Research on the Health Benefits of Acupuncture

Compiled by John G. Connor, M.Ac., L.Ac., Edited by Barbara Connor, M.Ac., L.Ac.

Recent Acupuncture Studies (Updated on 8-9-15):

Allergic rhinitis

Because acupuncture may modulate the immune system, it has been proposed as a useful treatment for patients with allergic rhinitis (AR). Here, we assessed the evidence for the clinical efficacy of acupuncture for the management of AR patients by performing a systematic review and meta-analysis of the published literature. Our meta-analysis suggests that acupuncture could be a safe and valid treatment option for AR patients. (Feng et al 2015)

Alzheimer’s disease

Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating Alzheimer’s disease (AD) in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients’ ability to carry out their daily lives. Moreover, acupuncture is safe for treating people with AD. (Zhou et al 2015)

Aromatase inhibitor-induced arthralgia

Aromatase inhibitors (AIs) are commonly used as adjunctive hormone treatment for early breast cancer patients. The major side effect of AIs is arthralgia, which affects adherence. Previous reviews suggested that acupuncture is effective in the management of cancer-related pain. The aim of this review is to evaluate the effects of acupuncture on arthralgia caused by AIs. This systematic review suggests that acupuncture has potential benefits to improve arthralgia caused by AIs. However, further trials of adequate sample size, appropriate control group, and longer follow-up are necessary to investigate the efficacy of acupuncture in AI-induced arthralgia. (Bae et al 2015)

Lymphedema in patients with breast cancer

The Saam acupuncture method appeared to provide reduction of lymphedema among women after they had undergone surgery for breast cancer. A randomized, controlled prospective study with a larger sample size is required to clarify the role of acupuncture for managing lymphedema in patients with breast cancer. (Jeong et al 2015)

Migraine

In a randomized, patient/assessor blinded, controlled trial with one-year follow-up it was found that manual acupuncture was an effective and safe treatment for short-term relief of frequent migraine in adults. Larger trials are warranted. (Wang et al 2015)

Nausea, vomiting and fatigue caused by chemotherapy

The results of clinical trials in acupuncture have provided important clues in oncologic practice. The evidence suggests that acupuncture is a safe and effective therapy for managing cancer and treatment-related symptoms, such as nausea and vomiting and fatigue caused by chemotherapy. As more evidence emerges, the potential advantages of acupuncture in tumor treatment will eventually be clear. (Wang et al 2015)

Parkinson’s disease

After 36 weeks of long-term acupuncture treatment, the mean Unified Parkinson’s disease rating scale (UPDRS) total scores and sub-score of mentation, behavior and mood, sub-score of complications of therapy and BDI-II score decreased significantly when compared to the pretreatment baseline. In conclusion, acupuncture treatment had integrated effects in reducing symptoms and signs of mind, behavior, mood, complications of therapy and depression in PD patients who received Western medicine. (Chen et al 2015)

Post-stroke shoulder-hand syndrome

Warm acupuncture combined with routine acupuncture and rehabilitation training is effective in improving shoulder pain, hand edema and limb motor function in stroke patients with shoulder-hand syndrome at phase I. (Meng & Wen 2014)

Primary hypertension

In this randomized controlled trial it was found that acupuncture combined with auricular point sticking for primary hypertension has a reliable effect. It is better than captopril for the improvement of 24 hr ambulatory blood pressure, angiotensin II level and creatinine level, and can improve dizziness, palpitations and other clinical symptoms. (Yang & Liu 2015)

Smoking cessation

Twenty-eight smokers were recruited to attend two 1 hour acupuncture sessions weekly for 12 weeks.Sixteen of the 28 patients enrolled (57%) completed 12 weeks of treatment. Of the 17 patients who completed the end-of-study questionnaire, 94% (16/17) rated the program as helpful, and 82% noted they would recommend it to friends for smoking cessation. Three of the 28 who initially enrolled in the study were confirmed abstinent at 12 weeks (10.7%); one of the 28 (3.6%) was abstinent at 26 weeks. A larger study with a slightly less rigorous and more acceptable treatment protocol is feasible and should be considered. (McFadden et al 2015)  

Original List of Acupuncture Studies (March 31, 2011)

INTRODUCTION 

Until the early 1970’s the evidence for the health benefits of acupuncture was mainly anecdotal.  In the past 40 years, however, numerous controlled studies have been carried out throughout the world.  What follows are the results of 111 scientific studies which show the positive health benefits of acupuncture in treating various conditions. All of these studies are indexed on PubMed with the exception of the paper on Immunity presented to the 5th World Congress of Acupuncture and the pilot study on IBS presented at the British Medical Acupuncture Society.

The following conditions have been shown to benefit from acupuncture as concluded in these studies:

After-Treatment of Accidents, Allergic Rhinitis and Allergic Asthma, Angina, Anxiety, Balance Disorders, Carpal Tunnel Syndrome, Chronic Fatigue and Fibromyalgia, Crohn’s Disease, Cystitis, Dental Pain, Depression, Depression and Anxiety, Dysmenorrhea, Facial Muscular Pain, Frozen Shoulder, Headache and Migraine, High Blood Pressure, Immunity, Incontinence, Infertility, Inflammation, Insomnia, Irritable Bowel Syndrome, Knee Pain, Low Back Pain, Nausea and Vomiting, Neck and Shoulder Pain, Osteoarthritis, Painful Conditions, Painful Peripheral Neuropathy, Premenstrual Syndrome, Raynaud’s Syndrome, Renal Colic, Rheumatoid Arthritis, Schizophrenia,, Sciatica, Sexual Dysfunction, Stroke Rehabilitation, Tennis Elbow, Urinary Tract Infections, Weight Reduction. and Whiplash Injury

AFTER-TREATMENT OF ACCIDENTS

• A study by Rabl V (article in German) entitled “The effect of standardized acupuncture programs in the after-care of accident patients” published in Unfallchirurgie 1983 Dec;9(6):308-13 involved 153 patients suffering from pain, edematous conditions, and impaired movement following traumas sustained in accidents who were treated or after-treated with acupuncture.  The study found that acupuncture proved itself to be an effective form of therapy for after-treatment of accident patients, presenting a valuable supplement to the field of rehabilitation, especially when combined with other physical therapeutic measures.

ALLERGIC RHINITIS AND ALLERGIC ASTHMA

• The results of a study published in the Am J Chin Med 2002;30(1):1-11 by Xue et al entitled “Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial” found that acupuncture is an effective and safe alternative treatment for the management of seasonal allergic rhinitis.

• A study entitled “Immunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized controlled study” published in Altern Complement Med 2000 Dec; 6(6): 519-25) by Joos et al showed that 79% of the participants suffering from allergic asthma indicated an improvement in general well-being with acupuncture treatment. It also concluded that acupuncture performed in accordance with the principles of Traditional Chinese Medicine showed significant immune-modulating effects.

• A German study entitled “Protective effect of acupuncture on allergen provoked rhinitis” published in Wein Med Wochenschr 1998;148 (19): 450-3 by Wolkenstein and Horak showed that patients receiving acupuncture for nasal allergen-provoked rhinitis showed a definite reduction of the subjective complaints.

• A comparative study done in China and published in J Tradit Chin Med  1993 Dec; 13(4): 243-8 by Lal entitled “Observation on the curative effect of acupuncture on type I allergic diseases” showed that acupuncture had an extensive and remarkable action against allergic asthma and allergic rhinitis.

ANGINA

• A study which appeared in the American Journal of Physiology June 1999 Vol 45. No. 6 H1227-H2134 by Chao et al entitled “Nalaxone reverses inhibitory effect of electroacupuncture on sympathetic cardiovascular reflex responses showed that electro-acupuncture significantly reduced myocardial ischemia and improved regional myocardial dysfunction. This finding suggests that electroacupuncture causes myocytes in the ischemic region to resume near-normal contractile function. The authors concluded that acupuncture may be a useful therapeutic approach for the treatment of angina in some patients. In this regard success with this approach has been reported.

• A study published in the J Altern Complement Med 1999 Oct;5(5):405-13 by Ballegaard et al entitled “Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: an open, prospective study” concluded that the addition of acupuncture and self-care education was found to be cost beneficial in patients with advanced angina pectoris.

