Allergies

Brinkhaus, B., Witt, C.M., Jenam, S., Liecker, B., Wegscheider, K., Willich, S.N. (2008). Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Annals of Allergy, Asthma and Immunology, 101, 535-543.

METHODS: Patients with allergic rhinitis were randomly allocated to receive up to 15 acupuncture sessions during a period of 3 months or to a control group receiving no acupuncture. All patients were allowed to receive usual medical care. RESULTS: The results of this trial suggest that treating patients with allergic rhinitis in routine care with additional acupuncture leads to clinically relevant and persistent benefits.


Ng, D.K., Chow, P.Y., Ming, S.P., Hong, S.H., Lau, S., Tse, D., Kwong, W.K., Wong, M.F., Wong, W.H., Fu, Y.M., Kwok, K.L., Li, H. & Ho, J.C. (2004). A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics, 114, 1242-7.

METHODS: 85 children with persistent allergic rhinitis were recruited from the pediatric outpatient clinic. They were randomized to receive either active acupuncture or sham acupuncture. Main outcome measures included daily rhinitis scores, symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and adverse effects. Acupuncture was performed twice per week for both groups. RESULTS: There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving active acupuncture, during both the treatment and follow-up periods. The visual analog scale scores for immediate improvement after acupuncture were also significantly better for the active acupuncture group. Numbness, headache, and dizziness were found in both the active and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting.


 Arthritis

 

Kwon, Y., Pittler, M., & Ernst, E. (2006). Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology, 45, 1331-7.

REVIEW: Systematic searches were conducted to evaluate the evidence for the effectiveness of acupuncture for peripheral joint osteoarthritis. Ten studies demonstrated greater pain reduction in the acupuncture groups.


Wang R, Jiang C, Lei Z, & Yin K. (2007). The role of different therapeutic courses in treating 47 cases of rheumatoid arthritis with acupuncture. Journal of Traditional Chinese Medicine, 27, 103-105.

METHODS: Forty-seven patients were treated with acupuncture for 6 courses and at the end of the third and sixth course of treatment, the therapeutic effects of acupuncture on morning rigidity, swelling and pain of joints as well as rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were observed. RESULTS: More acupuncture therapeutic courses can bring about better therapeutic results on rheumatoid arthritis.


Witt, C., Jena, S., Brinkhaus, B., Liecker, B., Wegscheider, K., Willich, S. (2006). Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional non-randomized arm. Arthritis and Rheumatology, 54, 3485-93.

METHODS: In a randomized, controlled trial, patients with chronic pain due to osteoarthritis of the knee or hip were randomly allocated to undergo up to 15 sessions of acupuncture in a 3-month period or to a control group receiving no acupuncture. All patients were allowed to receive usual medical care in addition to the study treatment. Clinical OA severity (Western Ontario and McMaster Universities Osteoarthritis Index) and health-related quality of life (Short Form 36) were assessed at baseline and after 3 months and 6 months. 357 were randomized to the acupuncture group and 355 to the control group. RESULTS: At 3 months, the WOMAC had improved more in the acupuncture group than the control group. Similarly, quality of life improvements were more pronounced in the acupuncture group versus the control group.


 Back Pain

 

Hope-Allan, N., Adams, J., Sibbritt, D. & Tracy, S. (2004). The use of acupuncture in maternity care: a pilot study evaluating the acupuncture service in an Australian hospital antenatal clinic. Complementary Therapy and Nurses Midwifery, 10, 229-32.

METHODS: 52 women were given a questionnaire, and 71% were completed and returned. Of the 37 women who attended the acupuncture clinic, 49% had previously used at least one form of complementary medicine/therapy. The most common reason for treatment was physiological symptoms including back pain, symphysis pubis dysfunction and sciatica. RESULTS: All 37 women stated that acupuncture improved their well-being and this finding was statistically significant. These findings are offered as a means of identifying potential issues for future investigation in this under-researched area.


Lewis, K., & Abdi, S. (2010). Acupuncture for lower back pain: a review. The Clinical Journal of Pain, 26, 60-69.

METHODS: Pubmed online search was conducted on all articles in the past 50 years related to acupuncture efficacy in low back pain. RESULTS: Although newer studies seem to show promise, effectiveness has not been clearly demonstrated. Further research is needed to help elucidate the mechanisms underlying acupuncture and to justify its clinical application.


Ratcliffe, J., Thomas, K.J., MacPherson, H., & Brazier, J. (2006) A randomized controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis. BMJ, 23, 626

METHODS: To evaluate the cost effectiveness of acupuncture in the management of persistent non-specific low back pain, ten individualized acupuncture treatments were given over three months or usual care only. RESULTS: A short course of traditional acupuncture for persistent non-specific low back pain in primary care conferred a modest health benefit for minor extra cost as compared with usual care.


 Cancer

 

Lu, W., Dean-Clower, E., Doherty-Gilman, A., & Rosenthal, D.S. (2009). The value of acupuncture in cancer care. Hematology/Oncology Clinics of North America, 22, 631-648.

