Recent Abstracts on AP, TENS & LLLT

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Hi All,

 

See recent abstracts on acupuncture, TENS & LLLT.

 

Phil

 

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1. Activation of long-term synaptic plasticity causes suppression of

epileptiform activity in rat hippocampal slices

2. Chronic transcutaneous electrical stimulation of calf muscles

improves functional capacity without inducing systemic

inflammation in claudicants

3. Changes of cerebrovascular response to visual stimulation in

migraineurs after repetitive sessions of somatosensory stimulation

(acupuncture): a pilot study

4. Electro-acupuncture reverses nerve growth factor abundance in

experimental polycystic ovaries in the rat

5. Evaluation of Chapman's neurolymphatic reflexes via applied

kinesiology: a case report of low back pain and congenital

intestinal abnormality

6. Successful treatment of oral lesions of chronic lichenoid graft-v-

host disease by the addition of low-level laser therapy to systemic

immunosuppression

7. Electrical twitch-obtaining intramuscular stimulation in lower

back pain: a pilot study

8. The effects of low laser irradiation on angiogenesis in injured rat

tibiae

9. Complementary and alternative medicine for bronchial asthma: is

there new evidence?

10. Electrical stimulation of human lower extremities enhances

energy consumption, carbohydrate oxidation, and whole body

glucose uptake

11. Electro-acupuncture preconditioning abrogates the elevation of

c-Fos and c-Jun expression in neonatal hypoxic-ischemic rat

brains induced by glibenclamide, an ATP-sensitive potassium

channel blocker

12. Utilization and perceived effectiveness of complementary and

alternative medicine in patients with dystonia

13. Stop Hypertension with the AP Research Program (SHARP):

clinical trial design and screening results

14. Electrical stimulation driving functional improvements and

cortical changes in subjects with stroke

15. Efficacy of low level laser therapy in reducing postoperative pain

after endodontic surgery-- a randomized double blind clinical study

16. Effects of acupuncture and care interventions on the outcome

of inflammatory symptoms of the breast in lactating women

17. Vagal nerve stimulation markedly improves long-term survival

after chronic heart failure in rats

18. Effects of acupressure, manual acupuncture and

Laserneedle® acupuncture on EEG bispectral index and spectral

edge frequency in healthy volunteers

19. Effects of electroacupuncture on gastric myoelectric activity

and substance P in the dorsal vagal complex of rats

20. Electrostimulation at sensory level improves function of the

upper extremities in children with cerebral palsy: a pilot study

21. AP decreases somatosensory evoked potential amplitudes to

noxious stimuli in anesthetized volunteers

22. Profound inhibition of chronic itch induced by stimulation of thin

cutaneous nerve fibres

23. AP reflexotherapy in the treatment of sensory urgency that

persists after transurethral resection of the prostate: A preliminary

report

24. Peripheral effects of needle stimulation (acupuncture) on skin

and muscle blood flow in fibromyalgia

25. Electroacupuncture reduces the extent of lipid peroxidation by

increasing superoxide dismutase and glutathione peroxidase

activities in ischemic-reperfused rat brains

26. Selected CAM therapies for arthritis-related pain: the evidence

from systematic reviews

27. AP increases nocturnal melatonin secretion and reduces

insomnia and anxiety: a preliminary report

28. Immunity and beta-endorphin concentrations in hypothalamus

and plasma in rats with steroid-induced polycystic ovaries: effect of

low-frequency electroacupuncture

29. AP compared to placebo-acupuncture for postoperative nausea

and vomiting prophylaxis : a randomised placebo-controlled patient

and observer blind trial

30. Countering misleading information

31. Myofascial pain disorders: theory to therapy

32. Mechanisms of acupuncture and moxibustion in regulation of

epithelial cell apoptosis in rat ulcerative colitis

33. Transcutaneous electrical acustimulation can reduce visceral

perception in patients with the irritable bowel syndrome: a pilot

study

34. Non-opioid-dependent anti-inflammatory effects of low

frequency electroacupuncture

 

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1 | Albensi, BC; Ata, G; Schmidt, E; Waterman, JD; Janigro, D |

Activation of long-term synaptic plasticity causes suppression of

epileptiform activity in rat hippocampal slices | Brain Res 998, 2004

Feb 13, 56-64 | Cerebrovascular Research Center, Cleveland Clinic

Foundtion, Ohio 44195, USA. | Electrical stimulation of cerebral

targets for the treatment of epilepsy is an area under active

investigation. Recent studies have shown that chronic stimulation

of the subthalamic nucleus, fornix, or hippocampus may be

effective in attenuating seizure frequency in animal models and in

patients with intractable epilepsy. However, many questions exist,

such as what are the specific electrical parameters, target sites,

and mechanisms, etc. , which should be investigated in animal

studies before considering the routine use of chronic stimulation in

epileptic patients. It is also important to understand what happens

to neural activity during repetitive pulse stimulation as well as after

stimulation. To this end, we hypothesized: (1) activation of synaptic

plasticity suppresses epileptiform activity and (2) low frequency

stimulation is an effective stimulation protocol for reducing

seizureintensity and frequency. We used rat hippocampal brain

slices to study how electrical stimulation affects spontaneous and

evoked epileptiform activity. Further, we compared low (1 Hz)

versus high (100 Hz) frequency stimulation in the same

preparation. We found that orthodromic stimulation of the Schaffer

collaterals for 10 min reduces the amplitude of normal responses

and diminishes epileptiform activity. The onset of suppression by 1

Hz stimulation was gradual, but persistent, whereas the onset of

suppression by 100 Hz was rapid; however, the effects of 100 Hz

stimulation were transient. Finally, the NMDA antagonist, AP5

reversed the antiepileptic effects achieved by 1 Hz stimulation.

Collectively, these data suggest that using different stimulation

parameters prolonged electrical stimulation in the hippocampus

may be effective in reducing seizure frequency in patients with

epilepsy and that suppression by low frequency stimulation may be

mediated by long-term depression (LTD).

 

2 | Anderson, SI; Whatling, P; Hudlicka, O; Gosling, P; Simms, M;

Brown, MD | Chronic transcutaneous electrical stimulation of calf

muscles improves functional capacity without inducing systemic

inflammation in claudicants | Eur J Vasc Endovasc Surg 27, 2004

Feb, 201-9 | Dept of Physiology, University of Birmingham, UK. |

OBJECTIVES: To assess whether electrical stimulation of

ischaemic calf muscles in claudicants causes a systemic

inflammatory response and to evaluate effects of its chronic

application on muscle function and walking ability. DESIGN:

Prospective randomised controlled trial of calf muscle stimulation.

MATERIALS AND METHODS: Stable claudicants were

randomised to receive either active chronic low frequency (6 Hz)

motor stimulation (n=15) or, as a control treatment, submotor

transcutaneous electrical nerve (TENS) stimulation (n=15) of calf

muscles in one leg, 3 x 20 min per day for four weeks. Leucocyte

activation was quantified by changes in cell morphology, vascular

permeability by urinary albumin:creatinine ratio (ACR), calf muscle

function by isometric twitch contractions and walking ability by

treadmill performance pre- and post-intervention. RESULTS : Acute

active muscle stimulation activated leucocytes less (28% increase)

than a standard treadmill test (81% increase) and did not increase

ACR. Chronic calf muscle stimulation significantly increased pain-

free walking distance by 35 m (95% CI 17, 52, p<.001) and

maximum walking distance by 39 m (95% CI 7, 70, p<.05) while

control treatment had no effect Active stimulation prevented fatigue

of calf muscles during isometric electrically evoked contractions by

abolishing the slowing of relaxation that was responsible for loss of

force. CONCLUSIONS: Chronic electrical muscle stimulation is an

effective treatment for alleviating intermittent claudication which, by

targeted activation of a small muscle mass, does not engender a

significant systemic inflammatory response.

