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Clinical Evidence for Acupuncture

Treatment of Heel Pain Using Acupuncture Point PC 7: A Pilot Study 針刺大陵穴治療足跟痛的前期研究 ZHANG Shi Ping 張世平 YIP Tsui-Pik 葉翠碧 , LI Qiu-Shi 李 求實 School of Chinese Medicine Hong Kong Baptist University 香港浸會大學中醫藥學院. Clinical Evidence for Acupuncture. Efficacy ? Specificity ?. Why Choose Heel Pain?.

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Clinical Evidence for Acupuncture

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  1. Treatment of Heel Pain Using Acupuncture Point PC 7: A Pilot Study 針刺大陵穴治療足跟痛的前期研究ZHANG Shi Ping張世平YIP Tsui-Pik葉翠碧, LI Qiu-Shi李求實School of Chinese MedicineHong Kong Baptist University香港浸會大學中醫藥學院

  2. Clinical Evidence for Acupuncture • Efficacy ? • Specificity ?

  3. Why Choose Heel Pain? • Common: • Affects about 10% of the general population • Well defined: • Usually caused by plantar fasciitis. • Efficacy and specificity supported by anecdotal evidence.

  4. Methods • Randomized controlled trial (RCT) • Double Blind: patient, assessor blinded • Specific acupuncture: PC 7(大陵) • Non-specific acupuncture: LI 4（合谷）

  5. Same method of manual needling, controlling for: • Intensity • Duration • Treatment: 5 times per week for 2 weeks.

  6. Inclusion Criteria • adult patients (>18 year old) • had heel pain that was localized to the medial tubercle of the calcaneum for over 3 months

  7. Exclusion Criteria • patients with a history of fracture or dysfunction of the ankle or knee, • arthritis; • signs of nerve injury; • severe systemic diseases, such as rheumatoid arthritis, diabetes or cardiovascular disorder; • patients unlikely to attend all treatment sessions; • needle phobia, pregnant or breast feeding

  8. Outcome measures • Roles and Maudsley Score (RMS) • 100 point visual analogue pain scales (VAS) for morning pain, activity pain and overall pain • Pressure pain algometry

  9. Assessment of the Credibility of the Controlled Treatment • Borkovec and Nau scale: • (i) How confident do you feel that this treatment can alleviate your complaint? • (ii) How confident would you be in recommending this treatment to a friend who suffered from similar complaints? • (iii) How logical does this treatment seem to you? • (iv) How successful do you think this treatment would be in alleviating other complaints? • Patients’ perception of acupuncture stimulation: • duration of the De Qi sensation (the feeling of numbness, aching or heaviness), • and intensities of De Qi sensation and pain on a 100 point visual analogue scale.

  10. Non-study treatments received by patients

  11. Credibility assessment of acupuncture *The Pre-&Post-treatment compare of LI4 is p<0.05, and compare with PC7 is p<0.05.

  12. Duration and intensity of needle sensation # unpaired t-test with 2-tailed.

  13. Adverse effects after needling

  14. Conclusion: • Acupuncture at both specific and non-specific points produces significant improvements for plantar fasciitis. • There is a specific effect for PC 7. • This is the first study showing specific effect of a single acupuncture point in treatment of pain condition.

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