Welcome to my blog, discover acupuncture with Dr Maggie Ju

Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Tuesday, 31 May 2022

How can acupuncture help patients with stroke?

Can acupuncture help patients with stroke?

Stroke is a serious condition which blood supply to the brain is cut off. It is the second most common cause of death worldwide, and the leading cause of adult disability. Patients with mild strokes or rapidly improving symptoms usually have a good prognosis, while patients with major strokes have a poor prognosis. Acupuncture help reduce brain damage and brain recovery. The mechanisms are as follows: Acupuncture has anti-inflammatory effects and increases cerebral blood flow which would protect the brain from ischaemic injury; acupuncture reduces cerebral odema after cerebral ischaemia and protect neuron damage; acupuncture also regulates biochemical changes involved in post stroke condition. Acupuncture acts on brain region which reduces sensitivity to pain and stress and promotes relaxation reducing anxieties. There have been many researches published recently to support the effectiveness of acupuncture on stroke recovery.  In China, stroke is treated with acupuncture. A survey of 1095 physicians from 247 hospitals in China between 1993 and 1994 has shown that 66% of Chinese doctors routinely used acupuncture to treat patients with stroke and 63% of them believed its effectiveness. Another survey in 2007 from patients with acute stroke has shown that 63% patients with stroke would choose acupuncture as part of medical intervention. Many researches were carried out to examine the effectiveness of acupuncture on stroke to support the clinical application of the interventions. Some research has shown that acupuncture can slightly help acute stroke by decreasing mortality rate and dependency at the end of long term follow up and improving neurological deficit scores. Acupuncture treatment for strokes has been listed as a proved effective treatment for stroke in world health organisation (WHO) website http://apps.who.int/medicinedocs/en/d/Js4926e/5.html.

Post stroke rehabilitation is an important part of the treatment of stroke to reduce disability and improve quality of life for patients with stroke. Available evidence suggested that acupuncture may be effective for treating poststroke neurological impairment and dysfunction

In Korea, integrative treatment is also used for patients with stroke. For inpatients, integrative management is applied at the request of the primary physician with consent of patients or their families. In the acute stage, neurologists or neurosurgeons take charge as the primary physicians. Korean medicine doctors cooperate as secondary physicians to the neurologists and neurosurgeons. When patients passed the acute stage, responsibilities are changed between primary and secondary doctors. The rehabilitation program is conducted under the supervision of rehabilitation medicine doctors. The most frequently used complementary and alternative medicines are acupuncture including manualacupuncture, electroacupuncture, and intradermal acupuncture, moxibustion, herbal prescriptions and acupuncture point injection. From their experiences, they believe the integration of complementary and alternative medicine and Western medicine have benefit for patients with stroke.  

Acupuncture improves spasticity in post stroke patients

Post stroke patients can be seriously affected by many complications as handicaps, unclear consciousness, aphasia, dementia, psychological abnormalities and incomplete bladder emptying. Spasticity is very common in post stroke patients. Spasticity is a condition in which muscles are constantly tight and stiff. It could cause reduced flexibility, posture and functional mobility; it could also cause joint pain, muscle and joint shortening etc. In post stroke patients, muscle spasm in one side of the body are in constant contraction state is very common. The affected side of the body is rigid, weak and has low functional abilities. Treatment includes antispastic medication such as baclofen, diazepam etc. Physiotherapy including muscle stretching and exercises could help preventing muscle shortening and atrophy. Acupuncture is use to help stroke rehabilitation and it improves post stroke motor ability. Some research study showed that acupuncture reduces spasticity by stroke and maintain a reduced level of spasticity. A study showed that combining a 6 week electroacupuncture and standard rehabilitation treatment reduced the spasticity of the elbow for chronic post stroke patients. The effect depends on the acupuncture points chosen for the treatment to improve spasticity.

Recently a study investigated the effect of acupuncture on muscle spasm. In this study, 44 patients were allocated in acupuncture group in which patients received acupuncture combined with rehabilitation treatment while 42 patients were in control group in which patients received only rehabilitation treatment. The key acupuncture points selected were from head, face, chest, abdomen, shoulder, back, hands, feet and ankles. Routine limb rehabilitation program was applied to both groups. One course included 10 treatments and two courses were performed in total. The effective rate of antispasm was 90% in acupuncture group which was superior to control group (73.8%). The improvement of motro function was significantly greater in acupuncture group. This study showed that acupuncture combined with rehabilitation therapy effectively relieves the muscle spams in post stroke patients, improves the limb function and the life activity.

References

Tong S Zhongguo Zhen Jiu (2013) 33:399-402

Bi-huei Wang et al Clin Interv Aging (2014) 9:147-156

Zhang JH et al Neuroepidemiology (2014) 42:50-8

Park SU et al Complement Ther Clin Pract (2014) 20:37-41

Acupuncture helps hemiplegia in post stroke patients.

Hemiplegia which is severer than hemiparesis is paralysis of one half of the body on the same side. Brain damage is one of the causes. The paralysis occurs on the opposite side of the damaged brain. For example if one has an injury to the right side of the brain, the hemiplegia will be on the left side of the body.  It is a common post stroke complication. Acupuncture is used in hemiplegia treatment in China. There was a study that investigated the immediate effects of acupuncture at GB34 acupoint on passive movement in stroke patients with hemiplegia using modern technique MRI to provide reference for clinical treatment. Six patients with right brain stroke and left hemiplegia in recovery stage were selected and scanned during passive fingers movement before and after acupuncture at acupoint GB34.  The activated areas of the passive movement in all the patients were mainly motor sensory cortex on the right side. Compared with sham control, acupuncture had better effect on activating brain motor related network.  This study used advanced technique and demonstrated that acupuncture is potential treatment method for hemiplegia in post stroke patients.

Treating upper limb hemiparesis with acupuncture and other interventions

Hemiparesis is a common complication for stroke survivors. The intervention for the conditions is aimed to improve quality of life for these patients. Pulman and Buckley from University of Liverpool UK reviewed the efficacy of different upper limb hemiparesis interventions on improving health-related quality of life in stroke patients. This is their findings:

Of the 22 studies, 12 reported significant findings within groups and between control groups. Interventions including BTX-A injections, CIMT, exercise programs, baclofen pump, robotic-assisted therapy, electrical stimulation, and acupuncture were reported to significantly improve either overall health-related QOL or certain individual QOL domains, such as strength, hand function, memory, mood, activities of daily living, mobility, social participation, communication, energy, pain, and sleep.

Example of acupuncture improves limb function in post stroke patients

Scalp acupuncture is that the needles are inserted in the acupuncture points on the scalp, while body acupuncture is that the needles are inserted in acupuncture points on the body. Both types of acupuncture are combined to treat stroke in China. Recent research showed the effectiveness of combined scalp and body acupuncture on limb function in stroke patients.  Tang et al studied the effect of acupuncture n limb function in subacute stroke patients using scalp and body acupuncture.  These patients were treated by routine neurological therapies. After 20 days, the limb function was better improved in acupuncture plus routine treatment group than that routine treatment only group. There were no significant differences between two groups in the ratios of mortality/disability and recurrence rates at the end of 3 and 6 months follow-up. He et al also studied the combined application of scal and body acupuncture on limb function in stroke patients. They also found better improvement in lower limb function in acupuncture group. After 8 weeks treatment, the walking ability rate in acupuncture group wa higher than that in the control group. The walking speed in the acupuncture group was faster than that in the control group.

