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Maggie Ju (2014) Current opinion in acupuncture on stroke rehabilitation
The Journal of Chinese Medicine And Acupuncture Volume 21 Issue 2 September 2014 P9
Maggie Ju. (2015) What Part Does Acupuncture Play in IVF?
The Journal of Chinese Medicine And Acupuncture Volume 22 Issue 1 March 2015 P21
Maggie Ju (2020) The Potentiality of COVID-19 Treatment with Chinese Herbal Medicine in the UK
The Journal of Chinese Medicine And Acupuncture Volume 27 Issue 2 November 2020 P9
Tuesday, 28 January 2014
Stroke is a serious condition which blood supply to the brain is cut off. It is the second most common cause of death worldwide, and the leading cause of adult disability. Patients with mild strokes or rapidly improving symptoms usually have a good prognosis, while patients with major strokes have a poor prognosis. Acupuncture help reduce brain damage and brain recovery. The mechanisms are as follows: Acupuncture has anti-inflammatory effects and increases cerebral blood flow which would protect the brain from ischaemic injury; acupuncture reduces cerebral odema after cerebral ischaemia and protect neuron damage; acupuncture also regulates biochemical changes involved in post stroke condition. Acupuncture acts on brain region which reduces sensitivity to pain and stress and promotes relaxation reducing anxieties. There have been many researches published recently to support the effectiveness of acupuncture on stroke recovery. In China, stroke is treated with acupuncture. A survey of 1095 physicians from 247 hospitals in China between 1993 and 1994 has shown that 66% of Chinese doctors routinely used acupuncture to treat patients with stroke and 63% of them believed its effectiveness. Another survey in 2007 from patients with acute stroke has shown that 63% patients with stroke would choose acupuncture as part of medical intervention. Many researches were carried out to examine the effectiveness of acupuncture on stroke to support the clinical application of the interventions. Some research has shown that acupuncture can slightly help acute stroke by decreasing mortality rate and dependency at the end of long term follow up and improving neurological deficit scores. Acupuncture treatment for strokes has been listed as a proved effective treatment for stroke in world health organisation (WHO) website http://apps.who.int/medicinedocs/en/d/Js4926e/5.html.
Post stroke rehabilitation is an important part of the treatment of stroke to reduce disability and improve quality of life for patients with stroke. Available evidence suggested that acupuncture may be effective for treating poststroke neurological impairment and dysfunction
In Korea, integrative treatment is also used for patients with stroke. For inpatients, integrative management is applied at the request of the primary physician with consent of patients or their families. In the acute stage, neurologists or neurosurgeons take charge as the primary physicians. Korean medicine doctors cooperate as secondary physicians to the neurologists and neurosurgeons. When patients passed the acute stage, responsibilities are changed between primary and secondary doctors. The rehabilitation program is conducted under the supervision of rehabilitation medicine doctors. The most frequently used complementary and alternative medicines are acupuncture including manualacupuncture, electroacupuncture, and intradermal acupuncture, moxibustion, herbal prescriptions and acupuncture point injection. From their experiences, they believe the integration of complementary and alternative medicine and Western medicine have benefit for patients with stroke.
Acupuncture improves spasticity in post stroke patients
Post stroke patients can be seriously affected by many complications as handicaps, unclear consciousness, aphasia, dementia, psychological abnormalities and incomplete bladder emptying. Spasticity is very common in post stroke patients. Spasticity is a condition in which muscles are constantly tight and stiff. It could cause reduced flexibility, posture and functional mobility; it could also cause joint pain, muscle and joint shortening etc. In post stroke patients, muscle spasm in one side of the body are in constant contraction state is very common. The affected side of the body is rigid, weak and has low functional abilities. Treatment includes antispastic medication such as baclofen, diazepam etc. Physiotherapy including muscle stretching and exercises could help preventing muscle shortening and atrophy. Acupuncture is use to help stroke rehabilitation and it improves post stroke motor ability. Some research study showed that acupuncture reduces spasticity by stroke and maintain a reduced level of spasticity. A study showed that combining a 6 week electroacupuncture and standard rehabilitation treatment reduced the spasticity of the elbow for chronic post stroke patients. The effect depends on the acupuncture points chosen for the treatment to improve spasticity.
