Invasive Acupuncture Research Articles

Does invasive acupuncture improve postoperative ileus after colorectal cancer surgery? A systematic review and meta-analysis.

Postoperative ileus (POI) is one of the main complications after colorectal cancer (CRC) surgery, and there is still a lack of effective treatment. At present, the evidence for improvement of POI by invasive acupuncture (manual acupuncture and electroacupuncture, IA) is limited. This meta-analysis of randomized controlled trials (RCTs) aims to systematically review and evaluate the effect of IA in improving POI after CRC surgery. This meta-analysis was reported according to PRISMA statement and AMSTAR guidelines. The retrieval time was from the inception to February 2023. The RCTs were screened by searching the databases (PubMed, Ovid, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP Database, Sinomed Database, and WANFANG). Two independent investigators screened and extracted the data, assessed the risk of bias, and performed statistical analysis. The statistical analysis was carried out by RevMan5.3. The PROSPERO International Prospective Register of Systematic Reviews received this research for registration (CRD42023387700). Thirteen studies with 795 patients were included. In the primary outcome indicators: the IA group had shorter time to the first flauts [stand mean difference (SMD), -0.57; 95% CI, -0.73 to -0.41, p < 0.00001], shorter time to the first defecation [mean difference (MD), -4.92 h, 95% CI -8.10 to -1.74 h, p = 0.002] than the blank/sham stimulation (B/S) group. In the secondary outcome indicators: the IA group had shorter time to the first bowel motion (MD, -6.62 h, 95% CI -8.73 to -4.50 h, p < 0.00001), shorter length of hospital (SMD, -0.40, 95% CI -0.60 to -0.21, p < 0.0001) than the B/S group. In terms of the subgroup analysis: IA associated with enhanced recovery after surgery (ERAS) group had shorter time to the first flauts (MD, -6.41 h, 95% CI -9.34 to -3.49 h, p < 0.0001), shorter time to the first defacation (MD, -6.02 h, 95% CI -9.28 to -2.77 h, p = 0.0003) than ERAS group. Invasive acupuncture (IA) after CRC surgery, acupuncture or electricacupuncture with a fixed number of times and duration at therapeutic acupoints, can promote the recovery of POI. IA combined with ERAS is better than simple ERAS in improving POI. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=387700, identifier CRD42023387700.

Acupuncture for dyspnea and breathing physiology in chronic respiratory diseases: A protocol of a systematic review and meta-analysis of randomized controlled trials.

Background:Dyspnea is one of the most common symptoms of chronic respiratory disease (CRD) and is closely related to increased functional disability and mortality, resulting in substantial adverse outcomes on patients and imposing great social and economic burden. Although multiple clinical trials and systematic reviews have suggested that acupuncture could be effective in treating COPD and lung cancer, little is known about its effects on dyspnea relief in patients with CRD. The present study aimed to use a systematic review approach to evaluate the effectiveness and safety of acupuncture in the treatment of dyspnea in patients with CRD.Methods:We will search the following 9 databases from inception to June 30, 2022, PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, WANFANG Database, Chinses Scientific and Technological Periodical Database, and Chinese Biomedical Database, and the Cochrane Library Database. Clinical randomized controlled trials in English or Chinese that evaluate invasive acupuncture versus control group in treatment of CRD with dyspnea will be included. The primary outcome will be dyspnea scores, breathing physiological function, and the secondary outcomes include exercise tolerance by six-minute walk distance quality of life, quality of life and adverse events. Two reviewers will independently conduct study selection, data extraction and quality assessment. The Review Manager software will be used for meta-analysis. This protocol will be carried out in accordance with the PRISMA-P guidance.Conclusion:This systematic review and meta-analysis will provide the evidence of whether acupuncture is an effective and safe intervention for CRD with dyspnea. The results will be disseminated through peer-reviewed publication.

Safety of acupuncture in oncology: A systematic review and meta-analysis of randomized controlled trials.

Acupuncture is frequently used to treat the side effects of cancer treatment, but the safety of this intervention remains uncertain. The current meta-analysis was conducted to assess the safety of acupuncture in oncological patients. The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched from their inception to August 7, 2020. Randomized controlled trials in oncological patients comparing invasive acupuncture with sham acupuncture, treatment as usual (TAU), or any other active control were eligible. Two reviewers independently extracted data on study characteristics and adverse events (AEs). Risk of bias was assessed using the Cochrane Risk of Bias Tool. Of 4590 screened articles, 65 were included in the analyses. The authors observed that acupuncture was not associated an with increased risk of intervention-related AEs, nonserious AEs, serious AEs, or dropout because of AEs compared with sham acupuncture and an active control. Compared with TAU, acupuncture was not associated with an increased risk of intervention-related AEs, serious AEs, or drop out because of AEs but was associated with an increased risk for nonserious AEs (odds ratio, 3.94; 95% confidence interval, 1.16-13.35; P = .03). However, the increased risk of nonserious AEs compared with TAU was not robust against selection bias. The meta-analyses may have been biased because of the insufficient reporting of AEs in the original randomized controlled trials. The current review indicates that acupuncture is as safe as sham acupuncture and active controls in oncological patients. The authors recommend researchers heed the CONSORT (Consolidated Standards of Reporting Trials) safety and harm extension for reporting to capture the side effects and better investigate the risk profile of acupuncture in oncology. According to this analysis, acupuncture is a safe therapy for the treatment of patients with cancer. Acupuncture seems to be safe compared with sham acupuncture and active controls.

