Welcome to my blog

Leading acupuncture specialist for cosmetic acupuncture, pain relief, stress relief, fertility, fatigue, anxiety.
Based at Harley Street and Kensington Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out. .

My profile

Practice contact for appointments and addresses

Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: for appointments at Harley Street (Wednesdays) please call 02076368845 or email at info@aloclinic.com

Address: Suite 3 Harmont House 20 Harley Street, London W1G 9PH

5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor 25 years ago in Western medicine in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Ji-sheng Han famous professor and neuroscientist in China and with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. Also I had training in fertility and had research experiences in uterine smooth muscles and blood vessels in China and the UK. I am dedicated to treat patients with acupuncture and am recognised as one of the world leading acupuncture specialists.


I obtained a PhD degree in the University of Leeds in the UK.
I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.
I had frequently presented my research findings in the top international conferences in the field.
I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practicing, I have developed unique effective treatment approaches for cosmetic acupuncture, acne, pain relief including vulvodynia, bladder pain, pelvic pain, chronic prostatitis, neck pain, headache, migraine, shoulder pain, back pain, stress relief, anxiety, fatigue, fertility, hot flushes, nerve pain, insomnia to achieve best treatment results.

My devotion and skills are highly praised by my patients.

https://www.youtube.com/watch?v=NKdoRpfr0ic

Wednesday, 28 February 2018

Infertility caused by tube blockage, how can acupuncture help?

The role of fallopian tube is in reproduction

The fallopian tube is a part of the women’s reproductive system. It plays an essential role in gamete transport, fertilization and the early development of the embryo. The tube contains inner lining and smooth muscle wall. In the inner lining there are two major cell types are the ciliated and secretory cells. The fallopian tube goes through cyclical changes responding to estrogen and progesterone levels. The ciliated cells are low in height during the menstrual periods of the cycle, increasing during the follicular phase to reach their maximal height in the periovulatory period. Around the time of ovulation, the secretory cells reach peak activity. In the luteal phase, both cell types reduce in height.

Fallopian tubes are very important for normal fertility. They play a key role in picking up eggs and transporting eggs, sperm and embryo. When an egg is release, it takes about 8 hours to reach the site within fallopian tube. The fallopian tubes are the places where eggs are fertilised and embryo is accommodated there for 72 hours. Once progesterone dominance begins lumen opens and the embryo is transported to the uterus. Fallopian tubes are vulnerable to infection and surgical damage. This may affect tube function and cause infertility. If the tubes are blocked, this will cause infertility. Falllopian tube obstructions are the most common cause of female infertility, accounting for 30%-40% of cases.

Fallopian tube spasm, tubal infertility and acupuncture

As mentioned above, the fallopian tube is essential on sperm, egg and embryo transport and embryo development and it is very important for women who desire to get pregnant naturally. In IVF procedure, the fallopian tube is circumvented. The fallopian tube is not a concrete tunnel. The tube wall is flexible and consisted of smooth muscles which are responding to monthly cyclic hormone changes. Sometimes the tube can be obstructed by debris in the tube and tube muscle spasm. Women with tube spasm will find it difficult to get pregnant.

Fallopian tube smooth muscle contraction is induced by sympathetic nerves. Acupuncture reduces sympathetic activity and relaxes tube muscles and the debris in the tube is flushed away by the tubal fluids. This makes the obstructed tube reopen. In this case, pregnancy occurs quickly after acupuncture treatment.

Pelvic infection is a major cause of tubal infertility. Tubal damage by infection can be caused by sexually transmitted diseases, for example Chlamydia trachomatis accounts for half of the cases of acute inflammatory pelvic infections in developed countries. Tubal damage can also occur after miscarriage, termination of pregnancy, puerperal sepsis, or insertion of an intrauterine contraceptive device. Endometriosis associated adhesions is likely cause tubal distortion. Previous laparotomy is a risk factor for tubal infertility. In addition, ectopic pregnancy and uterine fibroids can also damage the tubes.

Acupuncture help to reduce inflammation; as a result, it releases tube spasms, reduces scar tissue contraction and helps inflammation absorption and helps healing process. There were a few case reports in Chinese that tubal infertility with acupuncture treatment, pregnancy rate was up to 72%.

References

R.A.Lyons et al (2006)Human Reproduction Update, 12: 363–372
Papaioannou S Hum Rreprod (2004) 19:481-5

Tuesday, 27 February 2018

Suffer from leg pain, acupuncture can help

The leg is the section of the lower limb extending from the knee to the ankle. There two bones the tibia or shinbone together with the smaller fibula bone. Muscles in the legs move the ankle, foot and toes. There are three muscles at superficial layer: the calf muscles, including the gastrocnemius and soleus are the muscles at the back of the leg. Their tendon, known as Achilles tendon is attached to the calcaneus bone in the heel. Also plantaris is a superficial muscle.There are four muscles in the deep compartment of the posterior leg: the popliteus, tibialis posterior, flexor hallucis longus and flexor digitorum longus. These muscles contract to flex the foot — such as when standing on the tiptoes — and flex the toes. They also stabilize the ankle joint and foot and to maintain the body’s balance. There are four muscles in the anterior compartment of the leg; tibialis anterior, extensor digitorum longus, extensor hallucis longus and fibularis tertius.They dorsiflex, invert the foot at the ankle joint and extend the toes. There are two muscles in the lateral compartment of the leg; the fibularis longus and brevis. They turn the sole of the foot outwards.

Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues. Some types of leg pain can be caused by problems in the lower spine where the nerve to the leg originates and then travels to the legs, such as slipped disk, sciatica. Leg pain can also be caused by blood clots, varicose veins or poor circulation.

Leg pain can be mild that comes and goes, or severe that makes it difficult to sleep and walk. The pain is often described as aching, throbbing or burning and it can be accompanied by numbness, tingling and muscle weakness. For leg pain treatments, finding the cause is important and treatments depend on the causes. Acupuncture is effective for the leg pain management.

A muscle spasm also known as a muscle cramp is an involuntary contraction of a muscle. Skeletal muscle spasms happen suddenly and are very painful. The causes include overuse, over stretched, tiredness, injury or strain. Other causes include dehydration and depletion of electrolytes. Muscle cells require enough water, glucose, ions including sodium, potassium, calcium, and magnesium to contract. Abnormal supply of these elements can cause the muscle to become irritable and develop spasm. Narrowed arteries also can cause muscle spasm due to inadequate blood supply and nutrients. Exercises often cause leg spasms and chronic neck and back pain can often cause muscle spasms. Many conditions can result in muscle spasm.

A leg muscle cramp, for example is an episode of sudden pain in the muscles of the leg caused by an involuntary contracting of the leg muscle. Leg muscle cramps are common and it usually occurs in the calf muscles. It can also happen in any part of your leg, including your feet and thighs. When it happens, the muscles in your leg suddenly become tight and painful which will last seconds to minutes. After the cramping has passed, you may have pain and tenderness in your leg for some time. This often occurs at night during sleep. If you only get leg muscles cramps occasionally, it is not a cause for concern. If you get leg muscle cramps frequently, or if they are so painful they disrupt your sleep and you are unable to function normally the next day, you should get help from health care professionals. Sometimes the cause of leg cramps is not clear, we call it idiopathic leg cramps. Theoretically idiopathic leg cramps can be caused by abnormal nerve activity during sleep or excessive strain placed on leg muscles such as exercises, or a sudden restriction in the blood supply to the affected muscles. Shortened tendon can also be one of the causes in old people. Leg muscles cramps can be caused by some other conditions for example, pregnancy, neurological conditions, liver disease, infection, toxins or dehydration. Some medicines can also cause leg muscle cramps such as diuretics, statins, raloxifene, nifedipine and nicotinic acid.

Do you know that acupuncture can help with improving muscle cramps?

References

Schroder S et al Eur J Neurol (2007) 14:276-81

Li J et al Zhongguo Zhong Xi Yi Jie He Za Zhi (2012) 32:1624-7

Suffer from tailbone pain, acupuncture can help

Tailbone or coccyx is the lowest part of the spine and it is the triangular bony structure and consists of three to five different bones that fused together by joints and ligaments. It is surrounded by many tendons and ligaments. If the tailbone area becomes inflamed, it can cause tailbone pain or coccydynia. Soft tissue injury such as tendons and ligaments surrounding tailbone is the common cause of tailbone pain. The main symptom is pain and tenderness around the tip of the tailbone the area just above the buttocks. It is dull and achy most of the time, with occasional sharp pains. The pain is often worsened by sitting down, moving from sitting tostanding, standing for long periods, having sex and going for a poo. It may affect sleep and other daily activities. The pain can radiate to legs, buttocks and hips. Tailbone pain is often caused by an injury, such as sitting for a long time or bike rides, but it may have unknown causes. Vaginal birth in women sometimes is the cause of tailbone pain. The coccyx or pelvic bones injury is a risk factor and obesity is also a risk factor for getting tailbone pain. Secondary tailbone pain includes sciatica, infection such as shingles of the buttocks, sacroiliitis, and fractured bone. The major symptoms are pain and local tenderness at the tailbone. This can lead to difficulty sitting or leaning against the buttocks. Along with the pain with sitting, there is typical tenderness at the tailbone area.

Acupuncture can reduce tailbone pain effectively. Acupuncture points used in the treatment is very important. Recently a study compared two different acupuncture methods with different acupuncture points to treat sacroiliac joint injury which presents low back pain. In one group, 9 Ashi points were used and in another group as a control Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc were used. Treatment durations and frequencies are the same. Two courses with each course containing 10 treatments were given. After the two courses of treatments, the pain scale and function recovery were found in the both groups, but the group with Ashi points had better effects. From this example, we can see acupuncture points selected are very important to achieve the best treatment results.