ANXIETY

•  According to a study on 55 participants by Want and Kain entitled “Auricular acupuncture: a potential treatment for anxiety” published in Anesth Analg 2001 Feb;92(2):548-53 the authors concluded that auricular acupuncture at the “relaxation” point can decrease the anxiety level in a population of healthy volunteers.

• According to a study by Lo and Chung entitled “The sedative effect of acupuncture” published in Am J Chin Med 1979 Autumn;7(3):253-8 it was found that out of 8 patients with anxiety neurosis who were treated with acupuncture 6 of them showed good to moderate response while 2 had no change.

• In a study by Paraskeva et al entitled “Needling of the extra 1 point decreases BIS values and preoperative anxiety” published in Am J Chin Med 2004;32(5):789-94 in which 50 patients were randomly assigned to receive acupuncture at the extra 1 point or to a control point, it was found that needling of the extra1 point preoperatively significantly decreased the BIS (Bispectral Index) values and the VSS (verbal score scale) for anxiety but needling the control point decreased only VSS values.

• An open prepost clinical trial study conducted by Spence DW et al entitled “Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report” and published in J Neuropsychiatry Clin Neurosci 2004 Winter;16(1)19-28 studied the response to acupuncture of 18 anxious adult subjects who complained of insomnia.  The study found that acupuncture treatment may be of value for some categories of anxious patients with insomnia.

BALANCE DISORDERS

• A study done by Fattori et al and published in Acupunct Electrother Res. 1996 Jul-Dec;21(3-4)207-17 entitled “Acupuncture treatment for balance disorders following whiplash injury” involved using computerized static posturography and evaluating the postural changes after acupuncture treatment in a group of 15 patients with balance disorders caused by cervical torsion due to Whiplash Injury (WI). The control group consisted of 17 patients complaining of the same symptoms as the study group; due to WI, but treated with drugs (FANS and myorelaxing) and physiotherapy only.  The high percentage of positive results in our WI patients leads us to advocate the therapeutic efficacy of acupuncture for balance disorders due to cervical pathology, where it can be associated with or be a valued alternative to pharmacological treatment.

• Another more recent study done by Fattori et al and published in Int Tinnitus J. 2004; 10(2):156-60 entitled “Acupuncture treatment of whiplash injury” involved evaluation by computerized static posturography the postural changes after acupuncture treatment in a group of 27 patients having balance disorders caused by cervical torsion due to whiplash injury.  The control group consisted of 25 patients complaining of the same symptoms as those recorded by the study group due to whiplash injury but treated with nonsteroidal anti-inflammatory drugs and myorelaxation or with physiotherapy only.  The high percentage of positive results in whiplash injury patients leads the authors to advocate acupuncture for balance disorders to to cervical pathology.

CARPAL TUNNEL SYNDROME

• A study published in the J Altern Complement Med, 1999 Feb;5(1):5-26 by Branco and Naeser entitled “Carpal tunnel syndrome: clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies — an open protocol study” found that post treatment carpal tunnel syndrome pain was significantly reduced, and 33 of 36 hands had no pain or else pain had been reduced by more than 50%.  In follow-up after 1-2 years, in cases where the age was less than age 60, in only 2 of 23 hands had pain returned, but these were successfully re-treated within a few weeks.

CHRONIC FATIGUE AND FIBROMYALGIA

• The results of a study published in Rheumatology International 18:1.35-6 1998 entitled “Acupuncture treatment of patients with fibromyalgia was associated with decreased pain levels and fewer positive tender points as measured by VAS (visual analog scale) and dolorimetry.” found that in addition their serotonin concentrations in their platelets decreased and their serum serotonin increased. This study confirms that acupuncture does help fibromyalgia sufferers in terms of their muscle-joint pain

• The results of a study published in The Journal of Family Practice March 1999,483. 213-8 by Berman et al entitled “Is acupuncture effective in the treatment of fibromyalgia?” concluded that real acupuncture based on Oriental theories and techniques is more effective for the treatment of fibromyalgia than sham acupuncture for relieving pain, increasing pain thresholds, improving global ratings, and reducing morning stiffness of FMS; but the duration of benefit following the acupuncture treatment series is not known.

CROHN’S DISEASE

• A study published in Digestion 2004;69(3):131-9. Epub 2004 Apr 26 by Joos et al entitled “Acupuncture and moxibustion in the treatment of active Crohn’s disease: a randomized controlled study” concluded that apart from a marked placebo effect, traditional acupuncture offers an additional therapeutic benefit in patients with mild to moderately active Crohn’s disease.

CYSTITIS

• The results of a study (in Norwegian) in Tidsskr Nor Laegeforen 1998 Mar 30;118(9):1370-2 by Aune et al entitled “Can acupuncture prevent cystitis in women?” concluded that acupuncture seems a worthwhile alternative in the prevention of frequently recurring cystitis in women.

DENTAL PAIN

• The results of a study published in Arch Otolaryngol Head Neck Surg 1999 May;125(5)”567-72 by Lao et al entitled “Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial” concluded that acupuncture is superior to the placebo in preventing postoperative dental pain; noninsertion placebo procedure is valid as a control.

• The results of a study published in Br Dent J 1998 May 9;184(9):443-7 by Ernst and Pittler entitled “The effectiveness of acupuncture in treating acute dental pain: a systematic review” concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia.

DEPRESSION

• In a single-blind placebo-controlled study by Roschke et al entitled “The benefit from whole body acupuncture in major depression” published in J Affect Disord. 2000 Jan-Mar;57(1-3):73-81 seventy inpatients with a major depressive episode were randomly included in 3 different treatment groups: verum acupuncture, placebo acupuncture and a control group.  All three groups were pharmacologically treated with the antidepressant mianserin. Patients who experienced acupuncture improved slightly more than patients treated with mianserin along.  Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone.  However, they could not detect any differences between placebo and verum acupuncture.

• In a clinical trial by MacPherson et al entitled “Acupuncture for depression: first steps toward a clinical evaluation” published in J Altern Complement Med. 2004 Dec;10(6):1083-91 ten patients received up to 10 individualized acupuncture treatments from one of two acupuncturists.  In the case series, only 6 patients both received treatment and completed 10-week questionnaires; however, significant improvements between before and after were found in their levels of depression.  Many facts, as well as acupuncture, may have contributed to these improvements.  No serious adverse events occurred.

• In a study by Han, Li and Luo in Chinese entitled “Comparative study of electro-acupuncture and maprotiline in treating depression” published in Zhongguo Zhong Xi Yi Jie He Za Zhi2002 Jul;22(7):512-4, 521 it was found that both electro-acupuncture and maprotiline are effective in treating depression.

•  In a study by Han, Li, Luo and Zhao entitled “Clinical study on electro-acupuncture treatment for 30 cases of mental depression” published in J Tradit Chin Med 2004 Sep;24(3):172-6 it was concluded that electro-acupuncture therapy can produce the same clinical therapeutic effect as that produced by the drug maprotiline, giving less side effects and better symptomatic improvement.

• According to two consecutive clinical studies by Luo et al entitled “Clinical research on the therapeutic effect of the electro-acupuncture treatment in patients with depression” published in Psychiatry Clin Neurosci 1998 Dec;52 Suppl:S338-40 if was found that the results from both studies showed that the therapeutic efficacy of electro-acupuncture was equal to that of amitriptyline for depressive disorders.  Electro-acupuncture had a better therapeutic effect for anxiety somatization and cognitive process disturbance of depressed patients than amitriptyline.  Moreover the side effects of electroacupuncture were much less that than of amitriptyline.  The article suggested that electro-acupuncture treatment was an effective therapeutic method for depressive disorders.  Particularly, it was a treatment of choice for depressed patients who were unable to comply with the classic tricyclic antidepressants because of their anticholinergic side effects.

