Acupuncture Treatment Protocol Research Articles

An Acupuncture Protocol for the Treatment of Erectile Dysfunction: A Delphi Process

Plain Language SummaryAs many as 322 million men may be afflicted by erectile dysfunction (ED) (impotence) by 2025. The health consequences are substantial with an increased risk of cardiovascular diseases and higher mortality in addition to reduced quality of life. Acupuncture may be a potential treatment option with a low side-effect profile; however, a standardised treatment protocol has been lacking for the use in the clinic and in clinical trials. This study aimed to develop a best-practice acupuncture treatment protocol for the treatment of ED. Eleven acupuncture experts have by the means of a Delphi process reached tool consensus on a diagnostic and a treatment protocol for men suffering from ED. This is the first attempt in modern times and in the West to provide clinical acupuncturists and researchers with a treatment protocol for this common health issue.

Acupuncture and tuina knowledge graph with prompt learning.

Acupuncture and tuina, acknowledged as ancient and highly efficacious therapeutic modalities within the domain of Traditional Chinese Medicine (TCM), have provided pragmatic treatment pathways for numerous patients. To address the problems of ambiguity in the concept of Traditional Chinese Medicine (TCM) acupuncture and tuina treatment protocols, the lack of accurate quantitative assessment of treatment protocols, and the diversity of TCM systems, we have established a map-filling technique for modern literature to achieve personalized medical recommendations. (1) Extensive acupuncture and tuina data were collected, analyzed, and processed to establish a concise TCM domain knowledge base. (2)A template-free Chinese text NER joint training method (TemplateFC) was proposed, which enhances the EntLM model with BiLSTM and CRF layers. Appropriate rules were set for ERE. (3) A comprehensive knowledge graph comprising 10,346 entities and 40,919 relationships was constructed based on modern literature. A robust TCM KG with a wide range of entities and relationships was created. The template-free joint training approach significantly improved NER accuracy, especially in Chinese text, addressing issues related to entity identification and tokenization differences. The KG provided valuable insights into acupuncture and tuina, facilitating efficient information retrieval and personalized treatment recommendations. The integration of KGs in TCM research is essential for advancing diagnostics and interventions. Challenges in NER and ERE were effectively tackled using hybrid approaches and innovative techniques. The comprehensive TCM KG our built contributes to bridging the gap in TCM knowledge and serves as a valuable resource for specialists and non-specialists alike.

CAN ACUPUNCTURE BE A PART OF THE TREATMENT FOR BREAST CANCER-RELATED LYMPHEDEMA? A SYSTEMATIC REVIEW OF THE SAFETY AND PROPOSED MODEL FOR CARE

Acupuncture is a potential therapy for breast cancer-related lymphedema (BCRL). Despite a recent meta-analysis on efficacy, data on acupuncture safety in BCRL are lacking. Current clinical guidelines recommend avoiding needling in the upper extremity affected by lymph node dissection. We undertook a systematic review focusing on acupuncture safety and treatment protocols in clinical trials for BCRL. Literature searches were conducted in PubMed, Ovid, CINAHL, and Cochrane library. Eight clinical trials on acupuncture for BCRL were analyzed. The Standards of Acupuncture intervention (STRICTA 2010) and Cochrane risk of bias (RoB2 2019) were applied to assess methods for acupuncture interventions within Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Quantity and severity of adverse events (AE) were reviewed. A total of 189 subjects participated in 8 clinical trials with 2965 acupuncture treatments. No serious adverse events (SAE) were reported regardless of treatment laterality or protocol, with only a single grade 2 skin infection in 2,965 total treatments (.034%), including 1,165 bilateral and 225 ipsilateral treatments. Our comprehensive review of clinical trials of acupuncture for BCRL demonstrated no significant adverse events in 2,965 treatments, including 1,390 in the affected limb. An approach for routine integration of acupuncture into BCRL maintenance therapy is proposed.

Using evidence-based research approach and exploratory studies before conducting a new acupuncture randomized controlled trial

Adequate preliminary research is a prerequisite for ensuring the quality of randomized controlled trials (RCTs) on acupuncture. This paper proposes that prior to conducting a new RCT of acupuncture, an evidence-based research (EBR) approach and exploratory studies should be adopted to ensure value and avoid waste of research. EBR, defined as using systematic reviews of relevant clinical studies and obtain the perspectives of end users in a systematic and transparent way to justify research questions and inform trial design, is recommended as the first step before embarking on an acupuncture RCT to ensure its value and rationality. The subsequent exploratory studies can aid researchers in pre-evaluating the effect of acupuncture treatment protocols, identifying key factors that influence the outcome, and test trial feasibility for protocol optimization. This article elucidates the significance and implementation of the EBR approach and exploratory studies, with the aim of providing practical methods to enhance the quality of acupuncture RCTs.

