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Acupuncture Research
On this page you will find research abstracts for specific conditions. These are the most credible research studies currently published on acupuncture.
Please click on the condition you are interested in.
General Research on Acupuncture
NIH Consensus Panel. Acupuncture. NIH Consensus Development Statement. Bethesda, MD, Nov 3-5, 1997
OBJECTIVE: The objective of this NIH Consensus Statement is to inform the biomedical research and clinical practice communities of the results of the NIH Consensus Development Conference on Acupuncture. The statement provides state-of-the-art information regarding the appropriate use of acupuncture, and presents the conclusions and recommendations of the consensus panel regarding these issues. In addition, the statement identifies those areas of study that deserve further investigation. Upon completion, the reader should possess a clear working clinical knowledge of the state-of-the-art regarding this topic. The target audience of physicians for this statement includes, but is not limited to, family practitioners, medical acupuncturists, psychiatrists, and specialists in pain medicine. PARTICIPANTS: A non-Federal, nonadvocate, 12-member panel representing the fields of acupuncture, pain, psychology, psychiatry, physical medicine and rehabilitation, drug abuse, family practice, internal medicine, health policy, epidemiology, statistics, physiology, biophysics, and the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 1,200. EVIDENCE: The literature was searched through Medline, and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions.
CONCLUSIONS: Acupuncture as a therapeutic intervention is widely practiced in the United States. While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful.
Ernst E. Acupuncture – a critical analysis. J Intern Med 2006;259:125
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK.
Even though widely used in today's clinical practice, acupuncture has remained a controversial subject. Many reviews are currently available but most lack a critical stance and some are overtly promotional. The aim of this overview is to provide a balanced, critical analysis of the existing evidence. Some of the original concepts of traditional acupuncture are not supported by good scientific evidence. Several plausible theories attempt to explain how acupuncture works but none are proved beyond doubt. The clinical effectiveness of acupuncture continues to attract controversy. Many controlled clinical trials and numerous systematic reviews of these studies have been published. Considerable problems are encountered when interpreting these data. Heterogeneity is a significant drawback of both clinical trials and systematic reviews. Some of the controversies may be resolved through the use of the new 'placebo needles' which enable researchers to adequately control for placebo effects of acupuncture. The majority of studies using such devices fails to show effects beyond a placebo response. Acupuncture has been associated with serious adverse events but most large-scale studies suggest that these are probably rare. Nonserious adverse effects occur in 7-11% of all patients. In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response.
Sierpina VS, Frenkel MA. Acupuncture: a clinical review. South Med J 2005;98:330
Family Medicine Department, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
This article summarizes the research base, probable mechanism of actions, and clinical applications of acupuncture. It offers the clinician a deeper understanding of appropriate conditions for which acupuncture may be useful, outlines how to integrate acupuncture into a clinical practice, and describes referral and training issues.
Tsai HY et al. Further evidence for possible analgesic mechanism of electroacupuncture on neuropeptides and serotonergic neurons in rat spinal cord. Jpn J Pharmacol 1989;49:181
Department of Pharmacology, China Medical College, Taichung, Taiwan.
The possible mechanism of electroacupuncture (EAc) in reference to the effects of neuropeptides on serotonergic neurons in rat spinal cord was studied. The tested drugs were administered by intrathecal injection or spinal push-pull perfusion. The results showed that baclofen, substance P (SP) and naloxone administered intrathecally could reduce the tail pressure pain threshold. The pain threshold was increased by met-enkephalin (EK) and EAc. The action of EAc was antagonized by naloxone. The release of 5-HT in the spinal cord evoked by tail pressure pain stimulation (TP) was inhibited by EK, baclofen and EAc. However, naloxone could potentiate the 5-HT release evoked by TP. EAc reversed the naloxone potentiation of TP-evoked 5-HT release. The 5-HT release evoked by exogenous SP, however, was potentiated by EK and EAc. From these results, it is suggested that the influence of EAc on 5-HT release may be due to activation of enkephalin-interneurons, which presynaptically inhibit the primary sensory neurons in the spinal cord.
Hui KK et al. The integrated response of the human cerebrocerebellar and limbic systems to acupuncture stimulation at St 36 as evidenced by fMRI. Neuroimage 2005;27:479
Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Building 149, 13th Street, Room 2301, Charlestown, MA 02129, USA.
Clinical and experimental data indicate that most acupuncture clinical results are mediated by the central nervous system, but the specific effects of acupuncture on the human brain remain unclear. Even less is known about its effects on the cerebellum. This fMRI study demonstrated that manual acupuncture at ST 36 (Stomach 36, Zusanli), a main acupoint on the leg, modulated neural activity at multiple levels of the cerebro-cerebellar and limbic systems. The pattern of hemodynamic response depended on the psychophysical response to needle manipulation. Acupuncture stimulation typically elicited a composite of sensations termed deqi that is related to clinical efficacy according to traditional Chinese medicine. The limbic and paralimbic structures of cortical and subcortical regions in the telencephalon, diencephalon, brainstem and cerebellum demonstrated a concerted attenuation of signal intensity when the subjects experienced deqi. When deqi was mixed with sharp pain, the hemodynamic response was mixed, showing a predominance of signal increases instead. Tactile stimulation as control also elicited a predominance of signal increase in a subset of these regions. The study provides preliminary evidence for an integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 that correlates with the psychophysical response.
Pariente J et al. Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture. Neuroimage 2005;25:1161
Wellcome Department of Imaging Neuroscience, 12 Queen Square, WC1N 3BG London, UK.
Both specific and non-specific factors may play a role in acupuncture therapy for pain. We explored the cerebral consequences of needling and expectation with real acupuncture, placebo acupuncture and skin-prick, using a single-blind, randomized crossover design with 14 patients suffering from painful osteoarthritis, who were scanned with positron emission tomography (PET). The three interventions, all of which were sub-optimal acupuncture treatment, did not modify the patient's pain. The insula ipsilateral to the site of needling was activated to a greater extent during real acupuncture than during the placebo intervention. Real acupuncture and placebo (with the same expectation of effect as real acupuncture) caused greater activation than skin prick (no expectation of a therapeutic effect) in the right dorsolateral prefrontal cortex, anterior cingulate cortex, and midbrain. These results suggest that real acupuncture has a specific physiological effect and that patients' expectation and belief regarding a potentially beneficial treatment modulate activity in component areas of the reward system.
Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec 2002;269:257
Department of Neurology, University of Vermont College of Medicine, Burlington, VT 05405, USA.
Acupuncture meridians traditionally are believed to constitute channels connecting the surface of the body to internal organs. We hypothesize that the network of acupuncture points and meridians can be viewed as a representation of the network formed by interstitial connective tissue. This hypothesis is supported by ultrasound images showing connective tissue cleavage planes at acupuncture points in normal human subjects. To test this hypothesis, we mapped acupuncture points in serial gross anatomical sections through the human arm. We found an 80% correspondence between the sites of acupuncture points and the location of intermuscular or intramuscular connective tissue planes in postmortem tissue sections. We propose that the anatomical relationship of acupuncture points and meridians to connective tissue planes is relevant to acupuncture's mechanism of action and suggests a potentially important integrative role for interstitial connective tissue. Copyright 2002 Wiley-Liss, Inc.
Chernyak GV, Sessler DI. Perioperative acupuncture and related techniques. Anesthesiology 2005;102:1031
Outcomes Research Institute and Department of Anesthesiology, University of Louisville, Kentucky 40202, USA.
Acupuncture and related techniques are increasingly practiced in conventional medical settings, and the number of patients willing to use these techniques is increasing. Despite more than 30 yr of research, the exact mechanism of action and efficacy of acupuncture have not been established. Furthermore, most aspects of acupuncture have yet to be adequately tested. Therefore, considerable controversy remains about the role of acupuncture in clinical medicine. Acupuncture apparently does not reduce volatile anesthetic requirement by a clinically important amount. However, preoperative sedation seems to be a promising application of acupuncture in perioperative settings. Acupuncture may be effective for postoperative pain relief but requires a high level of expertise by the acupuncture practitioner. Acupuncture and related techniques can be used for treatment and prophylaxis of postoperative nausea and vomiting in routine clinical practice in combination with or as an alternative to conventional antiemetics when administered before induction of general anesthesia.
Lee H, Ernst E. Acupuncture analgesia during surgery: a systematic review. Pain 2005;114:511
Department of Medical Sciences, Graduate School of East-West Medical Science, KyungHee University, Yongin, South Korea.
The aim of this systematic review is to assess the effectiveness of acupuncture as an adjunctive analgesic method to standard anaesthetic procedures for surgery and to determine whether acupuncture has any analgesic-sparing effect. Electronic literature searches for randomised clinical trials (RCTs) of acupuncture during surgery were performed in seven electronic databases. No language restrictions were imposed. All included studies were rated according to their methodological quality and validity. As the studies were clinically heterogeneous, no meta-analyses were performed. The evidence was classified according to four levels: strong, moderate, limited, or inconclusive. Nineteen RCTs were identified. Seven of them suggested that acupuncture is efficacious. Of nine high-quality RCTs, two studies had positive outcomes. There was no significant association between study quality and direction of outcome. One of eight high-validity trials reported a positive outcome and there was a significant relationship between validity and direction of outcome. The evidence that acupuncture is more effective than no acupuncture as an adjunct to standard anaesthetic procedures is therefore inconclusive. Strong evidence exists that real acupuncture is not significantly different from placebo acupuncture. For an analgesic-sparing effect of acupuncture, evidence remains inconclusive. In conclusion, this review does not support the use of acupuncture as an adjunct to standard anaesthetic procedures during surgery.
Women’s Health
Cardini F. Moxibustion for Correction of Breech Presentation. JAMA 1998;280:1580-1584.
CONTEXT: Traditional Chinese medicine uses moxibustion (burning herbs to stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of fetuses in breech presentation. Its effect may be through increasing fetal activity. However, no randomized controlled trial has evaluated the efficacy of this therapy. OBJECTIVE: To evaluate the efficacy and safety of moxibustion on acupoint BL 67 to increase fetal activity and correct breech presentation. DESIGN: Randomized, controlled, open clinical trial. SETTING: Outpatient departments of the Women's Hospital of Jiangxi Province, Nanchang, and Jiujiang Women's and Children's Hospital in the People's Republic of China. PATIENTS: Primigravidas in the 33rd week of gestation with normal pregnancy and an ultrasound diagnosis of breech presentation. INTERVENTIONS: The 130 subjects randomized to the intervention group received stimulation of acupoint BL 67 by moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version anytime between 35 weeks' gestation and delivery. MAIN OUTCOME MEASURES: Fetal movements counted by the mother during 1 hour each day for 1 week; number of cephalic presentations during the 35th week and at delivery. RESULTS: The intervention group experienced a mean of 48.45 fetal movements vs 35.35 in the control group (P<.001; 95% confidence interval [CI] for difference, 10.56-15.60). During the 35th week of gestation, 98 (75.4%) of 130 fetuses in the intervention group were cephalic vs 62 (47.7%) of 130 fetuses in the control group (P<.001; relative risk [RR], 1.58; 95% CI, 1.29-1.94). Despite the fact that 24 subjects in the control group and 1 subject in the intervention group underwent external cephalic version, 98 (75.4%) of the 130 fetuses in the intervention group were cephalic at birth vs 81 (62.3%) of the 130 fetuses in the control group (P = .02; RR, 1.21; 95% CI, 1.02-1.43). CONCLUSION: Among primigravidas with breech presentation during the 33rd week of gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.
