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Acupuncture Migraine Relief Found Effective

Posted on 17 JANUARY, 2018 From HealthCM


Researchers find acupuncture effective for the prevention and alleviation of migraine attacks. Migraines are the source of intense pain, lasting for hours or days. Chronic migraine sufferers may experience nausea, vomiting, and hypersensitivities—making them prone to anxiety and depression. Research conducted at the 254th Hospital of the Chinese People's Liberation Army demonstrates that electroacupuncture therapy in the projection zone and conventional acupuncture are both effective protocols for the elimination of migraine attacks.


A total of 120 migraine patients, between ages 18–70, were randomly divided into four groups: 


Projection zone group
Patients were treated with electroacupuncture by licensed acupuncturists in the projection zone area—from Yuzhen (BL9) to Tianshu (ST25)—using 0.30 mm × 50 mm Hwato brand acupuncture needles (Suzhou Medical Supplies Co., Ltd.). Four equidistant needles were applied along the BL9 to ST25 line, until patients experienced deqi sensations (e.g., soreness, numbness, heaviness). A Han's Acupoint Nerve Stimulator (HANS) with a 2/100 Hz alternating frequency at 8–20 mA was applied to BL9–ST25. The 30 minute treatment was administered once per day, over the course of 10 consecutive days. 


Conventional acupuncture group
Acupuncture therapy was applied to the following acupoints and were manipulated to achieve a deqi response:

  • Taiyang (MHN9)
  • Lougu (SP7)
  • Xuanlu (GB5)
  • Touwei (ST8)
  • Fengchi (GB20)
  • Waiguan (TB5)
  • Taichong (LV3)
  • Zulinqi (GB41)

Next, electroacupuncture with the HANS device using identical electroacupuncture settings as the projection zone group was applied (8-20 mA, 2/100 Hz, 30 minutes). Daily treatment was similarly administered over 10 consecutive days.


Non-acupoint group
Patients were treated over 10 days with four equidistant needles applied 2 inches away from the Yuzhen (BL9)/Tianzhu (BL10) line, until deqi sensations were induced. This was also followed by the use of the HANS device with the same electroacupuncture settings (8-20 mA, 2/100 Hz, 30 minutes) as the projection zone group.


Drug group
Diclofenac sodium enteric-coated tablets were administered orally, twice per day, 50 mg per dose, over the course of 10 days. Diclofenac sodium is a nonsteroidal anti-inflammatory drug (NSAID).

Exclusion criteria were established. Patients with the following conditions were not admitted to the study:

  • blood disease
  • heart disease
  • liver disease
  • kidney damage
  • brain trauma
  • brain tumor
  • epilepsy
  • high blood pressure
  • mental illness
  • infectious diseases

Pregnant or lactating women were excluded from the study. In addition, patients taking migraine medications or with basilar migraines were excluded. Scores were taken before and after treatment for the comparison and analysis of the therapeutic effects. The study evaluated the therapeutic effects of the four groups using the following four types of rating methods:

  • Visual Analogue Scale (VAS) scores: a value based on the scale of pain
  • TCM syndrome scores: a value based on the frequency, intensity, duration, and associated symptoms of headaches
  • Self-rating anxiety scale scores (SAS)
  • Self-rating depression scale scores (SDS)

Results
The total effective rate of the therapy in the projection zone group (93.33%) was higher than that of the conventional acupuncture group (86.67%), drug group (70.00%), and non-acupoint group (63.33%), with statistical significance (P=0.004). Pre-treatment VAS scores and TCM syndrome scores in all four groups improved significantly (P<0.05) after treatment. Post-treatment VAS scores in the projection zone acupuncture group were significantly better than the other three groups, and their TCM syndrome scores were also significantly better than the drug group and non-acupoint group (P<0.05). SDS scores in all four groups also improved significantly, with statistical significance (P<0.05). Post-treatment SAS and SDS scores in the projection zone group were significantly better than the other three groups (P<0.05).


The researchers conclude that acupuncture successfully alleviates migraines and reduces associated anxiety and depression. Electroacupuncture in the projection zone outperformed all other groups in the investigation.


References
Xiao L, Wang Y, Wang S, Wang LX, Cui Q, Zhang C, Yao LH, Shao JY, Xing J. Clinical Study on electroacupuncture Treatment of Migraine in Surface Projection Zone of the Pyramid Decussation [J]Chinese Journal of Information on TCM, 2018 (01).

Xiao L, Cui Q, Zhang QJ et. al, Study on the Therapeutic Effect of electroacupuncture on 60 Cases of Migraine [J]. People's Liberation Army Medical Journal 2013,25(7): 61-64.

Zhao L, Chen J, Li Y et. al, The Long-term Effect of Acupuncture for Migraine Prophylaxis [J]JAMA Intern Med. 2017;177(4):508-515.

Zhao JP, Wang RH, National TCM Professional Qualification Examination Outline "Chinese Acupuncture Major” (Intermediate) [M]. Beijing: China TCM Publishing House, 2015:752,903-904.

Zhou WJ, Sun QL Hemiplegia rehabilitation assessment manual [M]Beijing: People's Medical Publishing House, 2006:66-67,69.

Acupuncture Outperforms Drug For Insomnia Relief

Posted on December 27, 2017 From HealthCM 


Acupuncture is effective for insomnia relief. Research published by Zhejiang Chinese Medical University finds acupuncture more effective than a powerful sleep drug for improving sleep duration, quality, latency, efficiency, and daytime functioning. Acupuncture achieved a 92.9% total effective rate and the drug zopiclone achieved a 67.9% total effective rate. [1] 


Zopiclone is a central nervous system depressant used for helping patients fall asleep and maintaining sleep throughout the night. The Zhejiang Chinese Medical University research indicates that acupuncture is more effective than zopiclone for improving these sleep parameters. Zopiclone is limited to short-term use because patients develop tolerance or dependence, risking the possibility of addiction. Although a nonbenzodiazepine hypnotic agent used as a sedative, zopiclone enhances GABA (gamma-aminobutyric acid) via benzodiazepine receptors. Consequently, withdrawal symptoms are similar to those of benzodiazepines. The research indicates that acupuncture is an effective alternative without the adverse effects associated with drug intake.