Effect of acupuncture on menopausal hot flashes: Study protocol for a randomized controlled clinical trial: 针刺对围绝经期潮热的影响:一项随机对照临床试验研究方案

BackgroundHot flashes are one of the most common symptoms in menopause and significantly affect the quality of life of 67% of menopausal women. Acupuncture is found to be a low risk treatment in treating hot flashes but the evidence for its effectiveness is inconclusive. We developed an optimized acupuncture treatment protocol and designed a randomized controlled trial (RCT) to assess the efficacy of acupuncture for reducing hot flashes in menopausal women. MethodsThis is a single-site, single-blind, randomized sham-controlled trial with two parallel arms. A total of 60 eligible patients will be recruited and randomly assigned to either the acupuncture group (n = 30) or the sham acupuncture group (n = 30). Treatment will be given twice a week, for 30 min, for six consecutive weeks. The primary outcome is the hot flashes scores, assessed using the validated hot flashes diary at baseline, week 3, week 6 and week 10. The secondary outcome will be measured by menopause-specific quality of life (MENQOL) at baseline, week 6, and week 10. Meanwhile, any adverse events will be recorded. DiscussionIf the outcome of this study confirms acupuncture to be an effective therapy to reduce hot flashes in menopausal women, we expect this study to inspire further investigations and provide useful information in forming an optimal acupuncture treatment protocol for clinic. Trial registrationChinese Clinical Trial Registry identifier: ChiCTR1800018638, Date of registration: 30th September 2018.URL: http://www.chictr.org.cn/showproj.aspx?proj=31462

Use of specific acupuncture techniques in lingering nummular eczema: A case report

Abstract Background Nummular eczema (NE) is an inflammatory skin disease characterized by pruritic coin-shaped lesions and a long-lasting and easy-relapsing course, which severely decreases patients’ quality of life. This case was designed to observe the effects of specific acupuncture techniques on pruritic NE management. Case presentation A 22-year-old female was first diagnosed with pruritic NE three years earlier. No allergies were found in the patch test; while emotional stress would trigger and aggravate the NE. External application of 0.1% tacrolimus failed to reverse this condition over a long period of treatment. Treatment & outcomes An individualized acupuncture treatment protocol was identified. Half needling and encircling needling were applied at local eczematous lesions, with routine needling at meridian points, once per week, for 12 treatment sessions. All outcome measures, including the Eczema Area and Severity Index, Visual Analogue Scale score for pruritus, Self-Rating Anxiety Score, and Dermatology Quality Life Index, substantially improved over 6 months from pre-treatment to 3 months post-treatment. Conclusion Acupuncture might be a promising non-pharmacological treatment method for patients with NE, especially for those with emotional stress. A randomized controlled trial with an adequate sample size and rigorous study design is required to verify the results of the study.

Acupuncture for the Treatment of Itch: Literature Review and Future Perspectives.

Background: Chronic pruritus is a prevalent, multifactorial and debilitating condition that is often underestimated. This article reviews current evidence to evaluate the efficacy of acupuncture for the treatment of itch. Results: Although many researchers have conducted observational studies, clinical trials, and systematic reviews on the subject, the lack of more-robust and well-designed studies to prove the effectiveness of acupuncture in the management of itch is evident. Many published studies are of poor quality, with no clear description of randomization methods, and an absence of control groups and measurable clinical outcomes. In addition, a lack of standardization in methods for assessing pruritus and the acupuncture treatment protocols hinders more-comprehensive and higher-quality pooled data analysis. Conclusions: Current evidence cannot fully support acupuncture for the treatment of itch yet.

Propagation of Acupuncture Research Findings: Creating Teams of Clinicians and Scientists to Achieve the Next Level.

Nascent research is beginning to link reduced opioid prescribing and increased well-being with acupuncture. While pain is the most common reason patients see physicians, acupuncture is often recommended to treat it. Due to lack of a common nomenclature around acupuncture treatment protocols, it can be difficult for clinicians to replicate research findings. This article discusses communication of ideas about how the National Institutes of Health (NIH) could help propagate meaningful research findings to practicing acupuncturists. While communication strategies can increase uptake of acupuncture in primary care and pain practices, the NIH could: (1) describe priorities in developing algorithmic acupuncture protocols; (2) require some grant applications to include both clinical and basic science outcomes; (3) develop a "dating service" to match clinical acupuncture researchers and those with the capability and interest to test mechanisms; and (4) initiating fellowships for young investigators that prioritize bringing together the art and science of acupuncture.

Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial

BackgroundFatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited.Method/designThis is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT.DiscussionThis trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment.Trial registrationChinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019.URL: http://www.chictr.org.cn/showproj.aspx?proj=37823

Transcutaneous electrical acupoint stimulation for people with chronic musculoskeletal pain: an exploratory review

Background: Transcutaneous electrical acupoint stimulation (TEAS) is a form of stimulation-induced analgesia with potential as a non-invasive alternative to acupuncture, suitable for self-application. The clinical evidence for TEAS for people with chronic musculoskeletal pain is limited.Objectives: This exploratory review aimed to evaluate the potential of TEAS as a pain relief option for people with chronic musculoskeletal pain and explore the evidence relating to dose parameters.Methods: A literature search was conducted using Medline, EMBASE, CINAHL, AMED and the Cochrane Database for studies that used TEAS or specified the use of Transcutaneous electrical nerve stimulation (TENS) over acupuncture points for people with chronic pain. Data relating to the treatment dose parameters was extracted including frequency, intensity, treatment duration and stimulation location, to identify themes and trends with a narrative analysis and review.Results: The review included 20 studies consisting of 13 randomised controlled trials, four comparative trials and three cross-over studies. Most RCTs indicated some beneficial effect on pain scores, but the overall quality of evidence was low. Most studies applied a TENS device for 20–40 minutes, several times a week similar to an acupuncture treatment protocol. There was no clear evidence that the electrical parameters of frequency and intensity or the choice of acupuncture points had an effect on the outcomes.Conclusions: People with chronic musculoskeletal pain may achieve pain relief using TEAS but the existing evidence is limited and high quality clinical evidence is required to establish efficacy. Effects appear to be achieved with short applications, several times a week in a protocol similar to those used with acupuncture. It is not clear whether the choice of acupuncture point, stimulation frequency or intensity has an impact on the results. Further investigation of the effect of stimulation duration for both TEAS and TENS is recommended.

Acupuncture to Improve Symptoms for Stable Angina: Protocol for a Randomized Controlled Trial.

BackgroundAcupuncture has demonstrated physiologic analgesic effects in Chinese patients with stable angina. One proposed mechanism of action for these analgesic effects is the downregulation of M1 macrophages, interleukin 1 beta, interleukin-6, interleukin-18, and tumor necrosis factor alpha.ObjectiveThis study aims to test a 10-session, 5-week acupuncture treatment protocol as a complementary therapy for symptoms of stable angina for American patients, who vary from Chinese patients in health care systems and other salient variables.MethodsWe are conducting a randomized controlled trial (RCT) of 69 adults (35 assigned to initial acupuncture and 34 to an attention control condition) with a medically confirmed diagnosis of stable angina, whose pain and associated symptoms have not been controlled to their satisfaction with guideline-directed medical management. Participants in the experimental group will receive a standardized traditional Chinese medicine point prescription. The attention control group will view non–pain-related health education videos over 5 weeks equal to the 10 hours of treatment for the acupuncture group. Participants will complete the McGill Pain Questionnaire and the Seattle Angina Questionnaire-7, as well as have inflammatory cytokines measured at baseline and study completion. The primary outcomes are anginal pain and quality of life.ResultsThis study has been funded over 2 years by the National Institutes of Health, National Institute for Nursing Research. We are currently recruiting and expect to have initial results by December 2020.ConclusionsWe will generate data on feasibility, acceptability, effect sizes, and protocol revisions for a future fully powered RCT of the protocol. Findings will help determine if patients with persistent ischemic symptoms experience a proinflammatory state and hyperalgesia caused by multiple neural and immune processes not always relieved with medication.International Registered Report Identifier (IRRID)DERR1-10.2196/14705

Neonatal Abstinence Syndrome: An Integrative Review of Neonatal Acupuncture to Inform a Protocol for Adjunctive Treatment.