REVIEW: The evidence currently available has suggested that acupuncture is a safe and effective therapy to manage cancer and treatment related symptoms, while giving patients the ability to actively participate in their own care plan. The article explains the potential benefits of acupuncture and describes the difficulties in studying its effectiveness


Nedstrand, E., Wyon, Y., Hammar, M. & Wijma, K. (2006). Psychological well-being improves in women with breast cancer after treatment with applied relaxation or electro-acupuncture for vasomotor symptom. Journal of Psychosomatic Obstetrics and Gynecology, 27, 193-9.

METHODS: Thirty-eight breast cancer-treated postmenopausal women with vasomotor symptoms were included in the study. They were randomized to either treatment with electro-acupuncture or applied relaxation over a 12-week study period with six months follow-up. Vasomotor symptoms were registered daily. Estimation of general well-being was made using the Symptom Checklist, and mood using the Mood Scale. These were applied during treatment and at follow-up. RESULTS: Hot flushes were reduced by more than 50%. Climacteric symptoms significantly decreased during treatment and remained so six months after treatment in both groups. Psychological well-being significantly improved during therapy and at follow-up visits in both groups. Mood improved significantly in the electro-acupuncture treated group.


Taspinar, A. & Sirin, A. (2009). Effect of acupressure on chemotherapy-induced nausea and vomiting in gynecologic cancer patients in Turkey. European Journal of Oncology Medicine, In Press.

METHODS: 34 patients with gynecologic cancer were given acupressure wristbands. RESULTS: The findings suggested that acupressure applied to the P6 acupuncture point with wristbands may be effective in reducing chemotherapy-related nausea and may decrease the antiemetic use after chemotherapy.


 Cardiovascular

 

Korinenko, Y., Vincent, A., Cutshall, S.M., Li, Z., Sundt III, T.M. (2009). Efficacy of acupuncture in prevention of postoperative nausea in cardiac surgery patients. The Annals of Thoracis Surgery, 88, 537-542.

METHODS: Cardiac surgery patients were randomly assigned to receive one preoperative acupuncture plus standard postoperative care or solely standard postoperative care. RESULTS: The acupuncture group had a lower incidence of nausea.


 Cerebral Palsy

 

Liu, Z., Pan, P. & Ma, M. (2007). Effects of acupuncture on quality of life in children with spastic cerebral palsy. Zhongguo Zhong Xi Yi Jie He Za Zhi, 27, 214-6.

METHODS: One hundred Spastic Cerebral Palsy children, 2 to 7 years old, were randomly assigned to two groups equally. The control group was treated with rehabilitation training using Bobath and Vojta physical training methods and the acupuncture group treated also with the same training but with acupuncture conducted additionally. The therapeutic course was 3-12 months arranged according to the state of illness. RESULTS: The total effective rate, development quotient (DQ), improvement rate of brain hypogenesis and atrophy showed by skull CT, and recovery rate of cerebral emission computed tomography (ECT) were all higher in the acupuncture group than those in the control group.


Wu, X., Bai, G., Wen, J. & Yang, J. (2005). Evaluation on the therapeutic effects of digital acupoint pressure for obstetric spastic cerebral palsy. Journal of Traditional Chinese Medicine, 25, 247-51.

METHODS: Spastic cerebral palsy was treated with digital acupoint pressure therapy. Ten indexes including intelligence, language, salivation, hand-grasping, thumb-adduction, turnover, sitting, standing, walking, and scissors-gait were divided into the 4 grades of normal, mild abnormal, moderate abnormal, and severe abnormal (dysfunction), The ranges were recorded and evaluated before and after the treatment on shoulder-abduction, elbow-extension, wrist-extension, forearm-backward-rotation, hip-abduction, straight-leg-lifting, knee-extension, and ankle-dorsiflexion. RESULTS: There were significant differences before and after the treatment in the 18 items under observation except for intelligence, with obvious improvement shown after the treatment (P<0.01), the effective rate being 92.5%.

 


Wu, Y., Jin, Z., Li, K., Lu, Z.L., Wong, V., Han, T.L., Zheng, H., Caspi, O., Liu, G., Zeng, Y.W., & Zou, L.P. (2008). Effect of acupuncture on the brain in children with spastic cerebral palsy using functional neuroimaging (FMRI). Journal of Child Neurology, 23, 1267-1274.

METHODS: fMRI were performed in children with cerebral palsy and healthy children during stimulation of a common acupoint on the left foot. RESULTS: Signal increase and decrease in various regions of the brain were found in both groups of children. However, the pattern was different for the 2 groups.


  Colitis

 

Tkahashi, T. (2006). Acupuncture for functional gastrointestinal disorders. Journal of Gastroenterology, 41, 408-17.

REVIEW: Acupuncture may be effective in patients with functional GI disorders because it has been shown to alter secretion, GI motility, and visceral pain.

 Delivery

 

Neri, I., Airola, G., Contu, G., Allais, G., Facchinetti, E. & Benedetto, C. (2004). Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. Journal of Maternal Fetal Neonatal Medicine, 15, 247-52.

METHODS: 240 women at 33-35 weeks of gestation carrying a fetus in breech presentation were randomized to receive active treatment (acupuncture plus moxibustion) or to be assigned to the observation group. Bilateral acupuncture plus moxibustion was applied at the BL67 acupoint (Zhiyin). The primary outcome of the study was fetal presentation at delivery. RESULTS: At delivery, the proportion of cephalic version was lower in the observation group than in the active-treatment group. Thus, the proportion of Cesarean sections indicated for breech presentation was significantly lower in the treatment group than in the observation group.