Acupuncture improved sleep latency for patients in the study. This is the time to transition from wakefulness to sleep. Acupuncture also improves sleep efficiency. This is the percentage of total time spent sleeping at night while in bed. In Traditional Chinese Medicine (TCM), these parameters are paramount to an accurate differential diagnosis. Imbalances preventing falling asleep and imbalances causing patients to wake have differing causes within TCM. As a result, acupuncture and herbal medicine modifications are based on how easily patients fall asleep, how often they wake, and what times of day they wake.


A total of 112 patients with primary insomnia were randomized into an acupuncture group and a zopiclone group. For the drug group, zopiclone was administered in 7.5 mg doses, once per day, for 30 days. All patients receiving acupuncture had the following acupoints inserted with 0.25 mm diameter, 40 mm length filiform acupuncture needles:

  • Baihui (GV20)
  • Sishencong (EX-HN 1)
  • Anmian (extra, midpoint of Fengchi (GB20) and Yiming)

Secondary acupuncture points were added based on diagnostic considerations. For patients with heart and sleep deficiency, the following acupoints were added:

  • Shenmen (HT7)
  • Taibai (SP3)
  • Zhizheng (SI7)
  • Fenglong (ST40)

For heart deficiency related timidity, the following acupoints were added:

  • Shenmen (HT7)
  • Zhizheng (SI7)
  • Qiuxu (GB40)
  • Guangming (GB37)

For liver qi depression transforming into fire, the following acupoints were added:

  • Taichong (LV3)
  • Yangfu (GB 38)

For phlegm heat, the following acupoints were added:

  • Fenglong (ST 40)
  • Neiting (ST 44)
  • Quchi (LI 11)

For patients with blood stasis, the following acupoints were added:

  • Xuehai (SP10)
  • Geshu (BL17)

Standards of manual acupuncture needle manipulation were maintained according to accepted TCM principles. An even reinforcing and reducing technique (ping bu ping xie) was applied to the three primary acupuncture points administered to all patients. Reinforcing or reducing techniques were applied to the secondary acupoints based on differential diagnostic considerations. One course of treatment was comprised of one acupuncture treatment per day for 10 days. A one day break between each course was observed. Patients received three courses of care. Needles were retained during each acupuncture session for 30 minutes.


Acupuncture, achieving a 92.9% total effective rate, significantly outperformed the medication, which achieved a 67.9% total effective rate. A closer look at the numbers reveals important findings. In the acupuncture group, 10 patients completely recovered, whereas there were only 3 complete recoveries in the drug group. On the other end of the spectrum, only 4 acupuncture patients did not improve, whereas 18 drug patients did not improve.


In the middle range of improvements, patients receiving acupuncture had more significant improvements across a wider array of parameters. Patients receiving drug therapy had improvements limited to sleep quality, latency, and duration. Acupuncture caused improvements across these parameters plus daytime functioning, sleep efficiency, and reduction of sleep disturbances.


The research presents historical insight into TCM theoretical principles. Insomnia is classified as Bu Mei or Bu De Wo (sleeplessness). The research indicates that “Scholars in history made rich discussion on physiology and pathogenesis of insomnia, mostly based on the theory of imbalance between yin and yang, in which it holds that change of yin and yang within human body determines the sleep and awake cycle, and it is an inevitable phenomenon of yin yang alternation.” [2,3] They add that the “brain is the house of the original spirit,” which is linked to mental states. As a result, regulation of yin, yang, and spirit (shen) is indicated for patients with insomnia.


In a detailed analysis of each acupoint, the research presents the reasons for each point selection. GV20 was chosen because yang gathers at this point; it is a crossing point of the hand and foot yang channels with the Governing Vessel. GV20 is designated as the sea of yang channels; it regulates the qi and blood of all yang channels. As a results, the research notes that the “pathological state of yang failing to enter yin can be corrected.” The research also notes that GV20 is effective for “relieving fright and calming spirit.” [4]


Sishencong shares similar therapeutic properties on the two acupoints of the four point combination that are located on the Governing Vessel. In addition, the lateral points are within 0.5 cun of the Bladder Channel, which connects with the kidneys and also enters the brain. As a result, the research indicates that the lateral points of the Sishencong combination refresh the brain and tonify essence. The acupoint Anmian, translated as peaceful sleep, was noted for its ability to improve sleep by regulating excitatory responses in the brain and for improving micro-circulation.


The research was conducted at the Hospital of Integrated Traditional Chinese and Western Medicine (Zhejiang Chinese Medical University). Based on the data, acupuncture is more effective than zopiclone for the treatment of insomnia. An additional benefit is that acupuncture is non-addictive whereas the drug presents tolerance and dependence risks. To learn more, visit the acupuncture continuing education course on the treatment of insomnia at HealthCMi:


Notes:
1. Shao, Yue. "Clinical study on acupuncture for primary insomnia." Journal of Acupuncture and Tuina Science 15, no. 6 (2017): 410-414.


2. Xu F, Feng ZT, Wang ZN. Heart-spleen deficiency insomnia treated by five notes syndrome differentiation cooperate Guipi Anmei decoction. Jilin Zhongyiyao, 2014, 34(6): 582-585.


3. Xue DX, Zhang ZJ. Discussion of the syndromes and treatment of insomnia in Shang Han Lun (Treatise on Cold Damage Diseases). Xin Zhongyi, 2014, 46(8): 232-234.


4. Shao, Yue. "Clinical study on acupuncture for primary insomnia." Journal of Acupuncture and Tuina Science 15, no. 6 (2017): 410-414.

Acupuncture Immune System Discovery

Posted on November 17, 2017 From HealthCM


Researchers conclude that acupuncture benefits the immune system. In a controlled laboratory experiment, Hubei University of Chinese Medicine researchers discovered that electroacupuncture stimulation of acupuncture point ST36 (Zusanli) “enhanced the level of immune cytokines and splenic CD4+ T cells through TRPV channels.”


[1] In addition, the researchers document that electroacupuncture applied to ST36 enhances serum interferon-γ (IFN-γ) levels, interleukin (IL)-2, and IL-17. Results were confirmed using immunohistochemical analysis. The research measured the effects of electroacupuncture and precisely identified that electroacupuncture at ST36 enhances cytokines, which are proteins secreted by cells that have a specific effect on the interactions and communications between cells. 