The current opioid epidemic in the United States has given rise to a growing incidence of neonatal abstinence syndrome (NAS). Treatments for this condition optimize nonpharmacologic therapies in an effort to improve withdrawal symptoms and reduce or eliminate the need for opioid medications, thereby reducing hospital length of stay and improving healthy neonatal outcomes. The purpose of this review was to evaluate the current evidence for neonatal acupuncture treatments and identify essential characteristics that must be included in a treatment protocol for NAS. An integrative review was conducted under the guidance of the Whittemore and Knafl methodology and near-term infant conceptual framework. An evaluation of the quality and levels of evidence was also included. A total of 10 studies were identified in this review. Four of these studies were randomized controlled trials, and utilized acupuncture in the neonatal population to evaluate impact on pain, NAS, and weight gain. This review provided the essential elements for the development of a complementary acupuncture treatment protocol for the management of NAS. Future research should include the identified essential characteristics in high-quality, blinded, randomized controlled trials to assess the treatment effect of acupuncture on neonates experiencing withdrawal symptoms.

Noneffectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome.

Comorbid generalized anxiety disorder and irritable bowel syndrome are common and therapeutically challenging. We aimed to assess the effectiveness of electroacupuncture in relieving anxiety and bowel symptoms in Chinese adults with this form of comorbidity. In a single-blind randomized sham-controlled trial, subjects with comorbid generalized anxiety disorder and irritable bowel syndrome were randomly assigned to receive 10 weekly sessions of electroacupuncture or sham electroacupuncture. Patients were assessed at baseline, immediately after intervention and at 6-week follow-up. Primary outcome was anxiety (7-item Patient Health Questionnaire section for anxiety). Secondary outcomes included bowel symptoms (bowel symptoms questionnaire), depressive symptoms (9-item Patient Health Questionnaire), somatic symptoms (15-item Patient Health Questionnaire), and health-related quality of life (EuroQol-5 Dimensions). Eighty subjects, 40 in each arm, were randomized. All but two in the sham group completed 10 weekly sessions. There was no significant difference in the proportion of patients experiencing significant (≥50%) reduction of anxiety symptoms between the two groups immediately after intervention (32.4% vs 21.6%, P=0.06) and at 6-week follow-up (25.7% in electroacupuncture vs 27% in sham, P=0.65). Anxiety, depressive symptom, and bowel symptom severity did not differ significantly between electroacupuncture and sham groups. Findings failed to support the effectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome. Further studies are needed to identify effective acupuncture treatment protocols for such comorbidity.

Combined electroacupuncture and auricular acupuncture for postoperative pain after abdominal surgery for gynecological diseases: study protocol for a randomized controlled trial

BackgroundPostoperative pain is a major complaint following abdominal surgery for gynecological diseases. Effective postoperative pain control after abdominal surgery is particularly important for patient recovery, mobility, and satisfaction. Acupuncture has been commonly used for pain management. However, its efficacy in postoperative pain control is inconclusive and health economic evaluation is limited.MethodsA randomized, sham-controlled, patient- and- assessor-blind trial is designed to evaluate the efficacy and safety of acupuncture in managing postoperative pain following abdominal surgery of gynecological diseases. Patients who are eligible for laparotomy with a midline incision for gynecological neoplasia, including ovarian mass, uterine mass, and cervical lesions, will be recruited. Seventy-two participants will be randomly allocated to an acupuncture or non-invasive sham control in a 1:1 ratio. Treatment will be done within 2 h before operation, upon arrival to the ward and once daily for 5 days. The Pain Numerical Rating Scale (NRS) on the first 5 days during hospitalization will be the primary outcome and will be analyzed using the area-under-the-curve (AUC) method. The secondary outcome measures include frequency of rescue analgesic use during hospital stay, cumulative morphine consumption; quality of recovery as measured by time to recovery variables and the Quality of Recovery-9 (QoR-9); quality of life as measured by the Short Form-6 dimension (SF-6D) and EuroQol-5 Dimension-5 Level (EQ-5D-5 L). The incremental cost-effectiveness ratio of acupuncture vs sham acupuncture will be calculated.DiscussionThis study protocol provides an example of integrative medicine practice in a hospital setting for the management of postoperative pain using acupuncture treatment. The acupuncture treatment protocol, if proven to be effective, can be implemented in routine settings to play a role in postoperative pain management for patients who have undergone abdominal surgery for gynecological diseases.Trial registrationClinicalTrials.gov, ID: NCT02851186. Registered on 19 July 2016.

