COMBINE acupuncture with western medicine?

[Guest guest]

Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose

steroids. In theory, exogenous steroids can inhibit adrenal release

of endogenous steroids. But some practitioners are not so sure that

steroids inhibit the clinical effects of AP.

 

Below are some recent abstracts that suggest a BENEFIT from combining

AP with steroids / NSAIDS.

 

What do you think?

 

Miller E, Maimon Y, Rosenblatt Y, Mendler A, Hasner A, Barad A, Amir

H, Dekel S, Lev-Ari S. Delayed Effect of AP Treatment in OA of the

Knee: A Blinded, Randomized, Controlled Trial. Evid Based Complement

Alternat Med. 2009 Jan 5. [Epub ahead of print] Unit of Complementary

Medicine, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv

64239, Israel. compmed To assess the efficacy in

providing improved function and pain relief by administering 8 weeks

of AP as adjunctive therapy to standard care in elderly patients with

OA of the knee. This randomized, controlled, blinded trial was

conducted on 55 patients with OA of the knee. Forty-one patients

completed the study (26 females, 15 males, mean age +/- SD 71.7 +/-

8.6 years). Patients were randomly divided into an intervention group

that received biweekly AP treatment (n = 28) and a control group that

received sham AP (n = 27), both in addition to standard therapy

[NSAIDS, cyclooxygenase-2 inhibitors, acetaminophen, intra-articular

hyaluronic acid and steroid injections]. Primary outcomes measures

were changes in the Knee Society Score (KSS) knee score and in KSS

function and pain ratings at therapy onset, at 8 weeks (closure of

study) and at 12 weeks (1 month after last treatment). Secondary

outcomes were patient satisfaction and validity of sham AP. There was

significant improvement in all three scores in both groups after 8

and 12 weeks compared with baseline (P<0.05). Significant differences

between the intervention and control groups in the KSS knee score (P

= 0.036) was apparent only after 12 weeks. Patient satisfaction was

higher in the intervention group. Adjunctive AP treatment seems to

provide added improvement to standard care in elderly patients with

OA of the knee. Future research should determine the optimal duration

of AP treatment in the context of OA. PMID: 19124552 [PubMed - as

supplied by publisher]

 

Qin XY, Li XX, Berghea F, Suteanu S. [Comparative study on Chinese

medicine and western medicine for treatment of osteoarthritis of the

knee in Caucasian patients] [Article in Chinese] Zhongguo Zhen Jiu.

2008 Jun;28(6):459-62. Xuanwu Hospital, Capital Medical University,

Beijing 100053, China. OBJECTIVE: To compare the efficacy, safety and

tolerability of different therapies in Caucasian patients with

osteoarthritis (QA) of the knee. METHODS: Seventy-five cases (90 knee

joints) of osteoarthritis were randomly divided into 3 groups,

western medicine (WM) group, TCM group, integrated TCM + WM group.

The WM group was treated with oral administration of Glucosamine

Sulfate, oral administration and external application of NSAID,

ultrasound physiotherapy, etc. The TCM group was treated with oral

administration of Juanbi Decoction, AP and moxibustion, cupping,

massage of acupoint and ear AP. The integrated TCM + WM group was

treated with oral administration of Glucosamine Sulfate, oral

administration and external application of non-steroid anti-

inflammatory agent, AP and moxibustion, cupping, massage of acupoint

and ear AP. The intensity of knee joint pain on walking, resting and

standing, the nocturnal pain, stiffness, the maximum walking distance

and the daily living ability were monitored after 30 days, 60 days

and 90 days of treatment. RESULTS: After 90 days of treatment, the

integrated TCM + WM group was better than other two groups in

improvement of percentages in self pain assessment with visual analog

scale (VAS), pain and stiffness measured by WOMAC scale, pain and

maximum walking distance measured by Lequesne scale (p <.05 or

p<.01). There were no significant differences in the therapeutic

effects between the TCM group and the WM group. All of these three

treatments were well tolerated, and no severe adverse events were

found. Combined TCM + WM treatment has rapid and definite therapeutic

effect in reducing pain and improving mobility of knee joints and

daily living ability in Caucasian patients of knee osteoarthritis.

PMID: 18630549 [PubMed - indexed for MEDLINE]

 

Wehling P, Reinecke J. [AP together with cytokine depressing herbs in

comparison to injection therapy with steroids in sciatic pain]

[Article in German] Schmerz. 1997 Jun 13;11(3):180-4. Praxis und

Klinik für Orthopädie und Neurochirurgie, Düsseldorf. Because of

their frequency and consequences sciatica remains a demanding

clinical entity with significant social and economical impact. There

is a high demand on therapeutic modalities, using folk medicine

methods in the treatment of orthopaedic diseases. No data is

available on the usefulness of methods like natural herbs in

combination with AP. Aim of our study was to present data on the

effect of AP and cytokine-inhibiting natural herbs in sciatic pain.

We compared these results with nerve root infiltration by local

anaesthetics and corticosteroids in our orthopaedic outpatient

clinic. MATERIALS AND RESULTS: 278 patients with chronic pain for at

least 3 months were observed. All three therapeutical modalities

showed improvement of pain scores. Best results were gained with

steroid injection ( n=26; 66% pain reduction), AP in combination with

herbs improved the pain in average of 62% ( n=230), whereas injection

with local anaesthetic had a pain reduction of 48% ( n=22). Sole

Mepivacain-HCl treatment had significant less pain reduction compared

to the other treatment modalities. AP in combination with herbs and

steroid nerve blocks appear to be an effective and thus recommendable

conservative therapy in cases of sciatic pain. Taking into account

that patients increasingly prefer ethnomedical modalities of

treatment our study gains importance for practising orthopaedists.

PMID: 12799820 [PubMed]

 

Yang JW, Jeong SM, Seo KM, Nam TC. Effects of corticosteroid and

Electro-AP on experimental spinal cord injury in dogs. J Vet Sci.

2003 Apr;4(1):97-101. College of Vet Med, Seoul National Univ, San 56-

1 Shillim 9-dong, Kwanak-gu, Seoul 151-742, Korea. The aim of this

study is to investigate the effects of Electro-AP (EAP),

corticosteroid and combination of two treatments on ambulatory

paresis due to spinal cord injury in dogs by comparing therapeutic

effects of EAP and corticosteroid. Spinal cord injury was induced in

20 healthy dogs (2.5-7 kg and 2-4 years) by foreign body insertion

which compressed about 25% of spinal cord. There was no conscious

proprioception, no extensor postural thrust and ambulatory. Dogs were

divided into four groups according to the treatment; corticosteroid

(Group A), EAP (Group B), corticosteroid and EAP (Group AB) and

control (Group C). Neurological examination was performed everyday to

evaluate the spinal cord dysfunction until motor functions were

returned to normal. Somatosensory evoked potentials (SEPs) were

measured for Aim and accurate evaluations. The latency in measured

potentials was converted into the velocity for the evaluation of

spinal cord dysfunctions. Pain perceptions were normal from pre-

operation to 5 weeks after operation. Recovery days of conscious

proprioception in groups A, B, AB and C were 21.2+/-8.5 days, 19.8+/-

4.3 days, 8.2+/-2.6 days and 46.6+/-3.7 days, respectively. Recovery

days of extensor postural thrust in Group A, Group B, Group AB and

Group C were 12.8+/-6.8 days, 13.8+/-4.8 days, 5.4+/-1.8 days and

38.2+/-4.2 days, respectively. There were no significant differences

between Group A and Group B. However, recovery days of Group AB was

significantly shorter than that of other groups and that of Group C

was significantly delayed (p<0.05). Conduction velocities of each

Group were significantly decreased after induction of spinal cord

injury on SEPs (p<0.05) and they showed a tendency to return to

normal when motor functions were recovered. Combination of

corticosteroid and EAP was the most therapeutically effective for

ambulatory paresis due to spinal cord injury in dogs. PMID: 12819372

[PubMed - indexed for MEDLINE]

 

Zhang RX, Lao L, Wang X, Ren K, Berman BB. Electro-AP combined with

indomethacin enhances antihyperalgesia in inflammatory rats.