References

Grgic V Lijec Viesn (2012) 134:49-55

Gataullin IG and Samitov Osh Khirurgiia (Mosk) (1989) 2:64-6

Jordan J et al Clin Evid (Online) (2011) pii:118

Shan YL Zhongguo Zhen Jiu (2011) 31:987-90



Monday, 26 February 2018

Suffer from sciatica, acupuncture can help

The sciatic nerve is the longest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and runs through the buttock area down to the lower limb ending at the feet. The pain of sciatica is sometimes referred to as sciatic nerve pain. Sciatica is pain caused by irritating sciatic nerve. It is a syndrome involving nerve root impingement or inflammation that causes neurological symptoms in the areas that are supplied by the affected nerve roots. The pain of sciatica radiates out from the lower back, down the buttocks and into one or both of the legs, right down to the calf. The most prominent symptoms include unilateral leg pain radiating to the foot or toes that is greater than low back pain. The accompanied symptoms can include numbness, tingling, muscle weakness, loss of tendon reflexes. It may involve increased pain on straight leg raising and neurological symptoms limited to one nerve root. Sciatic pain can range from being mild to very painful and may last just a few days or for months or years. The pain often gets worse over time and may also be made worse by: sneezing, coughing or laughing, standing or sitting for a long period of time, bending backwards. The treatment for sciatica is primarily aimed at pain control.

Many studies investigated the effect of acupuncture on sciatica. For example, a study involved with 962 patients with sciatica has shown that acupuncture significantly released sciatic pain and related other symptoms. Acupuncture was more effective than pain killers NSAIDs (ibuprofen, meloxicam, and diclofenac). Another study involved with a total of 1842 patients with sciatica has also shown that acupuncture reduces sciatic pain significantly and reduction of pain was greater than conventional medication such as ibuprofen as mentioned above. Acupuncture is clinically effective, reduces pain intensity, and increases pain threshold in patients with sciatica.

How does acupuncture work? Acupuncture stimulates inhibitory nerve fibers for a short period, reducing transmission of pain signal to the brain. Acupuncture also activates endogenous analgesic mechanisms causing secretion of endorphin which is an endogenous opioid and triggering release of adenosine producing a rapidly effective analgesic action on radicular sciatica. Extensive research has shown that acupuncture analgesia may be initiated by stimulation of high-threshold, small-diameter nerves in the muscles.

References

Qin et al Evid Based Complement Alternat Med. 2015;2015:425108. doi: 10.1155/2015/425108.

Ji m et al Evid Based Complement Alternat Med. 2015;2015:192808. doi: 10.1155/2015/192808.

Sunday, 25 February 2018

Suffer from slipped disk, acupuncture can help releasing the pain

A slipped disc or prolapsed or herniated disc is a condition in which the disc in the spine is torn and the central part inside comes out. It causes chronic back pain. The pain is often begins in the lower back and over time it spreads to other parts of the body. Sometime there is no symptom. This is because the slipped part of the disc is small which will not affect nerves or spinal cord. If sciatic nerve is affected the pain could travel from the low back, through the buttocks and down the legs to the feet. It could be also accompanied with numbness, tingling sensation in legs.

Acupuncture does not make slipped the disk back but acupuncture treatment can help to release the pain and other symptoms. There are many studies about acupuncture on slipped disk. Here are some examples of the research.

A recent study has shown that acupuncture had better effects than that of Fugui Gutong capsule and ibuprofen for slipped disc. The scores of clincial symptoms and therapeutic effect were observed before and after treatment. Results In the electroacupuncture group, the effective rate was 84.4% (38/45), which was superior to that of 65.0% (26/40) in the medication group. After treatment, the scores of symptoms significantly decreased in the two groups, and the reduction of scores in electroacupuncture group was superior to that in medication group. Recent study involved in 30 patients with slipped disk has shown that acupuncture releases the pain caused by slipped disk.

Which acupuncture points are used to treat slipped discs? A study analysed data from recent 10 years. They found 49 main acupuncture points from 173 studies. there were 10 most common used acupoints on Bladder Meridian [Geshu (BL 17), Xiaochangshu (BL 27), Shenshu (BL 23), Dachangshu (BL 25), Pangguangshu (BL 28), Guanyuanshu (BL 26), Weizbong (BL 40), Zhibian (BL 54), Chengshan (BL 57), Kunlun (BL 60)], 2 on Gallbladder Meridian [Huantiao (GB 30), Yanglingquan (GB 34)], 2 on Governor Vessel [Yaoyangguan (GV 3), Shuigou (GV 26)], 2 on Stomach Meridian [Zusanli (ST 36), Juliao (ST 3)], 2 on Spleen Meridian [Sanyinjiao (SP 6), Xuehai (SP 10)], and the rest were extra points (Huatuo Jiaji) and Ashi points, so a conclusion could be drawn that the most common used acupoints were Bladder Meridian acupoints and supplemented by Gallbladder Meridian, Governor Vessel, Stomach Meridian, Spleen Meridian, extra points and Ashi points. The selected acupoints were most located on the lumbosacral region, leg and fewer located on the face, back and local part.

References

Grgic V Lijec Viesn (2012) 134:49-55

Gataullin IG and Samitov Osh Khirurgiia (Mosk) (1989) 2:64-6

Jordan J et al Clin Evid (Online) (2011) pii:118

Shan YL Zhongguo Zhen Jiu (2011) 31:987-90

Qiu L et al Zhen Ci Yan Jiu (2016) 41:447-50


Suffer from restless legs syndrome, acupuncture can help

Restless legs syndrome is a common condition affecting nervous system. It causes an urge to move the legs and an uncomfortable sensation in the legs and sometimes arms, chest and face. It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. These symptoms can be mild or unbearable and are usually worse in the evening or during the night. These unpleasant sensations can often be relieved by moving or rubbing the legs. It can be difficult to sit for a long period of time. In severe cases, restless legs syndrome can be very distressing and disrupt a person's daily activities. About half of people with restless legs syndrome have some degree of lower back pain. Over 80% of people with restless legs syndrome also have a condition that is known as periodic limb movements (PLM). The symptoms of PLM are jerky or twitchy leg involuntary movements, usually at night while you are asleep. The cause of restless legs syndrome is not clear. A theory suggested that it is related to the falling of dopamine in the part of the brain. Having chronic conditions such as diabetes, parkinson’s disease etc is likely to trigger restless legs syndrome development. Iron deficiency anaemia is a trigger for the syndrome. Dopamine agonists are used to treat restless leg syndrome.

There were many case reports with acupuncture treating restless legs syndrome. Acupuncture helps with reducing severity of the symptoms and decreasing the frequency of the symptoms. For example a study has shown that acupuncture helps to improve abnormal leg activity. In this study, significant improvement was seen after 4 week and 6 week acupuncture treatments. There were no side effects found during the treatments.

More recently a study has investigated the effect of acupuncture on restless leg syndrome. There were 46 patients with restless legs syndrome participated the study. These patients were either received 10 session of acupuncture plus gabapentin or gabapentin alone over 4 weeks. The symptoms of patients were assessed at baseline (before treatment), just after the therapeutic course and 8 weeks later. The criteria used for the assessment included the Visual Analogue Scale (VAS), the International Restless Legs Syndrome Rating Scale (IRLSRS), and the Pittsburgh Sleep Quality Index (PSQI). The result has shown that VAS, IRLSRS, and PSQI improved greater in acupuncture group. After a treatment course and in 8 weeks follow up, VAS and IRLSRS had a significant improvement in both groups, but PSQI improved significantly just in the acupuncture group. Based on the findings of the present study, acupuncture was suggested to improve restless legs syndrome.

References

Wu et al Zhongguo Zhen Jiu (2008) 28:27-9

Pan W etc Evid Based Complement Alternat Med (2015) 2015:343201

Raissi GR et al J Acupunct Meridian Stud (2017) 10:346-350

Saturday, 24 February 2018

Suffer from low back pain? Which muscles involved? Acupuncture can help

Which muscles are involved in low back pain?

The Gluteal muscles

The gluteal muscles are a group of three muscles making up the buttocks: the glutes maximus, gluteus medius and the gluteus minimus. They originate from the back of the pelvic bone ilium and sacrum and end on the thigh (femur).

The largest and the most superficial of the three gluteal muscles is the gluteus maximus. It makes up a large portion of the shape and appearance of the hips. The functions of the muscles are extenson, abduction, external and internal rotation of the hip joint.

Gluteus maximus starts from the posterior gluteal line of the inner upper ilium crest, the posterior surface of the lower part of the sacrum and the side of the coccyx, aponeurosis of the erector spinae, sacrotuberous ligament and the fascia covering the gluteus medius. The gluteal maximus go downward and lateralward and insert into iliotibial band and glutealtuberosity. It extends and laterally rotates the hip and extends the trunk. Gluteus maximus injury is a common source of the low back pain. Trigger points are often presents at the originated fibers. The pain can radiate to the thigh, knee and even foot like sciatic pain.

Erector spinae muscles

The erector spinae muscles are a group of muscle and tendons lying along the side of the spine. They arise from the anterior surface of the tendon attached to the medial crest of the sacrum, spinous processes of the lumbar and last two thoracic vertebrae, the supraspinous ligament, the innerpart of the iliac crest and the lateral crest of the sacrum. They extend up through lumbar, thoracic and cervical regions. This group of muscle include iliocostalis, longissimus and spinalis. The erector spinae makes the back straight and rotate the back from side to side. Injury, strain chronic inflammation to these muscles may cause back spasm, pain and stiffness. Acupuncture can help with relaxing the muscles, reducing inflammation and releasing the pain and stiffness.

Others

The quadratus lumborum is a deep muscle at the back that runs from the last ribs and transverse processes of lumbar vertebrae to the top of the pelvis. It is quadrilateral in shape and forms posterior abdominal wall. When one side of the muscle contract, it flexes the spine laterally; when both side of the muscles contract, it extends the spine; it helps expiration and inhalation; and when it contracts on one side, it elevates pelvic bone. If trigger points are present in this muscle, it is a common source of low back pain. This is often caused by overuse, poor posture, stress, strain and tension from twisting, bending or lifting improperly etc.

The psoas major muscles are the deep muscles by the sides of the spinal column. They go downwards to the pelvic bone and end at lesser trochanter of the femur. Illacus muscles start from the interior side of the pelvic bone. The psoas major and the illacus muscles join together and form the iliopsoas. These muscles connect the core and lower limbs and they flex the hip joint, bend the spine forward and laterally and raise the spine from supine position. The pain and trigger points related to iliopsoas is at the low back and upper thigh. Walking and standing upright can be painful, if there are trigger point present in these muscles.

Acupuncture can help release low back pain.

Suffer from Piriformis syndrome? Acupuncture can help

Piriformis syndrome is an uncommon neuromuscular disorder. In this condition the sciatic nerve is compressed by piriformis muscle which is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement and it is used in almost every motion of the hips and legs. Through the piriformis muscle sciatic nerve passes and goes down the back of the thigh and leg. The spasm of the piriformis muscle can compress the nerve to cause some symptoms which include pain, tingling, or numbness in the buttocks. The pain can be sever and spread down to the leg and foot. The pain can be triggered by sitting for long periods of time, climbing stairs and running.

