slightly greater improvement in common peroneal nerve conduction velocity and superficial fibular nerve conduction velocity. Common peroneal nerve conduction velocity increased from 38.26 ± 12.8 to 44.75 ± 5.24 after the application of qi-guiding acupuncture, and increased from 39.11 ± 3.64 to 39.86 ± 10.95 after electroacupuncture. Superficial fibular nerve conduction velocity increased from 41.63 ± 4.37 to 42.55 ± 6.43 after the application of qi-guiding acupuncture, and increased from 40.71 ± 9.56 to 40.43 ± 4.01 after electroacupuncture.
A total of 549 patients with lumbar disc herniations were treated and evaluated in this study. These patients were diagnosed with lumbar disc herniations between December 2012 and March 2014. They were randomly divided into a treatment group and a control group, with 280 patients in the treatment group and 269 patients in the control group. The treatment group underwent qi-guiding acupuncture therapy, while the control group received electroacupuncture. Acupoint selection for both groups was based on meridian differentiation. Identical acupoints were selected for both patient groups.
For Taiyang meridian lumbago and leg pain (scelalgia):
For Yangming meridian lumbago and leg pain:
For Shaoyang meridian lumbago and leg pain:
For qi-guiding acupuncture, the following protocol was administered. Upon disinfection with 75% ethanol, a 0.30 mm x 40 mm filiform acupuncture needle was inserted into each selected acupoint. Huantiao and Juliao were needle to a depth of 2.5 inches. The remaining acupoints were needled to a depth of 1.2 inches. When a deqi sensation was achieved for all acupoints, qi-guiding needling with the Xie (reducing) manipulation technique was applied to Weizhong, Tiaokou, and Yanglingquan to transmit the needling sensation upward and toward the hip or waist. The same technique was applied to Huantiao, Juliao, and Biguan, instead transmitting the needle sensation downward and toward the legs. Subsequently, qi-guiding needling with the Bu (tonification) manipulation technique was applied on Dachangshu to transmit the needle sensation toward the lumbosacral area. The same technique was used on Shenshu until a deqi sensation of soreness or swelling was perceived at the lumbar region. A needle retention time of 20 minutes was observed during which the needles were rotated, lifted, and thrusted every 5 minutes to facilitate the flow of qi. One qi-guiding acupuncture session was conducted every other day for a total of 10 treatments.
Electroacupuncture for the control group was administered with the same aforementioned protocol. Before needle retention, the needles were connected to an electroacupuncture device. The device was then set to a continuous wave at 4 Hz with a 2mA current. A 20 minute needle retention time was subsequently observed. One electroacupuncture session was conducted every other day for a total of 10 treatments. The clinical results the Wu et al. study demonstrate that both qi-guiding acupuncture and electroacupuncture, when combined with meridian-differentiated acupoint selection, are suitable and effective therapies for lumbar disc herniation patients. However, qi-guiding acupuncture produces slightly better treatment outcomes in terms of nerve conduction velocity improvements.
In a related study, Wang H.D. (Xinping Hospital of Traditional Chinese Medicine) finds acupuncture combined with moxibustion therapy effective for the treatment of lumbodorsal myofascial pain syndrome. The study also finds that a silver needle protocol produces preferable treatment outcomes to conventional acupuncture. Lumbodorsal myofascial pain syndrome causes chronic lumbago and commonly occurs in young adults. Intensive acupuncture combined with moxibustion using silver needles was famously used by Professor Xuan Zhe Ren, a renowned Chinese orthopedist.
Acupoints were selected based on the degree of soft tissue damage, area of muscular tissue involved, and size of tendon contracture. In this approach, acupoints are 2 cm apart from each other and are mainly located on the lumbosacral region. Results from Wang’s study demonstrate that lumbodorsal myofascial pain syndrome patients receiving intensive acupuncture combined with moxibustion using silver needles achieved a 90% total treatment effective rate. Conventional acupuncture with moxibustion achieved an 83.3% total treatment effective rate.
Wang’s study involved a total of 60 patients with lumbodorsal myofascial pain syndrome. They were divided into a treatment group and a control group, with 30 patients in each group. The treatment group underwent intensive acupuncture-moxibustion therapy with silver needles. The control group received conventional acupuncture-moxibustion.
Intensive acupuncture-moxibustion with silver needles was applied to the T12 – L4 Jiaji acupoints and the acupoints located at the midpoint between each Jiaji acupoint. In addition, acupoints located 2 cm lateral to the Jiaji acupoints were needled. Finally, moxibustion applied with one Zhuang of 3 cm moxa cigar. One session was conducted daily for a total of 7 days. For conventional acupuncture-moxibustion therapy, the following primary acupoints were selected:
Additional acupoints were selected based on individual symptoms. For lumbago with chill-dampness:
For lumbago due to exhaustion:
For lumbago with kidney deficiency:
A needle retention time of 30 minutes was observed. Subsequently, moxibustion was applied using either a 4 hole or 6 hole moxa box on the lumbar acupoints. One session was conducted daily for a total of 7 days. The treatment efficacy for each patient was evaluated and categorized into 1 of 3 tiers:
Recovery: Complete elimination of symptoms. Physical movement regained completely. No pain points.
