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Ancient Roots & Modern Methods of Acupuncture Practice

Explore the origins, techniques, and benefits of acupuncture, from traditional Chinese medicine to modern applications. Learn about acupuncture's safety, use in treating various conditions, and the science behind its effectiveness.

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Ancient Roots & Modern Methods of Acupuncture Practice

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  1. By Marissa Grace Latin: Acus (needle) Punctura Values Assessment: Continuum…….

  2. Cognitive Objectives • List 3 stated benefits of acupuncture. • Define sham acupuncture. • Describe what Qi is. • Identify the most significant adverse effect related to safety and explain what it was related to. • Explain which treatment application (Back pain, OA of the Knee, or PONV) has the most evidence of benefits based on results, strengths and limitations.

  3. Origins • Trace back more than 2000 years in China • 6th Century spread to Korea and Japan • 8th and 10th Century trade into Vietnam • 16th Century Western France by Jesuit missionaries • 1972- Visit to China from President Nixon- • Member of US Press Corps with emergency appendectomy received acupuncture. • Experienced shared with New York Time

  4. N/V after chemotherapy Back Pain Osteoarthirtis Preop surgery pain Addiction Stroke Headache Menstrual Cramps Tennis elbow Fibromyalgia Asthma Carpal Tunnel Stated Benefits

  5. Techniques and Practices • Sham acupuncture • Okibari - Japanese style • Moxibustion • Cupping • Electroacupuncture (EA)

  6. Needles • Needles made of flint, thorns of plants, bamboo slivers or bone • Very fine and flexible about 1/2in (0.6cm) to 1 ½ in (38cm) • Attract or disburse energy along meridians • FDA approved needles by use of licensed practitioners in 1996. Sterile, non toxic, single use only

  7. Tools of the Tradehttp://www.lhasaoms.com/

  8. Traditional Chinese Medicine • Qi: Life force, vital energy behind all physiological processes. • warms body, pathogen protection, promotes growth • Meridian network system • Disruption of flow results in illness • Mechanism of Qi still mysterious

  9. Traditional Chinese Medicine • Meridians • Term for each of 20 pathways through body for flow of qi, accessed through acupuncture points • 12 main and 8 secondary • Up to 2000 points along meridian complex • Points regulate different areas of the body

  10. Theory • Stimulation of the nervous system to release chemicals in the muscles, spinal cord, and brain. • Beta-endorphin • Analgesia. • Placebo effect.

  11. Is acupuncture safe? A systemic review of case reportsLao L, et al. Alt Therapy in Health and Med Jan/Feb 2003:9,1:72-83 • Method • 202 cases reported (40% from US) from 1965-1999, • First hand reports included, case reports

  12. Is acupuncture safe? A systemic review of case reportsLao L, et al. Alt Therapy in Health and Med Jan/Feb 2003:9,1:72-83 • Results • Infection: Hepatitis 80% (94cases/35 years) • Needles not cleans/ repeated use/ inadequate sterilization • Internal Organ/tissue injury • Fewer complications after 1988: no further Hepatitis reports. • 20% of practitioners with no recognized qualifications

  13. Acupuncture for back pain: A meta-analysis of randomized controlled trials.Ernst, Arch of internal Med. 1998;158:20:2235-2241 • Methods • Randomized controlled trials of acupuncture of back pain in humans • 377 subjects, mostly with chronic poor prognosis back pain • Consulted by 6 experienced acupuncturists • 12 studies included (9 suitable for meta-analysis) • Conclusion • Insufficient evidence to state whether superior to placebo • Long term effect of back pain with acupuncture uncertain

  14. Acupuncture for back pain: A meta-analysis of randomized controlled trials.Ernst, Arch of internal Med. 1998;158:20:2235-2241

  15. Randomized trial comparing traditional medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Cherkin DC, Eisenberg D, Sherman KJ et al.Archives of internal medicine. 2001; 161, 8: 1081-1088. • Design • Only 17% of invited Washington State Group Health HMO patients participated (262 patients, age 20-70 years). • Ten acupuncture or massage visits in a 10 week period. • 95% of patients w/ Follow-up after 4, 10, and 52 weeks. • Symptoms and dysfunctions assessed • Results • F/U with 95% of participants • massage is an effective short-term treatment for chronic low back pain with benefits to last at least 1 year