Tried acupuncture? There were case reports showing effectiveness of acupuncture for priformis syndrome. For example, Liu JM et al observed 80 patients with piriformis syndrome. They found that after a course of acupuncture treatments, the pain threshold values were improved significantly. Another study by Chen RN and Chen YB has shown similar results that acupuncture reduced pain instantly in patients with piriformis syndrome. Shu also reported a case study. In this study there were 39 males and 36 females, at the age of 22-85; they suffered piriformis syndrome for from 3 days to 10 years. After acupuncture treatments, symptoms and signs of pain in the hip and thigh disappeared and the patient can move freely in 55 patients. Symptoms were obviously reduced, and signs were partially improved with basically normal walking and movement, but there was still pressure pain on piriformis in 24 patients. There was no effect in 2 patients. Here was a typical case in this study: A 71 year old lady had pain on her back for 10 months and the pain spread to her hip and thigh. The pain severity changed from mild to severe. There was tender point on the piriformis muscle. After 3 sessions of acupuncture treatments, the pain was reduced significnalty. Followed another 5 sessions of acupuncture, the pain was completely disappeared.

References

Liu JM et al Zhongguo Zhen Jiu (2013) 33:422-5

Chen RN and Chen YB Zhongguo Zhen Jiu (2009) 29:550-2

Shu H J Tradit Chin Med (2003) 23:38-9

Friday, 23 February 2018

It is time for facial acupuncture

After sun exposure

In summer time people are rushing to get away to go under the sun. Sun light makes one feel good and sun tan makes one look good. However exposure to the sun causes most of wrinkles and age spots on the face and skin color obtained from being in the sun speeds up skin aging. Sun exposure damages collagen and elastin fibers in the skin. When these fibers break down, the skin begins to sag, loose, and lose its ability to go back into place after stretching. Facial muscles are contracting under the sun creating wrinkles.

Increased age

With aging, skin changes including wrinkles and sagging skin are easily seen. These are not only changes in the aging skin. Also with aging, outer skin layer becomes thinner. Spots including age spot, liver spots etc may appear especially in sun-exposed areas. Skin’s strength and elasticity are reduced with the changes in the connective tissue. The blood vessels of the dermis become more fragile leading to bruising, bleeding under the skin. Skin becomes dry and itching because of less oil produced.

The most prominent characteristics by which skin aging is recognized are facial wrinkles and sagging. A study suggested that the average age at which distinct wrinkles occur at the corners of the eyes is 36.5 years old. Wrinkles appear to develop early and rapidly at the corners of the eyes compared with other facial sites. Wrinkles rapidly increase in depth and width in women 40 years or older and reach a plateau at the age of 60 years. The strongest age dependent decline in skin elasticity has been seen at the corners of the eyes. A comparison of wrinkle depth with skin elasticity in the same corners of the eyes revealed that wrinkle severity occurs in proportion to the reduced elasticity of human facial skin. Sun exposure can accelerate facial skin aging and create wrinkles and skin sagging.

Facial rejuvenation acupuncture

Is there any way to make up to the damage caused by sun exposure? Facial acupuncture is an efficient way to do so. Acupuncture on the face stimulates collagen and elastin synthesis and improves blood circulation to help skin repairing. As a result, skin becomes delicate and free of wrinkles again.

There is always doubt for those who never tried. A paper by Barrett JB was published in Aesthet Surg. In this paper the benefit of facial acupuncture included include elimination of some wrinkles and decrease in length and depth of others, decrease of facial edema, decrease of acne, improvement of facial muscle tone, improved skin texture with tighter pores, and decrease of sagging around the eyes, cheeks, chin, and neck.

References
Barrett JB Aesthet Surg J (2005) Jul-Aug 25:419-24

Thursday, 22 February 2018

To get rid of the wrinkles, acupuncture can help

Facial expression muscles contracting create lines on the face, such as smiling, frowning, and squinting and so on. These lines will disappear when the muscles are relaxed. If these muscles are constantly contracting, the wrinkles will stay. With age, skin cells change as well to contribute to the wrinkle formation. For example, with age the skin loses its ability to hold on moisture, makes less oil and has less ability to repair any damage. This all contributes to the wrinkle formation in some stages. Exposure to the sun too much damages the skin. This leads to wrinkles. Acupuncture can relax facial expression muscles and get rid of the wrinkles. Acupuncture can improve circulation on the face and help skin repairing.

To get rid of wrinkles on the forehead, acupuncture can help

The frontalis muscle (frontal belly) is the muscle on the forehead. It is a thin, quadrilateral form. There is a pair of them. There are no bony attachments. The medial fibers are going downwards and connected with the muscle fibers below which includes the Procerus; the corrugator and the orbicularis oculi. They attach to the skin of eyebrow. Its lateral fibers also mix with the latter muscle over the zygomatic process of the frontal bone. The muscle fibers move up and join the galea aponeurotica (tough fiber layer on the head).

The frontalis muscles lift eyebrows when looking up and wrinkle the forehead by pulling the scalp back. The antagonist muscle is orbicularis oculi muscle.

Acupuncture relaxes this muscle to get rid of the wrinkles on the forehead.

To get rid of crow feet wrinkles, acupuncture can help

The orbicularis oculi muscle is the ring like muscle surrounding the eye. It originates from the nasal part of the bone and goes all the way laterally surrounding the border of the orbit forming a broad and thin layer. It spread over the eyelids, temple and down to the cheek. The orbital orbicularis is the orbital portion of the muscle. It forms a complete circle without interruption. The upper part blends in with the frontalis and corrugators muscles. Palpebral orbicularis is the palpebral portion of the muscles responsible for the involuntary eye blink. Contraction of this muscle causes the eye to close or blink. The orbital portion can be consciously controlled. The antagonist of this muscle is the levator palpebrae superioris muscle. It raises the upper eyelid and exposes the front of the bulb of the eye. Contraction of the muscle also causes the wrinkles at the out corner of the eye which are called crow feet. For example, as under the sun, the skin of the forehead, temple, and cheek is drawn toward the medial angle of the orbit, and the eyelids are firmly closed. The skin is folded especially radiating from the lateral angle of the eyelids.

Acupuncture relaxes this muscle to get rid of the crow feet wrinkle.

In addition, the orbital and palpebral portions can work independent of each other, as in the furrowing of the brows by contraction of the orbital to reduce glare while keeping the eyes open by virtue of the relaxation of the palpebral.

Muscles on the cheek and wrinkles on the face

There are four muscles on the cheek: They are lying in the cheek from middle to lateral, from cheek bone to the upper lip: They are the levator labii superioris alaeque nasi, the levator labii superioris muscle, the zygomaticus minor, the zygomaticus major. They form the nasolabial groove, from the side of the nose to the upper lip. This line is deepened in expressions of sadness. These muscles draw the angle of the mouth upward and backward in smiling. These muscles’s contraction creates tension on the cheek, deep nasolabial groove, and gummy smile. Acupuncture relaxes these muscles and release the tension of the face and soften the nasolabial groove and gummy smile.

Muscles surrounding the mouth and wrinkles and sagging skin

There are a few groups of muscles around the mouth.

The orbicularis oris muscle is the muscle encircling the mouth and it lies between the skin and the mucous membranes of the lips. Contraction of this muscle closes and wrinkles the lips.

The risorius muscle draws the angle of the mouth outward when laughing.

A few muscles below the mouth draw the corner of the mouth down.

The depressor anguli oris is a muscle that originates from the mandible and inserts on angles of the mouth to depress the angle of the mouth.

The depressor labii inferioris muscle is a muscle of the face that draws the lower lip down and slightly laterally

The mentalis muscle elevates and protrudes the lower lip and wrinkles the skin of the chin.

The platysma muscle is a broad sheet of muscle originated from the the fascia covering the upper parts of the pectoralis major and deltoid going upwards to lower cheek and blend in with the muscle around the mouth. It draws the lower lip and corner of the mouth outward and downward.

Muscles lift up the upper lip. Muscles in the cheek involves in lifting upper lip. These muscles include the levator labii superioris alaeque nasi, the levator labii superioris muscle, the zygomaticus minor, the zygomaticus major. They all end in upper lip. .

The tension and contraction of these muscles wrinkle the lips, chin, create lines around the mouth and chin.

Acupuncture can release the tension of the muscles and get rid of the wrinkles.

Procerus muscles and corrugators and wrinkles on the face

The procerus muscle arises from the nasal bone and inserts into the skin over the lower part of the forehead between the two eyebrows. Its fibers blend in with those of the frontalis muscles. Its contraction pulls the skin between the eyebrows downwards creating horizontal wrinkle between the eyes.

The corrugators supercilli muscle is a small muscle at the medial end of the eyebrow. It originates from the medial end of the superciliary arch and its fibers pass upward and laterally and end at the deep surface of the skin above the middle of the orbital arch. It is beneath the frontalis muscle and above the orbicularis oculi muscle. Contraction of this muscle draws the eyebrow downward and medially producing the deep vertical wrinkles between the eyebrows. It is known as frowning muscle.

Acupuncture can relax these muscles and reduce the related wrinkles.

Wednesday, 21 February 2018

Suffer from hip pain, Iliotibial band syndrome, acupuncture can help

Suffer from hip pain, acupuncture can help

Hip pain is a common condition that can be caused by a wide variety of problems. The precise location of the hip pain can help to find out the underlying cause. Hip pain on the outside of the hip referred to the upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround the hip joint. Hip pain can also a referred pain from low back.

The muscles of the hip joint are the muscles involved in movement in the hip. There are four main groups of them.

Gluteal group

The gluteal muscles include the gluteus maximus, gluteus medius, gluteus minimus and tensor fasciae latae.

The gluteal muscles are a group of three muscles making up the buttocks: the glutes maximus, gluteus medius and the gluteus minimus. They originate from the back of the pelvic bone ilium and sacrum and end on the thigh (femur).

The largest and the most superficial of the three gluteal muscles is the gluteus maximus. It makes up a large portion of the shape and appearance of the hips. The functions of the muscles are extenson, abduction, external and internal rotation of the hip joint.