Significantly effective: Elimination of symptoms. Physical movement regained. Discomfort reoccurs only under exhaustion or change in weather. No pain or numbness.
Effective: Symptoms relieved. Pain or numbness present.
Not effective: No improvement in symptoms.
The total treatment effective rate for each patient group was derived as the percentage of patients who achieved at least an effective tier of improvement. The intensive acupuncture-moxibustion with silver needles protocol outperformed conventional acupuncture. However, both approaches produced significant positive patient outcomes.
Both aforementioned studies indicate that acupuncture is effective for the alleviation of lower back pain. These studies highlight the differences in therapeutic effects between various forms of acupuncture. As a result, qi-guiding acupuncture and intensive acupuncture-moxibustion with silver needles are found clinically effective for the relief of lower back pain.
Wu YC, Sun YJ, Zhang JF, Li Y, Zhang YY & Wang CM. (2014). Clinical Study of Qi-guiding Acupuncture at Points Selected According to Meridian Differentiation for Treatment of Lumbar Intervertebral Disc Herniation. Shanghai Journal of Acupuncture and Moxibustion. 33(12).
Cheng XN. (1987). The study of Chinese acupuncture-moxibustion. Volume 1, Beijing: People’s medical publishing house. 192-284.
Hu YG. (1995). Prolapse of lumbar intervertebral disc. Volume 2, Beijing: People’s medical publishing house. 226-228.
Zhu WM, Wu YC, Zhang JF, et al. (2010). Tuina combined with acupoint injection in treating prolapse of lumbar intervertebral disc. Chinese Journal of Sports Medicine. 29(6): 708-709.
Wang HD. (2013). Clinical Observation on Intensive Acupuncture-moxibustion with Silver Needles for Lumbodorsal Myofascial Pain Syndrome. Shanghai J Acu-mox. 32(8).
How Alternative Medicine Like Acupuncture Alleviates Menstrual Pain
Researchers find acupuncture combined with moxibustion more effective for the treatment of painful menstruation than ibuprofen. Across three independent studies, researchers made several important findings. Acupuncture plus moxibustion produces superior treatment outcomes to oral intake of ibuprofen. Acupuncture plus moxibustion is superior to using only acupuncture as a standalone therapy. Acupuncture improves blood circulation and hemorheological characteristics for patients with dysmenorrhea (painful menstruation). Let’s take a look at the results.
Hubei University of Medicine researchers (Jiao et al.) conducted a controlled clinical trial and confirm that the combination protocol of acupuncture plus moxibustion produces superior outcomes to using ibuprofen capsules to control menstruation cramping and pain. Jiao et al. conclude that acupuncture plus moxibustion has a 96.8% total treatment effective rate for the treatment of dysmenorrhea. Ibuprofen sustained time release capsules achieved a 58.1% total treatment effective rate. Acupuncture plus moxibustion outperformed ibuprofen by 38.7%. This is consistent with the independent research of Zhao et al. finding acupuncture effective for improving blood hemorheological characteristics, regulating blood viscosity, and enhancing the microcirculation of blood in the uterus for patients with dysmenorrhea.
Jiao et al. had a sample size of 62 human female patients and conducted a clinical trial at the Acupuncture Division of Hubei University of Medicine. Patients were randomly divided into an acupuncture group and a medication group, with 31 patients in each group. The acupuncture group received a combination of acupuncture and moxibustion therapy and the medication group received ibuprofen sustained time release capsules. The primary acupoints selected for all patients were the following:
Additional acupoints were selected on an individual symptomatic basis. Acupoints selection was based on the Traditional Chinese Medicine (TCM) system of differential diagnosis by pattern differentiation. For qi and blood stasis, the following acupoints were added:
For depressed liver qi with dampness and heat, the following acupoints were added:
For liver and kidney deficiency, the following acupoints were added:
For poor qi and blood circulation, the following acupoints were added:
Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.30 mm x 40 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. Manual acupuncture stimulation techniques for obtaining deqi including lifting, thrusting, and rotating. Once a deqi sensation was obtained, the needles were retained and moxibustion was conducted on the same acupoints.
Moxa cigar cuttings, each 2 cm long, were attached to each needle handle and ignited. Moxa was left in place to self-extinguish. One acupuncture session was conducted daily for 3 – 4 consecutive days during menstruation. Treatment was also conducted on the 2 days prior to the next menstrual cycle. The entire course of treatment comprised 3 menstrual cycles. Patients were also advised to avoid getting chilled and to keep warm during activities of daily living.
For the ibuprofen group, patients received 300 mg of ibuprofen sustained time release capsules starting 1 – 2 days prior to menstruation. Capsules were orally administered twice per day for 2 – 3 days until the symptoms were mitigated, for a total of 3 menstrual cycles. Vitamin B was administered additionally for patients who also experienced stomach discomfort. The results tabulated, the acupuncture plus moxibustion protocol provided greater pain relief than the ibuprofen protocol.