• In a three year study of three case histories by Kurland entitled “ECT and Acu-EST in the treatment of depression” published in Am J Chin Med 1976 Autumn;4(3):289-92 it was found that individual Acu-EST (Acupuncture Electric Stimulation Therapy) treatments were often less effective than individual ECT (electroconvulsive therapy).  However, series of Acu-EST did assist in producing significant remissions in depressive symptomatology.  Because it did not produce the temporary disabling memory defects which occurred with ECT, Acu-EST was more easily adaptable to outpatient treatment.

• In a study on the effectiveness of acupuncture treatment on 167 patients with depression associated with manic-depressive psychosis and schizophrenia by Poliakov in Russian entitled “Acupuncture in the treatment of patients with endogenous depression” published in Zh Nevropatol Psikhiatr Im S S Korsakova. 1987;87(4):604-8 acupuncture was found to be effective in some patients showing resistance to antidepressants.

• In a study by Manber et al entitled “Acupuncture: a promising treatment for depression during pregnancy” published in J Affect Disord. 2004 Nov 15;83(1):89-95 sixty-one pregnant women with major depressive disorder were assigned to one of three treatments: an active acupuncture group, an active control acupuncture group or a massage group.  Response rates at the end of the acute phase were statistically significantly higher for the active acupuncture group (69%) than for the massage group (32%) with an intermediate active control acupuncture response rate of 47%.  The active acupuncture group also exhibited significantly higher average rate of reduction in Beck Depression Inventory (BDI) scores from baseline to the end of the first month of treatment than the massage group.  The authors concluded that acupuncture holds promise for the treatment of depression during pregnancy.

DEPRESSION AND ANXIETY

• A placebo-controlled, randomized, modified double-blind study on 43 patients with minor depression and 13 patients with generalized anxiety disorders by Eich et al in German entitled “Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study” published in Fortschr Neurol Psychiatr 2000 Mar;68(3):137-44 indicated that needle acupuncture (Du.20, Ex.6, He.7, Pe.6 Bl.62) leads to a significant clinical improvement as well as to a remarkable reduction in anxiety symptoms in patients with minor depression or with generalized anxiety disorders.

DYSMENORRHEA

• The results of a study published in Gynakol Geburtshilfliche Rundsch. 2003;43(4):250-3 by Habek et al entitled “Efficacy of Acupuncture for the Treatment of Primary Dysmenorrhea” concluded that the success rate of acupuncture for the treatment of primary dysmenorrhea symptoms within 1 year after the acupuncture treatment is 93.3% compared with 3.7% in the placebo group.

• The results of a study published in Obstet Gynecol. 1987 Jan;69(1):51-6 by Helms entitled “Acupuncture for the management of primary dysmenorrhea” found that in the Real Acupuncture group 90.9% of the women showed improvement; in the Placebo Acupuncture group, 36.4%  and in the Standard Control group 18.2%.  There was a 41% reduction of analgesic medication used by the women in the Real Acupuncture group after their treatment series, and no change or increased use of medication seen in the other groups.

• The results of a study published in Croatian in Jugosl Ginekol Opstet. 1984 Sept-Dec;24(5-6):104-6 by Maric entitled “Use of acupuncture in the treatment of primary dysmenorrhea” concluded that a relief of dysmenorrheic pain was already evidenced after the first menstruation.  One year after the completed therapy there was a full disappearance of dysmenorrheic pain in 93% of the cases and a partial one in 7% of the cases.

• The results of a study published in Bulgarian in Akush Ginekol (Sofia). 1996;35(3):24-5 by Tsenov entitled “The effect of acupuncture in dysmenorrhea” found that the effect of acupuncture treatment on dysmenorrhea depends on its kind –primary dysmenorrhea is influenced very well, while secondary dysmenorrhea is influenced satisfactorily.

FACIAL MUSCULAR PAIN

• A study done by Johansson et al and published in Acta Odontol Scan 1991 Jun;49(3):153-8 entitled “Acupuncture in treatment of facial muscular pain” involved 45 individuals with long-standing facial pain or headache of muscular origin were randomly allocated into three groups.  The first group was treated with acupuncture, the second group received an occlusal splint, and the third group served as controls.  Both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs from the stomatognathic system.  No differences between these two groups were round with regard to treatment effects.  It is concluded that acupuncture is an alternative method to conventional stomatognathic treatment for individuals with craniomandibular disorders of muscular origin.

FROZEN SHOULDER

• A study entitled “Acupuncture for frozen shoulder” which was published by Sun et al in Hong Kong Med J. 2001 Dec;7(4):381-91  involving 35 patients with a diagnosis of frozen shoulder who were randomly allocated to an exercise group or an exercise group plus an acupuncture group and treated for a period for 6 weeks concluded that the combination of acupuncture with shoulder exercise may offer effective treatment for frozen shoulder.

• Another study done by Lin et al entitled “A comparison between the pain relief effect of electroacupuncture, regional nerve block and electroacupuncture plus regional nerve block in frozen shoulder” published in Acta Anaesthesiol Sin. 1994 Dec;32(4):237-42 concluded that the combined electroacupuncture and regional nerve block method had significantly higher pain control quality, longer duration and better range of movement of the shoulder joint than that of electroacupuncture or regional nerve block performed alone.

HEADACHE AND MIGRAINE

• A study done by Vickers et al entitled “Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial” published in the British Medical Journal 2004 Mar 27;328(7442):744 concluded that acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. Expansion of NHS (National Health Service) acupuncture services should be considered.

• The results of a study published in Neurol Sci 2003 May;24 Suppl 2:S138-42 by Allais et al entitled “Non-pharmacological approaches to chronic headaches: transcutaneous electrical nerve stimulation, lasertherapy and acupuncture in transformed migraine treatment” found that TENS, lasertherapy and acupuncture proved to be effective in reducing the frequency of headache attacks.  Acupuncture showed the best effectiveness over time.

• The results of a study published in Scand J Dent Res 1979 Oct; 87(5):373-80 by Jensen et al entitled “Effect of acupuncture on headache measured by reduction in number of attacks and use of drugs” concluded that acupuncture is a relevant therapy for headache with a definite symptomatic effect.

• The results of a study published in J Intern Med 1994 May;235(5):451-6 by Hesse et al entitled “Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation” concluded that trigger point inactivation by dry needling (acupuncture) is a valuable supplement to the list of migraine prophylactic tools, being equipotent to metoprolol in the influence on frequency and duration (but not severity) of attacks, and superior in terms of negative side-effects.

• The results of a study published in Headache 2002 Oct;42(9):855-61 by Allais et al entitled “Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine” concluded that acupuncture proved to be adequate for migraine prophylaxis.  Relative to flunarizine, acupuncture treatment exhibited greater effectiveness in the first months of therapy and superior tolerability.

• The results of a controlled trial conducted on 20 patients suffering from chronic migraine published in Clin J Pain 1989 Dec;5(4):305-12 by Vincent CA entitled “A controlled trial of the treatment of migraine by acupuncture” concluded that true acupuncture was significantly more effective than the control procedure in reducing the pain of migraine headache.  Post treatment reductions in pain scores and medication of 43% and 38% respectively, were recorded in the true acupuncture group; and were maintained at 4-month and 1-year follow-up.

HIGH BLOOD PRESSURE

• A study published in the J Tradit Chin Med 1996;16: 273-4 reported that it was found that acupuncture treatment and nifedipine (an antihypertensive medication) were equally effective in reducing blood pressure in 62 patients with hypertension. These positive results are supported by other controlled trials.

• According to a study published in Russian in Vopr Kurortol Fizioter Lech Fiz Kult 1991 Jan-Feb, (l):29-32 by Bobkova et al entitled “The effect of acupuncture on endocrine regulation in hypertensive patients” it was shown that acupuncture-related decline of arterial pressure occurs in participation of pituitary and adrenal hormones as well as the polypeptides beta-endorphine and neurotensin.

• According to a study published in Russian in Ter Arkh 1985:57(10): 42-5 by Anshelevich et al entitled “Serum aldosterone level in patients with hypertension during treatment by acupuncture” it was concluded that acupuncture resulted in a hypoaldosteronemic effect which showed statistically significant correlation with a decrease in the arterial blood pressure. The results obtained made it possible to regard the effect of acupuncture as one of the most significant mechanisms of its therapeutic action in hypertension.