Effects of different wavelengths of invasive laser acupuncture on chronic non-specific low back pain: a study protocol for a pilot randomized controlled trial

BackgroundChronic non-specific low back pain (CLBP) is a common musculoskeletal disorder for which patients seek complementary and alternative medical treatments, including laser acupuncture (LA). Invasive LA (ILA) involves the simultaneous application of invasive acupuncture treatment at acupoints and focused laser irradiation. The efficacy of ILA for CLBP remains controversial owing to the insufficient clinical trial data. We intend to obtain basic data regarding the efficacy and safety of ILA for CLBP by comparing the effects of different wavelengths of ILA on CLBP.MethodsThis will be a prospective, patient-blinded, parallel-arm, single-center (DongShin University Gwangju Korean Medicine Hospital, Republic of Korea), pilot randomized controlled clinical trial. Forty-five participants with CLBP will be randomized in equal numbers into the control, 650-nm ILA (650 ILA), or 830-nm ILA (830 ILA) group. The control group will receive sham ILA for 10 min and real electroacupuncture (EA) for 10 min. The 650 and 830 ILA groups will receive real ILA (i.e., 650 ILA group, 650-nm wavelength; 830 ILA group, 830-nm wavelength) for 10 min and real EA for 10 min once/day, twice a week for 4 weeks, at bilateral Shenshu (BL23), Qihaishu (BL24), Dachangshu (BL25), and Huantiao (GB30). The primary outcome will be an improvement in pain intensity assessed using the visual analog scale. Scores in the Korean version of the Oswestry Disability Index and the European Quality of Life Five Dimension Five Level scale will be recorded as secondary outcome measures. All scores will be recorded at baseline (before intervention), 4 weeks after the first intervention (at the end of the intervention), and 4 weeks after completion of the intervention.DiscussionThe study is expected to provide preliminary evidence regarding the efficacy, safety, and usefulness of ILA for the treatment of CLBP.Trial registrationThis trial was registered with the Clinical Research Information Service (registration No. KCT0004610; http://cris.nih.go.kr). Registered on 7 January 2020.

A comparison of noninvasive and invasive acupuncture in preventing postoperative nausea and vomiting: A protocol for systematic review and Bayesian network meta-analysis.

Postoperative nausea and vomiting (PONV) is a main complication of surgery, and by now, drugs cannot prevent it completely. Some meta-analyses have proved acupuncture therapy can prevent PONV. However, it is still controversial whether noninvasive acupuncture therapies are comparable with invasive ones. This study uses Bayesian network meta-analysis to compare the effectiveness of different forms of acupuncture in preventing PONV. PubMed/Medline, Cochrane library, Web of Science, Ebsco, Ovid/Embase, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc will be searched from inception to May 2020. All randomized control trails meet the criterion will be included. Quality evaluation of included studies will be implemented with Cochrane risk-of-bias tool. STATA 14.0 will be used to perform pairwise meta-analysis. Addis 1.16.8, R 3.6.3, OpenBUGS 3.2.3, and STATA 14.0 will be used to conduct network meta-analysis. The evidence will be assessed by the grading of recommendations assessment, development, and evaluation approach using GRADE Profiler 3.6. The results of this review will be submitted to a peer-reviewed journal for publication and generate a comprehensive review of current evidence. Our results will help to improve the clinical decision-making ability and policy-making in PONV domain. The protocol has been registered on INPLASY 202060108.

Acupuncture for cancer pain in adults.