In an independent research trial, Lu Ying (Xianning Hospital of Traditional Chinese Medicine) investigated the treatment efficacy of triple acupuncture and mild moxibustion for primary dysmenorrhea patients. Lu Ying determined that triple acupuncture with mild moxibustion yielded better treatment results than conventional acupuncture. For primary dysmenorrhea, triple acupuncture plus mild moxibustion therapy achieved a 96.7% total treatment effective rate. Conventional acupuncture achieved a 90% total treatment effective rate.
A total of 60 patients were treated and evaluated in the study. They were randomly divided into a treatment group and a control group, with 30 patients in each group. The treatment group underwent triple acupuncture with mild moxibustion therapy while the control group received conventional acupuncture therapy. The primary acupoints selected for the treatment group were the following:
Additional acupoints were selected based on individual symptoms. For poor blood and qi circulation, the following acupoints were added:
For poor blood and qi circulation with blood stasis, the following acupoints were added:
For chills and dampness, the following acupoint received moxibustion but needling was not applied:
For dampness and heat in liver, the following acupoint was needled bilaterally:
Patients were instructed to urinate prior to treatment and subsequently rested in a supine position. Upon disinfection of the acupoint sites, a 0.30 mm x 50 mm filiform acupuncture needle was inserted into the acupoints. For Zhongji, the needle was inserted toward Qugu (CV2) with a high entry speed at an entry angle of 45°, to a depth of 5 mm, and until the needle stimulated a deqi response at the midpoint of the upper edge of the pubic bone.
Subsequently, two acupoints located 3 mm laterally to Zhongji were swiftly pierced to a depth of 5 mm and were then inserted to become parallel to the needle at Zhongji. The same deqi response was stimulated at these points, as was in the case of Zhongji. This is the triple acupuncture technique applied to Zhongji.
The remaining acupoints were pierced perpendicularly until a deqi sensation was achieved. The deqi sensation was defined as the patient feeling soreness, numbness, swelling, or aching towards the bottom part of the perineum or a slight electrical sensation. A needle retention time of 30 minutes was observed. During needle retention, the needles were each manipulated every 10 minutes with manual acupuncture techniques. Additionally, during needle retention, mild moxibustion was conducted at Zhongji, until the skin was flushed and moxibustion heat was transmitted downward into the skin.
For the control group, selected acupoints were identical to those of the treatment group. Primary and additional acupoints were perpendicularly pierced with a 0.30 mm x 50 mm filiform acupuncture needle. Needle manipulation techniques varied based on individual body conditions. The triple acupuncture threading technique was not applied, only perpendicular insertion was used. For poor blood and qi circulation, blood clotting, or chills and dampness, the Xie (attenuating) manipulation technique was applied. For poor liver health, heat, and dampness, the Ping Bu Ping Xie (attenuating and tonifying) manipulation technique was applied. For poor blood and qi circulation, the Bu (tonifying) manipulation technique was applied. A needle retention time of 30 minutes was observed. During needle retention, the needles were each manipulated every 10 minutes.
Both groups of patients received their respective treatments 5 days prior to menstruation. For one treatment cycle, treatment was conducted once daily for 5 consecutive days. Treatment was ceased during menstruation. The entire treatment course comprised 4 menstrual cycles. In addition, patients were advised to maintain a positive emotional state and avoid exhaustion and becoming chilled. The clinical results demonstrate that triple acupuncture and mild moxibustion produce greater therapeutic effects than conventional acupuncture in the treatment of primary dysmenorrhea.
The average rate of dysmenorrhea in China is approximately 30% – 40%. During puberty, the rate is approximately 50%. Among all cases of dysmenorrhea, 10% – 20% are severe. The researchers provide a brief synopsis of the Traditional Chinese Medicine understanding of primary dysmenorrhea. In Traditional Chinese Medicine, primary dysmenorrhea falls under the Jing Xing Fu Tong class of disorders. TCM classifies primary dysmenorrhea into two major types based on the overall TCM pathology: deficiency and excess. Deficient primary dysmenorrhea is caused by weak qi and blood circulation, deficiency of the liver and kidneys, or qi and blood deficiency. Excess-type primary dysmenorrhea is exacerbated by emotional pressures, depressed liver qi, blood stasis, or poor qi circulation. Consuming cold drinks during menstruation also contributes to excess-type primary dysmenorrhea.
The researchers also provide some insight into TCM principles relative to the treatment of primary dysmenorrhea. Regulating the Chong and Ren meridians improves blood and qi circulation to produce healthy, well regulated, and trouble-free menstruation. The Guanyuan acupoint significantly restores yuan (source) qi, improves blood and qi circulation, eliminates blood stasis, and relieves pain for patients with dysmenorrhea. Administering moxibustion at Guanyuan warms the meridians, expels chills, and regulates the Chong and Ren meridians. Guanyuan, Qihai, and Zhongji are acupoints which benefit yang and regulate the Chong and Ren meridians. Sanyinjiao is a central acupoint for the maintenance of liver, spleen, and kidney health and is therefore beneficial to patients with dysmenorrhea.
Contact Affinity Acupuncture today for Nashville Acupuncture treatments and appointments!
Jiao FL, Liang YC & He M. (2014). Therapeutic Observation of Acupuncture-moxibustion for Primary Dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 33(5).