 

Oomman, S., Liu, D. & Cummings, M. (2005). Acupuncture for acute postoperative pain relief in a patient with pregnancy-induced thrombocytopenia--anxiety case report. Acupuncture Medicine, 23, 83-5.

 

METHODS: A 39 year old woman, scheduled for elective caesarean section in her second pregnancy, developed thrombocytopenia. Therefore, at the time of surgery, spinal anesthesia and non-steroidal analgesic drugs were avoided and she was given a standard general anesthetic procedure including fentanyl 100 microg and morphine 10 mg. In the early postoperative period she received tramadol 100 mg and a further 10 mg of morphine. RESULTS: These drugs did not control her pain, but caused side effects--in particular nausea and retching. Acupuncture to LI4 and PC6 pain on the right side produced dramatic pain relief within minutes.

 

Wang, S., Gaal, D., Maranets, I., Caldwell-Andrews, A. & Kain, Z. (2005). Acupressure and preoperative parental anxiety: a pilot study. Anesthetic Analg, 101, 666-9.

 

METHODS: Sixty-one parents received acupressure either at the Yin Yang point (midpoint between the two eyebrows) or at a sham point. Anxiety (as measured by the Stait-Trait Anxiety Inventory), arterial blood pressure, and heart rate were assessed before and after the intervention and a Bispectral Index monitor was used to continuously monitor hypnotic sedation levels. RESULTS: Repeated measures analysis of variance showed that parents in the acupressure group reported significantly less anxiety at 20 min post-intervention as compared with parents in the sham group. Bispectral Index values, heart rate, and arterial blood pressure, however, did not differ between the two study groups.

 Dementia

 

Yang, M., Wu, S., Lin, J. & Lin, L. (2007). The efficacy of acupressure for decreasing agitated behavior in dementia: a pilot study. Journal of Clinical Nursing, 16, 308-15.

METHODS: Participants were recruited from a nursing home caring specifically for patients with dementia. All the subjects were assigned to an experimental protocol and had a six-week acupressure treatment program. Baseline data were collected in the first week. Individual treatment sessions began at the second week of the study and lasted 15 minutes, twice a day, five days a week for four weeks. After a treatment-free period of one week, all the subjects served as controls undergoing a four-week control protocol consisting of companionship and conversation. RESULTS: Comparison between the control and experimental phases indicated significant differences between the two groups on all outcome measures (Cohen-Mansfield Agitation Inventory, daily agitation records about physical attack, verbal and non-verbal attack and non-physical attack) with better results found during the acupressure phase.

 Depression

 

Mukaino, Y., White, A., & Ernst, E. (2005). The effectiveness of acupuncture for depression—a systematic review of randomised controlled trials. Acupuncture Medicine, 23, 70-76.

METHODS: Randomized control trials were in included in which either manual acupuncture or electroacupuncture was compared with any control procedure in subjects with depression. Data were extracted for meta-analysis. RESULTS: Seven randomised comparative trials involving 509 patients were included. The evidence is inconsistent on whether manual acupuncture is superior to sham, and suggests that acupuncture was not superior to waiting list. Evidence suggests that the effect of electroacupuncture may not be significantly different from antidepressant medication. There is inconclusive evidence on whether acupuncture has an additive effect when given as an adjunct to antidepressant drugs.

 Diabetes

 

Tong, Y., Jia, Q., Sun, Y., Hou, Z., & Wang, Y. (2009). Acupuncture in the treatment of diabetic bladder dysfunction. Journal of Alternative and Complementary Medicine, 15, 905-909.

METHODS: Acupuncture effects were assessed in patients with diabetic bladder dysfunction. RESULTS: Bladder compliance, maximal bladder capacity, bladder volume at desire to void and urge to void improved over the 15-day acupuncture period.

 

Zhang, C., Ma, Y.X., Yan, Y. (2010). Clinical effects of acupuncture for diabetic peripheral neuropathy. Journal of Traditional Chinese Medicine, 30, 13-4.

METHODS: Patients were randomly divided into an acupuncture group and a drug group for a 3-month treatment. RESULTS: The treatment group had a total effective rate of 88% and the drug group had a total effective rate of 64%.

 

Martin DP, Sletten CD, Williams BA, Berger IH (2006) Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. Mayo Clinic proceedings, Mayo Clinic, 81, 749-57.


METHODS: Fibromyalgia patients receiving true acupuncture compared with a control group of patients who received simulated acupuncture. RESULTS: Total fibromyalgia symptoms were significantly improved in the acupuncture group compared with the control group during the study period. Fatigue and anxiety were the most significantly improved symptoms during the following-up period.

 Headaches

 

Hsieh, L.L., Liou, H.H., Lee, L.H., Chen, T.H., & Yen, A.M. (2010). Effect of acupressure and trigger points in treating headache: a randomized controlled trial. American Journal of Chinese Medicine, 38, 1-14.

METHODS:  Patients suffering chronic headache were randomly assigned to an acupressure group or a muscle relaxant medication group RESULTS: Pain scores at post-treatment assessment were significantly lower in the acupressure group and quality of life ratings were higher and the differences remained at 6-month follow-up.

