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, 30 August 2022

Osteoarthritis pain, can acupuncture help?

 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

Saturday, 27 August 2022

Pain from shingles, can acupuncture help?

 Acupuncture treatment for acute shingles


Herpes zoster known as shingles, is caused by varicella-zoster virus which affects nerve and the skin around it. This virus is also causes chickenpox which is primary infection. It remains dormant in the dorsal root ganglion after primary infection (causing chickenpox). It affects the sensory ganglia and their area of innervation. This is one of the most painful conditions with pain and rashes in the distribution of the affected nerve. Antiviral drugs are used to limit the damage of the nerve by the virus. Corticosteroids may be used to reduce inflammation. Various painkillers are used to reduce pain. Ursini et al from Pescara General Hospital in Italy studied acupuncture for the treatment of severe acute pain in shingles using randomized trial. They compared the efficacy of acupuncture in controlling intense or very intense pain in patients with shingles with standard pharmacological treatments. The treatments were given for 4 weeks for either acupuncture or painkillers. They found that both interventions (acupuncture and painkillers were largely effective. There were no significant differences observed in response rates, pain reduction, post-herpetic neuralgia after 3 months and pain after one year follow-up. No severe unwanted effects occurred on both interventions. Acupuncture is a potential intervention for treating acute severe pain in singles. 

Acupuncture for chronic pain from shingles 

Most people have chickenpox in childhood. When the illness has gone, the virus remains dormant in the nervous system being watched by the immune system. Once one’s immune system is compromised, the virus can be reactivated and cause shingles. Shingles is one of the most painful conditions. There is no cure for shingles and it can be unpleasant. In most case, the painful rash lasts 7-10 day and takes 2-4 weeks to fully heal. However about 25% of patients have pain lasting for more than one year. Unresolved pain can lead decreased quality of life, such as mood change, sleep disruption and depression etc. Hui F et al from University of Toronto studied three weeks complementary and alternative medicine including acupuncture to treat shingles related pain. The participants had a mean age of 69.8 years and had shingles related pain for a median of 4.8 months. Acupuncture points for acupuncture group were LI4, Liv 3 and ST36. After three weeks treatment, they found that pain score was significantly reduced in treatment groups. The pain reduction was maintained at 9 weeks after the treatment finished and one–two year follow-up. 

Li et al studied 80 cases of shingles which were divided into two groups, acupuncture group and medication group. They found that the therapeutic effect of electroacupuncture was significantly superior to that of medication. After 10 treatments visual analogous scale (VAS) scores for of both groups reduced significantly. Both the VAS score and the crust formation time of EA group were significantly lower than those of medication group. 

References 

Hui F et al Altern Med Rev (2012) 17:57-68  

Ursini T et al BMC Complement Altern Med (2011) 11:46 

Li X et al Zhen Ci Yan Jiu (2009) 34:125-7

Wednesday, 24 August 2022

Having foot drop? Tried acupuncture?

 Acupuncture helps improving foot drop


Foot drop, sometimes called drop foot is a muscular weakness or paralysis that makes it difficult to lift the front part of your foot and toes. This causes the toes to drag along the ground while walking. To avoid dragging the toes, people with foot drop may lift their knee higher than normal. Or they may swing their leg in a wide arc. Foot drop can happen to one foot or both feet at the same time. Foot drop is a symptom rather than a condition. The causes could be muscle disorders, nerve damage in the leg, or brain and/or spinal injury. Muscles disorders including muscular dystrophy, amyotrophic lateral sclerosis and polio cause the muscles to progressively weaken causing foot drop. Some conditions including sports injuries, diabetes, spending long hours sitting cross-legged or squatting, hip or knee replacement surgery, childbirth etc could cause peroneal nerve damage or compressed causing foot drop. Brain or spinal disorders including stroke, multiple sclerosis (MS) and cerebral palsy also can cause foot drop. 

The treatments depend on the causes of the foot drop which include physiotherapy, wearing an ankle-foot orthosis, electrical nerve stimulation and surgery. Acupuncture was also reported to be useful to help improving foot drop. 

References 

Jagirdar PC Indian J Lepr (1986 58:618-22

Liu ZP et al Zhongguoe Zhen Jiu (2012) 32:293-6

Tuesday, 23 August 2022

Fallopian tubes, tubal infertility and acupuncture

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.

When an egg is release, it takes about 8 hours to reach the site within fallopian tube where fertilization occurs and embryo is accommodated there for 72 hours. Once progesterone dominance begins lumen opens and the embryo is transported to the uterus.

Tubal infertility and acupuncture

The fallopian tube is essential on sperm, egg and embryo transport and dearly 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 spasm tube 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.

Risk factors of tubal infertility include increased age, cigarette smoking history of endometriosis and history of pelvic inflammatory disease which were significantly associated with tubal infertility.

Tubal infertility with acupuncture treatment

Fallopian tubes which are the pathway where eggs travel to the uterus are very important for normal fertility. They play a key role in picking up eggs and transporting eggs, sperm and embryo. The fallopian tubes are the places where eggs are fertilised. 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.

Causes of tubal infertility: Pelvic infection is a major cause of tubal infertility. Infective tubal damage 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. Pelvic endometriosis rarely causes complete tubal occlusion. Endometriosis associated adhesions 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.

Tube obstruction may occur at any part along the course of the tube. Tube occlusions may be caused by tube spasm, infection and surgery. Tube spasm likely occurs in the proximal and middle part of the tubes. Distal part of the tube (which is close to the ovary) occlusion is likely caused by pelvic infection. If your tubes were damaged, the body healing procedure will be initiated automatically in order to repair the damage. If you have a wound in your hand, you can see the repairing process clearly which is inflammatory process. The body was trying to repair and regenerate to heal the wound. There was a similar process going on if your tubes were damaged.

Patients with tubal infertility have reduced chance of natural conception, depending on the extent of tube damage. Transcervical cannulation is good option for proximal tube occlusion. Other surgical procedures could be another option. The disadvantage of surgery is that it can cause scar tissue and adhesion. The tubes may become blocked again, cause new pelvic infections and risk for ectopic pregnancy.

Apart from surgical treatment option, acupuncture is a good choice that can be very effective without causing additional scars and infection. Acupuncture increases reproductive system blood flow, reduces inflammation; as a result, it releases tube spasms, reduces scar tissues and helps healing process. This may get blocked tubes open again. 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

Monday, 22 August 2022

What are meridians in Chinese medicine?

What is meridian?

Meridians are like vessels forming a network and connecting skin and muscles to internal organs such as heart, liver etc to make energy and blood flowing freely and maintain balance in the body.

How many meridians are there? There are 12 regular meridians which are the main passageways for energy and blood, six of which are foot meridians and another six are hand meridians. Foot meridians either start on the foot or end on the foot and hand meridians either start on the hand or end on the hand. These 12 meridinas connect to internal organs and are running bilaterally in the body. Apart from 12 regular meridians there are eight extra meridians which are not as regular and do not connect to internal organs directly.

Name of twelve regular meridians

Taiyin Lung Meridian of Hand or Hand's Major Yin Lung Meridian

Shaoyin Heart Meridian of Hand or Hand's Minor Yin Heart Meridian

Jueyin Pericardium Meridian of Hand or Hand's Absolute Yin Heart Protector Meridian

Shaoyang Sanjiao Meridian of Hand or Hand's Minor Yang Triple Burner Meridian

Taiyang Small Intestine Meridian of Hand or Hand's Major Yang Small Intestine Meridian

Yangming Large Intestine Meridian of Hand or Hand's Yang Supreme Large Intestine Meridian

Taiyin Spleen Meridian of Foot or Foot's Major Yin Spleen Meridian

Shaoyin Kidney Meridian of Foot or Foot's Minor Yin Kidney Meridian

Jueyin Liver Meridian of Foot or Foot's Absolute Yin Liver Meridian

Shaoyang Gallbladder Meridian of Foot or Foot's Minor Yang Gallbladder Meridian

Taiyang Bladder Meridian of Foot or Foot's Major Yang Urinary Bladder Meridian

Yangming Stomach Meridian of Foot  or Foot's Yang Supreme Stomach Meridian

 

Feature of meridians

Meridians are channel networks in human body according to Chinese medicine meridian theory. This network with many acupoints did not have anatomy basis. However modern research investigated the characteristics of meridian and acupoints and the achievement was noticeable. For example, the temperature and microcirculation perfusion at the acupoints were higher than that at nonacupoints. Some biochemical reactions were more active such as there was higher ATP, oxygen partial pressure, transcutaneous CO2 emission etc at acupoints. After acupuncture stimulation of the acupoints these parameters were changed. Also there were some researches showing that skin temperature along meridians were different from other skin area. Recently research showed that skin and deep tissue microcirculation was higher along meridians along the governor meridian which is located along the midline of the back was higher in healthy adults than non meridian part. Also blood perfusion along governor meridian was higher than that the two bilateral medial bladder meridians which located at 1.5 body inch bilateral to the midline at the back. Local blood perfusion was important for organ function. The increased microcirculation along governor meridian may represent the common features of all other 12 common meridians. Further research will provide the microcirculation information about differences between meridians and nonmeridians and its role in pathological conditions.

