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Acupuncture Produces Anti-inflammatory Responses

Acupuncture Produces Anti-inflammatory Responses

by | Jul 11, 2016 | Acupuncture Nashville TN

Researchers discover anti-inflammatory effects stimulated by acupuncture.

Anti-inflammatory biochemical responses are stimulated by the application of acupuncture. As a result, the body decreases swelling associated with arthritis. In addition, acupuncture prevents postoperative intra-abdominal adhesions. The research is confirmed across several studies including laboratory investigations.

A laboratory study reveals that the anti-inflammatory effects of acupuncture involve the downregulation of proinflammatory cellular biochemicals. In a controlled experiment, rheumatoid arthritis rats were divided into three groups. Group A did not receive medical treatment. Group B received electroacupuncture and group C received prednisolone acetate via intragastric infusion. Prednisolone acetate is a corticosteroid medication. Acupuncture successfully reduced physical inflammation and downregulated proinflammatory biochemicals.

The non-treatment group had elevated levels of proinflammatory biochemicals and significant increases in physical inflammation. The acupuncture and prednisolone acetate groups demonstrated significantly lower levels of proinflammatory biochemicals in the bloodstream in addition to less physical inflammation measured at the ankles. Acupuncture was applied to acupoints Zusanli (ST36) and Kunlun (BL60) for thirty minutes, once per day, for ten days. Let’s take a look at the results.

Acupuncture and prednisolone acetate significantly downregulated serum TNF-α, IL-1β, and ICAM-1 in the rheumatoid arthritis model rats. Measurements taken at the ankles demonstrated significant reductions in swelling determined by the diameter of the ankles. The researchers conclude, “EA [electroacupuncture] intervention is effective in relieving RA [rheumatoid arthritis] rats’ inflammatory reactions by down-regulating the levels of serum TNF-α, IL-1β and ICAM-1.”

TNF-α (tumor necrosis factor alpha) is a cell signaling protein active in systemic inflammation. It is a cytokine comprising one of the biochemicals involved in acute phase reactions and is primarily produced by macrophages. TNF-α is implicated in the pathogenesis of severe infectious diseases including cerebral malaria. IL-1β (interleukin 1 beta) is a cytokine that contributes to inflammatory pain hypersensitivity. ICAM-1 (intercellular adhesion molecule 1) is exploited by rhinovirus as a receptor and produces proinflammatory effects including hypersensitivity reactions.

The research of Ouyang et al. is consistent with the biochemical findings demonstrating that acupuncture stimulates an anti-inflammatory biochemical cascade. Ouyang et al. note that electroacupuncture “effectively lower[s] the contents of TNF-α and VEGF in peripheral blood and joint synovia to improve the internal environment for genesis and development of RA [rheumatoid arthritis], so as to enhance the clinical therapeutic effectiveness.” The researchers demonstrated that both manual acupuncture and electroacupuncture significantly reduce both serum and synovial joint levels of TNF-a and vascular endothelial growth factor (VEGF) for human patients with rheumatoid arthritis.

The research of Du et al. is consistent with these findings. Du et al. note that electroacupuncture at acupoint ST36 (Zusanli) “reduced TNF-α and VEGF levels in adhesive tissue homogenates 7 d[ays] after surgery….” In addition, “sham acupuncture had no suppressive effects on TNF-α and VEGF levels.” Du et al. add that electroacupuncture prevents postoperative intra-abdominal adhesions and electroacupuncture at “ST36 alleviated the adhesion formation, with both of macroscopic and histopathologic adhesion scores significantly lower than” the sham acupuncture group.

The research presented here demonstrates the biochemical basis by which acupuncture exerts anti-inflammatory effects. The research indicates that acupuncture is beneficial to patients with rheumatoid arthritis and those recovering from abdominal surgery. Given the scientific evidence, additional research is warranted.

References:
Zhang, R., L. H. Guo, Y. Yin, T. W. Chen, and W. Z. Ma. “Effect of Electroacupuncture on Serum TNF-α, IL-1β and Intercellular adhesion molecule 1 Levels in Rheumatoid Arthritis Rats.” Zhen ci yan jiu= Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji] 41, no. 1 (2016): 51.

McGuire, William, Adrian VS Hill, Catherine EM Allsopp, Brian M. Greenwood, and Dominic Kwiatkowski. “Variation in the TNF-α promoter region associated with susceptibility to cerebral malaria.” (1994): 508-511.

Ouyang, Ba-si; Gao, Jie; Che, Jian-li; Zhang, Yin; Li, Jun; Yang, Hai-zhou; Hu, Tian-yan; Yang, Man; Wu, Yuan-jian; Ji, Ling-ling. Effect of electro-acupuncture on tumor necrosis factor-α and vascular endothelial growth factor in peripheral blood and joint synovia of patients with rheumatoid arthritis. Chinese Journal of Integrative Medicine. 2011-07-01. Chinese Association of Traditional and Western Medicine, China Academy of Chinese Medical Sciences. 672-0415, 505- 509 v17 issue 7.

