Welcome to my blog, discover acupuncture with Dr Maggie Ju
Friday, 16 September 2022
Do you know acupuncture can help reducing acid reflux?
Recently much research has been done to investigate the effectiveness of acupuncture on acid reflux. For example, a study compared the effect of acupuncture with that of Omeprazole capsules. They showed that the effect of acupuncture is much superior to this medication to improve acid reflux symptoms. Another study has shown that acupuncture improved functional state of esophagus, neurohumoral regulation of lower esophageal sphincter, decrease of acid producing function of stomach. A review analyzed current status of acupuncture on acid reflux. They suggested that acupuncture inhibits acid production, increases gastric and oesophageal motility, improves esophageal peristalsis, limits lower esophageal sphincter relaxation and decreases pain perception.
Gao &Bai (2016) Zhen Ci yan Jiu 41:150-3
Efendieva (2013) Eksp Klin Gastroenterol 5:49-52
Patrick (2011) Altern Med Rev 16:116-33
A miscarriage is the spontaneous loss of a pregnancy before the 20th week. About 10 to 20 percent of known pregnancies end in miscarriage. An early miscarriage is the loss of pregnancy at ≤13 weeks’ pregnancy. About one in four pregnancies, where a woman has missed a menstrual period and has a positive pregnancy test, ends in early miscarriage. 3 or more miscarriages in a row are known as recurrent miscarriages.
The impact of a miscarriage on women
Miscarriage can be a physical and emotional challenge. It can have a potentially devastating psychological impact on the woman in addition to the physical effects such as bleeding and pain after all the excitement and expectation by discovering the pregnancy. It is very common to feel sad and tearful after being shocked by the tragic event. Feeling angry, jealous or guilty is also common. There are feelings of emptiness and loneliness that others cannot understand; feeling not able to cope with daily life. There is fear of not being pregnant again or having another loss. Research study has shown that one month after pregnancy loss, nearly a third of women suffered post-traumatic stress while one in four experienced moderate to severe anxiety, and one in ten had moderate to severe depression; after nine months, nearly 1 in 5 women had post-traumatic stress; moderate to severe anxiety, and 1 in 20 had moderate to severe depression. One in six women experience long-term post-traumatic stress following miscarriage or ectopic pregnancy. (https://www.imperial.ac.uk/news/194715/miscarriage-ectopic-pregnancy-trigger-long-term-post-traumatic/).
Most women will have a healthy pregnancy after a miscarriage. About 20% of women who have had a miscarriage have another miscarriage the next time they become pregnant. Some of them have difficulty to get pregnant again.
After miscarriage, the women’s body need to recover physically and in particular emotionally. Physical recovery can take a couple of months to get hormones rebalanced, get rid of the inflammation from the miscarriage and get the period started. Emotional recovery can take much longer.
Will acupuncture help with a miscarriage recovery?
Acupuncture can be very useful in the recovery from a miscarriage physically and emotionally.
Acupuncture helps to rebalance hormones; improves ovarian and uterine blood flow to get good quality of eggs and good uterine linings and receptivity. Acupuncture reduces inflammation and stress and anxiety to get one ready to get pregnant again physically. More importantly acupuncture can help release stress, anxiety and emotions and help recovery emotionally to be ready to get pregnant psychologically. Acupuncture can help regulate brain region where controlling emotions such as amygdala and nervous system and balance chemicals which plays a vital role in emotional processing to help mental and emotional release.
If women have difficulty to conceive after miscarriage, acupuncture can help to get pregnant faster.
What does research say about acupuncture for miscarriages
Acupuncture can be helpful to prevent from miscarriages. A study found that there was a significant reduction with threatened miscarriage symptoms including bleeding, cramping and back pain for women receiving acupuncture compared with the control. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055689/).
Thursday, 15 September 2022
Is acupuncture effective in improving pain relief for low back pain? What do medical doctors say about it?
Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham acupuncture, usual care, or no treatment), with stronger effects observed immediately after treatment. Clinically significant reduction in pain is more reliably observed in chronic rather than acute low back pain (strength of recommendation: A, based on systematic review and meta-analysis of randomized controlled trials [RCTs]).