Pei J, Strehler E, Noss U, et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility July 2005;84(1):141-7.
Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
OBJECTIVE: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy. DESIGN: Prospective controlled study. SETTING: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy. PATIENT(S): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia. INTERVENTION(S): Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group. MAIN OUTCOME MEASURE(S): Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics. RESULT(S): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment. CONCLUSION(S): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.
Ehling D, Singer K. Gauging a Woman’s Health by her Fertility Signals: Integrating Western with Traditional Chinese Medical Observations. Altern Ther Health Med. 1999;5(6):70-83.
This article presents observations of traditional Chinese medical and Western concepts of a woman's fertility signals. A woman of child-bearing age cycles through processes of heating and cooling and moistening and drying to make her fertile. Her fertility signals--basal body temperature, cervical fluid, and cervix changes--can be observed and charted to gauge the woman's gynecological health as well as to avoid or enhance her chances of achieving pregnancy. Introductory information about charting fertility signals, an introduction to traditional Chinese medicine theories, and various basal body temperature charts with analysis from traditional Chinese medicine and Western medical perspectives are included.
Wang L, Cardini F, Zhao W, Regalia AL, Wade C, Forcella E, Yu J. Vitamin K acupuncture point injection for severe primary dysmenorrhea: an international pilot study. Med Gen Med. 2004 Dec 27;6(4):45.
Obstetrics & Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.
CONTEXT: Vitamin K acupuncture point injection, a menstrual pain treatment derived from traditional Chinese medicine, has been a standard treatment in some hospitals in China since the 1980s. OBJECTIVES: To investigate the effects of vitamin K acupuncture point injection on menstrual pain in young women aged 14 to 25 from different countries and cultural backgrounds who have had unmitigated severe primary dysmenorrhea for 6 months or more. DESIGN: Prospective, observational, clinical pilot study SETTINGS: One site in China (a hospital outpatient clinic in Shanghai) and 2 sites in Italy (a hospital clinic in Milan and a private gynecology practice in Verona). INTERVENTIONS: All subjects were treated with bilateral acupuncture point injection of vitamin K on the first or second day of menstrual pain. Vitamin K3 was used in China and vitamin K4 in Italy. MAIN OUTCOME MEASURES: Pain intensity, total duration, and average intensity of menstrual distress, hours in bed, normal daily activity restrictions, and numbers of analgesic tablets taken to relieve pain were recorded before the treatment and for 4 subsequent menstrual cycles. RESULTS: Noticeable pain relief was observed 2 minutes after treatment, and subsequent pain reduction occurred at 30 minutes (P < .001). Subjects reported significantly fewer daily life restrictions, fewer hours in bed, less consumption of analgesic tablets, and lower scores of menstrual pain duration and intensity (P < .001). There were no adverse events. Some women experienced mild, self-limited pain at the injection site. CONCLUSION: Acupuncture point injection with vitamin K alleviated acute menstrual pain, and relief extended through the nontreatment follow-up cycles in this uncontrolled pilot study conducted in 2 countries. Further investigation employing controlled experimental designs is warranted.
Wyon Y, et al. Menopausal Hot Flashes: Significant decrease in numbers of hot flashes in electro-acupuncture and in superficial needling acupuncture group. Lakartidningen. 1994: Jun 8;91(23):2318-22; and Wyon Y, et al. 1995 Menopause 2:3-12.
Hälsouniversitetet, Linköping.
Vasomotor symptoms are very common among perimenopausal women, but also among orchidectomized men. The cause of the symptoms is not the low steroid concentrations per se, but probably changes in central neuropeptide activity. Twenty-four healthy women with natural menopause, suffering from hot flushes, were included in the study and randomly assigned to either of two groups, one group received treatment with electrostimulated acupuncture (EA), the other with superficial needle position (SNP) acupuncture. Treatment was given for totally of eight weeks, twice a week during the first two weeks, and then once a week for the remaining six weeks. As recorded in logbooks kept by the participants, the frequency of flushes decreased significantly by more than 50 per cent in both groups, and remained decreased in the EA group, whereas in the SNP group it increased slightly again over the three months after treatment. Values for the Kupperman Index decreased in both groups during treatment, changes still evident at three-month follow-up, whereas the self-rated general climacteric symptoms (VAS) decreased significantly in the EA group only. The PGWB (Psychological General Well-Being) index did not change significantly in either group during treatment.
Kraft K, Coulon S. Postmenopausal High Blood Pressure: Standardized Acupuncture can reduce postmenopausal complaints, but does not alter blood pressure. Forsch Komplementärmed. 1999: Apr;6(2):74-9
Medizinische Poliklinik der Universität Bonn, Deutschland.
BACKGROUND: Acupuncture according to the Chinese syndrome is often used in patients with postmenopausal complaints. Often these patients have an increased blood pressure. As experienced therapists report that acupuncture is efficient also in hypertension, our aim was to investigate whether the acupuncture used for the treatment of postmenopausal syndrome also has an effect on blood pressure. PATIENTS AND METHODS: The efficacy of a standardized acupuncture according to the Chinese syndrome was evaluated in a randomized, single-blind, placebo-controlled cross-over study with 10 postmenopausal patients with mild hypertension. Blood pressure was measured by 24-hour ambulatory blood pressure measurement. Complaints and well-being were evaluated by validated questionnaires. In addition, serum lipids and excretion of catecholamines in the 24-hour urine were measured. RESULTS: Blood pressure was altered neither by verum nor placebo acupuncture, however, complaints were significantly reduced and well-being was improved after verum treatment. The improvement lasted less than two months. Serum lipids did not change, but the excretion of normetanephrine was reduced by verum acupuncture. CONCLUSIONS: Acupuncture with a standardized combination of acupuncture points according to the Chinese syndrome can transitorily reduce postmenopausal complaints, but does not alter blood pressure or serum lipids at the same time.
Ternov K, et al. Pain relief during Labor. Analgesic use less in Acupuncture group vs Standard care group: Acupunct Electrother Res. 1998;23(1):19-26]
Department of Anesthesia and Intensive Care, University Hospitals, Malmö, Sweden.
BACKGROUND: There are few studies on acupuncture in childbirth despite the generally established analgesic effect of acupuncture treatment. METHODS: The analgesic effect of acupuncture during childbirth was assessed by comparing the need for other pain treatments (epidural analgesia using bupivacaine, pudendal nerve block, intramuscular meperidine, nitrous oxide/oxygen, intracutaneous sterile water injections) in 90 women given acupuncture (acupuncture group) with that in 90 women not given acupuncture (control group). RESULTS: 52 women (58%) in the acupuncture group and 13 (14%) in the control group managed their deliveries without further pain treatment (p < 0.001). The groups were similar with respect to age, pariety, duration of delivery, use of oxytocine and incidence of Caesarean section. Acupuncture treatment was found to have no major side effects, and 85 women (94%) given acupuncture reported that they would reconsider acupuncture in future deliveries. CONCLUSION: Acupuncture reduces the need for other methods of analgesia in childbirth.
de Aloysio D, Penacchioni P. Morning sickness control in early pregnancy by Neiguan point acupressure. Obstetrics and Gynecology 1992;80:852-854.
Department of Obstetrics and Gynecology, Bologna University, Italy.
OBJECTIVE: To evaluate the antiemetic effect of acupressure at the Neiguan point. METHODS: Sixty women in early pregnancy were entered into a randomized, double-blind, cross-over, placebo-controlled trial. During a 12-day period, organized in four steps of 3 days each, the women were divided into two homogeneous groups to test the effectiveness of unilateral and bilateral acupressure. RESULTS: Use of acupressure resulted in a significantly lower frequency of morning sickness compared with placebo treatment. More than a 60% positive effect was found with unilateral and bilateral acupressure, compared with an approximately 30% positive effect of placebo acupressure. Changing from unilateral to bilateral pressure on the Neiguan point caused no significant statistical difference. No noteworthy side effects occurred. CONCLUSION: Acupressure on the Neiguan point relieves morning sickness.
Belluomini J, et al. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstetrics and Gynecology 1994;84:245-248.
Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco.
OBJECTIVE: To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy. METHODS: Symptomatic pregnant women were randomized to one of two acupressure groups: one treatment group using an acupressure point (PC-6) and one sham control group using a placebo point. Subjects were blind to the group assignment. Each evening for 10 consecutive days, the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred. Data from the first 3 days were used as pre-treatment scores. Beginning on the morning of the fourth day, each subject used acupressure at her assigned point for 10 minutes four times a day. Data from day 4 were discarded to allow 24 hours for the treatment to take effect. Data from days 5-7 were used to measure treatment effect. RESULTS: Sixty women completed the study. There were no differences between groups in attrition, parity, fetal number, maternal age, gestational age at entry, or pre-treatment nausea and emesis scores. Analysis of variance indicated that both groups improved significantly over time, but that nausea improved significantly more in the treatment group than in the sham control group (F1,58 = 10.4, P = .0021). There were no differences in the severity or frequency of emesis between the groups. There was a significant positive correlation (r = 0.261, P = .044) between maternal age and severity of nausea. CONCLUSIONS: Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women.
Riordan J, Nichols F: A descriptive study of lactation mastitis in long-term breastfeeding women. Journal of Human Lactation 6:53-8, 1990
This descriptive retrospective study surveyed women attending two lactation/breastfeeding conferences about their experiences with mastitis. One-third of the sample reported having mastitis while breastfeeding their last child. Episodes of mastitis occurred most often in the first three months postpartum; however, one-third occurred after six months and nearly one-quarter occurred after one year of breastfeeding. The outer upper quadrants of both breasts were found to be the most frequent sites of infection. The incidence of mastitis in the left and right breasts did not differ. More than one-third of the respondents did not contact their physician when they developed mastitis and and nearly half never used antibiotics for the infection. All respondents reported continuing to breastfeed through the infection. Mothers reported that the following factors (in order of importance) preceded their mastitis: fatigue, stress, plugged duct, change in the number of feedings, engorgement/stasis, an infection in the family, breast trauma and poor diet. Study findings indicate that the most important teaching areas for preventing mastitis are management and control of stress and fatigue.