Du, Ming-Hua, Hong-Min Luo, Yi-Jun Tian, Li-Jian Zhang, Zeng-Kai Zhao, Yi Lv, Rui-Jiang Xu, and Sen Hu. “Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation.” Journal of Surgical Research 195, no. 1 (2015): 89-98.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1634-acupuncture-produces-anti-inflammatory-responses

Research Shows Acupuncture Prevents and Clears Migraines

Research Shows Acupuncture Prevents and Clears Migraines

by | Jul 5, 2016 | Acupuncture Nashville TN

Researchers have successfully documented not only that acupuncture is safe and effective for the relief of migraines, but also how acupuncture achieves positive outcomes.

Acupuncture has been shown to induce important biological responses to prevent and alleviate migraines. Imaging studies of the brain using fMRI technology confirm that acupuncture causes specific cortical responses to achieve lasting analgesic effects. In addition, blood level measurements document specific responses to acupuncture that play an important role in preventing and eliminating pain. Let’s take a look at the data to see how scientists have mapped how acupuncture works to stop migraine headaches.

Researchers conclude that acupuncture is effective for the prevention and treatment of migraine headaches. A meta-analysis of controlled clinical and laboratory investigations is the basis for the conclusion. In one randomized-controlled trial on the effectiveness of acupuncture as a treatment for migraines, less migraine days and less pain intensity levels were recorded when acupuncture was administered. Furthermore, no severe adverse effects occurred. A follow-up of up to three months following acupuncture treatments maintained the same results and showed that acupuncture is effective for the treatment of migraines both on the short-term and long-term basis. 

In another investigation, researchers conducting a clinically-controlled study using fMRI (functional magnetic resonance imaging) found a significant decrease in the functional connectivity of the right frontoparietal network of migraine patients. This connectivity dysfunctions was found to be reversible after four weeks of treatment using acupuncture. This is another curative effect of acupuncture that is quantifiable in repeated controlled experiments.

For more than 2,000 years, people have used acupuncture in China for the treatment of various pain conditions, including migraines. It is useful, both as a supplementary treatment and as an alternative treatment, in situations where there is no response to drug therapy. Migraines are a headache disorder affecting a broad population that causes societal burdens due to associated healthcare costs and absenteeism from school and work. Approximately 23% of households in the United States have at least one member who suffers from migraines. The estimated total number of migraine patients in the United States exceeds 28 million and half of them have reduced work or school productivity. 

Scientists have uncovered some of the biochemical mechanisms responsible for acupuncture’s pain killing effects. Drugs used for the treatment of migraines often mediate the analgesic action for cerebral vasodilation dysfunction and pain through the induction of cerebral vasoconstriction. In the process of vasoconstriction, myosin light chain kinase in cerebral vessels are activated. In an experiment conducted using animals with migraines, acupuncture has been found to “induce activation of myosin light chain kinase in the middle meningeal artery.” This indicates that the effective action of acupuncture for relief and prevention of migraines is due, at least in part, to its ability to regulate myosin light chain kinase activity.

In another randomized-controlled trial, fMRIs reveal acupuncture’s ability to regulate key regions of the brain affected by migraines. The areas are essentially the pain circuitry regions of the brain and cognitive components of pain processing. In addition, acupuncture also restores normal serum nitric oxide (NO) levels that have been found to be almost 55% higher in patients with migraines. Excess NO is a potent vasodilator contributing to headaches and acupuncture restores homeostasis. The regulatory effects of acupuncture can be quantified as early as the fifth acupucture session and the effects are cumulative.

Additional research documents acupuncture’s ability to regulate bodily biochemistry. In one study, researchers document that acupuncture reduces MMP-2 (metalloproteinase-2) activity in patients without affecting its concentrations. In controlled experiments, researchers conclude that the combination of acupuncture and electrical stimulation of needles (electroacupuncture) relieves pain experienced during migraine attacks through the reduction of plasma glutamate levels. Based on these and other studies in the meta-analysis, the researchers conclude that acupuncture improves patients’ psychological profile, relieves pain, is safe and cost-effective, and has been found to be at least as effective as conventional preventative pharmacologic treatments for migraines.

References:
Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z (2015) Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up. Evid based Complement Alternat Med 2015: 920353.

Da Silva AN (2015) Acupuncture for migraine prevention. Headache 55: 470-473.

Vijayalakshmi I, Sjankar N, Saxena A, Bhatia MS (2014) Coomparison of effectiveness of acupuncture therapy and conventional drug therapy on psychological profile of migraine patients. Indian J Physiol Pharmacol 58: 69-76.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1661-acupuncture-prevents-and-clears-migraines

Acupuncture Moves Stool, Relieves Constipation

by | Jun 20, 2016 | Acupuncture Nashville TN

Acupuncture Moves Stool, Relieves Constipation

Clinical trials demonstrate that acupuncture relieves chronic constipation and produces greater long-term patient outcomes than drugs.