Lu Y. (2014). Therapeutic Observation of Triple Acupuncture at Zhongji (CV 3) plus Mild Moxibustion for Primary Dysmenorrhea. Shanghai Journal of Acupuncture and Moxibustion. 33(7).
Zhao NX, Guo RL, Ren QY et al. (2007). Acupuncture therapy in treating primary dysmenorrhea, treatment efficacy and hemorheology study. Zhejiang University of TCM Journal. 31(3): 364-365, 367
Researchers (Zheng-tao, et al.) find acupuncture effective for the treatment of obstructive sleep apnea and conclude that it is a potentially valid and successful substitute for the CPAP machine. The findings indicate that acupuncture is a proven treatment option for sleep apnea patients looking for a cost-effective alternative to standard treatment or for those who find sleeping with the machine difficult to manage.
Sleep apnea, often associated with snoring, is the condition where the airway is restricted during sleep, usually due to either an anatomical abnormality or a reduced function of the dilator muscle in the upper airway. This means that the person affected with sleep apnea will have inclement episodes throughout the night where they stop breathing in their sleep several times in the night, reducing the oxygen levels in their bodies. This is a growing health concern as it results in a decrease in quality of life and overall health.
Sleep apnea leads to sleepiness, irritability, depression, reduced concentration and memory, erectile dysfunction, and even cardiac and metabolic conditions. Sleep apnea can affect adults and children alike, but it tends to be more common in men and people with preexisting medical conditions like obesity, thyroid conditions, nasal obstruction, and alcohol consumption. Due to the effects of sleep apnea, this condition can become a real economic burden; therefore, it is important to both diagnose and treat it immediately.
While there are other methods available, the standard treatment for sleep apnea typically involves a machine called nCPAP, nasal continuous airway pressure, which involves a mask or tube on the mouth and/or nose and provides continuous oxygen. When used properly, the nCPAP is effective at managing the apnea and shallow breathing, known as hypopnea, thereby eliminating the lack of oxygen in the bloodstream caused by sleep apnea. By controlling the oxygen levels, the symptoms of sleep apnea, like fatigue and cardiovascular disease, are mitigated and the patient resumes a better quality of life.
In patients with severe obstructive sleep apnea caused by anatomical abnormalities or in cases where the nCPAP fails or is inadequate, a dental appliance may be recommended. Surgery may also be recommended in cases where the anatomical abnormality is obvious, such as large palatine or lingual tonsils. However, standard treatment with the nCPAP has been a proven method to reduce upper airway restrictions and, therefore, improves quality of life. Despite this effectiveness, it is not a permanent solution to ending obstructive sleep apnea.
The researchers sifted through research articles across several languages using a combination of medical search terms like “sleep apnea, obstructive,” “upper airway resistance sleep apnea syndrome,” and “acupuncture therapy.” For the Chinese database they used search terms “zhen” and “shuimian” or “ditongqi.” The reports included in this mega study had to have participants diagnosed with obstructive sleep apnea (OSA), but there were no restrictions on age, sex, or race. Patients with sleep apnea in the experimental groups received both manual acupuncture and electroacupuncture while the control groups received either no treatment or nCPAP treatment. Patients that received sham acupuncture, which is essentially a placebo effect where patients believe they are receiving acupuncture but in fact are not being inserted with needles or the needles are being placed on non-acupuncture points, were included in the control group. There was no differentiation of the types of needle materials or the acupoints chosen. The researchers only included studies that were randomized controlled trials, and threw out anything that involved animal experiments, case reports, reviews, or duplicates
All of this yielded about 216 potential studies, which were narrowed down to 6 studies that met all of the rigorous inclusion requirements set by the researchers. Two studies were conducted in Brazil and the other four by Chinese investigators within a single center. Between 2007 and 2015 there was a total of 362 participants enrolled in the various trials (197 patients in the acupuncture group and 165 in the control group, with ages ranging from 35–76). Outcomes of the study were based on reported Apnea-Hypopnea Index (AHI), apnea index, hypopnea index, and mean Sa02 levels, which is the percentage of oxygen saturation in the blood. What they discovered was amazing. The researchers discovered that acupuncture was more effective in the improvement of all AHI, apnea index, hypopnea index, and SaO2 levels than nonspecific treatment and that electroacupuncture was even more effective at treating AHI. What is even more astounding is that acupuncture in these studies proved to be more effective than even nCPAP at improving AHI, and had no side effects.
The goal of treating obstructive sleep apnea is to reduce both sleep disruption and AHI levels to improve overall health and quality of life. While the nCPAP is very effective at treating obstructive sleep apnea, compliance among patients is difficult due to the cumbersome mask placed on their face, and it can be an expensive appliance to obtain. In the studies included in this analysis, acupuncture consistently improved all measures used to assess the effectiveness of treatment. The researchers deliberately chose to use AHI, apnea index, hypopnea index, and SaO2 levels to judge the effectiveness of treatment because it reduced the risk of bias and all these data could be directly recorded overnight during polysomnography (PSG), which is the standard testing used to diagnose obstructive sleep apnea. Both manual acupuncture and electroacupuncture were included in the study, as each differ to some extent in the mechanism of action. For example, electroacupuncture causes the release of beta-endorphin and adrenocorticotrophic hormones into blood plasma, where manual acupuncture releases only beta-endorphins.