Recently a study investigated the effect of acupuncture on muscle spasm. In this study, 44 patients were allocated in acupuncture group in which patients received acupuncture combined with rehabilitation treatment while 42 patients were in control group in which patients received only rehabilitation treatment. The key acupuncture points selected were from head, face, chest, abdomen, shoulder, back, hands, feet and ankles. Routine limb rehabilitation program was applied to both groups. One course included 10 treatments and two courses were performed in total. The effective rate of antispasm was 90% in acupuncture group which was superior to control group (73.8%). The improvement of motro function was significantly greater in acupuncture group. This study showed that acupuncture combined with rehabilitation therapy effectively relieves the muscle spams in post stroke patients, improves the limb function and the life activity.
Tong S Zhongguo Zhen Jiu (2013) 33:399-402
Bi-huei Wang et al Clin Interv Aging (2014) 9:147-156
Zhang JH et al Neuroepidemiology (2014) 42:50-8
Park SU et al Complement Ther Clin Pract (2014) 20:37-41
Thursday, 16 January 2014
Acupuncture could help motor function, cognition, speech problems, shoulder pain, urinary incontinence, constipation, depression, fatigue and dysphagia etc.
Constipation can occur after a stroke. This is because you are not drinking enough liquids and you are in bed most of the time; or you are taking certain medicines as part of your treatment. If you have constipation, drink extra water and set a regular time for using toilet. Acupuncture can help post stroke constipation. There is a case report about treating post stroke constipation using acupuncture. There were 39 patients with post-stroke constipation received acupuncture treatment for 2 weeks and another 35 patients with post-stroke constipation received Chinese herb medicine Shengrue Tongbian Capsules for 2 weeks. After two weeks treatment, constipation symptoms were improved in these patients received both acupuncture and Chinese medicine. The improvement was greater in patients with acupuncture treatment. Acupuncture was potential treatment option for patients with post-stroke constipation.
Acupuncture could help post-stroke urinary incontinence.
Urinary incontinence is the unintentional passing of urine. This is a common problem in patients with stroke. In China, acupuncture is used to treat this problem. Recent clinical research compared the effect of acupuncture with that indwelling catheter. Acupuncture was received 5 times a week. The points used included Qugu (CV2), Zhongji (CV3), Shuidao (ST28, Qihai (CV6) and Guanyuan (CV4) etc. The effect was compared after 4 weeks of treatment. The urinary diary (including the interval of urination, nocturia frequency, urination difficulty, urinary incontinence severity), bladder capacity, patients’s satisfaction were assessed before and after the treatments and compared between the two groups. After treatments, the effects were observed in both groups with better effect in acupuncture group especially in total score, the patients’ satisfaction and bladder capacity. Acupuncture is potential treatment option for post stroke urinary incontinence.
Acupuncture has potential benefit for stroke patients with incomplete bladder emptying
Urinary retention and incomplete bladder emptying (IBE) are not uncommon in patients with stroke rehabilitation. This significantly increased the risk of urinary infection. Recently there was a study investigating the effect of acupuncture on IBE. The patients selected were diagnosed with infarction or hemorrhagic stroke for the first time; they did not suffer from an active urinary tract infection. During the study period, these patients continued to receive conventional therapy without major changes of medication. These patients received acupuncture five times a week for two weeks. Among the 49 patients in the study, nine (18%) had IBE, and seven of the stroke patients with IBE were treated with electroacupuncture. Increased spontaneous voiding volume and decreased PVR urine volume were noted after ten sessions of acupuncutre. They suggested electroacupuncutre may have beneficial effects on stroke survivors with IBE. Acupuncture is a potential intervention to improve urinary function.
