Two styles of acupuncture for treating painful diabetic neuropathy--a pilot randomised control trial.

Abstract

In a pilot study, we evaluated the clinical and mechanistic effects of two styles of acupuncture, Traditional Chinese Medicine (TCM) and Japanese acupuncture, for the treatment of painful diabetic neuropathy. Out of seven patients enrolled, three received Traditional Chinese acupuncture while four received Japanese style acupuncture. Treatments were delivered once a week for 10 weeks. Acupuncturists were permitted to select the needle interventions. Substantial differences in diagnostic techniques, choice of acupuncture points, and needle manipulation were observed between TCM and Japanese acupuncturists. Clinically, patients allocated to Japanese acupuncture reported decreased neuropathy-associated pain according to the daily pain severity score, while the group allocated to the TCM acupuncture reported minimal effects. Both acupuncture styles, however, lowered pain according to the McGill Short Form Pain Score. The TCM style improved nerve sensation according to quantitative sensory testing while the Japanese style had a more equivocal effect. No evident changes were observed in glucose control or heart rate variability in either group.

Acupunct Med. 2007 Jun;25(1-2):11-7.

Ahn AC, Bennani T, Freeman R, Hamdy O, Kaptchuk TJ.Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA. aahn@hms.harvard.edu

A sustained, non-insulin related, hypoglycaemic effect of electroacupuncture in diabetic Psammomys obesus.

Abstract

AIM/HYPOTHESIS: Electroacupuncture has been shown to induce a short-term hypoglycaemic effect in streptozotocin diabetic rats. We designed an experiment to investigate the effect of electroacupuncture in Psammomys obesus, a model of insulin resistance and non-insulin-dependent diabetes mellitus.

METHODS: We divided 29 diabetic Psammomys randomly into three groups: abdominal electroacupuncture (real, n = 11), back electroacupuncture (placebo, n = 9) and control (anaesthesia, n = 9). Electroacupuncture was carried out on days 1, 3 and 5 of the experiment. During the first week of the experiment, blood glucose was tested three times on treatment days and once on the following days. Over the next 2 weeks, blood glucose was tested every other day. Animals were weighed at the same time of blood sampling. After 3 weeks, at the end of the experiment, blood was drawn for measurement of insulin, fructosamine, cholesterol and triglycerides.

RESULTS: At day 5 (end of intervention), blood glucose (as per cent of primary concentrations, means +/- SE) was 57 +/- 10, 93 +/- 13 and 89 +/- 11 for the real, placebo and control groups respectively (p = 0.02). At day 8, blood glucose 68 +/- 14, 86 +/- 16 and 97 +/- 9 for the real, placebo and control groups respectively (p = 0.04). At day 22, blood glucose was 79 +/- 11, 85 +/- 15 and 131 +/- 2 for the real, placebo and control groups (p = 0.04). Comparison of the decline in blood glucose, throughout the 3 weeks, between the real and placebo groups by ANOVA was highly significant (p < 0.0001), the difference between the placebo and control groups at the same time was not significant (p > 0.05). Animal weight gain, serum insulin, fructosamine, cholesterol and triglycerides were not significantly different between real and placebo groups.

CONCLUSION/INTERPRETATION: Electroacupuncture at special abdominal acupoints induces a sustained hypoglycaemic effect in diabetic Psammomys compared with electroacupuncture at non-specific points, without weight loss. No hypoinsulinaemic effect was shown in the real and placebo groups.

Diabetologia. 2000 Jun;43(6):809-13.

Shapira MY, Appelbaum EY, Hirshberg B, Mizrahi Y, Bar-On H, Ziv E.Division of Internal Medicine, Hadassah University Hospital, Hebrew University, Hadassah Medical School, Jerusalem, Israel.

Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study.

Abstract

Forty-six diabetic patients with chronic painful peripheral neuropathy were treated with acupuncture analgesia to determine its efficacy and long-term effectiveness. Twenty-nine (63%) patients were already on standard medical treatment for painful neuropathy. Patients initially received up to six courses of classical acupuncture analgesia over a period of 10 weeks, using traditional Chinese Medicine acupuncture points. Forty-four patients completed the study with 34 (77%) showing significant improvement in their primary and/or secondary symptoms (P < 0.01). These patients were followed up for a period of 18-52 weeks with 67% were able to stop or reduce their medications significantly. During the follow-up period only eight (24%) patients required further acupuncture treatment. Although 34 (77%) patients noted significant improvement in their symptoms, only seven (21%) noted that their symptoms cleared completely. All the patients but one finished the full course of acupuncture treatment without reported or observed side effects. There were no significant changes either in the peripheral neurological examination scores, VPT or in HbA1c during the course of treatment. These data suggest that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy, although its mechanism of action remains speculative.

Diabetes Res Clin Pract. 1998 Feb;39(2):115-21.

