Helping Bladder Control and Leakage with Acupuncture

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:

SP6 (Sanyinjiao)

CV4 (Guanyuan)

KD3 (Taixi)

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:

Shangliao (BL31)

Ciliao (BL32)

Zhongliao (BL33)

Xialiao (BL34)

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.

References:
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.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1684-acupuncture-helps-bladder-control-stops-leakage

 

Music Electroacupuncture Outperforms Antidepressant Drug.

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.

 

References:
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.

http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1669-music-electroacupuncture-outperforms-fluoxetine-for-depression

Acupuncture Found Effective For Cervical Spine Disorders

Long needle acupuncture, electroacupuncture and Xiaoxingnao acupuncture show positive treatment outcomes for both cervical spondylosis and cervical spondylotic radiculopathy.

Two recent research studies find acupuncture a highly effective and flexible method for the treatment of cervical spondylosis and cervical spondylotic radiculopathy (neck spinal and soft tissue degeneration causing nerve impingement and subsequent pain or numbness). One study from Xindu District Hospital of Traditional Chinese Medicine found long needle acupuncture to be highly effective for the treatment of cervical spondylotic radiculopathy. Another from Tianjin University of TCM determined that electroacupuncture treatment in combination with Xiaoxingnao acupuncture produces significant patient outcomes.

In the first study, researchers Xie et al. (Xindu District Hospital of Traditional Chinese Medicine) conducted a scientific investigation of long needle acupuncture compared with conventional acupuncture for the treatment of cervical spondylotic radiculopathy. The results demonstrate that long needle acupuncture produces superior patient outcomes. Let’s take a look at the advanced procedures that produced the results. Please keep in mind that the following procedures are only appropriate for licensed acupuncturists trained in these expert techniques and procedures.

Cervical spondylotic radiculopathy is a common disease that usually affects patients between the ages of 25 and 65 years old. It is mainly caused by bone hyperplasia and hypertrophy of the intervertebral discs, vertebral joints and facet joints. Consequently, the corresponding spinal nerve roots and other nerve roots are compressed or damaged. The main symptoms of this condition include neck, shoulder, back, upper limb, and finger pain, numbness, radiculopathy, or limb and finger weakness (Yang et al., 2012).

Long needle acupuncture accelerates qi and blood circulation in the meridians and also facilitates communication between the yin and yang meridians or between multiple acupoints. For this reason, it is appropriate for the treatment of cervical spondylotic radiculopathy. The study found that long needle acupuncture demonstrates a higher efficacy rate than conventional acupuncture for the treatment of this condition.

A total of 126 patients with cervical spondylotic radiculopathy were selected for the study. They were divided into two groups: treatment group (64 patients), control group (62 patients). The treatment group underwent long needle acupuncture whereas the control group underwent conventional acupuncture treatment. Identical primary acupoints were selected for both therapies: neck Jiaji acupoints and traditional Hua Tuo Jiaji acupoints. These acupoints run in two parallel lines on either side of the spinal column and the Governing Vessel meridian, 0.5–1 cun lateral to the spinous process of each vertebrae. They function to stimulate the nerve segment corresponding to their specific locations.

For the long needle acupuncture treatment, a 3 inch acupuncture needle was held with both hands and inserted into each acupoint. For the neck Jiaji acupoints, the long needle was pointed downwards and inserted towards the seventh cervical vertebra. Upon insertion, either the Ping Bu Ping Xie (gently reinforcing and reducing) or the Xie (reducing) needle manipulation technique was applied. Needle techniques were selected depending upon the individual patient’s clinical symptoms. One acupuncture session was conducted daily for 20 days in total, in two cycles of 10 consecutive days, with a 1 to 2-day break between each cycle.

For conventional acupuncture, a 1.5 inch filiform needle was inserted into each acupoint, angled toward the midline. Upon insertion, either the Ping Bu Ping Xie or the Xie needle manipulation technique was applied, depending upon the individual patient’s clinical symptoms. One acupuncture session was conducted daily for 20 days in total, in two cycles of 10 consecutive days, with a 1 to 2 day break between each cycle. The patients receiving long needle acupuncture achieved a 95.3% total treatment effective rate, while those who received conventional acupuncture achieved an 80.6% rate. The results of this study indicate that long needle acupuncture is highly effective in treating cervical spondylotic radiculopathy, showing greater improvements in symptoms than conventional acupuncture.

