ACUPUNCTURE FOR LEUCOPENIA INDUCED BY CHEMOTHERAPY OR RADIOTHERAPY——A Meta-analysis

BACKGROUNDLeucopeniaisamainproblemofchemo orradio therapyfortreatmentofmalignanttumor .Inordertocontinuethetreatmentandreducesideeffects ,physicianshavetakenvariousmea suresincludingsupportingtreatment,alternativemedicinetherapies,etc ..Acupuncturetherapyisthemaincomponentofalternativemedicineandisapplicableforleucopenia .Clinicalapplica tionofacupuncturetherapyhasahistoryofover3 ,0 0 0 yearsinChina.Thediagnosisandtreat mentdescribedbytraditionalChinesemedicine(TCM )areinfluencedbybothme…     

ACUPUNCTURE FOR PRI MARY DYSMENORRHEA──A meta-analysis

Dysmenorrheais referredto painful menstruation due to spasmof the uterus in the period of menstrua- tion.Clinical management of dysmenorrhea common- ly consists of nonsteroidal anti-inflammatory drugs and oral administration of contraceptive pills ,both of which work well in reducing uterine muscular activi- ty . However ,these treatments are accompanied by a number of side effects , making a non-pharmacological therapy be potential value in treating dysmenorrhea . As aninterventionapproach,ac…     

Welche Wertigkeit besitzt die TCM in der Therapie von malignen Erkrankungen? Eine Expertenbefragung

Background

Acupuncture as a regulative therapy has proved itself in functional disorders. It is incapable, however, of repairing structurally damaged tissue. This dogma has remained unchallenged for decades, making benign as malign tumors a contraindication for acupuncture treatment. As in German-speaking countries, acupuncture has been taught for more than 50 years, it may be time to question and re-evaluate certain dogmas on the basis of modern scientific findings.

Aim

To find a consensus regarding the treatment of malignant tumors by means of Traditional Chinese Medicine.

Method

All instructors of four German-speaking acupuncture societies as well as all DGfAN were provided with a questionnaire containing 11 questions regarding procedures and experiences with Traditional Chinese Medicine in the treatment of carcinoma.

Results

Questionnaires were sent to 56 DGfAN instructors as well as all of the 1'200 members. Of these, 24 were returned. For nearly all participants, malignant tumors do not constitute a contraindication for acupuncture anymore. Many therapists successfully treat the side-effects of chemotherapy and/or radiotherapy by means of Traditional Chinese Medicine.No consensus could be found regarding the ipsilateral use of acupuncture in lymphedema after breast cancer surgery. There should be due caution as to the possible Interactions between chemotherapy and certain Chinese drugs.

Conclusion

The present findings suggest a revision of the current policy of discouraging acupuncture in patients receiving chemo- and/or radiotherapy/anti-hormone therapy. Further studies are recommended to support these findings. Also, further studies are needed to investigate the possibility of augmenting conventional malignoma therapy by stimulation of the immune system, and of preventing metastasis.     

针刺研究中电针应用状况的文献分析和初步研究

目的：通过对若干年针刺实验文献中电针的应用状况加以荟萃分析,探讨研究工作中存在的问题。方法：使用中医药文献学方法及电子计算机统计计算。结果：发现各文献在研究针效机理时采用的电针参数不一,大部分文献未完整标明所采纳的各种电针参数。结论：所分析的文献中电针参数不统一,故各文献的研究结果难以相互比较和引证,这是使得针刺研究较难以深入的原因之一。     

针刺的中枢调节机制研究进展

针刺作为一种有效的辅助治疗手段已被广泛应用于临床。近年来对针刺的镇痛作用及对功能性疾病的调节作用研究颇多 ,除应用传统电生理学方法外 ,还采用了分子生物学、免疫组织化学、脑功能成像等先进的技术来探讨针刺对脑的经典神经递质、神经激素、神经元代谢等的影响 ,为针刺的中枢调节机制提供了理论基础。本文主要就针刺的中枢作用及方法学等方面加以讨论     

Minimal Acupuncture is not a Valid Placebo Control in Randomised Controlled Trials of Acupuncture: A Physiologist's Perspective

Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During ,true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a ,limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to ,true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.     

