Electroacupuncture reduces myocardial infarct size and improves post-ischemic recovery by invoking release of humoral, dialyzable, cardioprotective factors

J Physiol Sci. 2013 May;63(3):219-23. doi: 10.1007/s12576-013-0259-6. Epub 2013 Mar 26.

Redington KL, Disenhouse T, Li J, Wei C, Dai X, Gladstone R, Manlhiot C, Redington AN.

Source

Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, M5G1X8, Canada.

Abstract

Previous studies have shown that electroacupuncture (EA) can induce cardioprotection against ischemia-reperfusion (IR) injury, but its mechanisms are incompletely understood. We have previously shown that several other forms of remote preconditioning of the heart work, at least in part, via the release of circulating cardioprotective factors into the bloodstream, that can be dialyzed and subsequently shown to reduce IR injury in isolated hearts. 

We used the same methods to assess whether EA leads to similar humoral cardioprotection. EA rabbits were subjected to 60 min of bilateral stimulation at the Neiguan point, following which their blood was drawn, dialyzed, and used to perfuse hearts in Langendorff preparation and subsequently subjected to 60 min of global ischemia and 120 min of reperfusion. Compared to controls, dialysate from EA animals led to significant reduction in infarct size and improved functional recovery. The degree of cardioprotection was no different to that seen in animals randomized to receive remote preconditioning using transient limb ischemia (4 cycles of 5 min ischemia/5 min reperfusion). 

These results suggest that EA recapitulates the cardioprotection achieved by remote preconditioning, by similarly leading to release of circulating cardioprotective factors.

The effect of acupuncture on high blood pressure of patients using antihypertensive drugs

Acupunct Electrother Res. 2013;38(1-2):1-15.
Cevik C, Işeri SO.

Source

Dept. of Clinical Biochemistry, Director of The Acupuncture Clinic & The Coordinator of The Acupuncture Certificate Courses, Gazi University Medical Faculty, Ankara/Turkey.

Abstract

Blood pressure control is an important component of cardiovascular disease prevention. Despite the advances in the treatment of hypertension; effective management remains poor. The combined use of multiple drug strategies fail to regulate blood pressure and chronic use of those agents cause severe side-effects. New strategies are required to control high blood pressure. 

We aim in our study to research the effects of acupuncture treatment on blood pressure of hypertensive patients who have already been exposed to antihypertensive drug therapy for at least 24 months. Each patient was using 1-3 antihypertensive drug of a heterogeneous pharmacological group ranging from ACE inhibitors, diuretics, and beta blockers and the most common complaint of those patients were fatigue, dizziness, weakness, headache and joint pain, sleeping problems, cold hands and feet, edema, depression. We did not alter patients' diet (salt intake), physical activity or use of antihypertensive drugs. The study includes 24 male and 10 female patients. Ki 3 (Taixi), Liv 3 (Taichong), Sp 9 (Yinlingquan), L.I. 4 (Hegu), Ht 7 (Shenmen), St 36 (Zusanli), Sp 6 (Sanyinjiao), Ki 7 (Fulio), Lu 9 acupuncture points were needled. 

After being treated with acupuncture for one month in every two days for a total of 15 sessions, we found significant reductions (p ? 001) in both systolic (from 163.14 +/- 19.33 to 129.49 +/- 18.52) and diastolic (from 94.37 +/- 19.70 to 79.31 +/- 7.87) blood pressures of these patients. 

The aim here is not to compare the effectiveness of acupuncture and drug therapy on blood pressure, but to simply report that on patients currently using antihypertensive medication, acupuncture facilitated a significant reduction in blood pressure and reduced the patients complaints. 

We therefore conclude that our data strongly suggest that acupuncture should be in the hypertension treatment guidelines and widely used for blood pressure regulation.

Efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine for Ischemic Stroke: A Randomized Controlled Trial

Am J Chin Med. 2013;41(5):971-981.

Zhang Y, Jin H, Ma D, Fu Y, Xie Y, Li Z, Zou Y.

Source

Department of Neurology and Stroke Center, Key Laboratory of Chinese Internal Medicine of Chinese Ministry of Education, China.