Chengdu University of Traditional Chinese Medicine researchers find true acupuncture more effective than sham acupuncture for the relief of constipation. In another study by Yang et al., acupuncture combined with herbal medicine relieves constipation in the elderly and demonstrates superior patient outcomes to pharmaceutical medications. Acupuncture plus herbs produced a high total effective rate and very low relapse rate. Let’s take a look at the results of the investigations.

Zheng et al. (Chengdu University of Traditional Chinese Medicine) conclude that acupuncture is safe and effective for the treatment of functional constipation, often referred to as chronic idiopathic constipation (CIC). This type of constipation does not have a known anatomical or physiological etiology in biomedicine. CIC often involves infrequent defecation, hard stools, straining during bowel movements, and incomplete evacuation of stools. Secondary symptoms include stomach cramping, pain, and abdominal bloating or distention.

The study examines the efficaciousness of front mu (ST25) and back shu (BL25) acupoints of the large intestine meridian. This approach is consistent with Traditional Chinese Medicine (TCM) principles. The large intestine foot-yangming channel is often an integral aspect to treatments for constipation.

The researchers note that functional constipation is classified in the Da Bian Nan (difficulty in bowel movement) category in TCM. They cite prior research indicating that acupuncture effectively treats the root causes of constipation. As a result, acupuncture patients have lower relapse rates than patients having taken mosapride, a medication used to facilitate bowel movements. Although the drug is effective, the research indicates a relatively high relapse rate (54.2%) following discontinuation of the drug. The researchers add that acupuncture is effective without significant adverse effects whereas mosapride may cause loose stools, dizziness, headaches, insomnia, abdominal pain, and borborygmus. Mosapride is a serotonin 5HT₄-receptor agonist and serotonin 5HT₃-receptor antagonist that is a gastroprokinetic agent.

Acupuncture at the large intestine foot-yangming front mu and back shu points was compared with sham acupoint controls to ensure validity of the data. In a prior meta-analysis, acupuncture had a 72.8% total effective rate for the treatment of constipation. In this study, the classic front mu and back shu combination achieved an 82.56% total effective rate.

The active sham control group had a 67.65% total effective rate compared with the 82.56% total effective rate of the true acupuncture group. Notably, the sham points were located and needled 1 cm laterally to the true acupuncture point locations. This active sham control method may have contributed to clinical successes in the sham group. Nonetheless, the true acupuncture group significantly outperformed the sham control group. True acupuncture had better frequency of bowel movement scores, difficulty of bowel movement scores, and a higher total effective rate. The study involved 72 voluntary patients from the gastrointestinal department at Chengdu University of Traditional Chinese Medicine. Inclusion criteria were established and included the following:

Visited the hospital between October 2010 and December 2014

Met the Rome III diagnostic standard for functional constipation

Between 18 – 75 years old

Did not take any stomach or intestinal prokinetic medications within one week prior to the research starting date

Not participating in any other clinical research

Patients who had the following conditions were filtered out of the selection:

Constipation secondary due to biologically identified illness

Unable to describe symptoms due to ambiguous consciousness or psychosis

Progressive malignant tumors or other severe consumptive diseases

Prone to infection and bleeding

Severe primary and concomitant cardiovascular, liver, kidney, digestive or hematopoietic diseases

Pregnant or lactating

Participating in other clinical research

The patients were randomly divided into two groups of 36 patients each: true acupuncture treatment group, sham control group. The average age of participants was 44 years. There were 9 males and 27 females in the treatment group. There were 11 males and 25 females in the control group. The acupoints selected for the treatment group were the following:

Tianshu (ST25) – Large intestine front mu acupoint

Dachangshu (BL25) – Large intestine back shu acupoint

For the control group, body points selected were neither meridian acupoints nor special acupoints. They were located at the following areas:

 

1 cm to laterally to ST25

1 cm to laterally to to BL25

For both groups, each point was pierced with a disposable 0.3 mm X 50 mm needle (Huatuo brand, Suzhou Medical Equipment Ltd.), adhering to standard piercing depths. For each acupuncture point, the following protocol was observed. After regular disinfection, the needle was inserted into the point and manipulated with pulling, pushing or twisting techniques at a speed of 60 – 90 times per minute. The angle of twist was 90 – 180 degrees and the depth was 0.3 – 0.5 cm. Next, a needle retention time of 30 minutes was observed. Thereafter, the needle was removed and pressure was applied to the point with a dry cotton ball to prevent bleeding.

One 30 minute session was conducted per day. A full treatment cycle consisted of 5 consecutive days. The entire treatment course comprised 4 treatment cycles for a grand total of 20 acupuncture treatments. To evaluate the treatment effective rate, patients were scored before and after the treatments. The constipation signs and symptoms were evaluated for the following:

Frequency of bowel movement

Difficulty in bowel movement

Time taken to bowel movement

Comfort during bowel movement (strain, incomplete bowel movement, bloating, etc.)

