Abstracts from the Society for Acupuncture Research 2013 International ConferenceImpact of Acupuncture Research on 21st Century HealthcareApril 18–21, 2013The Michigan LeagueAnn Arbor, MI

Abstract

The Journal of Alternative and Complementary MedicineVol. 19, No. 7 AbstractsFree AccessAbstracts from the Society for Acupuncture Research 2013 International ConferenceImpact of Acupuncture Research on 21st Century HealthcareApril 18–21, 2013The Michigan LeagueAnn Arbor, MIPublished Online:2 Jul 2013https://doi.org/10.1089/acm.2013.1502aAboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Oral AbstractsO-1 A RANDOMIZED COMPARATIVE EFFECTIVENESS CLINICAL TRIAL OF ACUPUNCTURE AS AN ADJUNCTIVE THERAPY IN PATIENTS WITH DEPRESSIONLinlin Sun, Beijing University of Chinese Medicine; Xuehong Ma, Dongfang Hospital, the second clinical medical college of Beijing University of Chinese Medicine; Xinjing Yang, Beijing University of Chinese Medicine; Sihan Wang, Beijing University of Chinese Medicine; Zhuo Guo, Beijing University of Chinese Medicine; Huifang Ma, Beijing University of Chinese Medicine; Fengxian Meng, Dongfang Hospital, the second clinical medical college of Beijing University of Chinese Medicine; Tuya, Beijing University of Chinese MedicinePurpose: To determine whether acupuncture plus the antidepressant paroxetine is more effective than paroxetine alone in patients with depression Methods: Outpatients with depression (n=88) were randomly divided into three groups: 1) manual acupuncture plus paroxetine (n=25); 2) electroacupuncture (EA) plus paroxetine (n=28); 3) paroxetine alone (n=35). Treatments were given for 6 weeks: manual acupuncture and EA (30 minutes every other day); paroxetine (10 mg/day for the first two days, 20 mg/day from the third day onward). The Hamilton Depression (HAMD) and Zung Self-Rating Depression (SDS) scales assessed treatment effect at weeks 0, 1, 2, 4, and 6. The Side Effects Rating Scale (SERS) was given at weeks 0, 2, 4, and 6. HAMD was given at follow up in week 10. Analyses included Intention-To-Treat (ITT) and Per-Protocol subjects (PP).Results: The scales showed no differences among the groups at baseline (P>0.05). The acupuncture groups scored significantly better on HAMD than did medicine alone at each time point (P<0.05); there were no statistically significant differences between the acupuncture groups. (See Fig. 1.) The acupuncture groups scored significantly better on SDS than did the paroxetine group at weeks 4 and 6 (P<0.05). The acupuncture groups scored significantly lower on SERS than did the paroxetine group at weeks 2, 4, and 6 (P<0.05).Conclusions: Our small-scale comparative effectiveness clinical trial indicates that acupuncture as an adjunctive therapy for patients with depression may be both safe and more effective than pharmaceuticals alone.O-2 ACUPUNCTURE AND OTHER PHYSICAL TREATMENTS FOR THE RELIEF OF CHRONIC PAIN DUE TO OSTEOARTHRITIS OF THE KNEE: NETWORK META-ANALYSISHugh MacPherson, University of York; Mark Corbett, University of York; Stephen Rice, University of York; Vichithranie Madurasinghe, Perinatal Institute; Russell Slack, University of York; Alex J Sutton, University of Leicester; Melissa Harden, University of York; Nerys Woolacott, University of YorkPurpose: To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to osteoarthritis of the knee, where treatment is additional or alternative to pharmacological analgesics.Methods: We conducted a network meta-analysis combining both direct (within-trial) and indirect (between-trial) evidence, such that all treatments were compared equally with each other, standard care, placebo, or no treatment, and which reported pain as an outcome. Data were pooled where there was sufficient clinical homogeneity. Analyses were conducted using Markov Chain Monte Carlo simulation to estimate model parameters following a Bayesian approach.Results: Of 138 eligible studies, 87 trials covering 22 different treatments and 6753 patients provided data suitable for analysis. Results showed that only six interventions, acupuncture, aerobic exercise, interferential therapy, muscle-strengthening exercise, pulsed electrical stimulation, and TENS