There are 361 acupuncture points along to these meridians. Each acupuncture point has specific effect

Acupuncture produces effect by acting through acupoints. Each acupoint has its specific effect. The mechanism of this specificity was studied. A study compared the effect of ST36, and LR3 acupoints. In this study, 26 healthy subjects were divided into three groups: ST36, LR3 and control groups. Acupuncture was received in ST36 and LR3 groups, but not control group. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac index (CI), systemic vascular resistance index(SVRI), superior mesenteric artery blood flow volume (SMABFV), and power of each frequency domain calculated from FRV (very low frequency (VLF), low frequency (LF), high frequency (HF) and LF/HF were measured before and 30 min after stimulation. VLF: generally reflects functions such as thermoregulation and rennin-angiotensin system activity. LF generally reflects both the sympathetic and parasympathetic nervous systems. HF generally reflects the parasympathetic nervous system. LF/HL generally reflects the balance between the sympathetic and parasympathetic nervous systems. The changes in these values were found 30 min after acupuncture stimulation at ST36 and LR3 and control groups by comparing to values before the intervention. In stimulation at ST36, VLF, LF, HF and LF/HFsignificantly increased, SBP significantly decreased and SMABFV significantly increased compared with that before the intervention. In LR3 stimulation, HF significantly decreased and LH/HF significantly increased and SMABFV did not change. In control group, VLF and SVRI increased and CI significantly decreased while SMABFV did not change. This study has shown the specific effect from ST36 and LR3 which has its own unique response to acupuncture stimulation. 

Biophysical properties in meridian and acupoints

Acupuncture is an important part of Chinese medicine. It is based on meridian theory. There are 14 meridians in human body. Along the meridians, there are hundreds of acupuncture points. Acupuncture at these acupuncture points was performed. Many acupuncture points on one meridian have similar function. Current research in China showed that gastric electric activity increased when acupuncture was performed at Sibai (ST2) and Dichange (ST4) which are located in the face and on the stomach meridian, but far from stomach. It also showed that there was no effect when acupuncture was performed a nonmeridian point beside ST2 and a point on small intestine meridian. There was a study that investigated acupuncture at acupuncture points on bladder meridian, non acupuncture points on bladder meridian and non acupuncture points of bladder meridian. They found that blood flow increased the most from acupuncture with acupuncture points on bladder meridian and the least from acupuncture with non acupuncture points of bladder meridian. Recently Zhang et al showed that acupuncture off acupuncture point BL57 on bladder meridian increased local blood flow.  This effect was higher than that acupuncture off acupuncture points and off bladder meridian. They suggested that keeping needling points on meridian is more important. More research suggested that the density of nerve terminals, blood vessels and mast cells at the acupuncture points is higher and the signals produced by acupuncture are stronger. Acupuncture on the meridians facilitate the signal transporting and increase blood flow.      

There was no anatomic evidence to show meridian existence. Recent research demonstrated the existence of meridian using biophysics, biochemistry and molecular biology techniques. Li J et al reviewed the biophysical studies of meridian/acupoints after obtaining the electronic database. Researchers used the resistance measurement to detect the resistance of the acupoints. They found that there was low resistance at some acupoints compared with nonacupoints at some studies. But there were many factors affecting the measurements so there was still in a debate. There were reports that the property of transmitting sound in meridians is better than that of the surrounding areas due to the enrichment of isotropic ions along meridians under the action of bioelectric field. Main and collateral channels are good medium for mechanical vibration wave and infrasonic wave. The high temperature along meridian and acupoints was reported. Also after acupuncture treatment the temperature along the meridian and acupoints was observed. Also characteristic of transmission of light is different between meridians and nonmeridians. A relatively stable circular current of electromagnetic and chemical oscillation was found along the low electric resistance pathway. Magnetic stimulation of acupoints could cause temperature variation along meridians. Migration of isotope along meridians and myoelectric activity were observed.    

Acupuncture increases blood perfusion around the acupoints.

Acupuncture is used to treat many conditions worldwide. The mechanism is based on Meridian theory in Traditional Chinese Medicine (TCM) which is not recognized by modern medicine.  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.  

References

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

Zhang WB et al Evid Based Complement Alternat Med (2013) 2013:426052 

Li J et al Evid Based Complement Alternat Med (2012):793841

 

Feeling drowsy? acupuncture can help.

Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate times. Many conditions can cause drowsiness, such as, chronic pain, diabetes, insomnia sleep apnea underactive thyroid, depression, anxiety etc. Life style such as night shifts, not sleep long enough, alcohol abuse and stress etc can also cause drowsiness.

Idiopathic hypersomnia (unexplained daytime sleepiness) is a condition in which excessive sleep or sleepiness interferes with everyday life. There is no underlying cause found. People with this condition are sleepy throughout the day, despite sleeping for a very long time at night. They are struggling to stay awake during the day and are usually compelled to take frequent long naps. The excessive sleepiness may have a negative impact on the person's work, relationships and social life, and they may also have anxiety, depression, fatigue mood changes think or speak slowly poor memory and difficulty to concentrate etc. There are no medicines specifically designed to treat idiopathic hypersomnia. Why not try acupuncture?

Lack of concentration, acupuncture can help

Most people have experienced a periodic event of difficulty concentrating. This is often accompanied with tiredness and stress. Many medical conditions can cause lack of concentration such as insomnia, chronic pain, brain trauma, stroke etc. Psychological conditions can also interfere with concentration such as anxiety, depression, emotional trauma, and stress etc.  However in most of cases there are no medical reasons found. Prolonged lack of concentration and feeling tired can be very frustrating. People often turn to stimulants like sugar and coffee to help.

There are many things that you can do to help to improve your brain concentrating.

Diet. Consequence of poor diet does not provide enough nutrients to the brain and this would affect brain function. Healthy diet such as nuts with high proteins is good for the brain.

Exercise. Exercise improves circulation and stimulates brain.

Vitamins. Vitamin B12 is needed to make blood cells and maintain healthy brain and nerve function and helps with memory and concentration Vitamin B12 is found in animal products such as meat, shellfish, milk, cheese, and eggs. Make sure you get enough B12 from these foods. Vitamin D also helps to maintain memory and concentration. Vitamin D is created in the skin by the natural sunlight. Make sure get enough sun shine.

Reduce stress and balance hormones. Stress and imbalanced hormones can affect brain function. Acupuncture can help reduce stress and balance hormones, improve concentration and make mind sharp.

Sunday, 21 August 2022

Acupuncture points, do you know anything about them?

Acupuncture points, do you know anything about them?

When you want to have acupuncture treatment, you see an acupuncturist. Your acupuncturist will put needles into your skin. However the treatment is not just put needles anywhere in your skin. The points for needling chosen are important to achieve best treatment results. There are 365 essential acupuncture points in the body and many more. Which acupuncture points to choose and right for your? Many people heard of tongue and pulse diagnosis. Do you know acupuncture points can contribute to the diagnosis and treatment? Acupuncture point is the essential factor in acupuncture diagnosis and treatment. There are pathological changes of the corresponding acupuncture points for particular conditions. For example, Diji (SP 8) is the most important and commonly used point for the treatment of dysmenorrhea. According to the theory of traditional Chinese medicine (TCM), SP 8 is the Xi-cleft point of the Spleen meridian of Foot Taiyin, where the meridian qi accumulates deeply and is suitable for treating acute pain and blood disease. Primary dysmenorrhea (period pain), a medical condition of cramping pain in the lower abdomen occurring before and during menstruation, is acute pain and blood disease in TCM. Tenderness in SP8 can be detected in patients with period pain. Pain threshold at this point is significantly lower. And this point is often used to treat period pain.