Type of Feces

Treatment effective rates were categorized into 4 tiers:

Full recovery: No functional constipation symptoms and physical signs. Improvement rate score ≥90%

Significant improvement: Significant improvement in functional constipation symptoms and physical signs. Improvement rate score ≥70%

Improvement: Moderate improvement in functional constipation symptoms and physical signs. Improvement rate score ≥30%

Ineffective: Little improvement in functional constipation symptoms and physical signs. Improvement rate score <30%

The clinical results of the study by Zheng et al. demonstrate that acupuncture is an effective procedure for the treatment of functional constipation. Compared with prior investigations, the classic front mu and back shu acupoint combination of the large intestine meridian demonstrates excellent rates of positive patient outcomes. Let’s take a look at another study.

Yang et al. (Tianjin and Tongren, China) investigated the effects of acupuncture and traditional herbal medicine on constipation in the elderly. They determined that the combination of both TCM modalities is a more effective constipation in the elderly treatment protocol than a conventional pharmaceutical medication. However, the results were close. TCM yielded a 100% total effective rate and the gastroprokinetic agent cisapride had a 94.83% total effective rate.

In the elderly, constipation is a common complication secondary to other illnesses. Epidemiological studies demonstrate that 60% of the elderly suffer from constipation to varying degrees (Du et al.). The prevention and cure for constipation therefore has a high clinical value and significance. Biomedical etiologies often point to poor peristaltic movement in many cases of constipation in the elderly. This lengthens the stool retention duration and hardens stools due to excess absorption of water.

Constipation may cause acute and chronic stress in the elderly. For elderly patients, exertion during bowel movements may cause a change in coronary and cerebral vascular flow, potentially leading to more threatening conditions including angina, acute myocardial infarction, arrhythmias, high blood pressure, cerebral vascular damage, or death. A common treatment for constipation with medications often employs the purgation method, which is effective in the short-term. However, long-term purgation treatments may result in electrolyte imbalances or varying degrees of stomachaches and diarrhea.

In TCM, chronic constipation in the elderly is often due to a weak liver and kidneys, poor qi and bood circulation, and subsequent malnourishment of the large intestine. TCM also states that long-term consumption of bitter and chilled foods damage the spleen and stomach, slows qi and blood replenishment, and ultimately weakens peristaltic movements thereby affecting the ability to evacuate feces. Professor Han Jing Xuan from Tianjin University of TCM established a protocol using the Sanjiao acupuncture method and the traditional herbal decoction Huang Di San. These two therapeutic approaches have been extensively used in the clinical treatment of a wide range of elderly related diseases including constipation in the elderly.

The acupuncture protocol involves the needling of Zhongwan, Zusanli, and Xuehai to promote spleen and stomach health. Xuehai also promotes blood circulation and minimizes blood stasis. The Waiguan acupoint circulates and nourishes qi in the Sanjiao (triple burner). The study by Yang et al. followed the protocols established by Prof. Han Jing Xuan.

Using the established protocols, acupuncture plus herbs achieved a 100% total effective rate. Cisapride achieved a 94.83% total effective rate. Furthermore, the long-term improvement rate for the Sanjiao acupuncture and Huang Di San protocol was 88.33%. Cisapride had a 46.55% long-term improvement rate.

A total of 118 elderly constipation patients were randomly divided into two groups: treatment group, control group. The control group was given cisapride and the treatment group was given the Sanjiao acupuncture and Huang Di San protocol. Upon starting and throughout the treatment, both groups were given daily activity recommendations: maintain positive emotions, consume high-fiber foods, keep warm. For the Sanjiao acupuncture therapy, the selected primary acupoints were the following:

Shanzhong (CV17)

Zhongwan (CV12)

Qihai (CV6)

Zusanli (ST36)

Xuehai (SP10)

Waiguan (TB5)

After standard disinfection, a 0.25 mm disposable needle was swiftly inserted into each acupoint with a high entry speed. The Shanzhong acupoint was needled transverse-obliquely following the path of the Ren meridian for 0.5 – 1 inches. Other acupoints were pierced perpendicularly up to a depth of 0.5 – 1 inches. The Bu (rotate and push) manipulation technique was applied for Shanzhong, Zhongwan, Qihai, and Zusanli for 1 minute. The Xie (rotate and pull) technique was used on Xuehai for 1 minute. A needle retention time of 30 minutes was observed.

