Recent Medline abstracts on acupuncture

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Boralevi F. [What additional measures should be recommended in

atopic dermatitis in children? [Article in French] Ann Dermatol Venereol.

2005 Jan;132 Spec No 1:1S79-85. Unite de Dermatologie Pediatrique,

Hopital Pellegrin-Enfants, Place Amelie-Raba-Leon, F-33076 Bordeaux

Cedex. franck.boralevi The so-called 'adjuvant'

measures are an important part of atopic dermatitis (AD) consultations.

The practitioner is the 'expert' in the patients' eyes in prescribing,

proposing, counselling and replying to the questions concerning

moisturizers, thermal spring water cures, the resort to alternative

medical, and vaccinations. Moisturizers are aimed at rapidly restoring

water in the epidermis, decreasing the sensitivity to irritants and

improving the patients' comfort. The available products are usually

composed of water, occlusive agents, humidifiers, varyingly combined

with tensioactive agents, preservatives and perfumes... Their short term

efficacy has been demonstrated, but no study has shown superiority of

one product over another. The recommended treatment is 1 to 2 daily

applications of a cream or lotion, selected among the products having

demonstrated their efficacy, contained the least amount of irritant or

sensitizers, the presentation and cost of which is acceptable to the

patient. There are no arguments to recommend moisturizers in the

absence of xerosis, nor for prolonged periods of clinical remission.

Spring water thermal cures. In France there are many cure centres and

the spring waters used are distinguished by their clinical or physical

features. Although there are no studies that clearly establish their

efficacy in AD, the craze and satisfaction of many patients for spring

water thermal cures must be taken into consideration, as well as the

educational dimension, in the hopes that a consensus will be reached

and that regular assessments be made. Alternative medical practices,

such as homeopathy or acupuncture, represent a therapeutic alternative

chosen by more than one third of patients with AD. However, no study

has sufficiently demonstrated the interest of these alternatives and they

cannot therefore be integrated in the validated arsenal of treatments.

Used in various oriental countries, Chinese herbs have been the subject

of controlled studies with encouraging results. But the data available on

safety prompt greater care and do not promote the use of such products

in children. Vaccination of atopic children is a much debated subject

among the medical corps, although currently consensual attitude is

possible. In general, there is no reason to limit or delay the French

vaccination calendar of an atopic child. Notably vaccination with ROR

can be used routinely, even in those allergic to eggs. It is sometimes

logical to avoid vaccination during severe flares of eczema. In the case

of documented allergy to eggs, the flu and yellow fever vaccinations

should be avoided, except in exceptional cases when vaccination is

made in hospital settings. PMID: 15984298 [PubMed - in process]

 

Chang CH, Huang JL, Ting CT, Chang CS, Chen GH. Atropine-induced

HRV alteration is not amended by electroacupuncture on Zusanli. Am J

Chin Med. 2005;33(2):307-14. Institute of Food Science, National

Chung Hsing University, Taipei, Taiwan. changcs

Acupuncture is known to influence autonomic nervous activity.

Acupuncture on Zusanli points has been shown to enhance the

regularity of gastric myoelectrical activity and accelerate gastric

emptying, partly through the vagal pathway, in dogs. The aim of this

study was to evaluate whether atropine-induced autonomic nervous

alteration, measured by heart rate variability (HRV), could be amended

by electroacupuncture on Zusanli points. HRV measurements were

recorded in 15 healthy volunteers before, during and after

electroacupuncture. Each subject was studied for three sessions in a

randomized sequence, which included electroacupuncture on the

Zusanli (St 36) points with or without premedication of atropine and

placebo stimulation on a non-acupoint. The analysis of low frequency

(LF), high frequency (HF) and LF/HF ratios were compared between

different sessions. Serum levels of gastrin, motilin and pancreatic

polypeptide (PP) levels were also measured. There was an increase in

the LF/HF ratio (indicating increased sympathetic activity) during the

post-acupuncture period with 2 Hz of electrical stimulation on the

Zusanli acupoints. When IV atropine was used immediately before the

electroacupuncture, there was a decrease in the LF power and HF

power during the acupuncture and post-acupuncture periods. In

addition, there was a significant increase in the LF/HF ratio during the

acupuncture and post-acupuncture periods. There was a significant

decrease in serum PP in the post-acupuncture period after

premedication with IV atropine. In conclusion, atropine-induced HRV

change might be mediated via the vagal pathway. However, atropine-

induced HRV alteration is not amended by electroacupuncture on

Zusanli points. PMID: 15974489 [PubMed - in process]

