RESEARCH
Increasing resources are now being devoted to acupuncture in the West.
If you would like us to send you results of a research document on – for example – Depression.

Acupuncture and Pain
PAINKILLERS: Who needs drugs when acupuncture works?
(Per WDDTY email 20 Jan 05)

If the NSAID painkillers cause gastric bleeding and the COX-2 variety can lead to heart problems, where can you turn? Step forward acupuncture, the painkilling method used by traditional Chinese medicine for a thousand years or so.

Western medicine has this week finally conceded that it does work. In two separate trials published in the Annals of Internal Medicine, researchers found it was an effective pain reliever for people with neck pain and as an effective treatment for sufferers of osteoarthritis.

In the first trial, Dr George Lewith and colleagues at Southampton University compared acupuncture with electrical stimulation of acupuncture points on a group of 135n patients with neck pain. Those in the acupuncture group reported a 'statistically significant' reduction in the neck pain. "We need to understand why such a safe treatment is so effective in the long term," Dr Lewith said.

Acupuncture was also found to be an effective treatment for osteoarthritis.
A group of 570 patients with osteoarthritis of the knee were treated either with 26 sessions of acupuncture, or of 'sham' acupuncture where the needles are not inserted, or had educational sessions on lifestyle changes. At the end of the trial period the acupuncture group experienced greater improvements in pain levels and general mobility than those in either of the other two groups. "This echoes the results of studies we have been doing for 11 years
now," commented lead researcher Dr Brian Bergin, director of the Center for Integrative Medicine at the University of Maryland School of Medicine.

Not that you could get your hands on a COX-2 drug in the UK. In a move that suggests an unprecedented interest in public health, regulators have ordered doctor to stop prescribing the drugs. Meantime the share price of Pfizer, the world's largest pharmaceutical company, has collapsed after news about problems with its COX-2 drug, Celebrex, finally reached the money markets.

Perhaps they could start investing in some needles.
(Source: Annals of Internal Medicine, 2004; 141: 901-10 (Berman study), 911-19 (Lewith study)).

Swallowing Reflex
Acupuncture can stimulate the swallowing reflex in those who have difficulty swallowing (dysphagia) due to a stroke.

In this study, 41 such patients were given acupuncture. After a single 15-minute treatment, all showed improvement of more than 55 per cent. On retesting after seven days, the improvement appeared to have been maintained
(J Am Geriatr Soc, 2003; 51: 726-7).

PROOF! says: Stroke-induced dysphagia is common. In most cases, it will resolve without treatment. Long-term sufferers are at high risk of dehydration, malnutrition, choking and pneumonia, and require long-term nursing care. Other treatments - electrical stimulation or cold applications to the throat - are not always successful. While this study shows that a single, short application of acupuncture can work, there is not yet enough information to show if the benefits can be sustained over the longer term.
Proof Vol 8 Issue 4.

Urinary Tract Infections UTI
Women who experience repeated bouts of urinary tract infections (UTI) have a good chance of preventing further episodes by abandoning antibiotics and using acupuncture instead.

Norwegian researchers investigated the benefits of acupuncture in 94 women, all of whom had experienced at least three UTIs in the previous 12 months. At least two of the infections were diagnosed and treated as a UTI by a doctor. Of the 94 women, 67 received acupuncture twice a week for four weeks.

The women with recurrent UTIs who were treated with acupuncture were half as likely to have another bout of infection during the next six months as women who did not receive acupuncture.

In addition, say the authors, the acupuncture-treated women showed a 50 per cent decrease in the urine left in their bladders after urinating, while residual urine levels remained unchanged in those not treated with acupuncture. Residual urine is a risk factor for recurrent UTIs
(Am J Publ Health, 2002; 92: 1609-11). Proof Vol 7 No 4.

De Qi
The therapeutic effect of acupuncture may originate from the way the needle is grasped (de qi) as it is removed from the skin.

Researchers at the University of Vermont College of Medicine, in Burlington, measured the amount of force required to remove an acupuncture needle from human skin. The force was measured when the needle was inserted straight in, rotated in one direction and rotated in two directions.

Needle rotation is a traditional acupuncture technique. It was found that 167 per cent more force is required to extract a needle rotated in one direction, and 52 per cent more force for a needle rotated back and forth, compared with removing a needle which had not been rotated.

The investigators also found that 18 per cent more force is needed to pull needles from acupuncture points specified in ancient texts compared with ‘control’ points that are not used in acupuncture.

