Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief.
Based at Kensington and Harley Street Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.

About Me

My photo

My specialised areas include fertility, facial rejuvenation, acne, various pain conditions, chronic fatigue, menopause and hormone regulation with acupuncture treatment.

Practice contact for appointments and addresses 

Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: for appointments  at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at info@aloclinic.com
Address
Suite 3 Harmont House
20 Harley Street, London W1G 9PH
5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor in Western medicine  in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. I am dedicated to treat patients with acupuncture and am recognized as one of the world leading acupuncture specialists.

I obtained a PhD degree in the University of Leeds in the UK.

I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.

I had frequently presented my research findings in the top international conferences in the field.

I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practicing, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, Parkison's disease etc to achieve best treatment results. My devotion and skills are highly praised by my patients. 


Saturday, 29 December 2012

Which types of ovarian cysts can acupuncture treat?

Ovarian cysts are small fluid-filled sacs that develop in ovaries. Most of the cysts are harmless. Some of the cysts may cause bleeding and pain. There are two types of cysts: functional cysts (simple cysts) and pathological cysts. Functional cysts include folicular cysts, corpus luteum cysts. Pathological cysts include dermoid cysts and cystadenoma cysts. See http://www.amazon.com/Know-Your-Ovary-Get-Pregnant-ebook/dp/B00P4K5AUQ

Polycystic-apppearing ovary is enlarged ovary with small cysts present around the outside of the ovary. These cysts can be found in healthy women or women with polycystic ovarian syndrome.

The cysts develop if there is hormone imbalance. Acupuncture can reduce the functional ovarian cysts by correcting imbalance and restoring hormone harmony.

Success story of ovarian cysts treated with acupuncture
Sarah was 25 year old. She was suffering from lower tummy pain and lower back pain for a year, the pain was getting worse for recent 6 months. She also had period pain. She had painful intercourse. Sometimes she felt bloated. She went to see doctor. Ultrasound scan found that there were a few small cysts from 2 cm to 4 cm in her ovaries. Also she was diagnosed with endometriosis. She was told that the ultrasound scan will be repeated in a few months time; if the cysts grow larger, they have to be removed by surgery. She was so upset, but she decided to do something rather than waiting. She started acupuncture treatment. At the same time she changed her diet. After a few acupuncture treatments she felt much less pain on the tummy and back. There was no intercourse pain. After 5 month acupuncture treatment, there was no sign of ovarian cysts on the ultrasound scan. All ovarian cysts were disappeared.

Thursday, 27 December 2012

Effect of acupuncture on carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness and a tingling sensation in the hand and fingers. This is caused by compression of median nerve that passes carpal tunnel and controls sensation and movement of the hand. If the nerve is entrapped in the tunnel, an unpleasant tingling, pain or numbness will occur in the distal distribution area which is in the hand and fingers. About 10% of people in the UK develop this condition. The symptoms include slowed median nerve conduction velocity, local pain and abnormal sensations such as tingling, burning, numbness etc. The symptoms develop gradually and are worse during the night. The affected fingers include thumb, index finger, middle finger and half of the ring finger. The risk of developing carpal tunnel syndrome include a family history of CTS, pregnancy, injuries to the wrist, other health conditions such as diabetes and rheumatoid arthritis and strenuous, repetitive work with the hand.

Treatments for carpal tunnel syndrome include surgical and non surgical options. The current beneficial non surgical treatments include steroid use, acupuncture and splinting. Nonsurgical treatments such as wrist splints and corticosteroid injections are recommended for mild to moderate cases of CTS. The effect of acupuncture is as effective as steroids and splinting. Acupuncture reduces pain dramatically. Acupuncture could reduce the pain completely or could reduce pain over 50% in some cases.

Research has shown that acupuncture could be an effective treatment for CTS and has greatly improved the symptoms in patients with CTS. Khosrawi S et al studied the acupuncture treatment for CTS using a randomised controlled trial. In this trial they recruited 64 patients who received 8 sessions of acupuncture treatment over 4 week period. They found that acupuncture improved the overall symptoms of CTS in these patients and nerve conduction velocity was improved as well. Another study by Kumnerddee W and Kaewtong A showed that 10 sessions of acupuncture over 5 weeks have better effect than that for night splinting in pain reduction. Yang CP observed the long term (1 year) effect of acupuncture on CTS. The patients with mild to moderate CTS received 8 sessions of acupuncture treatment over 4 week period. 1-year follow-up result showed that acupuncture treatment group had a significantly better improvement in overall symptoms, distal motor lantencies and distal sensory latencies compared to steroid group. These studies suggested that acupuncture has short term and long term effect in patients with CTS and acupuncture is a treatment option for patients with CTS.

Recently Maeda Y et al in Massachusetts General Hospital USA studied how brain contributes to the response to acupuncture in pain relief in patients with CTS. Brain response to electroacupuncture was assessed with functional MRI. The patients were allocated into three groups: local acupoints group, distal acupoint group and sham acupuncture group. In local acupoint group, two acupoints PC7 and TW5 on the affected wrist were used. In distal acupoint group, SP6 to LV4 acupoints were used. Sham acupoints were performed at nonacupoints locations on the affected wrist. They found that patients in the local and distal group reported reduced pain. Acupuncture group has greater reduction of abnormal sensation changes compared to sham group. Compared to sham group, local acupuncture produced greater activation in insula and S2 and greater deactivation in ipsilateral S1, while distal acupuncture produced greater activation in S2 and deactivation in posterior cingulated cortex. Brain activation in prefrontal cortex, SMA and S1 region was associated with analgesia.

Acupuncture is believed to stimulate the nervous system releasing neurochemical molecules to reduce pain. Acupuncture stimulates limb network in the brain and alter sensory process. Acupuncture reduces inflammation which may contribute to the mechanism.

References
Khosrawi S et al J Res Med Sci (2012) 17:1-7
Kumnerddee W and Kaewtong A J Med Assoc Thai (2010) 93:1463-9
Yang CP et al J Pain (2011) 12: 272-9
Maeda Y et al. Evid Based Complement Alternat Med (2013) Jun 17

Wednesday, 26 December 2012

Effect of acupuncture on chronic Achilles tendinopathy

Why can acupuncture help tendon injury?

Tendon is tough fibrous connective tissue which connects muscles to bones. Tendon is made of collagen. Tendon injury includes acute and chronic injury is very common. The symptoms include pain, redness, warmness, swelling, tenderness near the injured tendon. Pain increases with activity. Also pain can radiate to other part of the body. Rest, ice, steroids injection, massage can be used to treat tendon injury. Acupuncture is proven to be effective for tendon injury. Clinical study showed that acupuncture improves pain and functional activity in patients with tendon injury. Recent studies showed that acupuncture can modulate anti-inflammatory and mechanotransduction molecular pathways which subsequently increase collagen synthesis and reorganisation. This underlies acupuncture tendon healing mechanisms.

Effect of acupuncture on chronic Achilles tendinopathy

Achilles tendon is the tendon at the back of the lower legs and it passes posterior to the ankle. It is the thickest and strongest tendon in the body. Achilles tendinopathy (also called Achilles tendonitis) is pain and swelling you can get in your Achilles tendon. Achilles tendonitis is an inflammation in Achilles tendon which is caused by an overuse injury to the thick Achilles tendon at the back of the ankle. It is very common in runners. Achilles tendonitis can be either acute or chronic. Acute Achilles tendonitis is a new injury and usually more painful. Chronic Achilles tendonitis is a prolonged injury and it may follow the acute Achilles tendonitis. The characteristic of this condition is pain and inflammation at Achilles tendon. Many factors contribute to developing the condition. 1, increased activity, for example, suddenly increase distance, speed in running. 2, change to soft training surface, for example running on the soft surface can put on excessive stretch to the tendon. 3, weak calf muscles increases the strain on the Achilles tendon. 4 running on the hill will put on more stretch on the tendon. 5 Wearing high heels constantly shortens the tendon and calf muscles. Sudden change to flat shoes from high heels for exercising will put abnormal stretch to the tendon.

The main symptom is Achilles pain at the back of the ankle, just above the heel bone. There is stiffness in the Achilles tendon especially in the morning or after a long period of rest. This is thought to be due to adhesions between the tendon sheath and the tendon itself. Redness and swelling are often seen in acute stage. Nodules or lumps may be found in the Achilles tendon, particularly 2-4cm above the heel. Tenderness of Achilles tendon can be seen during examination.

Chronic Achilles tendonitis is a difficult condition to treat due to its poor blood supply.

In acute stage, rest is a must. Continuing to train on a painful Achilles tendon could lead to the injury becoming chronic and more difficult to treat. Appling ice within 24-48 hours of injury will reduce pain and inflammation. Wearing a 1cm high heel pad can take some strain away from Achilles tendon. Achilles tendon taping technique which uses elastic bandages to support the tendon can help. Acupuncture can improve blood flow, improve oxygen supply and nutrients supply to the tendon. Also acupuncture can reduce pain and decrease inflammation. In later stage apply heat to the tendon is beneficial. Pain killers can be used in acute stage, but they may not be very effective. Long term use could delay tendon healing. Steroid injection directly into the tendon is not recommended because this can increase the risk of a total rupture of the tendon in future. Right running shoes prevent from future injury.

Once you can perform daily activities pain-free, move on to next stage which focus on improving the flexibility of the calf muscles. Massage will help prevent adhesions forming within the tendon which stop the tendon sliding smoothly in its sheath and help blood flow of calf muscles. Eccentric exercises have been proven to be very effective in the treatment of chronic achilles tendonitis. If the injury has been severe and required a sustained period of rest and the neural control or co-ordination of the ankle has been affected, proprioception which is the neural control or co-ordination of a joint may need to be improved. Finally when the pain has disappeared at least a week and the range of motion at the ankle has improved then you can begin to return to training.

Acupuncture is widely used in the treatment of musculoskeletal disorders. There are some studies that suggested that acupuncture is effective to treat Achilles tendinopathy

There was a clinical study of acupuncture for chronic Achilles tendinopathy. This study investigated whether acupuncture treatment would improve outcome in chronic achilles tendinopathy. In this study, 64 patients aged from 18-70 year old with chronic Achilles tendinopathy were recruited and randomly allocated into two groups: acupuncture treatment group and control group (received eccentric exercises). The effects were assessed at the start of the treatments, 8, 16 and 24 weeks after the treatments. They found that 8, 16 and 24 weeks acupuncture significantly improved the pain sensation and activity in patients with chronic Achilles tendinopathy compared with the eccentric exercises. This finding provided an alternative treatment option for patients with chronic Achilles tendinopathy.

