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Improvement in fibromyalgia symptoms with acupuncture: results of a RCT

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Mayo Clin Proc. 2006 Jun;81(6):749-57.

 

 

Improvement in fibromyalgia symptoms with acupuncture: results of a

randomized controlled trial.

 

Martin DP, Sletten CD, Williams BA, Berger IH.

 

Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St

SW, Rochester, MN 55905, USA. martin.david

 

OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of

fibromyalgia. PATIENTS AND METHODS: We conducted a prospective, partially

blinded, controlled, randomized clinical trial of patients receiving true

acupuncture compared with a control group of patients who received simulated

acupuncture. All patients met American College of Rheumatology criteria for

fibromyalgia and had tried conservative symptomatic treatments other than

acupuncture. We measured symptoms with the Fibromyalgia Impact Questionnaire

(FIQ) and the Multidimensional Pain Inventory at baseline, immediately after

treatment, and at 1 month and 7 months after treatment. The trial was

conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty patients

participated in the study: 25 in the acupuncture group and 25 in the control

group. Total fibromyalgia symptoms, as measured by the FIQ, were

significantly improved in the acupuncture group compared with the control

group during the study period (P = .01). The largest difference in mean FIQ

total scores was observed at 1 month (42.2 vs 34.8 in the control and

acupuncture groups, respectively; P = .007). Fatigue and anxiety were the

most significantly improved symptoms during the follow-up period. However,

activity and physical function levels did not change. Acupuncture was well

tolerated, with minimal adverse effects. CONCLUSION: This study paradigm

allows for controlled and blinded clinical trials of acupuncture. We found

that acupuncture significantly improved symptoms of fibromyalgia.

Symptomatic improvement was not restricted to pain relief and was most

significant for fatigue and anxiety.

 

PMID: 16770975 [PubMed - in process]

 

 

 

 

 

 

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very interesting - what points did they use?

 

Karen R. Adams

Lic Ac, Dipl Ac, BA(Hons), BS

Four Directions Healing Arts

112 Avenue A

Turners Falls, MA 01376

413-863-8033

413-768-8333

 

Tom Verhaeghe wrote:

 

>

> Mayo Clin Proc. 2006 Jun;81(6):749-57.

>

>

> Improvement in fibromyalgia symptoms with acupuncture: results of a

> randomized controlled trial.

>

> Martin DP, Sletten CD, Williams BA, Berger IH.

>

> Department of Anesthesiology, Mayo Clinic College of Medicine, 200

> First St

> SW, Rochester, MN 55905, USA. martin.david

> <martin.david%40mayo.edu>

>

> OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of

> fibromyalgia. PATIENTS AND METHODS: We conducted a prospective, partially

> blinded, controlled, randomized clinical trial of patients receiving true

> acupuncture compared with a control group of patients who received

> simulated

> acupuncture. All patients met American College of Rheumatology

> criteria for

> fibromyalgia and had tried conservative symptomatic treatments other than

> acupuncture. We measured symptoms with the Fibromyalgia Impact

> Questionnaire

> (FIQ) and the Multidimensional Pain Inventory at baseline, immediately

> after

> treatment, and at 1 month and 7 months after treatment. The trial was

> conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty patients

> participated in the study: 25 in the acupuncture group and 25 in the

> control

> group. Total fibromyalgia symptoms, as measured by the FIQ, were

> significantly improved in the acupuncture group compared with the control

> group during the study period (P = .01). The largest difference in

> mean FIQ

> total scores was observed at 1 month (42.2 vs 34.8 in the control and

> acupuncture groups, respectively; P = .007). Fatigue and anxiety were the

> most significantly improved symptoms during the follow-up period. However,

> activity and physical function levels did not change. Acupuncture was well

> tolerated, with minimal adverse effects. CONCLUSION: This study paradigm

> allows for controlled and blinded clinical trials of acupuncture. We found

> that acupuncture significantly improved symptoms of fibromyalgia.

> Symptomatic improvement was not restricted to pain relief and was most

> significant for fatigue and anxiety.

>

> PMID: 16770975 [PubMed - in process]

>

>

>

>

>

>

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any idea frequency of tx, points used or tcm diagnosis or qualifications of

person performing ap?