Acupuncture point’s electrophysiological property

Acupuncture points are the sites where acupuncture needles are placed in the acupuncture treatments. What is the electrophysiological property in these points? Recently a research studied power spectral differences of electrophysiological signals at acupuncture points and non-acupuncture points. In this study, 10 acupoints and non-acupuncture points were chosen to see if there are electrical differences between acupoints and non-acupoints. 4 adjacent non-acupoints around each acupoint were chosen as a control group in 10 healthy subjects. The results show that acupoint electrophysiological signals have higher Power Spectral Density and power than nearby non-acupoint areas. The maximum power difference between acupoints and non-acupoint is 61.5% appeared in LI 11. From physiological view, the percentage is high enough to show the electrical specificity of acupoint, which is strong proof of Traditional Chinese Medicine theory and one of the bases for further research. As acupoint electrophysiological signals are driven by internal organs, they can reflect the health condition of internal organs effectively, and so analysis of acupoint electrophysiological signals may be a new way to diagnose organ diseases instead of with the experience of doctor of Traditional Chinese Medicine.

Which acupuncture points are frequently used in lower back pain?

There are 360 classic acupuncture points in human body according to Chinese medicine theory as mentioned above and there are more discovered. The selection of appropriate acupuncture points is the first step to obtain therapeutic effects. How acupuncturists select acupuncture points? There are three basic principles to select acupuncture points: the first is local acupoints near the area where symptoms occur; the second is distant acupoints along the meridian and the third is distant acupoints based on symptom differentiation. Lee SH et al analysed acupuncture points from 53 studies using modern techniques to extract most commonly used acupuncture points. There were 33 most frequently used acupoints for lower back pain (LBP). The most frequently used acupoints in the treatment of low-back pain were BL23 (51%), BL25 (43%), BL24 (32%), BL40 (32%), BL60 (32%), GB30 (32%), BL26 (28%), BL32 (28%), and GB34 (21%). All local acupoints for LBP are on the Bladder and the Governing vessel especially at the low back position of these meridians. Most of the distant acupoints are on the Bladder and Gallbladder meridians. The acupoints include seven acupoints (BL23, BL24, BL25, BL26, and BL32 as local points and BL40 and BL60 as distal points) on the bladder meridian and two acupoints (GB30 as a local point and GB34 as a distal point) on the gallbladder meridian.

References

Chen S et al (2015) Evid Based Complement Alternat Med 2015:158012. doi: 10.1155/2015/158012. Epub 2015 Jun 16.

Zhou Q Acupunct Electrother Res (2014) 39:169-81

Lee SH et al Evid Based Complement Alternat Med (2013) 2013:402180

Friday, 19 August 2022

How can acupuncture help hormone balance, ovulation and egg quality?

Acupuncture regulates hypothalamus-pituitary-ovarian axis and helps hormone balance. 

The female reproductive system is controlled by the hypothalamus-pituitary-ovarian (HPO) axis. This feedback loop begins with gonadotrophin-releasing hormone being released from the hypothalamus, resulting in the secretion of the gonadotrophins (LH and FSH) from the anterior pituitary, which in turn controls estrogen and progesterone production in the ovaries. Estrogen and progesterone play a central role in female fertility by stimulating growth, differentiation and maturation of follicles, preparing the endometrium for implantation and maintaining embryonic development. Altered levels of hormones and other factors that are involved in maintaining control of the HPO axis can have negative effects on fertility and pregnancy

Acupuncture promotes the release of beta-endorphin in the brain, which regulates gonadatrophin releasing hormone from the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary.

Egg quality

How to you know your egg quality is good or not? It is difficult to know your egg quality until IVF through which eggs can be seen. There are many factors that help estimate egg quality:

ovarian reserve tests including AMH, antral follicle count and FSH test, higher AMH and antral follicle count show good ovarian reserve. FSH from blood test less than 10 iu/l is good.

factors related to your menstrual cycles including cycle length, premenstrual spotting, ovulation day, peak estradiol and peak progesterone. Shorter cycles, spotting and low estradiol and progesterone indicate egg quality may not be good enough. 

women’s age: most women under age 35 would have good quality of eggs.

pregnancy loss followed by difficulty to conceive again; This indicates that your egg quality is deteriorating.  

IVF results which tests egg quality.

Acupuncture with or without TCM. Minimum 3 month acupuncture could improve egg quality.

Off pills, acupuncture helps resume ovulation

Oral contraceptive pills were developed over 40 years ago and they become the most common approaches of contraception in many countries. About 100 million women worldwide currently rely on this method for contraception. Do you know what the components of contraceptive pills and how they work? Most commonly used pills are called combined oral contraceptive (COC) pills which contain estrogen and progestogen. There are progestogen only pills available as well. These pills mainly inhibit ovulation by disturbing hypothalamus pituitary gland ovary axis ovary function and altering hormone balance. For most women their period will return within a few months once off the pills. But for some women, it might take longer to get their ovaries function again. This is understandable. For example if you fix one of your knee joints for a few months or longer. The knee joint may not function well and the related muscles will shrink and loss their function. When you release the knee, you have to work really hard and do lot of exercises to get the joint and muscles function well as normal again. When you are on pills your ovarian function is suppressed and they will not ovulate immediately. Some women’s ovary may be more sensitive to the pills. Once you are off pills, the ovaries have to work hard to regain their function. This takes some time. If they fail to do so, follicles may not develop and ovulation may not occur.

What you can do to help your ovary function? Acupuncture can help resume ovary function by improving ovary blood flow and regulating hormone balance as mentioned above  without taking more medications.     

References

Chang K and Tian SL Zhen Ci Yan Jiu (2012) 37:15-9

Wednesday, 17 August 2022

Living with Irritable bowel syndrome (IBS)? Can you get rid of it?

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder and it is a chronic condition featuring recurrent abdominal pain or discomfort associated with disturbed bowel function and bloating. Irritable bowel syndrome (IBS): is a common chronic functional bowel disorder. The symptoms include chronic abdominal pain, which is often associated with diarrhoea, constipation or bloating. Bowel habit is changed often with increased passing stool frequency and passage of mucus. IBS affects about 20% adult population globally and their quality of life is affected.

The exact causes of IBS are not clear. The possible causes include intestinal motility and intestinal smooth muscle functional disturbance, visceral paresthesia, alterations in the brain-gut axis, psychological factors, gastrointestinal hormones and intestinal infection. Some evidences suggested that neurohormonal and immune responses to physiological stimulation or psychological stress etc are possible risk factors.

This condition is not life threatening, but it does affect patient quality of life. Acupuncture is used to treat IBS and there were many researches showing its effectiveness, though there was different opinion on this.

There was a case study about acupuncture treatment on IBS published in Chinese acupuncture journal. The researchers compared trimebutine maleate, a commonly used drug for IBS. Two acupuncture points ST25 and BL25 were used for daily acupuncture treatment. The symptoms including duration and frequency of abdominal pain, morbidity of abnormal stool, defecation abnormality, stool mucus and score of bloating were assessed. The result showed that there was significant change for both groups which suggested that both acupuncture and the drug are effective on IBS. The effective rate for acupuncture group is higher than for the drug group which indicates that acupuncture was more effective compared to the drug.

Li H et al compared the effect of acupuncture with medicine for diarrhea-predominant IBS. 70 patients with IBS were allocated into two groups acupuncture group and medicine group. In acupuncture group, patients received acupuncture 3-4 treatment per week for 4 weeks. The points selected were Tianshu (ST 25), Zusanli (ST36), Shangjuxu (ST37), Sanyinjiao (SP6), Taichong (LR3) etc. The electric stimulation was added at bilateral ST25. Pinaverium (Dicetel) was given in medicine group. The clinical symptom score and IBS syndrome quality of life (IBS-QOL) score were assessed before and after treatment. The efficacy and the recurrence rate were assessed. Result showed that the symptom score and IBS-QOL score were all improved significantly after treatment in both groups. The efficacy in acupuncture group was greater. 3 month follow up showed that recurrence rate in acupuncture group was lower than medicine group.