 

Jena, S., Witt, C.M., Brinkhaus, B., Wegscheider, K., Willich, S.N. (2008). Acupuncture in patients with headache. Cephalalgia, 28, 969-979.

 

METHODS: In a randomized controlled trial plus non-randomized cohort, patients with headache were allocated to receive up to 15 acupuncture sessions over 3 months or to a control group receiving no acupuncture during the first 3 months. RESULTS: At 3 months, the number of days with headache decreased in the acupuncture group. Similarly, intensity of pain and quality of life improvements were more pronounced in the acupuncture vs. control group. Treatment success was maintained through 6 months.         

 

Li, Y., Liang, F., Yang, X., Tian, X., Yan, J., Sun, G., Chang, X., Tang, Y., Ma, T., Zhou, L., Lan, L., Yao, W., & Zou, R. (2009). Acupuncture for treating acute attacks of migraine: a randomized controlled trial. Headache, 49, 805-816.

 

METHODS: 175 patients with migraine were randomized into 3 groups. One group received real acupuncture while subjects in the other 2 groups were treated with sham acupuncture. Each patient received 1 session of treatment and was observed over a period of 24 hours. The main outcome measure was the differences in visual analog scale (VAS) scores before treatment and 0.5, 1, 2, and 4 hours after treatment. RESULTS: Most patients in the acupuncture group experienced complete pain relief and did not experience recurrence or intensification of pain Real acupuncture is more effective than sham acupuncture based on either Chinese or Western acupoints in reducing the discomfort of acute migraine. These findings support the contention that there are specific physiological effects that distinguish genuine acupoints from nonacupoints.

 

Melchart, D., Weidenhammer, W., Streng, A., Hoppe, A., Pfaffenrath, V., & Linde, K. (2006) Acupuncture for chronic headaches--an epidemiological study. Headache, 46, 632-41.

 

REVIEW: In this epidemiological study, headache patients reported clinically relevant improvements after receiving acupuncture. Randomized trials performed parallel to this study confirm the relevant overall effect, however, the effect may largely be due to potent unspecific needling and placebo effects.

 

Plank, S., & Goodard, J. (2009).The effectiveness of acupuncture for chronic daily headache: an outcomes study. Military Medicine, 174, 1276-1281.

 

METHODS: This pilot study used a standardized set of well-known acupuncture points over a predetermined time interval on 26 subjects suffering from chronic daily headache, the majority being migraines. Headache calendars and validated measurements were compared 12 weeks before and 12 weeks after the acupuncture intervention. RESULTS: Results showed continued improvements 12 weeks after the last treatment. Traditionally, acupuncture treatments are individualized at each visit. However the absence of a standardized treatment regimen obstructs data reproducibility across the discipline. A standardized approach may be useful.

 Heart rate Variability

 

Sakatani, K., Kitagawa, T., Aoyama. N., Sasaki, M. (2010). Effects of acupuncture on autonomic nervous function and prefrontal cortex activity. Advances in Experimental Medicine and Biology, 662, 455-460.

METHODS:  Activity in the prefrontal cortex caused by real acupuncture and sham acupuncture was measured with optical topography. RESULTS: Analysis of heart rate variability revealed a decrease of the LF/HF ratio, and an increase of the HF power by real acupuncture, indicating a shift to parasympathetic dominancy. Acupuncture also caused cerebral blood oxygenation changes in both directions, that is, an increase and/or a decrease of oxyhemoglobin in the bilateral prefrontal cortex.

 Immune

 

Arranz, L., Guayerbas, N., Sibonni, L. & De la Fuente, M. (2007). Effect of acupuncture treatment on the immune function impairment found in anxious women. American Journal of Chinese Medicine, 35, 35-51.

METHODS: Emotional disturbances lead to immune system impairment. The question for this study was whether acupuncture treatment could control and restore the immune response. The acupuncture protocol consisted of manual needle stimulation of 19 acupoints, with each session lasting 30 min. RESULTS: The most favorable effects of acupuncture on the immune functions appeared 72 hours after the single session and persisted one month after the end of the complete treatment. Impaired immune functions in anxious women (chemotaxis, phagocytosis, lymphoproliferation and NK activity) were significantly improved by acupuncture.

 Insomnia

 

Cao, H., Pan, X., Li, H., Liu, J. (2009). Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. Journal of Alternative and Complementary Medicine, 15, 1171-1186.

METHODS: This review included randomized controlled trials on acupuncture for insomnia. RESULTS: Meta-analyses showed a beneficial effect of acupuncture compared with no and real acupressure compared with sham on insomnia. Acupuncture plus medications had better effects than medications alone on total sleep duration.

 Labor

 

Borup, L., Wurlitzer, W., Hedegaard, M., Kesmodel, U.S., Hvidman, L. (2009). Acupuncture as pain relief during delivery: a randomized controlled trial. Birth, 36, 5-12.

METHODS: Women in labor at term either received acupuncture or traditional analgesics. RESULTS: Use of pharmacological and invasive methods was significantly lower in the acupuncture group.

Chang, S.B., Park, Y.W., Cho, J.S., Lee, M.K., Lee, B.C. & Lee, S.J. (2004). Differences of cesarean section rates according to San-Yin-Jiao (SP6) acupressure for women in labor. Taehan Kanho Hakhoe Chi, 34, 324-32.