Bob

www.acuherbals.com

 

Tom Verhaeghe <tom.verhaeghe wrote:

 

Mayo Clin Proc. 2006 Jun;81(6):749-57.

 

 

Improvement in fibromyalgia symptoms with acupuncture: results of a

randomized controlled trial.

 

Martin DP, Sletten CD, Williams BA, Berger IH.

 

Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St

SW, Rochester, MN 55905, USA. martin.david

 

OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of

fibromyalgia. PATIENTS AND METHODS: We conducted a prospective, partially

blinded, controlled, randomized clinical trial of patients receiving true

acupuncture compared with a control group of patients who received simulated

acupuncture. All patients met American College of Rheumatology criteria for

fibromyalgia and had tried conservative symptomatic treatments other than

acupuncture. We measured symptoms with the Fibromyalgia Impact Questionnaire

(FIQ) and the Multidimensional Pain Inventory at baseline, immediately after

treatment, and at 1 month and 7 months after treatment. The trial was

conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty patients

participated in the study: 25 in the acupuncture group and 25 in the control

group. Total fibromyalgia symptoms, as measured by the FIQ, were

significantly improved in the acupuncture group compared with the control

group during the study period (P = .01). The largest difference in mean FIQ

total scores was observed at 1 month (42.2 vs 34.8 in the control and

acupuncture groups, respectively; P = .007). Fatigue and anxiety were the

most significantly improved symptoms during the follow-up period. However,

activity and physical function levels did not change. Acupuncture was well

tolerated, with minimal adverse effects. CONCLUSION: This study paradigm

allows for controlled and blinded clinical trials of acupuncture. We found

that acupuncture significantly improved symptoms of fibromyalgia.

Symptomatic improvement was not restricted to pain relief and was most

significant for fatigue and anxiety.

 

PMID: 16770975 [PubMed - in process]

 

 

 

 

 

 

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any idea frequency of tx, points used or tcm diagnosis or qualifications of

person performing ap?

Bob

www.acuherbals.com

 

Tom Verhaeghe <tom.verhaeghe wrote:

 

Mayo Clin Proc. 2006 Jun;81(6):749-57.

 

 

Improvement in fibromyalgia symptoms with acupuncture: results of a

randomized controlled trial.

 

Martin DP, Sletten CD, Williams BA, Berger IH.

 

Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St

SW, Rochester, MN 55905, USA. martin.david

 

OBJECTIVE: To test the hypothesis that acupuncture improves symptoms of

fibromyalgia. PATIENTS AND METHODS: We conducted a prospective, partially

blinded, controlled, randomized clinical trial of patients receiving true

acupuncture compared with a control group of patients who received simulated

acupuncture. All patients met American College of Rheumatology criteria for

fibromyalgia and had tried conservative symptomatic treatments other than

acupuncture. We measured symptoms with the Fibromyalgia Impact Questionnaire

(FIQ) and the Multidimensional Pain Inventory at baseline, immediately after

treatment, and at 1 month and 7 months after treatment. The trial was

conducted from May 28, 2002, to August 18, 2003. RESULTS: Fifty patients

participated in the study: 25 in the acupuncture group and 25 in the control

group. Total fibromyalgia symptoms, as measured by the FIQ, were

significantly improved in the acupuncture group compared with the control

group during the study period (P = .01). The largest difference in mean FIQ

total scores was observed at 1 month (42.2 vs 34.8 in the control and

acupuncture groups, respectively; P = .007). Fatigue and anxiety were the

most significantly improved symptoms during the follow-up period. However,

activity and physical function levels did not change. Acupuncture was well

tolerated, with minimal adverse effects. CONCLUSION: This study paradigm

allows for controlled and blinded clinical trials of acupuncture. We found

that acupuncture significantly improved symptoms of fibromyalgia.

Symptomatic improvement was not restricted to pain relief and was most

significant for fatigue and anxiety.

 

PMID: 16770975 [PubMed - in process]

 

 

 

 

 

 

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I don't know any details about the study, but I just emailed Martin David,

hoping he will share some more details with us.

 

Best regards,

 

Tom.