Lu YH and Tang XD also showed that acupuncture is effective in 21 patients with IBS diarrhea. The patients received acupuncture 2-3 times a week. 8 treatments made up for one course. Symptoms after acupuncture treatment significantly reduced compared with that before the treatment. The total effective rate was 52.4% after first course and 90.5% after second course.

Sun JH et al also showed effectiveness of acupuncture in 63 patients with diarrhea predominant IBS. They showed acupuncture treatment reduced the severity and frequency of symptoms including abdominal pain, diarrhea, abdominal distension etc. They also showed that the quicker initiation of effect, the more evident clinical improvement in symptoms along the increase in treatment duration as well as the more significant elevation of QOL.

Chao and Zhang analised data from 1966 to 2013 to study the effect of acupuncture on IBS. There were 5 out of 6 high quality studies found. They found acupuncture was beneficial for patients with IBS though further studies are needed to confirm the conclusion because there were only a few studies met the criteria.

References

Chao and Zhang World J Gastroenterol (2014) 20:1871-1877

Shi ZM et al Zhongguo Zhen Jiu (2011) 31:607-9

Li H Zhongguo Zhen Jiu (2012) 32:679-82

Lu YH and Tang XD Zhongguo Zhen Jiu (2011) 31:975-7

Sun JH et al Chin J Integr Med (2011) 17:780-5

Had ectopic pregnancy to get pregnant again? acupuncture can help

What is ectopic pregnancy? Ectopic pregnancy is that the fertilized egg implanted outside of the uterus. The commonest site is in the fallopian tube. The egg will not develop a baby, but it is threatening condition for the pregnant women. Ectopic pregnancy occurs in 1% pregnancy. The risk factors include pervious pelvic inflammatory disease, infertility, tubal surgery, intrauterine contraceptive device and previous ectopic. Patient has positive urinary pregnancy test. Patient presents lower abdominal pain and slight vaginal bleeding. Ultrasound shows empty uterus and may identify ectopic embryo. If the egg dies before it can grow larger, the pregnancy terminates and the tissue is absorbed in the woman’s body. In this case, the pregnancy test becomes negative. If the pregnancy is left to grow, there is a risk that the fertilized egg grows larger and causes the tube to rupture which can cause life threatening internal bleeding. The signs of tube rupture are sudden severe sharp abdominal pain, feeling faint and dizzy, being sick, diarrhoea and shoulder tip pain. This is a medical emergency condition.

It is recommended that you wait for at least 2-3 menstrual cycles before trying for another pregnancy though many women are not emotionally ready for another pregnancy so soon. The chances of having a successful pregnancy will depend on the underlying health of the fallopian tubes. There are about 50% risks of infertility after ectopic and 20% recurrent rate. In subsequent pregnancy the women should receive early evaluation to confirm that the pregnancy is in uterus. It is hard to predict what the individual chance is for a successful pregnancy after the ectopic pregnancy surgery. Some research showed that about 65% of women achieved a successful pregnancy 18 months after having an ectopic pregnancy. Acupuncture could help the recovering of fallopian tubes by improving pelvic circulation, reducing inflammation and relaxing the tubes to be ready for next pregnancy. Also acupuncture can help to reduce stress in the women after pregnancy loss and surgery.

Appendectomy increases the risk of ectopic pregnancy

Fallopian tube damage is responsible for one third of infertility cases. Ruptured appendicitis has been considered a risk factor in causing scarring, which can lead to infertility and/or ectopic pregnancy. Does appendectomy increase the risk of tubal infertility? A research studied recent data on this subject. They found that previous appendectomy is not associated with increased incidence of infertility in women. However this study found that appendectomy is significantly associated with an increased risk of ectopic pregnancy.

Compromised ovarian function after salpingectomy, acupuncture can help.

After salpingectomy, the ovarian function on the operation side could be compromised because of reduced blood circulation.  A study involved in thirty-two patients with unilateral salpingectomy performed for ectopic pregnancy investigated this subject. In this study, ovarian function was assessed by antral follicle count, ovarian volume and ovarian stromal blood flow measured by three-dimensional (3D) power Doppler ultrasonography. Ovarian volume, antral follicle count and 3D power Doppler indices were comparable between the operated and the non-operated sides in the whole group and in the laparotomy group. The antral follicle count and 3D power Doppler indices were significantly reduced on the operated side in the laparoscopy group. It suggested that ovarian function seems to be impaired after laparoscopic unilateral salpingectomy at short-term.

Do you know that acupuncture improves blood circulation to the ovaries and other reproductive system? It could help to improve ovarian function.

References

Elraiyah T et al J Surg Res (2014) ii: S0022-4804(14)00784-7. doi: 10.1016/j.jss.2014.08.017.

Chan CC et al Hum Reprod (2003) 18:2175-80

Tuesday, 16 August 2022

Acupuncture helps with dementia

Dementia is due to damage of the brain caused by many diseases. The symptoms of dementia are memory loss, communication problem, behaviour changing and having difficulty of everyday life. For example, you may forget what you said earlier in the day or where you put things etc. You may be having difficulty to recognise persons you are familiar with or unable to find familiar places etc. You may find it difficult to communicate with others and feel depressed etc. The symptoms might be different depending on individual, but generally the symptoms are getting worse over time.

Dementia is due to damage of brain, which is caused by many diseases. Alzheimer’s disease (AD) is a most common form of dementia, which accounted for 70% of dementia. Alzheimer’s disease is degenerative which is caused by losing brain cells in the cerebral cortex and some other regions of the brain. This loss leads to shrink of the affected regions causing the symptoms mentioned above. Mild cognitive impairment (MCI) is the most important at risk state of AD which is a transition stage of normal aging and dementia. It has a high probability of degenerating into AD at a rate of 10-15% per year. Unfortunately there is no effective treatment for AD and MCI.

Acupuncture is used in treating AD and MCI in China. Recently Wang Z et al studied the effect of acupuncture on brain functional activity throughout the entire brain in patients with AD and MCI and compared with normal controls. Participants were 14 patients with AD, 8 patients with MCI and 14 healthy controls. At the resting state, in patients with MCI, there were increased activities in the brain regions of the temporal lobe, frontal lobe and left lentiform nuleus, while there were decreased activities in the regions of right cingulated gyrus and left fusiform gyrus compared with normal controls. In patients with AD, there were decreased activities in left temporal lobe and left middle frontal gyrus. Then data was taken during the process of acupuncture at points LI4 and LR3 bilaterally and 10 min after acupuncture treatments. They found that brain activities related to memory were altered during the acupuncture process and after the acupuncture treatment in patients with AD or MCI compared with the resting state. They found that acupuncture regulates brain activity bilaterally in patients with MCI which is it activates the regions with decreased activities in the resting state, while it deactivates the regions with increased activities in the resting state. In patients with AD it also showed increased or decreased regions of activities. They confirmed that the two points used for acupuncture can contribute to activate certain memory-related regions in patients with AD and MCI.

Zhou J and Jin J also showed that acupuncture at points HT7, ST36, ST40 and KI3 acupoints stimulated right main hemisphere activations (temporal lobe, such as hippocampal gyrus, insula, and some area of parietal lobe) and left activated regions (temporal lobe, parietal lobule, some regions of cerebellum). These activations by the acupuncture on these points were on the impaired regions in patients with AD, which closely associated with cognitive function such as memory, language etc. These researches provided strong evidence for the effect of acupuncture on dementia.

A ten-minute memory test operated by a computer programme is available. This test is aimed to recognize early stage of dementia, which could tell the differences between normal forgetfulness and memory loss of dementia. Early diagnosis of dementia could spot patients before their brain were damaged and help them to get early treatment which could delay the progress of the disease. For dementia care information you can find at Alzheimers society website http://alzheimers.org.uk/caring_for_someone_with_dementia and at department of health website http://www.dh.gov.uk/health/category/policy-areas/social-care/dementia.