Abuaisha BB, Costanzi JB, Boulton AJ.Department of Medicine, Manchester Royal Infirmary, University of Manchester, UK.

The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation.

Abstract

Human and animal studies suggest that acupuncture produces many beneficial effects through the central nervous system. However, the neural substrates of acupuncture actions are not completely clear to date. fMRI studies at Hegu (LI4) and Zusanli (ST36) indicated that the limbic system may play an important role for acupuncture effects. To test if this finding applies to other major classical acupoints, fMRI was performed on 10 healthy adults during manual acupuncture at Taichong (LV3), Xingjian (LV2), Neiting (ST44), and a sham point on the dorsum of the left foot. Although certain differences could be observed between real and sham points, the hemodynamic response (BOLD signal changes) and psychophysical response (sensory experience) to acupuncture were generally similar for all four points. Acupuncture produced extensive deactivation of the limbic-paralimbic-neocortical system. Clusters of deactivated regions were seen in the medial prefrontal cortex (frontal pole, pregenual cingulate), the temporal lobe (amygdala, hippocampus, and parahippocampus) and the posterior medial cortex (precuneus, posterior cingulate). The sensorimotor cortices (somatosensory cortices, supplementary motor cortex), thalamus and occasional paralimbic structures such as the insula and anterior middle cingulate cortex showed activation. Our results provide additional evidence in support of previous reports that acupuncture modulates the limbic-paralimbic-neocortical network. We hypothesize that acupuncture may mediate its antipain, antianxiety, and other therapeutic effects via this intrinsic neural circuit that plays a central role in the affective and cognitive dimensions of pain as well as in the regulation and integration of emotion, memory processing, autonomic, endocrine, immunological, and sensorimotor functions.

Hum Brain Mapp. 2009 Apr;30(4):1196-206.

Fang J, Jin Z, Wang Y, Li K, Kong J, Nixon EE, Zeng Y, Ren Y, Tong H, Wang Y, Wang P, Hui KK.Department of Radiology, Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China. fang@nmr.mgh.harvard.edu

Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome.

Abstract

OBJECTIVES: Quality of life (QoL) improvement in patients with irritable bowel syndrome (IBS) during acupuncture (AC) treatment seems to be due to a placebo effect. The aim was to explore if acupuncture has some specific influence on the neuroendocrinic and autonomic nervous system (ANS).

DESIGN/SETTING: Patients with IBS were randomly assigned to receive either acupuncture (AC) or sham acupuncture (SAC) using the so-called "Streitberger needle". QoL was measured with the functional quality of life diseases quality of life questionnaire (FDDQL) and SF-36. The effect on ANS was evaluated by measuring salivary cortisol and by cardiovascular responses on a tilt table before and after 10 AC treatments. Complete data sets of tilt table and salivary morning cortisol were available for 9 patients in the AC and 12 in SAC group.

RESULTS: QoL increased in both groups (p=0.001) with no group differences. Salivary cortisol decreased in all groups (F=10.55; p=0.006). However, the decrease was more pronounced in the AC group (F=4.07; p=0.033) (ANOVA repeated measures model). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (F=9.234; p=0.005), indicating an increased parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (F=10.1; p=0.006), but not in the SAC group.

CONCLUSIONS: The acupuncture specific physiological effects are in contrast to the unspecific improvement of QoL in both AC and SAC groups. Thus, different mechanisms seem to be involved in placebo and real-acupuncture driven improvements. The specific mechanism of action of acupuncture on the ANS remains unclear and deserves further evaluation.

Complement Ther Med. 2007 Dec;15(4):255-63. Epub 2007 Feb 20.

Schneider A, Weiland C, Enck P, Joos S, Streitberger K, Maser-Gluth C, Zipfel S, Bagheri S, Herzog W, Friederich HC.University Medical Hospital Heidelberg, Department of General Practice and Health Services Research, Vossstrasse 2, 69117 Heidelberg, Germany. antonius.schneider@med.uni-heidelberg.de

Serum IgG, IgA, IgM, and IgE levels after electroacupuncture and diet therapy in obese women.

Abstract

We investigated the effect of acupuncture therapy on obese women's body weight and peripheral blood levels of serum immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin E (IgE). Sixty-three healthy women were assigned into 3 groups: placebo electroacupuncture (n = 13; mean age, 40.5 +/- 4.2 years; body mass index [BMI], 33.5 +/- 4.2), diet restriction (n = 23; mean age, 42.9 +/- 4.0 years; BMI, 34.6 +/- 2.9), and electroacupuncture (n = 24; mean age, 40.1 +/- 5.9 years; BMI, 33.9 +/- 2.7). Electroacupuncture was applied to the Hunger and Shen Men ear points and to the LI 4, LI 11, St 36, St 44, and Ren 6 body points for 30 min once daily for 20 days. A restricted diet of 1400 kilocalories was given to participants in all 3 groups for 20 days. Weight was lost significantly in subjects in the electroacupuncture group compared to those in the diet restriction and placebo electroacupuncture groups (p < 0.000, Tukey test). Modulations in serum IgG (p < 0.001) were apparent in women treated with electroacupuncture compared with women treated with placebo electroacupuncture and restricted diet only. No significant changes were seen in serum IgA, IgM, and IgE levels among the 3 groups. Our results suggest that electroacupuncture can be effectively used to treat obesity. We also observed a modulating effect of serum IgG, which is associated with weight loss, in patients in the electroacupuncture group.