produced a statistically significant reduction in pain when compared with standard care. A majority of trials were rated as being of poor quality. Of the above six interventions, only acupuncture and muscle-strengthening exercise were represented by more than one trial in a sensitivity analysis of the better-quality studies; both interventions were statistically significantly better than standard care (8 trials of acupuncture, SMD: −1.01, 95% credible interval −1.42 to −0.62; 7 trials of muscle-strengthening exercise, SMD: −0.38, 95% credible interval −0.74 to −0.02) with acupuncture being statistically significantly better than muscle-strengthening exercise (SMD: 0.64, 95% credible interval 0.13 to 1.15). The results for both these interventions were consistent across both the main and sensitivity analyses.Conclusions: The first network meta-analysis of physical interventions for knee pain due to osteoarthritis indicates that acupuncture appears to be the treatment most likely to produce a clinically relevant effect in alleviating pain in the short-term.O-3 ACUPUNCTURE IN A MANAGED CARE PROGRAM: EVALUATING CLINICAL OUTCOMES, MEMBER SATISFACTION, AND COSTS OF CAREElizabeth Sommers, Boston University School of Public Health; Marilyn Moro-Carrion, Boston University School of Public Health; Maya Rauth, Boston University School of Public HealthA community health center and clinic specializing in acupuncture partnered with a large managed care organization to determine whether acupuncture treatment might influence clinical outcomes and costs of care for patients referred for the following conditions: pain, headache, menstrual or menopausal symptoms, carpal tunnel syndrome. Members of the managed care organization were referred through their physicians. Results of the project's first 5 years of this ongoing project will be presented.Data for this observational assessment were collected on demographics, health history, clinical outcomes, satisfaction, and associated costs. All patients received individualized acupuncture treatments provided by licensed acupuncturists according to standards of care. Data were collected on 488 individuals. Three hundred eighty-two (78%) were female, 47% were Hispanic/Latino, 13% were African-American, and mean age was 39 years. Of these, 73% were referred for pain, 16% for headache, 6% for menstrual symptoms, 2% for menopausal symptoms, and 2% for carpal tunnel syndrome. Mean reduction in pain severity based on a 10-point Likert scale was 1.88 (p<0.0001). Mood, sleep, ability to work improved (p<0.0001) although quality of life as indicated by SF1 did not appreciably change (p=0.08). Headache intensity levels were significantly reduced by 2.9 on a 10-point Likert scale (p<0.0001) as was quality of life (p=0.009). Women receiving acupuncture for menstrual difficulties reported reductions in cramps (p=0.001), insomnia (p=0.018) and edema (p=0.003). Preliminary cost estimates suggest a decrease in other healthcare costs ($40/member/month) and increased likelihood that individuals who received acupuncture continued their membership in the managed care plan.Preliminary results indicate that offering acupuncture in a community health setting is acceptable and desirable by patients and physicians. Favorable clinical and cost-of-care outcomes were observed in this ongoing project.O-4 ACUPUNCTURE IN PATIENTS WITH SEASONAL ALLERGIC RHINITIS – RESULTS OF A RANDOMIZED CONTROLLED TRIALBenno Brinkhaus, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin; Miriam Ortiz, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin; Claudia M Witt, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin; Stephanie Roll, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin; Klaus Linde, Institute of General Practice, Klinikum rechts der Isar, Technische Universität München, Munich; Florian Pfab, Department of Dermatology and Allergy, Technische Universität München, Munich; Bodo Niggemann, Pediatric Allergology and Pneumology, German Red Cross Hospital Westend, Berlin International; Josef Hummelsberger, Society for Chinese Medicine (Societas Medicinae Sinensis, SMS), Munich; András Treszl, Department of Medical Biometry and