In the second study, researchers Gong and Xue (Tianjin University of TCM) found that Xiaoxingnao acupuncture (a specialized acupuncture technique which effectively dredges meridians, improves blood circulation and refreshes the mind) combined with electroacupuncture on the cervical Jiaji acupoints is effective for the treatment of Vertebral artery cervical spondylosis. Vertebral artery cervical spondylosis arises from arterial oppression or damage from mechanical and dynamic factors. This leads to stenosis, which eventually decreases blood supply to the vertebral basilar artery. The main symptoms of vertebral artery cervical spondylosis include: neck and shoulder pain, dizziness, headache, cataplexy, optical conditions (e.g., fogged vision, dark spots, transient amaurosis, temporary vision defects, degenerated vision, ambiopia, visual hallucinations, blindness). In addition, bulbar paralysis and other neurological symptoms may be observed including slurred speech, dysphagia, pharyngeal reflex, choking due to backflow while drinking water, palatoplegia, voice hoarseness or facial paralysis.

The study involved a total of 60 patients with vertebral artery cervical spondylosis. They were divided into two equal groups of 30: the treatment group and the control group. Patients in the treatment group were treated with a combination of Xiaoxingnao acupuncture therapy with electroacupuncture. The control group patients received pharmaceutical medications. The clinical results of this study demonstrate that combining electroacupuncture and Xiaoxingnao acupuncture yields significantly better treatment outcomes than medications. Primary acupoints selected for the treatment group’s therapy were the following:

Fengchi (GB20)
Fengfu (GV16)
Tianzhu (BL10)
Wangu (SI4)
Dazhui (GV14)
Cervical Jiaji acupoints
Fengchi, Fengfu and Tianzhu acupoints were selected for their ability to reduce muscule spasms, regulate autonomic nerve functions, dilate blood vessels and improve blood supply to the brain. Wangu was selected for the treatment of headaches and neck pain. Dazhui was selected to facilitate blood flow. Finally, the cervical Jiaji acupoints were selected as local points to dredge the affected meridians (Deng et al., 2008). For the Fengchi, Fengfu, Tianzhu and Wangu acupoints, the needles were inserted 1.5 – 2 inches deep, toward the Adam’s apple. Acupoints were manipulated by rotating in small turns at a high frequency. For the Dazhui acupoint, multiple needles were inserted in various directions: upward, downward, to the left, to the right and perpendicularly (until the patient felt a sensation radiating toward the shoulder).

The cervical Jiaji acupoints were inserted perpendicularly to a depth of 1.5 – 2 inches. An electroacupuncture device was connected to the needles at the cervical Jiaji acupoints, set at 2 – 10 Hz with disperse-dense waves. Additional secondary acupoints were selected on an individual symptomatic basis as follows:

For phlegm and dampness retention:

Fenglong (ST40)
Yanglingquan (GB34)
For phlegm and blood stasis:

Hegu (LI4)
Sanyinjiao (SP6)
Geshu (BL17)
Zhongwan (CV12)
Fenglong (ST40)
Zusanli (ST36)
For accumulation of dampness and heat:

Danshu (BL19)
Yanglingquan (GB34)
Neiguan (PC6)
Shenmen (HT7)
Fenglong (ST40)
For blood deficiency:

Geshu (BL17)
Xuehai (SP10)
Zusanli (ST36)
Sanyinjiao (SP6)
Qihai (CV6)
For all secondary acupoints, the Ping Bu Ping Xie needle manipulation technique was applied. After needle insertion and manipulation, a needle retention time of 20 minutes was observed. One 20 minute acupuncture session was conducted daily for 2 consecutive weeks.