Acupuncture point injection of herbal extract and floating acupuncture helps post stroke shoulder pain.

Shoulder pain is very common after stroke. It can be treated with pain killers, steroid injections, positioning and handling, shoulder strapping, electrical stimulation. Recently acupuncture point injection of herbal extract on post stroke shoulder pain was studied. There were 24 patients participated the study. Acupuncture points injection of herbal extract was carried out three times a week for 2 weeks. The effects of treatment were assessed with a numerical rating scale (NRS), painless passive range of motion (PROM) of external shoulder rotation, and the motor function assessment (FMMA). The acupuncture point injection group showed significant improvement on the NRS compared with that for control group after 2 weeks of treatment. PROM decreased significantly in both groups with greater pain reduction in treatment group. This study showed that acupuncture point injection of herbal extract was an option for patients with post stroke shoulder pain. Another study compared acupuncture with medicine and herbs for shoulder pain in post stroke patients. They found that shoulder pain was relived and the daily life activity was improved in the patients with post stroke using floating acupuncture technique. The pain relief was superior to the oral western medicine mobic and local Chinese herbs fumigation.

Current situation of stroke with acupuncture treatment

There is an increase in interest in using acupuncture on stroke and its effectiveness. Much of the recent research has been carried out in the Scandinavian countries and the USA. In China many studies have compared different techniques and point combinations which often involved in very large numbers of patients. The studies carried out so far have developed a variety of methods and are strongly indicative of therapeutic benefit, though the precise details of acupuncture treatment given are not always clearly stated in the studies. And there was lack of standardization in the treatments. Recently Wu et al analysed recent existing data to investigate the spectrum of acupuncture points in post stroke patients treated with acupuncture and moxibustion. They collect 652 clinical research papers. They found 143 nonacupuncture points were used and the application frequency were 737; 253 acupuncture points were used and the application frequency were 5395. According to application frequency, the acupuncture points were divided into often used points (23points); sometime used points (100 points) and less used points (130 points). Apparently there was lack of standardization in stroke treatment with acupuncture. The selected acupuncture points were distributed in fourteen meridians and most common used meridians were Yangming and Shaoyang.

References

Wu et al Zhonguo Zhen Jiu (2013) 33:547-52

Si WJ et al Zhongguo Zhen Jiu (2013) 33:131-6

Seo YR et al Evid Based Complement Alternat Med (2013) 2013:504686

Wang J Zhongguo Zhen Jiu (2013) 33:294-8

Pulman and Buckley Top Stroke Rehabil (2013)  20:171-88

Tang et al Zhen Ci Yan Jiu (2012) 37:488-92

He et al Zhongguo Zhen Jiu (2012) 32:887-90

 

Acupuncture is effective with post-stroke constipation

Acupuncture could help motor function, cognition, speech problems, shoulder pain, urinary incontinence, constipation, depression, fatigue and dysphagia etc.

Constipation can occur after a stroke. This is because you are not drinking enough liquids and you are in bed most of the time; or you are taking certain medicines as part of your treatment. If you have constipation, drink extra water and set a regular time for using toilet. Acupuncture can help post stroke constipation. There is a case report about treating post stroke constipation using acupuncture. There were 39 patients with post-stroke constipation received acupuncture treatment for 2 weeks and another 35 patients with post-stroke constipation received Chinese herb medicine Shengrue Tongbian Capsules for 2 weeks. After two weeks treatment, constipation symptoms were improved in these patients received both acupuncture and Chinese medicine. The improvement was greater in patients with acupuncture treatment. Acupuncture was potential treatment option for patients with post-stroke constipation. 

Acupuncture could help post-stroke urinary incontinence.

Urinary incontinence is the unintentional passing of urine. This is a common problem in patients with stroke. In China, acupuncture is used to treat this problem. Recent clinical research compared the effect of acupuncture with that indwelling catheter. Acupuncture was received 5 times a week. The points used included Qugu (CV2), Zhongji (CV3), Shuidao (ST28, Qihai (CV6) and Guanyuan (CV4) etc. The effect was compared after 4 weeks of treatment. The urinary diary (including the interval of urination, nocturia frequency, urination difficulty, urinary incontinence severity), bladder capacity, patients’s satisfaction were assessed before and after the treatments and compared between the two groups. After treatments, the effects were observed in both groups with better effect in acupuncture group especially in total score, the patients’ satisfaction and bladder capacity. Acupuncture is potential treatment option for post stroke urinary incontinence.

Acupuncture has potential benefit for stroke patients with incomplete bladder emptying

Urinary retention and incomplete bladder emptying (IBE) are not uncommon in patients with stroke rehabilitation. This significantly increased the risk of urinary infection. Recently there was a study investigating the effect of acupuncture on IBE. The patients selected were diagnosed with infarction or hemorrhagic stroke for the first time; they did not suffer from an active urinary tract infection. During the study period, these patients continued to receive conventional therapy without major changes of medication. These patients received acupuncture five times a week for two weeks. Among the 49 patients in the study, nine (18%) had IBE, and seven of the stroke patients with IBE were treated with electroacupuncture. Increased spontaneous voiding volume and decreased PVR urine volume were noted after ten sessions of acupuncutre. They suggested electroacupuncutre may have beneficial effects on stroke survivors with IBE. Acupuncture is a potential intervention to improve urinary function.

Acupuncture for ischemic stroke

Most stroke (87% cases) is ischemic stroke which caused by blood clot blocking blood vessel in the brain. The blood clot can form in the blood vessel in the brain or it formed elsewhere and travelled to the vessel in the brain which cannot pass because the vessel is too narrow to pass. Loss of blood supply damages brain function. The recovery of brain function such as speech and walking was attributed to reduction of inflammation in the brain region of damage and rewire of the area. Recently a randomised controlled trial from China studied efficacy of integrated rehabilitation techniques of Chinese Medicine for ischemic stroke. They used acupuncture combined with massage techniques and compared this with conventional rehabilitation technique. They compared the related parameters on day 0, day 21 and day 90. They found better improvement in acupuncture and massage compared with baseline and conventional technique. They suggested there is potential benefit from acupuncture and massage for ischemic stroke rehabilitation. 

Acupuncture is beneficial for cognitive function in post stroke patients

Jing well points are very powerful points located at the end of fingers and toes. These points are very often used to treat stroke. Temple points on the side of the head are also used for stroke in China. Recently a research showed that these points are beneficial for patients with early vascular congnitive impairment in China. They compared acupuncture at Jing well points and temple points and conventional treatment in patients with stroke. They observed improvement with acupuncture treatment but not conventional treatment. This indicates that acupuncture has potential to improve cognitive function in post stroke patients with mild cognitive impairment.