Acupuncture for ischemic stroke
Most stroke (87% cases) is ischemic stroke which caused by blood clot blocking blood vessel in the brain. The blood clot can form in the blood vessel in the brain or it formed elsewhere and travelled to the vessel in the brain which cannot pass because the vessel is too narrow to pass. Loss of blood supply damages brain function. The recovery of brain function such as speech and walking was attributed to reduction of inflammation in the brain region of damage and rewire of the area. Recently a randomised controlled trial from China studied efficacy of integrated rehabilitation techniques of Chinese Medicine for ischemic stroke. They used acupuncture combined with massage techniques and compared this with conventional rehabilitation technique. They compared the related parameters on day 0, day 21 and day 90. They found better improvement in acupuncture and massage compared with baseline and conventional technique. They suggested there is potential benefit from acupuncture and massage for ischemic stroke rehabilitation.
Acupuncture is beneficial for cognitive function in post stroke patients
Jing well points are very powerful points located at the end of fingers and toes. These points are very often used to treat stroke. Temple points on the side of the head are also used for stroke in China. Recently a research showed that these points are beneficial for patients with early vascular congnitive impairment in China. They compared acupuncture at Jing well points and temple points and conventional treatment in patients with stroke. They observed improvement with acupuncture treatment but not conventional treatment. This indicates that acupuncture has potential to improve cognitive function in post stroke patients with mild cognitive impairment.
Acupuncture for post stroke depression
Patients with stroke not only suffer from physical disability but also emotional problems. Post stroke depression (PSD) is very common in patients with stroke in different stages. PSD is linked to increased disability, and poor functional and cognitive outcomes of stroke survivors. Reducing PSD could improve quality of life in patients with stroke. Anti-depression drugs could used to treat PSD. Because of their side effects, combination drugs and non drug treatments were recommended. Acupuncture is one of therapies without drugs, but its use in PSD is still in debate. Recently a pilot study investigated whether acupuncture is an effective treatment for PSD and whether the effect of acupuncture differs according to the degree of motor function impairments of the stroke patients. In this study 28 PSD patients were assessed and participated the study. They were treated with acupuncture every day for 16 weeks. Depression status was significantly improved during the treatment sessions. The depression of the good motor function groups was significantly more reduced than that of the poor motor function group. This study indicates that acupuncture therapy can improve PSD and that the effects depend on the degree of motor function impairment.
Another research from China studied the combination of herbs and acupuncture for post stroke depression. They compared herbs plus acupuncture with western medicine fluoxetine hydrochloride for treating post stroke depression. The treatments were given for four weeks. On six month followup, improvement was seen in herbs plus acupuncture and western medicine treatment with greater improvement in herbs plus acupuncture.
There was also study combined acupuncture and moxibustion or antidepression medication (using aroxetine hydrochloride tablets) on post stroke patients with depression. They compared the efficacy of medication only, acupuncture plus moxibustion and acupuncture plus medication. Daily acupuncture except weekends was offered for 4 weeks. The improvement of depression was superior in acupuncture plus medication group and acupuncture plus moxibustion group to medication only group.
Acupuncture helps post stroke swallowing difficulty
Swallowing difficulty can be present in post stroke patients. This problem is treated with acupuncture in China. Recently Zhou et al studied the effect of acupuncture on post stroke swallowing problem using modern research methods to provide evidence from conventional medicine point of view. They combined acupuncture with rehabilitation training program. There were 80 patients with post stroke swallowing difficulty. 40 patients were in control group treated with conventional approach and other 40 patients in acupuncture group treated with acupuncture. After treatment, assessment was carried out. They found there were improvements after the treatments in swallowing tests for both groups compared with those before the treatments. The improvements in acupuncture group were significantly greater. This showed that acupuncture is a potential effective treatment for swallowing difficulty in post stroke patients.
