Clinical Trial Of Acupuncture Treatment Research Articles

Review of Studies on Clinical Trials of Acupuncture Treatment for Parkinson’s Disease Using Neuroimaging Methods

Objectives The purpose of this study was to investigate the current state of clinical trials for acupuncture treatment of Parkinson’s disease (PD) using neuroimaging methods. Methods We searched for clinical trial studies of acupuncture treatment for Parkinson’s disease that used neuroimaging methods in the MEDLINE (PubMed) database. The identified studies were then selected manually based on inclusion criteria. We subsequently analyzed the characteristics of the selected articles and reviewed the neural substrates of acupuncture treatment in PD. Results Eight studies were included. The most frequently applied modality for PD was functional MRI. The most frequently selected acupoint for PD was GV34. Several studies showed that acupuncture treatment could improve the symptoms of PD. Through the analysis, we demonstrated that the neuroimaging method could capture the neural substrates associated with PD and that acupuncture treatment may affect the activation of brain areas that are impaired in PD in a different way than sham acupuncture. Conclusions Applying a neuroimaging method could be helpful in clinical trials of acupuncture treatment for PD, and more efforts should be made in this area. Keywords: neuroimaging, Parkinson’s disease, acupuncture

Clinical trials of acupuncture treatment of post-stroke shoulder pain

To observe the clinical therapeutic effect of "Tiaoshen Zhitong" (mental regulating and pain relieving) needling and its influence on serological indicators in the treatment of post-stroke shoulder pain, so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain. A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group (routine needling, 39 cases) and an observation group ("Tiaoshen Zhitong" needling, 41 cases) according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants, hypotensive drugs, hypoglycermic drugs, lipid-lowering drugs, etc. In addition, patients of the control group were also treated by routine acupuncture stimulation (uniform reinforcing-reducing stimulation) of Jianyu (LI15), Jianqian (EX-UE12), Jianhou (Extra), Jianliao (TE14), Waiguan (TE5) and Hegu (LI4) on the affected side, and those of the observation group also treated by "Tiaoshen Zhitong" needling of Ear-Shenmen (MA-TF1), bilateral Neiguan (PC6, lifting-thrusting-reducing method), Shuigou (GV26, lifting-thrusting-reducing method), and Jianyu (LI15), Jianliao(TE14), Jianzhen (SI9) and Yanglingquan (GB34, the latter 4 points were stimulated with uniform reinforcing-reducing method) on the affected side. The treatment was given once every day, 6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale (VAS), the upper limb function evaluated by using Fugl-Meyer assessment (FMA) scale, the shoulder-joint function evaluated by using Constant-Murley score (CMS) questionnaire, and the daily living ability assessed by using Barthel index (BI) scale. The enzyme linked immunosorbent assay (ELISA) was used to determine the contents of serum beta-endorphin (β-EP), enkephalin (ENK) and dynorphin (Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method. Of the 39 and 41 cases in the control and observation groups, 7(17.95%) and 12(29.27%) were basically cured, 12(30.77%) and 13(31.71%) experienced marked improvement, 8(20.51%) and 11(26.83%) were effective, 12(30.77%) and 5 (12.19%) failed, with the total effective rate being 69.23% and 87.80%, respectively. The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After the treatment, the VAS score was obviously reduced (P<0.01), and the scores of FMA scale, CMS questionnaire and BI scale, and contents of serum β-EP, ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment (P<0.01). The therapeutic effect of "Tiaoshen Zhitong" needling was significantly superior to that of the routine needling in lowering VAS, and in raising scores of FMA scale, CMS questionnaire and BI scale and in up-regulating serum β-EP, ENK and Dyn levels (P<0.01). "Tiaoshen Zhitong" needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum β-EP, ENK and Dyn.

Randomized controlled clinical trial of acupuncture treatment for knee osteoarthritis in the early stage