Acupuncture for post stroke depression

Patients with stroke not only suffer from physical disability but also emotional problems. Post stroke depression (PSD) is very common in patients with stroke in different stages. PSD is linked to increased disability, and poor functional and cognitive outcomes of stroke survivors. Reducing PSD could improve quality of life in patients with stroke. Anti-depression drugs could used to treat PSD. Because of their side effects, combination drugs and non drug treatments were recommended. Acupuncture is one of therapies without drugs, but its use in PSD is still in debate. Recently a pilot study investigated whether acupuncture is an effective treatment for PSD and whether the effect of acupuncture differs according to the degree of motor function impairments of the stroke patients. In this study 28 PSD patients were assessed and participated the study. They were treated with acupuncture every day for 16 weeks. Depression status was significantly improved during the treatment sessions. The depression of the good motor function groups was significantly more reduced than that of the poor motor function group. This study indicates that acupuncture therapy can improve PSD and that the effects depend on the degree of motor function impairment.

Another research from China studied the combination of herbs and acupuncture for post stroke depression. They compared herbs plus acupuncture with western medicine fluoxetine hydrochloride for treating post stroke depression. The treatments were given for four weeks. On six month followup, improvement was seen in herbs plus acupuncture and western medicine treatment with greater improvement in herbs plus acupuncture.  

There was also study combined acupuncture and moxibustion or antidepression medication (using aroxetine hydrochloride tablets) on post stroke patients with depression. They compared the efficacy of medication only, acupuncture plus moxibustion and acupuncture plus medication. Daily acupuncture except weekends was offered for 4 weeks. The improvement of depression was superior in acupuncture plus medication group and acupuncture plus moxibustion group to medication only group.  

Acupuncture helps post stroke swallowing difficulty

Swallowing difficulty can be present in post stroke patients. This problem is treated with acupuncture in China. Recently Zhou et al studied the effect of acupuncture on post stroke swallowing problem using modern research methods to provide evidence from conventional medicine point of view. They combined acupuncture with rehabilitation training program. There were 80 patients with post stroke swallowing difficulty. 40 patients were in control group treated with conventional approach and other 40 patients in acupuncture group treated with acupuncture. After treatment, assessment was carried out. They found there were improvements after the treatments in swallowing tests for both groups compared with those before the treatments. The improvements in acupuncture group were significantly greater. This showed that acupuncture is a potential effective treatment for swallowing difficulty in post stroke patients.

References

Yu KW et al Clin Interv Aging (2012) 7:469-74

Song et al Zhongguo Zhen Jiu (2013) 33:769-73

Ren et al Zhongguo Zhen Jiu (2013) 33:893-6

Youn JI et al J Phys Ther Sci (2013) 25:725-8

Hu JF et al Zhongguo Zhong Yao Za Zhi (2013) 38:2403-5

Nie and Huang Zhongguo Zhen Jiu (2013) 33:490-4

Li F et al Zhongguo Zhen Jiu (2013) 33:784-8

Zhang et al Am J Chin Med (2013) 41:971-81

Zhou XM et al Zhongguo Zhen Jiu (2013) 33:587-90

 

Monday, 30 May 2022

Thyroid dysfunction and autoimmunity affect fertility and pregnancy, acupuncture could help

Thyroid gland is located at the neck below the thyroid cartilage. It produces thyroid hormones including triiodothyronine (T3) and thyroxine (tetraiodothyronine, T4). These hormones regulate the metabolism rate of the body and affect growth and function of other part of the body. These hormones are important to maintain normal reproductive function. It has been extensively agreed that there are significant associations between thyroid disorders and abnormalities of the reproductive system; both hyperthyroidism and hypothyroidism in males and females affect reproductive function.

Changes of the thyroid function can lead to infertility both in male and female. In male, hyperthyroidism is associated with low sperm count and low sperm motility. Erectile function is also affected by thyroid function. These factors may contribute to male infertility. Restore of thyroid function after treatment results in sperm count increased and sperm motility improved. Erectile function is also improved after treatment. Hypothyroidism may cause testicular pathology, low testosterone levels and sperm abnormality.

Thyroid dysfunction and autoimmunity are common among women in reproductive age. In women with hyperthyroidism blood hormone levels including testosterone, adrostenedione, oestrogen (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) are increased. Abnormal period is noted in women with hyperthyroidism. Absence of period is very common. Reduced infertility is found in women with hyperthyroidism. Likewise hormonal changes and period cycle disturbances are also present in women with hypothyroidism.

The prevalence of thyroid dysfunction during pregnancy is about 2-3% and is mainly caused by chronic autoimmune thyroiditis. Thyroid auto-antibodies are found in 5-15% of women in reproductive age with or without thyroid dysfunction. Either thyroid dysfunction or thyroid autoimmunity is associated with negative pregnancy outcomes during pregnancy. Emmyvan den Boogaard et al conducted a systematic review on the clinical significance of thyroid dysfunction and thyroid autoimmunity prior to conception and in early pregnancy. They found that subclinical hypothyroidism (with high Thyroid stimulating hormone-TSH and normal free T4) in early pregnancy was associated with hypertension in pregnancy and perinatal mortality. Presence of thyroid antibodies was associated with an increased risk of unexplained subfertility, miscarriage, recurrent miscarriage, preterm birth and maternal post-partum thyroiditis.

More recently acupuncture was reported in regulating thyroid function and treating thyroid function disorders. There was a report of effectiveness of acupuncture on hyperthyroidism. This was involved in 125 patients. After acupuncture treatment symptoms were controlled completely in 71 patients which were 56.8%. Other 41 patient’s symptoms were partly controlled.  Recent study by Lyzina KE et al investigated the effect of acupuncture in 27 female patients with subclinical hypothyroidism. The treatment period was 3-4 month. They found that after the treatment, the initial clinical symptoms decreased significantly; TSH level decreased to normal range; the quality of life was improved. They concluded that acupuncture may be an alternative therapy for patients with subclinical hypothyroidism.

Acupuncture is used to treat hyperthyroidism as an adjunct therapy

Hyperthyroidism or overactive thyroid is a common hormonal condition in which too much thyroid hormone is produced in the thyroid gland. Excessive thyroid hormones can speed up metabolism causing a series symptoms. These include that anxiety, irritability and nervousness, insomnia, fatigue, muscle weakness, sensitive to heat, excessive sweating, weight loss, frequent passing stolls and urination, light periods or infrequent periods or missing periods, infertility. Physical signs include that enlarged thyroid gland, fast heart beat, tremor, warm skin, redness on the palms of the hands, hives, hair loss twitching in the face and limbs. Blood tests show that low level of thyroid-stimulating hormone (TSH) and high level of thyroxine and triiodothyronine (the thyroid hormones). The most common used medication is thionamides, such as carbimazole and propylthiouracil. In China, acupuncture is used as adjunct therapy together with these medications to increase the effect of medications and reduce the side effect of medications. As early as 1934 acupuncture was reported to treat thyperthyroidism. In 1970s, there were more researches on this subject.  Now many researches were done and provided the evidence that acupuncture improves metabolism, improves symptoms, reduces side effect of the medications and reduces recurrence rate. For example, there was a report with 125 cases of hyperthyroidism. After acupuncture treatment, the symptoms were controlled in 71 cases, improved in 41 cases, no effect in 13 cases. More recently a research studied the therapeutic effect and side effect of treatment on hyperthyroid exophthalmos with the combination of acupuncture and medication. Fifty-two cases were randomly divided into an acupuncture and medication group (27 cases) and a medication group (25 cases). Acupuncture in combination of oral taking of Thiamazole and Euthyrox were adopted for the acupuncture and medication group. And acupoints such as Jingming (BL 1), Chengqi (ST 1) and Sizhukong (TE 23) etc. were selected. Western medication for oral taking was applied as the only treatment for the medication group. The results have shown that the improvement of the objective marks of eye syndrome in the acupuncture and medication group was better than that in the medication group.  There were 4 cases with hypoleucocytosis, 3 cases with rash and 3 cases with aggravated symptom of exophthalmos in the medication group during the treatment, while no case with side effects was observed in the acupuncture and medication group.