[2] The researchers discovered that electroacupuncture enhancement of cytokines and helper T cells (CD4+ T cells) is through TRPV (transient receptor potential vanilloid) channels. TRPV channels are cellular sensors for a broad variety of physical and chemical stimuli involved in the formation of visual and auditory sensations, touch, olfactory perception, taste, temperature, and algesia. TRPV involvement in cell signaling triggers host cell responses to “benign or harmful environmental changes.” 


[3]The findings are significant because CD4+ T cells are of paramount importance in human immune systems. These cells are referred to as helper T cells and are active in the immune system’s defense against microbes, including viruses. CD4+ T cells have the ability to differentiate into many different types of cell subsets in the body’s effort to activate immune system cells, immunoregulation, and cytotoxic defense mechanisms.


The research reveals the role of electroacupuncture (2–15 Hz) in the enhancement of CD4+ T cells through TRPV channels, indicating an important pathway of acupuncture’s effective action. The researchers add, “These results proved that the rise in the intracellular Ca2+ induced by electroacupuncture at the ST36 acupoint was responsible for the differentiation, proliferation and activation of splenic CD4+ T cells.”


The researchers conclude, “the present study has demonstrated that electroacupuncture at the ST36 acupoint was able to regulate the production of immune cytokines (IFN-γ , IL-2 and IL-17) and the differentiation and activation of splenic T cells, which was mediated by the regulation of extracellular and intracellular Ca2+ concentrations.” 


The investigation was made possible by cooperation between three Hubei University of Chinese Medicine departments: Department of Biochemistry, Department of Anatomy, Department of Pathogenic Biology.The use of ST36 for the treatment of diseases in Traditional Chinese Medicine (TCM), according to the researchers, “has a long history of use as a supplementary therapy.” 


[4] The research supports the efficaciousness of traditional ST36 applications and maps the pathways and effective actions of needling ST36 when stimulated with an electroacupuncture device. This sheds light on the fundamental scientific question, how does acupuncture work? The researchers document that acupuncture achieves therapeutic results by Ca2+ signaling “in the context of T cell activation and differentiation.” 


[5]The research team notes that the investigation was prompted by results from prior investigations finding acupuncture effective in the treatment of stress induced immunodeficiency. [6,7] They add that the impetus for the investigation was also supported by prior research finding electroacupuncture stimulation of ST36 effective in activating the immune system and benefitting patients receiving anti-cancer therapy. 


[8–10] They added that an increased understanding of the “curative mechanisms of electroacupuncture” will help to expand the uses of the procedure on a greater scale.The researchers used modern techniques to measure the effects of electroacupuncture. Flow cytometry was used to measure the Ca2+ concentration of spleen cells. Immunofluorescence was integral to the immunohistochemical analysis. Ultrasonication was required for homogenates and an “ELISA assay was used to assess the IFN-γ, IL-2 and IL-17 levels in the serum and extracts from the ST36 acupoint area.” 


[11]The research is a quintessential laboratory investigation serving to more greatly understand ancient Traditional Chinese Medicine (TCM) in modern terms; specifically, the role of acupuncture point ST36 in reference to immune system enhancement. Traditionally, ST36 is known for its ability to tonify qi, nourish blood and yin, activate the channels, benefit source qi, and alleviate pain. The investigation updates this understanding with specific, quantifiable, and repeatable biochemical changes elicited by electroacupuncture stimulation of ST36.ST36 has long been an important acupuncture point in TCM. 


In approximately 440 CE, imperial medical officer Qin Cheng-zu stated that “all diseases can be treated” with the application of ST36. During the Han Dynasty (206 BCE–220 CE), the Chinese physician Hua Tuo applied ST36 for the treatment of the five taxations: excessive use of the eyes injuring the blood, excessive lying down injuring the qi, excessive sitting injuring the flesh, excessive standing injuring the bones, excessive walking injuring the sinews. These are but two historical examples for the uses of ST36. Now, with the advent of the Hubei University of Chinese Medicine research, we can add that ST36 enhances the immune system, stimulates production of helper T cells, and promotes cytokines. 


Notes:
1. Chen, Longyun, Anli Xu, Nina Yin, Min Zhao, Zhigang Wang, Tao Chen, Yisheng Gao, and Zebin Chen. "Enhancement of immune cytokines and splenic CD4+ T cells by electroacupuncture at ST36 acupoint of SD rats." PloS one 12, no. 4 (2017): e0175568.


2. Zhang, Jun-Ming, and Jianxiong An. "Cytokines, inflammation and pain." International anesthesiology clinics 45, no. 2 (2007): 27.


3. Zheng, Jie. "Molecular mechanism of TRP channels." Comprehensive Physiology (2013).


4. Chen, Longyun, Anli Xu, Nina Yin, Min Zhao, Zhigang Wang, Tao Chen, Yisheng Gao, and Zebin Chen. "Enhancement of immune cytokines and splenic CD4+ T cells by electroacupuncture at ST36 acupoint of SD rats." PloS one 12, no. 4 (2017): e0175568.


5. Ibid.


6. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012; 172(19):1444–53.


7. Richardson PH, Vincent CA. Acupuncture for the treatment of pain: a review of evaluative research. Pain. 1986; 24(1):15–40. PMID: 2937004.


8. Wu B, Zhou RX, Zhou MS. [Effect of acupuncture on interleukin-2 level and NK cell immunoactivity of peripheral blood of malignant tumor patients]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994; 14(9):537–9.


9. Rogers PA, Schoen AM, Limehouse J. Acupuncture for immune-mediated disorders. Literature review and clinical applications. Probl Vet Med. 1992; 4(1):162–93.


10. Wu B, Zhou RX, Zhou MS. [Effect of acupuncture on immunomodulation in patients with malignant tumors]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1996; 16(3):139–41.


11. Chen, Longyun, Anli Xu, Nina Yin, Min Zhao, Zhigang Wang, Tao Chen, Yisheng Gao, and Zebin Chen. "Enhancement of immune cytokines and splenic CD4+ T cells by electroacupuncture at ST36 acupoint of SD rats." PloS one 12, no. 4, pg. 13 (2017): e0175568.


12. Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neuroscience. 2003; 26(1):17–22.  