METHODS: 209 women were assigned to one of three groups SP6 acupressure, SP6 touch, and control group. For 30 minutes, the SP6 acupressure group received SP6 acupressure and the SP6 touch group received SP6 touch for the duration of each uterine contraction. The Control group was encouraged to deep breath and relax for the duration of each uterine contraction for 30 minutes. RESULTS: The rates of cesarean section were 13%, 30%, and 22% for the SP6 acupressure group, SP6 touch group, and control group respectively. Cesarean section rates were significantly different between the SP6 acupressure and non-SP6 acupressure group.

 

Chao, S. A., Chao, A., Wang, T., Chang, Y., Peng, H., Chang, S. Chao, A., Chang, C., Lai, C. & Wong, A. (2006). Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind placebo-controlled trial. Pain, 127, 214-20.

 

METHODS: Healthy full-term parturients in the active phase of first-stage labor were randomly assigned to either TENS on four acupuncture points (n=52) or the TENS placebo (n=53). A visual analogue scale (VAS) was used to assess pain before and 30 and 60 min after treatment. The primary outcome was the rate of VAS score decrease in each group. A questionnaire was given at 24h post-partum to evaluate the satisfaction of the pain relieving method and the willingness to have the same treatment again. Mode of delivery and neonatal outcomes were measured as secondary variables. RESULTS: The TENS group experienced greater VAS score reduction than the TENS placebo group. Willingness to use the same analgesic method for a future childbirth was also significantly different.

 

Chung, U., Hung, L., Kuo, S. & Huang, C. (2003). Effects of LI4 and BL 67 acupressureon labor pain and uterine contractions in the first stage of labor. Journal of Nurses Research, 11, 251-60.

 

METHODS: 127 parturient women were randomly assigned to three groups. Each group received only one of the following treatments, LI4 and BL67 acupressure, light skin stroking, or no treatment/conversation only. Data collected from the VAS and external fetal monitoring strips were used for analysis. RESULTS: there was a significant difference in decreased labor pain during the active phase of the first stage of labor among the three groups. There was no significant difference in effectiveness of uterine contractions during the first stage of labor among the three groups. Results of the study confirmed the effect of LI4 and BL67 acupressure in lessening labor pain during the active phase of the first stage of labor. There were no verified effects on uterine contractions.

 

Citkovitz, C., Klimenko, E., Bolyai, M., Applewhite, L., Julliard, K., & Weiner, Z. (2009). Effects of acupuncture during labor and delivery in a U.S. hospital setting: a case-control pilot study. Journal of Alternative & Complementary Medicine, 15, 501-505.

 

METHODS:  Forty-five (45) patients receiving acupuncture were compared to 127 historical controls matched for maternal age, gestational age, parity, and use of oxytocin (augmentation and induction were matched separately). RESULTS Acupuncture patients underwent significantly fewer cesarean sections. Acupuncture during labor and delivery is well tolerated by patients and medical staff. It should be further evaluated for its promise in potentially reducing the incidence of cesarean section

 

Lee, M., Chang, S. & Kang, D. (2004). Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. Journal of Alternative Complementary Medicine, 10, 959-65.

 

METHODS: Seventy-five women in labor were randomly assigned to either the SP6 acupressure or SP6 touch control group. The participants were matched according to parity, cervical dilation, labor stage, rupture of amniotic membrane, and husband's presence during labor. There was no additional oxytocin augmentation or administration of analgesics during the study period. Labor pain was measured four times using a structured questionnaire, a subjective labor pain scale before intervention, immediately after the intervention, and 30 and 60 minutes after the intervention. Length of delivery time was calculated in two stages: from 3 cm cervical dilation to full cervical dilatation, and full cervical dilatation to the delivery. RESULTS: There were significant differences between the groups in subjective labor pain scores at all time points following the intervention: immediately after the intervention; 30 minutes after the intervention; and 60 minutes after the intervention. The total labor time was significantly shorter in the SP6 acupressure intervention group than in the control group.

 Mechanisms

 

Li, G., Jack, C. & Yang, E. (2007). An fMRI study of somatosensory-implicated acupuncture points in stable somatosensory stroke patients. Journal of magnetic Resonance Imaging, 24, 1018-24.

METHODS: fMRI was performed with two different paradigms including tactile stimuli and electrical stimulation. RESULTS: Tactile stimulation in both patients and controls produced significant activation in primary and secondary sensory and motor cortical areas and the cerebellum. Greater activation was present in patients than controls in the somatosensory cortex with both the tactile task and the acupuncture point (acupoint) stimulation. Activation was greater during the tactile than the acupuncture stimulation in both the patients and the normal controls.

 

Li, K., Shan, B., Xu, J., Liu, H., Wang, W., Zhi, L., Li, K., Yan, B. & Tang, X. (2006). Changes in fMRI in the human brain related to different durations of manual acupuncture needling. Journal of Alternative and Complementary Medicine, 12, 615-623.

 

METHODS: Different durations of needle insertion have been evaluated using functional magnetic resonance imaging. RESULTS: The stimulation of manual acupuncture with different durations induced different effects on the central nervous system. The longer duration manual acupuncture had the most effect.

 

Moffet HH (2006) How might acupuncture work? A systematic review of physiologic rationales from clinical trials. BMC Complementary and alternative medicine, 7, 25.