References

Emmyvan den Boogaard et al Human Reproduction Update (2011) 17:605-619

Vopr Kurortol Fizioter Lech Fiz Kult (2011) 5:29-33

http://www.pharmnet.com.cn/tcm/zjdq/zjzl/100091.html

Xia Y et al Zhongguo Zhen Jiu (2010) 30:806-9

 

 

Sunday, 29 May 2022

Evening calming tea, Chinese herbal tea

Ingredients: Jujube, Longan Fruits, Gouqi berry and water boiled for a few minutes

This tea can help nourish blood, calm the mind and improve sleep. 

Read more about acupuncture here <www.drmaggiejuacupuncture.co.uk>

Do you know acupuncture is effective for diabetic and idiopathic peripheral neuropathy?

Diabetic neuropathy is that the nerves in the patients with diabetes were damaged which is caused by high blood sugar levels and decreased blood flow. In a high blood sugar environment nerve cells as well as repair mechanisms are more likely to be damaged. About 50% of patients with diabetes will develop nerve damage many years later after they have been diagnosed diabetes. Many nerves could be affected including cranial nerves (nerves in the skull), autonomic nerves (nerves for internal organs such as heart, stomach etc) and of course peripheral nerves (for instance, nerves for arms and legs). Symptoms may vary depending on which nerves are injured


If peripheral nerves (nerves for the arms and legs) are damaged, this is called peripheral neuropathy which occurs in 50% of the diabetes 2 patients. The early sign of peripheral nerve damage is abnormal sensation such as pain and numbness often started in the toes and feet. The symptoms tingling and burning pain and numbness could be present in the arms and legs. Some pain could be very severe. The nerve conduction became slow. Foot ulcer may occur because of poor blood supply to the skin. The symptoms are worsening with times and age.

The treatment for diabetic peripheral neuropathy included two aspects: first is to keep blood sugar controlled in a normal level to prevent further nerve damage; second is to reduce symptoms. Many medicines are available to relive pain symptoms. Long term use of these medicines could cause kidney damage. Recently there are many studies supporting using acupuncture for the treatment of peripheral neuropathy.

Recent research by Chinese clinicians showed that acupuncture helps improving symptoms of peripheral neuropathy. Chen etc (2009) and Ji XQ (2010) used randomized controlled trials to study effect of acupuncture on nerve conduction velocity in patients with diabetic peripheral neuropathy. They found that acupuncture significantly increased nerve conduction speed. Tong Y (2010) etc compared the effect of acupuncture in patients with diabetic peripheral neuropathy with that of sham acupuncture using randomised trials. After 15 sessions of acupuncture treatment, acupuncture significantly improved nerve conduction speed; acupuncture also significantly improved numbness, pain and rigidity in the arms and legs; vibration and temperature sensations were improved after acupuncture treatment. As we already know that acupuncture has analgesic effect and also acupuncture improves local blood flow, these could contribute to the effectiveness of the treatment.

Positive result of acupuncture in the treatment of diabetic painful neuropathy from Manchester

Role of acupuncture in the management of diabetic painful neuropathy (DPN) was studied by Garrow AP et al in Tameside Hospital NHS foundation Trust, Diabetes Center in greater Manchester UK. In this study, there were 45 patients involved and allocated to two groups real acupuncture group and sham acupuncture group which is a control group. A 10 week course acupuncture was offered to these patients and five standardised acupuncture points on the lower limb of each leg were used in the study: LR3, KI3, SP6, SP10 and ST36. Assessment was done before and after acupuncture treatments. Over the 10-week treatment period, small improvements were seen in Visual Analogue Scale which was used to assess lower limb pain, Measure Yourself Medical Outcome Profile and resting diastolic blood pressure in the true acupuncture group and little changes were in sham acupuncture group. They demonstrated the potential practicality and feasibility of acupuncture as an additional treatment for people with DPN. Acupuncture treatment was well tolerated with little side effects.

Peripheral nerve injury with acupuncture treatment

Peripheral nerve injury can occur through various traumas and it became increasingly common condition. Injury to motor nerves may produce symptoms including muscle weakness, atrophy, twitching and paralysis. Injury to sensory nerve may produce symptoms including continuous burning pain, sensitivity, numbness, tingling or pricking and problems with positional awareness. A first degree injury or neuraplaxia will recover quickly within a few months. The recovery will be completed with no lasting muscle or sensory problem. More severe injuries may take longer to recover completely or may not be fully recovered. The recovery depends on the severity of the injury and the time to get the treatment. Nerve injuries should be treated as early as possible. Apart from surgical treatment, nonsurgical treatments for nerve injuries include medication, massage therapy, orthotics, physical therapy and acupuncture. Studies showed that acupuncture has significantly better effect for nerve injuries than those without acupuncture treatment. Acupuncture provided immediate symptom relief for patients with peripheral nerve injuries. Acupuncture has effect to reduce pain sensation. Acupuncture also improves motor nerve recovery. In addition acupuncture improves nerve conduction over the period of treatment and has been shown effective for nerve repair. This indicates that acupuncture may help nerves regeneration. Acupuncture is a promising approach for nonsurgical treatment of peripheral nerve injuries.

Acupuncture helps with peripheral neuropathy

Peripheral neuropathy is a condition affecting nerves causing impaired sensation, movement, or other organ dysfunction. There are many factors causing the condition, such as diabetes, vitamin deficiency, medication, injury or infection etc. If the cause is unknown, this is called idiopathic neuropathy. The symptoms depend on which nerves are affected. For example, if motor nerves are affected, it could present painful cramps, muscle twitching, muscle weekness, muscle loss, bone degeneration, impaired balance and coordination. If sensory nerves are affected, it may present numbness, loss of sensation, poor balance and coordination, tingling, burning pain etc. If autonomic nerves are affected, it may present poor bladder control, abnormal blood pressure and heart rate, sweat changes abnormally.

Acupuncture can help with peripheral neuropathy, by improving blood supply to the nerves, reducing inflammation and increasing nerve conductivity.

Acupuncture helps motor nerve injury recovering

Recent research from China reported the effectiveness of acupuncture for peripheral nerve injury. Xiao GR et al did a control trial study which investigated and compared the effects of acupuncture on peripheral nerve injury with that of function training and no treatment. They recruited 90 patients and allocated them into three groups: acupuncture group, function training group and control group with each group of 30 patients. After three months of treatments basic function, practical function, EMG, nerve conduction velocity were compared among the 3 groups. They found that the acupuncture group achieved the best recovery; the function training group is the second. They suggested that acupuncture plus function training can accelerate nerve repair, promote functional recovery of the muscles.