The American College of Physicians issued a clinical practice guideline recommending acupuncture as a first-line therapy for acute and chronic nonradicular low back pain along with other nondrug therapy including stretching, heat application, massage, and manual spinal manipulation.5 The National Institutes of Health’s National Center for Complementary and Integrative Health considers acupuncture to be a safe treatment when done by trained acupuncturists using sterile needles.
Research evidence from systematic reviews
Systematic review and meta-analysis involved in 6656 participants comparing acupuncture with other treatments (sham acupuncture, no treatment, transcutaneous electrical nerve stimulation, medications, usual care) found that acupuncture was clinically superior to sham acupuncture in pain reduction for patients with chronic low back pain (CLBP) immediately after and up to 3 months following treatment. Further, acupuncture provided more pain relief in CLBP compared with no treatment and usual care, which typically consisted of nonacupuncture care like physical therapy, massage, and medication.
Systematic reviews involved in 11 682 participants comparing acupuncture with sham acupuncture, no treatment, or acupuncture plus conventional treatment, which included physical therapy, exercise, and medication, revealed inconsistent evidence of benefit in acute low back pain. Acupuncture was consistently found to provide superior pain relief for CLBP lasting greater than 3 months in the short term.
Systematic reviews involved in 7958 participants analysed acupuncture versus sham acupuncture for chronic low back pain and found that acupuncture significantly reduced pain intensity immediately and 12 weeks after treatment. Compared with medications (nonsteroidal anti-inflammatory drugs, muscle relaxants, or analgesics), acupuncture provided greater pain relief and improved function.
Neuroimaging Studies of Acupuncture on Low Back Pain suggested that improving abnormal structure and functional activities in the brain of the LBP patient is an important mechanism of acupuncture treatment for LBP. The brain regions involved in acupuncture analgesia for LBP were mainly located in the pain matrix, default mode network (DMN), salience network (SN), and descending pain modulatory system (DPMS).
Roselyn Clemente Fuentes et al Can Fam Physician. 2020 Mar; 66(3): 186–187.
Qiao Wen et al Front Neurosci. 2021; 15: 730322.
Skin blood flow significantly decreased with increase in age. Skin blood flow is 40% less at age 65 than at age 25. This is because skin blood flow decreases with decreased pumping blood from heart; skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure; less blood is redirected to the skin from other part of the body; blood vessel movement is impaired with aging and blood vessels are not relaxed to increase the blood flow.
Acupuncture increases blood perfusion and reduces skin aging
Acupuncture is used to treat many conditions in China. Its mechanism is based on meridian theory which is not accepted by Western medicine theory. Recent years researchers are trying to find how acupuncture works from a scientific aspect. Many research data suggested that acupuncture improves blood perfusion. For example, there was a study of acupuncture on 140 healthy volunteers. In this study, acupuncture was applied in LI4’ skin blood flow was measured using a Moor full-field laser perfusion imager before and after acupuncture stimulation. Recently study has shown that stimulating LI4 also increased facial blood flow and hand blood flow. After acupuncture of the right LI4 acupuncture the change ratio of mean blood flux in the left LI4 was increased significantly compared with the control group 60 minutes after acupuncture stimulation. Another study has shown that acupuncture at LI4 and LI11 increased blood circulation along the meridian. Study at ST36 point also has suggested increased skin blood perfusion around the acupuncture point in healthy subjects. In 22 healthy volunteers acupuncture at PC6 point increased microcirculation blood perfusion units along the meridian. Increased blood circulation was also seen at the back acupuncture point study. This also demonstrated in some conditions For example, in a study patients with dysmenorrhea were treated with acupuncture. After 10 sessions of acupuncture treatment, microcirculation was increased and the symptom scores, pain index, and visual analog scale decreased significantly in treatment group.