 

Che-Yi C, Wen CY, Min-Tsung K, Chiu-Ching H. Acupuncture in

haemodialysis patients at the Quchi (LI11) acupoint for refractory

uraemic pruritus. Nephrol Dial Transplant. 2005 Jun 28; [Epub ahead of

print]. Division of Nephrology, Department of Medicine, China Medical

University Hospital, Taichung, Taiwan. BACKGROUND: Uraemic

pruritus is a common problem in end-stage renal failure patients.

Traditional therapies produce marginal or no results. Acupuncture has

been reported to be effective. The aim of this randomized, controlled

study was to validate a single acupoint for relieving uraemic pruritus.

METHODS: We randomized 40 patients with refractory uraemic pruritus

into two groups. In group 1 (n = 20), acupuncture was applied

unilaterally at the Quchi (LI11) acupoint thrice weekly for 1 month. In

group 2 (controls, n = 20), acupuncture was applied at a non-acupoint 2

cm lateral to Quchi (LI11) thrice weekly for 1 month. Subjects

responded to a pruritus score questionnaire given before and at the end

of the 1 month treatment and at a 3 months follow-up. The results of the

pruritus scores were analysed with the repeated measures general

linear model to examine the effect of acupuncture on pruritus scores.

RESULTS: In group 1, pruritus scores before and after acupuncture and

at the 3 month follow-up were 38.3+/-4.3, 17.3+/-5.5 and 16.5+/-4.9, and

in group 2 (controls) they were 38.3+/-4.3, 37.5+/-3.2 and 37.1+/-5,

respectively. Laboratory tests showed no significant differences between

the two groups. Pruritus scores were significantly lower after

acupuncture and at the 3 month follow-up, P<0.001. CONCLUSIONS:

Acupuncture at the Quchi (LI11) acupoint is an easy, safe and effective

means of relieving uraemic pruritus. PMID: 15985509 [PubMed - as

supplied by publisher]

 

Hahn EG, Brinkhaus B, Joos S, Lindner M, Kohnen R, Witt C, Willich

SN. Integration of Complementary and Alternative Medicine into

German Medical School Curricula - Contradictions between the

Opinions of Decision Makers and the Status Quo. Forsch

Komplementarmed Klass Naturheilkd. 2005 Jun;12(3):139-43. Epub

2005 Jun 23. Institut fur Sozialmedizin, Epidemiologie und

Gesundheitsokonomie, Charite - Universitatsmedizin - Berlin, Germany.

Introduction: There is a growing demand for complementary and

alternative medicine (CAM) in Western societies. This trend has lead to

the gradual integration of CAM courses into medical school curricula.

The aim of this study was to survey key decision makers at German

medical schools with regard to their views on CAM and to examine the

extent to which CAM has already been integrated in the German

medical school system. Materials and Methods: A questionnaire was

sent to 753 clinic and institute directors at German medical schools.

Results: A total of 500 questionnaires (66%) were returned. 39% of

respondents had a positive opinion of CAM, 27% had a neutral opinion

and 31% had a negative opinion. 3% of respondents were unsure. The

CAM therapies viewed most positively were osteopathy (52%),

acupuncture (48%), and naturopathy (41%). Most respondents were in

favor of integrating CAM into the medical system. However, a larger

percentage favored its use in research (61%) and teaching (59%) rather

than in the treatment of patients (58%). Only 191 respondents (38%)

indicated that CAM treatment methods had been integrated into the

curriculum of their respective medical schools. In these schools, CAM

was mainly used in patient treatment (35%), followed by research (22%)

and education (21%). Conclusions: Our data show that the majority of

respondents were in favor of integrating CAM into medical school

curricula. However, at the time of our survey, only a small percentage of

medical schools had actually put this into practice. The reasons for this

discrepancy are unclear and should be further investigated. PMID:

15985777 [PubMed - in process]

 

Kotani, Naoki M.D. *; Hashimoto, Hiroshi M.D. *; Sato, Yutaka M.D. +;

Sessler, Daniel I. M.D. ++; Yoshioka, Hideki M.D. ; Kitayama,

Masatou M.D. ; Yasuda, Tadanobu M.D. ; Matsuki, Akitomo M.D.