Epidemiology, University Medical Center Eppendorf, Hamburg; Johannes Ring, Department of Dermatology and Allergy, Technische Universität München, Munich; Torsten Zuberbier, Department of Dermatology and Allergology, Charité University Medical Center, Berlin; Johannes Ring, Department of Medical Biometry and Epidemiology, University Medical Center Eppendorf, Hamburg; Stefan Willich, Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, BerlinBackground: Acupuncture is widely used to treat seasonal allergic rhinitis but the scientific evidence is insufficient. The aim of this study was to investigate the efficacy of acupuncture in seasonal allergic rhinitis.Method: Three-group randomized, controlled trial involving 422 patients suffering from seasonal allergic rhinitis (60% woman), mean (SD) age 33 (8) years, with clinical symptoms and IgE-sensitization to birch and grass pollen. Duration of follow-up was 3 months in the first and 8 weeks in the second year. The study interventions were acupuncture plus rescue medication (RM, Cetirizine) (n=212), sham acupuncture plus RM (n=102) or Rescue Medication alone (n=108). Acupuncture and sham acupuncture were administered by 46 specialized physicians in 6 hospital and 32 private outpatient clinics and consisted of 12 sessions per patient over 8 weeks. Primary outcome parameters were the Rhinitis Quality of Life Questionnaire overall score (RQLQ) and the RM Score (RMS) in weeks 7 and 8 post randomization. Duration of follow-up was 16 weeks in the first and 8 weeks in the second year without further treatment in both acupuncture groups.Results: Compared to sham acupuncture and to RM, acupuncture was associated with improvement in RQLQ (mean differences to sham 0.5, 97.5%CI 0.2–0.8, p<0.001, and to RM 0.7, 0.4–1.0, p<0.001) and lower RMS (mean differences 1.1, 0.4–1.9, p<0.001, and 1.5, 0.8–2.2, p<0.001, respectively). There were no differences after 16 weeks in the first year. After the 8-week follow-up phase in the second year acupuncture was again superior to sham acupuncture (mean differences RQLQ 0.3, 95%CI 0.03–0.6, p=0.032; and to RMS 1.0, 95%CI 0.2–1.9, p=0.018).Conclusion: Acupuncture led to improvements in disease-specific quality of life and antihistamine intake after 8 weeks of treatment compared to sham acupuncture and to rescue medication alone in the first and second year.O-5 ACUPUNCTURE SENSATION WITHOUT ACUPUNCTURE - WHAT IS THE PHYSIOLOGICAL BASIS?Florian Beissner, University Hospital Jena, Pain & Autonomics - Integrative Research; Maria Fink, University Hospital Jena, Pain & Autonomics - Integrative Research; Irene Marzolff, Goethe University, Frankfurt, Institute for Physical Geography; Franziska Brunn, University Hospital Jena, Pain & Autonomics - Integrative ResearchPurpose: A central concept of TCM theory explaining the effectiveness of acupuncture is that of meridians (chin.: “jingluo”), channel-like structures that traverse the body and are believed to circulate an immaterial substance called qi. After five decades of fruitless search for a corresponding anatomical correlate of these entities, there is unlikely to be one. Still, there is one good reason to believe in meridians: The patterns of acupuncture sensation. Here, we present the results of three different studies investigating patterns of acupuncture sensation (chin.: "deqi").Methods: In the first study, we used laser acupuncture under sensory deprivation to study the spatial aspect of sensation patterns. Using a geographic information system on subjects' drawings of their sensations, we compared these to patterns of referred pain from the literature. In the second study, we tested the importance of attention on the stimulated point, tactile stimulation and laser stimulation for the elicitation of the acupuncture sensation by manipulating each factor in a 2x2x2 single-blinded experimental design. In the third study, we tested if acupuncture sensations would also occur under pure placebo condition. For this purpose, the laser was left switched off during the whole experiment.Results: GIS analysis showed a close similarity between acupuncture sensation patterns and those of referred pain. This was true for all three