 

REVIEW: The dominant explanation for how acupuncture might work involves neurochemical responses and is not reported to be dependent on treatment objective, specific points, means or methods of stimulation.

 Menstruation

 

Cai, X.M., & Wu, J. (2009). The mind-tranquilizing and menstruation-regulating method for acupuncture treatment of delayed menstrual cycle--a clinical controlled study. Journal of Traditional Chinese  Medicine, 29, 35-38.

METHODS: Patients with delayed menstrual cycle were randomly divided into a treatment group (treated by the mind-tranquilizing and menstruation-regulating acupuncture method) and a control group (treated by the routine acupuncture method for delayed menstrual cycle). RESULTS: After treatment, the therapeutic effect of the mind-tranquilizing and menstruation-regulating acupuncture method is significantly superior to that of the routine acupuncture method for delayed menstrual cycle.

 Migraine

 

Streng, A., Linde, K., Hoppe, A., Pfaffenrath, V., Hammes, M., Wagenpfeil, S., Weidenhammer, W. & Melchart, D. (2006). Effectiveness and tolerability of acupuncture compared with metoprolol in migraine prophylaxis. Headache, 46, 1492-502.

METHODS: One hundred fourteen migraine patients were randomized to treatment over 12 weeks either to acupuncture (8 to 15 sessions) or metroprolol (100 to 200 mg daily). The main outcome measure was the difference in the number of migraine days between baseline and the weeks 9 to 12 after randomization (derived from a headache diary). RESULTS: The proportion of responders (reduction of migraine attacks by > or =50%) was 61% for acupuncture and 49% for metoprolol. Both physicians and patients reported fewer adverse effects in the acupuncture group.

 Nausea

 

Ouyang A, Xu L. (2007). Holistic Acupuncture approach to idiopathic refractory nausea, abdominal pain and bloating. World Journal of Gatroentology, 13, 5360-5366.  

 

METHODS: Twelve patients with no or mild nausea (those without nausea had bloating or pain) and 10 with a history of moderate to severe nausea were referred for acupuncture. All underwent an EGG and were treated at acupuncture points. Nineteen patients received three and three patients received two treatments. RESULTS: VAS scores for nausea reflected the clinical assessment and differed significantly between mild and moderate/severe nausea groups. Acupuncture significantly improved severity of nausea in both groups with improved pre-treatment nausea between the first and third treatments in the moderate/severe nausea group. Pain scores improved with acupuncture in the mild nausea group only and bloating improved only with the first treatment in this group. Acupuncture increased the power in the EGG.

 

 Neck Pain

 

Trinh, K., Graham, N., Gross, A., Goldsmith, C., Wang, E., Cameron, I., & Kay T. (2007) Acupuncture for neck disorders. Spine, 15, 236-43

METHODS: Neck Pain is one of the 3 most frequently reported complaints of the musculoskeletal system. 10 trials examined acupuncture treatments for chronic neck pain. RESULTS: The trials suggested moderate evidence that acupuncture was more effective than inactive, sham treatments. There was limited evidence that acupuncture was more effective than massage at short-term follow-up.

 Neurological Disorders

 

Lee, H., Park, H., Park, J., Kim, M., Hong, M., Yang, J., Choi, S. & Lee, H. (2007). Acupuncture application for neurological disorders. Neurological Research, 29, 49-54.

METHODS: This review was designed to summarize and to evaluate the available evidence of acupuncture for neurological disorders. RESULTS: No firm conclusion could be drawn on the use of acupuncture for epilepsy, Alzheimer's disease, Parkinson's disease, ataxic disorders, multiple sclerosis, amyotrophic lateral sclerosis and spinal cord injury.

 

Schröder, S., Liepert, J., Remppis, A., & Greten, J.H. (2007). Acupuncture treatment improves nerve conduction in peripheral neuropathy, European Journal of Neurology, 14, 276-281.  

 

METHODS: One hundred and ninety-two consecutive patients with PN as diagnosed by nerve conduction studies (NCS) were evaluated over a period of 1 year. Of 47 patients who met the criteria for PN of undefined etiology, 21 patients received acupuncture therapy according to classical Chinese Medicine as defined by the Heidelberg Model, while 26 patients received the best medical care but no specific treatment for PN. RESULTS: Sixteen patients (76%) in the acupuncture group improved symptomatically and objectively as measured by NCS, while only four patients in the control group (15%) did so. Three patients in the acupuncture group (14%) showed no change and two patients an aggravation (10%), whereas in the control group seven showed no change (27%) and 15 an aggravation (58%).

 Pain

 

An, K., Kim, Y.S., Kim, H.Y., Lee, H., Hahm, D.H., Lee, K.S., & Kang, S.K. (2010). Needle-free acupuncture benefits both patients and clinicians. Neurological Research, 32, 22-26.

METHODS: Patients suffering myofascial shoulder pain were randomly assigned to either needle-free or conventional needle injection acupuncture groups. RESULTS: Shoulder pain was significantly reduced by the treatment in both groups. Patients treated by needle-free acupuncture reported less anxiety, less discomfort and fewer adverse events.

 

Hong, Y. R. (2005). The effects of hand-acupuncture therapy on intermittent abdominal pain in children. Taehan Kanho Hakhoe Chi, 35, 487-493.