[//]. Preoperative Intradermal Acupuncture Reduces Postoperative Pain,

Nausea and Vomiting, Analgesic Requirement, and Sympathoadrenal

Responses. Anesthesiology. 95(2):349-356, August 2001. Abstract:

Background: In a controlled and double-blind study, the authors tested

the hypothesis that preoperative insertion of intradermal needles at

acupoints 2.5 cm from the spinal vertebrae (bladder meridian) provide

satisfactory postoperative analgesia. Methods: The authors enrolled

patients scheduled for elective upper and lower abdominal surgery.

Before anesthesia, patients undergoing each type of surgery were

randomly assigned to one of two groups: acupuncture (n = 50 and n =

39 for upper and lower abdominal surgery, respectively) or control (n =

48 and n = 38 for upper and lower abdominal surgery, respectively). In

the acupuncture group, intradermal needles were inserted to the left and

right of bladder meridian 18-24 and 20-26 in upper and lower abdominal

surgery before induction of anesthesia, respectively. Postoperative

analgesia was maintained with epidural morphine and bolus doses of

intravenous morphine. Consumption of intravenous morphine was

recorded. Incisional pain at rest and during coughing and deep visceral

pain were recorded during recovery and for 4 days thereafter on a four-

point verbal rating scale. We also evaluated time-dependent changes in

plasma concentrations of cortisol and catecholamines. Results: Starting

from the recovery room, intradermal acupuncture increased the fraction

of patients with good pain relief as compared with the control (P < 0.05).

Consumption of supplemental intravenous morphine was reduced 50%,

and the incidence of postoperative nausea was reduced 20-30% in the

acupuncture patients who had undergone either upper or lower

abdominal surgery (P < 0.01). Plasma cortisol and epinephrine

concentrations were reduced 30-50% in the acupuncture group during

recovery and on the first postoperative day (P < 0.01). Conclusion:

Preoperative insertion of intradermal needles reduces postoperative

pain, the analgesic requirement, and opioid-related side effects after

both upper and lower abdominal surgery. Acupuncture analgesia also

reduces the activation of the sympathoadrenal system that normally

accompanies surgery. © 2001 American Society of Anesthesiologists,

Inc. See full-text at: http://tinyurl.com/99plc

Lee H, Schmidt K, Ernst E. Acupuncture for the relief of cancer-related

pain - a systematic review. Eur J Pain. 2005 Aug;9(4):437-44. Epub

2004 Nov 11. Department of Medical Sciences, Graduate School of

East-West Medical Science, KyungHee University, Yongin, Republic of

Korea; Complementary Medicine, Peninsula Medical School,

Universities of Exeter and Plymouth, Exeter, UK. AIMS: This systematic

review summarises the existing evidence on acupuncture for cancer-rel

ated pain. METHODS: Literature searches were conducted in seven

databases. All clinical studies of acupuncture, electroacupuncture and

ear acupuncture in cancer patients with the main outcome measure of

pain were included. Data were extracted according to pre-defined

criteria by two independent reviewers and methodological quality was

assessed using the Jadad scale. RESULTS: Of the seven studies

included, one high quality randomised clinical trial of ear acupuncture

showed statistically significant pain relief in comparison with placebo ear

acupuncture. All the other studies were either non-blinded (n=2) or

uncontrolled clinical trials (n=4). Most investigations suffered from

methodological flaws such as inadequate study design, poor reporting of

results, small sample size and overestimation of the results.

CONCLUSIONS: The notion that acupuncture may be an effective

analgesic adjunctive method for cancer patients is not supported by the

data currently available from the majority of rigorous clinical trials.

Because of its widespread acceptance, appropriately powered RCTs

are needed. PMID: 15979024 [PubMed - in process]

Liptak GS. Complementary and alternative therapies for cerebral palsy.

