Recent Medline Abstracts on Acupuncture

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Hi All,

 

See these.

 

Phil

 

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Zhou W, Fu LW, Tjen-A-Looi SC, Li P, Longhurst JC. Afferent

Mechanisms Underlying Stimulation Modality-Related Modulation

of AP-Related Cardiovascular Responses. J Appl Physiol. 2004

Nov 5; [Epub ahead of print] Coll of Med, Univ of California, Irvine,

Irvine, CA, USA. Despite the use of AP to treat a number of heart

diseases, little is known about the mechanisms that underlie its

actions. Therefore, we examined the influence of AP on

sympathoexcitatory cardiovascular responses to gastric distension

in anesthetized Sprague-Dawley rats. Thirty min of low frequency,

low current (1-2 mA, 2 Hz) electroAP (EA), at PC05-PC06, ST36-

ST37 and HT06-HT07 overlying the median, deep peroneal nerve

and ulnar nerves significantly decreased reflex pressor responses

by 40, 39 and 44%, respectively. In contrast, sham AP involving

needle insertion without stimulation at PC05-PC06 or 30 min of EA

at LI06-LI07 acupoints overlying the superficial radial nerve did not

attenuate the reflex. Similarly, EA at PC05-PC06 using 40 or 100

Hz stimulation frequencies did not inhibit the reflex. Compared to

EA at PC05-PC06, EA at two sets of acupoints including PC05-

PC06 and ST36-ST37did not lead to larger inhibition of the reflex.

Two min of manual AP (MA, 2 Hz) at PC05-PC06 every 10 min for

30 min inhibited the reflex cardiovascular pressor response by

33%, a value not significantly different than 2 Hz EA at PC05-

PC06. Single unit afferent activity was not different between

electrical and manual stimulation. However, 2 Hz electrical

stimulation (ES) activated more somatic afferents than 10 or 20 Hz

ES. These data suggest that, although the location of acupoint

stimulation and the frequency of stimulation determine the extent of

influence of EA, there is little difference between low frequency

electro- and manual AP at PC05-PC06. Furthermore simultaneous

stimulation using two acupoints that independently exert strong

effects did not lead to an additive or a facilitative interaction. 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. PMID: 15531558

[PubMed - as supplied by publisher]

 

Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith CM, Ellis

N, Fisher P, Van Haselen R, Wonderling D, Grieve R. AP of

chronic headache disorders in primary care: randomised controlled

trial and economic analysis. Health Technol Assess. 2004

Nov;8(48):1-50. Integrative Medicine Service, Biostatistics Service,

Memorial Sloan-Kettering Cancer Center, New York, USA.

OBJECTIVES: To determine the effects of a policy of using AP,

compared with a policy of avoiding AP, on headache in primary

care patients with chronic headache disorders. The effects of AP

on medication use, quality of life, resource use and days off sick in

this population and the cost-effectiveness of AP were also

examined. DESIGN: Randomised, controlled trial. SETTING:

General practices in England and Wales. PARTICIPANTS: The

study included 401 patients with chronic headache disorder,

predominantly migraine. INTERVENTIONS: Patients were randomly

allocated to receive up to 12 AP treatments over 3 months or to a

control intervention offering usual care. MAIN OUTCOME

MEASURES: Outcome measures included headache score;

assessment of Short Form 36 (SF-36) health status and use of

medication at baseline, 3 months and 12 months; assessment of

use of resources every 3 months; and assessment of incremental

cost per quality-adjusted life-year (QALY) gained. RESULTS:

Headache score at 12 months, the primary end-point, was lower in

the AP group than in controls. The adjusted difference between

means was 4.6. This result was robust to sensitivity analysis

incorporating imputation for missing data. Patients in the AP group

experienced the equivalent of 22 fewer days of headache per year.

SF-36 data favoured AP, although differences reached significance

only for physical role functioning, energy and change in health.