 

METHODS: Forty children were assigned to the experimental or control group. The experimental group received Hand-Acupuncture therapy on the meridian point for 20 minutes, while the control group rested on the bed. RESULTS: In the experimental group, pain intensity and medication requirement were significantly lower than that of the control group.

 

Kelly, R.B. (2009). Acupuncture for pain. American Family Physician, 80, 481-484.

 

REVIEW: Acupuncture benefits patients with low back pain, neck pain, migraine headaches and knee osteoarthritis.

 

Linde, K., Witt, C.M., Streng, A., Weidenhammer, W., Wagenpfeil, S., Brinkhaus, B., Willich, S.N., & Melchart, D. (2007). The Impact of Patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain, 128, 264-71.

 

METHODS: Patients received either 12 sessions of acupuncture or minimal (sham) acupuncture (superficial needling of non-acupuncture points) over an 8 week period. Patients were asked at baseline whether they considered acupuncture to be an effective therapy in general and what they personally expected from the treatment. RESULTS: A significant association was shown between better improvement and higher outcome expectations.

 

Wu, S., Sapru, A., Stewart, M.A., Milet, M.J., Hudes, M., Livermore, L.F., Flori, H.R. (2009). Using acupuncture for acute pain in hospitalized children. Pediatric Critical Care Medicine, 10, 291-296.

 

METHODS: Children with acute pain received two 10- to 15-minute sessions of acupuncture 24-48 hours apart. RESULTS: In follow-up interviews, both parents and patients believed acupuncture helped the child's pain.

 

Parkinson

 

Huang, Y., Jiang, X., Zhuo, Y., Tang, A., & Wik. G. (2009). Complementary acupuncture treatment increases cerebral metabolism in patients with Parkinson's disease. International Journal of Neuroscience, 119, 1190-1197.

METHODS: Patients with Parkinson’s received scalp-acupuncture and Madopa,    or Madopa alone. RESULTS: PET scans before and after 5 weeks of acupuncture showed increased glucose metabolism in parietal, temporal and occipital lobes, the thalamus, and the cerebellum in the light-diseased hemisphere, and in parietal and occipital lobes of the severe-diseased hemisphere. No changes were observed in the Madopa-only group.

 

Joh, T.H., Park, H.J., Kim, S.N., Lee, H. (2010). Recent development of acupuncture on Parkinson’s disease. Neurological Research, 32, 5-9.

 

METHODS: Laboratory findings were reviewed on acupuncture effects on Parkinson's disease. RESULTS: Acupuncture treatments in animal experiments showed that acupuncture therapy increased neuroprotective including brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and cyclophilin A. In addition, acupuncture decreased cell death processes and attenuated oxidative stress to substantia nigra dopaminergic neurons.

 

Chae, Y., Lee, H., Kim, H., Kim, C.H., Chang, D.I., Kim, K.M., & Park, H.J. (2009). Parsing brain activity associated with acupuncture treatment in Parkinson's diseases. Movement Disorders 24, 1794-1802.

 

METHODS: fMRI scans were performed for acupuncture patients with Parkinson ’s disease and placebo groups. RESULTS: Motor function was improved after acupuncture.

Ifrim-Chen, F. & Ifrim, M. (205). Acupoints [corrected] and meridians: a histochemical study. Italian Journal of Anatomy and Embryology, 110, 51-7.

METHODS: samples of 356 specimens (287 from 48 adult and 2 newborn cadavers and the remaining 69 from living patients) were taken at three different levels: (1) beneath acupoints; (2) between meridians; (3) at a distance from meridians. Seven different stainings were performed to show the distribution of collagen fibers, reticular fibers, mucopolysaccharides (MPS), connective tissue, nerve threads, and blood vessels in specimens obtained from different areas. RESULTS: Some structural and biochemical discrepancies associated with acupoints and meridians included: (1) collagen fibers; (2) nerve endings.

 Postoperative Nausea

 

Ezzo, J., Streitberger, K., & Schneider, A. (2006). Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting. Journal of Alternative and Complementary Medicine, 12, 489-95.

METHODS: Reviews were found on postoperative sickness, chemotherapy-induced nausea and vomiting, and pregnancy-related nausea and vomiting. RESULTS: Results for postoperative nausea and vomiting show the most consistent results with showing the superiority of stimulation over sham and for both nausea and vomiting. Stimulation seemed to be superior to antiemetic medication for nausea and equivalent for vomiting. Results for chemotherapy-induced nausea and vomiting showed that electroacupuncture, but not manual acupuncture, was beneficial for first-day vomiting. Acupressure was effective for first-day nausea but not vomiting. Results for pregnancy-related nausea and vomiting were mixed.

 

Streitberger K, Ezzo J, Schneider A. (2006) Acupuncture for nausea and vomiting: an update of clinical and experimental studies. Autonomic Neuroscience: basic and clinical, 30, 107-17

 

REVIEW: For postoperative nausea and vomiting, results from 26 trials showed acupuncture-point stimulation was effective for both nausea and vomiting. For chemotherapy-induced nausea and vomiting, results of 11 trials differed according to modality, with acupressure appearing effective for first-day nausea, electroacupuncture appearing effective for first-day vomiting, and noninvasive electrostimulation appearing no more effective than placebo for any outcome. Experimental studies showed effects of P6-stimulation on gastric myoelectrical activity, vagal modulation and cerebellar vestibular activities in functional magnetic resonance imaging.