Another case report was from Millea PJ in Medical College of Wisconsin USA. A 41-year old female with a 1 week history of inability to write or extend the right wrist received 1 session of acupuncture treatment. Wrist motion returned strait away after the treatment. After acupuncture treatment wrist splint was then used. On the same day, the patient reported increasing strength in wrist and finger extension. On the next day, the patient cancelled the second session of acupuncture treatment, because of her hand recovered. 4 month followup found all wrist and finger extension, sensation and return of the brachioradialis reflex were normal. 1 year followup showed fully recovery to normal. Acupuncture potentially facilitates recovery and may accelerate peripheral motor nerve injury recovery. Although evidence that acupuncture is effective for any type of motor nerve injury is limited to case reports and case series, these findings are beneficial.

Common peroneal nerve palsy, acupuncture can help.

Common peroneal nerve palsy is damage to the peroneal nerve which is a branch of the sciatic nerve and supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve palsy is a type of peripheral neuropathy. This condition can affect people of any age. The peroneal nerve palsy leads to loss of movement or sensation in the foot and leg. There is a loss of feeling, muscle control, muscle tone, and eventual loss of muscle mass because the nerves aren't stimulating the muscles.

The causes include Trauma or injury to the knee, fracture of the fibula (a bone of the lower leg), use of a tight plaster cast (or other long-term constriction) of the lower leg, crossing the legs regularly, regularly wearing high boots, pressure to the knee from positions during deep sleep injury during knee surgery or from being placed in an awkward position during anesthesia, or unknown reasons. People who have diabetes or exposed certain toxins are in high risk.

The symptoms include decreased sensation, numbness, or tingling in the top of the foot or outer part of the upper or lower leg, foot drops, walking problems including slapping gait and toes drag while walking, weakness of the ankles or feet. Examination shows Loss of muscle control in the lower legs and feet, atrophy of the foot or leg muscles, difficulty lifting up the foot and toes and making toe out movements. Nerve conduction tests show reduced conduction velocity.

Treatments including surgery, physiotherapy etc are aimed for improving mobility and independence. Acupuncture helps improve recovery of peroneal nerve function and increase nerve conductivity. Acupuncture can also reduce pain caused to nerve injury.

References
Chen YL Journal of Chinese integrative medicine (2009), 7:273
Ji XQ Zhen ci yan jiu (2010), 35; 443-7
Tong Y J Acupunct Meridian Stud. (2010) 3:95-103.
Millea PJ J Altern Complement Med (2005) 11: 167-9
King JC. Peroneal neuropathy. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal disorders, pain and rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 66.
Yao ZH et al J Tradit Chin Med (1984) 4:97-100
Xiao GR et al Zhongguo Zhen Jiu (2007) 27:329-32
Garrow AP et al Acupunct Med (2014) Mar 21. doi: 10.1136/acupmed-2013-010495

Saturday, 28 May 2022

Can acupuncture help osteoarthritis?

Osteoarthritis is the most common joint condition and the most common form of arthritis which is progressive and degenerative. Osteoarthritis is caused by gradual loss of joint cartilage. It is the leading cause of disability and is associated with major impacts on physical function and mobility. The symptoms include loss of movement and joint pain. Diagnosis is based on radiological changes, and clinical presentation of joint pain; including tenderness, limitation of movement, joint effusion, and variable degrees of localized inflammation. Approximately 10% of men and 18% of women aged 60 years or older have symptomatic osteoarthritis worldwide.

 Osteoarthritis causes joint pain and stiffness. Anyone can get osteoarthritis. There is high risk if you are in late 40s or older women; if you are overweight or have had previous joint injury or another joint condition; if you have physically demanding job which need to have repetitive movements; people with joint injury history are more likely developing the disease later in life. Pain killers are commonly used for pain management. Complementary therapies are increasingly popular as treatments for osteoarthritis, including taichi, acupuncture, yoga, and massage therapy. There is available evidence suggesting that these therapies are safe for use by individuals with osteoarthritis. Positive short-term (less than 6 months) effects in the form of reduced pain and improved self-reported physical functioning were confirmed by research. There is limited information regarding the relative effectiveness of the therapies (which therapy is more effective compared to others). There is also limited information about treatment effects in persons with different joints, different age groups and different stages. Complementary therapies can reduce pain and improve function in adults with osteoarthritis.

Osteoarthritis generally affects joints in the hands, knees, hips and feet. In osteoarthritis cartilage in one or more joints is broken-down and eventually lost which may lead to inflammation. The most common symptom is joint pain. Joint pain is usually worse later in the day and can associated with swelling, stiffness, weakness of muscles around affected joints. Mobility reduction and joint creaking can also occur.

There is no known cure for the disease. Treatment is focusing on reducing pain and together with managing other symptoms. Painkillers are the standard therapy.These include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and in severe cases, narcotics. NSAIDs and acetaminophen are only effective for short-term relief of osteoarthritic pain and are associated with common adverse effects (e.g. upset stomach).

Can acupuncture help osteoarthritis? Long term use of painkiller can lead to many side effects, some of which are very serious such as bleeding problems associated with aspirin. As a consequence, in more recent years, patients have increasingly used acupuncture to relieve the chronic pain linked with osteoarthritis.

Acupuncture is reported to be effective in treating chronic pain caused by osteoarthritis. The use of acupuncture in adults with osteoarthritis was associated with significant reduction in pain intensity. Compared to intervention durations of ≤ 4 weeks, longer intervention periods were associated with significant difference reductions in pain intensity. Acupuncture significantly improved functional mobility and health-related quality of life. Longest intervention had the greatest benefits.

For example, s research studied effectiveness of acupuncture on relieving pain associated with osteoarthritis. This is a randomized, controlled clinical trial with a large number of patients---3633 patients in total. Patients treated with acupuncture showed significantly improvements in symptoms and quality of life compared to those in control group. Acupuncture which is believed invokes the release of endogenous opioid and depression of stress hormone release.

Hand osteoarthritis, acupuncture can help.

Osteoarthritis can occur at hand. It often occurs at certain spots of hand, such as in the joint located at the base of the thumb, in the joint at the end of the finger and in the joint in the middle of the finger. The symptoms include pain, swelling, deformity and loss of function. Hand osteoarthritis can treated with medications including pain killers and injections of steroids into the affected joint. Other treatments include using finger or wrist splints, resting the joints, heat treatments and physiotherapy and acupuncture etc. Surgical treatment may be needed in some cases.

Recently there was a study of observation on the efficacy of acupuncture and fire needle therapy for hand osteoarthritis. There were 80 cases in this study. 42 of them were received acupuncture treatment at acupoints including Sanjian (LI3), Zhongzhu (TE3), Houxi (SI3) and fire needle at Ashi points. Other 38 cases received votalin emulgel for local embrocation. Two courses of treatments (one course is 30 days) were given to these patients. After two courses of the treatments, the VAS score of arthralgia, joint function score and the duration of morning stiffness, joint tenderness, and swelling were significantly different from those of before the treatments. The efficacy of acupuncture was superior to that of medication. This study suggested that acupuncture was an effective treatment for hand osteoarthritis. 