A case report of Achilles tendinopathy

There was a case report of conservative treatment of Achilles tendinopathy. This was a 77 year old female patient with chronic Achilles endinopathy. The pain was present in the midportion of the Achilles tendon for 8 months. The pain was progressing. Activity makes the pain worse. Her tight lower leg was swelling around the right Achilles tendon. Right ankle movement was limited. There was tenderness and soft tissue thickening. Acupuncture and electric stimulation were applied for the treatment. Also physiotherapy exercise programme was performed. The treatment was twice a week for 4 weeks and then once a week for 4 weeks. The total treatments were 12. Gradual improvement was seen during each treatment. At the end of week 9, the improvement was significant. The only symptom was the mild tenderness of the Achilles tendon. Other tests were all within normal range. After finish whole course of treatments, the patient was encouraged to continue exercise programme. At 12 month follow-up, there was no recurrence occurred.

How can acupuncture help with Achilles tendinopathy? Studies have shown that acupuncture releases pain, increases in local blood flow and oxygen and nutrients supply to promote tissue healing.

References

Almeida MD et al Acupunct Med 2013 Dec 11Doi:10.1136

Zhang BM et al Chin J Integr Med (2012) Dec 21

Papa JA J Can Chiropr Assoc (2012) 56:216-24

Kubo K et al Int J Sports Med (2011) 32:807-13

Thursday, 20 December 2012

Chronic cough, acupuncture can help

Persistent coughs caused by mild chest infections were not benefit from antibiotic treatment. There was a study led by Prof Paul Little from the University of Southampton about antibiotic treatment for patients with persistent cough lasting more than 28 days. This study including about 2000 patients across European countries showed that the severity and duration of symptoms in these patients treated with antibiotics were no different to those given a sugar placebo. Unless pneumonia is suspected, using antibiotic to treat some respiratory infections is not helpful and could cause harm such as developing resistance and other side effects including diarrhoea, rash and vomiting. Most of mild chest infections are mainly caused by viruses which are not responding to antibiotic treatment. These infections will settle by themselves. This is because body defence system will fight against virus infection and eventually get rid of those viruses.

Do you know acupuncture can help chronic cough condition? Patients with such condition have difficulty to fight off virus infections, because their body defence system is relatively weaker. Acupuncture can strength body defence system by stimulating particular acupuncture points. As a result, this will reduce the severity of the symptoms, shorten the duration of the illness and help recovery from the chronic infection condition.

Acupuncture is effective for COPD

Chronic obstructive pulmonary disease (COPD) is one of the most common disorders and one of the most common causes of death worldwide. Chronic obstructive pulmonary disease (COPD) is a general term of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have difficulties breathing, primarily due to the narrowing of their airways. Irreversible airflow limitation in COPD is caused by damage to the airways and lung tissue. COPD is usually caused by smoking. Symptoms include cough with phlegm and breathlessness which is increasing when active. There are also frequent chest infections. These symptoms are progressing over time. Respiratory failure or right heart failure may occur in the end. The main aims of the treatments are to reduce symptoms, to prevent symptoms worsening, preserve lung function and improve daily quality life. The most important treatment is to stop smoking. Inhalers are commonly used to ease symptoms. Other treatments such as steroids, antibiotics, oxygen, and mucus-thinning (mucolytic) medicines are sometimes prescribed in more severe cases, or during a flare-up (exacerbation) of symptoms. Acupuncture is used in treating COPD in China. Clinical data to date suggest that acupuncture may be an effective treatment which contributes to medical care for COPD. Acupuncture reduces inflammation in respiratory system and improves mucus clearance.

For example, there was a case series study from Japan for COPD. There were 26 patients with COPD presenting with breathlessness on exertion due to COPD. All of these patients received acupuncture treatments once a week for 10 weeks plus standard medication treatments. At the end of 10 week acupuncture treatments all 26 patients showed significant improvement with reduced breathlessness on exertion. They suggested that acupuncture treatment is a useful treatment for patients with COPD.

A recent study is investigated the regulatory effects of acupuncture on exercise tolerance in patients with COPD at stable phase. Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The acupoints used were Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and so on. The total treatment period is 5 weeks. The exercise tolerance is measured by various methods including 6-min walking distance (6-MWD), exercise time, maximum oxygen uptake (VO2max) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), maximum ventilatory volume (MVV), St. George respiratory questionnaire (SGRQ). The results have shown that (1) exercise tolerance: the differences of 6-MWD and exercise time were statistically significant between groups, which were more superior in the treatment group; the VO2max was significantly increased after treatment in the treatment group. (2) Pulmonary ventilation function: the differences of FEV1%, FEV1/FVC and MVV% were statistically significant between groups, which were more superior in the treatment group. (3) SGRQ: the SGRQ was significantly improved after treatment in the treatment group (P<0.05), but there was no difference between two groups. This study suggested that the acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase, and shorten the onset time of aerobic exercise. Besides, acupuncture combined with aerobic exercise could effectively improve the pulmonary function.

Coyle ME et al analysed the effectiveness of acupuncture on COPD using existing studies. By analysing 16 clinical trials they found that the acupuncture therapies used in these studies improved health-related QoL. The team's conclusions, comparing results from the interventions with placebo, were based on data from 3 questionnaires that the studies used: (1) the St George's Respiratory Questionnaire (SGRQ), with a mean difference (MD) of -8.33 units (95% CI, -13.13 to -3.53); (2) dyspnea on the Medical Research Council's (MRC's) dyspnea scale, with an MD of -0.34 units (95% CI, -0.38 to -0.30); and (3) the Dyspnea Visual Analogue Scale (DVAS), with an MD of -8.85 mm (95% CI, -11.81 to -5.89). Compared with placebo, acupuncture therapies also increased the distance walked in 6 min (6MWT), with an MD of -28.14 (95% CI, 23.92 to 32.36) compared with placebo. No benefit was seen on measures of lung function when acupuncture therapies were compared with either placebo or drug therapy. They concluded that acupuncture therapies may result in clinically important improvements in QoL and dyspnea.

References

http://www.bbc.co.uk/news/health-20767470

Suzuki M Acupunct Med (2012) 30:96-102

Acupuncture improves exercises tolerance in patients with COPD

Tong J et al Zhongguo Zhen Jiu (2014) 34:846-50

Coyle ME et al (2014) Altern Ther Health Med 20:10-23

Tuesday, 4 December 2012

Morning sickness, a condition in pregnancy

When a woman is pregnant, she needs to be taken extra care: for example about what medicines to take which might be different from when she is not pregnant. How about using complementary and alternative therapies? There was a report by Stewart et al about healthcdare professional views and experiences of complementary and alternative medicine (CAM) therapies in obstetric practice in North East Scotland. They conducted a survey about the use of CAM therapies by UK healthcare professionals for pregnant women. The participants include midwives, obstetricians, and anaesthetists. 32.5% of the respondents had recommended (prescribed, referred or advised) the use of CAMs to pregnant women. The most frequently recommended CAM therapies were vitamins and minerals (excluding folic acid) 55%; massage 53%; homeopathy 50%; acupuncture 32%; yoga 32%; reflexology 26%; aromatherapy 24% and herbal medicine 21%. Midwives who had been in post for over 5 years, had received training in CAMs, were interested in CAMs and were themselves users of CAMs were more likely to recommend CAMs. Those who recommended CAMs were 8 times more likely using CAMs themselves.

Some NHS hospital hospitals provide maternity acupuncture service for paitents. Their survey of patient attitude to the maternity acupuncture service showed that 90% of patients were satisfied greatly about the maternity acupuncture service; 69% of women said that they were benefited from acupuncture and 65% said their wellbeing had significantly improved with acupuncture service; 88% said that presence of this service at the Whttington would ensure that they would preferentially re book at the Whitttington Hospital in future pregnancies rather than any other local hospital. From the back pain treatment 53% improvement in their symptoms was reported which provided pilot data for a research application and complies with the NICE recommendations for back pain.

Effect of acupuncture on nausea and vomiting in pregnancy

Up to 90% of pregnant women experience nausea and vomiting. Hyperemesis gravidarum is an extreme end of hyperemesis or morning sickness which is prolonged and severe nausea and vomiting in pregnancy. One of the main dangers of this condition is dehydration. Women with hyperemesis gradidarum could be constantly nausea and vomiting many times a day and it is difficult to keep fluids within the body. It could cause lot of weight loss, electrolyte imbalance and blood volume depletion. This condition is caused by hormone in pregnancy and is improved when the hormone levels go down as pregnancy turns to 13 weeks. Sometimes it could continue throughout of pregnancy. This condition is not likely to cause any harm to the baby. But there is a risk of the baby being born with a low birth weight if there is a significant weight loss during the pregnancy. Intravenous fluids and medication are used to control the vomiting and nausea.

Foods in rich carbohydrates and low fat and acid are recommended. Recommended foods include Light snacks, nuts, dairy products, beans and dry and salty biscuits. Electrolyte-replacement drinks and taking nutritional supplements are beneficial for maintenance of electrolyte balance and sufficient calories. Intake of food rich in protein is recommended. Use of ginger and vitamin B6 are effective though there is limited evidence.

Acupuncture was used in China to treat morning sickness. Carisson CP et al from University Hospital, Lund Sweden conducted a randomized placebo controlled trial to study the effect of acupuncture in treating morning sickness. Acupuncture treatments were given three times daily on treatment days. Each treatment lasted for 30 minutes. Acupuncture point PC6 was selected. Women in the acupuncture group had significantly quicker decrease in the amount of nausea they experienced compared with the placebo control group. There was also a significant difference in the amount of vomiting between the acupuncture and placebo groups. In acupuncture group there were fewer patients vomiting. There was no significant difference of food intake between the two groups. There were no side effects observed. The possible mechanisms for the acupuncture inhibiting nausea and vomiting include that acupuncture inhibits nociceptive transmission and autonomic reflexes; acupuncture decreases pain in the system; acupuncture has effect on gastric intestine tract; the effect of acupuncture is through somatovisceral reflexes.