 Pregnancy

 

Ekdahl, L. & Petersson, K. (2010). Acupuncture treatment of pregnant women with low back and pelvic pain - an intervention study. Scandinavian Journal of Caring Sciences, 24, 175-182.

METHODS: Healthy pregnant women with low back and pelvic pain received acupuncture treatment from gestational week 20 (group 1) or week 26 (group 2) for a period of 6 weeks divided into eight sessions of 30 minutes each. RESULTS:  The results of POM-VAS, SF-MPQ and SF-36 showed a relief of pain in both groups.

 

Smith, C.A. & Cochrane, S. (2009). Does acupuncture have a place as an adjunct treatment during pregnancy? A review of randomized controlled trials and systematic reviews. Birth, 36, 246-253.

 

METHODS: Studies were reviewed on acupuncture during pregnancy and birthing. RESULTS: Acupuncture reduced nausea during pregnancy as well as back and pelvic pain. In addition, it induced change in breech presentation and pain relief during labor.

 

Prenatal Depression

 

Manber, R., Schnyer, R.N., Lyell, D., Chambers, A.S., Caughey, A.B., Druzin, M., Carlyle, E., Celio, C., Gress, J.L., Huang, M.I., Kalista, T., Martin-Okada, R., & Allen, J.J. (2010) Acupuncture for depression during pregnancy: a randomized controlled trial. Obstetrics and Gynecology, 115, 511-520.

METHODS: Pregnant women with major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). RESULTS: Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity compared with the combined controls or control acupuncture alone. They also had significantly greater response rate than the combined controls and control acupuncture alone.

 

Smoking

 

Chae, Y., Kang, O.S., Lee, H.J., Kim, S.Y., Lee, H., Park, H.K., Yang, J.S., & Park, H.J.(2010). Effect of acupuncture on selective attention for smoking-related visual cues in smokers. Neurological Research, 32, 27-30.

METHODS: Smokers received real acupuncture or sham acupuncture for 2 consecutive days after quitting smoking. RESULTS: The real acupuncture group showed less bias towards smoking cues. The real acupuncture group also had fewer withdrawal symptoms.

 

Yeh, M.L., Chang, C.Y., Chu, N.F., Chen, H.H. (2009). A six-week acupoint stimulation intervention for quitting smoking. American Journal of Chinese Medicine, 37, 829-836.

 

METHODS: Smokers were randomly assigned to an experimental group receiving anti-smoking acupoints or a sham group. RESULTS: The smoking cessation rate in the experimental group was lower, but the daily tobacco consumption was also higher in that group.

 Stress

 

Karst, M., Winterhalter, M., Munte, S., Francki, B., Hondronikos, A., Eckardt, A., Hoy, L., Buhck, H., Bernateck, M., & Fink, M. (2007). Auricular acupuncture for dental anxiety: a randomized controlled trial. Anesthesia Analog, 104, 295-300.

METHODS: Patients having dental extractions were randomized to auricular acupuncture, placebo acupuncture, and intranasal midazolam and compared with a no-treatment group. RESULTS: The auricular acupuncture group and the midazolam group were significantly less anxious at 30 minutes after the treatment as compared with patients in the placebo acupuncture group. In addition, patient compliance assessed by the dentist was significantly improved if auricular acupuncture or application of intranasal midazolam had been performed.

 Surgical Removal of Nucleus Pulposus and Intervertebral fusion

 

Zhao, B.X., Wang, K.Z., Zhao, J.X., Wang, C.S., Huang, X.H., Shu-qiang, M., & Qiang, H. (2008), Clinical effects of acupuncture after surgical operation in patients with prolapse of the lumbar intervertebral disc. Journal of Traditional Chinese Medicine, 28, 250-254.

 

METHODS: Sixty-nine patients in this series, who had undergone the removal of nucleus pulposus and the intervertebral fusion as well, were randomly divided into a treatment group of 35 cases and a control group of 34 cases. The former was treated by acupuncture and conventional rehabilitation therapy, and the latter only by the rehabilitation therapy. RESULTS: In the treatment group, the average functional recovery rates in 3-month, 6-month and one-year periods were respectively 49.93%, 90.31% and 95.08%; while the rates were respectively 26.24%, 63.42% and 71.36% in the control group, showing statistically significant difference between the two groups (P<0.05). Acupuncture can confirmatively promote the functional recovery for patients with prolapse of the lumbar intervertebral disc after surgical removal of nucleus pulposus and with intervertebral fusion.

 

 

TMJ Pain

 

Smith P, Mosscrop D, Davies S, Sloan P, Al-Ani Z (2007). The efficacy of acupuncture in the treatment of temporomandibular joint myfascial pain: a randomised controlled trial. Journal of Dentistry, 35, 259-67

METHODS: To compare the effect of real acupuncture and sham acupuncture in the treatment of temporomandibulat joint myofascial pain, Group 1 received real acupuncture treatment whilst Group 2 received sham acupuncture. RESULTS:  Real acupuncture had a greater influence on clinical outcome measure of TMJ MP than those of sham acupuncture.