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Practice
Acu. | Issue #31 | Summer 2021
Evidence base Overseas member and recovering scientist Lisa Sherman selects top abstracts of the season from the Journal of Chinese Medicine's news section to keep you up to date with the latest in acupuncture research
Lisa Sherman Overseas Member: North Carolina Electroacupuncture shows significant benefits in knee osteoarthritis
A large randomised trial carried out in China has demonstrated a significant effect of electroacupuncture (EA) on knee osteoarthritis (KOA). Four hundred and eighty patients with KOA were randomly assigned to receive EA, manual acupuncture (MA), or sham acupuncture (SA) three times per week for eight weeks. Five obligatory acupoints and three adjunct acupoints were used in both EA and MA groups. The obligatory acupoints included ST 35 du bi, medial MN-LE-16 xi yan, LIV 8 qu quan, GB 33 xi yang guan and an ashi point. Adjunct acupoints were selected from an acupoint pool at the acupuncturist’s discretion, depending on which channel was affected. Deqi was required for both EA and MA groups. EA (2/100 Hz) was carried out at LIV 8 qu quan, GB 33 xi yang guan and two adjunct acupoints in the EA group. In the SA group, eight non-acupoints were superficially needled. Participants who received EA showed a significantly higher response rate compared with SA at week 8, however the difference between MA and SA groups did not meet statistical significance at this time (response rates at week 8 were 60.3 per cent, 58.6 per cent, and 47.3 per cent in EA, MA, and SA groups, respectively). The therapeutic benefits of EA for pain and function were maintained through week 26. Interestingly, by week 16, the MA group also showed significant benefits in pain and function compared with SA, and these were sustained through week 26. Efficacy of Intensive Acupuncture Versus Sham Acupuncture in Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2021 Mar;73(3):448-58 〉 tinyurl.com/2usn44v2
Tuina helps with paediatric diarrhoea
Paediatric tuina shows a significant effect on reducing symptoms in children with acute diarrhoea, according to Chinese investigators. Eighty-six children aged 0-6 years with acute diarrhoea were randomised to receive usual care plus either paediatric tuina or sham tuina for 15-25 minutes,
once per day, for three consecutive days. Tuina was applied to six points on the hands and abdomen according to a standardised prescription suggested by a panel of five paediatric tuina experts. Tuina was associated with a significant reduction in the number of diarrhoea episodes on day 3 compared with sham. Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial. Health Qual Life Outcomes. 2021 Jan 6;19(1):4 〉 tinyurl. com/7h2j2fdc
Acupuncture feasible and acceptable as adjunct to radiotherapy for cancer
A UK-based clinical trial suggests that it is feasible to implement acupuncture in a busy radiotherapy unit, when provided by specially trained radiographers. The study employed a pragmatic mixedmethods randomised parallel-group exploratory design to determine the feasibility of delivering acupuncture within a National Health Service setting, as part of routine cancer care. One hundred and one cancer patients undergoing radiotherapy treatment were randomised to receive either standard care plus acupuncture, or standard care alone. Acupuncture was carried out according to a standard treatment protocol designed to treat common symptoms (fatigue, hot flushes, mood and sleep problems). Points used were: two non-traditional Anxiety, Sickness and Dyspnoea (ASAD) acupoints (over the manubrium in the midline, directly above and below REN 21 xuan ji, plus LI 4 he gu, LIV 3 tai chong, SP 6 san yin jiao and ST 36 zu san li bilaterally, with bilateral P 6 nei guan added for those at high risk for radiotherapy induced nausea and vomiting. Patients received 3-8 weekly acupuncture treatments, determined by their number of radiotherapy treatments. Participants reported that they valued the positive impact and ‘holistic’ nature of acupuncture. Symptoms perceived as being alleviated by acupuncture included fatigue, nausea and vomiting, pain, sleeping problems and dyspnoea. These effects left participants feeling like they had improved wellbeing and were more ‘positive’ and ‘empowered’. In addition to the perceived beneficial effects of
acupuncture, patients also valued the extra care they received from a cancer healthcare professional in a relaxing environment. Although participants qualitatively reported benefit from acupuncture, analysis of quantitative data identified only one treatment effect, on fatigue, only in certain subgroups (women and breast cancer), and only at three months after treatment completion. Although participants typically reported other benefits from acupuncture, analysis of quantitative data revealed that no other single quality of life measure was consistently associated with a beneficial effect from acupuncture. The authors suggest more research with larger patient sample sizes in order to determine which outcome measures and time points should be employed in trials of acupuncture in cancer to detect changes qualitatively reported by patients. A feasibility trial of acupuncture in cancer patients undergoing radiotherapy treatment. Complement Ther Clin Pract. 2021 May;43:101372 〉 tinyurl. com/4b3pp26c
Acupuncture normalises relationship between brain networks in functional dyspepsia
Acupuncture which elicits deqi may act to repair disrupted relationships between brain networks in patients with functional dyspepsia (FD). In a study by Chinese researchers, 70 FD patients were randomised to receive 20 sessions of acupuncture treatment at unilateral REN 12 zhong wan and bilateral ST 36 zu san li either with or without deqi. In each group, 25 patients were randomly selected to undergo functional magnetic resonance imaging (fMRI) scans before and after treatment. The observed decrease in dyspepsia scores comparing before and after treatment in the deqi group was significantly greater than that in the group without deqi. The obvious deqi group showed significantly decreased resting state functional connectivity between regions in the amygdala (the brain’s ‘alarm system’) with structures belonging to the salience network and default mode network.