Infertility
Stener-Victorin E. Anovulation in PCOS: Electro-acupuncture appears to be useful to help stimulate ovulation in women with PCOS. Acta Obstet Gynecol Scand. 2000;79(3):180-8.
Department of Obstetrics and Gynecology, Göteborg University, Sweden.
BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.
Chang R, et al. Role of acupuncture in the treatment of female infertility. Fertil Steril, Dec 2002;78(6): 1149-53.
The Institute of East-West Medicine, New York, New York 10021, USA
OBJECTIVE: To review existing scientific rationale and clinical data in the utilization of acupuncture in the treatment of female infertility. DESIGN: A MEDLINE computer search was performed to identify relevant articles. RESULTS: Although the understanding of acupuncture is based on ancient medical theory, studies have suggested that certain effects of acupuncture are mediated through endogenous opioid peptides in the central nervous system, particularly beta-endorphin. Because these neuropeptides influence gonadotropin secretion through their action on GnRH, it is logical to hypothesize that acupuncture may impact on the menstrual cycle through these neuropeptides. Although studies of adequate design, sample size, and appropriate control on the use of acupuncture on ovulation induction are lacking, there is only one prospective randomized controlled study examining the efficacy of acupuncture in patients undergoing IVF. Besides its central effect, the sympathoinhibitory effects of acupuncture may impact on uterine blood flow. CONCLUSION: Although the definitive role of acupuncture in the treatment of female infertility is yet to be established, its potential impact centrally on the hypothalamic-pituitary-ovarian axis and peripherally on the uterus needs to be systemically examined. Prospective randomized controlled studies are needed to evaluate the efficacy of acupuncture in female fertility treatment.
Paulus W, et al. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and Sterility, April 2002;77(4):721-4.
Department of Reproductive Medicine, Christian-Lauritzen-Institut, Ulm, Germany. paulus@reprotox.de
OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer. RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group. CONCLUSION(S): Acupuncture seems to be a useful tool for improving pregnancy rate after ART.
Stener-Victorin E, et al. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reproduction, Vol.11, No.6, 1996.
Department of Obstetrics and Gynaecology, Fertility Centre Scandinavia, University of Gothenburg, S-413 45 Gothenburg, Sweden.
In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow impedance, 10 infertile but otherwise healthy women with a pulsatility index (PI) >=3.0 in the uterine arteries were treated with EA in a prospective, non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects on the PI. The baseline PI was measured when the serum oestradiol was <=0.1 nmol/l, and thereafter the women were given EA eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10-14 days after the EA period. Skin temperature on the forehead (STFH) and in the lumbrosacral area (STLS) was measured during the first, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both shortly after the eighth EA treatment (P < 0.0001) and 10-14 days after the EA period (P < 0.0001). STFH increased significantly during the EA treatments. It is suggested that both of these effects are due to a central inhibition of the sympathetic activity.
Westergaard LG, Mao Q, Krogslun M, Sandrini S, Lenz S, Grinsted J. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril, 2006 May;85(5):1341-6.
Fertility Clinic Trianglen, Hellerup, Denmark. l.g.westergaard@dadlnet.dk
OBJECTIVE: To evaluate the effect of acupuncture on reproductive outcome in patients treated with IVF/intracytoplasmic sperm injection (ICSI). One group of patients received acupuncture on the day of ET, another group on ET day and again 2 days later (i.e., closer to implantation day), and both groups were compared with a control group that did not receive acupuncture. DESIGN: Prospective, randomized trial. SETTING: Private fertility center. PATIENT(S): During the study period all patients receiving IVF or ICSI treatment were offered participation in the study. On the day of oocyte retrieval, patients were randomly allocated (with sealed envelopes) to receive acupuncture on the day of ET (ACU 1 group, n = 95), on that day and again 2 days later (ACU 2 group, n = 91), or no acupuncture (control group, n = 87). INTERVENTION(S): Acupuncture was performed immediately before and after ET (ACU 1 and 2 groups), with each session lasting 25 minutes; and one 25-minute session was performed 2 days later in the ACU 2 group. MAIN OUTCOME MEASURE(S): Clinical pregnancy and ongoing pregnancy rates in the three groups. RESULT(S): Clinical and ongoing pregnancy rates were significantly higher in the ACU 1 group as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%] and 34 of 95 [36%] vs. 19 of 87 [22%]). The clinical and ongoing pregnancy rates in the ACU 2 group (36% and 26%) were higher than in controls, but the difference did not reach statistical difference. CONCLUSION(S): Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, compared with no acupuncture. Repeating acupuncture on ET day +2 provided no additional beneficial effect.
Smith C, Coyle M, Norman RJ. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril, 2006 May;85(5):1352-8.
School of Health Science, The University of South Australia, South Australia, Australia. caroline.smith@acnhw.com.au
OBJECTIVE: To evaluate the effects of acupuncture on clinical pregnancy rates for women undergoing ET. DESIGN: Single-blind, randomized controlled trial using a noninvasive sham acupuncture control. SETTING: Repromed, The Reproductive Medicine Unit of The University of Adelaide. PATIENT(S): Women undergoing IVF. INTERVENTION(S): Women were randomly allocated to acupuncture or noninvasive sham acupuncture with the placebo needle. All women received three sessions, the first undertaken on day 9 of stimulating injections, the second before ET, and the third immediately after ET. MAIN OUTCOME MEASURE(S): The primary outcome was pregnancy. Secondary outcomes were implantation, ongoing pregnancy rate at 18 weeks, adverse events, and health status. RESULT(S): Two hundred twenty-eight subjects were randomized. The pregnancy rate was 31% in the acupuncture group and 23% in the control group. For those subjects receiving acupuncture, the odds of achieving a pregnancy were 1.5 higher than for the control group, but the difference did not reach statistical significance. The ongoing pregnancy rate at 18 weeks was higher in the treatment group (28% vs. 18%), but the difference was not statistically significant. CONCLUSION(S): There was no significant difference in the pregnancy rate between groups; however, a smaller treatment effect can not be excluded. Our results suggest that acupuncture was safe for women undergoing ET.
Dieterle S, Ying G, Hatzmann W, Neuer A. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril, 2006 May;85(5):1347-51
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. Dieterle@IVF-Dortmund.de
OBJECTIVE: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Randomized, prospective, controlled clinical study. SETTING: University IVF center. PATIENT(S): Two hundred twenty-five infertile patients undergoing IVF/ICSI. INTERVENTION(S): In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. MAIN OUTCOME MEASURE(S): Clinical and ongoing pregnancy rates. RESULT(S): In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%). CONCLUSION(S): Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.
Sinclair S. Male Infertility: Nutritional and environmental considerations. Altern Med Rev. 2000 Feb;5(1):28-38.
Green Valley Health, Hagerstown, MD 21742, USA.
Studies confirm that male sperm counts are declining, and environmental factors, such as pesticides, exogenous estrogens, and heavy metals may negatively impact spermatogenesis. A number of nutritional therapies have been shown to improve sperm counts and sperm motility, including carnitine, arginine, zinc, selenium, and vitamin B-12. Numerous antioxidants have also proven beneficial in treating male infertility, such as vitamin C, vitamin E, glutathione, and coenzyme Q10. Acupuncture, as well as specific botanical medicines, have been documented in several studies as having a positive effect on sperm parameters. A multi-faceted therapeutic approach to improving male fertility involves identifying harmful environmental and occupational risk factors, while correcting underlying nutritional imbalances to encourage optimal sperm production and function.
Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B. Does Acupuncture treatment affect sperm density in males with very low sperm counts? A pilot study. Andrologia. 2000, Jan;32(1):31-9.
Institute of Chinese Medicine, Tel Aviv, Israel.
Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average = 0.7 +/- 1.1 x 10(6) spermatozoa per ejaculate before treatment vs. 4.3 +/- 3.2 x 10(6) spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5 +/- 2.4 x 10(6) spermatozoa per ejaculate (Z = -2.8, P < or = 0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 +/- 0.6 x 10(6) spermatozoa per ejaculate to 3.3 +/- 3.2 x 10(6) spermatozoa per ejaculate; Z = -2.4, P < or = 0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.
Fischl F, Riegler R, Bieglmayer C, Nasr F, Neumark J. Modification of semen quality by acupuncture in subfertile males. Geburtshilfe Frauenheilkunde, 1984 Aug;4498):510-2.
Our first attempt in treating subfertility by acupuncture was carried out on 28 males. The results obtained from the experiences in veterinary medicine encouraged us to attempt this type of therapy. Each patient received a total of 10 treatments for a period of three weeks. Several spermiograms were made after diagnosis subfertility. We checked spermiograms and hormone levels before and after acupuncture. Total count, concentration and motility were evaluated. In all cases we observed a statistically significant improvement of sperm quality. Having obtained these good results in our first studies, we now intend to continue acupuncture therapy in subfertile males for insemination or intercourse at the time of the ovulation of their female partners.
Gerhard I. Auricular acupuncture in the treatment of female infertility. Gynecol Endocrinol. 1992;6(3):171-81.
Department for Gynecological Endocrinology and Reproduction, Women's Hospital, University of Heidelberg, Germany.
Following a complete gynecologic--endocrinologic workup, 45 infertile women suffering from oligoamenorrhea (n = 27) or luteal insufficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate medication. Women treated with hormones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four women of each group had abortions. Endometriosis (normal menstrual cycles) was seen in 35% (38%) of the women of each group who failed to respond to therapy with pregnancy. Only 4% of the women who responded to acupuncture or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group. Women who became pregnant after acupuncture suffered more often from menstrual abnormalities and luteal insufficiency with lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated with acupuncture had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those receiving hormones. Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture group. Side-effects were observed only during hormone treatment. Various disorders of the autonomic nervous system normalized during acupuncture. Based on our data, auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.
Beal MW: Acupuncture and acupressure: applications to women’s reproductive health care. Journal of Midwifery 1999; 44:217-230.
Yale University School of Nursing, New Haven, CT 06536-0747, USA.
An introduction to the therapeutic applications, history, and theory of acupuncture and acupressure is presented. The traditional concepts that underlie treatment of imbalances of ch'i, or vital energy, are presented, along with the theories of yin and yang, meridians, vital substances, pathogenic factors, five phases, and the eight principle patterns. Contemporary Western research findings on the biochemical mediaries and effects of acupuncture are reviewed. Clinical applications to women's reproductive care that are presented include treatment for dysmenorrhea, infertility, and childbearing. Data on clinical trials are reviewed, and licensure and educational preparation for practice of these modalities are discussed.
Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B: Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Archives of Andrology 1997; 39:155-161.
Institute of Chinese Medicine, Tel Aviv, Israel.
The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
Riegler R, Fischl F, Bunzel B, Neumark J: Correlation of psychological changes and spermiogram improvements following acupuncture. [German] Urologe – Ausgabe A. 1984; 23:329-333.
The purpose of the study was to find the correlation between the effect of acupuncture on fertility and psychological effects. To investigate its influence on male subfertility, 28 patients received acupuncture treatment after informed consent. We evaluated subjective parameters by written psychological tests, while objective parameters consisted of measuring concentration, volume and motility in the spermiogram before and after acupuncture. There was a significant increase in sperm quality in all parameters but volume. The psychological test showed no change caused by acupuncture. Hence, we believe, that the effect of acupuncture on sperm quality is not caused by placebo-mechanisms.
Chen BY. Acupuncture normalizes Dysfunction of Hypothalamic-Pituitary-Ovarian Axis. Acupunct Electro-Ther Res 1997; 22:97-108
Institute of Acupuncture and Department of Neurobiology, Shanghai Medical University, Shanghai 200032, P.R. China
This article summarizes the studies of the mechanism of electroacupuncture (EA) in the regulation of the abnormal function of hypothalamic pituitary-ovarian axis (HPOA) in our laboratory. Clinical observation showed that EA with the effective acupoints could cure some anovulatory patients in a highly effective rate and the experimental results suggested that EA might regulate the dysfunction of HPOA in several ways, which rneans EA could influence some gene expression of brain, thereby, normalizing secretion of some hormones, such as GnRH, LH and E2. The effects of EA might possess a relative specificity on acupoints.
Yamanka M, et al. Direct Effects of Chinese herbal medicine “Hacheuekkito” on sperm movement. Nippon Hinyokika Gakkai Zasshi 1998, 89(7):641-6.
Chinese herbal medicine, "Hochuekkitto" is widely used for male infertility in Japan. There have been many reports concerning its clinical usefulness but very few reports of in vitro experiments studying the mechanism of its effects. In addition to stimulating germ cells, we analyzed its direct effects on sperm using computer assisted semen analyzer (CASA). MATERIALS AND METHODS: Motile sperm were prepared using swim up technique from semen collected from ten healthy volunteers. Sperm movements (motility, velocity, linearity) were analyzed by CASA after adding either serum containing anti-sperm antibody (ASA) or normal serum with or without Hochuekkito. RESULTS: Two hours after adding serum with ASA, the decrease of sperm motility was significantly reduced from 25.1% (92.8%–>67.7%) to 12.5% (92.9%–>80.6%) by adding Hochuekkito. No significant difference in velocity and linearity was observed between two groups. By adding normal serum, any of three parameters differed significantly with or without Hochuekkito. CONCLUSION: Protective effects of Hochuekkito on sperm was suggested. Although normal sperm with ASA was used in this report, since the sperm of infertile patients are said to be more fragile, this results imply that direct protective effect is one of the mechanism of Hochuekkito for male infertility
Ishikawa H; Ohashi M; Hayakawa K; Kaneko S; Hata M. Effects of guizhi-fuling-wan on male infertility with varicocele. Am J Chin Med 1996, 24(3-4):327-31.
Department of Urology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan.
Thirty-seven infertile patients with varicocele were treated with Guizhi-Fuling-Wan (7.5 g/day) for at least 3 months. Before and after the administration, semen qualities such as sperm concentration and motility were examined, and the varicocele was graded. A varicocele disappearance rate of 80% was obtained with 40 out of 50 varicocele, and improvement of sperm concentration and motility were found in 71.4% and 62.1% of patients, respectively. From these results, Guizhi-Fuling-Wan is considered to be effective for circulation disorders in varicocele as well as semen quality.
Battaglia C, Salvatori M, Maxia N, Petraglia F, Facchinetti F, Volpe A. Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients.
Department of Obstetrics and Gynecology University of Modena, and Department of Surgical Sciences, University of Udine, Italy.
The objective of the present study was prospectively and randomly to evaluate the role of L-arginine in improving uterine and follicular Doppler flow and in improving ovarian response to gonadotrophin in poor responder women. A total of 34 patients undergoing assisted reproduction was divided in two groups according to different ovarian stimulation protocols: (i) flare-up gonadotrophin-releasing hormone analogue (GnRHa) plus elevated pure follicle stimulating hormone (pFSH)(n = 17); and (ii) flare-up GnRHa plus elevated pFSH plus oral L-arginine (n = 17). During the ovarian stimulation regimen, the patients were submitted to hormonal (oestradiol and growth hormone), ultrasonographic (follicular number and diameter, endometrial thickness) and Doppler (uterine and perifollicular arteries) evaluations. Furthermore, the plasma and follicular fluid concentrations of arginine, citrulline, nitrite/nitrate (NO2-/NO3-), and insulin-like growth factor-1 (IFG-1) were assayed. All 34 patients completed the study. In the L-arginine treated group a lower cancellation rate, an increased number of oocytes collected, and embryos transferred were observed. In the same group, increased plasma and follicular fluid concentrations of arginine, citruilline, NO2-/NO3-, and IFG-1 was observed. Significant Doppler flow improvement wsa obtained in the L-arginine supplemented group. Three pregnancies were registered in these patients. No pregnancies were observed in the other group. It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate.
Eskenazi B, Kidd SA, Marks AR, Sloter E, Block G, Wyrobek AJ. Antioxidant intake is associated with semen quality in healthy men. Hum Reprod. 2005 Apr;20(4):1006-12. Epub 2005 Jan 21.
We seek to determine whether dietary and supplement intake of specific micronutrients (zinc and folate) and antioxidants (vitamins C, E and -carotene) is associated with semen quality. METHODS: Ninety-seven healthy, non-smoking men provided semen and were interviewed. Average daily nutrient intake from food and supplements was derived from a self-administered food frequency questionnaire. Intake levels were summarized as low, moderate and high. Semen volume, sperm concentration, total sperm count, motility, progressive motility and total progressively motile sperm count (TPMS) were measured. RESULTS: After controlling for covariates, a high intake of antioxidants was associated with better semen quality but, in almost all cases, there was no clear dose relationship in that moderate intake groups had the poorest semen quality. For example, positive associations were observed between vitamin C intake and sperm number as reflected in the higher mean count (P=0.04), concentration (P=0.05) and TPMS (P=0.09); between vitamin E intake and progressive motility (P=0.04) and TPMS (P=0.05); and between -carotene intake and sperm concentration (P=0.06) and progressive motility (P=0.06). Folate and zinc intake were not associated with improved semen quality. CONCLUSIONS: In a convenience sample of healthy non-smoking men from a non-clinical setting, higher antioxidant intake was associated with higher sperm numbers and motility.
Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M. Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian J Androl 2003 Dec; 5: 345-348
Aim: To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities. Methods: In a prospective, controlled and blind study, nineteen patients, aged 24 years ~ 42 years and married for 3 years ~ 11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course. Results: The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U=16.0, critical U=17.0). Conclusion: The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.
Tanaka T; Mizuno K; Umesaki N; Ogita S. A preliminary immunopharmacological study of an antiendometriotic herbal medicine, Keishi-bukuryo-gan. Osaka City Med J, 44(1):117-24 1998 Jun.
Changes in the specific antiendometrial IgM antibodies in an endometriotic patient, who were treated with leuproride acetate and in turn with Keishi-bukuyogan, were investigated by the flowcytometric analysis which was developed in our laboratory. The oriental therapy decreased the specific IgM antibody titer gradually and kept the patient symptom-free for more than 7 months without any suppression of serum CA125 and estradiol levels. On the other hand, leuproride acetate therapy suppressed both serum CA125 and serum estradiol levels but not the IgM antibody titer. The results suggest that the specific antiendometrial IgM autoantibody could be a pathogenic molecule in endometriosis and it could also serve as a clinical marker for the oriental therapy of endometriosis.
Premenstrual Syndrome
Singh BB, Berman BM, Simpson RL, Annechild A: Incidence of premenstrual syndrome and remedy usage – a national probability sample study. Alternative Therapies in Health and Medicine 1998; 4:75-79.
Complementary Medicine Program, University of Maryland School of Medicine, Baltimore, USA.
CONTEXT: Premenstrual syndrome is believed to affect 30% to 80% of women. Studies in various cultures have used a variety of methodologies to determine prevalence, symptom profile, and effectiveness of available treatments. This study was designed to provide information on incidence of PMS and therapies used based on a national probability sample of US women. METHOD: In 1996 a national probability sample (N = 1052) of women aged 21 to 64 years was surveyed by telephone using random digit dial methods. The survey included demographic information, questions concerning respondent knowledge of premenstrual syndrome, incidence rates of common premenstrual syndrome symptoms, and any remedies that were used to control the symptoms. RESULTS: Forty-one percent of the women responded "yes" to the question, "Do you suffer from premenstrual syndrome?" An additional 17% indicated that they experienced symptoms prior to their menstrual cycle that are commonly associated with premenstrual syndrome (e.g., pain, bloating, feeling more emotional, weight gain, food cravings), though without associating these symptoms with premenstrual syndrome explicity. The most frequently noted severe symptom was that of "[feeling] more emotional." Of those reporting premenstrual syndrome symptoms, approximately 42% took either prescription or over-the-counter medications to relieve them. Eighty percent of the women taking any type of medication relied on over-the-counter medications. Prescription drug use for premenstrual syndrome symptoms focused on medications to control pain; hormone supplements were the second most frequently prescribed rugs. Fewer than 3% of the respondents used prescription medications. Respondents were asked to indicate whether they had used a complementary medical therapy to control symptoms. Exercise was used most frequently (18%), and acupuncture was the least frequently used. Although only a small percentage of women used complementary therapies, for most of these therapies a near-perfect concordance was found between usage and belief in efficacy. CONCLUSIONS: Women were aware of symptoms related to premenstrual syndrome more frequently than they recognized a formalized medical syndrome. Less than half of the women reporting symptoms had taken either over-the-counter or prescription drugs. Those who tried complementary therapies generally found them to be effective.
Oleson T, Flocco W: Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstetrics and Gynecology 1993; 82:906-911.
Division of Behavioral Medicine, California Graduate Institute, Los Angeles.