Pharmacol Biochem Behav. 2004 Aug;78(4):793-7. Center for Integrative

Medicine, School of Medicine, Univ of Maryland, Baltimore, MD 21201,

USA. Our previous study showed that Electro-AP (EAP) significantly

attenuated hyperalgesia and inflammation. The present study is an

evaluation of the potential synergism of EAP and a subeffective

dosage of indomethacin (INDO) in a rat model. Inflammation and

hyperalgesia, manifesting as edema and decreased paw withdrawal

latency (PWL) to a noxious stimulus, were induced by injecting

complete Freund's adjuvant (CFA) subcutaneously into the plantar

surface of one hind paw of the rat. EAP treatments were given at GB30

immediately and 2 h post-CFA. INDO at 2 mg/kg was given

(intraperitoneally) 40 min before the second EAP. PWL and edema were

measured prior to CFA and 2.5 and 5 h post-CFA. EAP at 10 and 100 Hz

significantly inhibited CFA-induced hind paw hyperalgesia. Both low-

and high-frequency EAP combined with INDO enhanced antihyperalgesia

compared to each component alone, and 10 Hz but not 100 Hz EAP

significantly reduced CFA-induced hind paw edema. A combination of

low-frequency EAP and INDO did not show synergistic inhibitory

effects on edema. EAP combined with INDO synergistically inhibited

hyperalgesia and may be an improved treatment strategy for

inflammatory pain. Copyright 2004 Elsevier Inc. PMID: 15301937

[PubMed - indexed for MEDLINE]

 

 

 

Best regards,

 

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0);

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)

<

 

 

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

[Guest guest]

Chinese Medicine , " "

< wrote:

 

" Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose steroids.

In theory, exogenous steroids can inhibit adrenal release of endogenous

steroids. But some practitioners are not so sure that steroids inhibit the

clinical effects of AP. "

 

 

 

 

Hi Phil, Hi All

my short answer is YES.

 

My only experience to date is with acupuncture for people who have cancer, who

receive the steroid DEXAMETHASONE.

 

'Dex' is commonly used in medical oncology practice, as a pre-med prior to

infusion of certain chemothepeutic agents, and at other times to engender

appetite in folk who are cachetic and/or anorexic due to treatment & /or their

conditions.

It's also used in many other non-cancer conditions, see links below.

 

I have observed, over and over, that this drug will amplify and exaggerate the

existing mental and emotional state of the person who is receiving it.

eg Liver constrained folk become overtly cranky, frustrated, loud, 'wired' and

ultra-sensitive to all external stimuli.

Heart Blood & /or Heart Yin Xu folk experience continuous free-floating anxiety.

Nobody sleeps properly when they're on Dex.

 

The mental / emotional side effects of the drug are well-documented.

 

Any acupuncture treatment given to calm the shen seems to give these folk a

12-36 hr 'reprieve' from some of their internal disarray.

 

I find in particular, that the quartet of extra points - si shen cong M-HN-1 are

very effective, with a couple of other points used for TCM pattern for each

person.

 

What this says about the mechanisms of acupuncture, and its relationship and

effect on the Adrenal-Hypothalamic-Pituitary Axis and synthetic cortico-steroids

is quite beyond me!

 

I just know it can soothe distressing, mind-altering side-effects experienced by

this patient group.

 

Go here for more info about the drug:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682792.html

http://www.drugs.com/pro/dexamethasone-sodium-phosphate.html

 

Look forward to reading how others find the acup-steroid-combo works in their

patients.

 

Margi

[Guest guest]

Hi Phil

This is an interesting question.

I think it needs a LOT of thought to really flesh out.

I don't like making generalisations, but, having said that, I will say that in

10 years of clinical practice, I can say the biggest challenge I face

repeatedly is when someone comes to me to treat a condition for which they are

already medicated. My experience is that, for the most part, medications seem

to hinder the effectiveness of acupuncture.

UNLESS - and this is a big UNLESS - the acupuncture is specifically being used

to minimise side effects of strong medications. I have worked with a LOT of

patients going through strong chemo for cancer and also for hepatitis - and

almost without exception, it was very very clear that the acupuncture really

reduced the side effects and helped the patients to sail through what would more

typically be a rough chemotherapeutic process.

But that is a very different 'partnership' between acupuncture and 'modern

medicine' than trying to treat a 'condition' for which a person is also

medicated.

 

Daniel

 

Chinese Medicine , " "

< wrote:

>

> Hi All,

>

> Do you COMBINE acupuncture with western medicine (especially steroid-

> or NSAID- therapy)?

>

> Some teachers and practitioners say that AP is less effective in

> people or animals currently on steroid therapy, especially high-dose

> steroids. In theory, exogenous steroids can inhibit adrenal release

> of endogenous steroids. But some practitioners are not so sure that

> steroids inhibit the clinical effects of AP.

>

> Below are some recent abstracts that suggest a BENEFIT from combining

> AP with steroids / NSAIDS.

>

> What do you think?

>

[Guest guest]

Dear Phil,

 

I believe that we need to make a clear distinction between combining two

modalities and integrating western biomedical substances into the Chinese

medical model.  I believe that this distinction is also an area of controversy

in China as well, and applies to acupuncture as well as herbal medicine.  (This

concern I have also extends to Western Naturopathic or eclectic medicine, as

well, in which natural substances or therapies treat conditions, taking the

approach that " whatever works " ). 

 

 The question really is one of the model we use for diagnosis and treatment of

our patients--do we treat symptoms and needle local points to ameliorate pain or

discomfort,  or do we treat based upon the patient's differential diagnosis,

constitution and history.  The former is pure bio-medicine, which I contend in

years to come will be viewed as a dinosaur--an extinct remnant of an ignorant

past, much the same as the medieval alchemy and  mercury therapies of years gone

by, (such as those used in Europe by Paracelsus) which killed far more than it

healed.  (now of course,  there were the exceptional remarkable alchemists

who did hone this dangerous skill and used it properly, but they were few and

far between). 

 

The time will come I believe, (and I hope soon!)  that there will be an " aha! "

moment--when Western biomedicine will wake up to the fact that their approach

of treating purely symptoms, more often than not ignoring the pathogenesis of

the illness, and ignoring the interconnectedness of the body is flawed.  They

will realize that medical acupuncture which only treats local points or simple

empirical patterns (ie. ST38 for shoulder pain) is no different than folk

medicine such as using herbs from the health food store to treat symptoms, and

is not really medicine.  (I don't know if any of you, BTW, have read any of the

case studies brought in Medical acupuncture journals-by MDs and for MDs.  They

are terribly unprecise in their methodologies and procedures!) . It will be a

seminal moment, just like the fall of communism, the " perfect " system, when

practitioners will wake up to the fact that their patients no longer trust their

methods of

treatment.  It will precipitate a paradigm shift in the way MDs diagnose and

treat, and then we will truly all practice complementary medicine.  But I

digress...

 

Getting back to the original question, this is the same problem with combining

Chinese medicine or acupuncture with Western medicine.  If we are using any

medicine to treat sympoms, we are not treating the whole person, and usually

the  " whole person " will not get well.  Either there will be some other

new condition, or the condition treated will return.  I am reminded of the

Mishna in Pirkei Avos (a talmudic text that Jews study during this time of year)

which says, " He've dan es kol ha'adam l'cof z'chus. "   This is usually translated

as, " Give every person the benefit of the doubt. "   But the correct,

and exact translation is, " One should judge the whole person as meritorious. "  

Meaning look to all of the factors that make up a person before forming an

opinion--look at the whole person.  The same here, as physicians we need

to treat the whole patient and not just symptoms, nor just suppressing or

ameliorating symptoms that

result as side effects from the original flawed therapy.  