Acupuncture And Herbs Regulate Cardiac Arrhythmias

Posted on October 30, 2017 From HealthCM 

Hunan Hengyang Traditional Chinese Medicine Hospital researchers find acupuncture combined with herbal medicine more effective than calcium channel blockers and beta-blockers for the treatment of cardiac arrhythmias. Results were confirmed by ECG (electrocardiogram). Patients receiving only pharmaceutical medications in one group and acupuncture plus herbs in another group were compared in a four week clinical trial. Twenty-four hour ECG tests confirm that acupuncture plus herbs produces superior patient medical outcomes. 


Traditional Chinese Medicine (TCM) scoring was used in addition to ECGs to confirm clinical efficacy. The TCM scoring system evaluated for key symptoms including heart palpitations, chest discomfort, shortness of breath, fatigue, and limb weakness. According to a four point scale (the more severe the symptom, the higher the score), patients were evaluated for improvements. Acupuncture plus herbs outscored drug therapy for the regulation of arrhythmias. Based on the results of ECGs and TCM scoring, the treatment efficacy for each patient was categorized into 1 of 4 tiers as detailed:

  • Clinical recovery: Complete recovery of symptoms, no abnormalities detected in ECG.
  • Significantly effective: Symptoms mostly remedied or under control, ECG showed significant reduction in arrhythmia frequency.
  • Effective: ECG showed ≥50% reduction in arrhythmia frequency, with a ≥50% reduction in duration for each abnormality.
  • Not effective: No significant reduction of arrhythmias, or worsening of condition.

Based on the data, the acupuncture plus herbs group had a 95.3% total effective rate, outscoring the drug therapy group by 15.3%. The drug group scored 80%. Both approaches to patient care were significantly effective. However, one advantage to acupuncture plus herbal medicine is a dramatically lower adverse effect rate. 


Another advantage applies to patients that may be taking medications for secondary conditions. For these patients, arrhythmia medications pose contraindication issues with their medication regimen.Looking at the data, the acupuncture plus herbs group and the drug group had similar TCM scores prior to the clinical trial. The acupuncture plus herbs treatment group had a score of 11.5 ± 2.3 and the control group had an 11.8 ± 2.4 score. Essentially, there were equivalent patient samples at the initiation of the investigation. After treatment, the scores varied enormously. 


The acupuncture plus herbs group had a 3.8 ± 1.4 score and the drug group had a 6.2 ± 2.1 score. The acupuncture plus herbs group outperformed drugs by 2.4 TCM score points. Keeping in mind that lower numbers reflect improvements in heart palpitations, chest discomfort, shortness of breath, fatigue, and limb weakness results, the quality of life improved more greatly for the acupuncture plus herbs group than the drug group. 


The ECG results tell an important story. There is a bias in commonly accepted conventional wisdom that drugs are more potent and effective than holistic therapies such as acupuncture and herbal medicine. The ECG numbers indicate that acupuncture plus herbs is significantly more effective for the regulation of arrhythmias than medications, bucking the myth that drugs are somehow a more bona fide and successful treatment option. 


The ECG results demonstrate that acupuncture plus herbs is a responsible rout for arrhythmia treatment protocols. The drug group and the acupuncture plus herbs group started with similar ECG mean 24-hour arrhythmia frequency scores prior to the investigation (1405.4 arrhythmias in 24 hours and 1378.4 respectively). After the four week treatment program, the ECG results for the acupuncture group were 328.4. The drug group also improved, albeit with a lower positive patient outcome: 451.5.The study design was straightforward. 


A total of 90 patients from Hunan Hengyang Traditional Chinese Medicine Hospital were treated and evaluated in the study. The patients were diagnosed with arrhythmias between January 2013 and December 2013. They were randomly divided into the acupuncture plus herbs and drug groups, with 45 patients in each group. All patients had confirmed diagnoses of cardiac arrhythmias. Patient were excluded from the clinical trial if they had the following conditions: severe internal medicine diseases, mental illness, tachycardia due to blood loss, fever, and hyperthyroidism. Pregnant and nursing women were also excluded from the study. The primary acupoints selected for the acupuncture plus herbs treatment group were the following:

  • Shenmen (HT7)
  • Neiguan (PC6)
  • Shanzhong (CV17)
  • Guanyuan (CV4)
  • Zusanli (ST36)
  • Qihai (CV6)

Secondary acupoints were selected based on TCM differential diagnostics. For qi deficiency in the heart and gallbladder, the following acupoints were added:

  • Xinshu (BL15)
  • Danshu (BL19)

For weakness of heart and spleen qi and blood, the following acupoints were added:

  • Xinshu (BL15)
  • Pishu (BL20)

For yin deficiency with heat excess, the following acupoints were added:

  • Shenshu (BL23)
  • Taixi (KD3)

One standard acupuncture session was conducted daily. After 6 consecutive days of treatment, a break day was observed. For TCM herbal treatment, a decoction was brewed and administered based on the Xiaoyaosan herbal formula, for oral ingestion. All decoctions contained the following herbs:

  • Chai Hu (15 g)
  • Dang Gui (10 g)
  • Bai Shao (15 g)
  • Bai Zhu (10 g)
  • Fu Ling (10 g)
  • Bo He (5 g)
  • Zhi Gan Cao (15 g)
  • Sheng Di Huang(30 g)
  • He Huan Pi (10 g)
  • Yuan Zhi (10 g)
  • Sheng Jiang (10 g)
  • Da Zao (10 g)

For patients experiencing headaches, the following herbs were added:

  • Chuan Xiong (10 g)
  • Huang Qin (10 g)

For irritability, the following herbs were added:

  • Mu Dan Pi (10 g)
  • Zhi Zi (10 g)

For belching and sour taste, the following herbs were added:

  • Chuan Lian Zi (10 g)
  • Yan Hu Suo (10 g)

The decoction was consumed when warm, once in the morning and once at night. For the drug therapy groups, standard protocols were observed for calcium channel blocker and beta-blocker administration. The TCM score and ECG results indicate that acupuncture plus herbs is an effective treatment option, outscoring two types of drugs.Early documentation of arrhythmias into the canons of TCM exists in the Huangdi Neijing Suwen-Ju Tong Lun; the principle of unblocking liver qi stagnation to soothe the heart was introduced. 