Tsuchida Y J Dermatol Sci (1993) 5:175-81
Guanjun W et al J Altern Complement Med (2012) 18:784-8
Huang H et al Evid Based Complement Alternat Med (2012) 2012:604590
Wang SY et al Zhen Ci Yan Jiu (2012) 37:482-7
Li X et al Evid Based Complement Alternat Med (2013) 2013:452697
Min Set al J Altern Complement Med (2014) Oct 29
Zheng SX et al BMC Complement Altern Med (2014) 14:323
An Y et al Med Devices (Auckl) (2014) 7:17-21
Xu QY et al Zhen Ci Yan Jiu (2013) 38:52-6
Huang T et al J Tradit Chin Med (2013) 33:757-60
Wednesday, 14 September 2022
Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition in men. It is usually not a serious threat to health, but it does affect quality of life. If the prostate becomes enlarged, it can place pressure on the bladder and urethra. It may cause difficulty starting urination, a frequent need to urinate, and difficulty fully emptying the bladder. Current treatment options for BPH include watchful waiting, lifestyle modifications, alpha blockers, 5 alpha-reductase inhibitors, phytochemicals, and BPH-related surgery. Although most of the aforementioned therapies have various degrees of documented effectiveness in the management of BPH, the use of these interventions are limited to specific patient populations or have certain side effects that interfere with patient's quality of life
Acupuncture is also used to treat BPH to improve the symptoms in china. Recent research provided evidence for the effectiveness of acupuncture on BPH. There was a study participated with 91 patients with BPH. After 4 weeks ofacupuncutre treatment, the Prostatic Symptom Score Prostatic Symptom Score (IPSS) which was used to assess BPH lowered, the maximal urinary flow rate increased, the post-voided residual urine volume decreased, the urinary symptom bother score reduced, times of holding urine in 24 h (HU) and the times of night-urinating (NU). Another study in 138 patients with BPH also showed that acupuncture were effective in improvement of IPSS cumulative score, life quality index cumulative score, nocturia times, urine stream state, hypogastrium symptom, maximal volume of urine flow, residual urine volume, prostatic volume.
Yang T et al Zhongguo Zhong Xi Yi Jie He Za Zhi (2008) 28:998-1000
Liu QG et al Zhongguo Zhen Jiu (2008) 28:555-9
Tuesday, 13 September 2022
Acupuncture helps implantation
When an egg is fertilised by a sperm, an embryo is formed and developing. At the same time, there are also changes in the uterus to prepare the arrival of the embryo. When an embryo arrives at the uterus, it will implant into uterine wall. A successful implantation depends on the synchronous development of both the endometrium and embryo. Uterine inner lining gets thicker, uterine smooth muscles are relaxed after ovulation. There is also communication between the uterine cells and the embryo to get the best time of implantation. Delayed implantation time will lead to implantation failure or miscarriage. During the development of uterine inner lining uterine blood circulation is the key factor to get ready for implantation. After embryo implanted, the embryo initially takes nutrients and oxygen from maternal blood circulation system and removes the waste via maternal blood circulation system. Good uterine blood circulation is essential for early stage of embryo development. To improve uterine blood circulation, acupuncture is the best candidate. Since a decade ago, acupuncture was suggested that it increases uterine blood flow. This will help embryo implantation and embryo development in the uterus.
Acupuncture improves uterine receptivity
If an egg is fertilised, it will be transported to the uterus and it will be implanted into uterine endometrium. Within the uterus, the foetus develops during pregnancy. Endometrium is the inner lining of uterus. It goes cyclic changes responding to ovarian hormone oestrogen and progesterone levels and sheds off each month with new endometrial lining replaced, if the egg is not fertilised. If pregnancy occurs, the endometrium will retain. After ovulation, the uterine endometrium becomes thicker to prepare for embryo implantation. If endometrium is not thick enough (less than 6 cm), implantation does not occur. If the thickness of endometrium is greater than 12 cm, there were three times more chances to get pregnant. To get embryo implanted, there must be a receptive uterus. Ovarian hormones oestrogen and progesterone are involved in regulating uterine receptivity. Uterine smooth muscles tend to contract especially at low progesterone level. Increased progesterone level makes uterus more relaxed. The thickness of endometrium and contractility of uterine smooth muscles are the key factors for the uterus becomes receptive.
Age and uterine receptivity
Women’s fertility is declining with advanced age which is attributed to declining of egg quality. A significant low success rate in IVF is an example. Success rate could be 48.8% for women younger than 30 years old while in comparison to 13.6% in women with 42 years old. Embryo implantation rates also decline in a linear fashion, from 29% in women younger than 34 years to approximately 5% at age 42. Apart from egg quality what other factors contribute to this change? This could be because of poor uterine receptivity in women with advanced age. This was suggested that in the case of egg donation, there was also low pregnancy rate in women with increased age.