CLINICAL APPLICATION OF ACUPUNCTURE ON ALLEVIATION OF STRESS REACTION INDUCED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

Acupuncturehasbeenappliedinanesthesiaforover40years,especiallyinanalgesia.Therearemanyreportsof itonsingleanesthesiaorcompoundmedicinalanesthesia.Forinstance,Qin,etal.[1]summarize174relevant paperspublishedon23kindsofmagazinesinrecent10years.Inrecentsever…     

经期针刺的思考

通过回顾经期针刺的不同认识,对女性经期是否适宜针刺治疗做一理论梳理,提出经期针刺并不存在严格的禁忌症,女性经期可以施行针刺治疗,关键是要掌握好选穴和针刺操作要点。     

井穴干预缺血性脑损伤的实验研究进展

临床应用井穴治疗急性或慢性脑缺血引起的脑梗死和血管性痴呆等疾病收到良好疗效,表明井穴对缺血性脑损伤具有良性干预作用。近年来通过建立缺血动物模型进行的一系列实验研究初步表明,抗自由基损伤、抑制钙超载、调节炎性反应相关细胞因子的表达和增强抑凋亡基因的表达等可能是井穴干预缺血性脑损伤的相关作用机制。但由于脑缺血损伤机制的复杂性,相关研究仍需进一步深入。     

针刺治疗慢性膝骨关节炎的神经影像学研究的质量控制＊

随着针灸及神经影像学技术的迅速发展,利用神经影像学技术探究针刺效应中枢机制成为近年热点,但针刺神经影像学研究的质量参差不齐。本文以梁繁荣教授正在进行的针刺治疗慢性膝骨关节炎的神经影像学研究为例,从临床试验开展和影像数据处理方面切入,探讨针刺神经影像学研究的质量控制,以期为针刺神经影像学质量控制标准的制定提供思路,为未来针刺神经影像学研究提供参考。     

Acupuncture-stimulated activation of sensory neurons

Acupuncture is one of the key therapeutics in clinical oriental medicine, and recent studies using experimental animals have begun to provide the pathophysiological basis for the efficacy of acupuncture. Here, we investigated neuronal responses in rodent models given acupuncture stimulation. In both mice and rats, acupuncture stimulation at zusanli (ST36) generated an increased expression of axonal growth-associated protein (GAP-43) in the sensory neurons of the dorsal root ganglion (DRG). Electroacupuncture stimulation at ST36 in rats induced GAP-43 mRNA and protein expression in DRG neurons at the levels of lumbar 4 and 5. Stimulation on a non-acupuncture site as a sham control induced GAP-43 expression as well, but the induction level was lower than it was with acupuncture. We further found that acupuncture stimulation upregulated phospho-Erk1/2 signals in DRG neurons. Electroacupuncture stimulation induced c-Fos expression in the neurons of the dorsal motor nucleus of the vagus nerve (DMV), which was identified by retrograde tracing. These data suggest that acupuncture stimulation may generate physiological effects on the autonomic nervous system via the activation of a somatosensory pathway.     

Acupuncture for the Treatment of Cardiovascular Diseases: A Systematic Review

Acupuncture, for the westerns countries, is an innovative and low-cost therapy for treatment and prevention of cardiovascular diseases (CVDs). However, most of its effects and mechanisms are poorly understood. Thus, the objective of this work was to systematically review the literature regarding the clinical effects of acupuncture for the treatment and prevention of CVDs. A search for papers published in English or Portuguese in the past 20 years was conducted at PubMed, SciELO, and PEDro databases. Clinical trials conducted on the effects of acupuncture were included in this review. Two reviewers extracted the data independently from the remaining 17 articles after screening. The most used acupoint was PC6 (10 studies, 64.7%), followed by ST36 (6 studies, 35.3%) and auricular acupoints (4 studies, 23.5%). Among the clinical applications, hypertension was the most studied CVD, with acupuncture being the most reported method among the studies (70.6%). Only three articles reported no benefit in the treatment of CVDs for the methodology used. We conclude that although several studies indicated an improvement in the response of the cardiovascular system in CVDs by acupuncture, electroacupuncture, or electrostimulation treatment, the heterogeneity of the studies does not allow a standardization of its application for each specific disease, making further studies necessary for its use to become a reality.     