experiments. Sensations were more frequent, when actual laser stimulation was taking place, but very similar patterns, qualities and intensities of the sensation were also observed under complete placebo conditions.Conclusions: Acupuncture sensation may be unrelated to acupuncture stimulation and may be a phenomenon of directed attention leading to perception of otherwise sub-threshold tonic activity of peripheral touch, pain and warm receptors.O-6 ACUPUNCTURE-INDUCED MOLECULAR SIGNALING PATHWAY IN MOUSE SKIN LAYERJi-Yeun Park, Acupuncture and Meridian Science Research Center(AMSRC), Kyung Hee University, Republic of Korea; Songhee Jeon, Dongguk University Research Institute of Biotechnology, Republic of Korea; Jongbae Park, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, USA; Younbyoung Chae, Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Republic of Korea; Hyangsook Lee, Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Republic of Korea; Hyejung Lee, Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Republic of Korea; Hi-Joon Park, Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Republic of KoreaAim of Investigation: Although acupuncture has been widely used as a therapeutic intervention, it is still unclear how acupuncture causes therapeutic effects. To clarify the acupuncture mechanism scientifically, it is required to observe the molecular event at the acupuncture point on the skin after acupuncture stimulation. The objective of this study is to find a correlation between local molecular changes in the skin layer after acupuncture stimulation and the therapeutic effects of acupuncture.Methods: Acupuncture stimulation was performed on acupuncture point of C57BL/6 mice. Molecular changes in RNA level were analyzed using cDNA microarray 1 hour after the stimulation. In addition, molecular changes after acupuncture stimulation were analyzed using western blot and histological analyses in protein level. Then, the linking between analgesic effects of acupuncture and molecular changes in the skin layer was investigated using mouse pain model.Results: In cDNA microarray, about 200 genes were changed compared to control group after acupuncture stimulation. In up-regulated genes, some pathways were mapped significantly. After acupuncture stimulation, molecular signals related to MAPK signaling pathway were increased, and we also obtained similar result in histological analysis. In mouse pain model, acupuncture stimulation attenuated nociceptive response, and this effect was partially blocked by MAPK inhibitor.Conclusions: Molecular signals from acupuncture stimulation in skin layer seem to play an important role for the analgesic effects of acupuncture stimulation.O-7 ADJUVANT WHOLE SYSTEMS TRADITIONAL CHINESE MEDICINE IMPROVED FRESH, NON-DONOR IN VITRO FERTILIZATION – A RETROSPECTIVE CHART REVIEWLee Hullender Rubin, Oregon College of Oriental Medicine; Michael Opsahl, Northwest Center for Reproductive Sciences; Klaus Wiemer, Northwest Center for Reproductive Sciences; Angela Humphrey, Oregon College of Oriental Medicine; Patrick Allen, Oregon College of Oriental Medicine; Scott Mist, Oregon Health and Science University; Deborah Ackerman, Oregon College of Oriental MedicineBackground: Surveys suggest in vitro fertilization (IVF) patients seek unproven adjuvant treatments to their IVF cycles, including whole systems traditional Chinese medicine (TCM). TCM treatment can include acupuncture, Chinese herbs, dietary and/or lifestyle recommendations, however research is needed to evaluate these components' effects on IVF live birth outcomes. In this study, live births were compared among IVF patients who (1) received usual care, (2) elected standardized acupuncture before and after embryo transfer (ET), or (3)elected TCM pre-treatment and acupuncture the day of ET.Methods: Data from records of 1,069 fresh, non-donor cycles from a private infertility clinic were reviewed. The main outcome measure was live birth beyond 24 weeks gestation. Live births were compared among: (1) Usual Care group (UC) received no additional treatment (N=580); (2) Acupuncture (Acu) group elected adjuvant acupuncture before and after ET(N=370); and (3) TCM group elected treatment prior to ET, which included acupuncture, Chinese herbs, dietary and/or lifestyle recommendations, and acupuncture on the day of ET(N=119). Outcomes were compared using logistic regression with covariates of FSH, age and number of embryos transferred.Results: Live births were significantly higher in the TCM group (N=73, 61.3%) than the UC group (N=280, 48.3%, p=0.01) but not the Acu group (N=188, 50.8%, p=0.39). In the TCM group, the mean number of acupuncture visits prior to ET was 12.0±12.4 (1 – 73). TCM with acupuncture on the day of ET was associated with a 73% increased odds of live birth than either UC or Acu alone (OR=1.73, 95% CI 1.16 – 2.60, p=0.008).Conclusion: Whole systems TCM pre-treatment prior to ET and acupuncture on the day of ET significantly improved live births in fresh, non-donor IVF cycles. This preliminary finding should be taken cautiously as adequately powered, randomized controlled trials are necessary to confirm this observation.O-8 ALTERED BRAIN RESPONSE TO ACUPUNCTURE AFTER A COURSE OF ACUPUNCTURE THERAPY FOR CTS IS ASSOCIATED WITH ANALGESIAYumi Maeda, Martinos Center for Biomedical Imaging, Massachusetts General Hospital/ Logan College of Chiropractic/University Programs; Jieun Kim, Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Stephen Cina, Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Claire McManus, Spaulding Rehabilitation Hospital; Cristina Malatesta, Spaulding Rehabilitation Hospital; Pia Mezzacappa, Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Leslie Morse, Spaulding Rehabilitation Hospital; Jessica Gerber, Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Rebecca Ogn-Sutherland, Spaulding Rehabilitation Hospital; Norman Kuttner, Logan College of Chiropractic/University Programs; Joseph Audette, Harvard Vanguard Medical Associates; Vitaly Napadow, Martinos Center for Biomedical Imaging, Massachusetts General Hospital/ Logan College of Chiropractic/University ProgramsCarpal tunnel syndrome (CTS) is a common entrapment neuropathy. While brain response to acupuncture stimuli has been well characterized in healthy adults, the response in patients with chronic pain disorders such as CTS is less well understood. Moreover, how this response changes after a longitudinal course of acupuncture therapy and is related to clinical outcomes are also unknown. CTS patients (N=13, 8F) were evaluated with functional MRI (fMRI) during acupuncture stimulation at baseline and after 8 weeks of 16 acupuncture treatments. FMRI data were acquired using a gradient echo T2*-weighted pulse sequence on a 3.0T Siemens Trio. Electro-acupuncture was applied at PC7 to TW5 on the affected forearm using an event-related design (2-sec stimulation with randomized ISI, 6–12 sec, total=5 min6 sec). A paired t-test contrasted acupuncture response at baseline versus after a longitudinal course of therapy. Results were voxel threshold at z>2.3, and cluster corrected for multiple comparisons at p<0.05. Short-term pain reduction at the time of scan was evaluated with VAS (0–10), while long-term pain reduction after 8weeks of therapy was evaluated with the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ, 1–5).Acupuncture activated bilateral insulae, S2, ACC, thalamus and NRD/PAG, and deactivated ipsilateral S1 and MPFC. Activation in ACC was significantly greater after 8weeks of therapy compared to baseline. Acupuncture produced short-term and long-term reduction of pain (−1.2±1.6, −0.9±1.0, p<0.05, respectively). Furthermore, activation in ACC at the baseline and final were negatively correlated with pain reduction (r=−0.49, −0.57, respectively). Altered ACC activation following 8weeks of therapy was correlated with long-term pain reduction (r=0.45).A longitudinal course of acupuncture therapy increased acupuncture-associated activation in the NRD/PAG, suggesting that repeated acupuncture strengthens NRD/PAG-mediated descending pain modulation. Altered ACC activation following therapy may play a role in improved clinical outcomes following acupuncture.O-9 BENEFITS OF COMBINED TREATMENT OF L-DOPA WITH ACUPUNCTURE ON PARKINSON'S DISEASE MOUSE MODELSeung-Nam Kim, AMSRC; Ah-Reum