Vascular dementia is a second main cause of dementia. There were many case studies that reported the effectiveness of acupuncture on vascular dementia. Shi GX et al studied the effect of acupuncture on vascular dementia in 16 patients with vascular dementia. They found that acupuncture improved cognitive function and quality of life in patients with vascular dementia and acupuncture reduced oxidative damage in patients with vascular dementia. Zhang H et al conducted a randomized control trial to study effect of acupuncture for treatment of vascular dementia. 270 patients with vascular dementia were recruited and received 6 weeks acupuncture treatment. The acupuncture points used Sishencong EX-HN1, Baihui GV20, Shenting GV24 and Fengchi GB20. They found acupuncture improve cognitive function and quality life in patients with vascular dementia. The effect was better than that for Nimodipine on its own, but acupuncture together with Nimodipine had better effect than acupuncture alone. Huang Y et al found that stimulating acupoints improves various brain area functions and this contributes to the improvement of cognition function, memory and daily life quality etc.

Acupuncture help sleep in patients with dementia

Elderly with dementia often have sleep problems. Recently there was a study investigating the effectiveness of acupuncture on sleep quality of elderly with dementia. There were 19 patients with dementia participated the study. These patients were followed through a control period for 6 weeks and an acupuncture treatment for 6 weeks. Sleep quality and congnitive function were measured and compared before and after the treatments period. The results showed that resting time and total sleep time in acupuncture treatment period significantly more than those in the control period. Improvement in congnitive function was not significantly different between the two periods. This study suggests that acupuncture was effective in improving some domain of sleep quality of patients with dementia and acupuncture was an acceptable intervention for these patients.

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.

References

Wang Z et al PloS One (2012) 7:e42730

Zhou J and Jin J Acupunct Electrother Res (2008) 33:9-17

Shi GX et al J Tradit Chin Med (2012) 32:199-202

Zhang H et al Zhongguo Zhen Jiu (2008) 28:783-7

Huang Y et al Chin J Integr Med (2007) 13:103-8

Kwok T et al Clin Interv Aging (2013) 8:923-9

Zeng XH et al Evid Based Complement Alternat Med (2014) 2014:483294

Monday, 15 August 2022

How overweight affects fertility and how can acupuncture help?

Obesity increasingly affects people’s health. It is well studied and extensively agreed that obesity has negative impact on fertility. Women with obesity are three times more likely to suffer from infertility than women with body normal weight. The impaired fertility has been seen in obese women naturally and obese women with assisted conception. Obesity reduced fertility by affecting ovulation, egg development, embryo development, endometrial development implantation and pregnancy loss.

Obesity affects ovulation and period cycles. Obesity has effect on hypothalamus-pituitary-ovarian axis which is important in regulation of sexual hormone production. If this axis is disturbed, normal hormone production is impaired leading to abnormal period cycle and anovulation. This causes infertility. Women with obesity respond poorly to ovulation induction. Weight loss only could restore normal period cycle and ovulation; it increased response to ovulation induction.

Obesity affects egg quality and egg quality is likely to be poor in women with obesity

Obesity has great impact on reproductive health. Women with obesity are nearly three times more likely than women without obesity to have difficulty to conceive and may take longer to conceive. Women with obesity also have an increased risk of miscarriage, pregnancy complications and congenital defects in offspring, if they do get pregnant. Obesity may affect egg competence and maturation caused by alterations in steroid hormone balance, particularly those hormones that trigger follicle maturation. This is because fat tissue is an important site for steroid hormone production and metabolism and excessive fat in obesity may alter steroid hormone levels. Also metabolic alterations in obesity occur in the serum which is reflected in the follicular fluid and some changes in this micro environment may affect egg quality. For example, serum insulin concentrations and resistance to insulin action in cells are increased in obesity. In women with obesity has increased C-reactive protein which is an inflammatory marker in follicular fluid. When undergoing IVF, women with obesity have less quality eggs collected. This is caused by reduced human chorionic gonadotrophin (hCG) concentration impairing egg maturation. Many studies showed that obese women undergoing IVF have lower fertilization rate than women with normal weight. Impaired egg development could lead to impaired embryo development and following impaired implantation.

Obesity reduces uterine receptivity

How obesity affects women’s fertility? Recent research suggested that obesity reduces uterine receptivity in overweight women. Bellver J et al analysed the reproductive outcome of recipients of donated ova according to their body mass index (BMI). These data were from 9587 first cycles of ovum donation from normal weight donors. Recipients received in vitro fertilization (IVF) were divided into four groups according to their BMI: group A lean BMI<20 kg/m2, group B normoweight BMI 20-24.9 kg/m2, group C overweight BMI 25-29.9 kg/m2 and group D obese BMI ≥30 kg/m2. There was no difference among the groups in IVF parameter. However, implantation, biochemical pregnancy, clinical pregnancy, twin pregnancy, and live-birth rates were significantly decreased as BMI increased. In the lean, normoweight, overweight and obese groups, the implantation rate was 40.4%, 39.9%, 38.5% and 30.9%. Clinical pregnancy rate was 56.9%, 55.9%, 54.3% and 45.3% and live-birth rate was 38.6%, 37.9%, 34.9% and 27.7% respectively. Clinical miscarriage rates were similar in all groups. They suggested that female obesity impairs the reproductive outcome of donated ovum because of reduced uterine receptivity. To make uterus more acceptable for pregnancy, it is time to lose weight for those overweight women.

Women with obesity are more likely to have early pregnancy loss once they are pregnant. Increased miscarriage rates were observed in pregnancy from natural conception, ovulation induction and assisted conception. This suggests that endometrium may play a part in early pregnancy loss.

Obesity affects assisted conception treatments. Many studies have shown that obese women undergoing assisted conception such as IVF have lower live birth rates. This is accumulated effect of lower implantation and pregnancy rate, higher miscarriage rates and increased pregnancy complications.

Weight loss improves fertility greatly no matter what weight loss methods were used. The first method used should be life style changes including diet and exercises. Many evidences showed improvement of ovulation frequency and pregnancy rates after good weight loss.

Acupuncture helps regulate metabolism of the body. Acupuncture helps increase ovarian and uterine blood flow to improve egg quality and uterine lining for conceiving and implantation and supporting pregnancy.

References

Bellver J et al Fertil Steril (2013) Jul 3

Yao H et al Zhen Ci Yan Jiu (2012) 37:497-501

How many acupuncture treatments are adequate?

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 are no standard protocols on the optimal acupuncture treatment for any particular condition. If you saw different acupuncturists for the same conditions, you would end up with different treatments and some require more treatments than others.

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.

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 are there 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.

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

 

Saturday, 13 August 2022

How does acupuncture work? Research shows that acupuncture alters brain activities.

Acupuncture is originated from China thousands years ago and has been used since. It is now more popular than ever in all over the world. However mechanisms of acupuncture on the central nervous system (CNS) still remain unclear.

New techniques are invented to study brain including Functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), Electroencephalography (EEG), and Evoked Potentials (EP). fMRI can used to measure the brain's neuronal activity and the resulting regional changes in metabolism and circulation.PET can be used to measure the brain's regional blood flow, oxygen, or glucose metabolism and reflect the activity in the according brain region. EEG is used to measure brain activity. EP measurement reflects the number of cortical cells activated and the intensity of the stimulus. These techniques are applied to acupuncture research. Using these technologies, researchers are able to examine the acupuncture process in the brain noninvasively and provide scientific evidences how acupuncture works.

Using biochemical approach, researchers found that acupuncture analgesia might be induced by the release of endogenous opioids, as well as by modulating other signalling systems such as the adrenergic system/the serotonin signalling system/the N-methyl-D-aspartic acid/AMPA/kainate signalling system etc. Recently by using neuroimaging techniques researchers found that acupuncture modulates brain networks such as brain resting state networks; acupuncture modulates a wide network of brain areas including cortical, subcortical/limbic, and brainstem areas; acupuncture can enhance functional connectivity among different brain regions.

References

Scheffold BE et al Evid Based Complement Alternat Med (2015) 2015:641742

Dermal fillers VS facial acupuncture-beauty treatment

Dermal fillers or injectable fillers are soft tissue fillers which can be injected into the skin to help fill in facial wrinkles and restore a smoother appearance. Most of the fillers are temporary because they are eventually absorbed by the body. The effect lasts for about six months or longer. There are many different types of fillers; some are natural and some are synthetic, but they all work in similar way to improve the appearance of skin aging. They fill in wrinkles including fine lines and deep creases on the face or lips. plump up the cheeks and contour the face such as jaw line. Common side effects of dermal filler procedure include bruising, redness, pain or itching. Less common side effects include infections or allergic reactions, which may cause scarring and lumps that may require surgical correction. Serious side effects include such as blindness due to retrograde embolization into the ophthalmic and retinal arteries; delayed skin necrosis as a complication of embolization.