Many scholars date the work to approximately 200 BCE, between the late Warring States period and the emergence of the Han dynasty. The Hunan Hengyang Traditional Chinese Medicine Hospital researchers tested the liver qi stagnation principle with the scientific method using the herbal formula Xiao Yao San (used to regulate liver qi) and acupuncture. The results support the ancient principle that freeing the liver qi benefits the heart.In related research, Changchun Traditional Chinese Medicine Hospital researchers document that acupuncture plus herbs outperforms medications for the treatment of premature ventricular contractions (PVCs). 


A total of 72 patients from Changchun TCM Hospital were treated and evaluated in the study. The patients were aged between 19 – 85, with a PVC history between 1 – 20 years. Patients were randomly divided into an acupuncture plus herbs treatment group and a drug control group, with 36 patients in each group. The treatment group was given acupuncture, an herbal medicine decoction, and an intravenous injection of TCM herbs. The control group received conventional medication. The primary acupoints selected for the treatment group were the following:

  • Shenmen (HT7)
  • Neiguan (PC6)
  • Xinshu (BL15)
  • Jueyinshu (BL14)

For qi deficiency, the following secondary acupoints were added:

  • Pishu (BL20)
  • Zusanli (ST36)
  • Qihai (CV6)

With the patients resting in a supine position, acupuncture was administered by manipulating each needle with the Ping Bu Ping Xie (tonify/attenuate) technique after insertion, until a deqi sensation was perceived. Thereafter, a 20 – 30 minute needle retention time was observed. One acupuncture session was conducted daily. The following auricular acupoints were selected for ear acupuncture:

  • Xuexin
  • Jiaogan
  • Shenmen
  • Pizhixia
  • Gan
  • Neifenmi
  • Sanjiao
  • Shen

A total of 3 – 4 auricular acupoints were pierced with moderate force during one ear acupuncture session. Needles were retained for 30 – 40 minutes. During needle retention, each needle was rotated rapidly 3 – 4 times. One ear acupuncture session was conducted daily. For TCM herbal treatment, different brews and ready-made formulas were administered to each patient, based on differential diagnostics. For deficiency of qi and yin, a modified Shengmaisan decoction and Wenxinkeli pills were administered. The decoction was comprised of the following herbs:

  • Shengshaishen
  • Maimendong
  • Wuweizi
  • Huangjing
  • Baihe
  • Tianmendong
  • Yuanzhi
  • Shichangpu
  • Longchi
  • Zhigancao

For weak heart and spleen qi and blood, a modified Guipitang decoction and ready-made Guipiwan pills were administered. The decoction was comprised of the following herbs:

  • Dangshen
  • Huangqi
  • Danggui
  • Longyanrou
  • Baizhu
  • Fushen
  • Yuanzhi
  • Fuxiaomai
  • Zhigancao

For deficiency of yin and yang, a modified Zhigancao decoction was administered, comprised of the following herbs:

  • Zhigancao
  • Xiyangshen
  • Maidong
  • Wuweizi
  • Guizhi
  • Danggui
  • Huangqi
  • Yuanhu
  • Gansong
  • Chaozaoren

For stasis of phlegm and blood, a modified combination decoction of Erchentang and Taohongsiwutang was administered:

  • Chenpi
  • Banxia
  • Fuling
  • Taoren
  • Honghua
  • Shengdi
  • Chuanxiong
  • Danggui
  • Chishao
  • Gualou

For stasis of blood and qi, a modified Xuefuzhuyutang decoction was administered:

  • Chaihu
  • Danggui
  • Shengdi
  • Niuxi
  • Jiegeng
  • Shaoyao
  • Taoren
  • Honghua
  • Chuanxiong
  • Danshen

For heart fire caused by hot phlegm, a modified Huanglianwendantang decoction was administered:

  • Huanglian
  • Banxia
  • Chenpi
  • Fuling
  • Zhishi
  • Yuanzhi
  • Shichangpu
  • Quangualou
  • Dannanxing

The following intravenous infusions were administered according to differential diagnostics:

  • Shenfu IV infusion
  • Shengmai IV infusion
  • Chuanxiong IV infusion
  • Fufangdanshen IV infusion
  • Honghua IV infusion

For the control group, betaloc tablets (23.75 mg) were administered twice per day. Metoprolol is an active ingredient in betaloc, a beta-blocker. Other medications were prescribed according to individual diagnostics, including antianginal and anticoagulant drugs.For both groups, the entire treatment course was 4 weeks. Patients were evaluated pre-treatment and post-treatment. The treatment efficacy for each patient was categorized into 1 of 4 tiers as detailed:

  • Significantly effective: Significant improvement in clinical symptoms. ≥70% reduction in TCM symptom score. Complete absence or occasional occurrence of PVC.
  • Effective: Improvement in clinical symptoms. ≥30% reduction in TCM symptom score. ≥60% reduction in PVC occurrence.
  • Not effective: No significant improvement, or worsening of clinical symptoms. <30% reduction in TCM symptom score. <60% reduction in PVC occurrence.

The total treatment effective rate of acupuncture and herbal TCM treatment was 94.5% and drug therapy produced an 86.1% total treatment effective rate. The results indicate that acupuncture plus herbs is effective for the treatment of PVCs. 


References:
Wei B. TCM Treatment of Arrhythmia 96 Clinical Cases[J]. Guangming TCM,2011,26(3): 565-566.


Zheng XY. TCM New Medicine Clinical Research Guidelines (Pilot)[M]. Beijing China Medical Technology Publishing House,2002.68.


Wang WN, Ding BY. TCM Treatment of Arrhythmia Clinical Research Advancement [J]. Yatai Traditional Medicine,2009,5(9):159-160.


Tan YJ. Modified Zhigancao Formula Treatment Efficacy for Heart Palpitations 58 cases [J]. China Medicine Guide,2010,8(5):77-78.


Yang NN, Zhou SH. Warm Acupuncture Treatment of Heart Palpitations Belonging to Deficiency of Heart-yang 40 Cases [J].Jiangxi TCM,2013,44(5):47-48


Zhou QW. Acupuncture in Treating PVC [J]. Xiaxi TCM,2003,24(2):11.


Yang ZM. Study of Acupuncture and Moxibustion Methods [M]. Shanghai: Shanghai Scientific Technology Publishing House, 1996.  