 

3 | Backer, M; Hammes, M; Sander, D; Funke, D; Deppe, M; Tlle,

TR; Dobos, GJ | Changes of cerebrovascular response to visual

stimulation in migraineurs after repetitive sessions of

somatosensory stimulation (acupuncture): a pilot study | Headache

44, 2004 Jan, 95-101 | Dept of Internal Medicine V, Kliniken Essen

Mitte, Germany. | Objectives. -To evaluate the effect of repetitive

somatosensory stimulation (acupuncture) on cerebrovascular

response in migraineurs by functional transcranial Doppler.

Methods. -Changes of cerebral blood flow velocity in the right

posterior and left middle cerebral arteries were measured by

functional transcranial Doppler during visual stimulation (flickering

light over 57 seconds) in 10 migraineurs before and after 10

acupuncture sessions. The same stimulation paradigm was

performed in 10 control subjects. Cerebral blood flow velocity data

were analyzed with a previously validated technique based on

automated stimulus-related averaging. To evaluate the clinical

effect of the treatment, a headache diary monitored the frequency

and intensity of the migraine attacks. A positive treatment effect

was defined as a reduction of at least 50% in the attack frequency

or the mean headache intensity (or both). Results. -Before

treatment, migraineurs showed overshooting cerebral blood flow

velocity changes at the beginning and at the end of the stimulation

and a delayed decline to baseline compared with control subjects.

After treatment, this response pattern was significantly diminished

(p</=.05) in those who benefited from treatment (n=6). Those who

did not benefit from treatment (n=4) showed a significantly

(p</=.05) more marked alteration of the cerebral blood flow velocity

pattern. Conclusions. -Data indicate that repetitive somatosensory

stimulation (acupuncture) might positively influence the abnormal

cerebrovascular response in migraineurs. In a subgroup of

migraineurs, however, the dysfunction of the cerebrovascular

system might deteriorate under the treatment.

 

4 | Bai, YH; Lim, SC; Song, CH; Bae, CS; Jin, CS; Choi, BC; Jang,

CH; Lee, SH; Pak, SC | Electro-acupuncture reverses nerve growth

factor abundance in experimental polycystic ovaries in the rat |

Gynecol Obstet Invest 57, 2004, 80-85 | Research Division of

Biological Science, Chosun University Medical School, Gwangju,

Korea. | Polycystic ovary syndrome (PCOS) remains one of the

most common causes of anovulation in women of reproductive age.

There is some evidence that nerve growth factor (NGF) is involved

in the pathogenesis of PCOS. Therefore, seeking the pathogenesis

of PCOS is important for controlling fertility. In traditional Oriental

Medicine, acupuncture has been used for the function of ovaries.

The present study was designed to determine whether electro-

acupuncture (EA) could affect experimentally induced polycystic

ovary (PCO) in the rat. The two acupoints Sp-6 and E-128 were

stimulated to test for efficacy in the protein expression of NGF.

Polycystic ovaries were induced by a single injection of estradiol

valerate (4 mg i. m. ). During the experimental period of 8 weeks,

some of the rats were treated with EA twice weekly; this group was

compared with a vehicle-treated control group and an estradiol-

injected group not subjected to EA. At day 60, the protein

expression of NGF was examined by immunohistochemistry in the

ovaries, the adrenal glands and some parts of the brain. The

estradiol treatment induced a clear PCO appearance, and was

associated with a robust increase in NGF expression in the

ovaries, the adrenal glands and the brain. EA treatment partly

reversed the NGF abundance, particularly in the ovaries, but not in

the brain. Our data show that EA affects the NGF involvement in

ovarian dysfunction. ; Copyright 2004 S. Karger AG, Basel

 

5 | Caso, ML | Evaluation of Chapman's neurolymphatic reflexes via

applied kinesiology: a case report of low back pain and congenital

intestinal abnormality | J Manipulative Physiol Ther 27, 2004 Jan,

66 | | OBJECTIVE: To describe the applied kinesiologic evaluation

of Chapman's neurolymphatic (NL) reflexes in the management of a

person with an unusual congenital bowel abnormality and its role in

the manifestation of low back pain. The theoretical foundations of

these reflexes will be elaborated on and practical applications

discussed. CLINICAL FEATURES: A 29-year-old man had chronic

low back pain. Radiographs of the patient's lumbar spine and pelvis

were normal. Magnetic resonance imaging (MRI) demonstrated a

mild protrusion of the fifth lumbar disk. Oral anti-inflammatory

agents, cortisone injections, and chiropractic manipulative therapy

provided little relief. Though generally in robust health, the patient

was aware of a congenital intestinal abnormality diagnosed when

he was a child; it was thought to be of no consequence with regard

to his current back condition. INTERVENTION AND OUTCOME:

The patient's history, combined with applied kinesiology

examination, indicated a need to direct treatment to LI. The

essential diagnostic indicators were the analysis of the Chapman's

neurolymphatic reflexes themselves, coupled with an evaluation of

the traditional acupuncture meridians. The primary prescribed

therapy was the stimulation of these reflexes by the patient at

home. This intervention resulted in the resolution of the patient's

musculoskeletal symptomatology, as well as improved bowel

function. CONCLUSION: The rather remarkable outcome from the

application of this relatively simple, yet valuable, diagnostic and

therapeutic procedure represents a thought-provoking impetus for

future study and clinical application.

 

6 | Chor, A; Azevedo, AM; Maiolino, A; Nucci, M | Successful

treatment of oral lesions of chronic lichenoid graft-v-host disease by

the addition of low-level laser therapy to systemic

immunosuppression | Eur J Haematol 72, 2004 Mar, 222-4 |

University Hospital, Universidade Federal do Rio de Janeiro, Rio de

Janeiro, Brazil. | We report a case of severe oral stomatitis caused

by lichenoid chronic graft-vs. -host disease in which low-level laser

therapy applied to the oral mucosa, in addition to standard

systemic immunosuppressive treatment, resulted in quick healing

and symptomatic relief.

 

7 | Chu, J; Yuen, KF; Wang, BH; Chan, RC; Schwartz, I;

Neuhauser, D | Electrical twitch-obtaining intramuscular stimulation

in lower back pain: a pilot study | Am J Phys Med Rehabil 83, 2004

Feb, 104-11 | United States | OBJECTIVES To determine if

electrical twitch-obtaining intramuscular stimulation (ETOIMS)

provides greater myofascial lower back pain relief than muscle

stimulation or skin stimulation. DESIGN In this single-blinded,

crossover, pilot trial performed at a university-affiliated outpatient

rehabilitation medicine Dept in Taiwan, 12 acupuncture-naive

patients with lower back pain of 3-60 mos duration received one

crossover treatment every 2 wks by monopolar needle electrode

insertion at bilateral T10-S1 levels to: (1) paraspinal muscles, (2)

overlying skin, and (3) paraspinal muscles with ETOIMS applied via

the needle electrode at individual treatment sites. A total of 30

manual insertions per side per treatment were performed, with

withdrawal after 2 secs. Beginning 1 wk before each trial and

continuing until 2 wks after, patients completed a visual analog

scale twice daily. In addition, on the day of treatment, patients

received a physical examination and completed a visual analog

scale both before and after treatment. RESULTS Significant and

immediate reduction in the visual analog scale levels was noted

only with ETOIMS. Immediate improvement occurred in one of nine

physical tests with muscle stimulation and ETOIMS only. In the 2

wks after treatment, absolute visual analog scale levels for ETOIMS

were significantly lower than muscle stimulation and skin

stimulation. ETOIMS resulted in a greater percentage of pain relief

in the first week after treatment, although it was not statistically

significant from muscle stimulation and skin stimulation.