• A study published in Am J Chin Med 1989;17(3-4):111-7 by Radzievsky et al entitled “Function of myocardial contraction and relaxation in essential hypertension in dynamics of acupuncture therapy” showed that as a result of acupuncture a stable hypotensive effect, improvement or normalization of contractile function and diastolic values, a decrease of energy loss and reversal of myocardial hypertrophy were achieved. It is the decrease of sympathetic influences on the circulation system that plays an important part in the onset of these positive changes.

• According to a study reported in the Journal of the British Medical Acupuncture Society 05/31 /1994; V.XII N.I; p.63 the clinical picture improved in 96% of those patients with hypertension who were treated with acupuncture. Acupuncture decreased pathological symptoms in patients with Stage I and II hypertension by 60% + or -15% on average when compared with the Initial level. This was accompanied by a 75% + or – 3.1% decrease in the use of drugs.

IMMUNITY

•  According to a paper presented at the 5th World Congress of Acupuncture acupuncture affects immunity in the following ways:  Acupuncture elevates levels of white blood cells, specific hormones, prostaglandins, gamma-globulins, antibodies and opsonins. Acupuncture constricts and dilates blood vessels, promoting the body’s release of vasodilators (known as histamines).   Acupuncture activates the secretions of endorphins specifically enkaphalins. Acupuncture elevates the levels of neurotransmitters, specifically serotonin and noradrenaline.

INCONTINENCE

• The results of a study published in Int J Urol 2002 Dec;9(12):672-6 by Honjo et al entitled “Treatment of monosymptomatic nocturnal enuresis by acupuncture.  A preliminary study.” concluded that acupuncture may be beneficial in the treatment of nocturnal enuresis by increasing nocturnal bladder capacity; and provide a promising alternative to conventional therapies for monosymptomatic nocturnal enuresis.

• The results of a study (in Japanese) published in Nippon Hinyokika Gakkai Zasshi 1998 Jul;89(7):665-9 by Honjo et al entitled “Acupuncture for urinary incontinence in patients with chronic spinal cord injury. A preliminary report” concluded that acupuncture could be a promising alternative for conventional therapies for urinary incontinence caused by detrusor hyperreflexia in patients with chronic spinal cord injuries.

• The results of a study published in Neurologija 1990;39(3):179-84 by Roje-Starcevic entitled “The treatment of nocturnal enuresis by acupuncture” confirmed that acupuncture represents a new possibility of treatment of patients with enuresis.

INFERTILITY

• The results of a study published in Asian J Androl 2003 Dec;5(4):345-8 by Gurfinkel et al entitled “Effects of acupuncture and moxa treatment in patients with semen abnormalities” concluded that the Chinese Traditional Medicine acupuncture and moxa techniques significantly increased the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.

• A study published in J Huazhong Unjiv Sci Technolog Med Sci 2002;22(3):228-30 by Zhang et al entitled “Influence of acupuncture on idiopathic male infertility in assisted reproductive technology” found that acupuncture can improve semen quality and fertilization rates in assisted reproductive technology.

• The results of a study published in Andrologia 2000 Jan;32(1):31-9 by Siterman et al entitled “Does acupuncture treatment affect sperm density in males with very low sperm count: A pilot study.” concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.

• A study published in Arch Androl 1997 Sep-Oct;39(2):155-61 by Siterman et al entitled “Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality” found that patients exhibiting low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.

• The results of a study published in J Tradit Chin Med 1993 Jun;13(2):115-9 by Mo et al entitled “Clinical studies on the mechanism for acupuncture stimulation of ovulation” found that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation.  The results of this research will provide some scientific basis for treating and further studying this disorder.

• The results of a study published in Gynecol Endocrinol 1992 Sep;6(3):171-81 by Gerhand and Postneek entitled “Auricular acupuncture in the treatment of female infertility” found that auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.

INFLAMMATION

• In a study published in Neurosci Lett. 2002 Feb 8;319(1):45-8 by Son YS et al entitled “Antipyretic effects of acupuncture on the lipopolysaccharide-induced fever and expression of interleukin-6 and interleukin-1 beta mRNAs in the hypothalamus of rats” they concluded that acupuncture stimulation may be effective for reducing elevated body temperature induced by bacteria inflammation, and part of its action may be mediated through the suppression of hypothalamic production of pro-inflammatory cytokines.

• In a study published in Am J Chin Med 2003;31(6):955-65 by Sekido R et al entitled “Differences of electroacupuncture-induced analgesic effect in normal and inflammatory conditions in rats.” they concluded that peripheral opioid receptors are involved in electroacupuncture during inflammatory conditions.

• In a study published in Acupunct Electrother Res. 2000;25(3-4):155-63 by Nepp J et al entitled “Tolosa Hunt Syndrome – intractable pain treatment with acupuncture?” they concluded that acupuncture seems to be a good additional method for reduction of intractable pain.

• In a study published in Exp Neurol 2004 Sep;189(1):189-96 by Liu XY et al entitled “Electro-acupuncture stimulation protects dopaminergic neurons from inflammation-mediated damage in medial forebrain bundle-transected rats” they concluded that the neuroprotective effect of electroacupuncture on the dopaminergic neurons may stem from the collaboration of its anti-inflammatory and neurotrophic actions.

• In a study published in Am J Chin Med 2004;32(2):269-79 by Sekido R et al entitled “Corticotropin-releasing factor and interleukin-1 beta are involved in the electroacupuncture-induced analgesic effect on inflammatory pain elicited by carrageenan” they concluded that the release of corticotropin-releasing factor or IL-1 elicited by electroacupuncture may trigger the release of opioid peptides within inflamed tissue which may activate peripheral opioid receptors and inhibit the pain.

• In a study published in the Am J Chin Med 2003;31(2):315-20 by Wozniak PR et al entitled “Anti-phlogistic and immunocompetent effects of acupuncture treatment in women suffering from chronic pelvic inflammatory diseases” the authors concluded that acupuncture treatment of pelvic inflammatory disease exhibits a clear anti-inflammatory and immunocompetent effect.

INSOMNIA

• A study conducted by Phillips and Skelton entitled “Effects of individualized acupuncture on sleep quality in HIV disease” was published in J Assoc Nurses AIDS Care in 2001 Jan-Feb;2(1):27-39.  Participating in the study were 21 HIV-infected men and women between the ages of 29 and 50 years who reported sleep disturbance three or more times per week and who scored greater than 5 on the Pittsburgh Sleep Quality Index.  Acupuncture was individualized to address insomnia and other symptoms reported by the participants.  Sleep activity and sleep quality significantly improved following 5 weeks of individualized acupuncture delivered in a group setting.

• A study conducted by Montakab (article in German) entitled “Acupuncture and insomnia” and published in Forsch Komplementarmed. 1999 Feb;6 Suppl 1:29-31 involved 40 patients with primary difficulties in either falling asleep or remaining asleep were diagnosed according to traditional Chinese medicine, allocated to specific diagnostic subgroups and treated individually by a practitioner in his private practice.  The patients were randomized into t3wo groups, one receiving true acupnctu4e, the other needled at non-acupuncture points for 3-5 sessions at weekly intervals.  Based on the results of this study it was concluded that true and individualized acupuncture indeed shows efficacy in primary sleep disorders.  However, a direct influence by the therapist cannot be excluded.

• An open prepost clinical trial study conducted by Spence DW et al entitled “Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report” and published in J Neuropsychiatry Clin Neurosci 2004 Winter;16(1)19-28 studied the response to acupuncture of 18 anxious adult subjects who complained of insomnia.  The study found that acupuncture treatment may be of value for some categories of anxious patients with insomnia.

• A systematic review conducted by Sok SR et al entitled “Effects of acupuncture therapy on insomnia” and published in J Adv Nurs 2003 Nov;44(4):375-84 concluded that acupuncture may an an effective intervention for the relief of insomnia.  Further research, using a randomized clinical trial design, is necessary to determine the effectiveness of acupuncture.

IRRITABLE BOWEL SYNDROME

• There was a pilot study presented at the British Medical Acupuncture Society on 24th April 1999 which found that patients with Irritable Bowel Syndrome who were treated with acupuncture for four weeks showed significant improvement in their general well being and a decrease in bloating along with pain reduction.