 

We are the torchbearers of a wonderful medicine.  Let us not lower ourselves to

using our tools wrongly, for using a sophisticated electronic devise as a

hammer. 

 

Respectfully, 

 

 

 

 

 

 

 

--- On Thu, 4/23/09, < wrote:

 

 

<

COMBINE acupuncture with western medicine?

,

traditional_Chinese_Medicine

Cc: PVA-L , Pa-l

Thursday, April 23, 2009, 5:18 PM

 

 

 

 

 

 

 

 

Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose

steroids. In theory, exogenous steroids can inhibit adrenal release

of endogenous steroids. But some practitioners are not so sure that

steroids inhibit the clinical effects of AP.

 

Below are some recent abstracts that suggest a BENEFIT from combining

AP with steroids / NSAIDS.

 

What do you think?

 

Miller E, Maimon Y, Rosenblatt Y, Mendler A, Hasner A, Barad A, Amir

H, Dekel S, Lev-Ari S. Delayed Effect of AP Treatment in OA of the

Knee: A Blinded, Randomized, Controlled Trial. Evid Based Complement

Alternat Med. 2009 Jan 5. [Epub ahead of print] Unit of Complementary

Medicine, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv

64239, Israel. compmed (AT) tasmc (DOT) health.gov. il To assess the efficacy in

providing improved function and pain relief by administering 8 weeks

of AP as adjunctive therapy to standard care in elderly patients with

OA of the knee. This randomized, controlled, blinded trial was

conducted on 55 patients with OA of the knee. Forty-one patients

completed the study (26 females, 15 males, mean age +/- SD 71.7 +/-

8.6 years). Patients were randomly divided into an intervention group

that received biweekly AP treatment (n = 28) and a control group that

received sham AP (n = 27), both in addition to standard therapy

[NSAIDS, cyclooxygenase- 2 inhibitors, acetaminophen, intra-articular

hyaluronic acid and steroid injections]. Primary outcomes measures

were changes in the Knee Society Score (KSS) knee score and in KSS

function and pain ratings at therapy onset, at 8 weeks (closure of

study) and at 12 weeks (1 month after last treatment). Secondary

outcomes were patient satisfaction and validity of sham AP. There was

significant improvement in all three scores in both groups after 8

and 12 weeks compared with baseline (P<0.05). Significant differences

between the intervention and control groups in the KSS knee score (P

= 0.036) was apparent only after 12 weeks. Patient satisfaction was

higher in the intervention group. Adjunctive AP treatment seems to

provide added improvement to standard care in elderly patients with

OA of the knee. Future research should determine the optimal duration

of AP treatment in the context of OA. PMID: 19124552 [PubMed - as

supplied by publisher]

 

Qin XY, Li XX, Berghea F, Suteanu S. [Comparative study on Chinese

medicine and western medicine for treatment of osteoarthritis of the

knee in Caucasian patients] [Article in Chinese] Zhongguo Zhen Jiu.

2008 Jun;28(6):459- 62. Xuanwu Hospital, Capital Medical University,

Beijing 100053, China. OBJECTIVE: To compare the efficacy, safety and

tolerability of different therapies in Caucasian patients with

osteoarthritis (QA) of the knee. METHODS: Seventy-five cases (90 knee

joints) of osteoarthritis were randomly divided into 3 groups,

western medicine (WM) group, TCM group, integrated TCM + WM group.

The WM group was treated with oral administration of Glucosamine

Sulfate, oral administration and external application of NSAID,

ultrasound physiotherapy, etc. The TCM group was treated with oral

administration of Juanbi Decoction, AP and moxibustion, cupping,

massage of acupoint and ear AP. The integrated TCM + WM group was

treated with oral administration of Glucosamine Sulfate, oral

administration and external application of non-steroid anti-

inflammatory agent, AP and moxibustion, cupping, massage of acupoint

and ear AP. The intensity of knee joint pain on walking, resting and

standing, the nocturnal pain, stiffness, the maximum walking distance

and the daily living ability were monitored after 30 days, 60 days

and 90 days of treatment. RESULTS: After 90 days of treatment, the

integrated TCM + WM group was better than other two groups in

improvement of percentages in self pain assessment with visual analog

scale (VAS), pain and stiffness measured by WOMAC scale, pain and

maximum walking distance measured by Lequesne scale (p <.05 or

p<.01). There were no significant differences in the therapeutic

effects between the TCM group and the WM group. All of these three

treatments were well tolerated, and no severe adverse events were

found. Combined TCM + WM treatment has rapid and definite therapeutic

effect in reducing pain and improving mobility of knee joints and

daily living ability in Caucasian patients of knee osteoarthritis.

PMID: 18630549 [PubMed - indexed for MEDLINE]

 

Wehling P, Reinecke J. [AP together with cytokine depressing herbs in

comparison to injection therapy with steroids in sciatic pain]

[Article in German] Schmerz. 1997 Jun 13;11(3):180- 4. Praxis und

Klinik für Orthopädie und Neurochirurgie, Düsseldorf. Because of

their frequency and consequences sciatica remains a demanding

clinical entity with significant social and economical impact. There

is a high demand on therapeutic modalities, using folk medicine

methods in the treatment of orthopaedic diseases. No data is

available on the usefulness of methods like natural herbs in

combination with AP. Aim of our study was to present data on the

effect of AP and cytokine-inhibiting natural herbs in sciatic pain.

We compared these results with nerve root infiltration by local

anaesthetics and corticosteroids in our orthopaedic outpatient

clinic. MATERIALS AND RESULTS: 278 patients with chronic pain for at

least 3 months were observed. All three therapeutical modalities

showed improvement of pain scores. Best results were gained with

steroid injection ( n=26; 66% pain reduction), AP in combination with

herbs improved the pain in average of 62% ( n=230), whereas injection

with local anaesthetic had a pain reduction of 48% ( n=22). Sole

Mepivacain-HCl treatment had significant less pain reduction compared

to the other treatment modalities. AP in combination with herbs and

steroid nerve blocks appear to be an effective and thus recommendable

conservative therapy in cases of sciatic pain. Taking into account

that patients increasingly prefer ethnomedical modalities of

treatment our study gains importance for practising orthopaedists.

PMID: 12799820 [PubMed]

 

Yang JW, Jeong SM, Seo KM, Nam TC. Effects of corticosteroid and

Electro-AP on experimental spinal cord injury in dogs. J Vet Sci.

