Acupuncture for Treatment of Uncontrolled Pain in Cancer Patients: A Pragmatic Pilot Study

Integr Cancer Ther. 2013 Nov 25.

Garcia MK, Driver L, Haddad R, Lee R, Palmer JL, Wei Q, Frenkel M, Cohen L.

Abstract

PURPOSE:

Pain control is an ongoing challenge in the oncology setting. Prior to implementing a large randomized trial at our institution, we investigated the feasibility, safety, and initial efficacy of acupuncture for uncontrolled pain among cancer patients.

HYPOTHESE:

Our hypotheses were that the acupuncture treatments provided would be feasible, safe, and a beneficial adjunct to pain management.

STUDY DESIG:

This was a single arm, nonrandomized pragmatic pilot study.

METHOD:

Participants experiencing pain ≥4 on a 0 to 10 numeric rating scale received a maximum of 10 treatments on an individualized basis. Recruitment, attrition, compliance, and adverse events (AEs) were assessed. Pain (Brief Pain Inventory-Short Form), quality of life (MD Anderson Symptom Inventory [MDASI]), and patient satisfaction were assessed at baseline and at the end of treatment.

RESULT:

Of 115 patients screened, 52 (45%) were eligible and agreed to participate. Eleven (21%) were lost to follow-up, leaving 41 who completed all study procedures. No AEs were reported. Mean pain SEVERIT: was 6.0 ± 1.3 at baseline and 3.8 ± 2.0 at follow-up ( : < .0001). Pain INTERFERENC: was 6.2 ± 2.3 at baseline and 4.3 ± 2.8 at follow-up ( : < .0011). On the MDASI, the mean symptom SEVERIT: was 4.6 ± 1.8 at baseline and 3.2 ± 1.9 at follow-up ( : < .0001), and mean symptom INTERFERENC: was 5.8 ± 2.4 at baseline and 4.1 ± 2.9 at follow-up ( : < .002). Prescribed pain medications decreased across the course of the study. Patient satisfaction was high: 87% reported that their expectations were met "very well" or "extremely well"; 90% said they were likely to participate again; 95% said they were likely to recommend acupuncture to others; and 90% reported they found the service to be "useful" or "very useful."

CONCLUSION:

Acupuncture was feasible, safe, and a helpful treatment adjunct for cancer patients experiencing uncontrolled pain in this study. Randomized placebo-controlled trials are needed to confirm these results.

Ear therapy and massage therapy in the elderly with dementia: a pilot study

J Tradit Chin Med. 2013 Aug;33(4):461-7.

Rodríguez-Mansilla J, González-López-Arza MV, Varela-Donoso E, Montanero-Fernández J, Jiménez-Palomares M, Garrido-Ardila EM.

Source

Department of Medical-Surgical Therapy, Medicine Faculty, Extremadura University, Badajoz 06006, Spain

Abstract

OBJECTIVE:

To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients.

METHODS:

We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format questions done by an occupational therapist not involved in the study.

RESULTS:

There was a statistically significant positive effect of massage and ear acupuncture (P < 0.001) on measured variables in the third month of intervention, which were maintained at two months after completing the treatment (P < 0.021), when compared to the control group.

CONCLUSION:

Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients.

Curative effect of acupuncture and moxibustion on insomnia: a randomized clinical trial

J Tradit Chin Med. 2013 Aug;33(4):428-32.

Gao X, Xu C, Wang P, Ren S, Zhou Y, Yang X, Gao L.

Source

College of Acupuncture and Massage, Henan University of Traditional Chinese Medicine, Zhengzhou 450008, China

Abstract

OBJECTIVE:

To observe the effect of acupuncture and moxibustion on insomnia and explore its mechanism.

METHODS:

One hundred and twenty patients were randomly divided into an experiment group and a control group. Sixty patients in the experiment group were treated once a day with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) and with moxibustion at Baihui (GV 20) and Sishencong (EX-HN 1). Sixty patients in the control group were acupunctured once a day at Shenmen (HT 7), Neiguan (PC 6), and Sanyinjiao (SP 6).The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep improvement between the two groups.

RESULTS:

The total effective rate was 87.7% in the experiment group and 76.3% in the control group. The PSQI scores and the total score were lower after treatment than before treatment in both groups. However, the reduction in the experiment group was greater than that in the control group in sleeping quality, time to fall asleep, sleeping disorder, and daytime function (P < 0.05).

CONCLUSION:

Acupuncture and moxibustion at Baihui (GV 20), Sishencong (EX-HN 1), Shenmai (BL 62), and Zhaohai (KI 6) significantly improved insomnia symptoms in the experiment group compared with the control group.

Gag reflex control through acupuncture: a case series

Acupunct Med. 2013 Nov 5. doi: 10.1136/acupmed-2013-010377.

Bilello G, Fregapane A.

Source

Section of Orthodontics, Department of Surgical, Oncology and Stomatologic Sciences, University of Palermo, Palermo, Sicily, Italy.

Abstract

BACKGROUND:

Many patients avoid dental appointments because of severe gagging when they have work performed, such as taking impressions. There are several methods known to alleviate gagging, and some studies have suggested that acupuncture may be effective in reducing gag reflex. The aim of the present study therefore was to evaluate whether acupuncture can produce a reduction of the gag reflex.

METHODS:

A total of 20 patients, aged between 19 and 80 years, with history of gag reflex on taking dental impressions, were recruited. All patients fulfilling the inclusion criteria had an upper and lower dental alginate impression taken without acupuncture, and a second upper and lower alginate impression taken immediately after acupuncture based on traditional Chinese medicine. After each impression, the patients recorded their emetic sensation using a visual analogue scale (VAS).

RESULTS:

The results showed a significant (p<0.05) reduction in the gag reflex scores after acupuncture. For upper impressions, they fell from 6.8 (1.1) to 1.1 (1.1); and for lower impressions, from 5.45 (1.0) to 0.4 (0.7) (mean (SD)).

CONCLUSIONS:

The findings from our study suggest that acupuncture may be useful for preventing and treating gag reflex, and justifies further study.

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.