• According to a study published in Hepatogastroenterology, 1997 Sep-Oct; 44 (IT): 1328-30  by Chan et al entitled “The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study” it was concluded that acupuncture seems to be effective in the treatment of irritable bowel syndrome and merits further study.

KNEE PAIN

• The results of a study published in J Altern Complement Med 1999 Dec;5(6):521-7 by Jensen et al entitled “Acupuncture treatment of patellofemoral pain syndrome” concluded that acupuncture may be an alternative treatment for patellofemoral pain syndrome.

• The results of a study (in Danish) published in Ugeskr Laeger 1993 Dec 6;155(49):4007-11 by Christensen et al entitled “Acupuncture treatment of knee arthrosis.  A long-term study” concluded that there was a significant reduction in pain, analgesic consumption and in most objective measures in the acupuncture treated group compared to the no treatment control group.  The results were significantly better in those who had not been ill for a long time.

LOW BACK PAIN

• A study of 50 patients with chronic low back pain receiving acupuncture published in Clin J Pain 2001 Dec;17(4):296-305  by Carlsson CP and Sjolund BH entitled “Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow up” found a long-term pain-relieving effect of needle acupuncture compared with true placebo in some patients with chronic nocieptive low back pain.

• The results of a study entitled “Acupuncture contra antiphlogistics in acute lumbago” published in Tidsskr Nor Laegeforen (In Norwegian) 2001 Apr 20;121(10):1207-10 done by Kittang G, Melvaer T and Baerheim A. found that patients receiving acupuncture for acute low back pain used significantly less analgesic drugs during the first week after the start of treatment than those receiving naproxen.  Patients receiving acupuncture also reported fewer new episodes of low back pain during the 6 + 12 month follow-up.  Side effects were frequent in the naproxen group, especially gastro-enteric side effects.  The authors concluded that standardized acupuncture treatment seems to be safe and effective in the treatment of acute low back pain in general practice.

• In a study done by Washio M, Takasugi S and Arai Y published in Japanese in Nippon Ronen Igakkai Zasshi entitled “Effects of acupuncture therapy on low back pain and/or knee pain in elderly patients.”  In the study 75 elderly patients with low back pain and/or knee pain visited an acupuncture and physical therapy unit in a geriatric hospital.  60 patients reported that their pain diminished following their therapy.   The proportion of patients who were treated with acupuncture therapy was higher in these 60 patients than the other 15 patients (55.5% vs. 26.7%, p=0.05).  46% of the patients with acupuncture therapy were also treated with other types of physical therapy.  The result suggests that acupuncture therapy may be able to relieve low back pain and/or knee pain in elderly patients.

• According to a pilot study done by Schmitt et al published in Schmerz 2001 Feb;15(1):33-7 entitled “Acupuncture treatment of low back pain” the authors concluded that acupuncture is a noninvasive treatment with very few complications and that it is a promising therapeutical option of low back pain, especially when associated with radicular symptoms.

• Another study done by Molsberger et al published in Pain 2002 Oct;99(3):579-87 entitled “Does acupuncture improve the orthopedic management of chronic low back pain — a randomized, blinded, controlled trial with 3 months follow up” concluded that acupuncture can be an important supplement of conservative orthopedic treatment in the management of chronic low back pain.

• In a study done by Meng et al published in Rheumatology (Oxford). 2003 Dec;42(12):1508-17 entitled “Acupuncture for chronic low back pain in order patients: a randomized, controlled trial” it was concluded that acupuncture is an effective, safe adjunctive treatment for chronic low back pain in older patients.  Fewer acupuncture subjects had medication-related side-effects compared with the control group.

• A study entitled “Acupuncture relieves pelvic and low-back pain in late pregnancy” done by Kvorning et al and published in Acta Obstet Gynecol Scand 2004 Mar;83(3):246-50 found that acupuncture relieves low-back and pelvic pain without serious adverse effects in late pregnancy.

• The results of a study published in Acta Obstet Gynecol Scand 2000 May;79(5):331-5 by Wedenberg et al entitled “A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy” concluded that acupuncture relieved pain and diminished disability in low-back pain during pre3gnancy better than physi9otherpay.

• A study published in Russian in Zh Nevropatol Psikhiatr Im S S Korsakova 1976;76(6):872-4 using acupuncture for lumbosacral radiculitis showed that there was a significant improvement in the group of patients who received only acupuncture (87.2%) and somewhat less (70.2%) in the group treated with conventional methods.

NAUSEA AND VOMITING

• The results of a study published in Birth 2002 Mar; 29(1):1-9 by Smith et al entitled “Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial.” concluded that acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy.

• The results of a study published in J Pain Symptom Manage 2000 Oct;20(4):273-9 by Carlsson et al entitled “Manual acupuncture reduces hyperemesis gravidarum: a placebo-controlled, randomized, single-blind, crossover study” found that active acupuncture on acupoint PC-6 in combination with standard treatment could make women with hyperemesis gravidarum (severe vomiting) better faster than placebo acupuncture.

NECK AND SHOULDER PAIN

• A study done by He et al entitled “Effect of acupuncture treatment on chronic neck and shoulder pain in sedentary female workers: a 6-month and 3-year follow-up study” published in  Pain 2004 Jun;109(3):299-307 concluded that adequate acupuncture treatment may reduce chronic pain in the neck and shoulders and also related headache.  They found that the effect lasted for 3 years.

• The results of a study published in Clin J Pain 1998 Sep;14(3):248-55 by Birch et al entitled “Controlled trial of Japanese acupuncture for chronic myofascial neck pain: assessment of specific and nonspecific effects of treatment” concluded that relevant acupuncture with heat contributes to modest pain reduction in persons with myofascial neck pain.

• The results of a study published in Acupunct Electrother Res 1987;12(1):37-44 by Peng et al entitled “Long-term therapeutic effects of electro-acupuncture for chronic neck and shoulder pain — a double blind study” found that 24 or 64.9% of their patients obtained significant long term improvement.  An increase in regional microcirculation by peripheral sympathetic blockage from elector-acupuncture is thought to be responsible for the tissue healing and subsequent pain relief.

OSTEOARTHRITIS

• According to a study published in Ann Intern Med 2004 Dec 21;141(12):901-10 by Berman BM, Lao L et al entitled “Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial involving 570 patients with osteoarthritis of the knee it was concluded that acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.

• The results of a study published in Rheumatology (Oxford) 1999 Apr; 38( 4): 346-54 by Berman et al entitled “A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee” concluded that acupuncture is an effective and safe adjunctive therapy to conventional care for patients with osteoarthritis of the knee.

• The results of a study published in Danish in Acta Anaesthesiol Scand 1992 Aug; 36 (6): 519-25 entitled “Acupuncture treatment of severe knee osteoarthrosis. A long-term study” concluded that acupuncture on patients waiting for arthroplasty surgery can ease the discomfort while waiting for the operation and perhaps even serve as an alternative to surgery. Seven patients responded so well that at the time of publication they did not want an operation. Comparing the acupuncture treated group with the group receiving no acupuncture it was noted that there was a significant reduction in pain, analgesic consumption and in most objective measures. In the second part of the study it was shown that it was possible to maintain the improvements with once a month acupuncture treatments.

PAINFUL CONDITIONS

• A study published in Singapore Med J 1999 Apr;40(4):260-4 by Yong D, Lim SH et al entitled “Acupuncture treatment at Ang Mo Kio Community Hospital — a report on our initial experience” involved 1,128 patients receiving a total of 12,172 acupuncture treatment sessions during the period between Sept. 1995 and Dec. 1996.  Most had either painful conditions (58%) or stroke-related dysfunction (23%).  Amongst the painful conditions, arthritis (25%), low back pain (22%) and other musculo-skeletal pain (12%) were the most common.  In a subgroup of patients treated for painful conditions, > 90% reported improvement.  The authors concluded that their preliminary experience showed that acupuncture is safe, and appears to be beneficial to patients with painful conditions.