UC Irvine – Acupuncture Reduces Hypertension Confirmed

Posted on September 26, 2017 From HealthCMI 

University of California School of Medicine researchers have proven that acupuncture lowers blood pressure in subjects with hypertension. [1] The depth and breadth of the research extends across multiple university controlled studies. 


The investigations also reveal how acupuncture works; the biological mechanisms stimulated by acupuncture are no longer a mystery. The University of California School of Medicine, Irvine, researchers determined several key items. Acupuncture produces long-lasting lowering of blood pressure in subjects with hypertension. Acupuncture regulates sympathetic nervous system responses resulting in lower blood pressure in cardiovascular related centers of the brain and “specific neurotransmitter systems.” 


[2] In addition, their cross-over double blinded research identifies specific acupuncture points and procedures that are especially effective for lowering blood pressure.The researchers note that electroacupuncture is effective “at two sets of standardized acupoints known to provide input to brain stem regions that regulate sympathetic outflow lowers blood pressure….” [3] They highlight three key points. First, electroacupuncture that is administered once per week in 30 minute acupuncture sessions over a period of 8 weeks is effective for lowering blood pressure in patients with hypertension. [4] Second, results are observed by the second week of acupuncture therapy and last for 4–6 weeks if no follow-up treatment is administered after completion of the 8 weeks of acupuncture therapy. [5] Third, monthly acupuncture maintenance treatments maintain the healthy low blood pressure for at least 6 months. 


[6]The University of California School of Medicine researchers find electroacupuncture a mediator of the autonomic nervous system. Plasma norepinephrine and renin-aldosterone measurements indicate that electroacupuncture lowers blood pressure by downregulating sympathetic nervous system outflows.


 [7] This mechanism resulted in a lowering of both systolic and diastolic blood pressure in subjects with hypertension. Furthermore, the researchers successfully differentiated acupuncture points that were effective from those that were not. 


Acupuncture Points
Electroacupuncture applied to PC5 (Jianshi)–PC6 (Neiguan) and ST36 (Zusanli)–ST37 (Shangjuxu) was found effective for lowering blood pressure. Electroacupuncture applied to LI6 (Pianli)–LI7 (Wenliu) and GB37 (Guangming)–GB39 (Xuanzhong, Juegu) was ineffective. Using 24/7 ambulatory blood pressure monitoring equipment, electroacupuncture applied to PC5–PC6 and ST36–ST37 was effective for reducing peak and average systolic and diastolic blood pressure. [8] The results were published in the
Journal of Intensive and Critical Care. Point Specificity


A closer look reveals extensive prior research by University of California School of Medicine researchers. One investigation demonstrates that electroacupuncture applied to PC5–PC6 produces “point-specific effects on cardiovascular reflex responses.” [9] The researchers add that sympathetic cardiovascular rostral ventral lateral medulla neurons that respond to both visceral (reflex) and electroacupuncture nerve stimulation “manifest graded responses during stimulation of specific acupoints.” 


[10]The researchers conclude that electroacupuncture "demonstrates a range of cardiovascular responses" and the levels of "visceral reflex pressor responses are influenced by the anatomic location of somatic nerves beneath the acupoints." [11] They identified specific responses; "deep nerves exerting strong influence and superficial cutaneous nerves demonstrating little or no attenuation of cardiovascular reflex responses." 


[12] The acupuncture continuing education results were published in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology.Another investigation by the University of California researchers was published in Autonomic Neuroscience. The research identifies specific regions of the brain regulated by acupuncture. Based on the findings, they conclude that electroacupuncture “suppresses elevated blood pressure (BP) by activating the arcuate nucleus, ventrolateral periaqueductal gray (vlPAG), and inhibiting cardiovascular sympathetic neurons in the rostral ventrolateral medulla.” 


[13] The research documents that “a reciprocal excitatory glutamatergic neural circuit between the arcuate and vlPAG contributes to long-lasting EA [electroacupuncture] cardiovascular inhibition.” [14] Glutamatergic biochemicals regulate the excitatory amino acid system throughout the body and brain. Endocannabinoids and Serotonin


In another investigation, the researchers mapped the effects of electroacupuncture on endocannabinoids and the cardiovascular system. The researchers determined that a “long-loop pathway, involving the hypothalamic arcuate nucleus (ARC), ventrolateral periaqueductal gray (vlPAG), and the rostral ventrolateral medulla (rVLM), is essential in electroacupuncture (EA) attenuation of sympathoexcitatory cardiovascular reflex responses.” 


[15] They note that electroacupuncture “releases endocannabinoids and activates presynaptic CB1 receptors to inhibit GABA release in the vlPAG. Reduction of GABA release disinhibits vlPAG cells, which, in turn, modulate the activity of rVLM neurons to attenuate the sympathoexcitatory reflex responses.” 


[16]University of California researchers completed another study mapping the effects of electroacupuncture on serotonin. They determined that electroacupuncture applied to PC5–PC6 “activate serotonin (5-HT)-containing neurons in the nucleus raphe pallidus (NRP).” [17] They note that “activation of the NRP, through a mechanism involving serotonergic neurons and 5-HT (1A) receptors in the rVLM during somatic stimulation with EA [electroacupuncture], attenuates sympathoexcitatory cardiovascular reflexes."


[18] In another study, the researchers document additional pathways. They conclude that the arcuate nucleus is required for prolonged suppression of reflex cardiovascular excitatory responses by electroacupuncture. [19] In the rostral ventrolateral medulla, opioids and GABA (γ-aminobutyric acid) are active in long-term electroacupuncture inhibition of sympathoexcitatory cardiovascular responses. [20] High and Low Frequency Electroacupuncture


In another investigation, the researchers discovered that manual acupuncture and electroacupuncture produce similar results at PC5 and PC6. The researchers conclude that “there is little difference between low-frequency EA [electroacupuncture] and MA [manual acupuncture] at P 5–6. Furthermore, simultaneous stimulation using two acupoints that independently exert strong effects did not lead to an additive or a facilitative interaction.” 


[21] Low frequency acupuncture proved more effective than higher frequencies. Two Hz electroacupuncture “activated more somatic afferents than” 10 or 20 Hz electroacupuncture. [22] The researchers add that the “similarity of the responses to EA and MA and the lack of cardiovascular response to high-frequency EA appear to be largely a function of somatic afferent responses.” 