Facial rejuvenation acupuncture which is acupuncture as cosmetic purpose can eliminate some wrinkles, improve facial muscle tone, improve skin texture with tighter pores, and decrease sagging around the eyes, cheecks, chin, lift droopy eyelids, face and mouth and clear age spots.

Facial acupuncture helps regeneration of healthy skin cells, increase nutrition to the skin's surface, improves the quality of the skin and enhances a healthy glow, stimulates normal breathing of the skin and makes skin healthy and stronger to prevent infections and clogged pores. Good skin circulation takes waste and reduces grease accumulation resulting in deep cleaning of the skin. Acupuncture stimulates the production of collagen and elastin in the skin. Recently research suggested that wrinkles were improved significantly after facial acupuncture treatment and facial elasticity was also improved in women aged 40 and 59 years.

The side effect was mild bruising (20/140 treatment sessions; 14.28%) at the needle site. No adverse events of scarring, nerve damage, or lengthy recovery periods were observed.

References

Yun et al Evid Based Complement Alternat Med (2013) 2013:424313
Barrett Aesthet Surg J (2005) 25:419-24
Imokawa G and Ishida K Int Mol Sci (2015) 16:7753-75

Thursday, 11 August 2022

What do you know about body fat? Lose weight or gain weight?

When we say fat, one might instantly think of obesity. What is fat? Fat is one of the basic components that make up the structure of the body. It is necessary for normal, healthy body functioning. Body fat can be divided into two types: essential fat and storage fat. Essential fat is necessary for normal, healthy functioning. In men, essential fat is approximately 3% of body weight, while in women it is about 12%. This also depends on age. With increased age, the essential body fat increased. Storage fat is the fat increased when you gain weight and this is the fat that you want to lose when you lose weight. Most of people know that too much fat is not healthy. Too much fat increases your risk for developing heart disease, high blood pressure, gallstones, type 2 diabetes, osteoarthritis, certain cancers and for an early death increases.

Do you know too little fat is not healthy either. If a man’s body fat is too low, his health may be compromised and he may become more vulnerable to illness or experience chronic fatigue. If a woman's body fat is too low, her periods may stop and she may experience infertility. Or the other way around if a woman’s periods stops she may have low body fat. Also if a woman’s body fat is too low, the health of her bones, normal hormonal function may be compromised and she may have osteoporosis.

Amenorrhoea is the absence of menstrual periods. Women who are athletes or who exercise excessively on a regular basis are at risk of developing athletic amenorrhoea.

Low levels of body fat and exercise-related hormones, such as beta endorphins and catecholamines, are thought to interfere with the functioning of the sex hormones oestrogen and progesterone. If left untreated, long-term complications include increased risk of broken bones and premature ageing.

For a doctor to diagnose athletic amenorrhoea, all other possible causes, such as certain reproductive disorders, must first be eliminated. Treatment options include exercising less or, in some cases, starting hormone replacement therapy (HRT).

The long-term complications of untreated athletic amenorrhoea include:

Infertility – a woman can’t conceive when she is amenorrhoeic, but athletic amenorrhoea has no effect on long-term fertility once menstruation returns.

High levels of blood cholesterol – are caused by an oestrogen-related fall in the ratio of good cholesterol (high-density lipoprotein or HDL) to bad cholesterol (low-density lipoprotein or LDL).

Osteoporosis – is a disease characterised by brittle bones that break easily.

Premature ageing – the skin loses its elasticity due to low levels of oestrogen.

Unwanted gaining weight, which hormones to check?

If you gain weight unexpectedly and have trouble to lose the weight, you need to get your hormones checked. Imbalanced hormones can make you put on weight. Which hormones do you need to check?

First , thyroid hormones. If your thyroid function is low and you don’t produce enough thyroid hormones, you can put on weight. Thyroid hormone regulates the rate of the metabolism in your body. If it does not work well, you will likely become fat and have low energy. You may have other symptoms of low thyroid including weakness, cold hands or feet, constipation, low immunity and brittle hair.

Second, insulin. Insulin is produced in pancreas and it is a fat-storing hormone released in response to excess blood sugar. If you have insulin resistance, which means that insulin isn't working very well in your body, this leads to weight gain. Apart from weight gain, other symptoms of insulin resistance include excess thirst and urination, hunger and sugar craving, fatigue and poor circulation, cold hands and feet, poor immunity, poor thyroid function, PCOS, heart and liver problem etc. Improving
your insulin response is a great way to reduce body fat, improve energy and overall health.

Third, Cortisol. Cortisol, called stress hormone is produced in adrenal gland. High or low level of cortisol can cause weight gain. High cortisol levels will lead to fat gain around the belly. Low cortisol levels caused by adrenal fatigue will cause weight gain as well. Other symptoms of adrenal fatigue include bloating, fatigue, sleep disturbances, salt cravings.

Finally, Estrogen and others. Estrogen is stored in fat. Excess estrogen stresses the adrenal glands and binds up thyroid hormone, making weight loss very difficult, especially in the hips and thighs.

Low AMH to get pregnant, acupuncture can help

Anti-Mullerian Hormone (AMH) is a substance produced in small ovarian follicles less than 4 mm which are so small that they can not be seen by ultrasound. Production decreases and then stops as follicles grow. There is almost no AMH made in follicles over 8mm.Therefore, the levels are fairly constant. Since AMH is produced only in small ovarian follicles, blood levels of this substance have been used to attempt to measure the size of the pool of growing follicles in women. The size of the pool of growing follicles is deeply influenced by the size of the pool of remaining ungrowing follicles. Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or "ovarian reserve". Because of the constancy, the AMH test can be done on any day of a woman's cycle. Women with few remaining follicles have low AMH. With increased age, AMH decreases. AMH can only indicates the remaining quantity of eggs that a woman has, but it does not indicate the quality of those eggs. Female age is a very important consideration when estimating the probability for conception because it is a strong determinant of egg quality. Low AMH levels (alone) do not predict low IVF success rates in women under 35. In age-related low AMH, the quality of the eggs may also be affected, as eggs accumulate mutations over time. When there are fewer developing eggs in the ovaries, the chance of a mature and healthy egg being released and fertilised decreases. This may mean that the chances of abnormal fertilisation and miscarriage are increased. Acupuncture can help improve blood circulation to help follicles development and increase the chance to get good quality of eggs.

Wednesday, 10 August 2022

How to get rid of tension headaches?

A tension headache is the most common type of primary headache accounting for about 90% of all headaches. It tends to start from the back of the head and moves forward to the top of the head. The exact causes are not clear. It is often linked to sensitivity to pain, stress and tension. It can be triggered by stress, anxiety, fatigue; and/or holding your head at one position for a long time, such as working on computer all day. The pain is bilateral and the head is like being squeezed or stabbed and the eyes are strained; The pain could be dull and feels like a band surrounding your head. Pain may involve the back part of the head or neck. A tension headache can be episodic lasting for days or become chronic. It can be debilitating, impacting our quality of life, lifestyle, mood and daily activities.

Do you know acupuncture can release tension headache effectively? Here is some research evidence for it.
More recently Granato et al analysed the current data about the effectiveness of acupuncture on tension-type headache. There were 11 trials involved in 2317 patients. Two trials compared acupuncture wit routine care only or treatment of acute headache only with a 3 month follow-up. Both studies measured responder rate, headache frequency, pain intensity and pain killer intake. They suggested that effect of acupuncture was better controls. There were five trials compared effect of acupuncture with that of sham acupuncture. Four trials had 6 month follow-up and one trial had 12 months follow-up. Numbers of headache days were significantly decreased in acupuncture group. Headache intensity and frequency of taking pain killers was significantly reduced in acupuncture group compared with sham acupuncture group. Three of the four trials compared the effect of acupuncture with physiotherapy, relaxation. Their conclusion is that there was short term benefit by adding acupuncture to routine care and acupuncture could be a nonpharmacological tool for treating patients with tension-type headache.