All of the studies used in this meta-analysis combined manual acupuncture and electroacupuncture protocols. Varying frequency settings using electroacupuncture devices were applied in differing treatment protocols. While the meta-analysis demonstrates that acupuncture is effective at treating sleep apnea, no conclusions can be drawn as to which type of acupuncture protocol is the most effective.
Lv Zheng-tao, Jian W, Huang J, Zhang J, and Chen A. The Clinical Effect of Acupuncture in the Treatment of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. 2016.
A powerful type of acupuncture is proven effective for the treatment of urinary incontinence. In a Heilongjiang University of Chinese Medicine clinical trial, standard acupuncture stimulation demonstrated a 54% total effective rate, however; a specialized electroacupuncture treatment protocol yielded an 86% total effective rate. We’ll take a look how these remarkable results were achieved.
Urinary incontinence (enuresis) is defined as the involuntary leakage of urine. Due to loss of bladder control, urine may leak during coughing, sneezing, laughing, heavy lifting, or other activities. The condition may also present in the form of urgent urination wherein one may not have enough time to get to the restroom. Urinary incontinence may take on a more insidious nature wherein there may be frequent, often imperceptible, dribbling of urine. In all presentations of the disorder, there is a loss of bladder control.
The discovery that acupuncture can safety and effectively treat this condition is significant. According to the CDC (Centers for Disease Control and Prevention), “incontinence presents a significant financial burden to the individual and to society. In the United States, the cost of bladder incontinence among adults in 2000 was estimated at $19.5 billion, with $14.2 billion incurred by community residents and $5.3 billion by institutional residents (Hu et al.).” Based on these figures, acupuncture is an important and cost-effective treatment option.
Heilongjiang University of Chinese Medicine researchers examined the effects of both manual and electroacupuncture on women with urinary incontinence in their acupuncture continuing education study. A total of 100 patients participated in the clinical trial at the university’s 2nd affiliated hospital. Manual acupuncture treatment was identical for both groups A and B. The only difference in treatment protocols was that group B received electroacupuncture in addition to the manual acupuncture therapy.
Treatment commenced with patients in a supine position. Upon disinfection, a 2 inch filiform acupuncture needle was inserted into each acupoint. For Guanyuan, Qihai, Zhongji, and Qugu, needles were slanted downwards and inserted transverse-obliquely to a depth of 1.2 – 1.5 inches until a deqi sensation was elicited. Next, rotating and reinforcing needle manipulation techniques were applied. For Zusanli and Sanyinjiao, needle were inserted vertically to a 0.5 – 1-inch depth. Subsequently, a needle retention time of 40 minutes was observed for all acupoints. One 40 minute acupuncture session was conducted daily for 30 consecutive days.
For the electroacupuncture group, intermediate frequency electrical acupoint stimulation was conducted simultaneously. An intermediate frequency electrical stimulation device was connected to Zhongji and Huiyin (CV1). The amplitude for each patient was set to individual tolerance levels for comfort. This electrical stimulation was administered for 20 minutes during each acupuncture session.
Huiyin (CV1, Meeting of Yin) is often underutilized in clinical practice due to its location. The modern research confirms traditional indications for use of this acupuncture point. Huiyin is traditionally indicated for the treatment of difficult urination and urinary incontinence. The research finds the addition of electroacupuncture from CV3 to CV1 increases the efficaciousness by 32%. Manual acupuncture had a 54% total effective rate and electroacupuncture increased the rate to 86%.
University College of London Hospital and Whipps Cross University Hospital researchers confirm that acupuncture is effective for the treatment of urinary incontinence in independent research. A total of 79% of patients participating in the clinical trial demonstrated clinically significant outcomes. The researchers add that acupuncture “should be considered as a potential alternative to our current therapeutic regimes” for patients with urinary incontinence. The study utilized only 3 acupuncture points, combined with electroacupuncture, for all patients:
Similar results were found across the two aforementioned studies. The first investigation had an 86% total effective rate and the second had a 79% total effective rate. Jin et al. confirm that electroacupuncture reduces urinary incontinence for women in another independent study. Electroacupuncture produced a 78.6% total effective rate. The protocol reduced leakage and urgency. The mean occurrence of urinary incontinence over 24 hours was reduced by 66.67%. The mean quantity of urinary leakage over 24 hours was 39 grams before acupuncture treatments and 18.6 grams afterwards.
Electroacupuncture was attached to BL32 and BL35. A disperse-dense wave was used for 30 minutes. The dense wave was 4 Hz and the disperse wave was set to 20 Hz. The intensity was set to patient tolerance levels. One 30 minute acupuncture treatment was administered 3 times per week for 8 weeks. The protocol achieved a 78.6% total effective rate.
Liu et al. achieved a 93.3% total effective rate for the treatment of stress urinary incontinence in women. The protocol had two components: acupuncture and pelvic floor muscle exercises. Acupuncture with moxibustion was applied to the Baliao acupuncture points:
Needling was applied obliquely with a needle retention time of 20 minutes per acupuncture treatment. Moxibustion was applied to all needles. Acupuncture was administered 5 times per week for 6 weeks. The 93.3% total effective rate suggests that this protocol produces optimal outcomes.