Acupuncture releases pain in late pregnancy without serious side effects

Pain in the pelvic and low back areas during pregnancy is very common and sometimes serious. Up to about 70% of pregnant woman have pelvic and/or low back pain which often increases progressively during pregnancy. Pain is often left insufficiently treated because of fear of using pain killers during pregnancy. Acupuncture was found to reduce pelvic pain and low back pain with little side effects. Recently Nina Knoening et al from Malmo University Hospital, Malno Sweden studied the effect of acupuncture on pelvic pain and low back pain in patients in later pregnancy. 72 Pregnant women with pelvic low back pain during pregnancy weeks 24-37 were randomly allocated in acupuncture group (37 patients) and in control group (35) patients. The acupuncture points used included LR3, GV20 and local tender points initially. If the response was not enough, BL60, SI3 and BL22-26 points were selected. Acupuncture was received by the patients once or twice a week until delivery or completely recovery for acupuncture group. No acupuncture was received for control group. During the study period, the pain intensity was decreased 60% in acupuncture group which was significantly greater than that for the control group 14%. At the end of study, 43% patients in acupuncture group were less bothered by pain which was significantly greater than for the control group 9%. No serious side effects were found in the patients and no adverse effects were found in the infants. The authors suggested that acupuncture could release [elvic pain and low back pain without serious side effects in late pregnancy.

Acupuncture for labour pain

After months of anticipation, your baby will due. When will the labour begin, no one knows. The due date calculated is only a reference point and normal labour begins anytime between 2 weeks before the due date and 2 weeks after the due date. If you are in labour, you will be experiencing pain. The amounts of pain women are experiencing vary. Women can manage their pain wit breathing and relaxing techniques; some of them need take pain killers. Acupuncture is used to relieve pain in labour. There are many reports that show the effectiveness of acupuncture on labour and labour pain. For example, Liu YL and Jin ZG studied the effects and safety of electroacupuncture at SP6 point on labour pain. They recruited 111 cases. They found that in electroacupuncture group with acupuncture on SP6 point, the active phase of the first labour stage was shorter than that in the non treatment control group and sham acupuncture group. Ma W et al studied the effect of electroacupuncture on labour pain in women during labour. 350 women in labour in three different hospitals were randomly divided into three groups: acupuncture group, sham acupuncture group and control group. The acupuncture point was at SP6. The pain scores from women in acupuncture group were less than in the control group at needle retaining at 30 min, as well as 2 hour and 4 hour after needle withdrawal. No side effects were observed during labour process. Their concluded that acupuncture at SP6 could reduce pain in labour.

Acupuncture and acupressure at acupoint LI4 relives labour pain. Peng T et al conducted a clinical study on the effect of on transcutaneous electrical nerve stimulation (TENS) reliving labour pain. They used TENS on four acupoints Hegu (LI4), Neiguan (PC6), Danshu (BL19) and WEishu (BL21) for reducing pain in labour. They found that pain in TENS group was significantly decreased compared with control group. The incidence of postpartum hemorrhage in the TENS treatment group was less than the control group. There was no side effect recorded in TENS on acupoints. Hamidzadeh A et al studied acupressure on LI4 acupoint on reducing labour pain by conducting a randomized controlled trial. There were 50 women in the acupressure group received LI4 point acupressure and 50 in controlled group received touch at LI4 acupoint without pressure. There were significant differences between the groups in labour pain score immediately and 20, 60, and 120 minutes after intervention. Active phase duration (3-4 cm dilatation to full dilatation) and second stage duration (full dilatation to birth) in labour were shorter in the acupressure group. The women in the acupressure group reported greater satisfaction. No side effect was reported. LI4 acupoint is an important acupoint for relieving labour pain.

Acupuncture treatment for depression during pregnancy

Manber et al in Stanford University in USA conducted a randomized controlled trial to investigate the efficacy of acupuncture in treating depression during pregnancy. 15 pregnant women who were diagnosed depression. The diagnosis met the criteria “Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) critieria for major depressive disorder. They were divided into three groups: specific acupuncture for depression group (52 patients), control non specific acupuncture group (49 patients) and massage group (49 patients). The treatments lasted 8 weeks with 12 sessions. Result showed that women who received acupuncture specific for depression had a greater rate of decrease in symptom severity and a greater response rate compared with the control groups (nonspecific acupuncture and massage groups). There was no significant difference between non specific acupuncture and massage groups. Their conclusion is that the short acupuncture in symptom reduction and a response rate for depression is comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.

Moxibustion at BL67 acupuncture point helps turn foetus around

Babies born in a breech position, the unfavoured position have an increased risk of birth complications. To minimise these risks, caesarean section deliveries have increased which results in health risks to the mother and baby and increased costs to health services. Strategies to promote normal birth are encouraged. Moxubustion at acupuncture points were used as one of the methods to correct foetal breech position. Recently Vas J et al reported a clinical trial of correcting foetal breech position to evaluate the conventional acupuncture point BL67 compared with SP1. There were 406 low-risk pregnant women with a fetus in breech presentation confirmed by ultrasound. The gestational age was range 33-35 weeks. These women were allocated into three groups: moxibustion at point BL67 plus usual care, moxibustion at SP1-a non specific acupuncture point plus usual care and usual care group alone. The results showed that 58.1% of the full-term presentations were cephalic (the correct position of birth) in moxibustion at point BL67 group, the highest in the three groups. There were no severe adverse effects found during the treatments. From this study, the authors concluded that moxibustion at acupuncture point BL67 is effective and safe approach to correct foetal breech position used between 33-35 weeks of pregnancy.

Reducing obesity is beneficial for pregnancy

Obesity is a major health problem. A recent survey showed that about a fourth of population is obese. About 50% of women in reproductive age are either overweight or obese. Obesity increases risk of maternal and fetal complications. About 20-40% women gain excessive weight during pregnancy. The maternal complications linked to obesity include miscarriage, hypertension, gestational diabetes, infection, caesarean section, instrumental and traumatic deliveries, wound infection and endometriosis. The fetal risks related to maternal obesity include stillbirths, neonatal deaths, preterm birth, congenital abnormalities and childhood obesity etc. Weight management during pregnancy need to have extra care, because reduction in weight gain or weight loss may be beneficial, but the weight loss itself or the interventions may potentially harm to the mother or bay. To evaluate the effectiveness of dietary and lifestyle interventions in reducing or preventing obesity in pregnancy and assess the beneficial and adverse effects of the interventions on obstetric, fetal and neonatal outcomes, Thagaratinam S et al did a systematic review. They searched database from 1950 to March 2011. There were 88 studies involving 182139 women. They found that weight management interventions in pregnancy significantly reduced hypertension during pregnancy and gestational diabetes. It also reduced preterm birth and should dystocia. Adverse effects were low. They concluded that weight management reduced weight gain during pregnancy. Dietary interventions were the most effective way to reduce weight gain in pregnancy and the risk of gestational hypertension and diabetes and shoulder dystocia. There were no adverse effects from dietary management.

References
Thangaratinam S et al Health Technol Assess (2012) 16:1-192
Nina Knoening et al Ata Obstet Gynecol Scand (2004) 83:246-250
Carisson et al J Pain Symptom Manage (2000) 20:273-9
Peng T et al Chin J Integr Med (2010) 16:234-8
Hamidzadeh A et al J Midwifery Womens Health (2012) 57:133-8
Liu YL and Jin ZG Zhongguo Zhen Jiu (2012) 32:409-12
Ma W et al Complement Ther Med (2011) 19 Suppl 1:S13-8
Manber R et al Obstet Gynecol (2010) 115:511-20
Vas J et al Acupunct Med (2013) 31:31-8
BJOG (2014) Feb11 doi:10.1111/1471-0528.12618
http://www.whittington.nhs.uk/default.asp?c=4243

Monday, 26 November 2012

Suffer from acne, acupuncture can help

What is acne? What causes acne? Acne is a disorder that occurs in the hair follicles in the face, chest and back. This is known as black heads, white heads, pimples, pustules and cysts on the skin. It is a common condition in teenagers and younger adults. Acnes can be on and off for a few years and disappear by mid 20s. Acne can have a big impact on psychological well-being.

Acne is thought triggered by hormone imbalance. Too much androgen secretion is the major trigger. Changing of hormone levels makes glands in the skin produce excessive amounts of an oily substance- sebum. Increased male hormone stimulates the oil gland attached to the hair follicles-small holes in the skin. Increased male hormone alters the oil production which causes the follicular pores clogged and hair follicles enlarged. Bacteria can access to the deeper layers of the skin through these follicles causing inflammation. Inflammation closed to the skin surface causing a pustule; inflammation in deeper layer leads to pimple and a cyst. And sometimes scar can form from abnormal wound healing following inflammatory damage. White head is caused by oil clogging to the skin surface while black head is caused by oxidized oil or accumulated melanin pigment. The factors that don’t cause acne include heredity, food, dirt, or stress.

From Traditional Chinese Medicine point of view, there are several factors causing acne: heat and damp is accumulated in lung and stomach meridians causing skin blockage. Spleen dysfunction makes food transportation, digestion and transformation abnormal and produces more heat. This also makes obstruction in the skin.

Do you know acupuncture helps reduce acne? The principle of treatment is to clear heat in the lung and stomach; to eliminate dampness; to strengthen spleen and stomach. Acupuncture may help with treat acne by reducing inflammation from promoting release of anti-inflammatory factors, modulating immune cell activities including natural killer cell activities and improving local blood circulation. Acupuncture unblocks the lung and stomach meridians and clears the heat.

There were many case reports that acupuncture can treat acne. For example, Son BK et al studied the effect of acupuncture on acne. They found that 12 sessions of acupuncture over 6 weeks reduced inflammatory lesion counts and quality of life in patients with acne. Recently Li B et al studied the current situation in research to evaluate the therapeutic effect and safety for clinical randomized and controlled trials of treatment of acne with acupuncture and moxibustion in China. They analysed 17 papers involving 1613 cases with acne and they found that acupuncture and moxibustion is safe and effective for treatment of acne and it is possibly better than routine western medicine.