Gluteus maximus starts from the posterior gluteal line of the inner upper ilium crest, the posterior surface of the lower part of the sacrum and the side of the coccyx, aponeurosis of the erector spinae, sacrotuberous ligament and the fascia covering the gluteus medius. The gluteal maximus go downward and lateralward and insert into iliotibial band and glutealtuberosity. It extends and laterally rotates the hip and extends the trunk.

Tensor fasciae latae originates from the anterior part of the outer lip of the iliac crest from the outer surface of the anterior superior iliac spine, and part of the outer border of the notch below it, and from the deep surface of the fascia lata. It is inserted between the two layers of the iliotibial band of the fascia lata about the junction of the middle and upper thirds of the thigh.

Adductor group

This group include five muscles: the adductor brevis, adductor longus, adductor magnus, pectineus and gracilis They all originate on the pubis and insert on the medial, posterior surface of the femur, with the exception of the gracilis which inserts just below the medial condyle of the tibia.

Iliopsoas group

The iliacus and psoas major are the two muscles that belong to illiopsoas group. The psoas major muscles are the deep muscles by the sides of the spinal column. They go downwards to the pelvic bone and end at lesser trochanter of the femur. Illacus muscles start from the interior side of the pelvic bone. The psoas major and the illacus muscles join together and form the iliopsoas. These muscles connect the core and lower limbs and they flex the hip joint, bend the spine forward and laterally and raise the spine from supine position. The pain and trigger points related to iliopsoas is at the hip, the low back and upper thigh. Walking and standing upright can be painful, if there are trigger point present in these muscles.

Lateral rotator group

This group comprises six muscles including the externus and internus obturators, the piriformis, the superior and inferior gemelli and guadratus femoris. These six muscles originate at or below the acetabulum of the ilium and insert on or near the greater trochanter of the femur.

Suffer from hip pain? Acupuncture can release hip pain.

Iliotibial band syndrome, acupuncture can help

The iliotibial band (IT band) is a thick band of fibers on the outside part of the thigh. It starts from the border of the most prominent bone of the pelvis and ends into the tibia bone, to which the gluteal muscles and tensor fscia latae muscle attached. IT band coordinates muscle function and stabilize the knee during running. This band is one of the most common overused among the runners causing Iliotibial Band Syndrome (ITBS). ITBS is caused by inflamed of IT band. When it happens, knee pain is the most common symptom and can be mild to severe. Also the lateral thigh pain is associated. Pain is most severe with the heel strike of walking or running and may radiate from the knee up the leg to the hip. Pain may also be felt with knee flexing, especially going up or down steps. Swelling on the outside of the knee can be seen in some cases. Tightness of IT band is very common. MRI can show a partial thickening of the IT band, which results from inflammation. When the IT comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone. This causes inflammation. ITBS is more common in women, possibly because some women's hips tilt in a way that causes their knees to turn in. Tenderness over the site of the iliotibial band insertion at the knee joint, and specific tender points may be found over the lateral femoral condyle.

Acupuncture is effective to treat acute and chronic ITBS. It releases the pain and inflammation; reduces tightness of IT band.

Tuesday, 20 February 2018

How much acupuncture treatment is adequate?

How much acupuncture treatment is adequate? This is the most frequently asked question from patients. This is a good question, but it is difficult to get accurate answers.

The effect depends on the points chosen by the acupuncturists

If you go to see different acupuncturists, you would probably notice that different acupuncturists do acupuncture differently. Many different styles of acupuncture practice exist. Acupuncture is so individualized and there is no agreement on the optimal acupuncture treatment for any particular condition. Birkeflet O et al did a research about the agreement of acupuncture diagnosis and treatment in 30 infertile and 24 previously pregnant women. These women were examined for traditional Chinese medicine (TCM) patterns by two acupuncturists who would independently decide on the TCM patterns and the prescription of acupuncture points. They found that 39 different TCM patterns and 36 different acupuncture points were used. Poor to no agreement was found for the choice of acupuncture points. On one hand this makes acupuncture unique; on the other hand this makes it difficult to be recognised. Some research trials failed to distinguish the differences between acupuncture treatment and sham controlled treatment because of the generalization of acupuncture and inadequate treatment received. There was review by Errington-Evans N on effect of acupuncture for anxiety. They found that there was enormous variety regarding the points used, number of points used in a session, duration of sessions, frequency of treatment and duration of treatment programme; all of these makes conclusion difficult. White A et al analysed 47 acupuncture trials to evaluate the adequacy of acupuncture treatment which leads to reliable conclusion. They recommend the concept of dose of acupuncture treatment. Different doses may be required for different conditions and adequate dose is established by clinical experiences or basic research studies. They found that out of 47 reviews only 6 met the criteria of adequacy of the acupuncture treatment.

The effect also depends on the individual body’s response to the acupuncture treatment

Why different people have different sensitivity to acupuncture?

Acupuncture is used to treat variety of conditions worldwide. This is a safe intervention and effective treatment for many people, but different people have different sensitivity to acupuncture. Everyone is different, but why is that? Researchers found a scientific explanation for this. Li LM et al in China studied effect of acupuncture stimulation of Zusanli (ST36) on cerebral regional difference in healthy subjects with different acupuncture analgesia sensitivity using MRI techniques. There are 45 healthy subjects with different sensitivity to acupuncture. These people were divided into three groups: insensitive group, normal group and sensitive group. The pressure pain threshold (PPT) of the Zusanli ST 36 region before and after acupuncture stimulation at the point was assessed. And two weeks later after acupuncture stimulation, resting-state fMRI images were obtained using MRI scan to assess the cerebral regional homogeneity (ReHo). They found that there was significant increase in PPT levels in the normal and sensitive groups after acupuncture at ST36 point, while there was no change in insensitive group. In normal group there was a significant increase of ReHo in the regions including left brainstem, the right cerebellum posterior, right parahippocampa gyrus, right fusiform gyrus, left angular gyrus, temperal lobe and the left frontal lobe; and a significant decrease of ReHo in the regions including the occipital lobes and the right superior temperal gyrus after acupuncture at ST36. In sensitive group a marked increase of ReHo was found in the regions includig the left brainstem, bilateral cerebellum posterior lobes, left inferior temporal gyrus, basal ganglia, the left insular lobe, anterior cingutate, frontal lobe, inferior parietal lobule and the right supplementary motor area; decrease ReHo was found in the regions including the bilateral occipital lobes, fusiform gyrus, posterior central gyrus, the right posterior cingutate, the left temporal lobe and the left paracentral lobule. While in the insensitive group, only a significant decrease of ReHo was found in the regions including the left fusiform gyrus, left inferior temporal gyrus, bilateral postcentral gyrus, and left anterior central gyrus. So brain constitution associated needling sensation may be an important factor for acupuncture analgesia effect. Brain react differently in different people which is responsible for different sensitivity to acupuncture.

Acupuncture response is not associated with needle sensations

Needles stimulate nerves at acupuncture points and have been used to treat illness. During the application of needling, people are experiencing different sensations. There was a study that investigated the sensations of the transcutaneous electrical nerve stimulation over acupuncture points (acu-TENS) and the changes of the sensations related to changes in autonomic nervous system activity. There were 36 healthy subjects who were in three groups experimental group which was given acu-TENS on right LI4 and LI11points, control group which was given acu-TENS to bilateral kneecaps, or placebo group (sham acupuncture on right LI4 and LI11 points). There were significantly physiological changes in experimental group and control groups which were given acupuncture at different sites. There was no physiological change in placebo group which was not given active acupuncture. There was significant difference between the groups. There was no association between sensation intensity and physiological responses in any groups. From this study, we can see that even if people experience different sensation during acupuncture, they all have physiological responses to the needling.

Acupuncture dosage comprise two components: the numbers of points selected in a single treatment and total number of the treatments that patients received. It is possible for patients to have beneficial effects from a couple of treatments together with a couple of points selected for stimulation, but this is rather more exceptional than general. The nature and duration of the condition is a very significant determining factor that how many treatments are effective. Acute conditions of short duration in younger patients are most likely to respond to small dosage of acupuncture. On the contrary, chronic conditions of long term duration need larger dosages of acupuncture.

How many sessions of acupuncture are needed for lower back pain?

During the past 40 years, acupuncture, a therapeutic technique of oriental medicine, has become more and more popular, evolving into one of the most utilized forms of complementary integrative medicine interventions in the United States. More than 10 million acupuncture treatments are administered annually in the United States alone. Its rise in popularity, particularly in the West, can be attributed in part to its effectiveness for pain relief and in part to the fact that scientific studies have begun to prove its efficacy.

Non-specific low back pain is the most common application of acupuncture. It is listed in NICE guidelines in the UK. A course of acupuncture needling comprising up to a maximum of 10 sessions may be offered for non specific back pain over a period of up to 12 weeks. In some cases with long history of lower back pain, much more sessions are needed to completely live in pain free life.

What clinical evidences used for NICE guidalines for low back pain treatment with acupuncture?

Five studies were included to support the application of acupuncture: 4 RCTs and 1 systematic review on acupuncture. In these trials patients received 6 x 30min over 6 weeks in one, 20 x 30min over 12 weeks in another, 8 x 30min over 4 weeks in the third trial and 12 x 30min (3 times a week) in the fourth one.

For example, One randomised controlled trial recruited patients through their GPs (a total of 16 GP practices were involved which included 39 GPs) (Thomas, K. J., MacPherson, H., Ratcliffe, J. et al , 2005). Patients included had to be between age 18-65 and had nonspecific low back pain for 4-52 weeks. They also had to have been assessed by their GP to check that primary care management was suitable. A total of 289 patients were identified and approached to join the study, of these 241 accepted and met the criteria. 160 were allocated to receive acupuncture and 81 were allocated to receive usual care, however, 1 patient from each group dropped out, 159 actually received acupuncture (146 were followed up at 3 months, 147 at 12 months and 123 and 24 months) and 80 received usual care (71 were followed up at 3 months, 68 at 12 months and 59 and 24 months). Participants in the acupuncture group received 10 individualised acupuncture treatments over 3 months from one of 6 qualified acupuncturists. The usual care group received 10 NHS treatment sessions according the GPs assessment of the patients clinical need; this was a mixture of interventions, including drugs and recommended back exercises. Half the group also received physiotherapy or manipulation during the first three months. Both groups also received adjunctive care which included massage and advice on diet, rest and exercise. The results showed that acupuncture does give a greater long-term benefit compared to usual care. Acupuncture was significantly more effective in reducing pain at 24 months than usual care. The study also showed that traditional acupuncture care delivered in a primary care setting was safe and acceptable to patients with non-specific low back pain.