CONCLUSIONS ETOIMS provided significantly greater immediate

and sustained myofascial lower back pain relief than muscle

stimulation and skin stimulation. Although a greater percentage of

pain reduction occurred with ETOIMS, it was not statistically

significant.

 

8 | Garavello, I; Baranauskas, V; da Cruz-Hfling, MA | The effects of

low laser irradiation on angiogenesis in injured rat tibiae | Histol

Histopathol 19, 2004 Jan, 43-8 | Dept of Semiconductors

Instruments, Institute of Biology, State University of Campinas

(UNICAMP), Campinas (SP), Brazil. | The influence of He-Ne laser

radiation on the formation of new blood vessels in the bone marrow

compartment of a regenerating area of the mid-cortical diaphysis of

the tibiae of young adult rats was studied. A small hole was

surgically made with a dentistry burr in the tibia and the injured

area received a daily laser therapy over 7 or 14 days

transcutaneously starting 24 h from surgery. Incident energy

density dosages of 31.5 and 94.5 Jcm(-2) were applied during the

period of the tibia wound healing investigated. Light microscopic

examination of histological sections of the injured area and

quantification of the newly-formed blood vessels were undertaken.

Low-level energy treatment accelerated the deposition of bone

matrix and histological characteristics compatible with an active

recovery of the injured tissue. He-Ne laser therapy significantly

increased the number of blood vessels after 7 days irradiation at an

energy density of 94.5 Jcm(-2), but significantly decreased the

number of vessels in the 14-day irradiated tibiae, independent of

the dosage. These effects were attributed to laser treatment, since

no significant increase in blood vessel number was detected

between 8 and 15 non-irradiated control tibiae. Molecular

mechanisms involved in low-level laser therapy of angiogenesis in

post-traumatic bone regeneration needs further investigation.

 

9 | Gyrik, SA; Brutsche, MH | Complementary and alternative

medicine for bronchial asthma: is there new evidence? | Curr Opin

Pulm Med 10,2004 Jan, 37-43 | Division of Respiratory Medicine,

University Hospital Basel, Switzerland. | PURPOSE OF REVIEW:

Complementary and alternative medicine is widely used in

bronchial asthma. Data on efficacy of these treatment modalities

are lacking. RECENT FINDINGS: Studies published since June

2002 on complementary and alternative medicine in bronchial

asthma were systematically reviewed. SUMMARY: Studies do not

support the use of homeopathy, air ionizers, manual therapy, or

acupuncture for asthma. These methods bear some risks to

patients related to undertreatment and side effects There might be

a possible, but so far not clearly established, role for antioxidant

dietary supplementation, and some natural antiinflammatory and

immunomodulatory remedies. However, their effect size compared

with the classical treatment and side-effect profile is not clearly

established. Strategies influencing breathing technique or

perception, such as breathing or retraining exercises, need to be

studied over the next few years to establish their additive role in the

treatment of asthma. Breathing exercises could improve lung

function and quality of life in different studies. Psychotherapy-

related methods such as relaxation, hypnosis, autogenic training,

speleotherapy, and biofeedback might have a small effect in

selected cases, but have not proven to be superior to placebo.

Nevertheless, more randomized controlled trials of good

methodological quality are required to allow firm conclusions.

 

10 | Hamada, T; Hayashi, T; Kimura, T; Nakao, K; Moritani, T |

Electrical stimulation of human lower extremities enhances energy

consumption, carbohydrate oxidation, and whole body glucose

uptake | J Appl Physiol 96, 2004 Mar, 911-6 | Laboratory of Applied

Physiology, Graduate School of Human and Environmental

Studies, Kyoto University, Kyoto 606-8501, Japan.

moritani | Our laboratory has recently

demonstrated that low-frequency electrical stimulation (ES) of

quadriceps muscles alone significantly enhanced glucose disposal

rate (GDR) during euglycemic clamp (Hamada T, Sasaki H,

Hayashi T, Moritani T, and Nakao K. J Appl Physiol 94: 2107-2112,

2003). The present study is further follow-up to examine the acute

metabolic effects of ES to lower extremities compared with

voluntary cycle exercise (VE) at identical intensity. In eight male

subjects lying in the supine position, both lower leg (tibialis anterior

and triceps surae) and thigh (quadriceps and hamstrings) muscles

were sequentially stimulated to cocontract in an isometric manner

at 20 Hz with a 1-s on-off duty cycle for 20 min. Despite small

elevation of oxygen uptake by 7.3+/-0.3 ml. kg(-1). min(-1) during

ES, the blood lactate concentration was significantly increased by

3.2+/-0.3 mmol/l in initial period (5 min) after the onset of the ES (P

60 0.01), whereas VE showed no such changes at identical

oxygen uptake (7.5+/-0.3 ml. kg(-1). min(-1)). ES also induced

enhanced whole body carbohydrate oxidation as shown by the

significantly higher respiratory gas exchange ratio than with VE (P

60 0.01). These data indicated increased anaerobic glycolysis by

ES. Furthermore, whole body glucose uptake determined by GDR

during euglycemic clamp demonstrated a significant increase

during and after the cessation of ES for at least 90 min (P 60 0.01).

This post-ES effect was significantly greater than that of the post-

VE period (P 60 0.01). These results suggest that ES can

substantially enhance energy consumption, carbohydrate

oxidation, and whole body glucose uptake at low intensity of

exercise. Percutaneous ES may become a therapeutic utility to

enhance glucose metabolism in humans.

 

11 | Jiang, KW; Zhao, ZY; Shui, QX; Xia, ZZ | Electro-acupuncture

preconditioning abrogates the elevation of c-Fos and c-Jun

expression in neonatal hypoxic-ischemic rat brains induced by

glibenclamide, an ATP-sensitive potassium channel blocker | Brain

Res 998, 2004 Feb 13, 13-9 | Dept of Neurology, Children's

Hospital School of Medicine, Zhejiang University, 57 Zhugan Xiang,

310003, Hangzhou, China | This study aimed to clarify the

neuroprotective mechanism of electro-acupuncture (EA)

preconditioning on hypoxic-ischemic brain injury (HIBI). Using

Western blot, the expression of c-fos protein (c-Fos) and c-jun

protein (c-Jun) induced by glibenclamide, an ATP-sensitive

potassium (K(ATP)) channel blocker was examined from cerebral

cortical and hippocampal samples in neonatal hypoxic-ischemic

rats, with or without EA preconditioning. EA was performed on

Hegu (LI4), a well-known acupoint commonly used in Oriental

medicine for the treatment of neuronal injury resulting from hypoxia-

ischemia (HI). Preconditioned rats were treated with either

diazoxide, a K(ATP) channel opener, glibenclamide, or sterile

saline injected into the left lateral ventricle (i. c. v. ), with or without

EA administration before HI insult. Interestingly, low c-Fos and c-

Jun expressions were found both in diazoxide and EA groups, 24 h

after HI. Furthermore, significant differences in relative optical

density (ROD) were found between glibenclamide and HI control

groups (p</=.05), as well as between the group administered

glibenclamide after EA and the HI control group (p</=.05).