  16. Randomized trial comparing traditional medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Cherkin DC, Eisenberg D, Sherman KJ et al.Archives of internal medicine. 2001; 161, 8: 1081-1088. • Results • If acupuncture has a positive effect it seems to be during the first 4 weeks with limited improvement thereafter. • Strengths- randomized design, involvement of therapist with protocol development, and high compliance rate. • Limitations -absence of control group, restriction of single form of acupuncture (TCM), possibility of atypical therapists, use of protocols that excluded treatments often used by some TCM acupuncturist.

  17. Osteoarthritis • OA most prevalent form of arthritis • Common site is knee joint and a leading cause of disability in the elderly • Acupuncture for OA is a therapeutic approach common in Asian societies

  18. A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the kneeBerman BM, et. al. Rheumatology 1999;38: 346-354 • Design • 73 patients from the Baltimore area (average age 65 years). • Inclusion criteria ≥ 50 older Dx of OA ≥ 6 months, moderate pain in knee most days in the last month, taking analgesic or anti-inflammatory agents for pain control at least one month. • protocol included TCM treatment for Bi syndrome which uses local and distal points on channels that cross the area of pain

  19. A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the kneeBerman BM, et. al. Rheumatology 1999;38: 346-354 • Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) • The patient’s scores were determined at 0, 4, 8 and 12 weeks during trial. • Results • the acupuncture group with about 34% ↓ on WOMAC at week 4 and 42% at week 8. • There were no significant changes in the control group from baseline to week 12. • Limitations noted lack of placebo control group.

  20. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Berman BM, Lao L, Langenberg P, et al. Annals of Internal Medicine. 2004 • Design • Reduce pain/improve function among patients with knee OA as compared to both sham acupuncture and education control groups • 8 week intense acupuncture treatment, followed by an 18 week tapering regime • 570 participants • Assessments conducted at baseline, 4, 8, 14, and 26 weeks

  21. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Berman BM, Lao L, Langenberg P, et al. Annals of Internal Medicine. 2004 • Results • True acupuncture groups improvement from baseline was significantly greater than the sham control group at weeks 8 (P=0.01), 14 (P=0.04), 26 (P=0.009) • Most believe they received true acupuncture at both times, suggesting the sham acupuncture to be a credible blinding strategy • At 4 weeks 67% of the true acupuncture group and 58% of sham believed they were receiving true acupuncture (P=0.06) and at 26 weeks 75% in acupuncture group and 58% in sham (P=0.003).

  22. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting (PONV): A meta-analysis Lee A, Done M. Anesthesia and analgesia. 1999. 88:6: 1362-1369. • Design • Stimulation of wrist at pericardium (P6) • Systemic review 24 randomized controlled trials (1679 patients) • Nonphamacologic- acupuncture, electroacupuncture, transcutaneous electrical nerve stimulation, acupoint stimulation and acupressure • Measured incidence of nausea, vomiting or both after surgery 0-6h (early) or 0-48h (late)

  23. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting (PONV): A meta-analysis Lee A, Done M. Anesthesia and analgesia. 1999. 88:6: 1362-1369. • Results • Pediatric studies failed to show significant benefit. • Antiemetic use in preventing early or late PONV in adults was comparable to the non-pharmacologic techniques. • Significant reduction of early vomiting in nonpharm. group compared with placebo w/in 6h of surgery for adults.

  24. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting (PONV): A meta-analysis Lee A, Done M. Anesthesia and analgesia. 1999. 88:6: 1362-1369. • Limitations • Combining different non-pharmacologic techniques. • May have different effects to prevent PONV • Optimal methods of applying techniques unknown. • Length of treatment (5min- 7days) • No statistical heterogeneity • Conclusions • Further RCT with better study methodology needed in adults. • Mechanism for prevention of PONV not established.

  25. Values Assessment: Continuum……./ Questions????

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