Can the effect of acupuncture stay?

People who have acupuncture treatment always like to know that how long the effect of acupuncture stays. A new research has shown that this effect can last very long time. This research used a large individual patient dataset from high quality randomised trials of acupuncture for chronic pain. The available individual patient dataset included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck and shoulder), osteoarthritis of the knee and headache/migraine. In trials comparing a course of acupuncture to no acupuncture control (wait-list, usual care, etc), the result suggests that about 90% of the benefit of acupuncture relative to controls would be sustained at 12 months. The effects of a course of acupuncture treatment for patients with chronic pain do not appear to decrease importantly over 12 months. Longer term outcomes of acupuncture need further research to measure.


References

White A et al Acupunct Med (2008) 26:111-20

Errington-Evans N CNS Neurosci Ther (2012) 18:277-84

Birkeflet O et al Acupunct Med (2011) 29:51-7

Anderson B and Rosenthal L. Complement Ther Clin Pract (2013) 19:1-5

http://www.nice.org.uk/guidance/cg88/resources/cg88-low-back-pain-full-guideline3

Shi Y et al Evid Based Complement Alternat Med (2015) 2015:210120. doi: 10.1155/2015/210120. Epub 2015 Jun 16.

Guo L et al Biomed Mater Eng 2014 24 1063-9 doi:10.3233/BME-130904

Yu DT et al Acupunct Med 2013 Nov 1.doi10.1136/acupmed-2013-010428

Li LM et al Zhen Ci Yan Jiu (2013) 38:306-13

Monday, 19 February 2018

Acupuncture beyond Ying and Yang, Qi and meridians. Acupuncture alters brain activities

What do you know about the brain?

The brain is the central control organ in the body and is protected by the skull bones of the head. Though the brain function is not fully understood, it is known that it controls the activities of the body including processing, integrating and coordinating the information it receives from the sense organs and takes action accordingly, such as send signal to the body to react. Sensory nervous system is involved in receiving and processing sensory information, such as the skin is a sensory organ and senses touch, pressure, pain vibration and temperature. Motor system controls muscle function and body movement. Emotion and cognition are a part of the brain function. The brain is a big energy consumer and it receives 20% of total body oxygen and energy consumption and 25% of total body glucose utilization. The brain mostly uses glucose for energy, and deprivation of glucose causes loss of consciousness. Sleep can reduce brain oxygen and energy consumption and help restore brain energy supply.

Acupuncture has been accepted globally. Acupuncture stimulates the brain releasing endorphins which is essential in acupuncture analgesic effect.

Acupuncture altered brain activity and releases low back pain

Functional magnetic resonance imaging (fMRI) is a new technology that is used to study brain. Pain stimulus could induce extensive activations in the limbic system [anterior cingulated cortex (ACC), periaqueductal gray (PAG), prefrontal cortex] and somatosensory system (thalamus, primary somatosensory cortex (S1), secondary somatosensory cortex (S2), posterior parietal cortices, insula, supplementary motor area, striatum, and cerebellum) areas as well as the pain matrix (S1, S2, insular, frontal lobe and parietal lobe). The pain matrix showed a strong relationship with pain, which plays an important role in the conduction and communication of pain. This can be seen changes on fMRI. Low back pain (LBP) is one of the most common clinical syndromes and affects 80–85% of people at some point in their life. Most LBP is nonspecific which does not have a definitive cause.

In a recent study, an experimental acute LBP model and fMRI was used to study the neural mechanisms of acupuncture analgesia. All LBP subjects first underwent two resting state fMRI scans at baseline and during a painful episode and then underwent two additional fMRI scans, once during acupuncture stimulation (ACUP) and once during sham stimulation, at the BL40 acupoint. They found that acupuncture induced more deactivations and fewer activations in the brain. Acupuncture can alter brain activity and this contributes to mechanism of analgesia of acupuncture to LBP.

Acupuncture altered brain network function

There was a study about acupuncture stimulating brain functional network. This study was based on sample entropy of electroencephalograph (EEG) under magnetic stimulation at PC6 acupoint which is on your forearm and near your wrist. Magnetic stimulation at acupuncture point is a new method for studying the theory of acupuncture. It helps to investigate brain network and understand how brain works. This study was trying to provide evidence for the mechanism of acupuncture which is a part of traditional Chinese medicine. The magnetic stimulation of PC6 acupoint was performed and EEG signals were recorded. By analysing the results they found the brain network topology was changed after acupuncture at PC6 acupoint, the connection of the network is increased, the efficiency of information transmission is improved and the small-world proper is strengthened through stimulation the PC6 acupoint.

Acupuncture at different acupoints may alter brain activities in different area.

Recent acupuncture research study the effect of acupuncture on brain activity using functional magnetic resonance imaging (MRI). Wang W et al used electro-acupuncture to stimulate the cerebral activated areas. They compared the altered activation areas of the acupuncture point LI4 on the right hand with some non acupuncture points on the face. There were 6 people in the LI4 group and 5 in the facial nonacupoint group. MRI ws performed before and after acupuncture. They found that activation or deactivation was found the multiple cerebral areas in both groups. In the LI4 group, activation was found in the areas including medline nuclear group thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; deactivation areas include bilateral hippocampus, parahippocampal gyrus, amygdale body area, rostral side/audal side of ingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, the activation and deactivation areas were different from LI4. They concluded that the deactivation area by LI4 was a similar area distribution of pain area in the brain and closely related to the anatomic structure of limbic system which is possibly related to pain relief. Activation of left anterior gyrus by LI4 represents the movement of facial muscles and activation of cerebellum is possibly related to effect of LI4 in treating facial palsy and facial muscle spasm.

Fang JL et al compared the effects of electroacupuncture at acupoints ST36 and CV4 using MRI in 21 healthy volunteers. The similar deactivation effects in the anterior cingulated and medial prefrontal cortices were induced by acupuncture at ST36 or CV4 acupoint. The functional brain network was significantly changed after acupuncture. The instant postacupuncture effects were mainly found in the ventral medial prefrontal cortex and ventral anterior cingulated cortex in the limbic-paralimbic-neocortical network and the effects were stronger at ST36 than that CV4.

Facial acupuncture increases brain blood flow

A new research studies the effect of facial acupuncture on brain blood flow. In this study brain blood flow and heart rate were measured before and after acupuncture treatment. The result has shown that brain blood flow was significantly greater in the brain more specifically in the prefrontal cortex in the acupuncture group. Heart rate was reduced.

References

Han js Neurosci (2004) 36:258-61

Kim S et al Evid Based Complement Alternat Med (2016) 9874207. doi: 10.1155/2016/9874207. Epub 2016 Jun 14.

Li XM et al Zhen Ci Yan Jiu (2013) 38:297-300

Wang W et al Chin J Integr Med (2007) 13:10-6

Fang JL et al Zhen Ci Yan Jiu (2012) 37:46-52

Yan G et al Evid Based Complement Alternat Med 2013: 2013:429703

Guo L et al Biomed Mater Eng. 2013 23(0):S1115-S1121

Hsiu H et al Microvasc Res (2013) Jun 24

An Y et al Med Devices (Aucl) (2014) 7:17-21

Waki H et al Acupunct Med (2017) Aug 1. pii: acupmed-2016-011247. doi: 10.1136/acupmed-2016-011247. [Epub ahead of print]

Sunday, 18 February 2018

Acupuncture beyond Ying and Yang, Qi and meridians. Acupuncture increases blood circulation.

One of the mechanisms of acupuncture effect is increasing blood circulation

Acupuncture is originated from China 2500 thousand years ago and the theory is based on the meridians and energy (Qi) flow through the body. Recent scientific research on acupuncture provided evidence of the mechanisms of acupuncture. In 1950s Chinese government began to invest in research on acupuncture. The interest in acupuncture is increased not only for medical professionals all over the world, but also for researchers. They would like to know how the needles work. Since 70’s, acupuncture becomes more and more popular in US and European countries. In 1971, a report in the New York Times inspired American doctors to China to study analgesia effect of acupuncture. In 1990s there was a remarkable increase in acupuncture research. The publications of acupuncture research continue to increase. Acupuncture has received an enormous boost in the last few years. In 50 years the achievements of acupuncture research is extraordinary. The National Institute of Health consensus conference in 1997 recognised acupuncture (and by extension Traditional Chinese Medicine) as a legitimate branch of scientific medicine. Acupuncture seems very likely to be accepted and incorporated into Western medicine. Acupuncture becomes popular than ever.

Acupuncture increases local blood flow.

Regulating blood flow both centrally and peripherally are important in contributing mechanism of acupuncture.

Recently a study investigated the changes of local blood flow in response to acupuncture stimulation. In this study eight random controlled trials involved 205 participants were included. In most of the selected studies, acupuncture was performed at points located distal to the elbows and knees such as LI4, ST36, and PC6, whereas one study simultaneously used several acupoints on the extremities. In one study the GB21 acupoint on the posterior region of the shoulder was stimulated with an acupuncture needle. All eight studies selected for the present review observed acupuncture-induced changes in blood flow in the skin, whereas three studies observed changes in blood flow in the muscle. Four reported significant increases in blood flow following acupuncture compared with control, whereas one other study observed reductions in microcirculation immediately after acupuncture needling. The studies that assessed patients with either fibromyalgia or trapezius myalgia found significant increases in blood flow in the skin and muscle. Additionally, the degree and duration of increases in microcirculation varied depending on the condition of the subjects and the manipulation technique.

Another study about effect of acupuncture in peripheral tissue perfusion has been done on two healthy subjects. Acupuncture was performed on two acupoints (LI4 and SI3) which are in the hands three treatments within 1 week. Local blood perfusion on the hands was measured before and after acupuncture treatments. The result has shown that the blood perfusion rates of the hands were noticeably increased immediately after acupuncture at the first treatment in both cases. At the third treatment the increased blood perfusion was seen in one case, not the other one.