However, the level of c-Fos and c-Jun expression in the group

administered glibenclamide after EA was significantly lower than in

the glibenclamide group (p</=.05). The present findings indicate

that the effectiveness of EA preconditioning against HIBI may be

mediated via the opening of K(ATP) channels.

 

12 | Junker, J; Oberwittler, C; Jackson, D; Berger, K | Utilization

and perceived effectiveness of complementary and alternative

medicine in patients with dystonia | Mov Disord 19, 2004 Feb, 158-

61 | Dept of Neurology, University of Muenster, Muenster,

Germany. | The use of complementary and alternative medicine

(CAM) is increasing worldwide, especially by patients with chronic

diseases. To date, no data are available about utilization and

perceived effectiveness of CAM in patients with dystonia. A

questionnaire survey on utilization and costs of CAM was

completed by 180 members of the German Dystonia Society, a

patient advocate group. In total, 131 dystonia patients (73%) were

current or former users of CAM, 55 patients used CAM in addition

to botulinum toxin A injections, and 86 patients had experience

with three or more CAM methods. The options used most widely

were acupuncture (56%), relaxation techniques (44%), homeopathy

(27%), and massages (26%). Among users of specific CAM

methods, breathing therapy, Feldenkrais, massages, and

relaxation techniques were perceived as most effective On average,

patients spent euro1,513 on CAM without reimbursement. There

was no correlation between costs and perceived effectiveness of

different methods. In line with other studies on chronically ill

patients, our results show that dystonia patients frequently utilize

CAM methods, often in addition to conventional treatment There is

a growing need to evaluate scientifically the effect of CAM methods

on symptom severity and quality of life in dystonia, to prevent

utilization of costly and ineffective CAM treatments; Copyright 2003

Movement Disorder Society

 

13 | Kalish, LA; Buczynski, B; Connell, P; Gemmel, A; Goertz, C;

Macklin, EA; Pian-Smith, M; Stevens, S; Thompson, J;

Valaskatgis, P; Wayne, PM; Zusman, RM | Stop Hypertension

with the AP Research Program (SHARP): clinical trial design and

screening results | Control Clin Trials 25, 2004 Feb, 76-103 | New

England Research Institutes, 9 Galen Street, Watertown, MA

02472, USA. | Hypertension is a major public health problem with

serious medical and financial consequences. Barriers to

successful conventional pharmacological treatment include side

effects, out-of-pocket expenses, patient noncompliance and

insufficient dosages. AP has been studied as an alternative therapy

for controlling blood pressure (BP) but previous studies have

serious methodological limitations. This paper describes the design

of the Stop Hypertension with the AP Research Program (SHARP)

trial, a pilot randomized clinical trial designed to gather preliminary

data regarding the efficacy of traditional Chinese medicine (TCM)-

based acupuncture for control of essential hypertension. The

design of the SHARP trial balanced rigorous clinical trial

methodology with principles of TCM. Eligible participants had

systolic BP (SBP) 140-179 mm Hg and diastolic BP (DBP) 90-109

mm Hg in the absence of antihypertensive therapy Following

screening, participants were randomized to one of three groups:

individualized, standardized or control acupuncture Treatments

were designed according to principles of TCM; nonspecific effects

associated with the interventions were standardized across the

randomized groups. For individualized acupuncture, points were

tailored to each participant. Standardized acupuncture used a

prespecified set of points. The invasive sham control acupuncture

regimen was designed to be non-active. Each participant received a

" prescription " for individualized acupuncture from an acupuncturist

who was masked to treatment assignment, and was subsequently

treated by an independent acupuncturist. Patients and those

assessing BP were masked to treatment group. AP was delivered

twice a week for 6 weeks. Follow-up visits were every 2 weeks to

week 10 and then at months 4, 6, 9 and 12. The primary endpoint

will be change in SBP from baseline to 10 weeks. DBP, BP

trajectories over the 12-month follow-up and antihypertensive

medication requirements will also be examined. Initial contact was

documented for 1442 prospective participants from March 2001 to

April 2002; 424 provided informed consent and 192 were ultimately

randomized.

 

14 | Kimberley, TJ; Lewis, SM; Auerbach, EJ; Dorsey, LL; Lojovich,

JM; Carey, JR | Electrical stimulation driving functional

improvements and cortical changes in subjects with stroke | Exp

Brain Res 154, 2004 Feb, 450-60 | Program in Physical Therapy,

University of Minnesota, MMC Box 388, MN 55455, Minneapolis,

USA, tjk | It has been proposed that somatosensory

stimulation in the form of electromyographically triggered

neuromuscular electrical stimulation (NMES) to the peripheral

nerve can influence functional measures of motor performance in

subjects with stroke and can additionally produce changes in

cortical excitability. Using a controlled, double-blind design, we

studied the effects of intensive (60 h/3 weeks) treatment at home

with NMES compared with a sham treatment, applied to the

extensor muscles of the hemiplegic forearm to facilitate hand

opening in 16 chronic stroke subjects. We investigated

improvement in functional use of the hand and change in cortical

activation as measured by functional magnetic resonance imaging

(fMRI). Following treatment, subjects improved on measures of

grasp and release of objects (Box and Block Test and Jebsen

Taylor Hand Function Test JTHFT : small objects, stacking, heavy

cans), isometric finger extension strength, and self-rated Motor

Activity Log (MAL): Amount of Use and How Well score. The sham

subjects did not improve on any grasp and release measure or self-

rated scale, but did improve on isometric finger extension strength.

Importantly, however, following crossover, these subjects improved

further in the measure of strength, grasp and release (Box and

Block JTHFT : page turning), and self-rated MAL: Amount of Use

score and How Well score. Using fMRI and a finger-tracking task,

an index of cortical intensity in the ipsilateral somatosensory

cortex increased significantly from pre-test to post-test following

treatment Cortical activation, as measured by voxel count, did not

change. These findings suggest that NMES may have an important

role in stimulating cortical sensory areas allowing for improved

motor function.

 

15 | Kreisler, MB; Haj, HA; Noroozi, N; Willershausen, B | Efficacy

of low level laser therapy in reducing postoperative pain after

endodontic surgery-- a randomized double blind clinical study | Int J

Oral Maxillofac Surg 33, 2004 Jan, 38-41 | Dept of Oral Surgery,

Johannes Gutenberg University Mainz, Mainz, Germany.

matthiaskreisler |

 

16 | Kvist, LJ; Wilde Larsson, B; Hall-Lord, ML; Rydhstroem, H |

Effects of acupuncture and care interventions on the outcome of

inflammatory symptoms of the breast in lactating women | Int Nurs

Rev 51, 2004 Mar, 56-64 | 1 Care Development Midwife and

Associate Professor, Dept of Obstetrics and Gynaecology,

Hospital of Helsingborg, Sweden Associate Professor, and Senior

Lecturer, Institution for Health and Care, University of Karlstad,

Sweden. | Objective: To compare modes of care and treatment for

lactating women with inflammatory symptoms of the breast, with

special focus on the use of acupuncture Method: Eighty-eight

mothers were randomized into three treatment groups. All three

groups were given advice regarding emptying of the breasts and

care in the form of comfort interventions. AP was included in the

treatment regime for two of the groups. A severity index was

created by adding together scores for signs and symptoms: breast

tension, erythema and pain. Findings: Mothers in all groups

expressed relative satisfaction with the breastfeeding situation

despite considerable discomfort. There was no significant

difference between the groups for the number of mothers requiring

more than three contact days for recovery nor for their severity

index scores on day 3. These findings must be interpreted with

care but may suggest that care interventions play as great a part in

the recovery of these women as acupuncture treatment or the use

of oxytocin spray. Antibiotic therapy was used in 9% of the study

population, which is in contrast to other studies. Proposed future

action: Based on these results, a new study has been designed to

test the hypothesis that acupuncture hastens recovery from

inflammatory processes in the lactating breast and approximately

200 mothers will be randomized in a new expanded study.