Effects of a Delphi consensus acupuncture treatment protocol on the levels of stress and vascular tone in women undergoing in-vitro fertilization: a randomized clinical trial protocol

BackgroundThe variability of published acupuncture protocols for patients undergoing In-Vitro Fertilization (IVF) complicates the interpretation of data and hinders our understanding of acupuncture’s impact. In 2012, an acupuncture treatment protocol developed by a Delphi consensus process was published to describe the parameters of best practice acupuncture for Assisted Reproductive Technology and future research. However, there has been no clinical trial utilizing this protocol to assess the effects of acupuncture. This study aims to assess the implementation of Dephi consensus acupuncture protocol and to examine the impact of acupuncture on stress and uterine and ovarian blood flow among women between ages 21-42 years seeking IVF.Methods/DesignThis study is a one site prospective, two-arm randomized controlled non-blind clinical trial conducted in a medical school-affiliated fertility center . Participants will be randomized 1:1 into either the acupuncture group or the standard of care (no acupuncture) group using computer generated tables.Both groups will have 3 regular clinical visits as their standard IVF care during an approximately 2 to 3 weeks window. Women who are randomized into the acupuncture group would receive three sessions based on the Delphi consensus acupuncture protocol in addition to the standard care. The first treatment will be administered between days 6 to 8 of the stimulated IVF cycle. The second session will be performed on the day of embryo transfer at least 1 h prior to the transfer. The third session will be performed within 48 h post-embryo transfer. Participants will be followed for their pregnancy test and pregnancy outcome when applicable.The outcomes stress and blood flow will be measured by a validated perceived stress scale and vasoactive molecules, respectively.DiscussionAlthough recruitment and scheduling could be challenging at times, the Delphi consensus acupuncture protocol was implemented as planned and well-accepted by the patients. Because of the time-specified sessions around patients’ IVF cycle, it is highly recommended to have on-site study acupuncturist(s) to accommodate the schedule.Trial RegistrationClinicalTrials NCT02591186 registered on October 7, 2015.

The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review.

To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. A literature search was carried out up to November 10, 2012 in the databases PubMed/MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms: radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords "dry mouth, thirst, dry tongue, dry eyes and dry lips" to search the effective acupuncture points for dry mouth-associated symptoms in ancient China. Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang (CV24), Shuigou (GV 26), Duiduan (GV 27), Jinjin (EX-HN 12), and Yuye (EX-HN 13) on head and neck, Sanjian (LI 3), Shangyang (LI 1), Shaoshang (LU 11), Shaoze (SI 1), Xialian (LI 8) on hand, Fuliu (KI 7), Dazhong (KI 4), Zuqiaoyin (GB 44), Taichong (LR 3), Zhaohai (KI 6) on foot, Burong (ST 19), Zhangmen (LR 13), Tiantu (CV 22), Qimen (LR 14) on abdomen, Feishu (BL 13), Danshu (BL 19), Xiaochaogshu (BL 27), Ganshu (BL 18) on back, Shenmen (TF 4), Shen (CO10, Kidney), Yidan (CO11, Pancreas) and Pi (CO13, Spleen) on ear. There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.

How does acupuncture affect insulin sensitivity in women with polycystic ovary syndrome and insulin resistance? Study protocol of a prospective pilot study

IntroductionHyperinsulinaemia and insulin resistance (IR) are key features of polycystic ovary syndrome (PCOS) and metabolic syndrome. The effect of 5 weeks of acupuncture treatment has been investigated in a completed...

Study on Clinical Research Methodologies for Acupuncture: Based on Review of Clinical Studies on Back Pain

Objectives : The results from randomized controlled trials on traditional medicine have been negative or ambiguous. The appropriateness of the research methodology started to be questioned. However, the research methodology appropriate for studying traditional medicine has not been well-established. This study aims to explore the appropriate research methodologies for clinical studies on acupuncture. Methods : Clinical researches evaluating the efficacy and effectiveness of acupuncture for back pain were systematically searched and evaluated focusing on research methodology. The acupuncture treatment protocol is evaluated by 9 items which is individual treatment based on diagnosis, combining proximal and distal acupoints, exact location of acupoint, De Qi, adequate stimulation, duration of acupuncture, treatment sessions, treatment interval, and establishing relationship between patients and doctors. Results : Systematic review of acupuncture researches on low back pain suggested that observational studies and pragmatic trials rather than explanatory studies could incorporate these elements. Qualitative studies also could help understanding complex characteristics of acupuncture treatment which could not be evaluated by quantitative studies. Conclusions : In designing clinical researches on acupuncture, various study designs, especially observational study and pragmatic study, should be considered according to research objectives and subjects. The efforts to incorporate the core characteristics of acupuncture practiced in everyday clinical setting are also essential.