One 30 minute acupuncture session was conducted once per day. A full treatment cycle consisted of 10 days. The entire treatment course comprised 2 treatment cycles for a grand total of 20 days. The mandatory ingredients used in the Huang Di San herbal decoction were as follows:

Huang Jing (15 g)

Sheng Di Huang (15 g)

Sha Ren (15 g)

Pei Lan (15 g)

Shou Wu (15 g)

Dang Gui (15 g)

Additional herbs were added according to the nature of constipation. For patients with deficiency the following herbs were added:

Rou Cong Rong (12 g)

Bai Zhu (12 g)

Mai Dong (12 g)

Huang Qi (12 g)

Dang Shen (12 g)

Shan Yao (12 g)

For patients with primary deficiency with secondary excess (Ben Xu Biao Shi) differential diagnostic pattern differentiations, the following herbs were added:

Yu Li Ren (10 g)

Chuan Xiong (10 g)

Chi Shao (10 g)

Tao Ren (10 g)

Dan Zhu Ye (10 g)

The prescribed ingredients were brewed with water to make an herbal decoction. One brew was consumed orally per day in three separate doses throughout the day. One treatment cycle consisted of 10 days and the entire treatment course comprised 2 treatment cycles for a grand total of 20 days. Subjects in the control group took 10 mg of cisapride tablets, 3 times per day, before lunch, dinner, and sleeping. Treatment efficacy was categorized into 4 tiers:

Recovery: Bowel movement within 12 hours. No other symptoms. Scored 0 for interval between bowel movements

Significantly effective: Significant improvement in constipation. Bowel movement within 24 hours. Normal or slightly dry feces. No difficulty in bowel movement. Scored 1 – 9 for interval between bowel movements

Effective: Bowel movement within 72 hours. Moist feces. Slight difficulty in bowel movement. Scored 10 – 18 for interval between bowel movements

Ineffective: No changes in symptoms. Scored 19 – 20 for interval between bowel movements

The results indicate that acupuncture with herbs is more effective than the prescribed medication. Both studies mentioned in this report demonstrate that acupuncture is safe and effective for the treatment of constipation. Important features of TCM protocols is that they produce a high total effective rate, low relapse rate, and no significant adverse effects.

Contact Affinity Acupuncture for Nashville Acupuncture treatments and techniques.

References:

Ouyang, H. & Chen, J. Therapeutic roles of acupuncture in functional gastrointestinal disorders [J]. Alimentary pharmacology & therapeutics, 2004, 20(8): 831-841.

 

Zheng, H. B. & Chen,Y. (2015). A clinical randomized controlled trial of acupuncture at the combination of back shu point and front－mu point of large intestine meridian in the treatment of functional constipation. Practical Journal of Clinical Medicine. 4 (12).

 

Yang JX, Yu JC & Han JX. (2014). Clinical Study on Treatment of constipation in the elderly with Combination of Acupuncture and Chinese Medicine. World Science and Technology-Modernization of Traditional Chinese Medicine. 16(6).

 

Du WF, Yu L, Yan XK et al. (2012). Meta-analysis in acupuncture therapy in treating constipation. Journal of Chinese Acupuncture. 32(1): 92-96.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1648-acupuncture-moves-stool-relieves-constipation

Acupuncture Helps Clear Acne

Acupuncture Helps Clear Acne

by | Jun 14, 2016 | Acupuncture Nashville TN

Acupuncture and moxibustion are effective treatment modalities for acne sufferers. Zhang et al. conducted a clinical trial to determine the efficaciousness of acupuncture and moxibustion for the treatment of acne due to yin deficiency with internal heat. While both modalities produced positive patient outcomes, moxibustion was slightly more effective than acupuncture for the treatment of this particular class of acne.

In Traditional Chinese Medicine (TCM), acne due to yin deficiency with internal heat has a complex pathology. It is a result of many different types of bodily imbalances. Symptomatic presentations of this disorder appear as excess conditions involving toxins, damp-heat, etc… However, the root of the condition is yin deficiency leading to internal heat. As a result, this type of acne is often pernicious and insidious.

Zhang et al. comment that according to TCM principles, the treatment of acne due to yin deficiency with internal heat focuses on nourishing the root of deficiency and clearing excess heat. To bring a yin deficient bodily state to a yin and yang balanced state, effective medical treatments often follow these principles: facilitate the balance of yin and yang, promote circulation, improve internal organ health, release heat and toxins from the body.

In this study, acne patients who received acupuncture treatment had an 83.33% total treatment effective rate. Participants receiving moxibustion treatment had a 90% total treatment effective rate. In both groups, patients demonstrating significant improvements in acne did not experience a relapse of the condition in the four week window after completion of treatment.

A total of 66 patients with acne due to yin deficiency and internal heat participated in this study. They were randomly divided into two groups: acupuncture group, moxibustion group. Each group received only acupuncture or moxibustion therapy respectively. Due to external factors, 6 patients were eventually disqualified from the study, therefore, the final results were tabulated from a total of 60 patients. The acupoints selected for both moxibustion and acupuncture were identical:

Shenque (CV8)
Qihai (CV6)
Guanyuan (CV4)
Shenshu (BL23)
Both groups underwent the same preparation procedures before starting their respective treatments. Firstly, the affected areas were disinfected. For each pustule, a disposable needle was used to gently pierce the pustule and release the pus. Disinfection was performed again after removal. Thereafter, each group underwent their respective treatments.