Schieapparelli P et al also support the effectiveness of acupuncture in treating primary headache particular tension-type headache and migraine. They suggested that acupuncture is an effective and valuable option for patients suffering from frequent tension-type headache and migraine; also acupuncture is cost-effective treatment.

Hao XA et al analysed five high quality trials. The results suggested that needle retention with 30 minutes was better than no needle retention; twice a week treatment was better than once a week treatment.

A research paper reviewed the effects of acupuncture for headaches. In this review, at least eight weeks of observation period is required, and twelve trials are included. There were 2349 participants. In two large high-quality trials with 1265 and 207 participants, acupuncture was compared with routine care or treatment of acute headaches. Results have shown that the proportion of participants experiencing at least 50% reduction of headache frequency was much higher in groups receiving acupuncture than in control groups. In seven good quality trials acupuncture group had high reduction of headache frequency compared with sham acupuncture. Withdrawals were low: 1 of 420 participants receiving acupuncture dropped out due to adverse effects.The conclusion from the data suggested that acupuncture is effective for treating frequent episodic or chronic tension-type headaches.

References
Granato A et al Neuroepidemiology (2010) 35:160-2
Schiapparelli P et al Neurol Sci (2011) 32 Suppl 1:S15-8
Hao XA et al J Alterm Complement Med (2012)

What is happening in the body, when you have pain?

Pain is a general term that describes uncomfortable sensations in the body and can be described as sharp stabbing, dull ache, throbbing, stinging, sore, and pinching.   It can range from uncomfortable to debilitating and can be consistent or on and off. Pain is highly subjective. People respond to pain differently. Some people have a high tolerance for pain, while others have a low tolerance.

Pain starts from activation of the nervous system. There are 9 steps of the pain circle:

Step 1: Local inflammation. There are injury, surgery, infection causing local inflammation.

Step2: Peripheral sensitization. Local inflammation irritates the nerves lowering the pain threshold causing peripheral sensitization.

Step3: Central sensitization. Nerve signals are transmitted to the brain causing central sensitization.

Step4:  Pain sensation. The brain tells you that there is pain in the body somewhere.

Step5: Pain cognitive processes. The brain where is sensing the pain connects other part of the brain where controls emotion causing emotional and behaviour changes.

Step6: Depression and anxiety. The brain where controls emotions is affected by the pain signals and alters its function causing depression and anxiety

Step7: Cortical reorganization. The brain reallocates its task to different parts of the body to reduce pain sensation and help replace the lost function.

Step8: Avoidance and disability. The body will respond the brain demands to redistribute the work causing avoidance and disabililty.

Step9: Muscle spasm deconditioning. Injured and related muscles become spasmed to protect the body from moving and feeling the pain causing muscle waste.  

Acupuncture is a therapy in which thin needles are inserted into the body to relieve the pain. 

Tuesday, 9 August 2022

What is piriformis syndrome? Low back pain? Can acupuncture 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.

Management of piriformis syndrome include avoiding positions that trigger pain. Rest, ice and heat may help reduce symptoms. Exercises and stretches may help reduce sciatic nerve compression reducing symptoms. Pain killers, muscle relaxants or local injection with corticosteroid or anesthetic may help with reduction of pain.

Acupuncture can be helpful. 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

With short luteal phase to get pregnant? acupuncture can help.

Short luteal phase with infertility and miscarriage? acupuncture can help

Women’s period cycle is divided into two phases: follicular phases when follicles develop and mature. The time for eggs to mature and release may vary between different women and same woman in different period cycle. This is the reason why period cycles vary to a great extent. When one of the eggs becomes mature, it is released from the ovary. As soon as egg is released, luteal phase began. Dwon KA and Gibson M studied body basal temperatures (BBT) charts and the luteal phase defect from three menstrual cycles of 20 normal women and 20 women with luteal phase defect. They found that luteal phase length in the normal women was 13.4 days and that of the women with luteal phase defect was 11.8 days. 30% of the women with luteal phase defect had luteal phases with less than 11 days and 5 of these women had severely endometrial problems. None of the normal women had luteal phase less than 11 days. Luteal phase does not vary much with length of period. It is normally12-14 days. After ovulation, the remaining part of the follicle forms the corpus luteum which continues to grow and produces a hormone called progesterone. Progesterone is very important for making inner lining of womb suitable for fertilized egg to implant and supporting for early pregnancy. The inner lining of womb is like a comfortable bed for the egg. If the luteal phase is shorter than 12 days, the bed is not ready. This may be because the corpus luteum dies earlier than12 days, your body may not produce enough progestone to make a good bed for the embryo. Luteal phase defect affects 10% women with infertility and over 60% women with miscarriage. The symptoms of luteal phase defect include a short period cycle, spotting, low progesterone, disrupted BBT after ovulation, and other nonspecific symptoms such as low back pain, vagina dryness etc.

There are three causes that could lead to luteal phase defect. 1) Poor follicle production: After ovulation, remaining follicle becomes corpus luteum. If follicle development is poor, this would create poor quality of corpus luteum which does not produce enough progesterone, resulting in poor uterine inner lining. 2) Premature failure corpus luteum. Corpus luteum does not last as long as normal corpus luteum does. This can occur even if initial quality of follicle is good. Again this makes poor uterine lining. 3) Failed response from uterine lining. In this case, uterine inner lining does not respond well to normal progesterone level. As a result it is not well developed for implantation.

According to traditional Chinese medicine (TCM) theory, luteal phase defect is caused by kidney or spleen qi deficiency. Or it is caused by liver qi stagnation. Qi deficiency and stagnation cause blood stagnation and blockage of channels. As a result corpus luteum dies earlier. This is agreed with recent research. During corpus luteum formation, it becomes one of the most highly vascularised organs in the body. Blood flow in the corpus luteum is important for the development of the corpus luteum and maintenance of luteal function. It is important for progesterone synthesis and release. The corpus luteum blood flow in women with luteal phase defect is significantly lower than women with normal luteal function. Increasing corpus luteum blood flow improves its function.

Acupuncture improves ovarian and corpus luteum blood flow. It is very effective to regulate period cycle and restore normal luteal phase. There was a report in Chinese Journals showing effectiveness of acupuncture on luteal phase defect with infertility. 50 patients were diagnosed luteal phase defect. Their age range is from 26 to 42 and average age 32. The history of difficulty to conceive is from 6 months to 4 years. Patients were received acupuncture. Pregnancy rate was calculated. Blood eostrogen and progesterone level was tested; egg development, ovulation and inner lining of womb were checked to measure the effectiveness of acupuncture. Result showed that 40% women achieved pregnancy during 3-6 months. In remaining 53% women, dominant matured egg size was increased, womb inner lining was thicker, blood oestrogen and progesterone level was increased comparing to those before the treatment. Follow up study with those pregnant showed that there was no miscarriage occurred.

Another report from China was about effectiveness of acupuncture treatment on patient with recurrent miscarriage. There were 558 cases with recurrent miscarriage 4 times. 211 cases were treated with acupuncture between 1973-1976; success rate was 86%; 347 cases were treated with acupuncture between 1982-1984, success rate was 93.4%.

References
Takasaki A et al J Ovarian Res. (2009) 14:2:1
Hongwei Yang and Xueyan Huang Shanghai Journal of Acupuncture and Moxibustion (2010) 10:626-628
Downs KA and Gibson M Fertil (1983) 40:466-8

Monday, 8 August 2022

Acupuncture provides hope for conceiving in women with premature ovarian failure

When women reach age 45, their ovaries may stop functioning. There is no egg supply and no ovulation. Hormone levels are changing. This is so called menopause. The signal for arrived menopause is stopped period which indicates the end of fertile life in a woman. This is a stage that every woman has to go through. For some women, their ovaries stop working before 40 years old. This is called premature ovarian failure (POF), or primary ovarian insufficiency (POI), or premature menopause or hypergonadotropic hypogonadism. POF is the result of premature exhaustion of the follicle pool or follicular dysfunction, such as due to mutations in the follicle-stimulating hormone (FSH) receptor. This is a common condition, affecting 1-2% women younger than 40 years of age and 0.1% of women younger than 30 years of age. The cause for POF could be genetic, because there is family history found in 10-20% women with POF. It also could be due to poor ovarian blood supply. Autoimmune damage could contribute to the cause of POF. Ovaries could be damaged by cancer therapies.