 

17 | Li, M; Zheng, C; Sato, T; Kawada, T; Sugimachi, M;

Sunagawa, K | Vagal nerve stimulation markedly improves long-

term survival after chronic heart failure in rats | Circulation 109,

2004 Jan 6, 120-4 | Cardiovascular Dynamics, Cardiovascular

Center Research Institute, Suita, Japan. | BACKGROUND:

Diminished cardiac vagal activity and higher heart rate predict a

high mortality rate of chronic heart failure (CHF) after myocardial

infarction. We investigated the effects of chronic electrical

stimulation of the vagus nerve on cardiac remodeling and long-term

survival in an animal model of CHF after large myocardial infarction.

METHODS AND RESULTS : Two weeks after the ligation of the left

coronary artery, surviving rats were randomized to vagal- and sham-

stimulated groups. Using an implantable miniature radio-controlled

electrical stimulator, we stimulated the right vagal nerve of CHF

rats for 6 weeks. The intensity of electrical stimulation was

adjusted for each rat, so that the heart rate was lowered by 20 to

30 beats per minute. The treated rats had significantly lower left

ventricular end-diastolic pressure (17.1+/-5.9 versus 23.5+/-4.2 mm

Hg, p<.05) and higher maximum dp/dt of left ventricular pressure

(4152+/-237 versus 2987+/-192 mm Hg/s, p<.05) than the

untreated rats. Improvement of cardiac pumping function was

accompanied by a decrease in normalized biventricular weight

(2.75+/-0.25 versus 3.14+/-0.22 g/kg, p<.01). Although the 140-day

survival of the untreated group was only half, vagal stimulation

markedly improved the survival rate (86% versus 50%, p=.008).

Vagal stimulation therapy achieved a 73% reduction in a relative

risk ratio of death CONCLUSIONS: Vagal nerve stimulation

markedly improved the long-term survival of CHF rats through the

prevention of pumping failure and cardiac remodeling.

 

18 | Litscher, G | Effects of acupressure, manual acupuncture and

Laserneedle® acupuncture on EEG bispectral index and spectral

edge frequency in healthy volunteers | European Journal of

Anaesthesiology 21 (1) January 2004, 13-19 | gerhard.litscher@uni-

graz.at; Dept of Biomedical Engineering and Research in

Anesthesia and Intensive Care, University of Graz,

Auenbruggerplatz 29, A-8036, Graz, Austria | Background and

objective: The main purpose of this study was to investigate the

effects of sensory (acupressure and acupuncture) and optical

stimulation (Laserneedle® acupuncture) on

electroencephalographic bispectral index, spectral edge frequency

and a verbal sedation score. Methods: Twenty-five healthy

volunteers (mean age+/-SD: 25.5+/-4.0 yr) were investigated during

the awake state. The acupuncture point Yintang and a placebo

control point were stimulated. The study was performed as a

randomized, controlled and partly blinded cross-over trial. Results :

Bispectral index and spectral edge frequency values both

decreased significantly (p<.001) during acupressure on Yintang to

values of 62.9 (minimum 35)+/-13.9 bispectral index and to 13.3

(minimum 2.9)+/-8.1 Hz (spectral edge frequency right) and 13.8

(minimum 2.7)+/-7.3 Hz (spectral edge frequency left), respectively.

Bispectral index was also significantly (p<.05) affected by

Laserneedle® acupuncture and acupressure on the control point

but the changes were not clinically relevant, 95.4+/-4 and 94.2+/-

4.8, respectively. All interventions significantly (Yintang: p<.001;

control point: p<.012) reduced verbal sedation score. Conclusions:

The study highlights the electroencephalographic similarities of

acupressure induced sedation and general anaesthesia as

assessed by bispectral index and spectral edge frequency

 

19 | Liu, JH; Yan, J; Yi, SX; Chang, XR; Lin, YP; Hu, JM | Effects of

electroacupuncture on gastric myoelectric activity and substance P

in the dorsal vagal complex of rats | Neurosci Lett 356, 2004 Feb

12, 99-102 | Dept of Analysis and Measurement Science, Wuhan

University, Wuhan, 430072, PR China. | AP has been widely

applied to treat gastrointestinal diseases in the clinic. However, its

precise mechanism remains unknown. In the present study, effects

of electroacupuncture (EA) at Zusanli acupoints (ST36) on gastric

myoelectric activity and substance P (SP) in the dorsal vagal

complex (DVC) were observed. EA at ST36 significantly increased

the frequency of slow waves and the frequency of the spike

potentials superimposed on the slow waves, which persisted for 90

min after cessation of EA and was completely abolished after

bilateral vagotomy. Meanwhile, the mean optical density of SP

immunoreactive fibers in the DVC increased following EA. The

results suggested that EA at ST36 promoted the gastric

myoelectric activity, which was regulated by the vagus, and SP in

the DVC may be involved in the excitatory effects Furthermore, EA

had a relative long-term post-effect We presumed that DVC may be

a supraspinal center in the effect of EA on gastric function.

 

20 | Maenpaa, H; Jaakkola, R; Sandstrm, M; Airi, T; von Wendt, L |

Electrostimulation at sensory level improves function of the upper

extremities in children with cerebral palsy: a pilot study | Dev Med

Child Neurol 46, 2004 Feb, 84-90 | Dept of Child Neurology,

Hospital for Children and Adolescents, Helsinki Central Hospital,

Lastenlinnantie 2, SF-00250 Helsinki, Finland.

helena.maenpaa | The aim of this study was to evaluate the

effect of electrical stimulation (ES) on the function of the upper

extremities in children with cerebral palsy (CP). The participants

were 12 children (seven females and five males) with spastic

hemiplegia (mean age 5 years 7 months, SD 3 years 9 months).

Indications were weak wrist dorsiflexion and elbow extension. The

ES was given at sensory level (20-40 minutes) on the infraspinatus

muscle and on the wrist dorsiflexors during 12 regularly scheduled

physical and occupational therapy sessions (during 4-5 weeks).

The Goal Attainment Scale, the Zancolli classification of hand

function, muscle testing according to Daniels and Worthington, and

King hypertonicity scale were used for evaluation. Assessments

were made twice before (between 4 weeks) and twice after

(between 12 weeks) the stimulation period except the King

hypertonicity scale, which was used once before and 3 months

after the stimulation period. Active elbow extension, wrist

dorsiflexion, and forearm supination with the elbow flexed and

extended improved when the results of assessments before ES

were compared with those made immediately before (p<.001) and

three months after (p<.01) this treatment Results of this pilot

uncontrolled study suggest that ES at sensory level can be used

as an adjunct to physiotherapy and/or occupational therapy in

children with spastic hemiplegia. These results will be used as

basis for further research.