To observe the therapeutic effect of acupuncture in the treatment of patients with knee osteoarthritis (KOA) in the early stage. A total of 60 KOA patients were randomized into medication group and acupuncture combined with medication (acupuncture) group (n＝ 30 in each group). Patients of the medication group were treated by external application of Diclofenac Diethylamine Emulgel around the affected joint, 3 times a day for 2 successive weeks and reasonable exercising training. Patients of the acupuncture group received routine medication and reasonable exercising training and acupuncture of Ashi-points, Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Neixiyan (EX-LE4) and Dubi (ST35) at affected side with filiform needles which were manipulated with uniform reinforcing-reducing method for a while, followed by retaining the needles for 30 min. The treatment was conducted once every other day for 2 weeks. The pain degree was assessed by using visual analog scale (VAS) and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scale (0－240 points) was used to evaluate the severity of KOA, and the "Diagnosis of Syndromes of Traditional Chinese Medicine" was used to assess the therapeutic effect after the treatment. After the treatment, the VAS and WOMAC scores of both medication and acupuncture groups were significantly and respectively decreased in comparison with their own pre-treatment (P<0.05), and the scores of the two indexes of the acupuncture group were evidently lower than those of the medication group (P<0.05). Of the two 30 cases in the medication and acupuncture groups, 5 (16.67%) and 6 (20.00%) were cured, 17 (56.67%) and 19 (63.33%) experienced marked improvement, 6 (20.00%) and 4 (13.33%) were effective, 2 (6.67%) and 1 (3.33%) were ineffective, with the effective rate of cure plus marked effectiveness being 73.33% and 83.33%, respectively. No significant difference was found between the two groups in the therapeutic effect (P>0.05). Acupuncture combined with medication has a better therapeutic effect in the treatment of KOA in the early stage than that of the simple medication.

Clinical trial of acupuncture treatment of gastroesophageal reflux cough by needling dorsal segment of the Governor Vessel

To observe the curative effect of acupuncture stimulation of the back segment (10 spots below the spinous processes from T3 to T12) of the Governor Vessel in the treatment of gastroesophageal reflux cough (GERC). A total of 60 cases of GERC patients were randomly divided into acupuncture and medication groups (n＝30 in each). For patients of the acupuncture group, the depression spots below the spinous processes from T3 to T12, including acupoints Shenzhu (GV12), Shendao (GV11), Lingtai (GV10), Zhiyang (GV9), Jinsuo (GV8) and non-acupoints (T4, T8, T12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by using "Reflux Diagnostic Questionnaire"(RDQ, scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), cough symptom score (0－3 points) and "Leicester Cough Questionnaire" (LCQ, scores of physiological, psychological and social functions, 0－21 points), respectively. Following the treatment, RDQ score and cough symptom scores during both daytime and night were significantly decreased in both groups (P<0.05)，and the scores of physiological status, psychological health and social function of LCQ were significantly increased in both acupuncture and medication groups in comparison with their own pre-treatment (P<0.05). The therapeutic effect of acupuncture was markedly superior to that of medication in lowering RDQ score and cough symptom scores of daytime and night, and in raising LCQ scores of the physiological status, psychological health and social function (P<0.05). Acupuncture stimulation of the dorsal segment of the Governor Vessel is effective in improving clinical symptoms and living quality of GERC patients.

Clinical trials of acupuncture treatment of post-stroke dysphagia by deep acupuncture of Tiantu (CV22) in combination with swallowing rehabilitation training

To observe the effect of deep acupuncture of Tiantu (CV22), etc. in combination with rehabilitation training on swallowing function of patients with post-stroke dysphasia. A total of 70 patients suffering from post-stroke dysphagia were randomly divided into control group (conventional acupuncture＋ swallowing rehabilitation training) and treatment group (deep acupuncture of CV22 ＋ rehabilitation training, n＝ 35 cases in each group). The swallowing rehabilitation procedure was conducted 30 min every time, twice daily, 5 times a week for 3 weeks. In patients of the treatment group, after deep insertion (about 80 mm) along the posterior margin of the manubrium sterna, the filiform needle in CV22 was lifted and thrusted repeatedly 9 times till the patient experienced a feeling of foreign matter blocking, followed by retaining the needle for 30 min. For patients of the control group, Lianquan (CV23) was punctured with 3 acupuncture needles (one vertical needling and bilateral slope needling toward the tongue root), and Fengfu (GV16), bilateral Bailao (EX-NH23), bilateral Renying (ST9) and bilateral Jialianquan (Extra) were punctured vertically with filiform needles. The treatment was conducted once daily, 5 times a week for 3 weeks. The swallowing function was evaluated by using Kubota water swallowing test (KWST) scale (0－5 points), Fujishima Ichiro rating scale (FIRS, 0－10 points), and video fluoroscopic swallowing study (VFSS, 0－10 points), separately. The therapeutic effect was also assessed according to the clinical scale scores and VFSS results. Following the treatment, of the two 35 cases in the control and treatment groups, 4 (11.43%) and 8 (22.86%) experienced marked improvement in their symptoms, 22 (62.86%) and 23 (65.71%) were effective, and 9 (25.71%) and 4 (11.43%) were failed, with the effective rates being 74.29% and 88.57%, respectively. After the treatment, the KWST score of the two groups were significantly decreased in comparison with their own pre-treatment (P<0.05), while the FIRS and VFSS scores of the two groups were considerably increased in comparison with their own pre-treatment (P<0.05). The therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate, lowering KWST score and in raising FIRS and VFSS scores (P<0.05)．. Acupuncture plus swallowing rehabilitation training is effective in improving the swallowing function of stroke patients with dysphagia, and the deep acupuncture stimulation of CV22 is apparently better than conventional acupuncture in the therapeutic effect.