PAINFUL PERIPHERAL NEUROPATHY

• A study published in Diabetes Res Clin Pract 1998 Feb;39(2):115-21 on 46 patients with chronic painful peripheral neuropathy concluded that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy, although its mechanism of action remains speculative.

• Another study published in Russian in the journal Probl Endokrinol (Mosk) 1991 Jul-Aug,37(4)-20-3 on diabetic angiopathy of the lower extremities on 55 patients with insulin-dependent diabetes mellitus showed a direct noticeable clinical effect with acupuncture in 78.2% of cases, determined perhaps by improved elastotonic properties of arteries of average caliber, enhanced blood outflow and regulation of lower limb vascular peripheral resistance.

PREMENSTRUAL SYNDROME

• The results of a study published in Arch Gynecol Obstet. 2002 Nov;267(1):23-6 by Habek et al entitled “Using acupuncture to treat premenstrual syndrome” found that the success rate of acupuncture in treating PMS symptoms was 77.8%, whereas it was 5.9% in the placebo group.  The positive influence of acupuncture in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opiodergic neurotransmission that modulates various psychosomatic functions.  The initial positive results of PMS symptoms with a holistic approach are encouraging and acupuncture should be suggested to the patients as a method of treatment.

RAYNAUD’S SYNDROME

• The results of a study published in J Intern Med 1997 Feb;241(2):119-24 by Appiah et al entitled “Treatment of primary Raynaud’s syndrome with traditional Chinese acupuncture”found that traditional Chinese acupuncture is a reasonable alternative in treating patients with primary Raynaud’s syndrome.

RENAL COLIC

• The results of a study published in J Urol 1992 Jan;147(1):16-8 by Lee et al entitled “Acupuncture in the treatment of renal colic” concluded that acupuncture can be a good alternative for the treatment of renal colic.

RHEUMATOID ARTHRITIS

• According to The Early Rheumatoid Arthritis Study, Albans City Hospital, UK; Exeter University, UK; reported in Reuter’s Medical Health, June 15,2001 acupuncture used by rheumatoid arthritis patients caused a significant reduction of both pain and the use of painkillers. Pain was reduced by a third in 73 percent of patients, and by at least 50 percent in more than half of those afflicted. Analgesic use also declined significantly, from an average of 17 tablets per week to just six.

SCHIZOPHRENIA

• A study by Zhuge and Chen in Chinese entitled “Comparison between electro-acupuncture with chlorpromazine and chlorpromazine alone in 60 schizophrenic patients” published inZhongguo Zhong Xi Yi Jie He Za Zhi 1993 Jul;13(7):408-9, 388 showed that the total curative effects of the two groups were similar.  However, the marked effects appeared earlier in combined therapy than that of using chlorpromazine alone, less chlorpromazine was needed, hence displayed fewer side effects.

• A study on 33 patients by Zhang in Chinese entitled “A controlled study of clinical therapeutic effects of laser acupuncture for schizophrenia” published in. Zhongguo Zhong Xi Yi Jie He Za Zhi 1991 Apr;24(2):81-3 found that laser acupuncture was as effective as chlorpromazine in the treatment of schizophrenia.

SCIATICA

• According to the results of a study by Wehling & Reinecke published in German in Schmerz 1997 Jun 13:11(3):180-4  entitled “Acupuncture together with cytokine depressing herbs in comparison to injection therapy with steroids in sciatic pain” in which 278 patients with chronic pain for a least 3 months were observed the following was found:  Best results were gained with steroid injection (66% pain reduction), acupuncture in combination with herbs improved the pain an average of 62%, whereas injection with local anaesthetic had a pain reduction of 48%.  The conclusion they drew from their results was that acupuncture in combination with herbs and steroid nerve blocks appear to be an effective and thus recommendable conservative therapy in cases of sciatic pain.

• The results of another study by Duplan B et al published in French in Sem Hop 1983 Dec 8:59(45):3109-14 entitled “Acupuncture and sciatica in the acute phase.  Double-blind study of 30 cases” involved the random assignment of 30 patients with acute sciatica into one of two groups. Objective and subjective criteria were analyzed before treatment and after five session of acupuncture. It was found that in the “placebo” group, no significant improvement was recorded.  Conversely, in the [acupuncture] treated group, study of objective criteria showed improvement of the Lasegue sign.  Among subjective symptoms, positive responses were recorded in the duration of improvement, degree of improvement in the decubitus and after ten minutes standing, and use of analgesics.  Compared to the “placebo” group these changes are statistically significant.

SEXUAL DYSFUNCTION

• In a study by Yaman et al entitled “The place of acupuncture in the management of psychogenic impotence” published in Eur Urol 1994;26(1):52-5 it would found that of the 29 patients treated with acupuncture 20 patients demonstrated successful erections following a varying number of acupuncture sessions.  In the light of their findings the authors concluded that acupuncture may be an effective alternative in the management of purely psychogenic impotence.

• In a study by Engelhardt et al entitled “Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study” published in Int J Impot Res 2003 Oct;15(5):343-6 the potentially curative effect of acupuncture was investigated in 22 patients with psychogenic erectile dysfunction.  The results of their pilot study indicated that acupuncture can be an effective treatment option in more than two-thirds of patients with psychogenic erectile dysfunction.

STROKE REHABILITATION

• The results of a study in Norwegian published in Tidsskr Nor Laegeforen 1998 Mar 30;118(9): 1362-6 by Kjendahl et al entitled “Acupuncture in stroke” showed that there was a significantly greater improvement in the acupuncture treated group than in the control group, both during the treatment period, and even more so during the following year.

• The results of a study published in Clin Rehabil 1997 Aug;11(3):192-200 by Kjendahl et al entitled “A one year follow-up on the effects of acupuncture in the treatment of stroke patients in the subacute stage: a randomized controlled study” concluded that there seems to be a positive long-term effect of acupuncture given in the subacute stage post stroke.

• The results of a study published in Acupunct Electrother Res 1994 Oct-Dec;19(4):227-49 by Naeser et al entitled “Acupuncture in the treatment of paralysis in chronic and acute stroke patients — improvement correlated with specific CT scan lesion sites” found that overall, 8 of the 20 patients receiving acupuncture had beneficial response with measurable objective improvement in more function.  Most improvements were sustained for at least 4 months after the last acupuncture treatment.

TENNIS ELBOW  (EPICONDYLITIS)

• The results of a study published in Rheumatology (Oxford) 1999 Apr; 38( 4): 346-54 by Berman et al entitled “A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee” concluded that acupuncture is an effective and safe adjunctive therapy to conventional care for patients with osteoarthritis of the knee.

• The results of a study published in Forsch Komplementarmed Klass Naturheilkd 2002 Aug;9(4):210-5 by Fink et al entitled “Chronic epicondylitis: effects of real and sham acupuncture treatment: a randomized controlled patient- and examiner- blinded long-term trial” concluded that in the treatment of chronic epicondylitis, the selection of so-called real acupuncture points gives better results than invasive sham acupuncture at early follow-up.

• The results of a study published in Rheumatology (Oxford) 2002 Feb;41(2):205-9 by Fink et al entitled “Acupuncture in chronic epicondylitis: a randomized controlled trial” concluded that in the treatment of chronic epicondylopathia lateralis humeri, acupuncture in which real acupuncture points were selected and stimulated was superior to non-specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm.

• The results of a study published in Br J Rheumatol 1994 Dec;33(12):1162-5 by Molsberger and Hille entitled “The analgesic effect of acupuncture in chronic tennis elbow pain” concluded that their results were statistically significant and that it showed that non segmental verum (real) acupuncture has an intrinsic analgesic effect in the clinical treatment of tennis elbow pain which exceeds that of placebo acupuncture.

URINARY TRACT INFECTIONS

• The results of a study published in Scand J Prim Health Care 1998 Mar;16(1);37-9 by Aune et al entitled “Acupuncture in the prophylaxis of recurrent lower urinary tract infection in adult women” concluded that acupuncture seems a worthwhile alternative in the prevention of recurring lower UTI in women.