2003 Apr;4(1):97- 101. College of Vet Med, Seoul National Univ, San 56-

1 Shillim 9-dong, Kwanak-gu, Seoul 151-742, Korea. The aim of this

study is to investigate the effects of Electro-AP (EAP),

corticosteroid and combination of two treatments on ambulatory

paresis due to spinal cord injury in dogs by comparing therapeutic

effects of EAP and corticosteroid. Spinal cord injury was induced in

20 healthy dogs (2.5-7 kg and 2-4 years) by foreign body insertion

which compressed about 25% of spinal cord. There was no conscious

proprioception, no extensor postural thrust and ambulatory. Dogs were

divided into four groups according to the treatment; corticosteroid

(Group A), EAP (Group B), corticosteroid and EAP (Group AB) and

control (Group C). Neurological examination was performed everyday to

evaluate the spinal cord dysfunction until motor functions were

returned to normal. Somatosensory evoked potentials (SEPs) were

measured for Aim and accurate evaluations. The latency in measured

potentials was converted into the velocity for the evaluation of

spinal cord dysfunctions. Pain perceptions were normal from pre-

operation to 5 weeks after operation. Recovery days of conscious

proprioception in groups A, B, AB and C were 21.2+/-8.5 days, 19.8+/-

4.3 days, 8.2+/-2.6 days and 46.6+/-3.7 days, respectively. Recovery

days of extensor postural thrust in Group A, Group B, Group AB and

Group C were 12.8+/-6.8 days, 13.8+/-4.8 days, 5.4+/-1.8 days and

38.2+/-4.2 days, respectively. There were no significant differences

between Group A and Group B. However, recovery days of Group AB was

significantly shorter than that of other groups and that of Group C

was significantly delayed (p<0.05). Conduction velocities of each

Group were significantly decreased after induction of spinal cord

injury on SEPs (p<0.05) and they showed a tendency to return to

normal when motor functions were recovered. Combination of

corticosteroid and EAP was the most therapeutically effective for

ambulatory paresis due to spinal cord injury in dogs. PMID: 12819372

[PubMed - indexed for MEDLINE]

 

Zhang RX, Lao L, Wang X, Ren K, Berman BB. Electro-AP combined with

indomethacin enhances antihyperalgesia in inflammatory rats.

Pharmacol Biochem Behav. 2004 Aug;78(4):793- 7. Center for Integrative

Medicine, School of Medicine, Univ of Maryland, Baltimore, MD 21201,

USA. Our previous study showed that Electro-AP (EAP) significantly

attenuated hyperalgesia and inflammation. The present study is an

evaluation of the potential synergism of EAP and a subeffective

dosage of indomethacin (INDO) in a rat model. Inflammation and

hyperalgesia, manifesting as edema and decreased paw withdrawal

latency (PWL) to a noxious stimulus, were induced by injecting

complete Freund's adjuvant (CFA) subcutaneously into the plantar

surface of one hind paw of the rat. EAP treatments were given at GB30

immediately and 2 h post-CFA. INDO at 2 mg/kg was given

(intraperitoneally) 40 min before the second EAP. PWL and edema were

measured prior to CFA and 2.5 and 5 h post-CFA. EAP at 10 and 100 Hz

significantly inhibited CFA-induced hind paw hyperalgesia. Both low-

and high-frequency EAP combined with INDO enhanced antihyperalgesia

compared to each component alone, and 10 Hz but not 100 Hz EAP

significantly reduced CFA-induced hind paw edema. A combination of

low-frequency EAP and INDO did not show synergistic inhibitory

effects on edema. EAP combined with INDO synergistically inhibited

hyperalgesia and may be an improved treatment strategy for

inflammatory pain. Copyright 2004 Elsevier Inc. PMID: 15301937

[PubMed - indexed for MEDLINE]

 

Best regards,

 

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0)1-6281- 222;

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)87-286- 8277

< (AT) eircom (DOT) net>

http://homepage. eircom.net/ ~progers/ vaplinks. htm

http://homepage. eircom.net/ ~progers/ tecnotes. htm

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Dear Phil,

 

I believe that we need to make a clear distinction between combining two

modalities and integrating western biomedical substances into the Chinese

medical model.  I believe that this distinction is also an area of controversy

in China as well, and applies to acupuncture as well as herbal medicine.  (This

concern I have also extends to Western Naturopathic or eclectic medicine, as

well, in which natural substances or therapies treat conditions, taking the

approach that " whatever works " ). 

 

 The question really is one of the model we use for diagnosis and treatment of

our patients--do we treat symptoms and needle local points to ameliorate pain or

discomfort,  or do we treat based upon the patient's differential diagnosis,

constitution and history.  The former is pure bio-medicine, which I contend in

years to come will be viewed as a dinosaur--an extinct remnant of an ignorant

past, much the same as the medieval alchemy and  mercury therapies of years gone

by, (such as those used in Europe by Paracelsus) which killed far more than it

healed.  (now of course,  there were the exceptional remarkable alchemists

who did hone this dangerous skill and used it properly, but they were few and

far between). 

 

The time will come I believe, (and I hope soon!)  that there will be an " aha! "

moment--when Western biomedicine will wake up to the fact that their approach

of treating purely symptoms, more often than not ignoring the pathogenesis of

the illness, and ignoring the interconnectedness of the body is flawed.  They

will realize that medical acupuncture which only treats local points or simple

empirical patterns (ie. ST38 for shoulder pain) is no different than folk

medicine such as using herbs from the health food store to treat symptoms, and

is not really medicine.  (I don't know if any of you, BTW, have read any of the

case studies brought in Medical acupuncture journals-by MDs and for MDs.  They

are terribly unprecise in their methodologies and procedures!) . It will be a

seminal moment, just like the fall of communism, the " perfect " system, when

practitioners will wake up to the fact that their patients no longer trust their

methods of

treatment.  It will precipitate a paradigm shift in the way MDs diagnose and

treat, and then we will truly all practice complementary medicine.  But I

digress...

 

Getting back to the original question, this is the same problem with combining

Chinese medicine or acupuncture with Western medicine.  If we are using any

medicine to treat sympoms, we are not treating the whole person, and usually

the  " whole person " will not get well.  Either there will be some other

new condition, or the condition treated will return.  I am reminded of the

Mishna in Pirkei Avos (a talmudic text that Jews study during this time of year)

which says, " He've dan es kol ha'adam l'cof z'chus. "   This is usually translated

as, " Give every person the benefit of the doubt. "   But the correct,

and exact translation is, " One should judge the whole person as meritorious. "  

Meaning look to all of the factors that make up a person before forming an

opinion--look at the whole person.  The same here, as physicians we need

to treat the whole patient and not just symptoms, nor just suppressing or

ameliorating symptoms that

result as side effects from the original flawed therapy.  

 

We are the torchbearers of a wonderful medicine.  Let us not lower ourselves to

using our tools wrongly, for using a sophisticated electronic devise as a

hammer. 

 

Respectfully, 

 

 

 

 

 

 

 

--- On Thu, 4/23/09, < wrote:

 

 

<

COMBINE acupuncture with western medicine?

,

traditional_Chinese_Medicine

Cc: PVA-L , Pa-l

Thursday, April 23, 2009, 5:18 PM

 

 

 

 

 

 

 

 

Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose

steroids. In theory, exogenous steroids can inhibit adrenal release

of endogenous steroids. But some practitioners are not so sure that

steroids inhibit the clinical effects of AP.

 

Below are some recent abstracts that suggest a BENEFIT from combining

AP with steroids / NSAIDS.

 

What do you think?

 

Miller E, Maimon Y, Rosenblatt Y, Mendler A, Hasner A, Barad A, Amir

H, Dekel S, Lev-Ari S. Delayed Effect of AP Treatment in OA of the

Knee: A Blinded, Randomized, Controlled Trial. Evid Based Complement

Alternat Med. 2009 Jan 5. [Epub ahead of print] Unit of Complementary

Medicine, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv

64239, Israel. compmed (AT) tasmc (DOT) health.gov. il To assess the efficacy in

providing improved function and pain relief by administering 8 weeks

of AP as adjunctive therapy to standard care in elderly patients with

OA of the knee. This randomized, controlled, blinded trial was

conducted on 55 patients with OA of the knee. Forty-one patients

completed the study (26 females, 15 males, mean age +/- SD 71.7 +/-

8.6 years). Patients were randomly divided into an intervention group

that received biweekly AP treatment (n = 28) and a control group that

received sham AP (n = 27), both in addition to standard therapy

[NSAIDS, cyclooxygenase- 2 inhibitors, acetaminophen, intra-articular

hyaluronic acid and steroid injections]. Primary outcomes measures

were changes in the Knee Society Score (KSS) knee score and in KSS

function and pain ratings at therapy onset, at 8 weeks (closure of

study) and at 12 weeks (1 month after last treatment). Secondary

outcomes were patient satisfaction and validity of sham AP. There was

significant improvement in all three scores in both groups after 8

and 12 weeks compared with baseline (P<0.05). Significant differences

between the intervention and control groups in the KSS knee score (P

= 0.036) was apparent only after 12 weeks. Patient satisfaction was

higher in the intervention group. Adjunctive AP treatment seems to

provide added improvement to standard care in elderly patients with

OA of the knee. Future research should determine the optimal duration

of AP treatment in the context of OA. PMID: 19124552 [PubMed - as

supplied by publisher]

 

Qin XY, Li XX, Berghea F, Suteanu S. [Comparative study on Chinese

medicine and western medicine for treatment of osteoarthritis of the

knee in Caucasian patients] [Article in Chinese] Zhongguo Zhen Jiu.

