Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation

Background: We have recently proved electroacupuncture (EA) ST36 exerted an anti- inflammatory effect in the early phase of intra-abdominal adhesion formation. Evidences indicate that the anti-inflammatory effect of EA ST36 involves a cholinergic anti- inflammatory pathway-dependent mechanism via the vagus nerve. However, the exact effects and accurate vagal modulation of acupuncture in prevention of postoperative intra- abdominal adhesion formation has not been thoroughly evaluated.

Materials and methods: Spraguee Dawley rats subjected to abdominal adhesion lesions operation at the cecum and abdominal wall were randomly divided into six groups as follows: (a) EAN: EA non-channel acupoints; (b) EA: EA ST36 after abdominal lesions; (c) VGX/EA: vagotomy (VGX) after abdominal lesions, then EA ST36; (d) VGX/EAN: VGX after abdominal lesions, then EAN; (e) a-BGT/EA: intraperitoneal injection of a-bungarotoxin (a- BGT, an antagonist of a7 subunit of cholinergic nicotinic receptor) before EA ST36, and (f) a- BGT/EAN group: a-BGT injection before EAN. Seven days after abdominal surgical lesions, the levels of tumor necrosis factor-a (TNF-a) and vascular endothelial growth factor (VEGF) in the adhesive tissue were evaluated, macroscopic observation and histopathologic evaluation of adhesion formation and assessment of angiogenesis by immunohistochemical staining of platelet endothelial cell adhesion molecule-1 (CD31) were performed. Results: EA ST36 reduced TNF-a and VEGF levels in adhesive tissue homogenates 7 d after surgery, whereas vagotomy or intraperitoneal injection of a-BGT before EA ST36 reversed its suppressive effects. EA at non-channel acupoints with or without vagotomy or intra- peritoneal injection of a-BGT before EA had no suppressive effects on TNF-a and VEGF levels. EA ST36 alleviated the adhesion formation, with both of macroscopic and histo- pathologic adhesion scores significantly lower than those of the EAN group (1.56 ` 0.29 versus 3.00 ` 0.82, 1.35 ` 0.4 versus 3.91 ` 0.8, respectively, both P < 0.05). Compared with the EAN group, EA ST36 significantly decreased angiogenesis evidenced by reduced CD31 positive microvessel density in adhesive tissue. Conclusions: EA ST36 might reduce the postoperative local inflammatory response, attenuate the angiogenesis, and alleviate the adhesion formation partly via activating the cholinergic anti-inflammatory mechanism.

Journal of Surgical Research 195 (2015) 89 - 98.

Long-Lasting Reduction of Blood Pressure
by Electroacupuncture in Patients with Hypertension: Randomized Controlled Trial

Background: Acupuncture at specific acupoints has experimentally been found to reduce chronically elevated blood pressure.
Objective: To examine effectiveness of electroacupuncture (EA) at select acupoints to reduce systolic blood pressure (SBP) and diastolic blood pressures (DBP) in hypertensive patients.

Design: Two-arm parallel study.
Patients: Sixty-five hypertensive patients not receiving medication were assigned randomly to one of the two acupuncture intervention (33 versus 32 patients).
Intervention: Patients were assessed with 24-hour ambulatory blood pressure monitoring. They were treated with 30-minutes of EA at PC 5-6 + ST 36-37 or LI 6-7 + GB 37-39 once weekly for 8 weeks. Four acupunc- turists provided single-blinded treatment.
Main outcome measures: Primary outcomes measuring effectiveness of EA were peak and average SBP and DBP. Secondary outcomes examined underlying mechanisms of acupuncture with plasma norepinephrine, renin, and aldosterone before and after 8 weeks of treatment. Outcomes were obtained by double-blinded evaluation.
Results: After 8 weeks, 33 patients treated with EA at PC 5-6 + ST 36-37 had decreased peak and average SBP and DBP, compared with 32 patients treated with EA at LI 6-7 + GB 37-39 control acupoints. Changes in blood pressures significantly differed between the two patient groups. In 14 patients, a long-lasting blood pressure– lowering acupuncture effect was observed for an additional 4 weeks of EA at PC 5-6+ST 36-37. After treatment, the plasma concentration of norepinephrine, which was initially elevated, was decreased by 41%; likewise, renin was decreased by 67% and aldosterone by 22%.
Conclusions: EA at select acupoints reduces blood pressure. Sympathetic and renin-aldosterone systems were likely related to the long-lasting EA actions.