 

21 | Meissner, W; Weiss, T; Trippe, RH; Hecht, H; Krapp, C;

Miltner, WH | AP decreases somatosensory evoked potential

amplitudes to noxious stimuli in anesthetized volunteers | Anesth

Analg 98, 2004 Jan, 141-7, table of contents | Dept of

Anesthesiology and Intensive Care, Friedrich-Schiller-University

Jena, 07740 Jena, Germany. meissner | The

effect of acupuncture on pain perception is controversial. Because

late amplitudes of somatosensory evoked potentials (SEPs) to

noxious stimuli are thought to correlate with the subjective

experience of pain intensity, we designed this study to detect

changes of these SEPs before and after acupuncture in a double-

blinded fashion. Sixteen volunteers were anesthetized by propofol

and exposed to painful electric stimuli to the right forefinger. Then,

blinded to the research team, the acupuncture group (n=8) was

treated with electric needle acupuncture over 15 min at analgesic

points of the leg, whereas the sham group (n=8) received no

treatment Thereafter, nociceptive stimulation was repeated. SEPs

were recorded during each noxious stimulation from the vertex Cz,

and latencies and amplitudes of the N150 and P260 components

were analyzed by analysis of variance. P260 amplitudes decreased

from 4.40+/-2.76 microV (mean+/-SD) before treatment to 1.67+/-

1.21 microV after treatment (P 60 0.05), whereas amplitudes of the

sham group remained unchanged (2.64+/-0.94 microV before

versus 2.54+/-1.54 microV after treatment). In conclusion, this

double-blinded study demonstrated that electric needle

acupuncture, as compared with sham treatment, significantly

decreased the magnitudes of late SEP amplitudes with electrical

noxious stimulation in anesthetized subjects, suggesting a specific

analgesic effect of acupuncture IMPLICATIONS: This double-

blinded study demonstrates that electric needle acupuncture, as

compared with sham treatment, significantly decreases the

magnitudes of late somatosensory evoked potential amplitudes

with electrical noxious stimulation in anesthetized subjects,

suggesting a specific analgesic effect of acupuncture.

 

22 | Nilsson, HJ; Psouni, E; Carstam, R; Schouenborg, J |

Profound inhibition of chronic itch induced by stimulation of thin

cutaneous nerve fibres | J Eur Acad Dermatol Venereol 18, 2004

Jan, 37-43 | Section for Neurophysiology, Dept of Physiological

Sciences, University of Lund, BMC-F10, Tornavagen 10, S-221 84

Lund, Sweden. | Despite the fact that severe itch is common in

many dermatological diseases, the therapeutic arsenal against

itching is limited. From neurophysiological experiments, using a

new technique termed cutaneous field stimulation, it is known that

acute itch can be effectively relieved by stimulation of cutaneous

nociceptors. METHODS: We tested the effects of cutaneous field

stimulation (25 min, 16 electrodes, 4 Hz per electrode, up to 0.8

mA) on chronic itch due to atopic dermatitis. TENS (100 Hz, up to

26 mA) was used for comparison. In 27 patients, itch was

measured just prior to, during and at regular intervals up to 12 h

after either type of treatment RESULTS : Both treatments

augmented the itch sensation during ongoing stimulation,

presumably reflecting an altered sensory processing in the

somatosensory pathways of chronic itch patients. However, after

cessation of cutaneous field stimulation, but not TENS, the itch

sensation was significantly depressed for up to 7 h. The peak

inhibitory effect (about 25% of control) was reached between 1 and

5 h poststimulation. Neither treatment had any significant effect on

alloknesis, as measured before and 10 min after stimulation.

CONCLUSION: It is concluded that cutaneous field stimulation

strongly depresses chronic itch, and is a potentially useful

symptomatic treatment of itch.

 

23 | Ricci, L; Minardi, D; Romoli, M; Galosi, AB; Muzzonigro, G |

AP reflexotherapy in the treatment of sensory urgency that persists

after transurethral resection of the prostate: A preliminary report |

Neurourol Urodyn 23, 2004, 58-62 | Anaesthesiology Unit, Azienda

Ospedaliera Umberto I degrees, Ancona, Italy. | AIMS: In this

study, we wanted to evaluate whether acupuncture reflexotherapy

is able to treat the sensory irritative components of LUTS (lower

urinary tract symptoms) that persist after transurethral resection of

the prostate. METHODS: We have evaluated 42 patients, randomly

selected into three groups: 14 patients received placebo, 15

patients received oxybutynin, and 13 patient were treated with

electrostimulation by acupuncture reflexotherapy. RESULTS :

Before treatment, the mean maximum flow rate (Qmax) was 21.0+/-

3.2 mL/sec, the mean International Prostate Symptom Score (I-

PSS) score was 12.9+/-4.2, the mean I-PSS Quality of Life (IPSS

QoL) score was 3.6+/-1.2. At the first check-up performed after 3

months, we could observe that the I-PSS and QoL scores were

12.6+/-4.3 and 3.8+/-1.3 in the group who received placebo; the

scores decreased to 11.1+/-3.2 and to 3.1+/-1.0, respectively, in

the 15 patients treated with oxybutynin and decreased to 6.1+/-2.6

and 1.3+/-1.1, respectively, in the 13 patients who underwent

acupuncture reflexotherapy. At 1-year follow-up, these parameters

were practically similar. The voiding diaries allowed us to deduce

that the average number of daytime voidings decreased by 8% in

patients who received oxybutynin and decreased by 20% in 13

patients who underwent reflexotherapy; the average number of

nocturnal micturitions decreased by approximately 20% and 60%,

respectively, in patients who received oxybutynin and

reflexotherapy. CONCLUSIONS: This study has pointed out that

acupuncture reflexotherapy has a real benefit in patients with

sensory urgency that persists after transurethral resection of the

prostate. Neurourol. Urodynam.23:58-62, 2004. ; Copyright 2003

Wiley-Liss, Inc.

 

24 | Sandberg, M; Lindberg, LG; Gerdle, B | Peripheral effects of

needle stimulation (acupuncture) on skin and muscle blood flow in

fibromyalgia | Eur J Pain 2004, 163-71 | Dept of Biomedical

Engineering, Linkoping University, Linkoping SE-581 85, Sweden. |

AP has become a widely used treatment modality in various

musculoskeletal pain conditions. AP is also shown to enhance

blood flow and recovery in surgical flaps. The mechanisms behind

the effect on blood flow were suggested to rely on vasoactive

substances, such as calcitonin gene-related peptide, released from

nociceptors by the needle stimulation. In a previous study on

healthy subjects, one needle stimulation into the anterior tibial

muscle was shown to increase both skin and muscle blood flow.

The aim of this study was to examine the effect of needle

stimulation on local blood flow in the anterior tibial muscle and

overlying skin in patients suffering from a widespread chronic pain

condition. Fifteen patients with fibromyalgia (FM) participated in the

study. Two modes of needling, deep muscle stimulation and

subcutaneous needle insertion were performed at the upper anterior

aspect of the tibia, i. e. , in an area without focal pathology or

ongoing pain in these patients. Blood flow changes were assessed

non-invasively by photoplethysmography (PPG). The results of the

present study were partly similar to those earlier found at a

corresponding site in healthy female subjects, i. e. , deep muscle

stimulation resulted in larger increase in skin blood flow (mean

(SE)): 62.4% (13.0) and muscle blood flow: 93.1% (18.6),

compared to baseline, than did subcutaneous insertion (mean (SE)

skin blood flow increase: 26.4% (6.2); muscle blood flow increase:

46.1% (10.2)). However, in FM patients subcutaneous needle

insertion was followed by a significant increase in both skin and

muscle blood flow, in contrast to findings in healthy subjects where

no significant blood flow increase was found following the

subcutaneous needling. The different results of subcutaneous

needling between the groups (skin blood flow: Formula: see text;

muscle blood flow: Formula: see text) may be related to a greater

sensitivity to pain and other somatosensory input in FM.