2008 Jun;28(6):459- 62. Xuanwu Hospital, Capital Medical University,

Beijing 100053, China. OBJECTIVE: To compare the efficacy, safety and

tolerability of different therapies in Caucasian patients with

osteoarthritis (QA) of the knee. METHODS: Seventy-five cases (90 knee

joints) of osteoarthritis were randomly divided into 3 groups,

western medicine (WM) group, TCM group, integrated TCM + WM group.

The WM group was treated with oral administration of Glucosamine

Sulfate, oral administration and external application of NSAID,

ultrasound physiotherapy, etc. The TCM group was treated with oral

administration of Juanbi Decoction, AP and moxibustion, cupping,

massage of acupoint and ear AP. The integrated TCM + WM group was

treated with oral administration of Glucosamine Sulfate, oral

administration and external application of non-steroid anti-

inflammatory agent, AP and moxibustion, cupping, massage of acupoint

and ear AP. The intensity of knee joint pain on walking, resting and

standing, the nocturnal pain, stiffness, the maximum walking distance

and the daily living ability were monitored after 30 days, 60 days

and 90 days of treatment. RESULTS: After 90 days of treatment, the

integrated TCM + WM group was better than other two groups in

improvement of percentages in self pain assessment with visual analog

scale (VAS), pain and stiffness measured by WOMAC scale, pain and

maximum walking distance measured by Lequesne scale (p <.05 or

p<.01). There were no significant differences in the therapeutic

effects between the TCM group and the WM group. All of these three

treatments were well tolerated, and no severe adverse events were

found. Combined TCM + WM treatment has rapid and definite therapeutic

effect in reducing pain and improving mobility of knee joints and

daily living ability in Caucasian patients of knee osteoarthritis.

PMID: 18630549 [PubMed - indexed for MEDLINE]

 

Wehling P, Reinecke J. [AP together with cytokine depressing herbs in

comparison to injection therapy with steroids in sciatic pain]

[Article in German] Schmerz. 1997 Jun 13;11(3):180- 4. Praxis und

Klinik für Orthopädie und Neurochirurgie, Düsseldorf. Because of

their frequency and consequences sciatica remains a demanding

clinical entity with significant social and economical impact. There

is a high demand on therapeutic modalities, using folk medicine

methods in the treatment of orthopaedic diseases. No data is

available on the usefulness of methods like natural herbs in

combination with AP. Aim of our study was to present data on the

effect of AP and cytokine-inhibiting natural herbs in sciatic pain.

We compared these results with nerve root infiltration by local

anaesthetics and corticosteroids in our orthopaedic outpatient

clinic. MATERIALS AND RESULTS: 278 patients with chronic pain for at

least 3 months were observed. All three therapeutical modalities

showed improvement of pain scores. Best results were gained with

steroid injection ( n=26; 66% pain reduction), AP in combination with

herbs improved the pain in average of 62% ( n=230), whereas injection

with local anaesthetic had a pain reduction of 48% ( n=22). Sole

Mepivacain-HCl treatment had significant less pain reduction compared

to the other treatment modalities. AP in combination with herbs and

steroid nerve blocks appear to be an effective and thus recommendable

conservative therapy in cases of sciatic pain. Taking into account

that patients increasingly prefer ethnomedical modalities of

treatment our study gains importance for practising orthopaedists.

PMID: 12799820 [PubMed]

 

Yang JW, Jeong SM, Seo KM, Nam TC. Effects of corticosteroid and

Electro-AP on experimental spinal cord injury in dogs. J Vet Sci.

2003 Apr;4(1):97- 101. College of Vet Med, Seoul National Univ, San 56-

1 Shillim 9-dong, Kwanak-gu, Seoul 151-742, Korea. The aim of this

study is to investigate the effects of Electro-AP (EAP),

corticosteroid and combination of two treatments on ambulatory

paresis due to spinal cord injury in dogs by comparing therapeutic

effects of EAP and corticosteroid. Spinal cord injury was induced in

20 healthy dogs (2.5-7 kg and 2-4 years) by foreign body insertion

which compressed about 25% of spinal cord. There was no conscious

proprioception, no extensor postural thrust and ambulatory. Dogs were

divided into four groups according to the treatment; corticosteroid

(Group A), EAP (Group B), corticosteroid and EAP (Group AB) and

control (Group C). Neurological examination was performed everyday to

evaluate the spinal cord dysfunction until motor functions were

returned to normal. Somatosensory evoked potentials (SEPs) were

measured for Aim and accurate evaluations. The latency in measured

potentials was converted into the velocity for the evaluation of

spinal cord dysfunctions. Pain perceptions were normal from pre-

operation to 5 weeks after operation. Recovery days of conscious

proprioception in groups A, B, AB and C were 21.2+/-8.5 days, 19.8+/-

4.3 days, 8.2+/-2.6 days and 46.6+/-3.7 days, respectively. Recovery

days of extensor postural thrust in Group A, Group B, Group AB and

Group C were 12.8+/-6.8 days, 13.8+/-4.8 days, 5.4+/-1.8 days and

38.2+/-4.2 days, respectively. There were no significant differences

between Group A and Group B. However, recovery days of Group AB was

significantly shorter than that of other groups and that of Group C

was significantly delayed (p<0.05). Conduction velocities of each

Group were significantly decreased after induction of spinal cord

injury on SEPs (p<0.05) and they showed a tendency to return to

normal when motor functions were recovered. Combination of

corticosteroid and EAP was the most therapeutically effective for

ambulatory paresis due to spinal cord injury in dogs. PMID: 12819372

[PubMed - indexed for MEDLINE]

 

Zhang RX, Lao L, Wang X, Ren K, Berman BB. Electro-AP combined with

indomethacin enhances antihyperalgesia in inflammatory rats.