 

----

 

Bob Linde,AP, Herbalist

06/18/06 15:39:51

Chinese Medicine

Re: Improvement in fibromyalgia symptoms with acupuncture:

results of a RCT

 

any idea frequency of tx, points used or tcm diagnosis or qualifications of

person performing ap?

Bob

www.acuherbals.com

 

Tom Verhaeghe <tom.verhaeghe wrote:

 

Mayo Clin Proc. 2006 Jun;81(6):749-57.

 

Improvement in fibromyalgia symptoms with acupuncture: results of a

randomized controlled trial.

 

Martin DP, Sletten CD, Williams BA, Berger IH.

 

Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St

SW, Rochester, MN 55905, USA. martin.david

 

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Bob and others,

 

I received a copy of the FM paper from David Martin, MD, Ph. D

 

The points used were:

" Acupuncture points. Needles were placed at the large

intestine 4 (LI-4), stomach 36 (ST-36), liver 2 (LR-2), spleen 6 (SP-

6), pericardium 6 (P-6), and heart 7 (HT-7). Electrical stimulation

was provided between LI-4 and ST-36 at 2 Hz. Axial points were

placed along the bladder meridian and stimulated at 10 Hz. The

cervical axial circuit was used only during the first 3 sessions, and

the lumbar axial circuit was used only during the last 3 sessions.

(axial circuit meaning Hua tuo ja ji points).

So points were standardized for all the patienrs. "

No special feeling of deqi qas elicited.

 

Frequency of therapy and qualification of acupuncturists:

" Patients received treatments

every 2 to 4 days during 2 to 3 weeks for a total of 6

sessions. All treatments were performed at 1 facility by 2

acupuncturists (D.P.M., I.H.B.) "

DPM stand for Doctor of Physical Medicine, IHB? perhaps International Health

Bureau?

 

Points were needled through an adhesive plaster. Control group had a bent

needle on a similar plaster sticked upon the same points. In both groups

patients could not see what was happening during treatment. Patients were

all new to AP.

 

From the discussion: "

" In this controlled, randomized, and blinded assessment of

acupuncture, our study patients were unable to determine

in which group they had participated. Such blinding is

necessary for quality research in acupuncture because the

control group displayed the expected placebo response that

is typical of pain studies.11 An alternative choice for control

treatments in studying acupuncture is to place needles at

incorrect or “sham” points. Although it would have been

easier to use this as a control, we agree with others who

have argued that needling at sham locations is also likely to

provide neuromodulatory inputs to the sensory nervous

system. Sham needling may in fact produce physiologic

changes indistinguishable from “true” acupuncture points.

We believe that the simulated acupuncture configuration

described herein provides an inexpensive and effective

method of providing realistic placebo acupuncture treat-

ments to patients who have not previously experienced

genuine acupuncture. "

 

Limitations:

" Our study has certain limitations. Perhaps most significant

is the relatively small size of the study population.

Additionally, some will argue that the acupuncture therapy

provided was not optimal with respect to point selection,

elicitation of de Qi, and electrical stimulation. To preserve

blinding, the design of the study did not allow customized

point selection or specific elicitation of the de Qi sensation,

sometimes referred to as “needle grab.” Some schools of

acupuncture require this sensation as an indication of

proper needle position. However, studies suggest that the

sensation of de Qi occurs equally frequently at true and

sham acupuncture points.16 Nevertheless, these deficiencies

would tend to minimize the treatment effect observed.

Hence, our results may represent a minimum effectiveness

of acupuncture.

Our patients were mostly women, which does not accurately

reflect the male-female ratio of the incidence of

fibromyalgia. This may represent scheduling difficulties on

behalf of potential patients or other factors that limited

enrollment by men. Our population was also predominantly

white, which reflects the community population in

Olmsted County, Minnesota, where this study was conducted.

Future research should extend these observations to

men and to other ethnic and racial groups. "

 

I wonder if the same effects would still be found with a larger population,

using the same set-up...

 

Tom.

 

 

 

 

----

 

Bob Linde,AP, Herbalist

06/18/06 15:46:57

Chinese Medicine

Re: Improvement in fibromyalgia symptoms with acupuncture:

results of a RCT

 

any idea frequency of tx, points used or tcm diagnosis or qualifications of

person performing ap?

Bob

www.acuherbals.com

 

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