For the moxibustion group, edible grade salt was spread on the selected acupoints. Next, a slice of raw ginger (with a hole pierced in the center) was placed over the salt. Subsequently, 20 g of conical moxa was placed on top of the raw ginger slice and lit. Each acupoint was treated with a grand total of 60 g of moxa, 5 minutes per each 20 g dose. Throughout the treatment, consistent checks were made with the patients to ensure that they felt warmth at the acupoints, but not excessive heat. Moxibustion treatment was conducted twice per week, on Monday and Friday. One treatment cycle consisted of four consecutive weeks. The entire treatment course was comprised of three treatment cycles.

For the acupuncture group, a 0.30 x 25 mm disposable filiform needle was perpendicularly inserted (after disinfection) into each acupoint until a deqi effect was achieved. Standard insertion depths of the acupoints were followed with one exception, the Shenque (CV8) acupoint was pierced up to a 3–5 mm depth. Normally, this acupoint is contraindicated for needling. A total needle retention time of 30 minutes was observed. The acupuncturist applied the reinforcement manipulation technique every 10 minutes. Acupuncture treatments were conducted twice per week, on Monday and Friday. Identical to the moxibustion protocol, one treatment cycle consisted of four consecutive weeks. The entire treatment course was comprised of three treatment cycles.

The total treatment effective rate was assessed according to skin improvements and changes in yin deficiency patterns. Yin deficiency improvements were evaluated by changes in the clinical presentation of symptoms. Skin improvements were categorized into 4 tiers:

Recovery: >90% reduction in acne, or only pigmentation change observed
Significantly effective: 60%–89% reduction in acne
Effective: 30%–59% reduction in acne
Not effective: <30% reduction in acne, or condition worsened
Zhang et al. conclude that both acupuncture and moxibustion are effective in treating acne due to yin deficiency with internal heat. Moxibustion outperformed acupuncture in this clinical protocol. Based on the findings, further research is warranted.

Contact Affinity Acupuncture today for Nashville Acupuncture treatments and appointments!

References:
Zhang XP, Tong YN, Xue D, Li M, Fu JY. (2013). Clinical Research on “Yin-deficiency with internal heat” Acne Treatment Using Acupuncture and Moxibustion. World Science and Technology-Modernization of Traditional Chinese Medicine. 15(6).

Zhang XP, Li M, Xue D, et al. (2012). Acupuncture and Moxibustion in treating Yin deficiency diseases. Journal of Shanghai University of Traditional Chinese Medicine. 26(6):30-32.

Zhang SJ. (2008). Moxibustion in treating terminal illnesses. China Journal of Acupuncture and Moxibustion. 28(10):739–741.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1645-acupuncture-and-moxibustion-clear-acne

Acupuncture relieves neck pain and improves range of motion.

by | Jun 8, 2016 | Acupuncture Nashville TN

Acupuncture relieves neck pain and improves range of motion. Chen et al. find acupuncture effective in alleviating cervical spondylosis, a painful disorder caused by intervertebral disc degeneration. Zeng et al. conclude that acupuncture alleviates cervical spondylosis and radiculopathy. The data demonstrates that acupuncture is more effective than NSAIDs (non-steroidal anti-inflammatory drugs). Zhou et al. find acupuncture effective for the alleviation of pain after surgery to the cervical spine. Li et al. conclude that acupuncture plus herbal medicine is effective for the relief of spasmodic torticollis, a disorder wherein the head becomes turned to one side, often due to painful muscle spasms. Liu et al. find acupuncture plus herbs effective for the relief of neck and shoulder pain. Neck points with sitting style technique are applied. 

Let’s take a look at each one of these discoveries. Chen et al. measured the effects of acupuncture on cervical spondylosis. Their findings indicate that a combination of auricular acupuncture with body style acupuncture is more effective than body style acupuncture as a standalone procedure.

Body style acupuncture combined with auricular acupuncture yielded the following results

70% recovered
26.67% significantly effective
3.33% ineffective
Body style only acupuncture yielded the following results

43.33% recovered
50% significantly effective
6.67% ineffective
Recovery was defined as: asymptomatic, muscular strength returned to normal, neck and limb function returned to normal, patient can return to normal work life and carry out more labor intensive activities. Significantly effective was defined as: mitigation of overall symptoms, neck and limb functional improvement, less pain of the neck, shoulder, and back.

Participants received acupuncture every other day for a total of ten sessions of care. Auricular acupuncture, also known as ear acupuncture, was applied to the intersecting region of the thoracic and cervical spine area on the outer ear. The needle was threaded subcutaneously through the cervical spine area. Needle retention time was thirty minutes and manual stimulation was applied 2 – 3 times during needle retention with 5 – 7 rotations each time.

Body style acupuncture was applied to acupoints including

Fengchi, GB20
Hegu, LI4
Jiaji (2 – 3 cervical points, affected side)
Mild reinforcing and reducing techniques were applied to elicit deqi. Needle retention time was thirty minutes, timed from the arrival of deqi. The researchers conclude that auricular acupuncture combined with body style acupuncture is highly effective in the treatment of cervical spondylosis. 