Pharmacol Biochem Behav. 2004 Aug;78(4):793- 7. Center for Integrative

Medicine, School of Medicine, Univ of Maryland, Baltimore, MD 21201,

USA. Our previous study showed that Electro-AP (EAP) significantly

attenuated hyperalgesia and inflammation. The present study is an

evaluation of the potential synergism of EAP and a subeffective

dosage of indomethacin (INDO) in a rat model. Inflammation and

hyperalgesia, manifesting as edema and decreased paw withdrawal

latency (PWL) to a noxious stimulus, were induced by injecting

complete Freund's adjuvant (CFA) subcutaneously into the plantar

surface of one hind paw of the rat. EAP treatments were given at GB30

immediately and 2 h post-CFA. INDO at 2 mg/kg was given

(intraperitoneally) 40 min before the second EAP. PWL and edema were

measured prior to CFA and 2.5 and 5 h post-CFA. EAP at 10 and 100 Hz

significantly inhibited CFA-induced hind paw hyperalgesia. Both low-

and high-frequency EAP combined with INDO enhanced antihyperalgesia

compared to each component alone, and 10 Hz but not 100 Hz EAP

significantly reduced CFA-induced hind paw edema. A combination of

low-frequency EAP and INDO did not show synergistic inhibitory

effects on edema. EAP combined with INDO synergistically inhibited

hyperalgesia and may be an improved treatment strategy for

inflammatory pain. Copyright 2004 Elsevier Inc. PMID: 15301937

[PubMed - indexed for MEDLINE]

 

Best regards,

 

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0)1-6281- 222;

VOIP Number: +353-1482-7068;

Tel: (M): +353-(0)87-286- 8277

< (AT) eircom (DOT) net>

http://homepage. eircom.net/ ~progers/ vaplinks. htm

http://homepage. eircom.net/ ~progers/ tecnotes. htm

 

" Man who says it can't be done should not interrupt woman doing it " -

Chinese Proverb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Hi Yehuda & All,

 

Yehuda wrote:

> I believe that we need to make a clear distinction between combining

> two modalities and integrating western biomedical substances into the

> Chinese medical model.  ... The question really is one of the model we

> use for diagnosis and treatment of our patients--do we treat symptoms

> and needle local points to ameliorate pain or discomfort,  or do we

> treat based upon the patient's differential diagnosis, constitution and

> history.  The former is pure bio-medicine, which I contend in years to

> come will be viewed as a dinosaur--an extinct remnant of an ignorant

> past ... Getting back to the original question, this is the same

> problem with combining Chinese medicine or acupuncture with

> Western medicine.  If we are using any medicine to treat sympoms, we

> are not treating the whole person, and usually the  " whole person " will

> not get well. ...We are the torchbearers of a wonderful medicine.  Let

> us not lower ourselves to using our tools wrongly, for using a

> sophisticated electronic devise as a hammer. 

 

Yehuda, I see no essential conflict in combining acupuncture and most

(at least the safer) western medicines, especially if the acupuncture

ALONE has not solved the problem.

 

One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong?

 

Best regards,

 

[Guest guest]

There are also " Alternative " therapies that are " Western " as well, such as

electroherbalism, Colloidal Silver, Scenar, etc.

 

 

 

 

-

" " <

 

Saturday, April 25, 2009 4:34 PM

Re: COMBINE acupuncture with western medicine?

 

 

Hi Yehuda & All,

 

Yehuda wrote:

> I believe that we need to make a clear distinction between combining

> two modalities and integrating western biomedical substances into the

> Chinese medical model. ... The question really is one of the model we

> use for diagnosis and treatment of our patients--do we treat symptoms

> and needle local points to ameliorate pain or discomfort, or do we

> treat based upon the patient's differential diagnosis, constitution and

> history. The former is pure bio-medicine, which I contend in years to

> come will be viewed as a dinosaur--an extinct remnant of an ignorant

> past ... Getting back to the original question, this is the same

> problem with combining Chinese medicine or acupuncture with

> Western medicine. If we are using any medicine to treat sympoms, we

> are not treating the whole person, and usually the " whole person " will

> not get well. ...We are the torchbearers of a wonderful medicine. Let

> us not lower ourselves to using our tools wrongly, for using a

> sophisticated electronic devise as a hammer.

 

Yehuda, I see no essential conflict in combining acupuncture and most

(at least the safer) western medicines, especially if the acupuncture

ALONE has not solved the problem.

 

One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong?

 

Best regards,

 

 

 

---

 

Chinese Herbal Medicine offers various professional services, including a

practitioner's directory and a moderated discussion forum.

 

 

 

[Guest guest]

Dear Phil,

 

I totally agree with you, but in my rush to finish posting late Friday afternoon

before it got to be too late (you see, I turn into a pumpkin every Friday at

Sunset), I left out one important point in my presentation--that I have no

problem using or combining western Meds as adjuncts to herbs and/or acupuncture,

but only if and when their properties (temperature, flavor and channel)

are indicated in treating the patient's pattern.  When they are used from that

paradigm, I think that they can be very useful, potentially.  What we must never

do, though, is use any medicine or therapy to suppress symptoms.  Pain relief,

for example,  is not necessarily synonymous with pain suppression.  Dosage also,

as with Chinese medicine can make a tremendous difference in terms of a

harmonizing treatment.  Micro-doses of NSAIDS or steroids, for example,  might

have wonderful benefits when integrated into herbal formulas, but not without

adequate studies and

research. 

 

Bottom line that I am suggesting, is that every medicinal substance should be

evaluated in terms of its actions, interactions, indication and

contraindications,  specifically in conjunction with other herbs and substances,

(and not just Chinese herbs, mind you!)  just as Chinese medicine rarely uses

single substances as formulas.  I can see some of our more traditionalists

cringing, but just as over the centuries, new substances from thousands of miles

away,  have been introduced to the Chinese pharmacopoeia, why shouldn't Western

medicinals be viewed the same way? 

 

 

 

 

 

 

 

 

 

--- On Sat, 4/25/09, < wrote:

 

 

<

Re: COMBINE acupuncture with western medicine?

 

Saturday, April 25, 2009, 4:34 PM

 

 

 

 

 

 

 

 

Hi Yehuda & All,

 

Yehuda wrote:

> I believe that we need to make a clear distinction between combining

> two modalities and integrating western biomedical substances into the

> Chinese medical model.  ... The question really is one of the model we

> use for diagnosis and treatment of our patients- -do we treat symptoms

> and needle local points to ameliorate pain or discomfort,  or do we

> treat based upon the patient's differential diagnosis, constitution and

> history.  The former is pure bio-medicine, which I contend in years to

> come will be viewed as a dinosaur--an extinct remnant of an ignorant

> past ... Getting back to the original question, this is the same

> problem with combining Chinese medicine or acupuncture with

> Western medicine.  If we are using any medicine to treat sympoms, we

> are not treating the whole person, and usually the  " whole person " will

> not get well. ...We are the torchbearers  of a wonderful medicine.  Let

> us not lower ourselves to using our tools wrongly, for using a

> sophisticated electronic devise as a hammer. 

 

Yehuda, I see no essential conflict in combining acupuncture and most

(at least the safer) western medicines, especially if the acupuncture

ALONE has not solved the problem.

 

One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong?

 

Best regards,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Right, and I have a problem with them, too, if their goal is to just suppress

symptoms and are not treating the whole person based upon the patients

constitution, patterns and differential diagnosis. 

 

 

 

 

 

 

 

 

--- On Sat, 4/25/09, Mercurius Trismegistus <magisterium_magnum

wrote:

 

 

Mercurius Trismegistus <magisterium_magnum

Re: Re: COMBINE acupuncture with western medicine?

 

Saturday, April 25, 2009, 9:58 PM

 

 

 

 

 

 

 

 

There are also " Alternative " therapies that are " Western " as well, such as

electroherbalism, Colloidal Silver, Scenar, etc.

 

-

" " < (AT) tinet (DOT) ie>

<>

Saturday, April 25, 2009 4:34 PM

Re: COMBINE acupuncture with western medicine?

 

Hi Yehuda & All,

 

Yehuda wrote:

> I believe that we need to make a clear distinction between combining

> two modalities and integrating western biomedical substances into the

> Chinese medical model. ... The question really is one of the model we

> use for diagnosis and treatment of our patients--do we treat symptoms

> and needle local points to ameliorate pain or discomfort, or do we

> treat based upon the patient's differential diagnosis, constitution and

> history. The former is pure bio-medicine, which I contend in years to

> come will be viewed as a dinosaur--an extinct remnant of an ignorant

> past ... Getting back to the original question, this is the same

> problem with combining Chinese medicine or acupuncture with

> Western medicine. If we are using any medicine to treat sympoms, we

> are not treating the whole person, and usually the " whole person " will

> not get well. ...We are the torchbearers of a wonderful medicine. Let

> us not lower ourselves to using our tools wrongly, for using a

> sophisticated electronic devise as a hammer.