Evidence-based Chinese medicine for cancer therapy

In contrast to western medicine (WM), traditional Chinese medicine (TCM) does not focus on a single target but on multiple targets involved in a particular disease condition by applying diverse modalities, such as herbal medicine, acupuncture, moxibustion, etc. There is no pre-determined treatment procedure in TCM, and every patient condition is handled individually. Such patient-tailored treatments have a millennia-old tradition in TCM. Illustrative examples of the power of TCM have been documented in cancer research, i.e., camptothecin, homoharringtonine, or arsenic trioxide. On the other hand, one major reason for reluctance of western academia towards TCM is due to the lack of clinical studies of TCM receipts. This situation is changing very recently, and a number of clinical studies were conducted on TCM providing convincing evidence for the first time to gain credibility and reputation outside China. Clinical trials with TCM remedies focus on three major fields in cancer research: (1) improvement of poor treatment response rates towards standard chemo- and radiotherapy, (2) reduction of severe adverse effects of standard cancer therapy, and (3) unwanted interactions of standard therapy with herbal medicines. Efficacy and safety of TCM treatments depend on the quality of TCM products. Appropriate quality assurance and control of TCM products as well as sustainable production methods are pre-conditions for the implementation of TCM in cancer therapy at an international level. In conclusion, the most important question for recognition and implementation of TCM into WM concerns the clinical evidence for the efficacy of TCM and international quality standards for TCM products.     

安慰针刺对照设计的研究进展与相关问题探讨

安慰对照已普遍用于临床研究,目的在于使心理因素降低到最小。然而,还没有见到最理想的安慰/假针刺设计用于针刺研究。因此,许多针灸临床研究并不符合设计常规临床试验的标准。弄清针灸安慰效应和药物学研究的差异是回答此种具有挑战问题的关键。在临床设计中为了避免失败,应当恰当地考虑安慰剂及假穴位的概念、穴位及经脉作用的特异性等。在以往的针灸研究中,对假穴位对照的设计常常拘泥于安慰剂定义。与化学药物作用于特异性受体不同,针刺可对机体多系统、多脏器、多种细胞、多种神经递质及调质、激素、多种受体产生影响。也正因为如此,针刺治疗如疼痛、紧张情绪等症状的临床效果常被斥之为是安慰效应。功能性核磁共振和其它许多研究提供的证据强烈提示:针刺对脑内多个心理和情感控制中枢,如边缘系统、前额叶皮层等有明显影响,从而导致一系列的功能调节,也可产生一定的安慰效果,但这种安慰效果对病人来说也是有益的。所以,针刺可能是治疗身心疾病的一种独特的疗法,安慰对照在针灸临床研究中需要重新评价。     

Quantification of DeQi sensation by visual analog scales in healthy humans after immunostimulating acupuncture treatment

Acupuncture is the most popular component of traditional Chinese medicine in Western countries. However, the mechanisms of its effects remain unclear. The therapeutic effect of acupuncture appears when a sensation of DeQi is achieved. We previously reported that repeated, but not single acupuncture treatment affected leukocyte circulation and blood pressure in healthy young humans. The objective of this study was to quantify DeQi sensation by using visual analog scales (VASs) and, to test whether DeQi induction is an important factor for the therapeutic effects of acupuncture in the same cohort. After either acupuncture or sham-acupuncture (placebo) treatment, a questionnaire containing five individual VASs was given to subjects to evaluate their DeQi sensation, including numbness, pressure, heaviness, warmth, and radiating paraesthesia, respectively. A separate VAS to measure their levels of anxiety during the treatment was also included. Our results showed that acupuncture significantly induced higher VAS values for numbness, pressure, warmth, and radiating paraesthesia, but not for heaviness than the placebo across three treatment sessions. Additionally, acupuncture did not induce higher anxiety levels than the placebo. These data confirm that VAS is an objective and reliable way to quantify DeQi sensation and, indicate that DeQi is unique to verum acupuncture treatment. Furthermore, either acupuncture-induced therapeutic effects or DeQi sensation should not be attributed to the stress-mediated effects. In summary, the induction of DeQi in each treatment session is an important factor for the physiological outcomes of repeated acupuncture treatment, and VASs offer objective, an easy and reliable way to assess it.     