According to the report, de qi or needle grasp is a measurable biomechanical aspect of acupuncture treatment. Say the researchers, the greater force needed may be due to the connective tissue in the skin becoming wrapped around the needle
(J Appl Physiol, 2001; 91: 2471-8). Proof vol 6 no 7.

Fibromyalgia
Acupuncture may succeed where conventional medicine fails in easing the pain of fibromyalgia, a painful muscular condition.

In a small study where 29 fibromyalgia patients were given acupuncture treatment during which no analgesic medication was allowed, acupuncture therapy was associated with decreased pain levels and fewer tender spots on the body.

Both before and after treatment, pain levels were measured using two different methods, and a variety of bioassays were performed.

These results seem to indicate that acupuncture produces positive chemical changes in the body, which affect pain-modifying substances in the blood.

The authors conclude that acupuncture is an effective treatment option for the pain of fibromyalgia.

Sprott H et al, Rheumatol Int, 1998; 18: 35-6 Proof Vol 3, No 2.

Tennis Elbow
Acupuncture can help reduce the pain of tennis elbow, even after just one treatment.

German researchers compared the effects of a single-needle acupuncture with a placebo, non-penetrative procedure. In the group receiving actual treatment, 55.8 per cent reported pain relief compared with 15 per cent of those in the placebo group. Nearly 80 per cent of the acupuncture group reported a reduction in pain of at least 50 per cent after only one treatment.

Molsberger A. Br J Rheumatol, 1994; 33 (12): 1162-5 Proof Vol 1, issue 2.

Research articles from US National Library of Medicine http://www.nlm.nih.gov/archive/20040823/pubs/cbm/acupuncture.html

Research from Germany
http://anaesthesie.uibk.ac.at/akupunktur/arg_english/index_engl.html

Back Pain
‘Acupuncture effectively relieves chronic low back pain’
Manheimer E, White A, Berman B, et al. “Meta-analysis: acupuncture for low back pain.” Annals of Internal Medicine. 142(8):651-663, 2005.
To assess acupuncture’s effectiveness for treating low back pain, randomized controlled trials were identified that compared needle acupuncture with sham acupuncture, other sham treatments, no additional treatment, or another active treatment for patients with low back pain. The 33 randomized trials included in this review were grouped according to acute or chronic pain, style of acupuncture and type of control group used. For the primary outcome measure of short-term chronic pain relief, the meta-analysis showed that acupuncture is significantly more effective than sham treatment and no additional treatment. Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies.

Allergic Rhinitis

A study reported in the Medical Journal of Australia in 2007 (Med J Aust. 2007; 187(6); 337-41) described a trial with 80 patients varying in age between 16 and 70 years. The patients were randomly split into two groups, only one of which had real acupuncture and they were treated twice weekly for 8 weeks, and their cases observed over the following 12 weeks.

At the end of the treatment period, the weekly mean difference in total nasal symptom score from the original baseline was significantly better in the real acupuncture group (-17.2 as compared with -4.2) and the improvement continued during the three months that followed.

What is encouraging from a health resources point of view is that the patients’ use of medication was also greatly reduced, and this decline in usage persisted over the next 12 weeks as well.

Do acupuncture meridians exist?

Scientists would love to be able to prove that the meridians exist, and they’ve been trying for many years. It has sometimes felt as if everyone using acupuncture knew they existed, in the same way that a pilot knows a given air route exists and is used time and again by aeroplanes, but you can’t actually see anything showing the way in the air. The pilot has no need to prove it because he does so every time he uses it, just like the acupuncturist.

But we are getting closer. Two different studies in China using light technology (lasers in one case and infrared thermal imaging in the other) showed different characteristics in the acupuncture meridian lines as compared with surrounding skin. For example, light propagated better along the meridian in one study. (Differences in Optical Transport properties between human meridian and non-meridian. Am J Chin Med 2007; 35(5);743-52) (Appearance of Human Meridian-like Structure and Acupoints and its time correlation by infrared thermal imaging. Am J chi Med.2007;35(2);231-40)

These remind the writer of a lecture by a retired Chinese professor given to surgeons and doctors at the Edinburgh (Scotland) Royal Infirmary in (?) 1986 during which he showed how in limbs from recent cadavers, sound transmitted much more effectively along the acupuncture meridians than other longitudinal lines nearby. (If anyone reading this knows the name of the lecturer or can provide more details, we shall be glad to publish it.