[23]The above-mentioned studies are only a fraction of the published research on acupuncture and its mediation of cardiovascular and cortical activity. Important is that there is both clinical and laboratory research that is blinded, randomized, and sham controlled. The findings determine efficacy rates for specific acupuncture points for specific conditions and the biological mechanisms responsible for positive patient outcomes. 


The University of California School of Medicine, Irvine, (UCI) researchers provide us with great insight into the active mechanisms involved in acupuncture treatments. Susan and Henry Samueli College of Health Sciences The quality and level of research produced at UCI brings exacting rigor to the scientific investigation of acupuncture.


In related news, the College of Health Sciences at UCI received a $200 million gift for the purposes of exploring and supporting interdisciplinary integrative health. This is one of the largest donations ever granted to a public university.The integrative health center, devoted to teaching and patient care, is named after its donors: The Susan and Henry Samueli College of Health Sciences. The goal of the center is to promote health, based on scientific evidence. This includes redefining the practitioner-patient relationship and a holistic approach to lifestyle, preventative measures, and healthcare disciplines. 


This complements the efforts of the existing Susan Samueli Integrative Health Institute, which focuses on research, education, service, and community.At the Healthcare Medicine Institute, we support and promote appropriate medicine, defined as medicine that is both safe and effective. The Susan and Henry Samueli College of Health Sciences and the Susan Samueli Integrative Health Institute adhere to this principle by identifying and supporting treatment options based on positive patient outcome rates. 


Fundamental to implementation of healthcare is the identification of optimal approaches to individual and community based medicine. We look forward to additional clinical and laboratory research that ultimately yields healthier outcomes.What we are seeing is a fundamental shift in awareness. 


Modern research now widens treatment options to those once considered outside the norm of scientific medicine. Acupuncture now gains acceptance, along with many other forms of holistic medicine, as scientific investigations map mechanisms of action and document rates of effectiveness. This understanding ultimately contributes to the humanitarian relief of suffering. 


Notes
1. Tjen-A-Looi, Stephanie C. "Reduction of Blood Pressure by Electro Acupuncture in Mild to Moderate Hypertensive Patients: Randomized Controlled Trial." Journal of Intensive and Critical Care 3, no. 1 (2017): 2, pg.1.
2. Ibid.
3. Ibid.
4. Ibid.
5. Ibid.
6. Ibid.
7. Ibid, 2.
8. Ibid, 1.
9. Tjen-A-Looi SC, Li P, Longhurst JC (2004) Medullary substrate and differential cardiovascular responses during stimulation of specific acupoints. Am J Physiol Regul Integr Comp Physiol 287: R852-R862.
10. Ibid.
11. Ibid.
12. Ibid.
13. Li P, Tjen-A-Looi SC, Guo ZL, Longhurst JC (2010) An arcuateventrolateral periaqueductal gray reciprocal circuit participates in electro acupuncture cardiovascular inhibition. Auton Neurosci 158: 13-23.
14. Ibid.
15. Tjen-A-Looi SC, Li P, Longhurst JC (2009) Processing cardiovascular information in the vlPAG during electroacupuncture in rats: roles of endocannabinoids and GABA. J Appl Physiol 106: 1793-1799.
16. Ibid.
17. Moazzami A, Tjen-A-Looi SC, Guo ZL, Longhurst JC (2010) Serotonergic projection from nucleus raphe pallidus to rostral ventrolateral medulla modulates cardiovascular reflex responses during acupuncture. J Appl Physiol 108: 1336-1346.
18. Ibid.
19. Tjen-A-Looi SC, Li P, Longhurst JC (2007) Role of medullary GABA, opioids and nociceptin in prolonged inhibition of cardiovascular sympathoexcitatory reflexes during electro acupuncture in cats. Am J Physiol Heart Circ Physiol 293: H3627-H3635.
20. Ibid.
21. Zhou W, Fu LW, Tjen-A-Looi SC, Li P, Longhurst JC (2005) Afferent mechanisms underlying stimulation modality-related modulation of acupuncture-related cardiovascular responses. J Appl Physiol 98: 872-880.
22. Ibid.
23. Ibid. 

Acupuncture Plus Herbs Beats Acid Reflux Drug

Posted on August  6, 2017 From HealthCMI

Acupuncture plus herbal medicine outperforms omeprazole (Prilosec, Zegerid) for the treatment of acid reflux. Often referred to as gastroesophageal reflux disease, GERD, or reflux esophagitis, acid reflux occurs when stomach acid reverses direction and enters the esophagus, causing inflammation, heartburn (burning pain), regurgitation of acid into the throat or mouth, nausea, or bloating. Acupuncture plus herbs was more effective than drug therapy in both the short and long-term. In addition, acupuncture plus herbal medicine had a lower relapse rate. 

 

In research conducted at the Hebei Provincial Hospital of Traditional Chinese Medicine, acupuncture plus herbs produced an 89.7% total effective rate, using only herbal medicine produced an 82.1% total effective rate, and drug therapy using omeprazole (a proton pump inhibitor) produced an 82.8% total effective rate. The results were measured with gastroscopy (esophagogastroduodenoscopy) and Reflux Disease Questionnaire (RDQ) scoring at the completion of all medical treatments. 

Another set of measurements were made in a 6 month follow-up for all patients in the study. The results indicate that acupuncture plus herbs has a lower relapse rate than drug therapy. Acupuncture plus herbs had a 21.7% relapse rate, using only herbs produced a 35.0% relapse rate, and omeprazole drug therapy had a 45.5% relapse rate. The data indicates that acupuncture and herbal medicine have significantly longer lasting results than drug therapy for the treatment of acid reflux.