Here is an example of a case. Lily is 30 year old. She had acne on her face on and off for 6 months. There are many newly formed pimples, cysts and some of them are infected by bacteria forming pustules. Scars can be seen on her face. She also had mouth odour and constipation. She heard from a friend that acupuncture may help her and wanted to try acupuncture. After a course of acupuncture, the acne symptoms were improved significantly. Also mouth odour was improved and there was no constipation at all. After 3 courses of treatment, acne was cured.

References
Li B et al Zhongguo Zhen Jiu (2009) 29:247-51
Son BK et al Acupunct Med (2010) 28:126-9
Gong and Qian J Tradit Chin Med )2007) 27:255-7
Acne treatment with acupuncture by [Ju, Dr Maggie]

Wednesday, 14 November 2012

Sperm DNA damage could be the cause for couples with unexplained infertility and miscarriage

Sperm DNA fragmentation is related to infertility

Male fertility is evaluated by sperm count, motility and morphology. This becomes a part of routine semen analyses. The basic semen analysis may provide useful information regarding male fertility potential. Sperm concentration, motility and morphology have been correlated with fertilization rates as a result of normal development during sperm production in the testes, normal maturation in epididymis and normal seminal plasma constituents. Abnormal sperm quality has been linked to several infertility problems. In certain cases, the initial semen examination can reveal some radical forms of sperm dysfunction, eg. azoospermia or globozoospermia that have serious negative consequences to natural conception. However limitations still exist in finding a cause of male infertility and a normal sperm parameter does not necessarily guarantee satisfactory fertilizing potential. An estimated 15% of men with normal basic semen analysis profiles have nonetheless been associated with infertility. A specialised test of sperm is checking sperm DNA damage measured by DNA fragmentation which may be linked to negative clinical outcomes. Recently there has been growing interest in the use of DNA integrity as a marker of male infertility.

DNA damage may exert its effect at different stages of the reproductive procedure, beginning from the pre-implantation development of the embryo to the achievement and sustaining of pregnancy and finally the creation of healthy offspring. An inverse relationship has been reported between the likelihood of achieving pregnancy either by natural intercourse or by application of ART and the presence of high sperm DNA fragmentation levels. Men with abnormal semen parameters have a higher risk of high levels of DNA fragmentation. Men with infertility have increased levels of fragmented sperm DNA and vice versa. Abnormal chromosome rate which triggers DNA fragmentation is higher in poor quality sperm samples. Research has shown that Sperm nuclear DNA fragmentation has been positively correlated with lower fertilization rates in IVF, impaired implantation rates, an increased incidence of abortion and disease in offspring. For example, a study investigated correlation of fertilization rate with sperm DNA fragmentation in A 85 couples undergoing infertility treatment with IVF/ICSI. The result has shown that fertilization rate was inversely correlated with DNA fragmentation. In addition, the slower embryo development and worst morphology on day 6 was correlated with higher sperm DNA fragmentation. There was a negative correlation between DNA fragmentation and the implantation rate. Analysis from a study including 2969 couples has shown that there was a significant increase in miscarriage in patients with high DNA damage compared with those with low DNA damage.

As mentioned above, sperm DNA damage is a useful biomarker for male infertility diagnosis and prediction of assisted reproduction outcomes. It shows more promise than conventional semen parameters from a diagnostic perspective. Another recent study has shown that it is associated with reduced fertilization rates, embryo quality and pregnancy rates, and higher rates of spontaneous miscarriage and childhood diseases; A study involved in 2,756 couples, 965 pregnancies has also shown that high-level sperm DNA fragmentation has a detrimental effect on outcome of IVF/ICSI, with decreased pregnancy rate and increased miscarriage rate. The analysis by type of procedure (IVF vs. ICSI) indicated that high sperm DNA damage was related to lower pregnancy rates in IVF but not in ICSI cycles, whereas it was associated with higher miscarriage rates in both IVF and ICSI cycles.

Sperm DNA damage is often the result of increased oxidative stress in the male reproductive tract, the potential contribution of antioxidant therapy. Do you know that acupuncture improves sperm quantity and quality? Acupuncture could reduce oxidative damage and is a potential useful therapy to treat sperm DNA damage.

References

Muriel et al Fertil Steril (2006) 85:371-83

Robinson et al HumRepord (2012) 27:2908-17

Zhao et al Fertil Steril (2014) 102:998-1005

Tuesday, 13 November 2012

Ectopic pregnancy, acupuncture helps recovering

What is ectopic pregnancy? Ectopic pregnancy is that the fertilized egg implanted outside of the uterus. The commonest site is in the fallopian tube. The egg will not develop a baby, but it is threatening condition for the pregnant women. Ectopic pregnancy occurs in 1% pregnancy. The risk factors include pervious pelvic inflammatory disease, infertility, tubal surgery, intrauterine contraceptive device and previous ectopic. Patient has positive urinary pregnancy test. Patient presents lower abdominal pain and slight vaginal bleeding. Ultrasound shows empty uterus and may identify ectopic embryo. If the egg dies before it can grow larger, the pregnancy terminates and the tissue is absorbed in the woman’s body. In this case, the pregnancy test becomes negative. If the pregnancy is left to grow, there is a risk that the fertilized egg grows larger and causes the tube to rupture which can cause life threatening internal bleeding. The signs of tube rupture are sudden severe sharp abdominal pain, feeling faint and dizzy, being sick, diarrhoea and shoulder tip pain. This is a medical emergency condition.

It is recommended that you wait for at least 2-3 menstrual cycles before trying for another pregnancy though many women are not emotionally ready for another pregnancy so soon. The chances of having a successful pregnancy will depend on the underlying health of the fallopian tubes. There are about 50% risks of infertility after ectopic and 20% recurrent rate. In subsequent pregnancy the women should receive early evaluation to confirm that the pregnancy is in uterus. It is hard to predict what the individual chance is for a successful pregnancy after the ectopic pregnancy surgery. Some research showed that about 65% of women achieved a successful pregnancy 18 months after having an ectopic pregnancy. Acupuncture could help the recovering of fallopian tubes by improving pelvic circulation, reducing inflammation and relaxing the tubes to be ready for next pregnancy. Also acupuncture can help to reduce stress in the women after pregnancy loss and surgery.

Appendectomy increases the risk of ectopic pregnancy

Fallopian tube damage is responsible for one third of infertility cases. Ruptured appendicitis has been considered a risk factor in causing scarring, which can lead to infertility and/or ectopic pregnancy. Does appendectomy increase the risk of tubal infertility? A research studied recent data on this subject. They found that previous appendectomy is not associated with increased incidence of infertility in women. However this study found that appendectomy is significantly associated with an increased risk of ectopic pregnancy.

Compromised ovarian function after salpingectomy, acupuncture can help.

After salpingectomy, the ovarian function on the operation side could be compromised because of reduced blood circulation. A study involved in thirty-two patients with unilateral salpingectomy performed for ectopic pregnancy investigated this subject. In this study, ovarian function was assessed by antral follicle count, ovarian volume and ovarian stromal blood flow measured by three-dimensional (3D) power Doppler ultrasonography. Ovarian volume, antral follicle count and 3D power Doppler indices were comparable between the operated and the non-operated sides in the whole group and in the laparotomy group. The antral follicle count and 3D power Doppler indices were significantly reduced on the operated side in the laparoscopy group. It suggested that ovarian function seems to be impaired after laparoscopic unilateral salpingectomy at short-term.

Do you know that acupuncture improves blood circulation to the ovaries and other reproductive system? It could help to improve ovarian function.

References

Elraiyah T et al J Surg Res (2014) ii: S0022-4804(14)00784-7. doi: 10.1016/j.jss.2014.08.017.

Chan CC et al Hum Reprod (2003) 18:2175-80

Gynaecological pain, acupuncture can help

Gynaecological pain, acupuncture can help

Chronic pelvic pain (CPP) is recurrent or constant pain in the lower abdominal region that has lasted for 6 months or more. CPP can be caused by many conditions and the symptoms are similar and nonspecific. CPP is a common disorder with 3.8% population occurrence and it is as high as 40% in women with infertility. CPP is a heavy burden in women of reproductive age, with a direct affect of their quality of life. The treatment is focusing on identifying underlying cause and treatment. If there is no underlying cause identified, pain management is essential.

Gynaecological pain

Inflammation and injury can be a problematic for internal organs. The organs become highly sensitive to any stimulation and pain sensation is very common. In women pain associated with their reproductive system is prevalent, such as period pain, labour pain etc. There is a particular sensory receptor that responds to potentially harmful stimuli by sending nerve signals to the spinal cord and brain. The receptors respond not only to intense mechanical stimuli such as distension and overstretching but also to irritant chemicals especially to the products of inflammation. They are very important in signalling pain from inflamed area. The uterus, cervix and adnexa share the same visceral innervations as the lower ileum, sigmoid colon and rectum. Signals from these organs pass through the sympathetic nerves to spinal cord segments T10-L1. Because of the shared pathway, gynaecological pain is difficult to be distinguished from gastrointestinal pain. Gynaecological pain can be felt in places far from the location of the reproductive organs. This is known as referred pain. The pain can be felt in the abdomen, pelvic region, or lower back. This pain sometimes cannot be located very accurately. The pain can be sensitized by altering sensory neurons so that they respond more intensely to the stimuli; and also by enhancing sensitivity of the sensory pathways in the brain that modulate sensation.

Some gynaecological conditions cause acute abdominal pain: ectopic pregnancy which occurs in 1% of pregnancies; pelvic inflammatory diseases; endometriosis, when large chocolate cysts ruptured; ruptured ovarian cysts.

In women, two conditions are very common: endometriosis related pelvic pain and pelvic inflammatory diseases and adhesions.

Endometriosis related pelvic pain. Endometriosis is an estrogen-dependent inflammatory disorder that occurs in women during reproductive years. CPP is one of the most common symptoms of endometriosis. The pelvic pain caused by endometriosis may vary with menstrual cycle, typically with severe pain toward the end of the cycle and pain declined during menstruation. Some women may have constant pain with various severities without association with menstrual cycle changes. Period pain, pain during intercourse, irregular period and infertility may coexist in these women with endometriosis. The causes for CPP in endometriosis are not clear. There are a few theories. One of them is that the lesions cause pain, but how they contributing to the pain remains mystery. Another hypothesis is that local inflammation contributes to the pain in endometriosis in which prostaglandins are activated. This established a foundation for new treatments involving agents and methods that can inhibit immunological and inflammatory factors. Recent studies suggested that innovation by newly sprouted nerve fibres underlies pain in endometriosis. This is supported by some clinical findings and studies from animal experiment. In animal experiment, transplanted pieces of uterine tissue become vascularised and grow rapidly and innervations and pain symptoms are seen. In clinical studies, various neuronal fibre types are found in different types of lesions and nerve fibre densities are associated with severity of pelvic pain.

