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:
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.
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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.
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
26.67% significantly effective
Body style only acupuncture yielded the following results
50% significantly effective
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
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
Jiaji (4 – 6 points)
Supplementary acupoints were added based on diagnostic parameters. For yangming meridian pain or numbness, the following were added
For shaoyang meridian pain or numbness the following secondary acupoints were applied
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
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
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.
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.
Is How You (Don’t) Sleep Making You Sick?
We all know that there are short term problems with not getting a good night’s sleep – a lack of mental sharpness, irritability, falling asleep at inopportune times, etc. Did you know there are potential long-term risks to your health also? For instance, people who sleep less than 6 hours per night are twice as likely to have a heart attack, and four times more likely to have a stroke than those who sleep more than 6 hours. They are also at greater risk of diabetes and obesity. Extreme fatigue increases appetite and decreases metabolism, and individuals who regularly get less than 4 hours of sleep 4 nights or more a week may easily be in a pre-diabetic state.
Half of adults 55+ have at least 1 symptom of insomnia at least 3 times per week including:
– Trouble falling asleep
– Waking during the night
– Waking to early and being unable to fall back to sleep
– Not feeling refreshed upon waking
Women suffer from insomnia more than men due to pregnancy, menstruation, and menopause.
Twenty million Americans take prescription sleep pills regularly. Over $100 million is spent in the US on over the counter sleep aids per year, and that number does not include prescriptions. Drug oriented OTCs have been studied and found no more effective than a placebo. Medications alter sleeping cycles, and suppress REM sleep. This can lead to light, restless sleep with nightmares once medications end, or “REM Withdrawl Sleep.” Many individuals often return to these sleep aids, even the ones advertised as “non-habit forming,” and the cycle continues. Medications can cause long-term harm to your body. Additionally, they are expensive, and only treat the symptom of an underlying problem.
Traditional Chinese Medicine believes that the symptoms of insomnia are the branches of a disease. An imbalance in the body, usually Chi, blood, Yin, Yan, Jing, or Shen, or a major organ system (lung, liver, heart, spleen, kidney, or liver) causes the imbalance or dysfunction, and acupuncture treatments help realign the body’s systems and help you find balance once more. Additional methods in Traditional Chinese Medicine, such as herbs, may also help your body better process energy and achieve restful sleep.
The following may lead to a lack of restful sleep:
Overeating, especially protein
Irregular sleeping hours
Lack of physical exercise
Hypothyroidism or hyperthyroidism
Sleep apnea (Associated with high blood pressure, increased risk of heart disease and stroke, emotional disturbances and even psychoses.)
Emotional or mental stress
Overstimulation to the nervous system
TV/video game excess
Lack of adequate ventilation; oxygen debt
Allergies – an increased heart rate follows exposure.
Lights left on at night (disrupts the pineal gland producing melatonin, a sleep hormone)
Temperature extremes in bed
Restless Sleepers may have excessive amounts of the following in their diets:
Heavy metals (such as mercury found in high fructose corn syrup, tuna, swordfish, and mackerel
Salt, which increases blood volume, heart output, and blood pressure.
Food additives, preservatives, and colorings
Refined carbohydrates, sugar, soda, ice cream or other sweets
They may be deficient in:
Lycopene (found in red and orange foods such as tomatoes, bell peppers)
Selenium (found in nuts, mushrooms, meat, and shellfish). Selenium helps with inflammation.
Lutein (found in green, leafy vegetables)
Iron or copper (found in shellfish, clams, lentils, nuts, and whole-grain foods). Deficiency may make it take longer to fall asleep, and sleep may be less refreshing.
The body converts tryptophan into seratonin, which is then converted into melatonin. Both make you feel relaxed and sleepy. Foods with tryptophan include bananas yogurt, dates, figs, warm milk, dairy, and turkey. These foods are metabolized best in combination with starches, which make the body release insulin. This pushes the amino acids except for tryptophan into the muscle cells, leaving the tryptophan alone in the blood stream and ready to go to the brain. Niacin, a B-vitamin, makes tryptophan work more effectively, and is found in lean meats such as canned tuna. Melatonin naturally exists in oats, sweet corn, rice, ginger, bananas, and barley.
Magnesium rich foods can also help you relax and have restful sleep. Low magnesium levels will stimulate brain-activation neurotransmitters, which leads to overstimulation of the brain. This is especially common in the elderly taking meds that may block magnesium absorption. Dried beans such as pinto and navy beans, green leafy vegetables, soybeans, pumpkin seeds, wheat germ, and almonds are all rich in magnesium.
Folic acid in spinach, especially if muscle cramping or restless leg syndrome keeps you awake, are good additions to your diet. Inosytol enhances REM sleep
Avoid red meat, chocolate, ham, bacon, sausages, cheese, tomatoes, which contain the CNS stimulant tyramine.
Alcohol does not, in fact, help you get a good night’s sleep. You may fall asleep easily, because alcohol turns off the hypocretin neurons which keep you awake, but it has a rebound effect and can wake you quickly.