Conditions of the uterus that affect uterine receptivity
Luteal phase deficiency (LPD) is a condition in which there is either no enough progesterone production or poor endometrial response. This is a major cause of infertility and recurrent pregnancy loss. In luteal phase defect, there is no enough progesterone produced which shows either low progesterone or too much fluctuation of progesterone levels. Or the uterine endometrium does not respond well to the progesterone stimulation because of lack of progesterone receptors or lack of cell surface adhesive proteins. There is poor endometrial development or delayed endometrial development, as a consequence, uterine receptivity is poor and the embryo loses its chance to implant.
Uterine endometrial tissues grow outside of uterus. Women with endometriosis were found to have decreased fertility. Poor egg development and poor egg quality, impaired fertilization lower the embryo ability to implant. Also failing to respond to progesterone well makes their uterine endometrium less receptive.
Hydrosalpinx is distally blocked, dilated, fluid-filled fallopian tube caused by infectious diseases. Women with haydrosalpinx have difficulty to get pregnant. Tube blockage is not the only factor that is contributed to the cause. Women with hydrosalpinx have lower implantation, pregnancy and delivery rates and a higher incidence of spontaneous miscarriage after IVF–embryo transfer compared with women with tubal infertility of other causes. The inflammation of the tubes could spread to the uterus and make inflammatory environment in the uterus.
Uterine fibroids are the most common uterine benign tumours in women of reproductive age. They can distort the uterine cavity or obstruct the fallopian tubes or cervical canal affecting women’s fertility. They may also change uterine receptivity and cause infertility.
Endometrial polyps are benign, localized overgrowths of endometrium. It may affect infertility by mechanically disrupting the transport of sperm and embryo and making endometrium not responding to progesterone.
Polycystic ovarian syndrome (PCOS)
PCOS is a common endocrinological disorder in women of reproductive age. Infertility associated with PCOS is mainly because there is no ovulation or less frequent ovulation. When ovulation was introduced by drugs in women with PCOS, implantation rates are lower than fertile controls and early pregnancy loss rates are increased which suggested that implantation failure is also contributing to the causes. The hormone imbalance in women with PCOS makes the endometrium less receptive.
Chronic endometritis causes prolonger inflammation in endometrium and affects endometrial receptivity which is associated with infertility and implantation failure.
Acupuncture can help uterine receptivity by regulating hormone balance, increasing uterine blood flow and relaxing the uterine smooth muscles. Whether you like to get pregnant naturally or via IVF, acupuncture can help your uterine receptivity to increase your chance to get pregnant and stay in pregnancy.
Monday, 12 September 2022
How the skin looking, young or old depends on the nature and organization of dermal collagen and the elastic fibers network. The collagens give the mechanical strength of the skin, whereas the elastic fibers are responsible for elasticity to the skin. They give skin elasticity and provide firm skin so that skin can bounce back when stretched.
The patterns of collagen organisation depend on the collagen types and other characteristics such as fiber length, fiber volume fraction and collagen molecular stretching, as well as the tilt angle of collagens determining its orientation. These change with age, becoming denser and begin to disorganise and contribute to the appearance of wrinkles and sagging skin. Both elastin and collagen production decline as people age. These two proteins can also become deteriorated by external factors over time, such as: UV exposure, smoking, pollutants in the environment, excess alcohol, poor nutrition etc. Not taking care of your skin or health can speed up the process of skin aging. This can make your skin look saggy and wrinkled at a younger age. Saggy skin, on both the face and body, is also associated with the loss of fat.
Saggy skin can happen almost anywhere on the body. Common areas include eyelids, jaw, chin, throat, upper arms and stomach.
The laboratory analysed samples from a biopsy pre- and post-treatment and found that both the macroscopic, as well as histological characteristics of the skin were significantly improved. Trichrome staining demonstrated a more compact dermis, with a healthy matrix network Specifically, the collagen fibers were larger and thicker with a more ordered alignment of fibers of the treated skin as compared to the pre-treatment condition.This finding was also confirmed by electron microscopy which demonstrated an increased dermis thickness compared with the pre-treatment condition. collagen the fibers were disorganized and of poorer quality before treatment and were better organized, good quality fibers of a more ordered alignment after the treatment.
Maria Sifaki et al Exp Ther Med. 2020 Jan; 19(1): 717–721.
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