A Classical Acupuncture Text from Korea

A Classical Acupuncture Text from Korea

Throughout the history of East Asian medicine, different kinds of acupuncture treatment experiences have been accumulated in classical medical texts. Reexamining knowledge from classical medical texts is expected to provide meaningful information that could be utilized in current medical practices. In this study, we used data mining methods to analyze the association between acupoints and patterns of disorder with the classical medical book DongUiBoGam of Korean medicine. Using the term frequency-inverse document frequency (tf-idf) method, we quantified the significance of acupoints to its targeting patterns and, conversely, the significance of patterns to acupoints. Through these processes, we extracted characteristics of each acupoint based on its treating patterns. We also drew practical information for selecting acupoints on certain patterns according to their association. Data analysis on DongUiBoGam’s acupuncture treatment gave us an insight into the main idea of DongUiBoGam. We strongly believe that our approach can provide a novel understanding of unknown characteristics of acupoint and pattern identification from the classical medical text using data mining methods. 

Source: Taehyung Lee, Won-Mo Jung, In-Seon Lee, Ye-Seul Lee,  Hyejung Lee, Hi-Joon Park, Namil Kim, and Younbyoung Chae. Data Mining of Acupoint Characteristics from the Classical Medical Text: DongUiBoGam of Korean Medicine. Evidence-Based Complementary and Alternative Medicine. Volume 2014 (2014), Article ID 329563.

Acupuncture and Lactulose Compared for Constipation

Acupuncture and Lactulose Compared for Constipation

Acupuncture is widely used for functional constipation. Effect of acupuncture might be related to the depth of needling; however, the evidence is limited. This trial aimed to evaluate the effect and safety of deep needling and shallow needling for functional constipation, and to assess if the deep needling and shallow needling are superior to lactulose. We conducted a prospective, superiority-design, 5-center, 3-arm randomized controlled trial. A total of 475 patients with functional constipation were randomized to the deep needling group (237), shallow needling group (119), and lactulose-controlled group (119) in a ratio of 2:1:1. Sessions lasted 30 minutes each time and took place 5 times a week for 4 weeks in 2 acupuncture groups. Participants in the lactulose group took lactulose orally for 16 continuous weeks. The primary outcome was the change from baseline of mean weekly spontaneous bowel movements (SBMs) during week 1 to 4 (changes from the baselines of the weekly SBMs at week 8 and week 16 in follow-up period were also assessed simultaneously). Secondary outcomes were the weekly SBMs of each assessing week, the mean score change from the baseline of constipation-related symptoms over week 1 to 4, and the time to the first SBM. Emergency drug usage and adverse effects were monitored throughout the study. SBMs and constipation-related symptoms were all improved in the 3 groups compared with baseline at each time frame (P < 0.01, all). The changes in the mean weekly SBMs over week 1 to 4 were 2 (1.75) in the deep needling group, 2 (1.75) in the shallow needling group, and 2 (2) in the lactulose group (P > 0.05, both compared with the lactulose group). The changes of mean weekly SBMs at week 8 and week 16 in the follow-up period were 2 (2), 2 (2.5) in the deep needling group, 2 (3), 1.5 (2.5) in the shallow needling group, and 1 (2), 1 (2) in the lactulose group (P < 0.05, all compared with the lactulose group). No significant difference was observed among the 3 groups regarding the score changes of straining, incomplete evacuation, abdominal distention during spontaneous defecating, or Cleveland Clinic Scores over week 1 to 4. However, the lactulose group got better effect than other 2 acupuncture groups in improving stool consistency (P < 0.01, both) and shortening the time to the first SBM (P < 0.05, both). The percentage of emergency drugs used in the 2 acupuncture groups were both lower than in the lactulose group at each time frame (P < 0.01, all). No obvious adverse event was observed in the deep or shallow needling group. Deep and shallow needling at Tianshu (ST25) can improve intestinal function remarkably and safely. Therapeutic effects of deep and shallow needling are not superior to that of lactulose; however, the sustained effects of deep and shallow needling after stopping the acupuncture treatments are superior to the therapeutic effect of lactulose, which might qualify the superiority of deep and shallow needling. 

Source: Wu J, Liu B, Li N, Sun J, Wang L, Wang L, Cai Y, Ye Y, Liu J, Wang Y, Liu Z. Effect and safety of deep needling and shallow needling for functional constipation: a multicenter, randomized controlled trial. Medicine (Baltimore). 2014 Dec;93(28):e284.