Patients taking medications received intravenous infusions including mannitol and safflower extract injections in addition to medications to promote blood circulation, nourish nerves, and energize the body. The medications were administered once daily for 2 consecutive weeks. The results of this study showed that patients who underwent combined Xiaoxingnao acupuncture and electroacupuncture achieved an excellent total treatment effective rate of 93.3%, while those who received conventional medications plus infusions achieved a 76.7% total treatment effective rate.

The two aforementioned clinical studies demonstrate that different types of acupuncture have varying efficacy rates for the treatment of cervical spondylosis and cervical spondylotic radiculopathy. Electroacupuncture and Xiaoxingnao acupuncture were more effective than medications. Long needle acupuncture produced greater positive patient outcomes than conventional acupuncture. This reflects the dynamic nature of acupuncture and its flexibility for the treatment of these common conditions.

References:
Xie XY, Qing S, Liao JK, Xiao Y, Liu JQ. (2013). Clinical Efficacy of Long Needle Penetration Acupuncture on Cervical Spondylotic Radiculopathy: A Clinical Observation of 64 Cases. Guiding Journal of Traditional Chinese Medicine and Pharmacology. 7(7).

Yang JX, Yu JC, Zhang JP et al. (2012). Triple Jiao acupuncture in treating cervical spondylotic radiculopathy. Chinese General Practice. 15(25): 2963-2965.

Gong XL, Xue YY. (2014). Clinical Observation of Xiaoxingnao acupuncture Combined with Electroacupuncture at Cervical Jiaji Points in Treatment of Vertebral Artery Type of Cervical Spondylosis.
Journal of Hubei University of Chinese Medicine. 16(5).

Deng LX, Wu XP, Huang W, Wu QK & Jiang GD. (2008). Electroacupuncture in treating vertebral artery type of cervical spondylosis. Journal of Hubei College of Traditional Chinese Medicine. 1.

Original article from:

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Research Shows Acupuncture Prevents and Clears Migraines

Research Shows Acupuncture Prevents and Clears Migraines

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

The Science of Acupuncture

New CT scan technology reveals acupuncture points. Click the following to read the story: Acupuncture Point Discovery.

Researchers have discovered how to measure and validate the existence of acupuncture points and their meridians. MRI studies and oxygen sensor studies come from some of the most prestigious universities in the world. Today, I want to start with remarkable research from investigators at one of the most prestigious universities in Korea.

Sungkyunkwan University (Seoul) was founded in 1398. Yes, over 600 years ago! It was recently acquired by the Samsung Group in 1996, which has helped preserve its legacy of excellence with substantial financial support. The university is a leader in many fields including nanotechnology and natural sciences, features a dual degree program with Ohio State University and has a collaborative program with the MIT (Massachusetts Institute of Technology) Sloan School of Management.

Two researchers from Sungkunkwan Univeristy worked with another researcher from the Department of Chemistry and Nano Science at Ewha Womans University on this ground breaking research. Notably, Ewha Womans University is considered one of the most prestigious schools in Korea and produced Korea’s first female doctor, lawyer, justice on the Constitutional Court and the first female prime minister of Korea.

Why all the fuss about researchers and the schools they hail from? In the many years I have worked in Chinese and Oriental Medicine, I have uniformly come across skepticism and resistance to valuable, peer reviewed research. I want to give a little background before going forward with something as important as this research. For some it seems, no research institute or study is sufficient so long as it says something positive about acupuncture and herbal medicine. Ethnocentrism abound, I wanted to stave off imperious pans decrying putative proofs and to assuage presumptive skepticism and concomitant guetapens. Perhaps establishing the authenticity and seriousness of the institutions from which the research emanates helps equanimity to mollify incredulity and for rapprochement to exist between the skeptic and modern scientists whose works demonstrate the existence of acupuncture points and their functions.

The research from Sungkyunkwan University and Ewha Woman University is entitled Heterogeneity of Skin Surface Oxygen Level of Wrist in Relation to Acupuncture Point.[1] The study used an amperometric oxygen microsensor to detect partial oxygen pressure variations at different locations on the anterior aspect of the left wrist. The researchers concluded that partial oxygen pressure is significantly higher at acupuncture points.