OBJECTIVE: To determine whether reflexology therapy--the application of manual pressure to reflex points on the ears, hands, and feet that somatotopically correspond to specific areas of the body--can significantly reduce premenstrual symptoms compared to placebo treatment. METHODS: Thirty-five women who complained of previous distress with premenstrual syndrome (PMS) were randomly assigned to be treated by ear, hand, and foot reflexology or to receive placebo reflexology. All subjects completed a daily diary, which monitored 38 premenstrual symptoms on a four-point scale. Somatic and psychological indicators of premenstrual distress were recorded each day for 2 months before treatment, for 2 months during reflexology, and for 2 months afterward. The reflexology sessions for both groups were provided by a trained reflexology therapist once a week for 8 weeks, and lasted 30 minutes each. RESULTS: Analysis of variance for repeated measures demonstrated a significantly greater decrease in premenstrual symptoms for the women given true reflexology treatment than for the women in the placebo group. CONCLUSION: These clinical findings support the use of ear, hand, and foot reflexology for the treatment of PMS.
Lewers D, Clelland JA, Jackson JR, Varner RE, Bergman J: Transcutaneous electrical nerve stimulation in the relief of primary dysmenorrhea. Physical Therapy 1989; 69:3-9.
Spain Rehabilitation Center, University of Alabama Hospitals, Birmingham 35294.
The purpose of this study was to replicate a previous study to determine the effectiveness of acupuncture-like transcutaneous electrical nerve stimulation in treating primary dysmenorrhea. Twenty-one women with dysmenorrhea received a placebo pill or 30 minutes of acupuncture-like TENS. All subjects completed two pain questionnaires before treatment; immediately posttreatment; 30, 60, 120, and 180 minutes posttreatment; and the next morning upon awakening. Each woman also participated in a separate study measuring electrical resistance at four auricular acupuncture points before and immediately after treatment. The data were analyzed with a two-factor repeated-measures analysis of variance, which revealed statistical significance over time but not for group or interaction between group and time. Results revealed an average pain relief of at least 50% immediately posttreatment, indicating that acupuncture-like TENS may be useful for dysmenorrheic pain. This study also suggests that auriculotherapy via acupressure may relieve the pain of primary dysmenorrhea.
Helms JM: Acupuncture for the management of primary dysmenorrhea. Obstetrics and Gynecology 1987; 69:51-56.
The effectiveness of acupuncture in managing the pain of primary dysmenorrhea was investigated in a randomized and controlled prospective clinical study. Forty-three women were followed for one year in one of four groups: the Real Acupuncture group was given appropriate acupuncture and the Placebo Acupuncture group was given random point acupuncture on a weekly basis for three menstrual cycles; the Standard Control group was followed without medical or acupuncture intervention; the Visitation Control group had monthly nonacupuncture visits with the project physician for three cycles. In the Real Acupuncture group, 10 of 11 (90.9%) women showed improvement; in the Placebo Acupuncture group, 4 of 11 (36.4%); in the Standard Control group, 2 of 11 (18.2%); and in the Visitation Control group 1 of 10 (10%). There was a 41% reduction of analgesic medication used by the women in the Real Acupuncture group after their treatment series, and no change or increased use of medication seen in the other groups.
Steinberger A: The treatment of dysmenorrhea by acupuncture. American Journal of Chinese Medicine 1981; 9:57-60.
Forty-eight female patients suffering from dysmenorrhea in various degrees were treated by acupuncture. Seven standard acupuncture loci were selected. Acupuncture was given only 5 times to 44 of these patients. The results were analyzed after 6 to 12 months. Although the therapy was short, limited to only 7 points and uniform, satisfactory results were found in more than 80% of the cases.
Menopause
Zell B, Hirata J, Marcus A, Ettinger B, Pressman A, and Ettinger KM: Diagnosis of symptomatic postmenopausal women by traditional Chinese medicine practitioners. Menopause 2000; 7:129-134.
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Centers, Richmond, California 94801-2565, USA.
OBJECTIVE: To learn more about the way that practitioners of traditional Chinese medicine (TCM) diagnose women who have menopausal symptoms. DESIGN: We assembled a cohort of 23 postmenopausal women who had hot flushes and were otherwise healthy. Each woman was examined independently by nine practitioners of TCM on the same day. Examination consisted of medical history and physical examination. Diagnoses were recorded and counted. RESULTS: The most frequent diagnosis made by the practitioners of TCM was kidney yin deficiency, which was the diagnosis made after 168 of 207 visits (81%); 23 women seen by nine TCM practitioners. Practitioners showed good agreement regarding presence of kidney yin deficiency: in 12 women (52%), this diagnosis was made by eight of nine practitioners; in 16 women (70%), seven of nine practitioners made this diagnosis; and in all 23 women (100%), at least five of nine practitioners made this diagnosis. CONCLUSIONS: Practitioners of TCM who diagnose postmenopausal women with vasomotor symptoms are likely to make a diagnosis that includes kidney yin deficiency.
Seidl MM, Stewart DE: Alternative treatments for menopausal symptoms: Qualitative study of women’s experiences. Canadian Family Physician 1998; 44:1271-1276.
Toronto Hospital.
OBJECTIVE: To describe women's experiences with alternative treatments for symptoms attributed to menopause. DESIGN: Descriptive qualitative study. SETTING: Personal interviews and focus groups were conducted in private rooms at the Toronto Hospital; telephone interviews were conducted at mutually convenient times. PARTICIPANTS: Thirteen perimenopausal women with a mean age of 52.6 +/- 2.6 years who were experiencing symptoms attributed to menopause and were using alternative therapies participated in the study. METHOD: Women using alternative therapies for menopausal symptoms were recruited via posted notices and were screened over the telephone. Data were collected during semistructured personal interviews, telephone interviews, and a focus group. All interviews were audiotaped, transcribed, and mailed to participants for verification. Recruitment continued until theme saturation was reached. MAIN FINDINGS: Because of their "natural" origin, the women perceived alternative treatments to be safe and considered them somewhat effective. Factors influencing use of alternative therapies included personal control over health, confidence in advice from nonphysicians, perceived pressure from physicians to use hormone replacement therapy, and physicians' disinterest and frequently negative attitudes toward alternatives. CONCLUSION: Personal control was a central issue. Helping women during their menopausal years feel they have some control over their health, including their informed choice of treatments, might help them to trust their physicians more and to feel more confident in their ultimate treatment decisions, which might include improvements in health behaviour.
Seidle MM, Stewart DE: Alternative treatment for menopausal symptoms: Systematic review of scientific and lay literature. Canadian Family Physician 1998; 44:1299-1308.
Toronto Hospital.
OBJECTIVE: To review the scientific literature on common alternative remedies for treatment of symptoms attributed to menopause and to contrast this with available lay literature. QUALITY OF EVIDENCE: Scientific articles were identified by searching MEDLINE, CINAHL, and HEALTH databases from 1966 to mid-1997 for English-language articles. More than 200 references were reviewed; 85 were selected for citation based on specific reference to alternative medicine for symptoms commonly attributed to menopause (e.g., hot flashes), to the effects of changing estrogen levels (e.g., irregular menses, vaginal dryness), and to reported side effects of the treatments. MAIN FINDINGS: The scientific literature was categorized under the headings nutritional supplements, herbal remedies, homeopathic remedies, and physical approaches. Some scientific evidence of the safety and efficacy of alternative treatments during menopause was uncovered, with the strongest evidence emerging in favour of phytoestrogens, which occur in high concentrations as isoflavones in soy products. CONCLUSIONS: In available controlled studies, the strongest data support phytoestrogens for their role in diminishing menopausal symptoms related to estrogen deficiency and for possible protective effects on bones and the cardiovascular system. Randomized controlled trials, standardization of dosage, and accurate safety and efficacy labeling are required to ensure proper use of alternative remedies.
Popivanov P: Menopausal indices as criteria for the effectiveness of acupuncture treatment of the climacteric syndrome (preliminary report). Vutreshni Bolesti 1983; 22:110-113.
Ten female patients with manifested climacteric syndrome (CS) were treated by acupuncture according to the traditional east methodology, the basic therapy making use of the points--Nai-Guan, Gun-Sun, Ha-Gu and Zsu-San-Li and for the determination of the severity of CS and the effect of its treatment --five of the most often applied menopause indices (MI) in the hormonal treatment of CS were used. Copperman, Blatt--modification of Neugarten and Kreins: Jones, Marshall and Nordin: Wenderlein and Striker. The favorable clinical results observed from the acupuncture treatment, determined by MI, are similar to the results, reported by the authors, making use of MI in the hormonal treatment of CS. That provided grounds to admit that they are suitable criteria also for the objectivization of the effect of the acupuncture treatment of climacteric syndrome.
Side-effects of Cancer
Vickers AJ. Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. J R Soc Med. 1996. 89.303-311
Research Council for Complementary Medicine, London, England.
The effects of acupuncture on health are generally hard to assess. Stimulation of the P6 acupuncture point is used to obtain an antiemetic effect and this provides an excellent model to study the efficacy of acupuncture. Thirty-three controlled trials have been published worldwide in which the P6 acupuncture point was stimulated for treatment of nausea and/or vomiting associated with chemotherapy, pregnancy, or surgery. P6 acupuncture was equal or inferior to control in all four trials in which it was administered under anaesthesia; in 27 of the remaining 29 trials acupuncture was statistically superior. A second analysis was restricted to 12 high-quality randomized placebo-controlled trials in which P6 acupuncture point stimulation was not administered under anaesthesia. Eleven of these trials, involving nearly 2000 patients, showed an effect of P6. The reviewed papers showed consistent results across different investigators, different groups of patients, and different forms of acupuncture point stimulation. Except when administered under anaesthesia, P6 acupuncture point stimulation seems to be an effective antiemetic technique. Researchers are faced with a choice between deciding that acupuncture does have specific effects, and changing from 'Does acupuncture work?' to a set of more practical questions; or deciding that the evidence on P6 antiemesis does not provide sufficient proof, and specifying what would constitute acceptable evidence.
Shen J, et al. Electroacupuncture for Control of myeloablative chemotherapy induced Emesis: A randomized controlled trial. JAMA, 2000. 284(21):2755-2761
National Institutes of Health, Laboratory of Clinical Studies/NIAAA, Room 6 S-240, Mail Stop 1610, 10 Center Dr, Bldg 10, Bethesda, MD 20892-1610, USA.
CONTEXT: High-dose chemotherapy poses considerable challenges to emesis management. Although prior studies suggest that acupuncture may reduce nausea and emesis, it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction. OBJECTIVE: To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen. DESIGN: Three-arm, parallel-group, randomized controlled trial conducted from March 1996 to December 1997, with a 5-day study period and a 9-day follow-up. SETTING: Oncology center at a university medical center. PATIENTS: One hundred four women (mean age, 46 years) with high-risk breast cancer. INTERVENTIONS: Patients were randomly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days (n = 37); minimal needling at control points with mock electrostimulation on the same schedule (n = 33); or no adjunct needling (n = 34). All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy (cyclophosphamide, cisplatin, and carmustine). MAIN OUTCOME MEASURES: Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days, compared among the 3 groups. RESULTS: The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone (median number of episodes, 5, 10, and 15, respectively; P<.001). The electroacupuncture group had fewer episodes of emesis than the minimal needling group (P<.001), whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group (P =.01). The differences among groups were not significant during the 9-day follow-up period (P =.18). CONCLUSIONS: In this study of patients with breast cancer receiving high-dose chemotherapy, adjunct electroacupuncture was more effective in controlling emesis than minimal needling or antiemetic pharmacotherapy alone, although the observed effect had limited duration. JAMA. 2000;284:2755-2761.