References

Marcus Sanders, Alternative Medicine Review (2011) 16, 228-238

Li H et al Zhongguo Zhen Jiu (2013) 33:885-8

Karner M et al Evid Based Complemennt Alternat Med (2013): 2013:427265

Dai et al Zhongguo Zhen Jiu (2014) 34:329-33

Plaster R et al Acupunct Med (2014) 32:236-41

Shengelia R et al Pain Manag Nurs (2013) 14:e274-88

Manyanga et al BMC Complement Altern Med (2014) 14:312

Modified ginger tea, Chinese herbal tea.

Ginger, Gouqizi, and Chenpi tea

Ingredients: Gouqi berry, orange skin washed, Ginger and water

boiled for a few minutes

This tea can help release coughing and phlegm; reduce bloating and diarrhea.

Why is it good to drink ginger tea?

Ginger can help your defence system.

Macrophages a type of defence cells in the body play a dual role in host defence. They act as the first line of defence by mounting an inflammatory response to antigen exposure and also act as antigen presenting cells and initiate the adaptive immune response. They are also the primary infiltrating cells at the site of inflammation. Inhibition of macrophage activation is one of the possible approaches towards modulating inflammation. Ginger, an herbal product with broad anti inflammatory actions was shown that it regulates immune function by inhibiting macrophage activation. A study has shown that ginger ginger improves on cytotoxicity induced by paraben (p-hydroxybenzoic acid) on red blood cells (RBC) in vitro from healthy adult human beings (25-30 years).

Ginger can help protect human bronchial epithelial cells.

Traditionally, ginger is used as an antiinflammatory drug. A recent study tested the effect of ginger extract in inflammation of human bronchial epithelial cells. They found that ginger extracts can reduce inflammatory substances production and suggested that distinct ginger compounds could be used as antiinflammatory drugs in respiratory infections.

Ginger reduces inflammatory and oxidative stress

This review investigated the effects of ginger supplementation on markers of inflammatory and oxidative stress. They evaluated the effects of ginger on some inflammation markers including serum CRP (C-reactive protein), TNF-α (tumor necrosis factor-alpha), IL-6 (interleukin-6), PGE2 (prostaglandin E2), TAC (total antioxidant capacity), and MDA (malondialdehyde). The results of this study indicated a statistically significant effect of ginger on serum CRP, TNF-α, IL-6, TAC, and MDA levels following ginger supplementation in compared to the controls. Also, the effects of ginger on serum PGE2 was marginally significant. They suggested that ginger supplementation has a significant effects on serum inflammatory and oxidative stress markers.

References

Tripathi S et al BMC Complement Altern Med. 2008 Jan 3;8:1. doi: 10.1186/1472-6882-8-1.

Ginger extract inhibits LPS induced macrophage activation and function.

Asnani V, Verma RJ. Acta Pol Pharm. 2006 Mar-Apr;63(2):117-9. Aqueous ginger extract ameliorates paraben induced cytotoxicity.

Podlogar JA, Verspohl EJ. Phytother Res. 2012 Mar;26(3):333-6. doi: 10.1002/ptr.3558. Epub 2011 Jun 23. Antiinflammatory effects of ginger and some of its components in human bronchial epithelial (BEAS-2B) cells.

Jalali M et al Phytother Res. 2020 Mar 8. doi: 10.1002/ptr.6638. [Epub ahead of print]

The effects of ginger supplementation on markers of inflammatory and oxidative stress: A systematic review and meta-analysis of clinical trials.

Read more about acupuncture at www.drmaggiejuacupuncture.co.uk


Friday, 27 May 2022

How many eggs retrieved in IVF are good numbers?

How many eggs retrieved in IVF are good numbers?

IVF becomes a popular technique for infertility treatment since it was invented 30 years ago. During the procedure it is difficult to predict the side effect and success for individuals. IVF success rate is related to egg number retrieved in the procedure. What is the optimum number of eggs for IVF? Is there a connection between egg numbers and live birth rate (LBR)? Ji J et al analysed the data from 2007 and 2011 from total 2455 patients who was undergoing first cycle of IVF treatment. All patients had normal menstrual cycles and were stimulated with a long GnR agonist protocol. Associations between egg number and LBR and miscarriage rate and the rate of moderate-severe ovarian hyperstimulation syndrome (OHSS) were analysed. These patients were divided into four groups according to the egg number retrieved: 0-5, 6-10,11-15 and >15. The fresh embryo transfer LBR and cumulative LBR were assessed. Their data suggested that for IVF cycles stimulated with a long protocol the optimal number of eggs for achieving a live birth is between 6-15. With increased egg number, the incidence of moderate-severe OHSS was increased. There was no significant difference in the miscarriage rates among the patient groups.

There was another research studied the association between egg number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth in fresh IVF cycles. In this research they analysed data from 256381 IVF cycles. Patients were divided into five groups according to the egg numbers retrieved. The data showed that the LB rate increased up to 15 eggs, then levelled (0-5: 17%, 6-10: 31.7%; 11-15: 39.3%; 16-20: 42.7%; 21-25: 43.8%; and >25 oocytes: 41.8%). While the rate of OHSS became much more clinically significant after 15 eggs (0-5: 0.09%; 6-10: 0.37%; 11-15: 0.93%; 16-20: 1.67%; 21-25: 3.03%; and >25 oocytes: 6.34%). These data showed that retrieval more than 15 eggs significantly inceases OHSS risk without improving LB rate in fresh IVF cycles.

Acupuncture reduces pain in IVF egg retrieval

Acupuncture has been used to assist IVF. There are different approaches for the use. Using acupuncture on the day of egg retrieval could help reduce pain. There was a study on this subject to observe analgesic effect and safety of acupuncture in egg retrieval. In this study 316 patients undergoing IVF were divided into two groups acupuncture plus anaesthesia group (146 patients) and a simple anaesthesia (control) group (170 patients). The treatments were carried out 30 min before egg retrieval. They found that pain rating and pain score were significantly better for acupuncture group than that for control group. The incidence rate of abdominal pain at 1hour and 2-5 hour after egg retrieval was lower for acupuncture group. There was no side effect found. Recently there was another study on the effect of acupuncture on pain in egg retrieval. In this study there were 90 patients participated the study. The treatments were also carried out 30 min before egg retrieval. Pain rated index (PRI), visual analogy scale (VAS) and present pain intensity (PPI) were used to measure pain. The result showed that PRI, VAS and PPI immediate after and 1 hour after egg retrieval were significantly lower for acupuncture group than that for control group. They also found that neuropeptide level in follicular fluid is higher in acupuncture group which may be the mechanism of acupuncture analgesic effect on egg retrieval.