Clinical Trial of Acupuncture Treatment of Gastroesophageal Reflux Disease Accompanied with Somnipathy at Acupoints of Governor Vessel at Back Segment

To observe the curative effect of needling stimulation of the back segment (10 spots below the spinous processes from T 3 to T 12)of the Governor Vessel in the treatment of gastroesophageal reflux disease(GERD)accompanied with somnipathy. A total of 58 patients of GERD accompanied with somnipathy were randomly divided into acupuncture group (n＝28) and medication group (n＝30)according to random number table method. For patients of the acupuncture group, the spots below the spinous processes from T 3 to T 12, including acupoints Shenzhu (GV 12), Shendao (GV 11), Lingtai (GV 10), Zhiyang (GV 9), Jinsuo (GV 8), Zhongshu (GV 7) and non-acupoints (T 4, T 8, T 12) were punctured with filiform needles, once every other day for 8 weeks. Patients of the medication group were ordered to take Omeprazole capsules (20 mg/time), twice a day for 8 weeks. The therapeutic effect was assessed by "Reflux Diagnostic Questionnaire" (RDQ，scores of symptoms of heartburn, retrosternal pain, acid regurgitation and food regurgitation, 0－40 points), GERD symptom scale (scores of symptoms of the digestive system, five-sense organs, cardiovascular system, etc., 0－84 points) and Pittsburgh Sleep Quality Index (PSQI, scores of sleep quality, fall asleep time, sleep duration, sleep efficiency, etc., 0－21 points), respectively. After the treatment, RDQ score, GERD symptom scale score and PSQI score were significantly decreased in both acupuncture and medication groups compared with their own pre-treatment(P<0.01), and the decreased scores of RDQ, GERD scale and PSQI were significantly lower in the acupuncture group than in the medication group (P<0.01). The cured plus markedly effective rates for RDQ in the two groups were 43.3% (13/30) and 71.4% (20/28), respectively, and the effective rates of the medication and acupuncture groups were 56.7% (17/30) and 89.3% (25/28) for GERD scale, and 60.0% (18/30) and 92.9% (26/28) for PSQI, respectively. The cured plus markedly effective rate for RDQ, and the effective rates for GERD scale and PSQI were signi-ficantly higher in the acupuncture group than in the medication group respectively (P<0.05，P<0.01)．. Acupuncture stimulation of acupoints of Governor Vessel at the back segment is effective in improving symptoms of GERD patients with somnipathy.

Close look at the experiences of patients enrolled in a clinical trial of acupuncture treatment for atrial fibrillation in Korea: a qualitative study nested within a randomised controlled trial

ObjectiveTo explore the experiences of patients with atrial fibrillation (AF) in the context of a prospective, two-parallel-armed, participant-blinded and assessor-blinded sham-controlled randomised trial.DesignA nested qualitative study within an ongoing randomised...

514 REVIEW OF ACUPUNCTURE TREATMENT FOR HYPERTENSION IN CLINICAL TRIALS

Objectives: This study evaluated clinical trials of acupuncture treatment for hypertension and to assess their methodology and results. Methods: Eight Korean databases and four international databases were searched for clinical trials of acupuncture treatment for hypertension up to June 2011. Study quality was assessed using the risk of bias (ROB) tool. Results: Twenty-four trials of acupuncture for hypertension were included. There were 14 randomized and 1 non-randomized controlled trials and 9 before-after studies. The most frequently used acupuncture points were zsnli (ST36), qch (LI11), fngch (GB20), snynjio (SP06), snjin (LI03) and hgu (LI04). In more than half of the studies, needle retention time was 20~30 minutes. Compared to baseline, change of blood pressure after treatment was significant in all studies. However, the results of effect on blood pressure between acupuncture and control were not consistent. Conclusions: There is insufficient evidence to suggest that acupuncture is an effective treatment for hypertension. Further well-designed clinical trials will be required to evaluate the effects and safety of acupuncture treatment for hypertension.