King CR. Nonpharmacologic management of chemotherapy-induced nausea and vomiting. Oncol Nurs Forum 1997;24 (suppl. 7):41-48.
Special Care Consultants, Highland Hospital, Rochester, NY, USA.
PURPOSE/OBJECTIVES: To review the nonpharmacologic interventions indicated to prevent or control chemotherapy-induced nausea and vomiting. DATA SOURCES: Journal articles. DATA SYNTHESIS: Despite improvements in antiemetic drug therapy, as many as 60% of patients with cancer who are treated with antineoplastic agents experience nausea and vomiting. Anticipatory nausea and vomiting are thought to be caused by the behavioral process of classical conditioning. Most nonpharmacologic interventions that are used to prevent or control nausea and vomiting in patients with cancer are classified as behavioral interventions. Behavioral interventions involve the acquisition of adaptive behavioral skills to interrupt the conditioning cycle. CONCLUSIONS: Nonpharmacologic interventions appear to be effective in reducing anticipatory and post-treatment nausea and vomiting. IMPLICATIONS FOR NURSING PRACTICE: These behavioral interventions can be effective in reducing anticipatory and post-treatment nausea and vomiting. Oncology nurses must learn these nonpharmacologic techniques and teach their patients to use them in combination with their prescribed antiemetic therapy.
Fan CF, et al. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analgesia 1997;84:821-825.
Department of Anesthesiology, Maimonides Medical Center, Brooklyn, New York 11219, USA.
Postoperative nausea and vomiting are still common problems after general anesthesia, especially in ambulatory surgery. Drug therapy is often complicated with central nervous system symptoms. We studied a nonpharmacological method of therapy--acupressure--at the Pericardium 6 (P.6) (Nei-Guan) meridian point. Two hundred consecutive healthy patients undergoing a variety of short surgical procedures were included in a randomized, double-blind study: 108 patients were in the acupressure group (Group 1) and 92 patients were in the control group (Group 2). Spherical beads of acupressure bands were placed at the P.6 points in the anterior surface of both forearms in Group 1 patients, while in Group 2 they were placed inappropriately on the posterior surface. The acupressure bands were placed before induction of anesthesia and were removed 6 h postoperatively. They were covered with a soft cotton wrapping to conceal them from the blinded observer who evaluated the patients for presence of nausea and vomiting and checked the order sheet for any antiemetics prescribed. In both groups, the age, gender, height, weight, and type and duration of surgical procedures were all comparable without significant statistical difference. In Group 1, only 25 of 108 patients (23%) had nausea and vomiting as compared to Group 2, in which 38 of 92 patients (41%) had nausea and vomiting (P = 0.0058). We concluded that acupressure at the P.6 (Nei-Guan) point is an effective prophylaxis for postsurgical nausea and vomiting and therefore a good alternative to conventional antiemetic treatment.
Ezzo J et al. Acupuncture point stimulation for chemotherapy-induced nausea and vomiting. J Clin Oncol 2005;23:7188
JPS Enterprises, Baltimore, MD 21209, USA. jeanetteezzo@prodigy.net
PURPOSE: Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Materials and METHODS: Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. RESULTS: Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% CI, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% CI, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% CI, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95% CI, -0.38 to -0.01; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. CONCLUSION: This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologic antiemetic therapy.
Dibble SL, Chapman J, Mack KA, Shih A. Acupressure for nausea: results of a pilot study. Oncology Nursing Forum Feb 2000;27(1):41-7.
Institute for Health and Aging, University of California, San Francisco, USA. sdibble@itsa.ucsf.edu
PURPOSE/OBJECTIVES: To compare differences in nausea experience and intensity in women undergoing chemotherapy for breast cancer between those receiving usual care plus acupressure training and treatment and those receiving only usual care. DESIGN: Single-cycle, randomized clinical trial. SETTING: Outpatient oncology clinic in a major teaching medical center and a private outpatient oncology practice. SAMPLE: Seventeen women participated in the study. The typical participant was 49.5 years old (SD = 6.0), Caucasian (59%), not married/partnered (76%), on disability (53%), born a U.S. citizen (76%), and heterosexual (88%); lived alone (59%); had at least graduated from high school (100%); and had an annual personal income of $50,000 or greater (65%). METHODS: The intervention included finger acupressure bilaterally at P6 and ST36, acupressure points located on the forearm and by the knee. Baseline and poststudy questionnaires plus a daily log were used to collect data. MAIN RESEARCH VARIABLES: Nausea experience measured by the Rhodes inventory of Nausea, Vomiting, and Retching and nausea intensity. FINDINGS: Significant differences existed between the two groups in regard to nausea experience (p < 0.01) and nausea intensity (p < 0.04) during the first 10 days of the chemotherapy cycle, with the acupressure group reporting less intensity and experience of nausea. CONCLUSIONS: Finger acupressure may decrease nausea among women undergoing chemotherapy for breast cancer. IMPLICATIONS FOR NURSING PRACTICE: This study must be replicated prior to advising patients about the efficacy of acupressure for the treatment of nausea.
Porzio G et al. Cancer Patients’ Quality of Life: Acupuncture improved anxiety, depression, somatic and vasomotor symptoms in tamoxifen-treated women. Tumor. 2002: 88(2):128-3
Medical Oncology Unit, University of L'Aquila, Italy. porzio1@interfree.it
Fifteen patients were enrolled in a pilot study to evaluate the safety and efficacy of acupuncture for the treatment of menopausal symptoms in tamoxifen-treated patients. Patients were evaluated before treatment and after one, three and six months with the Greene Menopause Index and were treated according to the traditional Chinese medicine. Anxiety, depression, somatic and vasomotor symptoms were improved by the treatment; libido was not modified. Acupuncture seems to be safe and effective for the treatment of menopausal symptoms in women with previous breast cancer taking tamoxifen. Confirmatory studies with a larger number of patients and with a placebo-treated group are warranted.
Vickers AJ, et al. Acupuncture for dyspnea in advanced cancer: a randomized, placebo-controlled pilot trial. BMC Palliat Care, 2005 Aug 18,4:5.
Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA. vickersa@mskcc.org
BACKGROUND: Dyspnea, or shortness of breath, is a common symptom in patients with advanced cancer. Pharmacologic management is of proven benefit, but it does not help all patients. Preliminary data suggest that acupuncture can relieve dyspnea in a variety of populations, including cancer patients. We conducted a pilot study (ISRCTN89462491) preparatory to a fully powered randomized, placebo-controlled trial to determine whether acupuncture reduces dyspnea in patients with lung or breast cancer. METHODS: The study sample was comprised of forty-seven patients with lung or breast cancer presenting with dyspnea. Patients receiving symptomatic treatments were not excluded as long as no changes in management were planned during the trial. Patients were randomized to receive a single session of true or placebo acupuncture in addition to their existing dyspnea treatments. Semi-permanent acupuncture "studs" were then inserted: patients applied pressure to these studs twice a day to provide ongoing stimulation to acupuncture points. The subjective sensation of dyspnea was assessed with a 0-10 numerical rating scale immediately before and after acupuncture treatment and daily for a week thereafter. RESULTS: All but two of 47 randomized patients provided follow-up data. Dyspnea scores were slightly higher for patients receiving true versus placebo acupuncture, for both the period immediately following acupuncture treatment and for the daily one week follow-up (differences between means of 0.34, 95% C.I. -0.33, 1.02 and 0.56, 95% C.I. -0.39, 1.51). The 95% confidence interval excludes the prespecified minimum clinically significant difference of a 20% greater improvement in dyspnea for patients receiving acupuncture. CONCLUSION: The acupuncture technique used in this trial is unlikely to have effects on dyspnea importantly larger than placebo for patients with advanced cancer.
Alimi D, et al. Analgesic effect of auricular acupuncture for cancer pain: A randomized, blinded controlled trial. J Clin Oncol, 2003. Vol 21(22):4120-4126.
Pain Management Unit, INSERM, U521, Villejuif, France.
PURPOSE: During the last 30 years, auricular acupuncture has been used as complementary treatment of cancer pain when analgesic drugs do not suffice. The purpose of this study is to examine the efficacy of auricular acupuncture in decreasing pain intensity in cancer patients. PATIENTS AND METHODS: Ninety patients were randomly divided in three groups; one group received two courses of auricular acupuncture at points where an electrodermal signal had been detected, and two placebo groups received auricular acupuncture at points with no electrodermal signal (placebo points) and one with auricular seeds fixed at placebo points. Patients had to be in pain, attaining a visual analog score (VAS) of 30 mm or more after having received analgesic treatment adapted to both intensity and type of pain, for at least 1 month of therapy. Treatment efficacy was based on the absolute decrease in pain intensity measured 2 months after randomization using the VAS. RESULTS: The main outcome was pain assessed at 2 months, with the assessment at 1 month carried over to 2 months for the eight patients who interrupted treatment after 1 month. For three patients, no data were available because they withdrew from the study during the first month. Pain intensity decreased by 36% at 2 months from baseline in the group receiving acupuncture; there was little change for patients receiving placebo (2%). The difference between groups was statistically significant (P <.0001). CONCLUSION: The observed reduction in pain intensity measured on the VAS represents a clear benefit from auricular acupuncture for these cancer patients who are in pain, despite stable analgesic treatment.
Wong R, Sagar CM, Sagar SM. Integration of Chinese medicine into supportive cancer care: a modern role for an ancient tradition. Cancer Treatment Reviews 2001;27:235-246.
Department of Medicine, McMaster University, Hamilton Regional Cancer Centre, Ontario, Canada.
Recent evidence suggests that many traditional Chinese medical therapies are effective for the supportive care of cancer patients. This is a review of some of the published literature (indexed in Medline) and our own practical experience. It is not intended to be a systematic review, but does provide various levels of evidence which support further research into a developing model of integrative care. The holistic approach of Traditional Chinese Medicine (TCM) may be integrated into conventional Western Medicine to supplement deficiencies in the current biomedical model. The philosophy of TCM proposes novel hypotheses which will support the development of a science-based holistic medicine. Copyright 2001 Harcourt Publishers Ltd.