The findings are consistent with those of Zeng et al. whose research at the Guangzhou Dongsheng Hospital finds acupuncture plus herbs effective for the treatment of cervical spondylosis and related radiculopathy. The Traditional Chinese Medicine (TCM) group receiving both acupuncture and herbs had a 96.67% total effective rate. The control group received pharmaceutical medications and had an 83.33% total effective rate.

The control group received an NSAID (diclofenac) and mecobalamin (a form of B12). Diclofenac was administered in 75 mg doses, once per day. B12 was administered in 0.5 mg doses, three times per day. The drugs were administered for twenty days.

The primary acupuncture points used for the treatment group were

Fengchi, GB20
Bailao, M-HN-30
Jiaji (4 – 6 points)
Dazhui, DU14
Ashi
Tianzong, SI11
Supplementary acupoints were added based on diagnostic parameters. For yangming meridian pain or numbness, the following were added

Binao, LI14
Quchi, LI11
Shousanli, LI10
Hegu, LI4
For shaoyang meridian pain or numbness the following secondary acupoints were applied

Waiguan, SJ5
Zhongzhu, KD15
For pain or numbness of the taiyang meridian the researchers added Houxi (SI3). Manual stimulation was applied to acupoints until the arrival of deqi. Next, electroacupuncture was applied to 3 – 4 acupoints with a continuous wave. Intensity was set to tolerance levels. Additional manual techniques were applied to 1 – 2 spots of localized pain using the green dragon tail sweeping method. Needle retention time was thirty minutes per acupuncture session. A total of twenty acupuncture treatments were applied at a rate of once per day.

Herbal medicine was decocted in water and was administered orally once in the morning and also at night for twenty days. The formula included

Gui Zhi 15 g
Ge Gen 30 g
Bai Shao 15 g
Dan Shen 30 g
Yan Hu Suo 15 g
Fang Feng 10 g
Xu Duan 12 g
Dang Gui 10 g
Gan Cao 3 g
Additional herbs were added based on indications and differential diagnostics. For chills and aversion to wind combined with painful obstruction of the meridians, the following were added

Qiang Huo 12 g
Zhi Cao Wu 10 g
For dampness with heat and numbness, the following were added

Cang Zhu 15 g
Huang Bai 10 g
For blood stasis with painful blockage of the meridians, the following were added

Chuan Xiong 12 g
E Zhu 10 g
Acupuncture plus herbs yielded a 96.67% total effective rate and the medications yielded an 83.33% total effective rate. Acupuncture outperformed the medication group by 13.34%. The researchers conclude that acupuncture plus herbs is effective for the alleviation of cervical spondylosis and associated radiculopathy. Electroacupuncture applied to upper back and neck points is shown. 

Foshan Chinese Medicine Hospital researchers (Zhou et al.) looked at a very different type of neck pain. Their investigation examined the efficaciousness of electroacupuncture as a means to minimize pain after cervical spine surgery. Perioperative application of electroacupuncture to LI4 (Hegu) and PC6 (Neiguan) successfully reduced pain after surgery. In addition, patient controlled analgesia requests dropped sharply.

Several other clinical advantages to perioperative acupuncture were documented by the researchers. Electroacupuncture significantly reduced the dosage needs for remifentanil (synthetic opioid analgesic) and propofol (sedative). Acupuncture stabilized the heartbeat rate and the average arterial pressure. In addition, the time needed to regain consciousness after surgery was reduced by acupuncture. The time reduced from an average of 22.31 minutes for the medication only group to 7.01 minutes for the acupuncture plus medication group. Electroacupuncture significantly reduced the frequency of nausea, vomiting, and constipation after surgery.

LI4 and PC6 were needled perpendicularly and manual stimulation was applied to elicit the arrival of deqi. Continuous wave electroacupuncture was applied with a frequency increasing from 100 Hz to 1,000 Hz. The researchers concluded that electroacupuncture is effective in providing significant pain relief and minimizes complications due to surgery of the cervical spine.

Tianjin University of Traditional Chinese Medicine First Hospital (Li et al.) researchers document that acupuncture frees neck movement and stops pain. Their research also finds that combining Chinese herbal medicine with acupuncture increases the efficacy rate. A one year follow-up demonstrated that the acupuncture plus herbs protocol provides significant long-lasting clinical results.

Exclusion criteria were applied. For example, CT scans were used to ensure that participants did not have intracranial lesions. X-rays ruled out cervical spondylosis. Neurophysiological exams were used to determine inclusion criteria for spasmodic torticollis.