Three Essential Principles of Acupuncture Therapeutics

Three Essential Principles of Acupuncture Therapeutics

Three essential principles of acupuncture therapeutics: disease differentiation; meridian differentiation; and pattern differentiation.  Acupuncture treatment is different from treatment of materia medica. However, syndrome differentiation system of internal medicine is adopted all the time for the present acupuncture textbooks. It is held that the characteristics of acupuncture can not be fully reflexed, and advantages of acupuncture can not be brought into full play. Therefore, it's urgent to build up a modem theory on acupuncture treatment which is fit for the clinical practice of acupuncture and can give a better play for the treatment of acupuncture. A clear target is one of the characteristics of acupuncture treatment. And it is based on the understanding of the location of disease, therefore, disease differentiation is held as the basis of acupuncture treatment. The aim of meridian differentiation is to select distal effective points on the base of diseases differentiation, which is also taken as the characteristics of acupuncture treatment. Syndrome differentiation is a process of understanding the general pathological states of the human body, it is an important process to enhance the therapeutic effect of acupuncture. Thus, the key point for establishing the modern acupuncture theory is clarifying the values of disease differentiation, meridian differentiation and syndrome differentiation.

Source: Yang G. Discussion on the key points of building modern theory of acupuncture treatment. Zhongguo Zhen Jiu. 2013 Oct;33(10):935-7.

Acupuncture for Opioid Addiction

 Acupuncture for Opioid Addiction

This review systematically assessed the clinical evidence for and against acupuncture as a treatment for psychological symptoms associated with opioid addiction. The database was accessed from MEDLINE and China Knowledge Resource Integrated Database. We included all randomized clinical trials published in Chinese and English regardless of their controls. Meta-analysis was performed using the RevMan software, version 5.2. We conducted a literature search of 16 databases from their inception to January 2014. Four studies from Western countries did not report any clinical gains in the treatment of psychological symptoms associated with opioid addiction. 10 of 12 studies from China have reported positive findings regarding the use of acupuncture to treat the psychological symptoms associated with opioid addiction. The methodological quality of the included studies was poor. The meta-analysis indicated that there was a significant difference between the treatment group and the control group for anxiety and depression associated with opioid addiction, although groups did not differ on opioid craving. This review and meta-analysis could not confirm that acupuncture was an effective treatment for psychological symptoms associated with opioid addiction. However, considering the potential of acupuncture demonstrated in the included studies, further rigorous randomized controlled trials with long followup are warranted. 

Source: Zhang Boyuan, Chen Yang, Cheng Ke, Shen Xueyong, and Liu Sheng.  Efficacy of Acupuncture for Psychological Symptoms Associated with Opioid Addiction: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine. Volume 2014 (2014), Article ID 313549.

Acupuncture Reduce the Severity of Acute Pancreatitis

Acupuncture Reduce the Severity of Acute Pancreatitis

A Chinese study was conducted to examine the effects of electroacupuncture (EA) on inflammatory responses in patients with acute pancreatitis (AP). Eighty patients with mild or severe AP were randomly allocated to a control group or an EA group. All patients were managed conservatively. In addition, the EA group received acupuncture for 30 min per day for 7 days at bilateral points ST36, LI4, TE6, ST37 and LR3. Interleukin (IL)-6, IL-10 and C-reactive protein (CRP) levels were measured on admission and on day 7. The time to re-feeding and length of stay in hospital were also recorded. A total of 58 patients provided complete data. The characteristics of the patients in the EA and control groups were similar. After 7 days the serum concentrations of IL-10 were higher in the EA group than in the control group (mild AP: 6.2±1.2 vs 5.2±0.9 pg/mL, p<0.05; severe AP: 14.9±7.8 vs 7.9±6.3 pg/mL, p<0.05). For patients with severe AP, the CRP level in the EA group was lower than in the control group (p<0.05). EA may reduce the severity of AP by inducing anti-inflammatory effects and reducing the time to re-feeding; however, it did not reduce the length of hospital stay.

Source: Zhu SF, Guo H, Zhang RR, Zhang Y, Li J, Zhao XL, Chen TR, Wan MH, Chen GY, Tang WF. Effect of electroacupuncture on the inflammatory response in patients with acute pancreatitis: an exploratory study. Acupunct Med. 2014 Dec 17.