Below are two images from the study measuring the increase of partial oxygen pressure combined with an overlay of the local acupuncture point locations. The images are representative of typical readings found in the study and remarkably map the Lung Hand Taiyin, Pericardium Hand Jueyin and Heart Shaoyin channels and their associated local points. Depicted are P7 and P6 clearly showing high oxygen pressure levels. The same is true for LU9, LU8, HT7, HT6, HT5 and HT4. Note that non-acupuncture point regions do not show higher oxygen pressure levels. These measurements are not needled points but are natural resting states of acupuncture points absent stimulation. This biomedical research gives us insight into the structural makeup of acupuncture points. This type of basic research is not isolated and numerous studies from multitudes of the top research centers and universities demonstrate specific properties and physiological actions of acupuncture points.

Wrist acupuncture points including the Peridcardium channel and Lung channel.  (Seen Above)

The nexus of most research on the physical existence of acupuncture points and acupuncture meridians is hemodynamic, MRI, oxygen pressure, histological, physiological, clinical and electroconductivity research. Researchers at the University of California School of Medicine (Irvine, California) noted, “Recent evidence shows that stimulation of different points on the body causes distinct responses in hemodynamic, fMRI and central neural electrophysiological responses.” The investigators reviewed MRI results and noted that “stimulation of different sets of acupoints leads to disease-specific neuronal responses, even when acupoints are located within the same spinal segment.” This summarizes research in the vanguard of technical documentation on acupuncture.[2][3]

University of California researchers Choi, Jiang and Longhurst note of acupuncture, “hemodynamic, functional magnetic resonance imaging and neurophysiological studies evaluating the responses to stimulation of multiple points on the body surface have shown that point-specific actions are present.”[4] Naturally, they are running into the difficulty of AhShi points and their specific actions. Perhaps they will discover new effective actions for AhShi points as a result of basic research. Other research shows point specificity in brain physiology and reflects the overall direction of scientific investigation in the field of acupuncture.

The Journal of Magnetic Resonance Imaging featured research on the neurophysiological effects of acupuncture points using MRI imaging noting that acupoint GB40 stimulation enhanced “connectivity between the superior temporal gyrus (STG) and anterior insula.” The investigators concluded, “The current study demonstrates that acupuncture at different acupoints could exert different modulatory effects on RSNs. Our findings may help to understand the neurophysiological mechanisms underlying acupuncture specificity.”[5] Here, the researchers have validated acupuncture point specificity and suggest a possible physiological model of understanding acupuncture points.

HRV (Heart Rate Variability) is a measure of cardiovascular health. One study notes that, “HRV changes significantly during auricular acupuncture….” This research also notes that, “HRV total increases during auricular acupuncture….”[6] Another related study from the International Society for Autonomic Neuroscience notes that acupuncture “causes the modulation of cardiac autonomic function.” These are but two examples of investigations citing specific medicinal actions of specific acupuncture points and is in no way exhaustive of the vast body of research demonstrating acupuncture point specificity for the treatment of hypertension, atrial fibrillation and other cardiovascular disorders.[7] Investigators from the University of California (Los Angeles and Irvine) “have shown that electroacupuncture stimulation activates neurons” in specific brain regions thereby reducing hypertension.[8]

Dr. Berman, M.D. served as a lead researcher in a University of Maryland School of Medicine investigation published in the prestigious Annals of Internal Medicine. The research concludes that, “Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.”[9] What is interesting in this clinical trial is that it was an early study showing that sham acupuncture was not as effective as verum acupuncture. The study sought to isolate and address the placebo effect and found that it is not responsible for the medical benefits associated with acupuncture therapy. There are many papers showing the specific medical benefits of acupuncture on internal organs, tissues and towards the resolution of specific ailments. I thought I would highlight this investigation given its historical value.