WEIGHT REDUCTION

• The results of a study published in the Journal of Traditional Chinese Medicine. 1993 Mar, 13(1):22-6 by Sun, Q. and Xu Y. entitled “Simple obesity and obesity hyperlipema treated with otoacupoint pellet pressure and body acupuncture” indicated that treatment in the auricular and body acupoint group was superior to treatment in the control group.  In the acupoint group body weight dropped by an average of 5.04 kg in 84.55% of the patients, who also showed decreased appetite, blood TC and TG.

• The results of another study which was published in Australian Family Physician 1998 Jul; 27 Suppl 2:S73-7 by Richards, D. and Marley, J. entitled “Stimulation of auricular acupuncture points in weight loss” found that frequent stimulation of specific auricular acupuncture points is an effective method of appetite suppression which leads to weight loss.

WHIPLASH INJURY

• A study done by Fattori et al and published in Acupunct Electrother Res. 1996 Jul-Dec;21(3-4)207-17 entitled “Acupuncture treatment for balance disorders following whiplash injury” involved using computerized static posturography and evaluating the postural changes after acupuncture treatment in a group of 15 patients with balance disorders caused by cervical torsion due to Whiplash Injury (WI). The control group consisted of 17 patients complaining of the same symptoms as the study group; due to WI, but treated with drugs (FANS and myorelaxing) and physiotherapy only.  The high percentage of positive results in our WI patients leads us to advocate the therapeutic efficacy of acupuncture for balance disorders due to cervical pathology, where it can be associated with or be a valued alternative to pharmacological treatment.

• Another more recent study done by Fattori et al and published in Int Tinnitus J. 2004; 10(2):156-60 entitled “Acupuncture treatment of whiplash injury” involved evaluation by computerized static posturography the postural changes after acupuncture treatment in a group of 27 patients having balance disorders caused by cervical torsion due to whiplash injury.  The control group consisted of 25 patients complaining of the same symptoms as those recorded by the study group due to whiplash injury but treated with nonsteroidal anti-inflammatory drugs and myorelaxation or with physiotherapy only.  The high percentage of positive results in whiplash injury patients leads the authors to advocate acupuncture for balance disorders to to cervical pathology.

REFERENCES

Entrez-PubMed website: http://www.ncbi.nlm.nih.gov/PubMed/
Stux, G and Hammerschlag, R, Clinical Acupuncture, Scientific Basis, Berlin: Springer-Verlag 2001

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-475-1005.

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Beneficial Foods for the Brain

by John & Barbara Connor, M.Ac., L.Ac.

John and I would like to share with you today some of the research we have come across on different foods that are beneficial for the brain. Age-related cognitive decline is rising as one of the world’s most detrimental health problems which often leads people to find a respite care program for seniors for seniors in the later stages of their lives.

We feel that one of the many ways in slowing down this cognitive decline is to eat foods that are good for the brain. We hope that what we present here is helpful in your quest for optimal cognitive function.

Every year, more than 10 million people suffer from neurodegenerative diseases worldwide, and this figure is expected to grow by 20% over the next decade. Neurodegenerative diseases are a group of progressive neurological disorders that damage or destroy the function of neurons. (Kannappan et al 2011)

One leading theory of aging is based on the concept that damage, either due to the toxic products of metabolism or inefficient repair/defensive systems, accumulates throughout our entire life span and gradually leads to cell and organ dysfunction. There is substantial support for the role of reactive oxygen species (ROS) in the aging process. The free radical theory of aging proposes that ROS is responsible for macromolecular damage and for age-related tissue degeneration. (Pierno et al 2014)

Oxidative stress has been implicated in normal aging and many neurodegenerative diseases. The term “oxidative stress” refers to an imbalance between the production of reactive oxygen species (ROS) and their neutralization by antioxidant defenses. (Choi et al 2015)

At high levels, ROS can react with different cell molecules, causing damage to DNA, lipids, and proteins, and modulate intracellular signaling pathways, leading to cellular degeneration and apoptosis. ROS can also initiate proinflammatory pathways, further exacerbating the deleterious oxidized environment. The brain is particularly vulnerable to oxidative stress because of its high oxygen consumption, high content of oxidizable polyunsatured fatty acids, and low antioxidant defense capacities especially in aging brains. (Tarozzi et al 2013)

There is increasing evidence to suggest that diet, one of the most important modifiable lifestyle factors, may play a role in preventing or delaying cognitive decline and Alzheimer’s disease (AD), a major public health problem. (Berti et al 2015)

The following is a list of foods that John and I think may be beneficial for your brain health followed by the various studies describing their benefits:

Blueberries
Cocoa
Coconut oil
Concord grape juice
Fish
Fruit
Legumes/pulses
Mediterranean diet
Nuts
Orange juice
Pomegranate juice
Potatoes
Red wine
Soy
Tea
Tomatoes
Vegetables
Whole grains

Orange juice – Chronic daily consumption of flavanone-rich 100% orange juice over 8 weeks is beneficial for cognitive function in healthy older adults. The potential for flavanone-rich foods and drinks to attenuate cognitive decline in aging and the mechanisms that underlie these effects should be investigated. (Kean et al 2015)

DHA (the n-3 fatty acid found in fish) – Overall, where individual omega-3 PUFAs have been investigated in trials of healthy aging, mild cognitive impairment and Alzheimer’s disease the focus has been on DHA, which is consistent with the pre-clinical evidence. DHA treatment appears to show the greatest promise compared to EPA and DPA, and the benefits of DHA treatment currently appear to be to improve memory and learning in participants with MMSE scores above 26–27, particularly non-ApoE-ε4 carriers, although support from clinical trials is currently extremely limited. (Dyall SC 2015)

Coconut oil comprises medium-chain fatty acids (MCFA). MCFA are unique in that they are easily absorbed and metabolised by the liver, and can be converted to ketones. Ketone bodies are an important alternative energy source in the brain, and may be beneficial to people developing or already with memory impairment, as in Alzheimer’s disease (AD). (Fernando et al 2015)

Fruits, vegetables, and juices – The data suggest that chronic consumption of fruits, vegetables, and juices is beneficial for cognition in healthy older adults. The limited data from acute interventions indicate that consumption of fruit juices can have immediate benefits for memory function in adults with mild cognitive impairment; however, as of yet, acute benefits have not been observed in healthy adults. Conclusions regarding an optimum dietary intake for fruits, vegetables, and juices are difficult to quantify because of substantial heterogeneity in the categorization of consumption of these foods. (Lamport et al 2014)

Blueberry and grape seed extracts rescued rotenone-induced defects in mitochondrial respiration in a dopaminergic cell line, and a purple basal extract attenuated nitrite release from microglial cells stimulated by lipopolysaccharide. These findings suggest that anthocyanin- and proanthocyanidin-rich botanical extracts may alleviate neurodegeneration in Parkinson’s disease (PD) via enhancement of mitochondrial function. (Strathearn et al 2014)

Fruits and Vegetables – For a long time, the increased consumption of fruits and vegetables was considered critical in protecting humans against a number of diseases, such as cancer, diabetes, neurodegenerative diseases, and heart and brain vascular diseases. Presently, it is thought that the protective properties of these foods result from the presence of low-molecular antioxidants that protect the cells and their structures against oxidative damage. A number of studies have shown, however, that consuming less common fruits and vegetables contribute much more to the reduction of free-radical processes, most likely because they contain a large amount of non-vitamin antioxidants, such as polyphenols and anthocyanins. (Harasym & Oledzki 2014)

Fruit, vegetables, fish, (whole) grains and legumes/pulses and potatoes – According to both a posteriori and a priori dietary patterns, some key ‘ingredients’ can be identified that are associated consistently with longevity and better cardiometabolic and cognitive health. These include high intake of fruit, vegetables, fish, (whole) grains and legumes/pulses and potatoes, whereas dietary patterns rich in red meat and sugar-rich foods have been associated with an increased risk of mortality and cardiometabolic outcomes. (Kiefte-de Jong et al 2014)

Red wine – Several epidemiological studies have shown that moderate wine consumption can be effective in slowing down age-related cognitive decline. Resveratrol, a natural polyphenol, is mainly present in red wine and has been suspected to be the major driving force behind the French paradox. Resveratrol is a multi target compound and may represent an effective therapeutic tool in aging-related neurodegenerative processes. Consistently, several clinical trials are ongoing to test its effectiveness as dietary supplement to slow dementia progression. In agreement, pterostilbene, a resveratrol derivative, has shown promise in preclinical models of neurodegeneration, resulting more efficient than resveratrol itself in modifying Alzheimer’s disease and aging-related cognitive decline. (Granzotto & Zatta 2014)