Medial Acupuncture Volume 27, Number 4, 2015

Battlefield Acupuncture in the U.S. Military: A Pain-Reduction Model for NATO

Background: Acupuncture originated in China more than 5000 years ago. Battlefield Acupuncture (BFA), developed by Niemtzow, consists of treating 5 points on each ear, using semi-permanent needles to reduce pain in a few minutes. Easily taught to North Atlantic Treaty Organization (NATO) troops, this methodology can be explained in 3 hours.

Objective: This article describes how the BFA technique may be taught to military medical personnel in a few hours and may be used in a NATO medical treatment facility or battlefield environment without the necessity for patients’ disrobing.
Methods: Five tiny, sterile 2-mm needles are inserted into specific points of each ear. The points are: (1) Cingulate Gyrus; (2) Thalamus; (3) Omega 2; (4) Shen Men; and (5) Point Zero. The needles may remain in the ears for up to 3 days.

Conclusions: BFA produces rapid pain relief in a few minutes with almost no side-effects. This is an ideal technique to use when pain has not responded to narcotics or when habit-forming drugs are not desired, especially during critical military missions.

Medical Acupuncture Volume 27, Number 5, 2015.

Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial

Background: Sore throat is a common cause of pain in outpatient encounters. Battlefield auricular acupuncture (the placing of needles in specific points in the ear) is a modality used to treat acute pain as- sociated with a variety of ailments. The aim of our study was to determine whether auricular acupuncture reduces pain, medication usage, and missed work hours when added to standard therapy in adult patients with acute sore throat.

Methods: We conducted an unblinded, pragmatic, randomized controlled trial among adult, nonpregnant patients presenting to an Air Force family medicine clinic with pain from acute sore throat. A total of 54 patients were followed for 48 hours after treatment.

Results: Patients receiving auricular acupuncture reported lower pain scores than those who did not at 15 minutes (6.0 [95% confidence interval (CI), 5.4 – 6.6] vs 2.6 [95% CI, 1.7–3.5]; P < .0001), 6 hours (4.8 [95% CI, 4.0 –5.6] vs 2.5 [95% CI, 1.6 –3.4]; P .0005), and 24 hours (4.1 [95% CI, 3.3– 4.9] vs 1.3 [95% CI, 1.0 –2.8]; P .0006). They also reported taking fewer cumulative doses of pain medication at 6 hours (1.07 [95% CI, 0.69 –1.45] vs 0.39 [95% CI, 0.2– 0.58]; P .003), 24 hours (2.63 [95% CI, 1.95–3.31] vs 1.37 [95% CI, 0.92–1.82]; P .004), and 48 hours (4.07 [95% CI, 2.9 – 5.24] vs 2.19 [95% CI, 1.44 –2.94]; P .009). There was no difference in time missed from work be- tween the auricular acupuncture and standard therapy groups.

Conclusions: Compared with usual treatment, battlefield auricular acupuncture was associated with reduced sore throat pain for 24 hours and decreased use of pain medication for up to 48 hours. There was no apparent effect on hours missed from work.

J Am Board Fam Med 2015; 28:697–705.

Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic

Objective: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief.
Methods: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture - Bladder meridian points to the side with acute renal colic pain (UB-21, UB-22, UB-23, UB-24, UB- 45, UB-46, UB-47, and UB-48), and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes.

Results: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P = .001). After 60 minutes, mean VAS scores of groups I and III (P = .753) were similar. The mean VAS score of group III was lower than that of group II (P = .013). After 120 minutes, the difference in the VAS scores was (P = .000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P = .488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS.

Conclusions: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality.

American Journal of Emergency Medicine 33 (2015) 749–753