Einstein’s Theory of Relativity initially did not catch on and was ridiculed before acceptance. The same is true for much of medicine both old and new. People’s presuppositions often circumvent equanimity and receptiveness to new insights. Backing up a bit, one might have thought that a basic neurologic test for the Babinski Sign was pure fiction. It may have seemed logical and self-evident that rubbing someone’s foot and looking for dorsiflexion of the great toe and fanning of the other toes could not possibly indicate brain or spinal cord damage. Yet, the great French neurologist of Polish origin, Babinski, discovered that this plantar reflex identifies central nervous system damage, which is now an accepted medical reality by medical doctors and is an effective diagnostic tool for central nervous system damage.

Acupuncturists and herbalists have faced acrimonious traducements and caluminiations towards substantiated supportive research. Often there is a predilection towards rejecting the efficacy of Chinese and Oriental Medicine that trumps the realities of hard evidence and smacks of ethnocentrism. The Flat Earth Society felt the same way about the infidels suggesting that the earth is round. Galileo had his fair share of troubles too. It cannot be underestimated how high the stakes really are for patient care and beneficial patient outcomes. At risk is non-integration of cost-effective medicine that roots out the source of suffering by healing illness. A time honored traditional clinical medicine history combined with supportive modern research data suggests that acupuncture is an effective modality of therapeutic care. Acupuncture seems impossible? Recall the words of Mark Twain, “Fiction is obliged to stick to possibilities. Truth isn’t.”

It may appear to some that it is self-evident and logical that acupuncture points exist only as part of some sort of chimerical hermeneutic system. However, extensive research has already been conducted at major universities worldwide demonstrating not only that acupuncture points and meridians exist but also how they physiologically function. There is a resistance to an enormous body of research. Cloaked in veil of mature skepticism and realism, naysayers grasp at piecemeal attack pieces to fight off what has already been measured, documented and peer reviewed both in individual studies and large scale meta-analyses. I suggest an era of open-mindedness towards the modern research documenting the efficacy of Chinese and Oriental medicine, acupuncture and herbal medicine.

Footnotes:
[1] Minyoung Hong, Sarah S. Park, Yejin Ha, et al., “Heterogeneity of Skin Surface Oxygen Level of Wrist in Relation to Acupuncture Point,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 106762, 7 pages, 2012. doi:10.1155/2012/10a6762.
[2] Point specificity in acupuncture. Chin Med. 2012 Feb 28;7:4. doi: 10.1186/1749-8546-7-4. Choi EM, Jiang F, Longhurst JC.
[3] Susan Samueli Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, Irvine CA 92697-4075, USA.
[4] Point specificity in acupuncture. Chin Med. 2012 Feb 28;7:4. doi: 10.1186/1749-8546-7-4. Choi EM, Jiang F, Longhurst JC.
[5] Zhong, C., Bai, L., Dai, R., Xue, T., Wang, H., Feng, Y., Liu, Z., You, Y., Chen, S. and Tian, J. (2011), Modulatory effects of acupuncture on resting-state networks: A functional MRI study combining independent component analysis and multivariate granger causality analysis. Journal of Magnetic Resonance Imaging.
[6] Evidence-Based Complementary and Alternative Medicine. Volume 2012 (2012), Article ID 817378, 7 pages. doi:10.1155/2012/817378. Sino-European Transcontinental Basic and Clinical High-Tech Acupuncture Studies—Part 1: Auricular Acupuncture Increases Heart Rate Variability in Anesthetized Rats. Xin-Yan Gao, Kun Liu, Bing Zhu and Gerhard Litscher.
[7] Kurono Y, Minagawa M, Ishigami T, Yamada A, Kakamu T, Hayano J. Auton Neurosci. Acupuncture to Danzhong but not to Zhongting increases the cardiac vagal component of heart rate variability. 2011 Apr 26;161(1-2):116-20. Epub 2011 Jan 7.
[8] Evidence-Based Complementary and Alternative Medicine. Volume 2012 (2012), Article ID 878673, 9 pages. doi:10.1155/2012/878673. Neuroendocrine Mechanisms of Acupuncture in the Treatment of Hypertension. Wei Zhou and John C. Longhurst. Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Department of Medicine, University of California Irvine, Irvine, CA.
[9] Ann Intern Med, Berman, Lixing, Lagenberg, Lee, Gilpin, Hochberg. 2004; 141:901-910.