Am J Chin Med. 2007;35(6):955-65.

Cabioglu MT, Ergene N, Surucu HS, Celik HH, Findik D.Department of Physiology, Medical Faculty, Başkent University, Ankara, Turkey. tugcab@yahoo.com

Electroacupuncture treatment of obesity with psychological symptoms.

Abstract

The aim was to study the effect of placebo EA, electroacupuncture (EA), and diet on obesity and accompanying psychological symptoms. One hundred and sixty-five volunteer women participated in the study. There were three groups: (i) Placebo EA, (ii) EA, and (iii) diet restriction group. EA was performed by using three ear and six body points. There was a 4.8% reduction in weight of patients with EA application, whereas patients with a diet restriction and placebo EA had a 2.5% and 2.7% weight reduction, respectively. There were significant decreases in phobia, anger, anxiety, obsession, paranoid symptoms, and depression in the EA groups compared to those of the placebo EA and diet groups. It was suggested that electroacupuncture may be an effective therapy for obesity including the psychological signs and symptoms in women.

Int J Neurosci. 2007 May;117(5):579-90.

Cabioglu MT, Ergene N, Tan U.Department of Physiology, Selçuk University, Meram Medical School, Konya, Turkey. tugcab@yahoo.com

Electroacupuncture in obese women: a randomized, controlled pilot study.

Abstract

OBJECTIVE: To compare the effects of electroacupuncture and sit-up exercise on reducing body weight (BW) and waist circumference (WC) among obese women.

METHODS: A randomized, controlled clinical trial was conducted from July 1, 2002, to June 30, 2003, in the outpatient department of Taipei Hospital, Taiwan. The subjects were 72 obese women, with WC>90 cm and body mass index (BMI)>30 kg/m2 and who had not received any other weight control maneuver within the prior 3 months. The subjects were randomly divided into groups A, B, and C. Group A (n=22) received electroacupuncture, group B (n=20) was assigned sit-up exercises, and group C (n=21) received no intervention. All three treatments lasted for 6 weeks. The measurements of BW, BMI, and WC were performed in the beginning and after 6 weeks. The data were compared and expressed as percent reductions.

RESULTS: Electroacupuncture showed significantly greater percent reductions in BW (p=0.009, 0.004), BMI (p=0.008, 0.016), and WC (p=0.013, 0.006) compared with sit-up exercises or no intervention.

CONCLUSIONS: In this pilot study, electroacupuncture treatment was more effective than situp exercise or no intervention in reducing BW, BMI, and WC.

J Womens Health (Larchmt). 2005 Jun;14(5):434-40.

Hsu CH, Hwang KC, Chao CL, Chang HH, Chou P.Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.

Laser acupuncture and low-calorie diet during visceral obesity therapy after menopause.

Abstract

BACKGROUND: To compare the efficiency of low-calorie diet and low-calorie diet applied together with laser acupuncture in the therapy of visceral obesity in postmenopausal women.

METHODS: The study population consisted of 74 postmenopausal females with visceral obesity who were divided into two groups according to an employed 6-month slimming procedure. In the first group (n = 36) a low-calorie diet was applied, while women in the second group (n = 38) were on the same kind of diet, having additionally one cycle of laser acupuncture procedure at the same time. At baseline and at the end of the study, body weight, body mass index and waist-to-hip ratio were determined in all women.

RESULTS: After 6 trial months both groups exhibited a statistically significant drop in body weight, body mass index and waist-to-hip ratio. The mean reduction of body weight, body mass index and waist-to-hip ratio was significantly higher in the second group of women (laser acupuncture plus low-calorie diet).

CONCLUSIONS: (1) Our results testify that the combination of a low-calorie diet and laser acupuncture is characterized by a higher efficacy than a low-calorie diet alone in lowering body weight, body mass index and waist-to-hip-ratio. (2) Laser acupuncture is an additional useful healing method in the therapy of visceral postmenopausal obesity.

Acta Obstet Gynecol Scand. 2003 Jan;82(1):69-73.

Wozniak P, Stachowiak G, Piêta-Doliñska A, Oszukowski P.Specialistic Outpatient Clinics of Obstetrics and Female Diseases, Polish Mother's Memorial Hospital, Research Institute, Lód, Poland. wozniak@mazurek.man.lodz.pl