Abstract

This study aimed to determine the efficacy of Integrated Rehabilitation Techniques of Traditional Chinese Medicine (IRT-TCM) on patients with ischemic stroke as an alternative therapy to conventional rehabilitation techniques. 

Sixty-nine patients with ischemic stroke were randomly assigned to receive either IRT-TCM (intervention group, n=46) or conventional rehabilitation techniques (control group, n=23). The IRT-TCM consisted of a sequential combination of acupuncture and massage techniques. The Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) and modified Rankin Scale (mRS) were measured on day 0 (baseline, before treatment), day 21, and day 90. 

We observed that the scores in FMA and BI were increased, and NIHSS were decreased in both groups on day 21 and 90, compared with the baseline (day 0). Furthermore, significantly better scores in FMA of lower limbs and NIHSS were found in patients treated with IRT-TCM on day 21 and 90. For mRS, the percentage of patients ranking 0 and 1 in the intervention group presented a striking contrast to the control group on day 90 but with no significant difference. 

The results indicated that, as a feasible alternative therapy, IRT-TCM is beneficial for patients with ischemic stroke. Further research with larger sample size, long-term observation, and strict blinding are still in need to confirm the efficacy of IRT-TCM.

Effectiveness of Acupuncture for Smoking Cessation in a Chinese Population

Asia Pac J Public Health. 2013 Oct 4.
Ma E, Chan T, Zhang O, Yang JS, Wang YY, Li YC, Ho R, Lai C, Lam PY.

Source

Department of Health, Hong Kong.

Abstract

An observational study was conducted to evaluate the effectiveness of acupuncture for smoking cessation, and determine predictors for successful quitters. Smokers received at least 6 sessions of body acupuncture provided by Chinese medicine practitioners and initiated self-administered auricular acupuncture. We determined self-report 26-week and 52-week quit rates by intention-to-treat analysis and examined predictors for successful quitting by univariate and multivariate analyses. A total of 1002 smokers were recruited; 26-week and 52-week quit rates were 16.8% and 15.8%, respectively. Male sex, older age, lower nicotine dependence level, and number of body acupuncture and counseling sessions received were associated with successful quitting. A multiple logistic regression model showed that sex, nicotine dependence level, and number of body acupuncture sessions received were predictors for successful quitting. Body and auricular acupuncture is effective in smoking cessation and should be considered as an alternative to help smokers in quitting, especially for those whose past attempts using conventional methods were in vain.

Effects of electro-acupuncture on personality traits in depression: A randomized controlled study

Chin J Integr Med. 2013 Oct;19(10):777-782. Epub 2013 Oct 4.

Wang WD, Lu XY, Ng SM, Hong L, Zhao Y, Lin YN, Wang F.

Source

Department of Psychology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China

Abstract

OBJECTIVE:

To explore the personality-adjusting effect of electro-acupuncture treatment for depression and compared this treatment with paroxetine treatment.

METHODS:

A non-blinded, randomized controlled trial was adopted. Sixty depressed patients, who met trial criteria, were randomly assigned to the treatment and the control groups. In the treatment group, electro-acupuncture treatment was used, and paroxetine treatment was used in the control group. During the 24-week study period, 12 patients dropped out and 48 patients completed the study. The Minnesota Multiple Personality Inventory (MMPI) was adopted as the evaluation tool. At the same time, the Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Montgomery-Asberg Depression Rating Scale (MADRS) were used to evaluate the psychological state. Evaluations were done before and after treatment.

RESULTS:

After treatment, patients' psychological state improved significantly in both groups (P<0.01). For the treatment group, within-group comparison between baseline and after 24 weeks of treatment showed that severity of depression had significantly decreased (P<0.01). MADRS and SDS scores decreased significantly (P<0.05) and MMPI subscale scores for hypochondriasis, depression, psychopathic deviate, psychasthenia, social introversion and fake decreased significantly (P<0.05). For the control group, severity of depression also decreased significantly. MADRS and SDS scores decreased significantly (P<0.05); and MMPI subscale scores for hypochondriasis, depression, hysteria, paranoia, and psychasthenia decreased significantly (P<0.05). Between-group comparison demonstrated that for the MMPI subscales paranoia and social introversion, the decrease of score was greater in the treatment group than in the control group (P<0.05). However, there were no other significant differences between the control group and the treatment group.