Pelvic inflammatory diseases and adhesion: If women with pelvic pain have a history of previous sexually transmitted infection, intercourse pain, backache, infertility, ectopic pregnancy or fever, pelvic inflammatory disease is very likely an underlying cause of CPP. If the pain is associated with stretching movements or organ distension, adhesion may exist.

Acupuncture may benefit. There are some good reasons to choose acupuncture to treat CPP. First, acupuncture is effective to treat some underlying causes of CPP, such as endometriosis, pelvic inflammatory diseases; second, acupuncture is effective way to release the pain in CPP; third, acupuncture has no side effect.

Acupuncture reduces back and pelvic pain in pregnant women

More than two-thirds of pregnant women have low back pain (LBP) and one-fifth have pelvic pain. With pregnancy advanced pain increases which could affects work, daily activities and sleep. Pennic V and Liddle SD assessed the effects of different interventions for preventing and treating pelvic and back pain in pregnancy. They studied 26 randomised trials involved in 4093 pregnant women in the review. Usual prenatal care was added to the interventions. For LBP exercises significantly reduced pain and disability, though the evidence was low quality. Water-based exercise significantly reduced LBP-related sick leave. There was no significant difference in pain or function between two types of pelvic support belt, between osteopathic manipulation and usual care or sham ultrasound. Specially-designed pillow may relief night pain better than a regular pillow. For pelvic pain, the quality evidence was moderate which showed that acupuncture significantly reduced evening pain better than exercise; both approaches were better than usual care. A rigid belt plus exercise improved average pain. An eight to twenty wee exercise program reduced the risk of having lumbo-pelvic pain. Exercise and significantly reduced lumbo-pelvic-related sick leave and improved function. Osteopathic manipulation reduced pain and improved physical function. Acupuncture was started at 26 rather than 20 weeks of pregnancy improve pain and function more. Adverse events were minor and transient.

Acupuncture is as effective as pain killers for period pain (dysmenorrhoea).

Dysmenorrhoea is the medical term for the painful period cramps. It is also known as period pain. Period pain is very common affecting about over 50% women. The pains can be mild dull pain which may rarely noticeable or severe which may affect women’s daily life. They can be periodic or continual. It presents cramping pain in the abdomen before or during the menstrual period. Women with period pain may also feel pressure in the abdomen, pain in the hips, lower back and inner thighs. They may have other symptoms including upset stomach with or without vomiting and loose stools or constipation. Period pain may be accompanied by a headache, dizziness, fainting and fatigue and urgent frequent urination. Period pain is caused by uterine muscle contractions in response to prostaglandins and other chemicals. Uterine lining is shed off during menstruation and uterus contracts to squeeze the tissue out of the uterus.

Symptoms could start as early as immediately after ovulation and last until the end of menstruation. Common period pain often starts immediately before or at the beginning of the period and last for one to three days. Period pains generally begin one to two years after a woman starts getting her period and they become less painful as a woman ages and may stop entirely after the woman has a baby.

Why some women get more painful periods than others? Painful period is associated with changing of hormonal levels with ovulation. Prostaglandins produced in the endometrium of uterus cause uterine contraction which causes pain. Compared with other women, women with severe painful periods have increased uterine contractibility and more frequency of contraction. Women with more painful periods have higher level of prostaglandins compared with those with less painful period. Some factors including narrow cervical canal, backward tilting uterus, lack of exercises and emotional stress increase the period pain.

There are two types of period pain: primary period pain and secondary. In primary period pain, there is no cause of underlying gynaecological condition. Normally period pain occurs in the ovulatory cycles. In secondary period pain, some gynaecological conditions such as endometriosis or ovarian cysts are underlying causes of the period pain.

The treatment is aimed reducing pain. Non-steroidal anti-inflammatory drugs (NSAID) known as pain killers are common used to relieve the pain. These drugs decrease prostaglandins production and reduce pain. Contraceptive pills can be used to treat period pain because they stop ovulation.

Can acupuncture help period pain? Yes, acupuncture is well known to reduce pains in various conditions and it is very effective to relieve period pain. Acupuncture at particular points stimulates nerve ends producing pain releasing substances such as endorphins and neuropiptide which acts as endogenous painkillers.; acupuncture reduces inflammation by increasing blood flow and releasing vascular and immunomodulatory fators; acupuncture makes uterus relaxed.

Recently Kiran et al compared the effect of acupuncture and medicines (NSAID) for the treatment of primary period pain. The study is involved in 35 young women with a diagnosis of primary dysmenorrhea. They were divided into two groups: acupuncture group and medicine group. One month treatments were given to these women with dysmenorrhea and then the pain scores were assessed. They found that acupuncture is as effective as NSAID to reduce period pain.

When is a good time of acupuncture treatment for period pain

It is well known that acupuncture is effective in treating period pain. When is the best time to seek acupuncture treatment if you suffer from period pain? Ma YX et al studied this time related treatment. They recruited 600 patients with period pain. They compared the effect of acupuncture treatment with no treatment. They also compared the effect of acupuncture treatment before the period started with the effect of immediate acupuncture treatment as soon as pain occurrence. They found that acupuncture significantly relieves period pain compared with the control group with no treatment. The pain has been relieved within 5 min after acupuncture treatment. By comparing the pain scores used for the pain assessment, they found the acupuncture treatment before period has better effect than that when the pain occurred. This study suggests that acupuncture prevents period pain. Acupuncture reduces period pain by a few mechanisms. Acupuncture regulates hypothalamus-pituitary ovary axis; acupuncture relaxes uterine smooth muscles and inhibits uterine contraction; acupuncture increases relaxation and reduces tension; acupuncture releases endorphins and other neurohumoral factors and changes pain processing in the brain and spinal cord; acupuncture reduces inflammation by increasing release of vascular and immunomodulatory factors.

Which acupuncture points for women’s period pain

If you see an acupuncturist for period pain, you might like to know which acupuncture points were used. There is a lot variation for acupuncture points used. A study analysed research data from January 1978 to April 2014 to assess the acupuncture points for period pain. They found that there were 20 acupuncture points frequently used. Acupoints on lower limbs were most frequently used. Three points including Sanyinjiao (SP06), Guanyuan (CV04), and Qihai (CV06) were used most frequently. The most frequently used meridians were Conception Vessel, Spleen Meridian of Foot Taiyin, and Bladder Meridian of Foot Taiyang. 67.24% of acupoints used were specific acupoints.

Case report for period pain and endometriosis with acupuncture treatment

Alice is 27 years old. She had severe period pain and sometimes lower tummy pain between periods. She was diagnosed endometriosis one year ago. She took painkillers and antibiotics, but she still had unbearable pain in her lower tummy. And then she was advised to use birth control pills to inhibit ovulation in order to stop the pain and endometriosis. But she still suffers from pain. She never got pregnant before, but she wanted to have a baby some day. So she decided to stop taking birth control pills and seek help from acupuncture for period pain. After a few sessions of acupuncture treatment, her pain reduced markedly. With continuing a few month acupuncture treatments, she was no longer having pain in her periods.

References

Kiran G et al Eur J Obstet Gynecol REprod Biol. 2013 Mar 19

Ma YX J Ethnopharmacol. (2013) 148:498-504

Pennic V & Liddle SD Cochrane Database Syst Rev. (2013) Aug.

Yu S et al Evid Based Completment Alternat Med (2015) 2015:752194

Sunday, 11 November 2012

Acupuncture regulates hypothalamus-pituitary-ovary axis

Acupuncture regulates hypothalamus-pituitary-ovarian axis

The female reproductive system is controlled by the hypothalamus-pituitary-ovarian (HPO) axis. This feedback loop begins with gonadotrophin-releasing hormone being released from the hypothalamus, resulting in the secretion of the gonadotrophins (LH and FSH) from the anterior pituitary, which in turn controls estrogen and progesterone production in the ovaries. Estrogen and progesterone play a central role in female fertility by stimulating growth, differentiation and maturation of follicles, preparing the endometrium for implantation and maintaining embryonic development. Altered levels of hormones and other factors that are involved in maintaining control of the HPO axis can have negative effects on fertility and pregnancy

Acupuncture promotes the release of beta-endorphin in the brain, which regulates gonadatrophin releasing hormone from the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary.

Egg quality

How to you know your egg quality is good or not? It is difficult to know your egg quality until IVF through which eggs can be seen. There are many factors that help estimate egg quality:

ovarian reserve tests including AMH, antral follicle count and FSH test, higher AMH and antral follicle count show good ovarian reserve. FSH from blood test less than 10 iu/l is good.

factors related to your menstrual cycles including cycle length, premenstrual spotting, ovulation day, peak estradiol and peak progesterone. Shorter cycles, spotting and low estradiol and progesterone indicate egg quality may not be good enough.

women’s age: most women under age 35 would have good quality of eggs.

pregnancy loss followed by difficulty to conceive again; This indicates that your egg quality is deteriorating.

IVF results which tests egg quality.

Acupuncture with or without TCM. Minimum 3 month acupuncture could improve egg quality.

Off pills, acupuncture helps resume ovulation

Oral contraceptive pills were developed over 40 years ago and they become the most common approaches of contraception in many countries. About 100 million women worldwide currently rely on this method for contraception. Do you know what the components of contraceptive pills and how they work? Most commonly used pills are called combined oral contraceptive (COC) pills which contain estrogen and progestogen. There are progestogen only pills available as well. These pills mainly inhibit ovulation by disturbing hypothalamus pituitary gland ovary axis ovary function and altering hormone balance. For most women their period will return within a few months once off the pills. But for some women, it might take longer to get their ovaries function again. This is understandable. For example if you fix one of your knee joints for a few months or longer. The knee joint may not function well and the related muscles will shrink and loss their function. When you release the knee, you have to work really hard and do lot of exercises to get the joint and muscles function well as normal again. When you are on pills your ovarian function is suppressed and they will not ovulate immediately. Some women’s ovary may be more sensitive to the pills. Once you are off pills, the ovaries have to work hard to regain their function. This takes some time. If they fail to do so, follicles may not develop and ovulation may not occur.