Hsiu H et al studied the microcirculatory blood flow response following acupuncture stimulation using beat to beat laser Doppler flowmetry (LDF) which could provides important information on the circulatory regulatory activities. Changes in the arterial pulse transmission or the opening condition of arteriolar opening might change the fluctuation pattern of the microcirculatory blood supply. They measured LDF signals to study the microcirculatory blood flow response at the needled site particularly at Hegu LI4 acupuncture point) after acupuncture stimulation. They selected 29 male healthy volunteers to measure microcirculatory blood flow after acupuncture stimulation. The measurements were at three times: before acupuncture stimulation, immediately after acupuncture stimulation and about 1 hour after acupuncture stimulation. They found that acupuncture not only improves local blood supply and but also regulates microciculatory blood flow by altering microcirculatory blood supply parameters. Their findings could help to identify the mechanism underlying the effects of acupuncture stimulation.

Acupuncture increases blood perfusion around the acupoints.

Researchers are using modern techniques to study the mechanisms of acupuncture to explain the phenomenon from modern science aspect. Li XM et al studied influence of different acupuncture manipulations at Zusanli (ST36) on skin microcirculation blood perfusion in healthy subjects. They measured local blood perfusion at ST 36 acupuncture points after acupuncture stimulation at 1min, 5 min, 10, 15min, 20 min, 25 min and 30 min. They also compared blood perfusion levels of microcirculation around the acupoints among the different manipulation techniques. They found that microcirculation around the selected acupoint was significantly increased from 1-10 min following simple needle insertion, from 5 -30 min after uniform reinforcing-reducing manipulation, from 1-30 min after reinforcing manipulation, and from 1-25 min following reducing manipulation respectively. The reinforcing manipulation was superior to other techniques. From this study we can see acupuncture increases local blood perfusion in normal subjects. The reinforcing manipulation had better effect.

Acupuncture dilates blood vessels

Research has shown that there were more of nerve fibers/trunks, blood vessels, hair follicles, and sweat glands as well as density of the gap junction in the acupuncture points. Recent research has shown that nitric oxide (NO) level is elevated in the acupoints and is associated with an enhanced expression of NO synthase endowed with transient receptor potential vanilloid type-1. This suggests that acupuncture induces NO-mediated vasodilatation, which increases local blood flow and allows for a flush of algesic or sensitizing substances, leading to pain relief.

Microcirculation and water retention

Microcirculation is the blood flow in the small blood vessels which spread out in organ tissues. These blood vessels include arterioles, capillaries and venules. The main functions of the microcirculation are the delivery of oxygen and nutrients to the tissues and the removal of CO2 from the tissues. It also regulates blood flow and tissue perfusion. Microcirculation responds to inflammation which is related to swelling. Capillaries are a sector of the microcirculation where gas and fluid exchange take place. About 7% of the blood in the capillaries is continuously exchanges with the fluid outside of the blood vessels. If there is problem with microcirculation, such as compression of the part of the body, the microcirculation is likely to be disturbed and water retention occurs. Acupuncture stimulates the nerve ending and relaxes blood vessels and skeletal muscles, it improves microcirculation and relieves water retention.

Acupuncture helps lymphatic circulation

The lymphatic system is a part of the circulatory system and it also involves immune function of the body as a part of the immune system. It consists of a network of lymphatic vessels which carries lymph-a clear fluid in the body which formed from tissue fluids known as interstitial fluid from the tissues. It carries large amount of lymphocytes and other white blood cells which play a role in the immune function. Its main function is to help tissue fluid circulation. The lymph capillaries absorb the interstitial fluid from the tissues and lymph vessels conduct the fluids to the blood vessels. As a part of the defence system, it also contains waste products and cellular debris together with bacteria and proteins etc which are toxic to the body.

The lymphatic system is responsible for maintaining the balance of the body fluids. Its network of capillaries and collecting lymphatic vessels work to efficiently drain and transport the fluid, along with proteins and antigens, back to the circulatory system. The lymphatic system is not closed system and the vessel walls are not as strong as blood vessels. If the circulation is blocked for various reasons, e.g. there is tension on the body, the transportation is disturbed and the fluids cannot be drained properly causing water retention. Also the toxins could remain in the body longer than they should be causing toxic to the body.

Acupuncture can help lymphatic circulation, improve water retention and help get rid of toxins of the body.

References

Kim S et al Evid Based Complement Alternat Med (2016) 9874207. doi: 10.1155/2016/9874207. Epub 2016 Jun 14.

Li XM et al Zhen Ci Yan Jiu (2013) 38:297-300

Wang W et al Chin J Integr Med (2007) 13:10-6

Fang JL et al Zhen Ci Yan Jiu (2012) 37:46-52

Yan G et al Evid Based Complement Alternat Med 2013: 2013:429703

Guo L et al Biomed Mater Eng. 2013 23(0):S1115-S1121

Hsiu H et al Microvasc Res (2013) Jun 24

An Y et al Med Devices (Aucl) (2014) 7:17-21

Ma SX Chin JIntegr Med (2017) 23:812-815

Saturday, 17 February 2018

Suffer from acne, acupuncture can help

What is acne? What causes acne? Acne is a disorder that occurs in the hair follicles in the face, chest and back. This is known as black heads, white heads, pimples, pustules and cysts on the skin. It is a common condition in teenagers and younger adults. Acnes can be on and off for a few years and disappear by mid 20s. Acne can have a big impact on psychological well-being.

Acne is thought triggered by hormone imbalance. Too much androgen secretion is the major trigger. Changing of hormone levels makes glands in the skin produce excessive amounts of an oily substance- sebum. Increased male hormone stimulates the oil gland attached to the hair follicles-small holes in the skin. Increased male hormone alters the oil production which causes the follicular pores clogged and hair follicles enlarged. Bacteria can access to the deeper layers of the skin through these follicles causing inflammation. Inflammation closed to the skin surface causing a pustule; inflammation in deeper layer leads to pimple and a cyst. And sometimes scar can form from abnormal wound healing following inflammatory damage. White head is caused by oil clogging to the skin surface while black head is caused by oxidized oil or accumulated melanin pigment. The factors that don’t cause acne include heredity, food, dirt, or stress.

From Traditional Chinese Medicine point of view, there are several factors causing acne: heat and damp is accumulated in lung and stomach meridians causing skin blockage. Spleen dysfunction makes food transportation, digestion and transformation abnormal and produces more heat. This also makes obstruction in the skin.

Acne has great impact on quality of life

Acne is a very common disease in adolescents. Acne has great impact on quality of life. A study involved in 600 high school students investigated this aspect. There were 303 girls and 260 boys aged between 13 and 19. 83% of them was self reported acne. 40% was mild, 36% was moderate and 6.5% severe. There was a direct link between subjective, severety of acne and symptoms of anxiety, depression and lower self-esteem.

Stress makes acne worse

Acne is a very common disease in adolescents. Psychological stress has also been identified amongst factors that worsen acne. Recently a study involved in 160 students was carried out to investigate the association between acne severity and stress levels as well as the mechanism for this. They demonstrated a statistically significant positive correlation between increased self-reported stress and increased severity of acne; there was no correlation between increased stress and sebum levels. They explained that increased acne severity may result not from increased sebum secretion and excretion but from changes in neuropeptide secretion and sebum lipid composition. Other studies have shown that stress may affect the production of inflammatory mediators and specific lipids involved in inflammation by the sebaceous glands rather than the quantity of sebum. Acupuncture reduces inflammation and is used to treat acne effectively.

Do you know acupuncture helps reduce acne? Acupuncture may help with treat acne by reducing inflammation from promoting release of anti-inflammatory factors, modulating immune cell activities including natural killer cell activities and improving local blood circulation.

There were many case reports that acupuncture can treat acne. For example, Son BK et al studied the effect of acupuncture on acne. They found that 12 sessions of acupuncture over 6 weeks reduced inflammatory lesion counts and quality of life in patients with acne. Recently Li B et al studied the current situation in research to evaluate the therapeutic effect and safety for clinical randomized and controlled trials of treatment of acne with acupuncture and moxibustion in China. They analysed 17 papers involving 1613 cases with acne and they found that acupuncture and moxibustion is safe and effective for treatment of acne and it is possibly better than routine western medicine.

Here is an example of a case. Lily is 30 year old. She had acne on her face on and off for 6 months. There are many newly formed pimples, cysts and some of them are infected by bacteria forming pustules. Scars can be seen on her face. She also had mouth odour and constipation. She heard from a friend that acupuncture may help her and wanted to try acupuncture. After a course of acupuncture, the acne symptoms were improved significantly. Also mouth odour was improved and there was no constipation at all. After 3 courses of treatment, acne was cured.

Acne treatments can take months to have some effects. Acupuncture is used to treat acne efficiently. There was a study using acupuncture to treat acne. In this study the criteria of participant selection is that they (older than 13 year old) had more than 10 papules and less than 10 nodules on the face and had acne for more than 3 months (chronic stage). They did not use retinoids, antibodies or herbal medicine for acne before. They did not have chemical peeling, intense pulsed light or laser treatment within the past month. After 6 week treatments, there was a significant reduction in the inflammatory acne lesion counts.

They suggested that acupuncture treatment of moderate acne vulgaris was associated with reduction of inflammatory lesions and improvement of the quality of life. The significant effects can be obtained in 6 weeks.

Acupuncture has better effect for treating acne than oxycycline

A study has compared the efficacy differences between acupuncture and oxycycline tablets for the treatment of moderate to severe acne vulgaris. Sixty cases of moderate to severe acne vulgaris were involved in this study and they were divided into acupuncture group and medication group with oxycycline treatment). The treatment duration was 20 days. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups. The results have shown that the curative rate was 69.0% (20/29) in the acupuncture group, which was significantly higher than 40.0% (12/30) in the medication group. The fading time of each type of skin damage in the acupuncture group was shorter than that in the medication group. Recurrence rate was similar between two groups.

Study has shown that acne patients used antibiotics too long

Acne is not a life threatening condition, however it affects patients quality of life so much. The spots take their happiness away. Women cannot go out without covering the spots up first. They often use over-the-counter creams, prescription gels, and finally: oral antibiotics. Antibiotics was used too long and increased the antibiotic resistance makes antibiotics loss their effects. A research study at a dermatology practice in an academic medical center has shown that the average duration of antibiotic use was 331.3 days. In all, 21 patients (15.3%) were prescribed antibiotics for 3 months or less, 88 patients (64.2%) for 6 months or more, and 46 patients (33.6%) for 1 year or longer. Patients treated only at the study site had a mean duration of antibiotic treatment of 283.1 days whereas patients who also received antibiotics from another institution had a mean duration of 380.2 days.