The treatment protocol featured strong acupuncture techniques. Bird-pecking-pulling (Que Zhuo Xie) manual acupuncture was applied to acupoint Shuigou (DU26) upwardly at 45˚. A pulling technique (Ti Cha Xie Fa) was applied with perpendicular insertion to Laogong (PC8) and Yongquan (KD1). Que Zhuo Xie was applied to Baihui (DU20) and Yintang was inserted to the bridge of the nose. Additional acupoints included

Tianzhu, BL10
Fengchi, GB20
Tianrong, SI17
Renying, ST9
Tianding, LI17
Ahshi
The herbal medicine decoction was based on the formula Zhen Gan Xi Huo Tang. The base formula consisted of

Sheng Long Gu 30 g
Zhen Zhu Mu 15 g
Jiang Can 10 g
Ci Shi 30 g
Additional herbs were added for specific conditions. For severe neck stiffness, the following were added

Bai Shao 45 g
Ge Gen 15 g
Gou Ji 15 g
For heat with phlegm, the following were added

Shi Chang Pu 15 g
Yuan Zhi 15 g
Zhu Ru 10 g
For participants with depression, the following herbs were added

Yu Jin 15 g
He Huan Pi 15 g
The herbs were decocted once per day and were administered in two doses, one in the morning and one at night. Outcomes measures included documentation of range of motion changes, shoulder lift, twitching, and tremors. The researchers concluded that acupuncture is effective for the treatment of spasmodic torticollis but acupuncture plus herbs is even more effective.

Liu et al. find acupuncture plus herbs effective for the relief of neck and shoulder dysfunction characterized by pain, numbness, inflammation, range of motion impingement, and hypodynamia (decrease in strength). The researchers commented that, statistically, white collar workers that spend a great deal of time sitting at a desk are particularly susceptible to this condition. In these cases, workers noted that their neck and shoulder tension and pain was partially alleviated by days off from work.

Acupuncture was applied to 2 – 4 points from a set of primary acupoints including

Taichong, LV3
Zulinqi, GB41
Xuanzhong, GB39
Fenchi, GB20
Jianjing, GB21
Zhongzhu, KD15
Manual needle stimulation was applied while patients actively and passively moved the neck and shoulder. Needle retention time was twenty minutes for this portion of the treatment session. Supplementary points were added for specific indications. For these points, electroacupuncture was applied. For posterior neck pain, Houxi (SI3) was added. For dampness, Fenglong (ST40) was added. For blood stasis, Xuehai (SP10) was added. An additional twenty minutes of needle retention time was added for the secondary electroacupuncture portion of the treatment session.

Herbal medicine was prescribed based on diagnostics. Patients with cold type pain were given Xiao Yao San. If neutral temperatures were determined, Si Ni San was prescribed. Dan Zhi Xiao Yao San was prescribed for patients with heat. For patients with deficiency, a combination of Xiao Yao San and Dang Gui Shao Yao San was prescribed. For cases of excess, Chai Hu Shu Gan San with Si Ni San was prescribed. Customization formulas based on differential diagnostics included the addition of herbs including Bai Shao, Gui Zhi, Huang Qi, Chai Hu, Fu Ling, and Ge Gen.

The researchers note that both the total recovery rate and the total effective rate was significant for participants receiving acupuncture plus herbs. All of the aforementioned studies indicate that acupuncture is an effective modality for the treatment of neck pain. The investigations demonstrate a variety of clinical scenarios and treatment protocols for the resolution of neck pain using acupuncture or acupuncture plus herbs.

References: 
Chen XP, Liang Q & Zhou SM. (2014). Controlled Clinical Studies on Treating Neck Cervical Spondylosis with Combination of Point-to-point Auricular Acupuncture along the Skin and Body Acupuncture. Clinical Journal of Chinese Medicine. 6(36).

Huang LC. (1991). Auricular Acupuncture: Diagnosis and Treatment. Beijing: Journal of Science & Technology.

Zeng R & Huang HF. (2015). Clinical observation on treating cervical spondylotic radiculopathy by floating-acupuncture, electro-acupuncture plus TCM medicine. Clinical Journal of Chinese Medicine. 7(29).

Zou XG. (2012). TCM, acupuncture, moxibustion, Tui Na and cervical traction in treating cervical spondylotic radiculopathy: 19 cases.China Modern Applied Medicine. 6(3): 42-43.

Zhou W, Chen YX & Ou JY. (2014). Electro Acupuncture on Hegu Point and Neiguan Point to Treat Acute Pain after Surgery on Anterior Cervical Spine. World Chinese Medicine. 9(4).

Li ZR. (2003). Acupuncture Experiments. Beijing: China TCM Publisher. 154.

Li, W. W. & Wu, L. Z. (2015). Clinical Observations on Combined Use of Acupuncture and Medicine for Treatment of Spasmodic Torticollis. Shanghai Journal of Acupuncture and Moxibustion. 34 (2).

Chen, Y., Qiao, K. & Jiang, W. X., et al. (2006). 146 cases of clinical study on EMG-guided botulinum toxin type A treatment of spasmodic torticollis [J]. Chinese Journal of Clinical Neurosciences. 14(2).

Liu YD. (2014). The treatment of neck-shoulder syndrome from liver and gallbladder theory by acupuncture plus TCM medicine. Clinical Journal of Chinese Medicine. 6 (16).

Shao SJ, Xie Q. (1999). Wei Jia Acupuncture Therapy. Shanghai University of TCM Publisher. 66.

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