CONCLUSION:

Electro-acupuncture is effective for treating depression and affects personality traits.

Moxibustion in the management of irritable bowel syndrome: systematic review and meta-analysis

BMC Complement Altern Med. 2013 Oct 2;13(1):247.

Park JW, Lee BH, Lee H.

Abstract (Full-Text PDF)

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Many patients suffer from IBS that can be difficult to treat, thus complementary therapies which may be effective and have a lower likelihood of adverse effects are being sought.This systematic review and meta-analysis aimed at critically evaluating the current evidence on moxibustion for improving global symptoms of IBS.

METHODS:

We searched Medline, EMBASE, the Cochrane Central Register of Controlled Trials, AMED, CINAHL, and CNKI databases for randomised controlled trials (RCTs) of moxibustion comparing with sham moxibustion, pharmacological medications, and other active treatments in patients with IBS. Trials should report global symptom improvement as an outcome measure. Risk of bias for each RCT was assessed according to criteria by the Cochrane Collaboration, and the dichotomous data were pooled according to the control intervention to obtain a risk ratio (RR) of global symptom improvement after moxibustion, with 95% confidence intervals (CI).

RESULTS:

A total of 20 RCTs were eligible for inclusion (n = 1625). The risk of bias was generally high. Compared with pharmacological medications, moxibustion significantly alleviated overall IBS symptoms but there was a moderate inconsistency among studies (7 RCTs, RR 1.33, 95% CI [1.15, 1.55], I2 = 46%). Moxibustion combined with acupuncture was more effective than pharmacological therapy but a moderate inconsistency among studies was found (4 RCTs, RR 1.24, 95% CI [1.09, 1.41], I2 = 36%). When moxibustion was added to pharmacological medications or herbal medicine, no additive benefit of moxibustion was shown compared with pharmacological medications or herbal medicine alone. One small sham-controlled trial found no difference between moxibustion and sham control in symptom severity (mean difference 0.35, 95% CI [-0.77, 1.47]). Moxibustion appears to be associated with few adverse events but the evidence is limited due to poor reporting.

CONCLUSIONS:

This systematic review and meta-analysis suggests that moxibustion may provide benefit to IBS patients although the risk of bias in the included studies is relatively high. Future studies are necessary to confirm whether this finding is reproducible in carefully-designed and conducted trials and to firmly establish the place of moxibustion in current practice.

Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial

Abstract (Full-Text PDF)

Background

Depression is a significant cause of morbidity. Many patients have communicated an interest in non-pharmacological therapies to their general practitioners. Systematic reviews of acupuncture and counselling for depression in primary care have identified limited evidence. The aim of this study was to evaluate acupuncture versus usual care and counselling versus usual care for patients who continue to experience depression in primary care.

Methods and Findings

In a randomised controlled trial, 755 patients with depression (Beck Depression Inventory BDI-II score ≥20) were recruited from 27 primary care practices in the North of England. Patients were randomised to one of three arms using a ratio of 2:2:1 to acupuncture (302), counselling (302), and usual care alone (151). The primary outcome was the difference in mean Patient Health Questionnaire (PHQ-9) scores at 3 months with secondary analyses over 12 months follow-up. Analysis was by intention-to-treat.

PHQ-9 data were available for 614 patients at 3 months and 572 patients at 12 months. Patients attended a mean of ten sessions for acupuncture and nine sessions for counselling. Compared to usual care, there was a statistically significant reduction in mean PHQ-9 depression scores at 3 months for acupuncture (−2.46, 95% CI −3.72 to −1.21) and counselling (−1.73, 95% CI −3.00 to −0.45), and over 12 months for acupuncture (−1.55, 95% CI −2.41 to −0.70) and counselling (−1.50, 95% CI −2.43 to −0.58). Differences between acupuncture and counselling were not significant. In terms of limitations, the trial was not designed to separate out specific from non-specific effects. No serious treatment-related adverse events were reported.

Conclusions

In this randomised controlled trial of acupuncture and counselling for patients presenting with depression, after having consulted their general practitioner in primary care, both interventions were associated with significantly reduced depression at 3 months when compared to usual care alone.