Ment Retard Dev Disabil Res Rev. 2005;11(2):156-63. University of

Rochester Medical Center, Rochester, New York. The optimal practice

of medicine includes integrating individual clinical expertise with the best

available clinical evidence from systematic research. This article reviews

nine treatment modalities used for children who have cerebral palsy

(CP), including hyperbaric oxygen, the Adeli Suit, patterning, electrical

stimulation, conductive education, equine-assisted therapy, craniosacral

therapy, Feldenkrais therapy, and acupuncture. Unfortunately, these

modalities have different degrees of published evidence to support or

refute their effectiveness. Uncontrolled and controlled trials of

hippotherapy have shown beneficial effects on body structures and

functioning. Studies of acupuncture are promising, but more studies are

required before specific recommendations can be made. Most studies

of patterning have been negative and its use cannot be recommended.

However, for the other interventions, such as hyperbaric oxygen, more

evidence is required before recommendations can be made. The

individual with CP and his or her family have a right to full disclosure of

all possible treatment options and whatever knowledge currently is

available regarding these therapies. © 2005 Wiley-Liss, Inc. MRDD

Research Reviews 2005;11:156-163. PMID: 15977320 [PubMed - in

process]

Park J, Park H, Lee H, Lim S, Ahn K, Lee H. Deqi sensation between

the acupuncture-experienced and the naive: a Korean study II. Am J

Chin Med. 2005;33(2):329-37. Complementary Medicine, Peninsula

Medical School, Universities of Exeter and Plymouth, UK.

Jongbae_Park Previous experience of acupuncture

is believed to affect people's expectation of future treatments.

Therefore, subjects who have had acupuncture are generally excluded

from sham-controlled acupuncture clinical trials. However, this

assumption has not been proven, but just accepted because of the lack

of evidence to the contrary. To investigate the difference in frequency

and intensity of acupuncture sensation between subjects who have had

acupuncture and those who have not, 36 acupuncture-experienced

subjects were invited to take part in the study. After informed consent

was obtained, participants were asked to complete the acupuncture

sensation scale (ASS) according to what they expected needling to feel

like. The needling was done at the left Hegu (LI 4) point and consisted

of insertion, stimulation for 30 seconds and removal. After needling, the

subjects were asked to complete the same ASS according to what they

actually experienced. Adverse events were monitored. The frequency of

each sensation expected and experienced, as well as acupuncture

sensation scores were compared. More than 60% of the subjects

expected to feel sensations of penetrating (87.6% to 100%), aching

(71.2% to 95.5%), tingling (87.6% to 100%), pricking (79.7% to 99.2%)

and throbbing (64.2% to 91.4%). In fact, the subjects experienced sharp

(60.9% to 89.1%), intense (60.9% to 89.1%), radiating (71.2% to 95.5%)

and heavy (74.8% to 97.4%) sensations just as much. The subjects

expected more hurting (p = 0.001), tingling (p < 0.001), pricking (p =

0.010), stinging (p = 0.012), burning (p = 0.001) and pulsing (p = 0.009)

than they experienced, while more heaviness (p = 0.011) was

experienced than expected. The same outcome measures were also

compared between experienced and naive groups. Apart from the fact

that the acupuncture-experienced participants expected to feel pricking

(p = 0.030) and stinging (p = 0.002), and experienced hurting (p =

0.022) and stinging (p = 0.028) significantly less than those who had not

had acupuncture before, there was no significant difference between

first time and experienced subjects. The results indicate that previous

experience does not affect the people's expectation and does not hinder

people from experiencing Deqi. In addition, a constellation of Deqi-

related acupuncture-specific sensations is more than just a general pain

intensity dimension, which requires a biochemical and physiological

exploration. PMID: 15974491 [PubMed - in process]

Pourzarandian A, Watanabe H, Ruwanpura SM, Aoki A, Ishikawa I.