References

Li B et al Zhongguo Zhen Jiu (2009) 29:247-51

Son BK et al Acupunct Med (2010) 28:126-9

Gong and Qian J Tradit Chin Med )2007) 27:255-7

Gil Yosipovitch et al Acta Derm Venereol 2007; 87: 135–139.

Jiang M et al Zhongguo Zhen Jiu (2014) 34:663-6

Bodo C Melnik, Clinical, Cosmetic and Investigational Dermatology 2015:8 371–388

Caperton et al J Clin Aesthet Dermatol (2014) 7:19-23

Naqler AR et al J Am Acad Dermatol (2015) Oct 29. pii: S0190-9622(15)02254-9. doi: 10.1016/j.jaad.2015.09.046

Son et al Acupunct Med (2010) 28:126-9

Friday, 16 February 2018

Suffer from thigh pain? acupuncture can help

Thigh is the area between the hip and the knee. There is only single bone in the thigh called fumar, but there are a few groups of muscles in the thigh. Anterior group include pectineus, satorius and quadriceps (rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Posterior group includes hamstring muscles (semimembranosus, semitendinosus and beceps femoris. Medial group include adductor magnus, adductor longus and adductor brevis and gracilis. The lateral is tensor fasciae which continues with iliotibial tract. The iliotibial tract, also known as the iliotibial band, is a thick strip of connective tissue connecting several muscles in the lateral thigh. It arises at its proximal end from the tendons of the tensor fasciae latae and gluteus maximus muscles and then travels along the lateral side of the thigh and across the knee joint, inserting on the lateral epicondyle of the tibia

Thigh pain

Thigh pain is a very common complaint. It presents constant aching, or throbbing pain sometimes cramping in the thighs or it could be on and off, but the pain does not go away. It could be one thigh or both thighs. This pain could radiate down to the knees, legs and feet or up to the hips. The pain can be felt when sitting and lying down. It could cause trouble walking long distance. Thigh pain comes up or becomes worse after running.

The pain on the outside of your hip, upper thigh, outer buttock or outside of knee is usually caused by problems with muscles, ligaments, tendons and other soft tissues. The iliotibial band inflammation is one of the common causes of thigh pain. Iliotibial band provides stability to the knee and hip and helps prevent dislocation of those joints. The band may tighten and rub across the hipbone or the outer part of the knee. Each time the knee is bent or the hip flexed, the band rubs against bone. This is particularly common in runners, cyclists, and people who participate in other aerobic activities. Also the inflammation stimulates muscle contracting and this contributing to the pain. Acupuncture is very effective to reduce the inflammation and relax the muscles to release the pain.

Iliotibial band syndrome

Iliotibial band is one of the most common overused among the runners causing Iliotibial Band Syndrome (ITBS). ITBS is caused by inflamed of IT band. When it happens, knee pain is the most common symptom and can be mild to severe. Also the lateral thigh pain is associated. Pain is most severe with the heel strike of walking or running and may radiate from the knee up the leg to the hip. Pain may also be felt with knee flexing, especially going up or down steps. Swelling on the outside of the knee can be seen in some cases. Tightness of IT band is very common. MRI can show a partial thickening of the IT band, which results from inflammation. When the IT comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone. This causes inflammation. ITBS is more common in women, possibly because some women's hips tilt in a way that causes their knees to turn in. Tenderness over the site of the iliotibial band insertion at the knee joint, and specific tender points may be found over the lateral femoral condyle.

Acupuncture is effective to treat acute and chronic ITBS. It releases the pain and inflammation; reduces tightness of IT band.


References
Aigner N et al Schmerz (1997) 11:113-5
Alexander RE Acupunct (2013) 31:435-9

Thursday, 15 February 2018

Suffer from hay fever? Acupuncture can help

Hay fever also known as allergic rhinitis is a very common condition in UK affecting over 30% populations. It is caused by allergy. The common allergen is pollen. House dust mites and pet skin flakes are also common allergic antigens. When these tiny particles come into contact with the cells that line your mouth, nose, eyes and throat, they irritate them and trigger an allergic reaction. This makes them inflamed. This is caused by overreacting of the immune system which releases chemical substances causing all the symptoms such as itching eyes and a running nose. The symptoms of allergic rhinitis are like common cold, such as sneezing, running or blocked nose, headache, itchy, red or watery eyes, an itchy throat, mouth, nose and ears, coughing, headache, tiredness, disturbance of sleep etc. These symptoms could be irritating and affecting people’s quality of life. Nasal sprays and antiallergic medicines such as antihistamine drugs and steroids are useful, but not suitable for long term use. Acupuncture is effective to improve patient symptoms and overall health.

A randomized trial study by Brinkhaus B. etc (2008) provided evidence for effectiveness of acupuncture treatment for allergic rhinitis by assessing patient quality of life. They compared acupuncture and routine care for patients with allergic rhinitis. 5237 patients average aged 40 year old were included in this study. The patients were allocated in to two groups: acupuncture group and control group. 15 acupuncture sessions during a period of 3 months were given to the patients in acupuncture group and no acupuncture received for those in control group. Quality of life survey was evaluated after 3 and 6 months. Results showed that quality of life was improved better in acupuncture group both at 3 and 6 months. They concluded that acupuncture played a part in treatment for allergic rhinitis and patient benefit.

Shiue HS etc was the first group using cDNA microarray analysis to study effect of acupuncture on blood gene expression for inducing immune and inflammatory response in patients with allergic rhinitis. They compared the gene expression in blood before and after acupuncture treatment. They studied 18 patients with allergic rhinitis. 8 sessions of acupuncture was given over 4 weeks and the blood was taken at each visit for gene expression analysis. Quality of life was also assessed using quality of life questionnaire. They found that gene expression in these patients was significantly decreased at 2 hours, 24 hours and 4 weeks after acupuncture treatment. This means acupuncture altered immune system function. The allergic rhinitis symptoms were also improved. They suggested that acupuncture is effective in treating allergic rhinitis by improving patient immune defence system.

Acupuncture is as effective as nasal spray for hay fever

Recently a study evaluated the effect and safety of acupuncture therapy on patients with moderate to severe allergic rhinitis. 76 patients with allergic rhinitis participated the study. The acupuncture group received 8-week acupuncture therapy, and the medication group received budesonide nasal spray with cetirizine tablets for 8 weeks. The clinical symptoms and signs were analyzed before treatment, at 4 and 8 weeks after the start of treatment, and at 12 weeks after the end of treatment. Furthermore, the clinical efficacy and safety indicators were compared between the two groups. The result has shown that the scores of each clinical symptom and sign, including sneezing, runny nose, stuffy nose, nasal itching, and turbinate edema, and the total scores decreased over time in both groups. All the tests including blood routine, urine routine, aspartate transaminase, alanine aminotransferase, urea nitrogen and creatinine were all in the normal reference ranges during the treatment in the acupuncture group. This study suggested that acupuncture therapy is as good as the medication treatment for patients with moderate to severe allergic rhinitis, and it is safe with no severe adverse effects.

Research has shown that acupuncture helps with hay fever by regulating immune response

Acupuncture is used to effectively treat persistent allergic rhinitis, which is suggested by clinical evidence, but the physiologic basis of these improvements is not well understood. Recent research adults investigated possible modulation of mucosal immune responses. A total of 151 individuals participated to the study. Acupuncture was applied for twice-weekly treatments for 8 weeks. Various cytokines, neurotrophins, proinflammatory neuropeptides, and immunoglobulins were measured in saliva or plasma from baseline to 4-week follow-up. Statistically significant reduction in allergen specific IgE for house dust mite was seen in the acupuncture group, Statistically significant down-regulation was also seen in proinflammatory neuropeptide substance P (SP) 18 to 24 hours after the first treatment. Nasal obstruction, nasal itch, sneezing, runny nose, eye itch, and unrefreshed sleep improved significantly in the acupuncture group and continued to improve up to 4-week follow-up.

This study suggested that acupuncture modulated mucosal immune response in the upper airway in adults with persistent allergic rhinitis. This modulation appears to be associated with down-regulation of allergen specific IgE for house dust mite. Improvements in nasal itch, eye itch, and sneezing after acupuncture are suggestive of down-regulation of transient receptor potential vanilloid 1.

References

Yu L etc. Zhongguo Zhen Jiu. (2010) 30:787-92.

Tan C etc. Zhen Ci Yan Jiu. (2011) 36:302-6.

Yang QY etc Clin Rev Allergy Immunol. 2012 Jun 3.Brinkhaus B etc Ann Allergy Asthma Immunol. (2008)101:535-43.

Shiue HS eetc J Altern Complement Med. (2008) 14:689-98.

Reinhold T et al Ann Allergy Asthma Immunol. (2013) 111:56-63

Chen YD et al Chin J Integr Med 2016 Mar 21. [Epub ahead of print]

McDonald JL et al (2016) Ann Allergy Asthma Immunol May 3. pii: S1081-1206(16)30126-0. doi:

Tuesday, 13 February 2018

Suffer from Parkinson’s disease, acupuncture can help

1 in 500 people are affected by Parkinson’s disease (PD), a condition caused by loss of nerve cells in the part of the brain. It is the second most common neurodegenerative disease after Alzheimer’s disease. These cells produce a chemical called dopamine. Because of the loss, dopamine production was reduced leading to three main symptoms of the condition, tremor, muscle stiffness and physical slow movement. Numerous nonmotor symptoms including neuropsychiatric disturbance, abnormal sensation, sleep disorders, and autonomic dysfunction are also present. Complementary and alternative medicine (CAM) plays an important part in the treatment of the condition.

Lokk J and Nilsson M studied use of CAM in patients with Parkinson’s disease at a neurological outpatient clinic Sweden. They studied the frequency, type and factors associated with the use of CAM in all patients with PD 421 in the outpatient clinic. The patients received questionnaire. 172 men and 153 women responded the questionnaire. 30% and 39% women used CAM and acupuncture usage was in the highest frequency.

Acupuncture, is used to treat PD in China. Although the therapeutic effect of acupuncture in PD is under debate, increasing evidence shows that it can alleviate motor symptoms and nonmotor symptoms, such as sleep and pain and mood disturbances and improve the quality of life in PD patients.