Plant used in traditional Chinese medicine may treat metabolic diseases and obesity

Plant used in traditional Chinese medicine may treat metabolic diseases and obesity

New research published in the December 2014 issue of the Journal of Leukocyte Biology, shows that a component found in the plant, Glycyrrhiza uralensis, may inhibit the development of metabolic disorders by stopping the activation of NLRP3, a protein involved in the disease process. Specifically, the researchers identified isoliquiritigenin as having the ability to attenuate high-fat, diet-induced obesity, type 2 diabetes and hepatic steatosis in mice.

"Identification of small compounds that inhibit the NLRP3 inflammasome is required to design effective therapeutics," said Kiyoshi Takatsu, Ph.D., a researcher involved in the work from the Department of Immunobiology and Pharmacological Genetics, Graduate School of Medicine and Pharmaceutical Science for Research at the University of Toyama in Toyama Japan. "We hope that our findings will provide new information and strategy that can be exploited for development of new herbal medication of those diseases."

To make this find, scientists stimulated mouse macrophages with different inflammasome activators in the presence of isoliquiritigenin. Then, activation of NLRP3 inflammasome was examined by measuring IL-1beta production in the culture supernatants. Results showed that relatively low concentrations of isoliquiritigenin were highly effective in inhibiting IL-1beta production compared with known NLRP3 inflammasome inhibitors, such as parthenolide and sulfonylurea drug glyburide. For animal studies, three groups of mice were used. The first group of mice was fed a normal diet and the second group of mice was fed a high-fat diet. The third group of mice was fed a high-fat diet supplemented with 0.5 percent isoliquiritigenin. High-fat diet feeding for 20 weeks induced obesity, type 2 diabetes and hepatic steatosis in mice, but supplementation of ILG markedly improved these disorders. Finally, supplementation of isoliquiritigenin inhibited high-fat diet-induced IL-1beta production in adipose tissue.

"Obesity and associated metabolic disorders are one of the most important emerging medical conditions. Recent work demonstrates a critical role for obesity-driven inflammation in a multitude of medical problems arising from obesity with a central role for the inflammasome," said John Wherry, Ph.D., Deputy Editor of the Journal.

Journal Reference: H. Honda, Y. Nagai, T. Matsunaga, N. Okamoto, Y. Watanabe, K. Tsuneyama, H. Hayashi, I. Fujii, M. Ikutani, Y. Hirai, A. Muraguchi, K. Takatsu. Isoliquiritigenin is a potent inhibitor of NLRP3 inflammasome activation and diet-induced adipose tissue inflammation. Journal of Leukocyte Biology, 2014; 96 (6): 1087 DOI: 10.1189/jlb.3A0114-005RR

Click here.

Acupuncture for Military PTSD Found Effective

Acupuncture for Military PTSD Found Effective 

Acupuncture effectively treats posttraumatic stress disorder (PTSD). Researchers conducting a randomized controlled study of active duty US military service personnel concludes that acupuncture significantly improves patient outcomes for PTSD patients. Acupuncture also induced secondary improvements: reduced depression and pain, improved mental and physical health functioning. 

The researchers note that there is underutilization of mental healthcare for PTSD patients. The research team notes that US military personnel have a 17% PTSD rate after combat deployment. However, research confirms that war veterans are reticent towards receiving medical care for PTSD.

The researchers note several examples of underutilization. An examination of Iraq and Afghanistan War veterans with PTSD, anxiety disorder or clinical depression finds that 81% acknowledge that they have mental health disorders. However, only 41% “reported interest in receiving help.” Only 30% sought professional help and 14% saw a mental health specialist. In addition, 25% of service members felt that mental healthcare does not work, 28% felt mental healthcare providers were untrustworthy and 41% felt that mental health treatment “would be embarrassing.”

A study of the general population reveals that only 7% of individuals with PTSD had initial contact with primary care treatment within the first year of illness. A national study reports that 59% of men and 26% of women “believed that PTSD treatment would not help.” The researchers note that acupuncture is “a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain….” They add that the underutilization of mental healthcare workers “suggests(s) that a novel and effective treatment option may help increase the proportion of those with PTSD who seek early treatment.” They note, “Acupuncture is a novel and therapeutic option that may help to improve population reach of PTSD treatment.”

To read more, click here.