Effect of low-level Er:YAG laser irradiation on cultured human gingival

fibroblasts. J Periodontol. 2005 Feb;76(2):187-93. Section of

Periodontology, Department of Hard Tissue Engineering, Graduate

School, Tokyo Medical and Dental University, Tokyo, Japan.

amir.peri BACKGROUND: Low-level laser irradiation has

been reported to enhance wound healing. Activation of gingival

fibroblasts (GF) has a potential for early wound healing in periodontal

treatment. The present study aimed to investigate the direct effect of

low-level Er:YAG laser irradiation on gingival fibroblasts proliferation in

order to clarify the laser effect on healing. METHODS: Cultured human

gingival fibroblasts (hGF) were exposed to low-power, pulsed Er:YAG

laser irradiation with different energy densities ranging from 1.68 to 5.0

J/cm(2). The cultures were analyzed by means of trypan blue staining

and counted under a light microscope. The effect of Er:YAG laser on

hGF was also evaluated using a transmission electron microscope

(TEM). RESULTS: Cultures irradiated with Er:YAG laser presented

faster cell growth when compared with untreated controls. This

difference was statistically significant. Transmission electron microscopy

revealed rough endoplasmic reticulum, prominent Golgi complexes, and

mitochondria after laser irradiation. CONCLUSIONS: Our results

showed that the low-level Er:YAG laser irradiation stimulates the

proliferation of cultured gingival fibroblasts. The optimal stimulative

energy density was found to be 3.37 J/cm(2). This result suggests that

Er:YAG laser irradiation may be of therapeutic benefit for wound

healing. PMID: 15974841 [PubMed - in process]

Saadeh CE. Chemotherapy- and radiotherapy-induced oral mucositis:

review of preventive strategies and treatment. Pharmacotherapy. 2005

Apr;25(4):540-54. Department of Pharmacy Practice, College of

Pharmacy, Ferris State University, Big Rapids, Michigan, USA.

saadehc Oral mucositis is a frequently encountered and

potentially severe complication associated with administration of

chemotherapy and radiotherapy. Although many pharmacologic

interventions have been used for the prevention and treatment of oral

mucositis, there is not one universally accepted strategy for its

management. Most preventive and treatment strategies are based on

limited, often anecdotal, clinical data. Basic oral hygiene and

comprehensive patient education are important components of care for

any patient with cancer at risk for development of oral mucositis.

Nonpharmacologic approaches for the prevention of oral mucositis

include oral cryotherapy for patients receiving chemotherapy with bolus

5-fluorouracil, and low-level laser therapy for patients undergoing

hematopoietic stem cell transplantation. Chlorhexidine, amifostine,

hematologic growth factors, pentoxifylline, glutamine, and several other

agents have all been investigated for prevention of oral mucositis.

Results have been conflicting, inconclusive, or of limited benefit.

Treatment of established mucositis remains a challenge and focuses on

a palliative management approach. Topical anesthetics, mixtures (also

called cocktails), and mucosal coating agents have been used despite

the lack of experimental evidence supporting their efficacy.

Investigational agents are targeting the specific mechanisms of mucosal

injury; among the most promising of these is recombinant human

keratinocyte growth factor. PMID: 15977916 [PubMed - in process]

Xu H, Lawson D, Kras A, Ryan D. The use of preventive strategies for

bone loss. Am J Chin Med. 2005;33(2):299-306. School of Health

Sciences, Victoria University Melbourne City, Vic 8001, Australia.

hong.xu Osteoporosis is a worldwide problem that is

increasing significantly as the global population both increases and

ages. While osteoporosis has been extensively studied in recent years,

the utilization of traditional Chinese medicine (TCM) for the diagnosis,

prevention and treatment of this condition has seldom been examined.

This paper examines the theories and the literature that relate to

diagnosis, prevention and treatment of bone loss at the time of

menopause according to the principles of TCM. It also considers

practical developments in these areas as illustrated by the authors'

research findings in recent studies. TCM diagnosis attributes a number

of different underlying patterns to menopausal bone loss. A very

common pattern in this situation is a Kidney qi and yin deficiency

pattern. TCM analysis can be used as an early determinant of those

persons who are potentially at risk of bone loss. Acupuncture, herbal

medicine and Tai Ji exercise can then be applied to prevent and treat

osteoporosis. These treatments can be effective, if they are applied

correctly. The therapies may also be used in the treatment and

prevention of osteoporosis, as well as the general maintenance of

women's health during menopause. PMID: 15974488 [PubMed - in

process]

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