References

Nedeljkovic M et al Forsch Komplementmed (2013) 20:112-8

Manheimer E et al (2008) BMJ 8: 545-549

Zheng CH et al Evid Based Complement Alternat Med (2012)2012:543924

Kong FY et al Zhongguo Zhen Jiu (2012) 32:113-116

Chen J et al Zhongguo Zhen Jiu (2009) 29:775-9

Cui W et al Zhongguo Zhen Jiu (2011) 31:687-691

Dieterle S et al Fertil Steril (2006) 85:1347-51

Isoyama D et al Acupunct Med (2012) 30:85-8

Balk J et al Complement Ther Clin Pract (2010) 16:154-7

Villahemosa et al Acupunct Med 2013 31:157-62

Meng P et al Zhongguo Zhen Jiu (2008) 28:451-5

Zhang J et al J Tradit Chin Med (2013) 33:294-7

Steward RG et al Fertil Steril (2014) S0015-0282

Ji J et al Hum Reprod (2013) Jul 25

Don't put up with wrist pain.


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Wednesday, 25 May 2022

How to check your ovulation? What is the easiest way?

What is basal body temperature? Basal body temperature (BBT) is the lowest body temperature during rest. It is usually measured in the morning as soon as you wake up and before you engage any physical activity. In women, BBT changes with the menstrual cycles. If you make a daily BBT chart in a full menstrual cycle you can see the BBT chart is biphasic which means there are two temperature phases. Ovulation increases BBT for about up to 0.5 degree Celsius. The average BBT is 36.37 ±0.12 ºC during follicular phase (the phase prior to ovulation) and 36.72 ±0.12 ºC in luteal phase (the phase after ovulation). If conception does not occur, the temperature goes down and then the next menstrual cycle starts. If the conception occurs, the temperature stays at the higher level until the end of first trimester of the pregnancy.

If you are trying to conceive, making your BBT chart is the easiest way to know if or when you are ovulated precisely, though it does not predict ovulation. Your BBT chart also can tell if your body is the best form and is ready to sustain a pregnancy. BBT was regulated by hormones estrogen and progesterone which produced by ovaries. High levels of estrogen lower BBTs while high levels of progesterone increase BBTs. If your BBT chart is normal, this means your ovaries are functioning well and you are ready for pregnancy.

If you have difficulty to conceive, it may reflex on your BBT chart. For example, if you are not ovulating, your BBT chart does not have two phases. If you have short luteal phase which is difficult to sustain your pregnancy it shows a disturbed BBT chart. If your first three day’s BBT is greater than 36.6 ºC, this may be associated with endometriosis. 

Read more about acupuncture for fertility <drmaggiejuacupuncture.co.uk>

Ankle pain solution?


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Monday, 23 May 2022

Infertility and hormones, how can acupuncture help?

If you are having difficulty to conceive, what could go wrong? Things could go wrong either in women or in men or both. About one-third of infertility is caused by women’s problem. Another one third is due to men’s problem. The remaining one third is caused by both women and men.

Egg and sperm quality
High quality of eggs is essential for conceiving. Women are born with millions of follicles. These follicles stay in the cortex of ovaries where they will develop and some of them will be mature and released. This is a long process and it takes about a year for an egg to develop and to be released. The original follicles are preantral type of follicles. These follicles are in deep sleep stage. Some of them will wake up and be recruited to develop. This is preantral development which is a slow process and it takes about 10 months. This process is hormone independent. After 10 months of development, some of them will be selected to develop to dominant follicles. It takes about 2 months for these dominant follicles to develop to a preovulatory stage. This stage is hormone dependent. And then one of the follicles will be mature and released in 15-20 days which is highly depending hormone balance.

Hormonal balance is the key in human reproductive system. In women, there are five hormones involved in reproductive function: gonadotropin-releasing hormone (GnRH) produced in hypothalamus (a part of the brain), follicle stimulating hormone (FSH) and luteinizing hormone (LH) both produced in pituitary gland (another part of the brain), and oestrogen and progesterone both produced in ovaries located in pelvis. To be fertile, these five hormones have to be well balanced, which means they have to be at the right level at the right time. If the balance is disturbed at any points in a cycle, this would affect fertility. Most of the infertility in women is caused by imbalanced hormones. Hormonal imbalance could cause poor egg development; as a result, poor quality egg is produced (fertilization is affected) or no egg is released in the mid-cycle. Hormonal imbalance could also cause poor uterine lining affecting implantation and causing early pregnancy loss.

The hormonal system is very sensitive, even a slightly change can disrupt hormonal production leading to anovulation. Common causes related to hormonal imbalance include stress, anxiety and eating disorders which are associated with inhibition of GnRH production in hypothalamus. Polycystic ovarian syndrome (PCOS) is the most common cause of infertility which is associated with hormonal imbalance. Excessive male hormones (androgens) were produced in women with PCOS. Another hormonal imbalance is excessive production of hormone LH which is involved in stimulating ovary to produce hormones.

Sperm production in men is different. Sperm production and maturation takes about 74 days. Sperm production takes place in testicles where temperature is lower than body temperature. This process is hormone dependent and follicular stimulating hormone (FSH) and Luternizing hormone (LH) are involved in the process. This process takes about 60 days. Sperms produced then mature in epididymis where they obtain motility and it take about 14 days.

In men there are four hormones involved in reproductive function: GnRH, FSH and LH produced in brain, and testosterone produced in testicle located in scrotum. Hormonal imbalance in men causes poor sperm development resulting in low sperm count and/or poor sperm quality. Stress can disturb hormonal balance affecting men’s fertility.

To improve fertility, correcting hormonal imbalance is the key. It takes time (at least a few months) to restore hormonal balance; sometimes it takes much longer than you expected. So determination and patience are needed to achieve the goal. Acupuncture treatment could help restoring hormonal balance by stimulating sympathetic nerve and lowering sympathetic activity. Balanced diet and regular exercises could also help.

Local chronic inflammation is another important factor causing infertility. In women inflammation in pelvic area could cause fallopian tube spasm which blocks the eggs passing through. After lower abdominal surgery, or following pregnancy loss, inflammation could occur in pelvic area. Endometriosis causes inflammation in pelvic area surrounding the misplaced tissue affecting ovulation, egg transportation. Endometriosis is another common cause for infertility. In men inflammation in scrotum could impair sperms. Reducing local inflammation can significantly improve fertility in relatively short time, if there is no hormonal imbalance involved in infertility. Acupuncture can help reducing local inflammation by stimulating nerve endings and improving local blood flow.

Low AMH
AMH is short for anti-mullerian hormone. It is a substance made by small follicles in women’s ovaries. When the follicles grow bigger, they are no longer producing AMH. Since AMH is produced only in smaller follicles and its blood levels are constant, AMH has been used to measure the size of the pool of growing follicles in women. AMH blood levels reflect the size of the remaining egg supply. If your AMH is low, it means your egg supply is poor. With increasing women’s age, the size of their pool of remaining small follicles decreases. Their AMH levels and the number of ovarian small follicles visible on ultrasound also decrease. Some women may have problems of recruitment and development of follicles; in this case they have fewer follicles developed and their AMH tends to be low. Women with low AMH would have less chance to have good quality eggs. So they may have difficulty to conceive naturally. Women with low AMH level are likely to have poor response to ovarian stimulation for IVF and have fewer eggs retrieved. This reduces their chance to conceive via IVF.

Read more about how acupuncture can help to balance hormones at <drmaggiejuacupuncture.co.uk>

Low progesterone to get pregnant, How?


