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Practice
Acu. | Issue #33 | Winter 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 RESEARCH
Electroacupuncture as good as drugs for chronic constipation
Electroacupuncture (EA) can be as effective as the prokinetic drug prucalopride for treating severe chronic constipation. Chinese researchers randomised 560 participants experiencing fewer than two complete spontaneous bowel movements (CBSMs) per week to either EA or prucalopride, over a 32-week period. Twenty-eight sessions of electroacupuncture were administered over the first eight weeks, followed by no-treatment over the subsequent 24 weeks. EA was found to be noninferior to prucalopride for the primary outcome measure. The proportion of participants with more than three mean weekly CSBMs was 36.2 per cent with EA versus 37.8 per cent with prucalopride. The proportion of treatment responders in weeks one to eight was also similar in the EA and prucalopride groups (24.91 per cent versus 25.54 per cent). Except during the first two weeks of treatment, no between-group differences were found in outcomes of excessive straining, stool consistency, or quality of life. Adverse events occurred in 17.69 per cent of participants in the EA group compared with 44.24 per cent in the prucalopride group. Electroacupuncture vs Prucalopride for Severe Chronic Constipation: A Multicenter, Randomized, Controlled, Noninferiority Trial. Am J Gastroenterol. 2021 May 1;116(5):1024-35 〉 https://pubmed.ncbi.nlm.nih.gov/33273258/
Electroacupuncture speeds recovery after knee replacement by improving circulation
Adding electroacupuncture (EA) treatment to conventional anaesthesia can support functional recovery after total knee arthroplasty by reducing pain and oedema and improving blood circulation. In a Chinese trial 200 patients undergoing total knee arthroplasty were randomly divided into four groups: intravenous analgesia (PCIA group), femoral nerve block
analgesia (PCNA group), intravenous analgesia combined with EA treatment (PCIA + EA group) and femoral nerve block combined with EA (PCNA + EA group). Compared with the PCIA group, PCNA group, and PCIA + EA group, the PCNA + EA group showed a significantly reduced incidence of lower limb deep vein thrombosis (28 per cent, 14 per cent, 12 per cent and 4 per cent, respectively). Objective measures of blood flow were observed to be significantly better in both EA groups compared with the anaesthetic only groups on the seventh day after the operation. Both EA groups showed significantly lower coagulation markers (D-dimer index, whole blood viscosity and red blood cell aggregation) on day seven, with the PCNA + EA group additionally showing a significant reduction in platelet counts. By relieving postoperative pain and reducing the incidence of deep vein thrombosis, EA combined with femoral nerve block enabled patients to participate in joint movement and lower limb muscle strength training sooner. The Preventive Effect of Computed Tomography Image-Guided Electroacupuncture Combined with Continuous Femoral Nerve Block on Deep Vein Thrombosis After Total Knee Arthroplasty Based on an Adaptive Algorithm. World Neurosurg. 2021 May;149:362-71 〉 https://pubmed.ncbi.nlm.nih.gov/33248303/
Electrical acupoint stimulation improves cognitive state in elderly undergoing colon cancer surgery
Transcutaneous electrical acupoint stimulation (TEAS) is associated with a lower duration of postoperative cognitive decline (POCD) in elderly patients undergoing colon cancer surgery. A Chinese research team randomised 100 patients undergoing laparoscopic resection of colon cancer into TEAS and control groups. Patients in the TEAS group received percutaneous acupoint electrical stimulation at bilateral LI 4 he gu, P 6 nei guan and ST 36 zu san li points from 30 minutes before anaesthesia
induction to the end of surgery. Serum inflammatory markers (IL6 and hs-CRP) were observed to be significantly lower in the TEAS group compared with controls at one hour after beginning surgery and at the end of surgery. POCD was also observed to be significantly decreased on postoperative days two and three in the TEAS group compared with the control group. The authors conclude that TEAS may reduce neuroinflammation by influencing levels of inflammatory mediators and neuropeptides involved in communication along the gut– brain axis. Effects of Transcutaneous Electrical Acupoint Stimulation on Postoperative Cognitive Decline in Elderly Patients: A Pilot Study. Clin Interv Aging. 2021 May 3;16:757-65 〉 https://pubmed.ncbi.nlm.nih.gov/33976542/
Electroacupuncture changes brain connectivity to reduce fibromyalgia pain
Electroacupuncture (EA) can reduce pain severity in fibromyalgia (FM) by changing the way the brain’s amygdala connects with its representation of the body, report American scientists. Seventy-six patients with FM were randomised to receive either electroacupuncture (EA) or mock laser acupuncture (ML), twice a week for a total of eight treatments. The EA group received low-frequency (2 Hz) EA at three pairs of acupoints: right LI 11 qu chi to LI 4 he gu, left GB 34 yang ling quan to SP 6 san yin jiao, and bilateral ST 36 zu san li. Needles were also inserted at DU 20 bai hui, right ear shen men, and left LIV 3 tai chong, but no electrical current was delivered to these sites. EA treatment was designed to generate sustained somatosensory afferent activity, while ML was designed to generate no somatosensory afference. Fibromyalgia patients who received EA experienced a greater reduction in pain severity, compared to patients who received ML (mean difference in pain index from pre- to post-treatment was -1.14 in the