The main symptoms of POF include no regular periods, low blood oestrogen level and high FSH under the age 40. Anti-Mullerian hormone (AMH) level is low. Oestrogen is produced by follicles and its blood level is low if follicles are short of supply or dysfunctional. FSH is produced in the pituitary gland at the base of the brain and it stimulates follicles growing. If a woman is running out of eggs in ovaries in the case of POF, resulting in low level of oestrogen, the pituitary gland will work hard to produce more FSH in order to stimulate ovaries to make more good eggs. AMH is a substance produced only in small ovarian follicles and its level is quite constant correlating strongly with the number of growing follicles. Since this hormone is not dependent on hypothalamic-pituitary-gonadal axis function and decreased to undetectable level at menopause, it could potentially help assess remaining function of ovaries and egg supply.

Women with POF could experience menopause symptoms, for instance hot flushes, night sweats and vaginal dryness, similar to those going through a natural menopause. POF could result in many health problems, such as osteoporosis, heart diseases etc. Associated with the development of POF is the loss of fertility, which in most cases is due to the absence of follicles, and in other cases the inability of remaining follicles to respond to stimulation. For most women, there are no obvious signs before the stop of periods. Most women have a normal period history, and possibly fertility before the start of POF symptoms. A common presentation is for women to fail to resume period after a pregnancy or after stop of taking oral contraceptive pills. For most of women, it is a deeply upset diagnosis not only with unpleasant symptoms, but also with infertility. It may have a huge psychological impact on those diagnosed this condition. Infertility is a significant issue for most women with POF, though many women may ovulate at some points, this cannot be predicted with any reliability.

There are treatments that can help some of the symptoms; however women with POF are unlikely to get pregnant without treatments because their ovaries do not work properly. There is no proven medicine to improve a woman’s ability to get pregnant, if she is diagnosed with POF. A number of treatment regimens have been evaluated with the aim of restore fertility; however, treatments with clomiphene, gonadotrophins, GNRH agonists or immunosuppressants do not significantly improve the chance of conception and are not used. Use of donor eggs is only a reliable option from Western medicine point of view. Is there really nothing you can do apart from accepting that you will no longer have a chance to have a child naturally with your own eggs? Why not try acupuncture? There is a chance to conceive naturally with acupuncture treatment.

According to traditional Chinese medicine (TCM) theory, POF is mainly caused by kidney qi deficiency. Liver and spleen qi deficiency may also contribute. Qi deficiency causes blood stagnation and blockage of channels resulting in ovaries losing function. Acupuncture unblocks the channels and restores qi flowing and blood supply to ovaries. From western medicine point of view, acupuncture improves function of hypothalamic-pituitary-ovarian axis regulating blood hormone levels; acupuncture increases ovarian blood flow improving ovarian function. Acupuncture also regulates nervous system function.

There was a case report in Chinese acupuncture website about effectiveness of acupuncture treatment for POF. There were 76 patients aged from 26-40 with POF diagnosis for 1-9 years. These cases were treated from 1990-1996. Acupuncture treatment was given for 6 months. 68% patients restored normal period, ovulation or pregnancy. FSH level decreased to normal and oestrogen level increased significantly.

Recently research provided evidence of effectiveness of acupuncture on POF. Kehua Zhou et al investigated the effects of acupuncture on FSH, oestrogen (E2) and LH in women with POF. They also studied the menstruation changes in these women. They recruited 11 women with diagnosed POF for 4 months to 10 years. Ages of these women were from 25-39. These women had no menstrual period for at least four months or longer. They had high FSH over 40 iu/l. Before acupuncture treatment, they stopped all medications that possibly affect hormones. After the treatments, there was three month follow-up. Assessments were done before the treatment, at the end of three month treatment and at the end of three month follow-up. They found that after acupuncture treatment, E2 increased while FSH and LH decreased which last at the end of three month follow-up. 10 out of 11 patients resumed menstruation; 9 of them still had menstruation at the end of follow-up. Other symptoms such as night sweating, hot flashes and mood swings were reduced during acupuncture treatments and at the end of follow-up.

The advantage of acupuncture treatment for women with POF is that it is not only effective for improving symptoms caused by POF, but also increases fertility.

References

http://www.wfas.org.cn/lunwen/wfas10/200709/1055.html

Kehua Zhou et al Evid Based Complement Alternat Med (2013) 2013: 657234 Published on line 2013 Feb 28

If wrinkles are disappearing in front of your eyes, do you believe it?

Facial acupuncture rejuvenates the skin, this is not imagining, there is research evidence for it.

How do you know your skin is aging?

The skin is the largest organ wrapping around the body protecting us from harsh environment such as sun, wind, pollution and toxins The skin changes with aging. In harsh environment, skin itself can be damaged and age quickly. Also sometimes we don’t look after the skin causing skin damage by doing things like smoking, drinking, poor diet and stress which would accelerate skin aging. How the skin changes with aging? With aging the skin becomes rougher; becomes slack due to loss of elastin and collagen in the skin; becomes more transparent and fragile because of thinning of the surface layer of the skin; becomes easily bruised due to thinning of the blood vessel walls.

Sun exposure accelerates skin aging. UV lights damage elastin and collagen in the skin causing the skin sagging and losing elasticity. Saying out of the sun can prevent skin damage and delay the skin changes. Gravity contributes to skin slack and drooping of the eyebrows and eyelids etc when the skin loses its elasticity. Smoking can damage the skin due to the chemicals in tobacco. Drinking makes the skin dehydrated and damages skin cells. Aging skin wrinkles easily.

Facial acupuncture helps skin repairing and delays aging process and rejuvenate the skin.

Is there any research showing the evidence for it?

Research has shown that facial acupuncture increases skin elasticity

Beauty and skin health are important factors as a part of the quality of life in modern society. Cosmetic acupuncture or cosmetic acupuncture or facial cosmetic acupuncture is the use of acupuncture on the head, face, and neck for cosmetic purposes and has been introduced as an intervention for skin rejuvenation for facial wrinkles, facial muscle tone, and elasticity etc. A recent research studied if facial acupuncture has effects on facial elasticity. In the research five sessions of facial acupuncture were given over three weeks: twice a week for the first two weeks, then once a week for the last week, with three to four days between sessions. The result was measured using the Moire topography criteria after treatment compared with baseline before the treatments. Moire topography is an optical measurement that does not require direct contact and allows high-precision visualization of facial shape in three dimensions. Moire topography is used in studies of many facial conditions facial palsy, zygomatic fractures, facial morphology, and facial plastic surgery and facial elasticity. The result has shown that facial cosmetic acupuncture increases the skin elasticity.

Research has shown that facial acupuncture moisturizes facial skin.

There is a study that exam the effect of facial acupuncture on regulating the water and oil content of the facial skin. Two women (50-year-old participant A, 29-year-old participant B) received five consecutive acupuncture sessions once a week for 1 month. Water content and oil content of the facial skin were measured and compared before and after the first acupuncture session and before and after the five consecutive acupuncture sessions. The results suggest that cosmetic acupuncture increased the water and oil content of facial skin in a female participant whose water content and oil content were lower before receiving acupuncture than those of the mean values of women of the same age.

Research has shown that facial acupuncture reduces wrinkles.

The forehead and the corner of eyes are the common place to get wrinkles. How to get rid of these wrinkles? Facial acupuncture is a good option. It is absolutely natural and no severe side effects. Do you have to see research evidence to show that it is effective to convince you? Here is the publications for it. This is a case report. 8 people (5 female and 3 male and age from 26 to 61) participated the study. Four for the wrinkles on the forehead, two for wrinkles between eye brows and two for crow feet wrinkles. They received 2 acupuncture treatments and the photos were taken three times, before the first treatment, before the second treatment, two to four weeks after the second treatment. The result has shown that the winkle reduction was found in all cases on all types of wrinkles; all participants were very satisfied with the results. The only side effect was mild bruise which went soon after the treatment.
References

Younghee Yun et al (2013) Evidence-Based Complementary and Alternative Medicine, Article ID 424313, 5 pages

Donoyama N Acupunct Med 2012;30:152–153.
Hae In Park et al The Acupuncture 2014; 31(2): 165-171.

Recent research has shown that acupuncture is effective to release pain for chronic prostatitis

Acupuncture is effective for prostatitis. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common urological di...