针灸治疗化疗所致恶心呕吐的国内外临床研究对比

目的:比较国内外针灸治疗化疗所致恶心、呕吐研究的差异及今后研究应注意的问题。方法:总结近20年来相关文献的内容,比较国内外研究在结论和临床试验方法学上的差异,并指出国内研究的存在的问题。结论:有必要严格按照随机对照的临床研究方法对针灸治疗化疗所致恶心、呕吐的有效性进行进一步证实,同时应加强具有中医特色的辨证论治和针灸介入时机的研究。     

针刺治疗肥胖临床方案制定的基本思路和方法

笔者以课题组多年针刺治疗肥胖症的临床和机理研究资料为主,结合相关针灸临床报道和肥胖症临床及机理研究的进展,从针刺治疗肥胖的治疗对象选择、辨病与辨证相结合进行穴位选择、刺激量的掌握及针刺减肥体重变化的特点4个方面,论述了制定针刺治疗肥胖临床方案的基本思路与方法,以期总结和探索针刺治疗肥胖的临床规律,推动针刺治疗肥胖规范化临床方案的早日建立.     

针刺治疗中风后失眠临床疗效Meta分析

摘 要 目的:采用Meta分析方法综合评价针刺治疗中风后失眠的临床疗效。方法:通过计算机检索中国知网（CNKI）、万方数据库（Wanfang Data）、维普中文科技期刊数据库（VIP）、PubMed、Cochrane Library中针刺治疗中风后失眠的随机对照研究文献，按照文献纳入、排除标准进行筛选，选取符合标准的文献，将资料录入Excel表，并使用Cochrane Revman5.3软件进行Meta分析。结果:共纳入19项随机对照研究文献，其中单纯针刺12项，针刺联合7项，共纳入研究病例1535例。单纯针刺治疗中风后失眠 Meta分析结果显示其临床疗效优于口服药物，漏斗图基本对称，潜在偏倚可能性较小；针刺联合其他疗法（耳穴贴压、认知疗法、中西药物等）其临床疗效亦优于单纯口服药物，考虑为多疗法综合效应。结论:针刺治疗中风后失眠确有疗效，针刺联合其他疗法或可协同增效，但仍需更多高质量研究提供可靠的证据。     

Thermal Effects of Acupuncture by the Infrared Thermography Test in Patients With Tinnitus

Previous studies have confirmed the efficacy of acupuncture treatment for tinnitus. However, no relevant studies of the exact mechanism of acupuncture efficacy on tinnitus have been published. Enrolled participants with left-sided tinnitus received acupuncture treatment at TE3 and TE5. The acupuncture session lasted for 30 minutes. The infrared thermography (IRT) test of each participant's bilateral aural regions and visual analog scale scores were taken before and after the first acupuncture treatment session. Fifty-four participants accepted acupuncture treatment and the IRT test. The temperature differentials of both sides were reduced significantly, but the maximum, minimum, and average temperature of bilateral aural regions did not have a significant difference before and after acupuncture session. The acupuncture's effects for tinnitus were associated with the improvement of cochlear blood flow via the IRT test. We have planned a full-scale randomized controlled trial to find out more about the underlying mechanisms of acupuncture for tinnitus.     

Acupuncture and immunomodulation

Acupuncture is a well-known form of Asian medical treatment and it is used not only as an effective curative method but also to prevent illness and maintain health. It is used for the production of analgesic effect; stress related physical-mental disorders and homeostasis. Electroacupuncture (EA) stimulation, an application of electrical current on acupuncture needles, is one of the most popular types of this traditional therapy. In recent years, intensive studies have been carried out to explain the underlying mechanisms of the efficacy of acupuncture. An increase in the release of endogen opioid peptides is generally accepted to be a keystone pathway that affects the immune system after the acupuncture application. To understand the huge gap between specific skin point applications and immune responses, a vast number of accumulating data of experimental and clinical studies in the literature have been collected. This paper reviews the data to explain the updated mechanisms related to immune modulation via acupuncture therapy.