 

Chinese Medicine Theory

The results are attributable, according to Traditional Chinese Medicine (TCM) theory, to the basic principles involved in the acupuncture point prescription and herbal formula selection. Both selections treat the root cause of the disorder and the symptom. A basic approach to TCM therapy, a percentage of each therapy focuses on symptomatic relief and another percentage treats the underlying root cause of the disease. In this research review, we will take a look at the acupuncture point selection and herbal medicine prescription responsible for obtaining the high positive patient outcome rates. TCM principles specify that reflux esophagitis is often due to dysfunction of the stomach, liver, and spleen. TCM principles also notate that emotional swings or dietary irregularities weaken the liver’s ability to govern the free coursing of qi, impairs the spleen’s ability to transport and transform water and grain, and damages the stomach’s ability to maintain the balance of upward and downward bearing qi. Water and grain (i.e., food) in the stomach fail to be transformed into essence and instead turn into toxic masses. If the downward flow of qi in the stomach is disturbed, it pathologically ascends. As a result, the stomach contents backflow into the esophagus. Reflux esophagitis in TCM focuses on transforming turbidity, harmonizing the stomach, and restoring the downward bearing of stomach qi to prevent counterflow. This focus restores normal functioning of the lower esophageal sphincter (LES), enhances gastric motility, and improves gastric emptying. 

 

Dietary Instructions

All three groups (i.e., acupuncture plus herbs, herbs only, drugs only) received treatment for 8 consecutive weeks. All groups received identical instructions prior to beginning the clinical trial. Patients were advised to adhere to a bland diet and to avoid spicy, rich, and high-fat foods. They were asked not to lie down right after eating and not to eat 2–3 hours before bedtime. Patients were also advised to raise the height of their pillows by 10–20 cm. Objective and subjective assessments were made after completion of therapy and in a 6 month follow-up examination.  

Patient Breakdown

A total of 86 patients with reflux esophagitis were treated and evaluated in this study. The patients were diagnosed with reflux esophagitis between January 2014 and June 2015. They were randomly divided into an acupuncture plus herbs group, an herbal medicine group, and a drug group with 29, 28, and 29 patients in each group respectively. The acupuncture plus herbs and herbs only group received identical herbal medicines (Huazhuo Jiedu Jiangni Tang). For the drug group patients, two 20 mg omeprazole sustained release capsules were given to the patients daily, one after breakfast and one after dinner. The statistical breakdown for each randomized group was as follows. The average age in the acupuncture plus herb group was 25 (±3) years. The average course of disease in the acupuncture plus herb group was 3.6 (±1.5) years. The average age in the herb group was 22 (±3) years. The average course of disease in the herb group was 3.6 (±1.6) years. The average age in the drug group was 23 (±3) years. The average course of disease in the drug group was 3.6 (±1.5) years. There were no significant statistical differences in terms of age, gender, and course of disease relevant to patient outcome measures. 

 

Acupuncture Sessions


Peer review by Healthcare Medicine Institute licensed acupuncturists finds the acupuncture treatment protocol selected by the researchers consistent with standard TCM primary acupuncture point prescriptions. No use of proprietary or off channel acupuncture points were added to the acupuncture point prescription. The main difference between the acupuncture points received by all patients in the study versus those received by patients in a standard acupuncture clinical session is that the acupoint prescription was identical for all patients and not based on differential diagnostic considerations. 

 

Acupuncture treatments commenced with patients in a lateral position on the right side. After disinfection of the acupoint sites, a 0.35 mm x 50 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. For Ganshu and Danshu, the needles were inserted perpendicular-obliquely towards the direction of the spine, up to a depth of 15 mm. For Neiguan, Zusanli, Zhongwan, and Taichong, the needles were inserted perpendicularly, to a depth of 10–30 mm. For all acupoints, a deqi sensation was obtained and the needles were manually stimulated with the Ping Bu Ping Xie (attenuating and tonifying) manipulation techniques every 10 minutes during the 30 minute needle retention times. Acupuncture sessions were administered once per day.

Acupuncture point Zusanli was selected to promote spleen and stomach health and to benefit the functioning of the lower esophageal sphincter (LES), enhance the frequency of gastric motility, and improve gastric emptying. Zhongwan was chosen to accelerate qi and blood circulation and to promote the transformation of turbidity. Zhongwan enhances fluid and blood flow at the fundus of the stomach, inhibits acid secretion, and benefits gastric mucosa. Taichong, Ganshu, and Danshu regulate the liver and bladder and relieve stomach distention and qi counterflow. Neiguan regulates qi flow and alleviates vomiting.


The researchers note that the ingredients help the body to transform turbidity, remove toxicity, and promote the downward movement of qi and prevent counterflow rebellious qi. The herbal formula was decocted and brewed once per day. Patients consumed 300 ml of the decoction, twice per day, 2 hours after breakfast and dinner. After treatment completion for patients in all three study groups, the treatment efficacy for each patient was categorized into 1 of 4 tiers: 

  • Recovery: Absence of symptoms. 
  • Significantly effective: Significant absence of symptoms. 
  • Effective: Symptoms showed improvement.
  • Not effective: Symptoms showed no visible improvement.  

Patients were evaluated before and after the treatment course. Both subjective and objective instruments were used to measure patient outcomes. All patients took the Reflux Disease Questionnaire (RDQ) before and after their treatments. RDQ is an instrument that measures treatment responses for reflux esophagitis patients. Next, gastroscopy was conducted and the condition of the esophageal mucosa was scored according to the Consensus on the Treatment of Gastroesophageal Reflux Disease in China with Both Traditional Chinese Medicine and Western Medicine (2010). All three groups demonstrated significant improvements in RDQ scores and gastroscopy examination scores. Compared with the herbs group and the drug group, the acupuncture plus herbs group produced better RDQ scores. Statistical analyses of outcomes demonstrates that the acupuncture plus herbs group had the greatest rate of positive patient outcomes. The researchers conducted follow-up examinations 6 months after treatment completion. They found that the recurrence rate of reflux esophagitis in the acupuncture plus herbs group was 21.7%. The recurrence rate of reflux esophagitis in the herbs treatment group was 35.0%. The recurrence rate of reflux esophagitis in the drug group was 45.5%. The results indicate that acupuncture with herbs is more effective than herbs as a standalone therapy or administration of the proton pump inhibitor drug. The study mentioned in this report demonstrates that acupuncture is safe and effective for the treatment of reflux esophagitis. Important features of TCM protocols is that they produce a high total effective rate, low relapse rate, and no significant adverse effects.   


Reference:Zhang W, Li BL, Sun JH, Wang ZK, Zhang NN, Shi F, Pei L. Therapeutic Effects of The Integrated Acupuncture and Chinese Herbal Medicine on Reflux Esophagitis [J]. Chinese Acupuncture and Moxibustion, 2017, Vol37, No.7.