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Saturday, 11 January 2014
First, pre-testicular factors affect sperm production. In these conditions, hormonal imbalance and poor general health fail to support the testes to produce sperms. These include hypogonadotropic hypogonadism, obesity, alcohol, smoking, drugs, certain medications and genetic abnormalities. Second, testicular factors make testes produce low quantity and poor quality sperms. Varicocele which is abnormal veins above the testicle is common cause of low quantity of poor quality of sperms. Other causes include undescended testicle, infections in the testicle, and some medications including chemotherapy. Third, post-testicular factors including Vas deferens obstruction, infection such as prostatitis, ejaculatory duct obstruction, impotence, retrograde ejaculation etc.
Stress affects male fertility as well. Very recently there was a study about stress on male fertility. This study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed. 27% of them had HADS anxiety and depression score ≥8 which was abnormal HADS score showing stress condition. The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. This study suggested that psychological stress affects male fertility and sperm quantity and quality. Note acupuncture can help reducing stress to boost male fertility as well.
Obesity has negative impact on male fertility. Obesity is increased in Western countries and 10-30% of adult men are now obese. This has impact on male fertility.
Smoking affects people’s general health and also it impairs sperm production. In adult men smoking leads to hypoxia in testis this is because smoking causes small blood vessel contraction and reduces blood and oxygen supply to the testis. Compromised oxygen supply to testis would impair sperm production. Mother in pregnancy smoked heavily could affect her son’s sperm production when he grew up. Men’s sperm production could decrease about 40% by maternal smoking in pregnancy.
Recent some research data suggest that acupuncture improves male fertility by increasing sperm count and improving sperm quality and motility. The possible mechanisms for these are: acupuncture helps lower scrotal temperature; acupuncture improves blood flow of male reproductive system and reduces inflammation in the reproductive system; acupuncture also corrects hormonal imbalance to improve sperm maturation, acupuncture modulates the immune system and improves sexual and ejaculatory dysfunction in male infertility. A simple and popular hypothesis is that acupuncture stimulates nerve receptors at point location, transmitting signals to specific areas of the central nervous system, which initiate physiological changes in the body. From traditional Chinese medicine point of view, there is disharmony of kidney and liver in male infertility. Kidney Qi deficiency and stagnation fail to regulate liver blood flow causing blood stagnation and fluid and damp accumulation. Acupuncture makes Qi flow freely again to restore kidney and liver harmony. Acupuncture treatment for male infertility period is up to 3 month per course.
Sperm is impaired by inflammation and acupuncture can help
Semen quality is affected by prostate and genital tract inflammation. There was a study on 382 voluntary male subjects who underwent the screening for prostate health. Sperm motility and prostate-related parameters were significantly impaired in patients with chronic prostatitis syndromes and lower urinary tract symptoms in comparison with controls. Elevated seminal markers of inflammation were in positive association with body mass index, prostate-specific antigen, and estradiol level in serum while in negative association with semen volume, total sperm count, and sperm motility. It was suggested that one of the possible pathways for impaired reproductive quality in male subjects >45 years could be related to infection and inflammation in the genital tract with subsequent (partial) obstruction and damage of prostate and other male accessory glands. Previous study has shown that acupuncture could improve sperm parameter in men with genital tract inflammation.
Anti sperm antibodies (ASA) can be detected in seminal fluid where they may be bound to the sperm surface in male. In infertile male partners 10% show ASA in the seminal plasma or attached to the surface of sperm. ASA can also be found in cervical mucus , oviductal fluid or follicular fluid in female partners. This occurs in 5% of infertile female partners.
ASA have an adverse impact on male fertility by (1) directly interfering with sperm motility and sperm-oocyte binding and (2) indirectly by mediating the release of cytokines that can impair sperm function and by impeding cervical mucus penetration. Sperm ASAs have generally been associated with poor sperm motility, and, reduced natural pregnancy rates. Do you know that acupuncture can help reduce ASA in semen and helps conceive naturally?
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My article is out now. The Potentiality of COVID-19 Treatment with Chinese Herbal Medicine in the UK
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