Tagliaferri M. et al. Complementary and alternative medicine in early stage breast cancer. Seminars in Oncology, Vol 28, No 1(Feb), 2001:127.
University of California at San Francisco, 94143-1714, USA.
Complementary and alternative medicine (CAM) are becoming increasingly popular in many medical situations, particularly among patients with cancer. CAM encompasses a range of modalities including dietary and vitamin supplements, mind-body approaches, acupuncture, and herbal medicines. In contrast to standard chemotherapeutic and hormonal regimens used for the adjuvant treatment of early-stage breast cancer, controlled clinical trials have generated few data on the relationship between CAM and the outcomes of recurrence or survival, or even overall quality of life and safety. The objectives of CAM treatments are manifold: the reduction of toxicities of therapy, improvement in cancer-related symptoms, enhancement of the immune system, and even a direct anticancer effect. The primary basis of CAM rests on empirical evidence and case studies, as well as theoretic physiologic effects. In some cases, laboratory or clinical data lend support to these modalities. Some types of CAM are based on ancient Oriental forms of medicine founded on centuries of experience documented through oral and written text. Nevertheless, the paucity of evidence in the clinical setting limits firm conclusions about the effectiveness or safety of most CAM approaches in breast cancer. This review will summarize the basis for the application of certain CAM modalities in the therapy of early-stage breast cancer and will highlight some of the directions of investigative work that could lead to a rational integration of CAM into conventional adjuvant therapy.
Weiger W, Smith M, Boon H, et al. Advising patients who seek complementary and alternative therapies for cancer. Annals of Internal Medicine 2002;137:899-903.
Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Many patients with cancer use complementary and alternative medical (CAM) therapies. Physicians need authoritative information on CAM therapies to responsibly advise patients who seek these interventions. This article summarizes current evidence on the efficacy and safety of selected CAM therapies that are commonly used by patients with cancer. The following major categories of interventions are covered: dietary modification and supplementation, herbal products and other biological agents, acupuncture, massage, exercise, and psychological and mind-body therapies. Two categories of evidence on efficacy are considered: possible effects on disease progression and survival and possible palliative effects. In evaluating evidence on safety, two types of risk are considered: the risk for direct adverse effects and the risk for interactions with conventional treatments. For each therapy, the current balance of evidence on efficacy and safety points to whether the therapy may be reasonably recommended, accepted (for example, dietary fat reduction in well-nourished patients with breast or prostate cancer), or discouraged (for example, high-dose vitamin A supplementation). This strategy allows the development of an approach for providing responsible, evidence-based, patient-centered advice to persons with cancer who seek CAM therapies.
Irritable Bowel Syndrome
Chan, et al. The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study. Hepatogasteroenterology 44(17):1328-30. Sep-Oct 1997.
Gastrointestinal Research Unit, Leicester General Hospital, England.
BACKGROUND/AIMS: The aim of this pilot study was to investigate the potential value of acupuncture in the treatment of irritable bowel syndrome (IBS). METHODOLOGY: The study was an open design study of 7 patients with established irritable bowel syndrome in which assessment was by a diary card. RESULTS: The results showed a significant improvement both in general well-being and in symptoms of bloating. CONCLUSIONS: Acupuncture seems to be effective in the treatment of irritable bowel syndrome and merits further study.
Schneider, et al. Acupuncture treatment in irritable bowel syndrome. Gut. May 2006; 55(5):649-54.
Department of General Practice and Health Services Research, University Medical Hospital, University of Heidelberg, Vossstrasse 2, 69120 Heidelberg, Germany.
BACKGROUND AND AIMS: Despite occasional positive reports on the efficacy of acupuncture (AC) on functions of the gastrointestinal tract, there is no conclusive evidence that AC is effective in the treatment of irritable bowel syndrome (IBS). PATIENTS AND METHODS: Forty three patients with IBS according to the Rome II criteria were randomly assigned to receive either AC (n = 22) or sham acupuncture (SAC) (n = 21) using the so-called "Streitberger needle". Treatment duration was 10 sessions with an average of two AC sessions per week. The primary end point was improvement in quality of life (QOL) using the functional digestive diseases quality of life questionnaire (FDDQL) and a general quality of life questionnaire (SF-36), compared with baseline assessments. QOL measurements were repeated three months after treatment. RESULTS: Both the AC and SAC groups improved significantly in global QOL, as assessed by the FDDQL, at the end of treatment (p = 0.022), with no differences between the groups. SF-36 was insensitive to these changes (except for pain). This effect was partially reversed three months later. Post hoc comparison of responders and non-responders in both groups combined revealed a significant prediction of the placebo response by two subscales of the FDDQL (sleep, coping) (F = 6.746, p = 0.003) in a stepwise regression model. CONCLUSIONS: Acupuncture in IBS is primarily a placebo response. Based on the small differences found between the AC and SAC groups, a study including 566 patients would be necessary to prove the efficacy of AC over SAC. The placebo response may be predicted by high coping capacity and low sleep quality in individual patients.
Takahashi, T. Acupuncture for functional gastrointestinal disorders. J Gasteroenterol. May 2006.; 41(5):408-18.
Department of Surgery, Duke University Medical Center, Durham, NC 27705, USA.
Functional gastrointestinal (GI) symptoms are common in the general population. Especially, motor dysfunction of the GI tract and visceral hypersensitivity are important. Acupuncture has been used to treat GI symptoms in China for thousands of years. It is conceivable that acupuncture may be effective in patients with functional GI disorders because it has been shown to alter acid secretion, GI motility, and visceral pain. Acupuncture at the lower limbs (ST-36) causes muscle contractions via the somatoparasympathetic pathway, while at the upper abdomen (CV-12) it causes muscle relaxation via the somatosympathetic pathway. In some patients with gastroesophageal reflux disease (GERD) and functional dyspepsia (FD), peristalsis and gastric motility are impaired. The stimulatory effects of acupuncture at ST-36 on GI motility may be beneficial to patients with GERD or FD, as well as to those with constipation-predominant irritable bowel syndrome (IBS), who show delayed colonic transit. In contrast, the inhibitory effects of acupuncture at CV-12 on GI motility may be beneficial to patients with diarrhea-predominant IBS, because enhanced colonic motility and accelerated colonic transit are reported in such patients. Acupuncture at CV-12 may inhibit gastric acid secretion via the somatosympathetic pathway. Thus, acupuncture may be beneficial to GERD patients. The antiemetic effects of acupuncture at PC-6 (wrist) may be beneficial to patients with FD, whereas the antinociceptive effects of acupuncture at PC-6 and ST-36 may be beneficial to patients with visceral hypersensitivity. In the future, it is expected that acupuncture will be used in the treatment of patients with functional GI disorders.
Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Treatment of Irritable Bowel Syndrome with Chinese Herbal Medicine. A prospective, randomised controlled, double-blind, placebo controlled study. JAMA. 1998;280:1585-1589.
Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.
CONTEXT: Irritable bowel syndrome (IBS) is a common functional bowel disorder for which there is no reliable medical treatment. OBJECTIVE: To determine whether Chinese herbal medicine (CHM) is of any benefit in the treatment of IBS. DESIGN: Randomized, double-blind, placebo-controlled trial conducted during 1996 through 1997. SETTING: Patients were recruited through 2 teaching hospitals and 5 private practices of gastroenterologists, and received CHM in 3 Chinese herbal clinics. PATIENTS: A total of 116 patients who fulfilled the Rome criteria, an established standard for diagnosis of IBS. INTERVENTION: Patients were randomly allocated to 1 of 3 treatment groups: individualized Chinese herbal formulations (n = 38), a standard Chinese herbal formulation (n = 43), or placebo (n = 35). Patients received 5 capsules 3 times daily for 16 weeks and were evaluated regularly by a traditional Chinese herbalist and by a gastroenterologist. Patients, gastroenterologists, and herbalists were all blinded to treatment group. MAIN OUTCOME MEASURES: Change in total bowel symptom scale scores and global improvement assessed by patients and gastroenterologists and change in the degree of interference in life caused by IBS symptoms assessed by patients. RESULTS: Compared with patients in the placebo group, patients in the active treatment groups (standard and individualized CHM) had significant improvement in bowel symptom scores as rated by patients (P=.03) and by gastroenterologists (P=.001), and significant global improvement as rated by patients (P=.007) and by gastroenterologists (P=.002). Patients reported that treatment significantly reduced the degree of interference with life caused by IBS symptoms (P=.03). Chinese herbal formulations individually tailored to the patient proved no more effective than standard CHM treatment. On follow-up 14 weeks after completion of treatment, only the individualized CHM treatment group maintained improvement. CONCLUSION: Chinese herbal formulations appear to offer improvement in symptoms for some patients with IBS.
Depression
Luo H, Meng F, Jia Y, Zhao X: Clinical research on the therapeutic effect of the electro-acupuncture treatment in patients with depression. Psychiatry and Clinical Neurosciences 1998; 52 (Suppl):S338-S340.
Department of Traditional Chinese Medicine, Institute of Mental Health, Beijing Medical University, PR China.
Electroacupuncture (EA) stimulation has been found to influence the brain (norepinephrine metabolism in experimental animals). Preliminary clinical research has shown that EA treatment is as effective as amitriptyline for patients with depression. In this study, two consecutive clinical studies on the treatment of depression with EA are conducted. The first study was double blind placebo controlled, in which 29 depressed inpatients were recruited. Patients were randomly divided into three groups: EA + placebo; amitriptyline; and EA + amitriptyline. They received EA and/or amitriptyline treatment for 6 weeks. The Hamilton Rating Scale for Depression, Clinical Global Impression and ASBERG scales for the side effect of antidepressants were used to evaluate the therapeutic efficacy and side effects. Based on the results and research protocol of the first study, a multi-centered collaborative study was conducted, in which 241 inpatients with depression were recruited. Patients were randomly divided into two treatment groups: the EA + placebo and the amitriptyline groups. The results from both studies showed that the therapeutic efficacy of EA was equal to that of amitriptyline for depressive disorders (P > 0.05). Electro-acupuncture had a better therapeutic effect for anxiety somatization and cognitive process disturbance of depressed patients than amitriptyline (P < 0.05). Moreover, the side effects of EA were much less than that of amitriptyline (P < 0.001). The article suggested that EA treatment was an effective therapeutic method for depressive disorders. Particularly, it was a treatment of choice for depressed patients who were unable to comply with the classic tricyclic antidepressants because of their anticholinergic side effects. The possible mechanism of EA treatment is discussed.
Ernst E, Rand Jl, Stevinson C: Complementary therapies for depression: an overview. Archives of General Psychiatry 1998; 55:1026-1032.