Acupuncture for the Treatment of Vulvodynia

PurposeA randomized controlled pilot study was conducted to evaluate the effect of an acupuncture protocol for the treatment of vulvodynia.Hypotheses1) Acupuncture reduces vulvar pain and dyspareunia in women with vulvodynia. 2) Acupuncture increases sexual function in women with vulvodynia.SignificanceThe incidence of vulvodynia in US women has been reported to be as high as 16%. Research suggests that there is no consistently effective standardized treatment for vulvodynia.MethodsThirty‐six women with vulvodynia met inclusion criteria, and 36 women completed the study. The women were randomly assigned either to the acupuncture group or to the wait‐list control group. The 18 participants assigned to the acupuncture group received acupuncture 2 times per week for 5 weeks for a total of 10 sessions.ResultsVulvar pain and dyspareunia showed statistically significant reductions, and sexual function showed a statistically significant increase for women in the acupuncture group as compared to the wait‐list control group. Acupuncture showed a trend for increased vaginal lubrication and reduced affective pain. Acupuncture did not increase sexual desire, sexual arousal, ability to orgasm, or sexual satisfaction in women with vulvodynia.DiscussionThis was the first randomized controlled pilot study to examine the use of acupuncture for the treatment of vulvodynia. The acupuncture protocol was feasible and in this small sample reduced vulvar pain and dyspareunia, and increased sexual function in women with vulvodynia. This study should be replicated in a larger double‐blind randomized controlled trial, and if results indicate, this acupuncture treatment protocol should be considered a valid and important option in the treatment of this incapacitating pain syndrome.

Akupunkturbehandlungsmodalitäten bei künstlicher Befruchtung - ein Vergleich der Behandlungspraxis in schweizerischen, deutschen und österreichischen Kinderwunschzentren mit Erhebungen in randomisierten kontrollierten Studien

Hintergrund: Unerfüllter Kinderwunsch belastet jedes fünfte Paar. Zur Wirksamkeitssteigerung der künstlichen Befruchtung werden oftmals Akupunkturbehandlungen durchgeführt. Wenig ist über die Akupunkturbehandlungsmodalitäten in Kinderwunschzentren bekannt. Ziel der vorliegenden Arbeit war es, diese zu erfassen und mit den in randomisierten kontrollierten Studien (RCTs) untersuchten Akupunkturbehandlungsmodalitäten zu vergleichen. Methoden: 180 Kinderwunschkliniken, die auf den Webseiten der schweizerischen, deutschen und österreichischen reproduktionsmedizinischen Vereinigungen aufgeführt waren, wurden zur Teilnahme an einer Onlinebefragung über das Akupunkturangebot bei künstlicher Befruchtung eingeladen. Die Umfrageergebnisse wurden den Angaben aus 17 RCTs gegenübergestellt. Ergebnisse: Akupunktur wird von 33 (38,4%) aller an der Umfrage beteiligten Kinderwunschkliniken (n = 86) angeboten (Rücklaufquote = 47,8%). Die Wahl der Akupunkturpunkte ist in 39,4% der Kliniken standardisiert, in 24,2% semi-standardisiert und in 27,3% erfolgt sie individuell nach TCM-Diagnose. Körperakupunktur mit Nadelstimulierung wurde am häufigsten genannt (84,8%). In einigen Kliniken wird ergänzend zur Körperakupunktur auch Ohrakupunktur (24,2%) und Moxibustion (21,2%) angewendet. Die Leistungserbringer sind überwiegend ärztliche Akupunkturtherapeuten (84,8%). Im Vergleich zu den RCTs wurden große Unterschiede hinsichtlich Bestimmung der Akupunkturpunkte, Stimulierungsverfahren und beruflichem Hintergrund der Akupunktur-Leistungserbringer festgestellt. Schlussfolgerungen: Weniger als 40% aller Akupunktur anbietenden Kinderwunschkliniken im deutschsprachigen Raum verwenden standardisierte Akupunkturpunkteprotokolle. Um die externe Validität der Akupunkturforschung in der Reproduktionsmedizin zu erhöhen und die klinische Wirksamkeit dieser adjuvanten Behandlungsform zu untersuchen, sollten in zukünftigen Studien semi-standardisierte und individuelle Bestimmungen der Akupunkturpunkte berücksichtigt und der Einsatz von angelerntem Personal vermieden werden.