 

25 | Siu, FK; Lo, SC; Leung, MC | Electroacupuncture reduces the

extent of lipid peroxidation by increasing superoxide dismutase and

glutathione peroxidase activities in ischemic-reperfused rat brains |

Neurosci Lett 354, 2004 Jan 9, 158-62 | Dept of Rehabilitation

Sciences, The Hong Kong Polytechnic University, Hung Hom,

Hong Kong, SAR, China. siufkw | Reactive oxygen

species can be scavenged by superoxide dismutase (SOD) and

glutathione peroxidase (GPx). During ischemia-reperfusion, the

normal functioning of these antioxidant enzymes may be

insufficient for the prevention of oxidant-induced peroxidation of

membrane lipids and hence cerebral infarction. We therefore

investigated whether electroacupuncture (EA) treatment at Fengchi

points in post-ischemic rats could increase the antioxidant enzyme

activities and thereby reduce the extent of lipid peroxidation. The

results indicated that while EA did not alter the antioxidant enzyme

activities in non-ischemic normal rat brains, ischemia-reperfusion

caused significant increases in SOD and GPx activities. EA

treatment further increased the antioxidant enzyme activities in

ischemic-reperfused brain tissues, with a concomitant decrease in

the extent of lipid peroxidation. EA treatment at Fengchi reduced

the extent of lipid peroxidation in ischemic-reperfused rat brains,

possibly by increasing the activities of SOD and GPx.

 

26 | Soeken, KL | Selected CAM therapies for arthritis-related pain:

the evidence from systematic reviews | Clin J Pain 20, 2004 Jan-

Feb, 13-8 | Complementary Medicine Program, University of

Maryland School of Nursing, Kernan Hospital Mansion, 2200

Kernan Drive, Baltimore, MD 21207,

USA.ksoeken | OBJECTIVES: The purpose

is to examine what is known about the efficacy of selected

complementary and alternative medicine (CAM) therapies for pain

from arthritis and related conditions based on systematic reviews

and meta-analyses. METHODS: Results specifically related to pain

were retrieved from review articles of acupuncture, homeopathy,

herbal remedies, and selected nutritional supplements. RESULTS :

Evidence exists to support the efficacy of reducing pain from

osteoarthritis (OA) for acupuncture; devil's claw, avocado/soybean

unsaponifiables, Phytodolor and capsaicin; and chondroitin,

glucosamine, and SAMe. Strong support exists for gamma

linolenic acid (GLA) for pain of rheumatoid arthritis (RA).

CONCLUSIONS: Despite support for some of the most popular

CAM therapies for pain from arthritis-related conditions, additional

high quality research is needed for other therapies, especially for

herbals and homeopathy.

 

27 | Spence, DW; Kayumov, L; Chen, A; Lowe, A; Jain, U;

Katzman, MA; Shen, J; Perelman, B; Shapiro, CM | AP increases

nocturnal melatonin secretion and reduces insomnia and anxiety: a

preliminary report | J Neuropsychiatry Clin Neurosci 16, 2004

Winter, 19-28 | Centre for Addiction and Mental Health, Toronto,

Ontario, Canada. | The response to acupuncture of 18 anxious

adult subjects who complained of insomnia was assessed in an

open prepost clinical trial study. Five weeks of acupuncture

treatment was associated with a significant (p=.002) nocturnal

increase in endogenous melatonin secretion (as measured in urine)

and significant improvements in polysomnographic measures of

sleep onset latency (p=.003), arousal index (p=.001), total sleep

time (p=.001), and sleep efficiency (p=.002). Significant reductions

in state (p=.049) and trait (p=.004) anxiety scores were also found.

These objective findings are consistent with clinical reports of

acupuncture's relaxant effects AP treatment may be of value for

some categories of anxious patients with insomnia.

 

28 | Stener-Victorin, E; Lindholm, C | Immunity and beta-endorphin

concentrations in hypothalamus and plasma in rats with steroid-

induced polycystic ovaries: effect of low-frequency

electroacupuncture | Biol Reprod 70, 2004 Feb, 329-33 | Dept of

Physiology, Gotenborg University, Gotenborg. elsv | The

human endocrinological disorder polycystic ovary syndrome

(PCOS) is a common cause of reproductive failure Even though the

cause of PCOS is unknown, hormone and immune disturbances as

well as hyperactivity in the sympathetic nervous system are likely

to be involved in the pathogenesis of the disease. The present

study was undertaken to elucidate if rats with estradiol valerate

(EV)-induced polycystic ovaries (PCO) have altered beta-endorphin

concentrations in the hypothalamus and in plasma and if they have

alterations in circulating immune cell populations and the activity.

Repeated low-frequency (2 Hz) electroacupuncture (EA) treatments

are known to modulate the release of beta-endorphin, immune

responses, and the activity in the autonomic nervous system. We

therefore also investigated the effect of EA treatments on the beta-

endorphin and the immune systems. Low-frequency EA was given

12 times, 25 min each, over 30 days starting 2-3 days after i. m.

injection of EV. The beta-endorphin concentrations in the

hypothalamus and in plasma as well as the frequencies of CD4+ T

cells and CD8+ T cells were significantly lower in EV-injected

control rats as compared to oil-injected control rats. Repeated EA

treatments in EV-injected rats significantly increased beta-

endorphin concentrations in the hypothalamus. These findings

show that both the beta-endorphinergic and the immune system

are significantly impaired in rats with steroid-induced PCO and that

repeated EA treatments can restore some of these disturbances.

 

29 | Streitberger, K; Diefenbacher, M; Bauer, A; Conradi, R;

Bardenheuer, H; Martin, E; Schneider, A; Unnebrink, K | AP

compared to placebo-acupuncture for postoperative nausea and

vomiting prophylaxis : a randomised placebo-controlled patient and

observer blind trial | Anaesthesia 59, 2004 Feb, 142-9 | Dept of

Anaesthesiology, Coordination Centre for Clinical Trials, University

of Heidelberg, 69120 Heidelberg, Germany. konrad,

streitberger | This randomised, placebo-

controlled, patient and observer blinded trial was conducted to

determine whether acupuncture at the acupuncture point P6 is

effective in preventing postoperative nausea and vomiting (PONV)

compared to placebo acupuncture Female patients (n=220)

scheduled for gynaecological or breast surgery were randomly

assigned to two groups receiving either acupuncture (n=109) or

placebo acupuncture (n=111). Each group was stratified for type of

surgery and included two subgroups receiving intervention either

before or after induction of anaesthesia. The incidence of PONV

and/or antiemetic rescue medication within 24 h after surgery was

the main outcome measure which showed no statistically

significant difference between groups (43.7% acupuncture, 50.9%

placebo, p=.27). The differences were more pronounced for patients

having gynaecological surgery (48.9% acupuncture, 67.6%

placebo, p=.07) than for those having breast surgery (38.7%

acupuncture, 40.3% placebo, p=.86). The secondary outcome,

vomiting, was significantly reduced by acupuncture from 39.6% to

24.8% (p=.03). Subgroup analysis showed no difference between

applications of acupuncture before compared to after induction of

anaesthesia.