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, England. E.Ernst@exeter.ac.uk
Depression is one of the most common reasons for using complementary and alternative therapies. The aim of this article is to provide an overview of the evidence available on the treatment of depression with complementary therapies. Systematic literature searches were performed using several databases, reference list searching, and inquiry to colleagues. Data extraction followed a predefined protocol. The amount of rigorous scientific data to support the efficacy of complementary therapies in the treatment of depression is extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (Hypericum perforatum), and, to a lesser extent, acupuncture and relaxation therapies. There is a need for further research involving randomized controlled trials into the efficacy of complementary and alternative therapies in the treatment of depression.
Roschke J, Wolf C, Kogel P, Wagner P, Bech S: Adjuvant whole body acupuncture in depression. A placebo-controlled study with standardized mianserin therapy. [German] Nervenarzt 1998; 69:961-967.
Psychiatrische Klinik und Poliklinik, Universität, Mainz.
In order to examine the efficacy of whole body acupuncture additionally applied to drug treatment in depression, a single-blind placebo-controlled study with 70 inpatients administered to three different treatment groups has been carried out. All patients were pharmacologically treated with the tetracyclic antidepressant mianserin. The verum group (n = 22) received acupuncture at specific points considered to be effective in the treatment of depression. The placebo group (n = 24) was treated with acupuncture at non-specific locations and the control group (n = 24) received only pharmacological treatment. Acupuncture was applied three times a week over a period of four weeks. Psychopathology was rated by judges blind to verum/placebo conditions twice a week over eight weeks with the CGI, GAS, BRMS and BfS rating scales. Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin did by itself. However, we could not detect any differences between placebo and verum acupuncture.
Kurland HD. ECT and Acu-EST in the treatment of depression. American Journal of Chinese Medicine 1976; 4:289-292.
This paper presents three brief case histories from a three year study comparing electroconvulsive therapy (ECT) with acupuncture treatment in functional psychoses. Acupuncture effects were augmented by the simultaneous, non-painful electrical stimulation of eight acupuncture needles. The resulting treatment is called Acupuncture Electric Stimulation Therapy (Acu-EST). Each patient was utilized as her own control, treating exacerbations of depression alternately with ECT and Acu-EST. Acu-EST was not found to be a panacea and did not enable the discontinuation of antidepressant and neuroleptic medication. Individual Acu-EST treatments were often less effective than individual ECT treatments. However, series of Acu-EST did assist in producing significant remissions in depressive symptomatology. Because it did not produce the temporary disabling memory defects which occurred with ECT, Acu-EST was more easily adaptable to outpatient treatment.
Allergies
Chen CJ, Yu HS: Acupuncture treatment of urticaria. Archives of Dermatology 1998; 134:1397-1399.
Department of Internal Medicine, Kaohsiung Medical College, Taiwan.
Acupuncture has long been used to treat urticaria in the Asian world. Acute urticaria can be easily and effectively treated with acupuncture. L111 (Quchi), Sp10 (Xuehai), Sp6 (Sanyinjiao), and S36 (Zusanli) are the 4 acupuncture points most commonly prescribed. Chronic urticaria is a challenge for medical therapy. There are at least 6 kinds of acupuncture methods developed to overcome this challenge. The combination of ordinary acupuncture and auricular acupuncture has been observed to be a highly effective cure of chronic urticaria. Acupuncture point injection with thiamine hydrochloride (vitamin B1) is also an effective treatment. However, results of these clinical observations have not been systematically confirmed for lack of a control group and the need for standard classification of urticaria. Although these observational results have clinical limitations, they do offer insight into an alternative to conventional treatment of urticaria. In the future, acupuncture or acupuncturelike techniques may provide an effective alternative for treatment of patients with urticaria, particularly those refractory to medication therapy.
Wolkenstein E, Horak F: Protective effect of acupuncture on allergen provoked rhinitis. [German] Wiener Medizinische Wochenschrift 1998; 148:450-453.
Kaiserin-Elisabeth-Spitals der Stadt Wien, Österrreich/Austria.
A study of the protective effect of an acupuncture therapy against a nasal allergen-provoked rhinitis was undertaken on patients suffering from seasonal allergic rhinitis. The effects of a specific acupuncture therapy ("verum") were compared with those of a non-specific acupuncture therapy ("placebo"). The allergen-provocation was carried out in the "Vienna Provocation Chamber" (VCC) (Horak, 1987). 24 patients suffering from seasonal allergic rhinitis were allocated at random either to Group B and given a specific ("verum") acupuncture therapy or to Group A and given a non-specific ("placebo") acupuncture therapy. A nasal allergen-provocation was carried out before onset and after completion of 9 treatments. The objective and subjective results of the allergen-provocation in the VCC were not able to verify a protective effect of the acupuncture therapy. The "Diary of Complaints (Symptoms)" which the participants had to keep over the 2 months following the treatment showed a definite reduction of the subjective complaints in the verum group during the second month. The range of scatter was too great for a statistically significant result.
Krop J, Lewith GT, Gziut W, Radulescu C: A double blind, randomized, controlled investigation of electrodermal testing in the diagnosis of allergies. Journal of Alternative & Complementary Medicine 1997; 3:241-248.
University Department of Medicine, Southampton General Hospital, England.
This investigation evaluates electrodermal (ED) testing in 41 polysymptomatic allergic patients. Electrodermal testing discriminated correctly 82% of the time between house dust mite and histamine (allergens) and saline or water (nonallergens) in our first study group involving 17 patients (p = 0.007). The second study involved 24 patients and used the same double-blind methodology discriminating 96% of the time between allergic and nonallergic substances (p = 0.000002). We conclude that ED testing is a reliable method of differentiating between allergic and nonallergic substances in the context of our study.
Arnetz BB, Berg M, Anderzen I, Lundeberg T, Haker E: A nonconventional approach to the treatment of “environmental illness.” Journal of Occupational & Environmental Medicine 1995; 37:838-844.
National Institute for Psychosocial Factors and Health, Stockholm, Sweden.
Twenty patients with symptoms of "environmental illness" were subject to a controlled study of deep versus superficial acupuncture. The patients were evaluated by a detailed questionnaire concerning their occupational, environmental, and medical history. Blood samples were taken as well. Patients were randomized to deep or superficial acupuncture. Both groups improved significantly in key variables during and after treatment. There were no group differences. There were no changes in biological variables apart from a gradual and continuous increase in serum cortisol and a decrease in neuropeptide Y, which was somewhat more accentuated in those receiving deep acupuncture. This rise in cortisol may have contributed to decreased dermal symptoms among the participants. It is hypothesized that the positive treatment results observed are partly due to weakening of the conditioned response, linking bodily symptoms to environmental agents. To date, a number of different methods have been tried in the management of patients with environmental illness. However, only rarely have the treatments been evaluated in controlled studies.
Lau BH, Wong DDS, Slater JM: Effect of acupuncture on allergic rhinitis: clinical and laboratory evaluations. American Journal of Chinese Medicine 1975; 3:263-270.
Of 22 subjects with allergic rhinitis who received a series of 6 acupuncture treatments, 11 (50%) were virtually symptom-free by the end of the series, 8 (36%) experienced a moderate reduction in symptoms, and 3 (14%) received no significant relief. Clinical assessment of symptoms was made on a 6-point scale before the first treatment and before each subsequent session. Laboratory tests included absolute blood eosinophils, percentage of nasal eosinophils, and radioimmunoassay of serum IgE, performed before the first treatment, at the end of the series, and 2 months later. A significant decrease in subjective clinical rating of symptoms correlated with a concurrent drop in absolute numbers of blood eosinophils and percentage of nasal eosinophils. IgE levels decreased in 64% of the subjects by completion of treatment and in 76% at 2-month follow-up.
Brinkhaus, B., et al. Acupuncture and Chinese herbal Medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy, 2004:59 (9);953-960.
Department of Medicine I, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen Germany.
BACKGROUND: Patients with allergic rhinitis (AR) increasingly use complementary medicine. The aim of this study was to determine whether traditional Chinese therapy is efficacious in patients suffering from seasonal AR. METHODS: Fifty-two patients between the ages of 20 and 58 who had typical symptoms of seasonal AR were assigned randomly and in a blinded fashion to (i) an active treatment group which received a semi-standardized treatment of acupuncture and Chinese herbal medicine, and (ii) a control group which received acupuncture applied to non-acupuncture points in addition to a non-specific Chinese herbal formula. All patients received acupuncture treatment once per week and the respective Chinese herbal formula as a decoction three times daily for a total of 6 weeks. Assessments were performed before, during, and 1 week after treatment. The change in severity of hay fever symptoms was the primary outcome measured on a visual analogue scale (VAS). RESULTS: Compared with patients in the control group, patients in the active treatment group showed a significant after-treatment improvement on the VAS (P = 0.006) and Rhinitis Quality of Life Questionnaire (P = 0.015). Improvement on the Global Assessment of Change Scale was noted in 85% of active treatment group participants vs 40% in the control group (P = 0.048). No differences between the two groups could be detected with the Allergic Rhinitis Symptom Questionnaire. Both treatments were well-tolerated. CONCLUSIONS: The results of this study suggest that traditional Chinese therapy may be an efficacious and safe treatment option for patients with seasonal AR.
Chang TT, Huang CC, Hsu CH. Clinical evaluation of the Chinese herbal medicine formula STA-1 in the treatment of allergic asthma. Phytother Res. 2006 May;20(5):342-7.
Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan.
Although some formulae of traditional Chinese medicines (TCM) have been used for antiasthma treatment, few of them have had sufficient discussion on their efficacy, safety and mechanisms. In this study, the availability of the TCM formula STA-1 for the treatment of allergic asthma was investigated by conducting a double-blind, placebo-controlled and randomized trial. One hundred and twenty patients between the ages of 5 to 20 years with mild-to-moderate asthma were included. These patients were treated with either STA-1 or placebo in a dose of 80 g/kg/day and were administered twice daily for 6 months. The main outcome measures were a daily diary record of symptoms, supplementary bronchodilator and glucocorticoid treatment, changes of pulmonary function (forced expiratory volume in 1 s), changes of total and Dermatophagoides pteronyssinus (DP)-specific IgE and side effects. The results showed a statistically significant reduction of symptom scores, systemic steroid dose, total IgE and specific IgE in the STA-1 group. Furthermore, STA-1 also improved the pulmonary lung function FEV(1) compared with the placebo group and only minimal side effects were shown. These results suggested that STA-1 is available for the treatment of mild-to-moderate chronic asthma. Copyright 2006 John Wiley & Sons, Ltd.
Upper Respiratory Infections
Takeuchi H, Jawad MS, Eccles R: The effects of nasal massage of the “yingxiang” acupuncture point on nasal airway resistance and sensation of nasal airflow in patients with nasal congestion associated with acute upper |