 

Yehuda, I see no essential conflict in combining acupuncture and most

(at least the safer) western medicines, especially if the acupuncture

ALONE has not solved the problem.

 

One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong?

 

Best regards,

 

 

------------ --------- --------- ------

 

Chinese Herbal Medicine offers various professional services, including a

practitioner' s directory and a moderated discussion forum.

 

http://www.chineseh erbacademy. org

[Guest guest]

writes "

 

" One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong? "

 

Not wrong, but certainly incomplete. Even most Western physicians do

not have a deep grasp of the effects of pharmaceuticals. For example,

the use of antibiotics and the high incidence of serious side effects

(1 in 400) such as anaphylactic shock. Or how about the high

incidence of serious side effects of NSAIDS in elderly patients?

 

Even for TCM practitioners who are willing to seriously learn how to

analyze the clinical research data of pharmaceuticals and the limits

and dangers of thereof, caution and extremely humility are

recommended.

 

Phil, himself, as a veterinarian undoubtedly has a better grasp of

pharmaceuticals that most TCM practitiioners.

 

Nevertheless, anyone who observes the use of drugs by the average

Western practitioner will be appalled at the lack of anything but the

most superficial understanding of the total effects of

pharmaceuticals. Studies clearly show that a high percentage of

physicians obtain most of their knowledge from Pharma salespeople.

 

 

 

--

Duncan E

 

 

" We are here to help each other get though this thing, whatever it is. "

-Mark Vonnegut

[Guest guest]

Dear Phil,

 

I totally agree with you, but in my rush to finish posting late Friday afternoon

before it got to be too late (you see, I turn into a pumpkin every Friday at

Sunset), I left out one important point in my presentation--that I have no

problem using or combining western Meds as adjuncts to herbs and/or acupuncture,

but only if and when their properties (temperature, flavor and channel)

are indicated in treating the patient's pattern.  When they are used from that

paradigm, I think that they can be very useful, potentially.  What we must never

do, though, is use any medicine or therapy to suppress symptoms.  Pain relief,

for example,  is not necessarily synonymous with pain suppression.  Dosage also,

as with Chinese medicine can make a tremendous difference in terms of a

harmonizing treatment.  Micro-doses of NSAIDS or steroids, for example,  might

have wonderful benefits when integrated into herbal formulas, but not without

adequate studies and

research. 

 

Bottom line that I am suggesting, is that every medicinal substance should be

evaluated in terms of its actions, interactions, indication and

contraindications,  specifically in conjunction with other herbs and substances,

(and not just Chinese herbs, mind you!)  just as Chinese medicine rarely uses

single substances as formulas.  I can see some of our more traditionalists

cringing, but just as over the centuries, new substances from thousands of miles

away,  have been introduced to the Chinese pharmacopoeia, why shouldn't Western

medicinals be viewed the same way? 

 

 

 

 

 

 

 

 

 

--- On Sat, 4/25/09, < wrote:

 

 

<

Re: COMBINE acupuncture with western medicine?

 

Saturday, April 25, 2009, 4:34 PM

 

 

 

 

 

 

 

 

Hi Yehuda & All,

 

Yehuda wrote:

> I believe that we need to make a clear distinction between combining

> two modalities and integrating western biomedical substances into the

> Chinese medical model.  ... The question really is one of the model we

> use for diagnosis and treatment of our patients- -do we treat symptoms

> and needle local points to ameliorate pain or discomfort,  or do we

> treat based upon the patient's differential diagnosis, constitution and

> history.  The former is pure bio-medicine, which I contend in years to

> come will be viewed as a dinosaur--an extinct remnant of an ignorant

> past ... Getting back to the original question, this is the same

> problem with combining Chinese medicine or acupuncture with

> Western medicine.  If we are using any medicine to treat sympoms, we

> are not treating the whole person, and usually the  " whole person " will

> not get well. ...We are the torchbearers  of a wonderful medicine.  Let

> us not lower ourselves to using our tools wrongly, for using a

> sophisticated electronic devise as a hammer. 

 

Yehuda, I see no essential conflict in combining acupuncture and most

(at least the safer) western medicines, especially if the acupuncture

ALONE has not solved the problem.

 

One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong?

 

Best regards,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Chinese Medicine , wrote:

 

" ...I have no problem using or combining western Meds as adjuncts to herbs

and/or acupuncture, but only if and when their properties (temperature, flavor

and�channel) are�indicated�in treating�the patient's pattern.� When

they are used from that paradigm, I think that they can be very useful,

potentially.� What we must never do, though, is use any medicine or therapy to

suppress symptoms. "

 

" Bottom line that I am suggesting, is that every medicinal substance should be

evaluated in terms of its actions, interactions, indication and

contraindications,� specifically in conjunction with other herbs and

substances, (and not just Chinese herbs, mind you!) �just as Chinese medicine

rarely uses single substances�as formulas.� I can see some of our more

traditionalists cringing, but�just as over the centuries, new substances from

thousands of miles away, �have been introduced to the Chinese pharmacopoeia,

why shouldn't Western medicinals be viewed the same way?� "

 

 

Hi Yehuda, Phil, Everyone

 

Well-reasoned Yehuda.

And worth remembering too, that there are many 'western scientific medicine'

[WSM] pharmaceutical agents in daily use, for many conditions, which have their

origins in the plant and mineral kingdoms.

Hitting the FDA website, and reading up on the full extent of actions,

interactions, and side-effects of any chosen drug, one sees that the TCM model

can be applied to ALL pharmaceuticals, and if we look deeply enough, to cellular

level of organization and activity.

 

Moving along to Phils's statement and question below:

 

" One CAN select relevant acupoints to treat both Root and Branch. If

that does not produce rapid and good clinical results, one can ADD

other modalities - rubs, homeopathy, NSAIDs, steroids, antibiotics -

as needed.

 

Am I wrong? "

 

 

The flip-side to this, is that in daily practice, we are presented with people

who have been, or still are, taking any number of pharmaceuticals. Not so many

people out there by now, who haven't been medicated with pharmaceuticals.

 

Stating the obvious, I know, but the longterm or repeated use of these agents

means that we are forced to sift through what is substance-induced, and what is

not.

We must then discern how this affects our ability to make a TCM diagnosis, the

impact the agent has on Root & Branch, and then decide what and how to treat

accordingly.

For example - one of the most evident distorters of the pulse is the

beta-blocker class of drugs.

They render the pulse moderate or slow, and kind of heavy and ponderous, in

people whose pulses were probably unlike that before medication began.

Is such a pulse a useful guide towards diagnosing the - original - Root of a

disharmony which manifested as hypertension, possibly angina, and/or myocardial

infarction?

 

These are the questions I ask myself in everyday clinical life.

Not whether it's appropriate to combine herbs & acupuncture - with WSM,

but HOW to manage the complexities of both, in each person who comes along for

help.

 

This kind of thinking was not evident in my degree, where we learnt TCM pattern

after TCM pattern and innumerable presenting complaints as single entities. We

weren't shown how to read and interpret multiple co-existing disharmonies, with

or without the alterations and interweavings caused by previous or concurrent

'other' treatments.

 

Integrative medicine is not an easy discipline for those who practice energy

medicine, and whole systems medicine [or whatever it's being called these days].

 

Margi

[Guest guest]

My apologies for jumping into this intriguing dialogue a little late as I just

returned from a business trip to San Diego and have been out of the net for a

few days. However, I would like to add my humble opinion to this dialogue.