The effectiveness of acupuncture in treating PD was observed in research. Recently researchers used the magnetic resonance imaging (MRI) to investigate the effect of acupuncture stimulation in brain activity. They found that acupuncture stimulation in aupoint GB34 increased neural responses in regions including substantia nigra, caudate, thalamus and putamen which are the impaired regions caused by PD.

There was a study on effectiveness of acupuncture on twenty patients with PD with mean age 68 years disease duration 8.5 years. On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety. There were no adverse effects. Acupuncture therapy is safe and well tolerated in PD patients.

Recently Zeng et al have shown that acupuncture stimulation in Parkinson'smodels had generated valuable mechanistic insight of Parkinson's and showed that acupuncture treatment is a neuroprotective therapy that increase the release of various neuroprotective agents such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and cyclophilin A. In addition, acupuncture therapy slows cell death process and attenuates oxidative stress to dopaminergic neurons in the substantia nigra. Further, acupuncture therapy modulates neuronal activity of the basal ganglia output structures. These results suggest that early application of acupuncture therapy to Parkinson's patients may be helpful for the best efficacy of acupuncture treatment. It is hopeful that translation of achievement in acupuncture research in Parkinson's models will maximize the potentials of acupuncture treatment.

Recently more studies were published showing that acupuncture activates brain in patients with Parkinson’s disease and patients with mild cognitive impairment. For example, magnetic resonance imaging (MRI) is a new technique that helps researcher and clinicians understand brain function. Using this technique, we can see how acupuncture stimulates the brain and alters brain function. There was a study in which brain activation in response to acupuncture in a group of 12 patients with Parkinson’s disease was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment. The result has shown that Acupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.

Another study investigated whether acupuncture at Taixi (KI3) acupoint in elderly patients with mild cognitive impairment can activate neurons in some brain regions. Results showed that 20 brain regions were activated in participants, including the bilateral anterior cingulate gyrus (Brodmann areas [BA] 32, 24), left medial frontal cortex (BA 9, 10, 11), left cuneus (BA 19), left middle frontal gyrus (BA 11), left lingual gyrus (BA 18), right medial frontal gyrus (BA 11), bilateral inferior frontal gyrus (BA 47), left superior frontal gyrus (BA11), right cuneus (BA 19, 18), right superior temporal gyrus (BA 38), left subcallosal gyrus (BA 47), bilateral precuneus (BA 19), right medial frontal gyrus (BA 10), right superior frontal (BA 11), left cingulate gyrus (BA 32), left precentral gyrus (BA 6), and right fusiform gyrus (BA 19).

More recently acupuncture as an additional treatment with drugs was studied. In this study, patients with PD were allocated into two groups, acupuncture plus drug group and drug only group. The result has shown that tremor, rigidity, and bradykinesia, are all significantly decreased in acupuncture group. Sleep quality and depression were also significantly improved in acupuncture group.

A group of experiments from animal models of PD indicate that acupuncture is effective in reducing oxidative stress , decreasing neuroinflammation with a major feature of microglial activation, stimulating release of neurotrophic factors, and regulating homeostasis of the network between cortex and striatum.

Acupuncture reduces oxidative stress of the cells

Oxidative stress is a sign of the imbalance between the production of reactive oxygen species and detoxification of the antioxidant system. As a result, this causes cell function damage and diseases. Oxidative stress is a critical feature in the pathological process of various diseases such as vascular dementia, Alzheimer’s disease and Parkinson’s disease. Recent research from last 5 years has shown that acupuncture treatment could decrease oxidative stress of the body and increase antioxidant system ability. Because of this acupuncture could improve memory impairment in vascular dementia and Alzerimer’s disease and reduce brain damage. Increased oxidative stress and depletion of the antioxidant are important mechanisms of the onset and progression of Parkinson’s disease. Acupuncture could reduce oxidative stress, inhibit cell death in the neurons and protect neurons improving motor function.

Recently a study assessed the effect of acupuncture for PD. In this study 19 randomized controlled trials were included and it found that acupuncture was effective in relieving PD symptoms compared with no treatment and conventional treatment alone, and acupuncture plus conventional treatment had a more significant effect than conventional treatment alone. Acupuncture does have positive effect for patients with PD.


References
Loddk J and Nilsson M Parkinsonism Relat Disord (2010) 16:540-4
Yeo S et al CHS Neurosci Ther (2012) 18:781-90
Shulman LM et al Mov Discord (2002) 17:799-802
Zeng et al (2013) Int Rev Neurobiol (2013) 111:141-58
Yeo Et al BMC Complement Altern Med (2014) 14:336
Chen et al Neural Regen Res (2014) 9:1163-8
Wang F et al Evid Based Complement Alternat Med (2015) 2015:692795
Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294
Lee SH et al Medicine (Baltimore) (2017) Jan;96(3):e5836. doi: 10.1097/MD.0000000000005836.

Monday, 12 February 2018

Suffer from painful urination? acupuncture can help

Acupuncture reduces bladder pain

Bladder is located in the lower abdomen and it is for storing urine. As the urine goes into the bladder, bladder muscles relax so that it can expand. As the bladder empties during urination, the muscles contract to squeeze the urine out through the urethra. Some condition can cause bladder pain. It is very painful as urinate. The most common condition causing urination pain is interstitial cystitis. Interstitial cystitis (IC) is a chronic condition in which the bladder becomes inflamed and irritated. The inflammation stiffens the bladder wall, and makes it difficult for the bladder to fully expand when filling with urine. Patients with IC have painful urination and have to urinate more frequently and have a feeling of urgency to urinate, though there is no much urine each time. The main symptom of IC is pain which is generally located in the lower back, abdomen or groin region. Bladder pain is often recurring. Acupuncture can help to release bladder pain and stop it recurring.

A recent research studied the effect of acupuncture for bladder pain. 12 female patients with bladder apin received 10 sessions of acupuncture twice a week.

The following signs were monitored including visual analog score (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), O'Leary-Saint symptom score (OSS), Patient Health Questionnaire (PHQ9), Pelvic pain and urgency & frequency patient symptom scale tests (PUF) and maximum voided volume (MVV) was completed in 1st, 3rd, 6th and 12th months following the treatment. The results have shown that t here was a statistically significant decrease in all of the scores evaluated at first month compared with the baseline. While the change in VAS score in 1, 3, 6 and 12th months were found statistically significant, measurements of ICSI, OSS and PUF scores and MVV values in the 6th and 12th months. The results of this study suggest that acupuncture appears to be an effective, useful, non-invasive method in IC/BPS patients. It can be used as an appropriate treatment method not only in refractory but also in IC patients since it is rather advantageous compared to other treating agents.

Recurrent urinary tract infections, acupuncture can help

Acute lower urinary tract infections (UTIs) are common in adult women, and as many as 6% of members of the adult female population experience 3 or more episodes during a given year. Women with frequently recurrent cystitis may need prophylactic antibacterial treatment, however if the infection is recurring and this causes development of antimicrobial resistance. Acupuncture is used to treat UTIs. Recently there was a research from Norway which studied the effect of acupuncture on recurring UTIs in women. In this study, it included women aged 18-60 year old who had to have had 3 or more episodes of distal urinary symptoms (i.e., dysuria and frequent urination or suprapubic discomfort) during the previous 12 months, and at least 2 of these episodes had to have been diagnosed and treated as acute lower UTIs by a medical doctor. Acupuncture was offered twice a week for 4 weeks. Following treatment, 73% of women in the acupuncture group were free of UTIs during the 6-month observation period. Several episodes of acute distal urinary symptoms were noted in which bacterial cultures either were not obtained or were negative. One third as many episodes per person-month occurred in the acupuncture group as in the control group. Women in the acupuncture group experienced a 50% reduction in residual urine after 6 months relative to baseline, whereas women in the untreated group exhibited no significant change in residual urine. This study indicated that acupuncture treatment may be effective in preventing recurrent lower UTIs .

Overactive bladder, acupuncture can help

Overactive bladder is one of the most common urinary tract problems in women. Women have to go to bathroom frequently, feeling severe urge to urinate and feeling fullness of the bladder. This condition is not life threatening, but it affects quality of life in women.At minimum, 11 to 16 million women in the United States cope on a daily basis with symptoms that include sudden strong urges to urinate, difficulty delaying voids, frequent urination, and in many cases involuntary loss of urine when urgency strikes. This causes much stress in women. However the treatments are not satisfactory. Study has shown that acupuncture can help reducing the symptoms. Wang S et al studied long-term effect of acupuncture for overactive bladder. At least 5 years were evaluated. 106 patients participated the study. Evaluation was based on a questionnaire including questions on storage, voiding, and postmictutrition syndromes. The mean treatment sessions were 21.2. The results showed that complete resolution was 42.5% and 50% improvement was 85.5%. 62 patients were followed up for 5-10 years. 35 of these 62 patients maintained the posttreatment effect; 18 changed from better to complete resolution; 7 got back to less than 50% improvement; 4 changed less 25% improvement.

Acupuncture is effective for leaking urine

Urinary incontinence is the involuntary leakage of urine from the bladder. It affects 10% of the population. Women are more commonly affected. The most common types of leaking urine are stress incontinence and urge incontinence. Stress incontinence is when urine leaks out at times when the bladder is under pressure, such as coughing, sneezing, heavy lifting exercising and laughing. Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter. Urge incontinence is when urine leaks as a sudden, intense urge to pass urine is needed. Urge incontinence is usually the result of overactivity of the muscles, which control the bladder. It is also known as overactive bladder. Pelvic floor muscle training is one of the treatments used to treat this condition. Acupuncture is also used to treat this condition. Research on leaking urine with acupuncture treatment is emerging. For example

Recently Xu et al investigated the effectiveness of acupuncture on stress urinary incontinence. Before treatment a 72-hour bladder diary recorded by participants at baseline (week 0) and then acupuncture treatment was applied and the bladder diary was recorded during the treatment period (weeks 2, 4 and 6) and follow-up period (weeks 15–18 and weeks 27–30). In the bladder diary, the participants recorded in detail the time and frequency of UI, activity that occurred at the time of leak, and the type and volume of liquid intake. 80 women participated the study and they reported significant improvement after 6, 18, and 30 weeks acupuncture treatments.

References
Sonmez MG and Kozanhan B Ginekol Pol (2017) 88(2):61-67. doi: 10.5603/GP.a2017.0013.
Hartmann KE Evid Rep Technol Assess (Full Rep) (2009) 187:1-20
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Xu et al PloS One ( 2016) 11(3):e0150821.