Nuts – We found a modest relationship between long-term total nut intake and cognitive function. In multivariable-adjusted linear regression models, higher long-term total nut intake was associated with better average cognitive status for all cognitive outcomes. Nut intake could potentially represent a fairly simple dietary modification if future research confirms our findings. Additional investigations- particularly with a focus on those who consume nuts frequently – is warranted. (O’Brien et al 2014)

Tea, Cocoa and Blueberry -Phytochemical–rich foods, particularly those rich in flavonoids, have been shown to be effective in reversing age-related deficits in memory and learning. In particular, studies using Camellia sinensis (tea), Gingko Biloba, Theobroma cacao (cocoa) and Vaccinium spp (blueberry) have demonstrated beneficial effects on memory and learning in both humans and animal models. Our data support the claim that flavonoids are likely causal agents in mediating the cognitive effects of flavonoid-rich foods. (Rendeiro et al 2013) Flavonoids are capable of crossing the blood-brain barrier (BBB) and reaching the central nervous system. (Faria et al 2014)

Pomegranate juice – This preliminary randomized placebo-controlled, double-blind trial of pomegranate juice in older adults with mild memory complaints suggests that 8 ounces of pomegranate juice taken daily over one month improve a sensitive measure of verbal memory and alter neural activity during a visual source memory task. The presence of polyphenol metabolites validated compliance with the experimental regimen and efficacy of pomegranate juice in releasing polyphenols. fMRI results suggest that the mechanisms of change may involve increases in task-related cerebral blood flow, particularly during associative encoding tasks. While preliminary, these results suggest a role for pomegranate juice in augmenting memory function through task-related increases in functional brain activity. (Bookheimer et al 2013)

Mediterranean diet – We assessed 522 participants at high vascular risk (44.6% men, age 74.6 5.7 years at cognitive evaluation) enrolled in a multicentre, randomised, primary prevention trial (PREDIMED), after a nutritional intervention comparing two Mediterranean diets (supplemented with either extra-virgin olive oil (EVOO) or mixed nuts) versus a low-fat control diet. An intervention with Mediterranean diets enhanced with either EVOO or nuts appears to improve cognition compared with a low-fat diet. (Martinez-Lapiscina et al 2013)

Concord grape juice – Polyphenol compounds found in berry fruits, in particular flavonoids, have been associated with health benefits including improvement in cognition and neuronal function with aging. Concord grape juice contains polyphenols, including anthocyanins and flavanols, and previous research has shown improvement in a number of human health conditions with grape juice supplementation. These findings provide further evidence that Concord grape juice can enhance neurocognitive function in older adults with mild memory decline. (Kirkorian et al 2012)

n-3 fatty acid, DHA, found in fish – The objective of this review is to provide an overview of nutritional factors involved in cognitive aging and dementia with a focus on nutrients that are also important in neurocognitive development. Several dietary components were targeted, including antioxidant nutrients, dietary fats and B-vitamins. A critical review of the literature on each nutrient group is presented, beginning with laboratory and animal studies of the underlying biological mechanisms, followed by prospective epidemiological studies and randomised clinical trials. The evidence to date is fairly strong for protective associations of vitamin E from food sources, the n-3 fatty acid, DHA, found in fish, a high ratio of polyunsaturated to saturated fats, and vitamin B12 and folate. (Morris MC 2011)

n-3 PUFA, DHA and EPA – The aim of the present study was to investigate the benefits of supplementing a diet with n-3 PUFA, DHA and EPA, for depressive symptoms, quality of life (QOL) and cognition in elderly people with MCI. We conducted a 6-month double-blind, randomised controlled trial. Compared with the LA (n-6 PUFA linoleic acid) group, GDS scores improved in the EPA and DHA groups and verbal fluency in the DHA group. Improved GDS scores were correlated with increased DHA plus EPA. Improved self-reported physical health was associated with increased DHA. There were no treatment effects on other cognitive or QOL parameters. Increased intakes of DHA and EPA benefited mental health in older people with MCI. Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia. (Sinn et al 2011)

Mediterranean diet – A high adherence to the Mediterranean diet has been associated with slower cognitive decline, with reduced risk of mild cognitive impairment conversion to Alzheimer’s disease and with reduced risk of Alzheimer’s disease. This dietary pattern is characterized by abundant plant foods consumption in the form of fruits, vegetables, breads, other forms of cereals, potatoes, beans, nuts and seeds; fresh fruit as the typical dessert; olive oil as the main source of monounsaturated fat; dairy products as principally cheese and yogurt; a low to moderate consumption of fish depending of the proximity of the sea; a low to moderate consumption of poultry; fewer than four eggs consumed per week; low amount of red meat and wine consumed in low to moderate amounts, normally during meals. (Feart et al 2010)

Flavonoids – Recent evidence has indicated that a group of plant-derived compounds known as flavonoids may exert particularly powerful actions on mammalian cognition and may reverse age-related declines in memory and learning. In particular, evidence suggests that foods rich in three specific flavonoid sub-groups, the flavanols, anthocyanins and/or flavanones, possess the greatest potential to act on the cognitive processes. (Spencer JP 2010)

Cocoa, wine, grape seed, berries, tea, tomatoes, soy and pomegranate – Several epidemiological studies suggest that the regular consumption of foods and beverages rich in flavonoids is associated with a reduction in the risk of several pathological conditions ranging from hypertension to coronary heart disease, stroke and dementia. The impairment of endothelial function is directly related to ageing and an association between decreased cerebral perfusion and dementia has been shown to exist. Cerebral blood flow (CBF) must be maintained to ensure a constant delivery of oxygen and glucose as well as the removal of waste products. Increasing blood flow is one potential way for improving brain function and the prospect for increasing CBF with dietary polyphenols is extremely promising. The major polyphenols shown to have some of these effects in humans are primarily from cocoa, wine, grape seed, berries, tea, tomatoes (polyphenolics and nonpolyphenolics), soy and pomegranate. (Ghosh & Scheepens 2009)

Berries and cocoa – The consumption of flavonoid-rich foods, such as berries and cocoa, throughout life holds a potential to limit neurodegeneration and prevent or reverse age-dependent deteriorations cognitive performance. However, at present, the precise temporal nature of the effects of flavonoids on these events is unclear. For example, it is presently unclear as to when one needs to begin consuming flavonoids in order to obtain maximum benefits. It is also unclear which flavonoids are most effective in inducing these changes. (Spencer JP 2009)

Fruits, nuts, vegetables, and spices – Recent studies suggest that consumption of diets rich in antioxidants and anti-inflammatory components such as those found in fruits, nuts, vegetables, and spices, or even reduced caloric intake, may lower age-related cognitive declines and the risk of developing neurodegenerative disease. (Joseph et al 2009)

Spinach, kale, asparagus, broccoli, avocado and parsley– A reduction in key antioxidants such as glutathione has been noted in brain tissue undergoing oxidative stress in aging and neurodegeneration. Protection against oxidative stress is directly afforded through the oxidation of glutathione in mitochondria, and decreased concentrations of glutathione were reported in the aging rat brain. (Choi et al 2015) Glutathione containing foods include spinach, kale, asparagus, broccoli, avocado and parsley. They are rich in constituents which form glutathione precursors.

Avoid sugar substitutes – After long-term treatment with fructose, erythritol (sugar alcohols), acesulfame K (artificial sweeteners), or rebaudioside A (rare sugars), the cerebral ischemic injury (both infarct volumes and neurobehavioral outcomes) was significantly aggravated, angiogenesis in ischemic brain was reduced, and endothelial progenitor cell function was impaired in mice compared with control. Long-term consumption of sugar substitutes aggravated cerebral ischemic injury in mice, which might be partly attributed to the impairment of endothelial progenitor cells and the reduction of angiogenesis in ischemic brain. (Dong et al 2015)

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