Wang et al. confirm that acupuncture is 90% effective for the treatment of urinary incontinence. In the clinical trial, acupuncture was compared with drug therapy. Solifenacin produced an 86.9% total effective rate. Guiyang College of Traditional Chinese Medicine researchers from the university hospital’s urology department conducted a clinical trial lasting four weeks. Patients taking drug therapy received 4 mg of solifenacin via oral administration, once daily after breakfast.
Manual acupuncture stimulation was applied to the needles. Each acupuncture session lasted 30 minutes and one minute of manual stimulation was applied every 10 minutes. Acupuncture was applied once per day for four weeks.
Solifenacin had an outcome of 4 patients cured, 23 patients with significant progress, and 4 patients with no progress. Acupuncture had an outcome of 5 patients cured, 22 with significant progress, and 3 patients with no progress. The total effective rate for the acupuncture group was 90% and 86.9% for the solifenacin group. The results confirm that of the aforementioned studies; acupuncture is effective for the treatment of urinary incontinence.
Gao X, Xing YL, Dong SQ, Ding Y, Xia M. (2013). Effect of Acupuncture with Intermediate Frequency Electrical Stimulation by Acupoint on Female Stress Urinary Incontinence. Journal of Clinical Acupuncture and Moxibustion. 29(8).
Hu TW, Wagner TH, Bentkover JD, Leblanc K, Zhou SZ, Hunt T. Costs of urinary incontinence and overactive bladder in the United States: A comparative study. Urology 63(3):461– 5. 2004.
Post-treatment, Pre-treatment, and ICIQ-UI Short Form. Acupuncture in the Management of Overactive Bladder Syndrome. 2014.
Philp T, Shah PJR, Worth PHL. Acupuncture in the treatment of bladder instability. British Journal of Urology 1988 Jun: 61(6); 490-493.
Jin CL, Zhou XY & Pang R. (2013). Effect of electro-acupuncture on mixed urinary incontinence in women. Journal of Clinical Acupuncture and Moxibustion. 29(6).
Jain P, Jirschele K, Bostros SM, et al. (2011). Effectiveness of midurethral slings in mixed urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 22(8): 923-932.
Liu Jie, Yang Shaoqin, Shi Ying, Curative effect observation of needle warming moxibustion Ba Liao point combined with pelvic floor muscle exercise in the treatment of female stress urinary incontinence, Chinese Community Doctors, 2015 (8).
Wang, Bo, Youping Xiao, Kai Fan, Congjun Huang. “Treatment of female overactive bladder with acupuncture.” Journal of Beijing University of Traditional Chinese Medicine 36.10 (2013): 713-716.
Acupuncture and herbs outperform drug therapy for the treatment of irritable bowel syndrome (IBS). Researchers compared two groups, one received acupuncture and herbal medicine and the other received drug therapy. The group receiving acupuncture and herbs had superior positive patient outcome rates. Acupuncture and herbs produced clinical outcomes yielding greater improvements in stool consistency and significantly greater reductions of abdominal pain, mucus in the stool, bloating, and bowel urgency.
Chongqing Nanchuan Hospital researchers started with a sample size of 126 human patients with IBS. The patients were randomly divided into the acupuncture plus herbs group and the drug group, with a total of 63 patients in each group. For both groups, there were improvements in abdominal pain and discomfort scores. However, the acupuncture plus herbs group demonstrated significantly greater clinical improvements. In addition, the group receiving acupuncture plus herbs had greater reductions of anxiety levels and behavioral disorders. The data indicates that the acupuncture plus herbs group had significant improvements in general psychological well-being and overall perceived energy levels.
IBS affects the large intestine and involves cramping, distention, diarrhea or constipation, and abdominal pain. Often, there is mucus in the stool and the condition is chronic. Exacerbating factors include specific foods, hormonal changes, stress, and secondary illnesses. IBS tends to occur in younger patients and the rate is double for women. IBS, when presenting as a long-standing illness, often involves dietary restrictions and accidental malnourishment caused by an attempt to avoid exacerbating foods. The long-standing nature of the illness may also contribute to mental depression. Two major types of diagnostic criteria define IBS, the Rome criteria and the Manning criteria.
For the Rome criteria, one important parameter is that abdominal pain lasts for a minimum of 3 days per month and involves at least two of the following: decreased pain after defecation, changes in frequency of defecation, changes in consistency of stool. The Manning criteria includes pain relieved by defecation but also takes into account mucus in stool, incomplete bowels movements, and variability of stool consistency. An MD may order a colonoscopy, sigmoidoscopy, lower GI series (liquid barium X-ray), or CT scan to confirm the diagnosis.
All participants and procedures were approved by the Chongqing Nanchuan Hospital medical ethics committee. All participants were volunteers with a diagnosis of IBS, prerequisite abdominal pain, and abnormal defecation. No participants were admitted to the study groups that had taken medications within three month prior to the investigation. Exclusion criteria involved several other parameters: mental illness, low blood pressure, history of abdominal surgery.