Compared with controls, patients randomised to AP used 15% less

medication, made 25% fewer visits to GPs and took 15% fewer

days off sick. Total costs during the 1-year period of the study were

on average higher for the AP group than for controls because of the

AP practitioners' costs. The mean health gain from AP during the

year of the trial was 0.021 QALYs, leading to a base-case estimate

of GBP9180 per QALY gained. This result was robust to sensitivity

analysis. Cost per QALY dropped substantially when the analysis

incorporated likely QALY differences for the years after the trial.

CONCLUSIONS: The study suggests that AP leads to persisting,

clinically relevant benefits for primary care patients with chronic

headache, particularly migraine. It is relatively cost-effective

compared with a number of other interventions provided by the

NHS. Further studies could examine the duration of AP effects

beyond 1 year and the relative benefit to patients with migraine with

compared to tension-type headache. Trials are also warranted

examining the effectiveness and cost-effectiveness of AP in

patients with headache receiving more aggressive pharmacological

management. PMID: 15527670 [PubMed - in process]

 

Linde K. [should AP be reimbursed? Three AP programmes of

German Statutory Health Insurance Funds (SHI) and their scientific

evaluation - Article in German] Z Arztl Fortbild Qualitatssich. 2004

Sep;98(6):467-8. Zentrum fur naturheilkundliche Forschung, II.

Medizinische Klinik und Poliklinik, Technische Universitat

Munchen. Klaus.Linde An estimated 40,000

physicians offer AP treatment to patients in Germany. Due to a

decision of the German Federal Committee of SHI-accredited

Physicians and Health Insurance Funds, AP treatment for chronic

low back pain, headache and osteoarthritic pain may be

reimbursed from 2000 onwards if patients and physicians

participate in specific scientifically evaluated model projects of the

Statutory Health Insurance Funds. Currently, three separate AP

programmes are offered by different Statutory Health Insurance

Funds. The scientific evaluation of all these programmes includes

both randomised trials (comparing AP to no treatment, sham AP or

standard treatment in 300 to several thousands of patients) and

large cohort studies. Details of the three programmes will be

presented in the following chapters. PMID: 15527186 [PubMed - in

process]

 

Hayashi M, Sakakura E, Horikawa N, Katakura Y, Kishi R. [Health

status and socioeconomic factors related to home remedy

practices among elderly subjects living in a community in Okinawa -

Article in Japanese]. Nippon Koshu Eisei Zasshi. 2004

Sep;51(9):774-89. Dept of Public Health, Graduate School of

Medicine, Hokkaido Univ. OBJECTIVE: The purpose of the present

study was to clarify health status and socioeconomic

characteristics of elderly persons who practice home remedies as

complementary alternative medicine. Whether such usage is

associated with health-related factors was also assessed.

METHODS: The subjects are 243 independent elderly living at

home in A-village of Okinawa prefecture, aged 65 years or older. A

self-administered questionnaire was mailed to all subjects in 2001.

Included were questions on socioeconomic indicators, health

status, IADL, health habits, social network, social support and

home remedy practices. All data were statistically analyzed by

Student's t test and the chi-square test. In addition logistic

regression was used to calculate the odds ratios for current

practitioners for each of the factors. RESULTS: The present study

included 200 subjects who responded and completed all questions.

(Table 2). The main results are as follows: The practitioner rate for

home remedies was 50.8% in males and 71.9% in females, the

difference being significant (P<0.05). Usage was found to be

significantly related to hypertension (P<0.05), arthritis and

rheumatic disease (P<0.01), some health habits and provision

nursing of social support (OR = P<0.05). Logistic regression

analysis adjusted for age, gender, and income revealed current

practitioners of AP to have a significantly higher level of history of

hospital admission in the previous year (OR = 0.2 P<0.05), food

control habits (OR = 4.3 P<0.05) and provision nursing of social

support (OR = 4.2 P<0.05) than non-current practitioners.

CONCLUSION: The findings suggest that home remedy practices

are associated with health-related habit and provision of social

support for good quality of elderly life. The purpose is not only

physical care but also health maintenance and promotion. PMID:

15526761 [PubMed - in process]

 

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