Doo, AMSRC; Ji-Yeun Park, AMSRC; Insop Shim, AMSRC; Younbyoung Chae, AMSRC; Hyejung Lee, AMSRC; Hi-Joon Park, AMSRCParkinson's disease is characterized by dopaminergic neuronal death and dopamine deficits in midbrain. Although it has serious adverse events, L-dopa is the gold standard to treat early Parkinson's patients for mitigating their motor dysfunction. Acupuncture treatment has been studied to be a good alternative therapy for Parkinson's disease in two aspects, dopamine neuron protection and dopamine transmission enhancement. In this study, we firstly tried to study the effectiveness of combined treatment of L-dopa with acupuncture treatment. 6-OHDA was administered to C57Bl/6 mice to develop hemi-Parkinsonian mice model. Then, we found that a 50% dose of L-dopa was needed in combination therapy to have the same efficacy on motor function recovery. In the results on L-dopa-induced dyskinesia (LID), which is one of the serious adverse events of L-dopa, combination therapy showed significant alleviation of abnormal involuntary movement induced by LID. We examined HPLC analysis of midbrain for investigating what is the mechanism of this therapeutic effect. As the results, combined therapy significantly decreased GABA contents in substantia nigra compared to L-dopa treatment. Interestingly, with the low dose, which is ineffective to motor function, combination therapy improved motor function and normalized GABA and glutamate contents. All of the results showed that combination therapy enhances the force of drug and mitigates LID by normalizing basal ganglia system. This study shows the efficacy of novel method, which is more effective and safe treatment of L-dopa, that is combined with acupuncture treatment. And the results give us the understanding therapeutic mechanism of L-dopa and acupuncture underlying basal ganglia system.O-10 CENTRAL MECHANISM OF INSTANT ANALGESIA EFFECT OF AUPOINTS ON SHAO-YANG MERIDIANS TO MIGRAINE PATIENTSJie Yang, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine; Yue Feng, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine; Fang Zeng, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine; Ji Chen, Chengdu University of Traditional Chinese Medicine; Yu-Lan Ren, Chengdu University of Traditional Chinese Medicine; Fan-Rong Liang, Chengdu University of Traditional Chinese MedicineObjective: To observe the changes of cerebral glucose metabolism by puncturing at the acupoints on the shaoyang meridian for migraine patients in the attack stage and explore the central mechanism of instant analgesic effect of puncturing at acupoints on the shaoyang meridian for migraine patients.Methods: 20 patients who matched the inclusion criteria were randomly divided into 2 groups: Group A: acupuncture acupoints on the shaoyang meridian once (GB20,SJ5,GB34); Group B was waiting-list group. Headache intensity grading and VAS were assessed before and after acupuncture treatment to observe instant analgesic effect of puncturing at different acupoints. Positron emission tomography-computed tomography (PET-CT) was performed to detect the cerebral glucose metabolism among 40 patients after the first administration of puncturing. Then the difference among them was analyzed by SPM2, which was used to discuss the central mechanism of instant analgesic effect of puncturing at acupoints on the shaoyang meridian for migraine patients.Results: Compared to the GroupB, the patients in Group A showed increased glucose metabolism in Middle Temporal (BA 17), Insula (BA 13), Medial Frontal (BA 9,10), Precuneus (BA31,39), ACC (BA32), MCC (BA31) PCC (BA23 31); decreased glucose metabolism in Left Hippocampus, Parahippocampal Gyrus, Fusiform Gyrus (BA18,19), Postcentral Gyrus(BA2) and Cerebellum.Conclusions: The effect of puncturing at the acupoints on the shaoyang meridian could influence the regions related with pain, including Middle Cingulate Gyrus, Posterior Cingulate Gyrus, Insula, Hippocampus, and Parahippocampal Gyrus, etc.O-11 DO NEGATIVE ATTITUDES ABOUT ACUPUNCTURE ACCOUNT FOR NON-USE? FINDINGS FROM THE NATIONAL HEALTH INTERVIEW SURVEY (NHIS) 2007Dawn Upchurch, UCLA; Bethany Wexler Rainisch, California State University, Northridge; Deborah