The sample size involved 67 males and 59 females, with an average age of 55 years. The average duration of IBS per patient was 31 years. After randomization into the two groups, there were no significant differences in terms of age, gender, and course of IBS duration.
The group receiving drug therapy was administered loperamide hydrochloride capsules (1 tablet, 3 times per day), 30 minutes before meals. In addition, they received 9 g of Si Shen Wan, two times per day. Loperamide hydrochlorida (trade name IMODIUM) is used to control diarrhea. Functionally, loperamide hydrochloride slows bowel movements to achieve its effective action. The drug may cause drowsiness, fatigue, or dizziness and is not recommended for breast-feeding mothers because the drug is transferred through the milk. In this acupuncture continuing education study, the group receiving acupuncture plus herbal medicine was administered the following medicinal formula (prepared in the form of a decoction):
Zhi Gan Cao
Based on diagnostics, modifications were made to the formula. For patients with severe diarrhea, Bai Bian Dou and Fu Ling were added. Zhi Ke, Fo Shou, and Mu Xiang were added for cases of pronounced abdominal swelling and pain. For mucus in the stool, Huo Po and Cang Zhu were added. Yu Li Ren was added for patients with constipation. The following protocolized set of acupuncture points were administered to the patients:
Shangjuxu, ST37 (Upper Great Void)
Quchi, LI11 (Pool at the Crook)
Dachangshu, BL25 (Large Intestine Shu)
Tianshu, ST25 (Heaven’s Pivot)
Sterile filiform acupuncture needles were used. At ST37, the needle insertion depth range between 1–2 inches. For LI11, the depth of insertion was 0.5–2 inches. For BL25, the insertion depth was 0.8–1.2 inches. For ST25, needle depth was 1–1.5 inches. Reinforcing and reducing manual acupuncture techniques were applied with twisting, lifting, and thrusting motions. Total needle retention time was 30 minutes per acupuncture visit. For both the drug and acupuncture plus herbs groups, the total treatment duration was 28 days. Dietary modifications for all patients in both groups included the following recommendations:
No raw, cold, or spicy food
Regulate consumption of food to moderate levels of intake
Regular meals consumed at regular intervals, 3 times per day
Non-oily, light foods that are easily digested are appropriate
Non-oily, light, and easily digested foods are appropriate
Several important findings were made. The acupuncture plus herbal medicine group had greater positive patient outcomes. In addition, the relapse rate was lower in the acupuncture plus herbs group than the drug group. The results indicate that acupuncture, herbs, and continuing patient education on dietary modifications is an effective integrative approach to patient care for patients with IBS.
Herbal medicine gained recognition for the treatment of IBS in the Journal of the American Medical Association (JAMA). The prestigious journal published the findings of an Australian randomized, double-blinded, placebo controlled study conducted by gastroenterologists and herbalists. The researchers concluded that Chinese herbal medicine “offer[s] improvements in symptoms for some The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.patients with IBS.” The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.
Zhang Yousheng, Zhang Xiaodong, Investigation of the Effect on Treatment of Irritable Bowel Syndrome with Traditional Chinese Medicine and Acupuncture, Chongqing Nanchuan Hospital, 2016.
Sun YZ & Song J. (2014). Therapeutic Observation of Acupuncture at Jiaji (EX-B2) for Irritable Bowel Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 34(9).
Zhongguo Zhen Jiu. 2012 Oct;32(10):957-60. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. Acupuncture and Rehabilitation Department, Jiangsu Province Hospital of TCM, Nanjing, China.
JAMA. 1998 Nov 11;280(18):1585-9. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.
Liu, Xiao-xia. “Moxibustion on Shenque (CV 8) improves effect of acupuncture for diarrhea-predominant irritable bowel syndrome.” Journal of Acupuncture and Tuina Science 12, no. 6 (2014): 362-365.
Researchers conclude that music electroacupuncture causes improved behavioral changes and benefits to neuronal structures in the hippocampus. In a laboratory experiment on depressive rats, music electroacupuncture outperformed fluoxetine (Prozac) for regulating monoamine neurotransmitter levels. Based on the findings, researchers (Cao et al.) conclude that music electroacupuncture demonstrates effectiveness for the treatment of depression.
In a separate investigation (Tang et al.), two types of acupuncture are found to successfully regulate behavioral changes. Based on the findings, the researchers note that music electroacupuncture and standard pulsed electroacupuncture, may assist in the prevention of Alzheimer Disease. In a controlled experiment, laboratory rats receiving electroacupuncture had decreased latency times, improved swimming distances, and significant reductions of β-amyloid protein levels. β-amyloid (Aβ) proteins are the main constituents of amyloid plaques occurring in Alzheimer disease patients’ brains. The researchers noted that music electroacupuncture and standard electroacupuncture improved “learning and memorizing abilities.” Overall, music electroacupuncture outperformed standard electroacupuncture.