 

 

 

Combining acupuncture with western medicine does not necessarily mean western

drug medicine. My idea of integrated medicine, which I practice most

proficiently, is combining western high-tech medical treatment technology with

aupuncture and oriental medicine. This includes non-needle microcurrent medical

technologies, Russian SCENAR and COSMODIC therapy. These are treatment

technologies that are billed under physical medicine. I also make use of

western diagnostics such as labs, xrays, MRI's etc. I believe that if the

ancient Chinese had access to these, they too would have used them. Our

medicine must adapt. It's adaptive capabilities are why it has survived and

grown. AOM is successful, and adapting and integrating modern techologies makes

it more so. However, integrating western technologies within AOM must be done

in accordance with AOM theory. That does not mean we ignore western science,

cell physiology, and physics. We must also understand these so that we can

integrate western medical technology under AOM theory fluidly. This turns

western medical technology into Oriental Medicine because we use these tools

differently than they use them, and our outcomes cannot be matched by their

technicians even when they use the same equipment.

 

 

 

This is only my opinion and my pracitice. This, to me, is integrated medicine.

 

 

 

Sincerely Yours,

 

 

 

Dr. Don J. Snow, Jr., DAOM, MPH, L.Ac.

 

 

 

Chinese Medicine

margi.macdonald

Fri, 24 Apr 2009 01:45:04 +0000

Re: COMBINE acupuncture with western medicine?

 

 

 

 

 

 

 

Chinese Medicine , " "

< wrote:

 

" Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose steroids.

In theory, exogenous steroids can inhibit adrenal release of endogenous

steroids. But some practitioners are not so sure that steroids inhibit the

clinical effects of AP. "

 

Hi Phil, Hi All

my short answer is YES.

 

My only experience to date is with acupuncture for people who have cancer, who

receive the steroid DEXAMETHASONE.

 

'Dex' is commonly used in medical oncology practice, as a pre-med prior to

infusion of certain chemothepeutic agents, and at other times to engender

appetite in folk who are cachetic and/or anorexic due to treatment & /or their

conditions.

It's also used in many other non-cancer conditions, see links below.

 

I have observed, over and over, that this drug will amplify and exaggerate the

existing mental and emotional state of the person who is receiving it.

eg Liver constrained folk become overtly cranky, frustrated, loud, 'wired' and

ultra-sensitive to all external stimuli.

Heart Blood & /or Heart Yin Xu folk experience continuous free-floating anxiety.

Nobody sleeps properly when they're on Dex.

 

The mental / emotional side effects of the drug are well-documented.

 

Any acupuncture treatment given to calm the shen seems to give these folk a

12-36 hr 'reprieve' from some of their internal disarray.

 

I find in particular, that the quartet of extra points - si shen cong M-HN-1 are

very effective, with a couple of other points used for TCM pattern for each

person.

 

What this says about the mechanisms of acupuncture, and its relationship and

effect on the Adrenal-Hypothalamic-Pituitary Axis and synthetic cortico-steroids

is quite beyond me!

 

I just know it can soothe distressing, mind-altering side-effects experienced by

this patient group.

 

Go here for more info about the drug:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682792.html

http://www.drugs.com/pro/dexamethasone-sodium-phosphate.html

 

Look forward to reading how others find the acup-steroid-combo works in their

patients.

 

Margi

 

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Dear Don,

 

I couldn't agree with you more.  I believe that on a purely physical level (and

there's so much more to illness than that, of course) in order to achieve

satisfying and  lasting results, the patient's imbalances  need to be addressed 

biochemically, biomechanically, and bioelectrically.  Any tools that can be used

to promote that process, are wise to employ.  I hope the day comes soon when

integrative therapies such as you use become standard for diagnosis and

treatment. 

 

Congratulations on finding your niche.  I hope you are able to teach others by

way of texts and/or seminars.    

 

respectfully,

 

 

 

 

 

 

 

 

 

--- On Sun, 4/26/09, Donald Snow <don83407 wrote:

 

 

Donald Snow <don83407

RE: Re: COMBINE acupuncture with western medicine?

Chinese Traditional Medicine

Sunday, April 26, 2009, 6:08 PM

 

 

 

 

 

 

 

 

 

My apologies for jumping into this intriguing dialogue a little late as I just

returned from a business trip to San Diego and have been out of the net for a

few days. However, I would like to add my humble opinion to this dialogue.

 

Combining acupuncture with western medicine does not necessarily mean western

drug medicine. My idea of integrated medicine, which I practice most

proficiently, is combining western high-tech medical treatment technology with

aupuncture and oriental medicine. This includes non-needle microcurrent medical

technologies, Russian SCENAR and COSMODIC therapy. These are treatment

technologies that are billed under physical medicine. I also make use of western

diagnostics such as labs, xrays, MRI's etc. I believe that if the ancient

Chinese had access to these, they too would have used them. Our medicine must

adapt. It's adaptive capabilities are why it has survived and grown. AOM is

successful, and adapting and integrating modern techologies makes it more so.

However, integrating western technologies within AOM must be done in accordance

with AOM theory. That does not mean we ignore western science, cell physiology,

and physics. We must also understand these

so that we can integrate western medical technology under AOM theory fluidly.

This turns western medical technology into Oriental Medicine because we use

these tools differently than they use them, and our outcomes cannot be matched

by their technicians even when they use the same equipment.

 

This is only my opinion and my pracitice. This, to me, is integrated medicine.

 

Sincerely Yours,

 

Dr. Don J. Snow, Jr., DAOM, MPH, L.Ac.

 

 

 

margi.macdonald@ gmail.com

Fri, 24 Apr 2009 01:45:04 +0000

Re: COMBINE acupuncture with western medicine?

 

Traditional_ Chinese_Medicine , " "

<@ ...> wrote:

 

" Hi All,

 

Do you COMBINE acupuncture with western medicine (especially steroid-

or NSAID- therapy)?

 

Some teachers and practitioners say that AP is less effective in

people or animals currently on steroid therapy, especially high-dose steroids.

In theory, exogenous steroids can inhibit adrenal release of endogenous

steroids. But some practitioners are not so sure that steroids inhibit the

clinical effects of AP. "

 

Hi Phil, Hi All

my short answer is YES.

 

My only experience to date is with acupuncture for people who have cancer, who

receive the steroid DEXAMETHASONE.

 

'Dex' is commonly used in medical oncology practice, as a pre-med prior to

infusion of certain chemothepeutic agents, and at other times to engender

appetite in folk who are cachetic and/or anorexic due to treatment & /or their

conditions.

It's also used in many other non-cancer conditions, see links below.

 

I have observed, over and over, that this drug will amplify and exaggerate the

existing mental and emotional state of the person who is receiving it.

eg Liver constrained folk become overtly cranky, frustrated, loud, 'wired' and

ultra-sensitive to all external stimuli.

Heart Blood & /or Heart Yin Xu folk experience continuous free-floating anxiety.

Nobody sleeps properly when they're on Dex.

 

The mental / emotional side effects of the drug are well-documented.

 

Any acupuncture treatment given to calm the shen seems to give these folk a

12-36 hr 'reprieve' from some of their internal disarray.

 

I find in particular, that the quartet of extra points - si shen cong M-HN-1 are

very effective, with a couple of other points used for TCM pattern for each

person.

 

What this says about the mechanisms of acupuncture, and its relationship and

effect on the Adrenal-Hypothalami c-Pituitary Axis and synthetic

cortico-steroids is quite beyond me!

 

I just know it can soothe distressing, mind-altering side-effects experienced by

this patient group.

 

Go here for more info about the drug:

http://www.nlm. nih.gov/medlinep lus/druginfo/ meds/a682792. html

http://www.drugs. com/pro/dexameth asone-sodium- phosphate. html

 

Look forward to reading how others find the acup-steroid- combo works in their

patients.

 

Margi