What you can do to help your ovary function? Acupuncture can help resume ovary function by improving ovary blood flow and regulating hormone balance as mentioned above without taking more medications.

References
Chang K and Tian SL Zhen Ci Yan Jiu (2012) 37:15-9

Monday, 5 November 2012

Tennis elbow, elbow pain, acupuncture can help

Tennis elbow has many alternative names including lateral elbow pain, lateral epicondylitis, rowing elbow, tendonitis of the common extensor origin, and peritendinitis of the elbow. It can affect sufferer’s work and quality of life. Tennis elbow is common and affects up to 3% of the population and it is characterised by pain and tenderness over the outer part of the elbow and pain on resisted dorsiflexion of the wrist, middle finger, or both. This is caused by an overuse injury of the extensors of the forearm which attach at the lateral epicondyle. Patients with tennis elbow are typically over 40 year old and have a history of repetitive activity during work or recreation. Non steroids pain killers and steroids injection have short term effects in improving symptoms such as pain reduction, global improvement, and grip strength compared with placebo and other conservative treatments. Physiotherapy is commonly used though there is lack of evidence of efficacy.

Acupuncture is an appropriate option for tennis elbow treatment. Previous research showed acupuncture had short term benefit (three days to two months) in pain reduction. The longer term effect still needs to be studied. More recently a study published in a Chinese acupuncture journal. 34 patients with tennis elbow were in two groups for acupuncture treatment in different acupuncture points. Group A was used anti-Ashi-points (points of pain relief or disappearance after local press) and group B was used Ashi-points (pain spots) and surrounded points. Acupuncture was performed once in every two days; 2 courses treatment was given with 10 treatments for 1 course. The effect was assessed at the end of the treatment day, the 7th day, the 30th day, the 6th months and one year after treatment. They found that short term effect was better for group A than group B, but the long term effect (6 months and one year) were similar between the two groups.

Another study analysed the effectiveness of acupuncture on lateral elbow pain (LEP). By comparison of acupuncture and sham acupuncture treatment, patients with LEP received acupuncture treatment had significantly more reduction in pain and greater improvement in elbow mobility, more strength in the arm. There was immediate effect after acupuncture treatment and the effect last for 2 weeks followup period.

By comparison of acupuncture and conventional treatment, it was found from those studies that the acupuncture group had a significantly higher cured rate than conventional therapy, including prednisolone injection, triamcinolone acetonide, lidocaine injection. At 6 month followup, Acupuncture group had significant reduction in VAS pain score when compared with the group that received pulsated ultrasound and massage. Study has shown there was no significant difference between moxibustion and conventional treatment.

By comparison of acupuncture plus moxibustion combination and acupuncture alone, one study has suggested combination of acupuncture with moxibustion had better pain reduction and another study has shown that electro acupuncture had better pain reduction, but there was no clear conclusion because of poor methodology.

About adverse effects, there was no adverse effect reported in acupuncture treatment. One case of permanent scar from blister was reported in moxibustion treatment.

Clinically there were some cases that patients with tennis elbow were completely cured after acupuncture treatments.

Here are some success stories for elbow pain with acupuncture treatment. For example, Lisa who was 42 years of age was diagnosed with tennis elbow for 5 years. Her right elbow pain became persistent after a few years. This affected her daily life. She had terrible pain in her arms around the elbow whenever she used the arm. She tried everything she could to get rid of the pain without success. A friend told her to try acupuncture which she did. After first session of acupuncture, she felt less painful immediately. She was encouraged so much and continued to do a few sessions. She felt much better and could use the arm without feeling too much pain. She did a few more sessions again. The pain was completely gone. After a few years a follow up showed that there was no recurrence of the elbow pain.

Sarah was 50 year old. She had left elbow pain for 10 years. Initially the pain stayed at the lateral part of the elbow and the pain came and went. However the pain spread later to the medial part of the elbow, to the front and the back of the forearm and the arms as well. The pain was getting worse. She could not do anything using the left arm such as writing, combing hair or lifting arm (Because she was left-handed, this causes more problems for her). The examination showed pain at the lateral and medial part of the elbow when she was doing elbow extension and flexion, left arm lifting, left wrist extension and flexion. There were highly sensitive tender points around the elbow. This was a typical case of soft tissue injury around the left elbow or so called tennis elbow. Acupuncture was effective for this case. After a few sessions of acupuncture treatments, she could do things using her left arm without feeling too much pain. With continuing a few sessions of treatments the pain was gone completely. 1 year follow up showed there was no pain at all. She could use the left arm do anything as the right arm. Examination showed there was no pain when she was doing the left elbow extension, flexion or arm lifting. There were no tender points around the elbow.

Acupuncture help relieve symptoms of tennis elbow. It stimulates nerve ends leading to release of analgesic substances such as endorphins to relive the pain. It also reduces inflammation by improving local circulation. It also improves muscle stiffness and joint mobility by increasing local microcirculation.

References
Johnson GW et al Am Farm Physician (2007) 76:843-8
Wan X Zhongguo Zhen Jiu (2011) 31:1078-80
Gadau M et al BMC Complement Altern Med (2014) 14:136

Saturday, 27 October 2012

Acupuncture is effective for Parkinson’s disease

1 in 500 people are affected by Parkinson’s disease (PD), a condition caused by loss of nerve cells in the part of the brain. It is the second most common neurodegenerative disease after Alzheimer’s disease. These cells produce a chemical called dopamine. Because of the loss, dopamine production was reduced leading to three main symptoms of the condition, tremor, muscle stiffness and physical slow movement. Numerous nonmotor symptoms including neuropsychiatric disturbance, abnormal sensation, sleep disorders, and autonomic dysfunction are also present. Complementary and alternative medicine (CAM) plays an important part in the treatment of the condition.

Lokk J and Nilsson M studied use of CAM in patients with Parkinson’s disease at a neurological outpatient clinic Sweden. They studied the frequency, type and factors associated with the use of CAM in all patients with PD 421 in the outpatient clinic. The patients received questionnaire. 172 men and 153 women responded the questionnaire. 30% and 39% women used CAM and acupuncture usage was in the highest frequency.

Acupuncture, is used to treat PD in China. Although the therapeutic effect of acupuncture in PD is under debate, increasing evidence shows that it can alleviate motor symptoms and nonmotor symptoms, such as sleep and pain and mood disturbances and improve the quality of life in PD patients.

The effectiveness of acupuncture in treating PD was observed in research. Recently researchers used the magnetic resonance imaging (MRI) to investigate the effect of acupuncture stimulation in brain activity. They found that acupuncture stimulation in aupoint GB34 increased neural responses in regions including substantia nigra, caudate, thalamus and putamen which are the impaired regions caused by PD.

There was a study on effectiveness of acupuncture on twenty patients with PD with mean age 68 years disease duration 8.5 years. On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety. There were no adverse effects. Acupuncture therapy is safe and well tolerated in PD patients.

Recently Zeng et al have shown that acupuncture stimulation in Parkinson'smodels had generated valuable mechanistic insight of Parkinson's and showed that acupuncture treatment is a neuroprotective therapy that increase the release of various neuroprotective agents such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and cyclophilin A. In addition, acupuncture therapy slows cell death process and attenuates oxidative stress to dopaminergic neurons in the substantia nigra. Further, acupuncture therapy modulates neuronal activity of the basal ganglia output structures. These results suggest that early application of acupuncture therapy to Parkinson's patients may be helpful for the best efficacy of acupuncture treatment. It is hopeful that translation of achievement in acupuncture research in Parkinson's models will maximize the potentials of acupuncture treatment.

Recently more studies were published showing that acupuncture activates brain in patients with Parkinson’s disease and patients with mild cognitive impairment. For example, magnetic resonance imaging (MRI) is a new technique that helps researcher and clinicians understand brain function. Using this technique, we can see how acupuncture stimulates the brain and alters brain function. There was a study in which brain activation in response to acupuncture in a group of 12 patients with Parkinson’s disease was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment. The result has shown that Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.

Another study investigated whether acupuncture at Taixi (KI3) acupoint in elderly patients with mild cognitive impairment can activate neurons in some brain regions. Results showed that 20 brain regions were activated in participants, including the bilateral anterior cingulate gyrus (Brodmann areas [BA] 32, 24), left medial frontal cortex (BA 9, 10, 11), left cuneus (BA 19), left middle frontal gyrus (BA 11), left lingual gyrus (BA 18), right medial frontal gyrus (BA 11), bilateral inferior frontal gyrus (BA 47), left superior frontal gyrus (BA11), right cuneus (BA 19, 18), right superior temporal gyrus (BA 38), left subcallosal gyrus (BA 47), bilateral precuneus (BA 19), right medial frontal gyrus (BA 10), right superior frontal (BA 11), left cingulate gyrus (BA 32), left precentral gyrus (BA 6), and right fusiform gyrus (BA 19).

More recently acupuncture as an additional treatment with drugs was studied. In this study, patients with PD were allocated into two groups, acupuncture plus drug group and drug only group. The result has shown that tremor, rigidity, and bradykinesia, are all significantly decreased in acupuncture group. Sleep quality and depression were also significantly improved in acupuncture group.

A group of experiments from animal models of PD indicate that acupuncture is effective in reducing oxidative stress , decreasing neuroinflammation with a major feature of microglial activation, stimulating release of neurotrophic factors, and regulating homeostasis of the network between cortex and striatum.

Acupuncture reduces oxidative stress of the cells

Oxidative stress is a sign of the imbalance between the production of reactive oxygen species and detoxification of the antioxidant system. As a result, this causes cell function damage and diseases. Oxidative stress is a critical feature in the pathological process of various diseases such as vascular dementia, Alzheimer’s disease and Parkinson’s disease. Recent research from last 5 years has shown that acupuncture treatment could decrease oxidative stress of the body and increase antioxidant system ability. Because of this acupuncture could improve memory impairment in vascular dementia and Alzerimer’s disease and reduce brain damage. Increased oxidative stress and depletion of the antioxidant are important mechanisms of the onset and progression of Parkinson’s disease. Acupuncture could reduce oxidative stress, inhibit cell death in the neurons and protect neurons improving motor function.