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Sunday, 22 May 2022

No periods? Acupuncture can help

Absence of menstrual periods and acupuncture treatment

Regular menstrual periods are a sign of well functioned reproductive system in women. Menstrual cycles are very important in women not only for reproduction but also for general health. If a woman’s periods are missing, this could cause infertility as well as some other health problems such as cardiovascular problems and osteoporosis.

Absence of menstruation is called amenorrhea in medical field which is a condition that menstrual periods have stopped for more than three cycles. This is not rare condition and many factors affect menstruation. If your periods are missing, If your periods disappeared for some time, you need to get it checked with your doctor and you need to rule out of pregnancy and menopause depending on your age. If you are not pregnant and you don’t have periods, it is most likely that your ovary is not working.

Common conditions that could cause absent periods are those affecting hypothalamus, pituitary gland, ovarian axis. These cause hormonal level changes responsible for reproductive function. For example, extreme weight loss, emotional or physical stress, high intensive exercise and severe illness could affect the hypothalamus and cause absent periods; pituitary gland conditions lead to increasing level of hormone prolactin, hypothyroidism causing missing periods; If you are under extreme stress, this could be the reason for disappeared periods. Though it has long been recognised, there are no specific diagnostic tests for this and diagnosis is usually made by exclusion. The mechanisms how psychological stress affects the women’s period cycle are still not clear. But it is widely accepted that it is linked to hypothalamic pituitary axis. In the situation of stress, corticotrophin-releasing hormone (CRH) production from hypothalamus is increased. The effects of increased CRH on the hypothalamic-pituitary axis reduce circulating luteinising hormone (LH) levels. Absence of period cycle caused by psychological stress may last from a few months to many years. Women with stress related absence of period cycle have increased basal plasma cortisol and decrease response to CRH administration. In many cases, normal periods return after the psychological problems are overcome. But in other cases, missing periods could cause new stress and help is needed to get periods return.

Ovarian conditions can also cause absence of periods, which include premature ovarian failure, polycystic ovary syndrome. It is very common that menstrual period does not return after stop taking contraceptive pills in three months. Infertility is one of the complications of absence of periods. Treatments are also depending on the causes. Correcting hormone imbalance is the target of the treatments to reestablish menstrual cycles and prevent complications.

In traditional Chinese medicine (TCM), missing periods are divided into five types according to the symptoms:

1 kidney and liver deficiency, symptoms include missing menstrual periods or light or less frequent periods, feeling week, lower back pain, dizziness, tinnitus, red tongue and week pulse.

2 qi and blood deficiency, symptoms include missing menstrual periods, dizziness, blur vision, short of breath, tiredness, pale, light tongue and week pulse.

3 yin deficiency, symptoms include missing menstrual periods, hot flashes, fever, night sweating, cough with blood, red tongue, week pulse.

4 qi and blood stasis, symptoms include missing menstrual periods, depression, feeling anger, feeling bloated, lower tummy pain, dark tongue, floating pulse.

5 dampness and phlegm blockage, obesity, cough with phlegm, swelling, excessive vaginal discharge, thick tongue coating, and slippery pulse.

Acupuncture could help correcting hormonal imbalance, reducing stress level and resuming menstrual cycles by stimulating nerve ends at particular acupuncture points and improving hypothalamus function.

There were some researches showing that effectiveness of acupuncture on resuming menstruations. Here are some examples.

There was a study with women with premature ovarian failure. 11 women had absence of periods. They received 3 month acupuncture treatments. 10 women had resumed their periods.

There was a random control clinical trials with women diagnosed with polycystic ovarian syndrome. 16 weeks of acupuncture treatment, menstruation frequency is increased.

There was a case report from China. In this report, 33 women aged from 23 -45 had absence of periods for 3 months to 3 years. They were received acupuncture treatments and 29 women out of 33 resumed their periods; 4 women did not respond to acupuncture treatments. About 63% had regular periods during the course of 6 months followup and about 24% had irregular periods during that time.

Stop taking the pills and no periods, acupuncture could help

When will your periods come back after you stop taking the pills? This is a good question. This is may vary depending on individuals. It could take a while for your periods to come back after you stop taking the pill. Most women will have a period two to four weeks after stopping the pill. It could take longer. Your periods may not be regular when you first stop the pills and this could take six months to become normal again. If your periods never come back, this may suggest a problem in your ovaries and you need to see your doctor to investigate what is wrong. Contraceptive pills suppress ovulation and follicle developments. Acupuncture could help ovarian blood flow to help restoring ovarian function when stopping the pills. Regular periods indicate that your ovaries are functioning well. If your ovaries are functioning well, your periods would come back and become regular.   

References

Zhou K Evid Based Complement Alternat Med (2013) 2013:657234

Jedel E et al Am J Physiol Endocrinol Medtab (2011) 300:E37-45   

Han Y J Trads Chin Med (2004) 24:42-43 

 

Saturday, 21 May 2022

How too make Barley tea.

 

Roast Barley to brown and store in an air tight container. To make tea, add one spoon of roasted Barley and boiling water to a cup and leave it for 10 min.

Benefits of Barley tea. It contains vitamins along with antioxidants. Good for digestion, reducing bloating, anti-inflammatory and antiaging.

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Hope for women with premature ovarian failure.


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Sunday, 8 May 2022

Can't cope with excessive stress? Acupuncture can help

 

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Saffron tea, Chinese herbal tea


Saffron is a spice that comes from the flowers of crocus sativus Linné. Like many other herbs and spices, saffron can be prepared as a tea. The benefits of saffron tea include good for heart and lowing blood pressure, urinating problem, menstrual issues, eye disorders, stomach issues, mental health antidepressant
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Monday, 2 May 2022

Three bean tea, an ancient recipe, Chinese herbal teas


Three bean tea, an ancient recipe from China is a famous Chinese medicine formula as well as food remedy. This formula contains three beans including small read beans, black beans, as well as green beans. It nourishes skin and helps skin problems such as spots, skin patches itchiness etc. It nourishes blood too and good for fertility and pregnancy.

Cooking methods

No1,

1, Soak equal amount of three beans which you can get from Chinese supermarkets in warm water for a couple of hours.

2, Boil the beans in plenty of water in low heat for a couple of hours.

3, It is ready to drink. You can add honey, if you have sweet tooth.

No2,

1, Soak three beans in the warm water as above.

2, Grand the mixture and boil it.

3, It is ready to drink. You can add honey, if you have sweet tooth.

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Sunday, 1 May 2022

Mint tea, Chinese herbal tea

 



Mint tea benefits:

Relief cold and flu symptoms, release upset stomach symptoms, release skin rashes and itchiness, sooth and calm, release tension headaches, muscle soreness and pain,release menstrual pain.

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Rosebuds tea, Chinese herbal tea


Roses have been used as tea, one of Chinese teas for thousands of years. Rose tea is made from the fragrant petals and buds of rose flowers.

The health benefits of rose tea are improving Qi and blood circulation, alleviating menstrual pain, antiaging effects, reducing allergic reactions, improving liver and heart health, anti inflammatory and anti arthritic effects, reducing stress, calming, soothing and anti depression, reducing fatigue, helping wound healing etc.

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What can you about your health from your tonger?

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