Music electroacupuncture differs from standard electroacupuncture by switching frequencies and waveforms in rhythmic patterns instead of a consistent pulse. Choices of electroacupuncture settings are based on five musical notations (Gong, Shang, Jue, Zhi, Yu). Each setting corresponds to Traditional Chinese Medicine principles of the Five Elements (wood, fire, earth, metal, water) and their corresponding organ systems (liver/gallbladder, heart/small intestine, spleen/stomach, lung/large intestine, kidney/bladder). The settings are adjusted for different diagnosis of each patient.
The Healthcare Medicine Institute (HealthCMi) has not had a chance to test the music electroacupuncture device yet however, we recently tested the ITO ES-160 electroacupuncture device and confirmed its efficaciousness for the alleviation of pain using the sweep mode. Sweep mode involves a gradual increase and decrease of pulse frequencies over time. The adding of subtle gradations between frequency changes in sweep mode demonstrated significant clinical advantages for the treatment of several pain conditions. While the ES-160 has standard intermittent modes, it shows the sweep mode is an important addition.
The laboratory research finds that music electroacupuncture and conventional pulsed electroacupuncture are effective in treating depression in rats. Researchers (Tang et al.) from Beijing University of Chinese Medicine determined, through a protocolized investigation, that both types of electroacupuncture produced positive outcomes in depressed rat models, but music electroacupuncture produced the highest rate of positive outcomes across various metrics. Given the prevalence of depression in society, this research includes important subjective and objective findings.
In this laboratory study, rats receiving electroacupuncture (either music or conventional) displayed higher horizontal activity, vertical activity, sugar consumption, body mass, and expression of serotonin (5-HT), dopamine (DA), and norepinephrine (NE) in the frontal lobe and hippocampus. Additionally, rats treated with music electroacupuncture reported having a higher 5-HT expression than those treated with conventional electroacupuncture. Overall, music and conventional pulsed electroacupuncture demonstrated antidepressant effects in rats, however, music electroacupuncture demonstrated a greater regulatory effect on monoamine neurotransmitters than conventional pulsed electroacupuncture and fluoxetine.
The experiment involved several controlled variables. A total of 50 depression model rats were divided into 5 equal groups of 10 as follows:
Control group: Rats were grouped together. Unlimited supply of water and food was provided. Did not receive any stimulation.
Model group: Rats were isolated. Received 21 days of chronic unpredictable mild stress stimulation.
Fluoxetine group: Rats were isolated. Fluoxetine was diluted with saline to a density of 2 mg/ml. For each rat, 10 ml of diluted fluoxetine was administered per kg of body mass. Medication was administered once per day, one hour before chronic unpredictable mild stress stimulation.
Standard pulsed electroacupuncture group: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.
Music electroacupuncture: Rats were isolated. Treatment was administered one hour prior to chronic unpredictable mild stress stimulation.
The acupuncture point prescription included standard filiform needle stimulation of acupoints Yintang (MHN3) and Baihui (GV20). For each acupoint in the standard pulsed electroacupuncture group, a filiform acupuncture needle was connected to an electroacupuncture device and was inserted horizontally. The tip of the needle was pointed posteriorly for Baihui and downwards for Yintang. The electrical frequency was set to 2/100 Hz and the intensity was set to 1 mA. The needles were retained for 20 minutes. One 20 minute acupuncture session was conducted per day for a total of 21 days.
For the music electroacupuncture group, acupoint selection and treatment of acupoints was identical to that of the pulsed electroacupuncture group. However, instead of a conventional electroacupuncture device, the needles were connected to a music electroacupuncture device. Voltage was set to 2 V and intensity to 1 mA, until the needle tip was vibrating slightly but did not cause the rat to squeak. An antidepressant music electroacupuncture setting was chosen. The needles were retained for 20 minutes while an acupuncture session was conducted per day for a total of 21 days.
The Tang et al. laboratory experiment demonstrated significant improvements in behavioral and objective results, including improvements in serotonin (5-HT), dopamine (DA), and norepinephrine (NE) levels determined by radioimmunoassay in depression model rats. Additional testing with human subjects is required, including large sample size meta-analyses, to determine the overall efficaciousness of music electroacupuncture for the treatment of depression. The Healthcare Medicine Institute plans on taking a closer look at this innovative approach to electroacupuncture.
Tang YS, Ji Q, Cao J, Teng JY, Deng XF, Li J, Li ZG. (2014). Influence of Music Electroacupuncture and Pulsed Electroacupuncture on the Different Encephalic Regions of Monoamine Neurotransmitter Chronic Unpredictable Mild Stress Depression Model Rats. Journal of Clinical Acupuncture and Moxibustion. 30(3).
Cao J, Tang Y, Li Z, Ji Q, Yao H, Mo Y, Wang X, Song L. Effects of Music Electro-Acupuncture on the Expression of Monoamine Neurotransmitter in Different Encephalic Regions in Chronic Unpredictable Mild Stress Depression Model Rats. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A39.
Tang Y, Cao J, Li Z, Chen W, Xu AP, Mo YP, Yao H, Wang X, Liang C. Effects of Music Electro-Acupuncture and Pulsed Electro-Acupuncture on Behavioral Changes and the Serum β-amyloid Protein in SAMP8 (Senescence Accelerated Mouse Prone 8) Mice. The Journal of Alternative and Complementary Medicine. 2014 May 1;20(5):A38.