References

Loddk J and Nilsson M Parkinsonism Relat Disord (2010) 16:540-4

Yeo S et al CHS Neurosci Ther (2012) 18:781-90

Shulman LM et al Mov Discord (2002) 17:799-802

Zeng et al (2013) Int Rev Neurobiol (2013) 111:141-58

Yeo Et al BMC Complement Altern Med (2014) 14:336

Chen et al Neural Regen Res (2014) 9:1163-8

Wang F et al Evid Based Complement Alternat Med (2015) 2015:692795

Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294

Saturday, 6 October 2012

Acupuncture helps skin problem

Eczema is a very common inflammatory skin condition. In the UK, it affects up to 20% of children and 10% of adults. It is a chronic condition. The skin become itchy, red, dry and cracked. It is commonly found behind knees, the inside of the elbows, around the neck and around eyes and ears. The symptoms can be episodic and recurrent. Some triggers can flare up the symptoms, for example stress can trigger the symptoms or make them worse. The causes for eczema are involved in genetic and environmental factors. Itch is a major symptom of skin problem. This is often caused by allergy. It is very important to identify potential allergens and avoid contacting with them. Changing diet is necessary if certain food is reactive. Main treatments include emollients and topical corticosteroid creams.

Acupuncture is believed to be beneficial for eczema and recent research has a very positive view for the effects of acupuncture in the treatment of chronic inflammatory skin conditions. Acupuncture may help to relieve symptoms in people with eczema. For example the itching can be reduced by up to 50% after one treatment and the skin will be back to normal gradually after a course of treatment. This is because acupuncture reduces inflammation, regulates mediators of the allergic reaction to extrinsic allergens, regulates immune cell types and functions and increases local blood flow reducing swelling

There was a blinded, randomised controlled trial. 30 patients with ectopic eczema participated in the study and allocated into three groups: acupuncture group, sham acupuncture and no acupuncture group. The allergy stimulus was applied to these patients 30 min before and after the interventions: acupuncture or no acupuncture. Two acupuncture points were selected: Quqi (LI11) and xuehai (SP10). The result showed that itch intensity and skin rash were significantly lower in acupuncture group compared with sham acupuncture or no acupuncture group. A further study was done by the same group. They compared the effect of acupuncture with that of cetirizine, an antihistamine drug commonly used for treating skin allergic reaction. This trial involved 20 patients with ectopic dermatitis. They were tested in several interventions: acupuncture, placebo acupuncture, cetirizine, certirizine placebo and no interetion. The result showed that both acupuncture and cetirizine treatments have significantly lower mean itch intensity and skin rash compared with both placebo and control groups. These studies suggested that acupuncture is effective in treating allergic skin reactions and it is as effective as some antihistamine drugs. They investigated the mechanism of acupuncture treatment of atopic eczema. 10 patients were in two groups acupuncture group and no treatment group. Allergen-induced basiphil cell (related to allergy) activation was measured after allergy stimulation. Itch intensity was significantly lower in acupuncture group on day 15 (after five treatments) and day 33 of the treatments (after 10 treatments). Less basiphil cells after stimulation were found in patients in the acupuncture group after the acupuncture treatments.

Allergic contact dermatitis (ACD) is a chronic inflammatory skin disorder. The incidence of ACD has increased worldwide. It has been suggested that ACD is related to activation of inflammatory cells linked to various allergic immune responses. ACD has been treated with steroid therapy and immunosuppressive agents. However these medications may cause many adverse effects. The use of alternative medicine such as acupuncture and herbs is increasing. The effect of acupuncture has been proven in the clinical study; however the mechanism is still unclear. Park JY et al studied the mechanism of acupuncture on ACD. They found that acupuncture on LI11 point which is commonly used in the treatment of ACD significantly inhibited cutaneous hyperplasia, serum IgE levels and expression of proinflammatory cytokines and proteins which contributes to immune response. From this study, it can be seen that acupuncture regulates immune activities in the treatment of ACD.

References
Pfab F et al Allergy (2010) 65: 903-10
Pfab F et al Allergy (2010) 67:566-73
Pfab F et al J Alterm Complement Med (2011) 17:309-14
Park JY et al Evid Based Complement Alternat Med (2013) 2013:982095

Tuesday, 2 October 2012

Anxiety impairs immune function, acupuncture reverses it

Generalised anxiety disorder (GAD) is a psychological disorder together with a broad range of physiological symptoms. People with GAD feel anxious about a wide range of situations and they could have both psychological (mental) and physical symptoms. They feel worried, irritable, inpatients and easily distracted. They could have various physical symptoms such as dizziness, pin and needles, tiredness, shortness of breath etc. It is widely accepted that anxiety impaired immune system function. Immune system defended you from illness. If your immune system is compromised, it does no good to your health.

Arranz L et al studied the effect of acupuncture in 34 women aged 30-60 with anxiety diagnosed and impaired immune function. Acupuncture was performed manually on 19 acupoints. A single session 30 min was employed. Before acupuncture and 72 hours after acupuncture, immune function was measured by blood test. They found that the best effect was seen at 72 hours after a single acupuncture treatment. They also studied long term effect of acupuncture. 12 patients completed 10 sessions in a year until the anxiety symptoms disappeared. The immune function was measured after a month at the end of a year treatment. They found that the immune function in these women was returned to the level closed to that in healthy control women. This study suggested that acupuncture improve immune function in women caused by anxiety.

There was another report comparing acupuncture with clonazepam in treating GAD. 80 patients were participated the study. 40 patients were acupuncture group and another 40 patients were in clonazepam group. Twelve medridians acuppoints were applied. Meaning quick needling at the apecific acupoints of each meridian for example, LU7, LI4 and HT7were applied. The total treatments were 6 weeks. Hamilton Anxiety Scal (HAMA) and brain activity were used to evaluate the effects. The improvements of the total HAMA scores could be seen in 2, 4 and 6 weeks in both group but the improvements were greater in acupuncture group. The brain activity was improved in both groups. So acupuncture could be a potential option for treatment of GAD.

References
Arranz L et al Am J Chin Med (2007) 35:35-51
Zhou XF et al Zhongguo Zhen Jiu (2013) 33:395-8

Monday, 1 October 2012

Acupuncture is an effective treatment for dementia

Dementia is due to damage of the brain caused by many diseases. The symptoms of dementia are memory loss, communication problem, behaviour changing and having difficulty of everyday life. For example, you may forget what you said earlier in the day or where you put things etc. You may be having difficulty to recognise persons you are familiar with or unable to find familiar places etc. You may find it difficult to communicate with others and feel depressed etc. The symptoms might be different depending on individual, but generally the symptoms are getting worse over time.

Dementia is due to damage of brain, which is caused by many diseases. Alzheimer’s disease (AD) is a most common form of dementia, which accounted for 70% of dementia. Alzheimer’s disease is degenerative which is caused by losing brain cells in the cerebral cortex and some other regions of the brain. This loss leads to shrink of the affected regions causing the symptoms mentioned above. Mild cognitive impairment (MCI) is the most important at risk state of AD which is a transition stage of normal aging and dementia. It has a high probability of degenerating into AD at a rate of 10-15% per year. Unfortunately there is no effective treatment for AD and MCI.

Acupuncture is used in treating AD and MCI in China. Recently Wang Z et al studied the effect of acupuncture on brain functional activity throughout the entire brain in patients with AD and MCI and compared with normal controls. Participants were 14 patients with AD, 8 patients with MCI and 14 healthy controls. At the resting state, in patients with MCI, there were increased activities in the brain regions of the temporal lobe, frontal lobe and left lentiform nuleus, while there were decreased activities in the regions of right cingulated gyrus and left fusiform gyrus compared with normal controls. In patients with AD, there were decreased activities in left temporal lobe and left middle frontal gyrus. Then data was taken during the process of acupuncture at points LI4 and LR3 bilaterally and 10 min after acupuncture treatments. They found that brain activities related to memory were altered during the acupuncture process and after the acupuncture treatment in patients with AD or MCI compared with the resting state. They found that acupuncture regulates brain activity bilaterally in patients with MCI which is it activates the regions with decreased activities in the resting state, while it deactivates the regions with increased activities in the resting state. In patients with AD it also showed increased or decreased regions of activities. They confirmed that the two points used for acupuncture can contribute to activate certain memory-related regions in patients with AD and MCI.

Zhou J and Jin J also showed that acupuncture at points HT7, ST36, ST40 and KI3 acupoints stimulated right main hemisphere activations (temporal lobe, such as hippocampal gyrus, insula, and some area of parietal lobe) and left activated regions (temporal lobe, parietal lobule, some regions of cerebellum). These activations by the acupuncture on these points were on the impaired regions in patients with AD, which closely associated with cognitive function such as memory, language etc. These researches provided strong evidence for the effect of acupuncture on dementia.

A ten-minute memory test operated by a computer programme is available. This test is aimed to recognize early stage of dementia, which could tell the differences between normal forgetfulness and memory loss of dementia. Early diagnosis of dementia could spot patients before their brain were damaged and help them to get early treatment which could delay the progress of the disease. For dementia care information you can find at Alzheimers society website http://alzheimers.org.uk/caring_for_someone_with_dementia and at department of health website http://www.dh.gov.uk/health/category/policy-areas/social-care/dementia.

Vascular dementia is a second main cause of dementia. There were many case studies that reported the effectiveness of acupuncture on vascular dementia. Shi GX et al studied the effect of acupuncture on vascular dementia in 16 patients with vascular dementia. They found that acupuncture improved cognitive function and quality of life in patients with vascular dementia and acupuncture reduced oxidative damage in patients with vascular dementia. Zhang H et al conducted a randomized control trial to study effect of acupuncture for treatment of vascular dementia. 270 patients with vascular dementia were recruited and received 6 weeks acupuncture treatment. The acupuncture points used Sishencong EX-HN1, Baihui GV20, Shenting GV24 and Fengchi GB20. They found acupuncture improve cognitive function and quality life in patients with vascular dementia. The effect was better than that for Nimodipine on its own, but acupuncture together with Nimodipine had better effect than acupuncture alone. Huang Y et al found that stimulating acupoints improves various brain area functions and this contributes to the improvement of cognition function, memory and daily life quality etc.