 

30 | Veal, L | Countering misleading information | Complement Ther

Nurs Midwifery 10, 2004 Feb, 54-7 | Urarstekkur 5, 109, Reykjavi;k,

Iceland | Orthodox medicine generally demands evidence in the

form of randomised controlled trials (RCTs) before accepting the

value of a particular therapy/intervention from the CAM field. Yet

many RCTs are badly executed as they are carried out by doctors

or scientists rather than holistic practitioners, and peer reviewers

for conventional medical journals may not have sufficient knowledge

to be able to assess a CAM paper properly. This article discusses

inadequacies found in RCTs and other papers related to CAM, and

pinpoints how research should be critically evaluated and reviewed.

Examples are taken from the fields of aromatherapy, herbalism,

acupuncture/TCM and homeopathy. The aim of this paper is to

highlight common misunderstandings and misguided assumptions

that may arise when undertaking research in the field of

complementary medicine that may result in erroneous conclusions

being drawn from data and which may have far reaching

implications for clinical practice. The STRICTA recommendations

for acupuncture are discussed.

 

31 | Wheeler, AH | Myofascial pain disorders: theory to therapy |

Drugs 64, 2004, 45-62 | Charlotte Spine Center, Charlotte, North

Carolina, USA. | Voluntary muscle is the largest human organ

system. The musculotendinous contractual unit sustains posture

against gravity and actuates movement against inertia. Muscular

injury can occur when soft tissues are exposed to single or

recurrent episodes of biomechanical overloading. Muscular pain is

often attributed to a myofascial pain disorder, a condition originally

described by Drs Janet Travell and David Simons. Among patients

seeking treatment from a variety of medical specialists, myofascial

pain has been reported to vary from 30% to 93% depending on the

subspecialty practice and setting. Forty-four million Americans are

estimated to have myofascial pain; however, controversy exists

between medical specialists regarding the diagnostic criteria for

myofascial pain disorders and their existence as a pathological

entity. Muscles with activity or injury-related pain are usually

abnormally shortened with increased tone and tension. In addition,

myofascial pain disorders are characterised by the presence of

tender, firm nodules called trigger points Within each trigger point

is a hyperirritable spot, the 'taut-band', which is composed of

hypercontracted extrafusal muscle fibres. Palpation of this spot

within the trigger point provokes radiating, aching-type pain into

localised reference zones. Research suggests that myofascial pain

and dysfunction with characteristic trigger points and taut-bands

are a spinal reflex disorder caused by a reverberating circuit of

sustained neural activity in a specific spinal cord segment. The

treatment of myofascial pain disorders requires that symptomatic

trigger points and muscles are identified as primary or ancillary

pain generators. Mechanical, thermal and chemical treatments,

which neurophysiologically or physically denervate the neural loop

of the trigger point, can result in reduced pain and temporary

resolution of muscular overcontraction. Most experts believe that

appropriate treatment should be directed at the trigger point to

restore normal muscle length and proper biomechanical orientation

of myofascial elements, followed by treatment that includes

strengthening and stretching of the affected muscle. Chronic

myofascial pain is usually a product of both physical and

psychosocial influences that complicate convalescence.

 

32 | Wu, HG; Gong, X; Yao, LQ; Zhang, W; Shi, Y; Liu, HR; Gong,

YJ; Zhou, LB; Zhu, Y | Mechanisms of acupuncture and

moxibustion in regulation of epithelial cell apoptosis in rat ulcerative

colitis | World J Gastroenterol 10, 2004 Mar 1, 682-8 | Shanghai

Institute of AP- Moxibustion and Meridians, Shanghai 200030,

China.wuhuangan | AIM: To investigate the effect of

acupuncture and moxibustion on epithelial cell apoptosis and

expression of Bcl-2, Bax, fas and FasL proteins in rat ulcerative

colitis. METHODS: A rat model of ulcerative colitis was

estabelished by immunological methods and local stimulation. All

rats were randomly divided into model control group (MC), electro-

acupuncture group (EA), herbs-partition moxibustion group (HPM).

Normal rats were used as normal control group (NC). Epithelial cell

apoptosis and expression of Bcl-2, Bax, fas and FasL proteins

were detected by TUNEL and immunohistochemiscal method

respectively. RESULTS : The number of epithelial cell apoptosis in

MC was significantly higher than that in NC, and was markedly

decreased after the treatment with herbs-partition moxibustion or

electro-acupuncture The expression of Bcl-2, Bax, fas and FasL in

colonic epithelial cells in MC was higher than that in NC, and was

markedly down- regulated by herbs-partition moxibustion or electro-

acupuncture treatment CONCLUSION: The pathogenesis of

ulcerative colitis in rats involves abnormality of apoptosis. AP and

moxibustion can regulate the expression of Bcl-2, Bax, fas and

FasL proteins and inhibit the apoptosis of epithelial cells of

ulcerative colitis in rats by Bcl-2/Bax, fas/FasL pathways.

 

33 | Xing, J; Larive, B; Mekhail, N; Soffer, E | Transcutaneous

electrical acustimulation can reduce visceral perception in patients

with the irritable bowel syndrome: a pilot study | Altern Ther Health

Med 10, 2004 Jan-Feb, 38-42 | Dept of Gastroenterology,

Biostatistics, Cleveland Clinic Foundation, Cleveland, OH, USA. |

OBJECTIVES: AP has been used as a therapy for various

gastrointestinal disorders, including irritable bowel syndrome (IBS).

However, there is scant information on the effect of acupuncture on

gut physiology. The purpose of this study was to evaluate the effect

of transcutaneous electrical acustimulation (TEAS) on rectal tone,

compliance and perception in IBS patients. METHODS: Seven

patients with diarrhea-predominant IBS were studied during control,

sham stimulation and acupoints (ST36 and P6) stimulation periods.

Rectal tone, compliance and perception to rectal balloon distension

were assessed with a barostat apparatus. RESULTS :

Acustimulation at ST36 and P6, but not sham stimulation,

significantly increased the threshold of rectal sensation of gas,

desire to defecate and pain, as compared to control period.

However, rectal tone and compliance were not significantly affected

during TEAS. CONCLUSIONS: TEAS, at the above acupoints, can

reduce rectal sensitivity in IBS patients. The effect is not

modulated by changes in rectal biomechanics.

 

34 | Zhang, Shi Ping; Zhang, Jin Shan; Yung, Ken KL; Zhang, Hong

Qi | Non-opioid-dependent anti-inflammatory effects of low

frequency electroacupuncture | Brain Research Bulletin 62 (4)

January 15, 2004, 327-334 | spzhang; School of

, Hong Kong Baptist University, Kowloon Tong,

Hong Kong, China | Low frequency electroacupuncture, which is

commonly used in pain relief, is known to induce opioid-mediated

analgesia. This study examined the contribution of the opioid

system in mediating the anti-inflammatory effects of low frequency

EA in a standard model of acute inflammation, the carrageenan-

induced edema model. Carrageenan was injected in the hind paw

of anesthetized rats and low frequency electroacupuncture was

applied to acupoints equivalent to Zusanli (St 36) and Sanyinjiao

(Sp 6) in humans just prior to the induction of inflammation in the

ipsilateral leg. Induction of Fos protein, reflecting neuronal

activation, was investigated in the spinal cord with

immunohistochemistry. It was found that electroacupuncture

strongly inhibited the carrageenan-induced edema by over 60%,

and suppressed the associated Fos expression in the superficial

laminae (I-II) of the ipsilateral dorsal horn by 50%. Neither the anti-

edematous effect nor the suppression of Fos expression in the

superficial spinal laminae was affected by intraperitoneal injection

of the opioid antagonist naloxone. These results demonstrate that

low frequency electroacupuncture is capable of inhibiting peripheral

inflammation and the associated central neuronal activity via a non-

opioid-dependent mechanism.

 

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