Ackerman, Oregon College of Oriental MedicinePurpose: National prevalence estimates of acupuncture use among adults, although increasing, are low. In 2007, 6.8% reported lifetime use and only 1.5% reported use in the past 12 months. Compared to other provider-based CAM modalities (e.g., chiropractic, massage), acupuncture is 6 times less prevalent. Clearly differences in the number of practitioners available account for some of the variability; however, little national data are available to assess people's attitudes toward acupuncture. The goal of this study was to evaluate reasons for non-use of acupuncture among a group of never and prior users. We were especially interested in understanding the extent to which negative attitudes contributed to non-use.Methods: Data were from the 2007 NHIS, a cross-sectional, nationally representative sample of adults 18+(N=23,393). Never-users (N=21,002) and prior users (N=1,168) were asked a battery of questions regarding why acupuncture had not be used. Weighted univariate, bivariate, and multivariate analyses were performed to account for complex sample design and provide national estimates.Results: Among never-users, the most common reasons for non-use were ‘no reason’ (32.5%) or ‘didn't need it’ (24.7%). Another third mentioned they either did not know or thought about it. Specific negative attitudes (‘don't believe in it/it doesn't work’) or concerns about safety were in single digits (only 5.5% said they did not believe it worked). Concerns about costs (2.2%) or medical proof (0.5%) were minimal. Findings were similar among prior users, although 17.7% mentioned acupuncture had not worked for them. As expected, demographic characteristics were significantly associated with acupuncture attitudes among both never and prior users.Conclusions: Negative attitudes or scientific skepticism about acupuncture were not common reasons for non-use. These findings suggest a need for continuing outreach and education to provide the community with information on possible uses of acupuncture.O-12 DOSES OF CAFFEINE RELEVANT TO DIETARY HUMAN INTAKE CAN INHIBIT THE ACUPUNCTURE-INDUCED ANALGESIAAri Ojeda Ocampo More, UFSC; Francisco Cidral-Filho, UFSC; Leidiane Mazzardo-Martins, UFSC; Daniel Martins, UFSC; Francisney Nascimento, UFSC; Shin Min Li, UFSC; Adair Santos, UFSCThe use of acupuncture in the treatment of pain conditions has been extensively investigated. However, the influence of dietary ingredients on acupuncture induced analgesia (AA) remains unexplored. Recently, the role of adenosine receptors in AA has been shown, and caffeine, one of the world's most commonly consumed dietary ingredients, is an antagonist of these receptors. In this study, the post-incisional pain model was used to investigate caffeine's influence on AA. Mice were treated with acupuncture needling after administration of acute or chronic of caffeine. Acupuncture needling was performed using two different types of stimuli, manual acupuncture and electroacupuncture bilaterally in the acupoint SP6. We found that acute pre-administration of caffeine (10 mg/kg, i.p.) completely reversed AA in both types of acupuncture. In the chronic pre-administration, we used two doses that mimicked the average daily caffeine consumption in Western countries and China. Interestingly, the “Western dose” of caffeine (70 mg/kg/day) administered during eight days in the drinking water reversed AA and the “Chinese dose” (4 mg/kg/day) administered during the same period did not. These results indicate that the use of caffeine can inhibit the analgesic effect of different forms of acupuncture. Also, our findings suggest that doses of caffeine relevant to dietary human intake levels could be a confounding factor in the context of acupuncture research.O-13 EFFECTIVENESS OF MOXIBUSTION TREATMENT AS ADJUNCTIVE THERAPY IN OSTEOARTHRITIS OF THE KNEE: A RANDOMIZED CONTROLLED CLINICAL TRIALLing Zhao, Shanghai University of Traditional Chinese Medicine; Fan Wu, Shanghai University of Traditional Chinese Medicine; Lizhen Wang, Shanghai University of Traditional Chinese Medicine; Haimeng Zhang, Shanghai University of Traditional Chinese Medicine; Haipin