Acupuncture help sleep in patients with dementia

Elderly with dementia often have sleep problems. Recently there was a study investigating the effectiveness of acupuncture on sleep quality of elderly with dementia. There were 19 patients with dementia participated the study. These patients were followed through a control period for 6 weeks and an acupuncture treatment for 6 weeks. Sleep quality and congnitive function were measured and compared before and after the treatments period. The results showed that resting time and total sleep time in acupuncture treatment period significantly more than those in the control period. Improvement in congnitive function was not significantly different between the two periods. This study suggests that acupuncture was effective in improving some domain of sleep quality of patients with dementia and acupuncture was an acceptable intervention for these patients.

Acupuncture reduces oxidative stress of the cells

Oxidative stress is a sign of the imbalance between the production of reactive oxygen species and detoxification of the antioxidant system. As a result, this causes cell function damage and diseases. Oxidative stress is a critical feature in the pathological process of various diseases such as vascular dementia, Alzheimer’s disease and Parkinson’s disease. Recent research from last 5 years has shown that acupuncture treatment could decrease oxidative stress of the body and increase antioxidant system ability. Because of this acupuncture could improve memory impairment in vascular dementia and Alzerimer’s disease and reduce brain damage. Increased oxidative stress and depletion of the antioxidant are important mechanisms of the onset and progression of Parkinson’s disease. Acupuncture could reduce oxidative stress, inhibit cell death in the neurons and protect neurons improving motor function.

References

Wang Z et al PloS One (2012) 7:e42730

Zhou J and Jin J Acupunct Electrother Res (2008) 33:9-17

Shi GX et al J Tradit Chin Med (2012) 32:199-202

Zhang H et al Zhongguo Zhen Jiu (2008) 28:783-7

Huang Y et al Chin J Integr Med (2007) 13:103-8

Kwok T et al Clin Interv Aging (2013) 8:923-9

Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294

Saturday, 29 September 2012

Menopause, perimenopausal syndrome and acupuncture

Menopause is women’s period stopped permanently. At this time ovaries stopped working. Perimenopause means the time around the start of menopause. As ovaries stopped working, the hormone produced by ovaries (estrogen and progesterone) reduced. In many women this could cause many symptoms; hot flash is a well known symptom. Other symptoms include mood change, fatigue, insomnia and memory problem etc. Recently research showed that acupuncture is very effective in treating perimenopausal syndrome.

Shang YJ et al reported effectiveness of acupuncture on perimenopausal syndrome. They compared effect different acupuncture points. 80 patients were allocated into two groups: The acupuncture points for the first group were KI3, LR3, SP3, SP6, BL23, BL18, BL20 and CV4. The acupuncture points for the second groups were GV20, CV4, BL23, KI3 and SP6. The Kepperman score (score to measure menopausal syndrome), blood estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured and compared before and after acupuncture treatment for both groups. Total effect rate was 92.5% for the first group and 80% for the second group. Mean Kupperman score after treatment was 24.85 for the first group which was significantly lower than that (35.38) for the second group. E2, FSH and LH levels after treatment were significantly improved for both groups, but first group had better improvement. From their study, we can see acupuncture is effective in treating perimenopausal syndrome. Effects are different between different acupuncture points chosen.

Xia XH et al studied the effect of electroacupuncture at acupoint SP6 on perimenopausal syndrome. 81 patients were in acupuncture group and 76 patients were in medication group. Electroacupuncture at SP6 were applied three times a week for 3 months. The effect was assessed by symptom score, E2, FSH and LH values. After treatment, symptoms reduced significantly; FSH and LH level decreased significantly; E2 level increased compared with before treatment. The effect of acupuncture was similar to the medication.

Qin ZY et al studied the effect of acupuncture point SP6 on perimenopausal syndrome and compared the effect with that of nilestriol together with medrysone. There were 81 patients in acupuncture group and 76 patients in medication group. Acupuncture group received electroacupuncture at SP6 bilaterally for 30 min, three times a week for 3 months. Medication group received nilestriol treatment for 3 months and medrysone on the third month. E2, FSH and LH were measured before and after treatments. After treatments, FSH and LH decreased and E2 increased significantly for both group. And acupuncture had better effect than nilestriol and medrysone.

Jin H et al also observed the effect of acupuncture at acupuncture five-zangshu points on perimenopausal syndrome. Their cases include 20 patients in each group. Effect rate for acupuncture group was 90%.

From the results of these researches, we can see the effectiveness of acupuncture on perimenopausal syndrome. The effect rate depended on the acupuncture points.

References
Shang YJ et al Zhongguo Zhen Jiu (2009) 29: 444-8
Xia XH et al Zhen Ci Yan Jiu (2008) 33:262-6
Qin ZY et al Zhongguo Zhen Jiu (2007) 32: 255-9
Jin H et al Zhongguo Zhen Jiu (2007) 27: 572-4

Friday, 28 September 2012

Effect of acupuncture on premenstrual syndrome

Premenstrual syndrome is believed to affect many women. Suffer from PMS, acupuncture can help

Premenstrual syndrome is a serial of symptoms occurred before woman’s monthly period. These include physical and emotional symptoms such as bloating, breast tenderness, insomnia, headache fatigue, mood swing, irritability, tension, stress and anxiety etc. 90% of women have experienced premenstrual symptoms (PMS). It occurs in the second half of the menstrual cycle and disappears when your periods arrive. PMS can range in severity from mild discomfort to severe form dysphoric disorder. It can cause significant disruption to your daily activities. Women in their 40s tend to be affected most severely. The symptoms of PMS include two aspects: emotional and physical symptoms such as anxiety, mood swings, tiredness, irritability, anger, aggression, depression, difficulty sleeping, headache, feeling bloated, increase in appetite or food cravings, water retention, pain in your joints, tender breasts, abdominal (tummy) pain, backache, spots, acne, tiredness, constipation, dizzness. If you think you have PMS, keep a diary of your symptoms for two or three menstrual cycles. The symptoms of PMS are non specific and the most important thing is the timing of the symptoms and its repetitive pattern which is related to your menstrual cycle. What causes PMS is not clear yet. One reason is that the body’s sensitivity to hormone levels which varies during the menstrual cycle and these hormones interact with brain mood controlling chemicals.

About a decade ago there was a survey about premenstrual syndrome in US. There was 1052 of women aged 21-64 involved. The result showed that 41% women said that they suffered from premenstrual syndrome and 42% of them took prescription or over counter medicine to release the symptoms. Fewer people used acupuncture. Recent years with research advance, acupuncture was proven to be effective to treat premenstrual syndrome.

Habek D et al Observed the effect of acupuncture in patient with premenstrual syndrome. They found 9 patients received two acupuncture treatments and their symptoms are disappeared completely; 8 patients received three acupuncture treatments and symptoms had gone completely; 1 patient had 4 acupuncture treatments and symptoms had gone. The total effect rate was 77.8% in acupuncture group while the effect rate was 5.9% in placebo group.

Kim SY et al analysed data available in the research to study the effect of acupuncture on premenstrual syndrome. Ten randomly controlled trials throughout of 2009 were included their study. These studies performed sham acupuncture control, medication and no treatment control. They found that 8 trials showed that effect of acupuncture was better than for the control. The improvement of symptoms in acupuncture was better than sham acupuncture. No side effects were observed. They concluded that acupuncture is a promising approach in treating premenstrual syndrome.

Anil A et al studied the effect of acupuncture on premenstrual syndrome. There were 11 participants (aged 23-40) with premenstrual syndrome diagnosed. Acupuncture points used were Ren2, Ren6, Ren12, LI4, LI11, P6, Liv3, SP6, ST36 and Du20. The treatment period was three menstrual cycles. The results showed that the symptoms such as muscle pain, period pain and breast tenderness in all patients were reduced or disappeared completely.

It is well accepted that pain sensation has changed in specific acupuncture points related to specific conditions. Chae Y et al analysed 46 participants to study acupuncture points sensation. These participants were divided into two groups: with premenstrual syndrome group, without premenstrual syndrome group (control group). Pressure pain threshold (PPT) was measured in acupuncture points in the leg and arm. The points chosen included three acupuncture points SP6, GB39, LR3 and one non acupuncture points in the leg and three acupuncture points P6, TE5 and LI4 and one non acupuncture point in the arm. And then the PPT was compared between the two groups. They found that PPT at SP6 for premenstrual syndrome group was significantly lower than for the control group and it was linked to the severity of the conditions. This finding provided a possible basis for the clinical diagnosis and acupuncture treatment.

Acupuncture for premenstrual dysphoric disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome. Symptoms start before the period and end shortly after period begins. It presents a cyclic pattern every month. Mood changes including anxiety and depression were dominant. Carvalho F et al studied the effects of acupuncture on the symptoms of anxiety and depression caused by PMDD. They compared the effect of acupuncture and sham acupuncture on these symptoms. 15 patients were in each group. Acupuncture was performed twice a week for two menstrual cycles. There were 16 sessions of treatments. There were no differences in the symptom assessment between the two groups before the treatments. After 16 sessions of treatments the symptoms of anxiety and depression were reduced in both groups, but the improvement was significantly better in acupuncture group compared with sham acupuncture group. They suggested that acupuncture could be treatment option for patients with PMDD.

A survey in US has shown that 80% of women preferred non-pharmacological interventions, such as vitamins and supplements or alternative methods of treatments.

Acupuncture is one of the preferred treatment options for patients with PMS. Recently Jang analysed existing data for the effectiveness of acupuncture on PMS. They found that acupuncture treatment improved physical symptoms including headache, cramps, backache, cold sweats, hot flashes, breast pain, skin disorders, swelling of hands and feet, sensitivity to cold, abdominal pain and bulging as much as 50%.

References

Anil A et al Clin Exp Obstet Dynecol (2012) 39:209-13

Kim SY et al BJOG (2011) 118:899-915

Chae Y et al J Physiol Sci (2007) 57:115-9

Habek D et al Arch Gynecol Obstet (2002) 267:23-6

Singh BB et al Altern Ther Health Med (1998) 4:75-9

Carvalho F et al Acupunct Med (2013) Sep 12 doi 10.1136

Jang SH et al BMC Complement Altern Med (2014) 10:14:11