Forty per cent of individuals with early or intermediate stage cancer and 90% with advanced cancer have moderate to severe pain and up to 70% of patients with cancer pain do not receive adequate pain relief. It has been claimed that acupuncture has a role in management of cancer pain and guidelines exist for treatment of cancer pain with acupuncture. This is an updated version of a Cochrane Review published in Issue 1, 2011, on acupuncture for cancer pain in adults. To evaluate efficacy of acupuncture for relief of cancer-related pain in adults. For this update CENTRAL, MEDLINE, EMBASE, PsycINFO, AMED, and SPORTDiscus were searched up to July 2015 including non-English language papers. Randomised controlled trials (RCTs) that evaluated any type of invasive acupuncture for pain directly related to cancer in adults aged 18 years or over. We planned to pool data to provide an overall measure of effect and to calculate the number needed to treat to benefit, but this was not possible due to heterogeneity. Two review authors (CP, OT) independently extracted data adding it to data extraction sheets. Data sheets were compared and discussed with a third review author (MJ) who acted as arbiter. Data analysis was conducted by CP, OT and MJ. We included five RCTs (285 participants). Three studies were included in the original review and two more in the update. The authors of the included studies reported benefits of acupuncture in managing pancreatic cancer pain; no difference between real and sham electroacupuncture for pain associated with ovarian cancer; benefits of acupuncture over conventional medication for late stage unspecified cancer; benefits for auricular (ear) acupuncture over placebo for chronic neuropathic pain related to cancer; and no differences between conventional analgesia and acupuncture within the first 10 days of treatment for stomach carcinoma. All studies had a high risk of bias from inadequate sample size and a low risk of bias associated with random sequence generation. Only three studies had low risk of bias associated with incomplete outcome data, while two studies had low risk of bias associated with allocation concealment and one study had low risk of bias associated with inadequate blinding. The heterogeneity of methodologies, cancer populations and techniques used in the included studies precluded pooling of data and therefore meta-analysis was not carried out. A subgroup analysis on acupuncture for cancer-induced bone pain was not conducted because none of the studies made any reference to bone pain. Studies either reported that there were no adverse events as a result of treatment, or did not report adverse events at all. There is insufficient evidence to judge whether acupuncture is effective in treating cancer pain in adults.

Migraine prevention with a supraorbital transcutaneous stimulator: A randomized controlled trial

Schoenen et al.1 provided evidence that trigeminal neurostimulation with a supraorbital transcutaneous stimulator (STS) is effective for migraine. STS involves the application of electrodes and stimulator via an invasive surgical procedure that includes expensive medical consumables and possible complications. Only 70.6% of patients are very satisfied or moderately satisfied and approximately 1 out of 5 was not satisfied after STS effective neurostimulation.1 This means that 20%–30% of patients were dissatisfied with the procedure. Unfortunately, there is no way to preoperatively predict which patients will respond to the stimulation. STS has a sedative effect via a change in CNS activity.1 Acupuncture (e.g., somatic acupuncture, ear acupuncture, or electroacupuncture) has been successfully used for migraine2,3 and reduces sympathetic nerve activity.4 Based on those data, we propose that acupuncture can predict the efficacy of STS: if acupuncture is effective, STS will also be effective. For migraineurs, inexpensive and minimally invasive acupuncture can be performed before the STS. If acupuncture is efficient, STS may also be efficient and worth performing.

Acupuncture for treating fibromyalgia.

Background One in five fibromyalgia sufferers use acupuncture treatment within two years of diagnosis.

P6 acupoint stimulation for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomized controlled trial

BackgroundThe incidence of postoperative nausea and vomiting (PONV) is 50 to 79% after neurosurgery. Our study is designed to evaluate the efficacy of pericardium 6 (P6; also known as Neiguan) acupoint stimulation versus placebo, and versus routine antiemetic for the prevention of PONV after craniotomy, as well as to compare the efficacy of invasive acupuncture with non-invasive transcutaneous electrical nerve stimulation (TENS) on P6.Methods/designThis is a single-center, prospective, double-blind, five-arm, parallel-group, randomized controlled trial (RCT). All groups will be given routine intravenous ondansetron 8 mg administered before skin closure. Upon regaining consciousness from general anaesthesia, patients will receive one of five interventions: 1) P6 acupuncture bilaterally for 30 minutes, stimulated every 10 minutes to keep de qi sensation; 2) sham acupuncture bilaterally for 30 minutes with no stimulation; 3) P6 stimulation via active TENS electrodes bilaterally for 30 minutes, with stimulation frequency and intensity set to when de qi sensation is felt; 4) sham P6 stimulation via inactive TENS electrode bilaterally for 30 minutes; and 5) usual practice of pharmacological emesis prevention. The incidence of postoperative vomiting during the first 24 hours is the main outcome. Secondary outcomes include: complete response rate, severity of nausea, total rescue metoclopramide dose used and patient satisfaction with PONV management.DiscussionThe results from this study could potentially confirm that P6 acupoint stimulation is an effective adjunct to standard antiemetic drug therapy for the prevention of PONV in patients undergoing craniotomy. Our study may also confirm that conventional acupuncture is more effective than TENS.Trial registrationThis study is registered with the Chinese Clinical Trial Registry: ChiCTR-TRC-13003026.

Evidence for the efficacy of acupressure for preventing post-operative nausea and vomiting: an ongoing debate

Evidence for the efficacy of acupressure for preventing post-operative nausea and vomiting: an ongoing debate

Clinical Manual of Pain Management in Psychiatryby Raphael J. Leo, M.D. Arlington, Va, American Psychiatric Publishing, 2007, 283 pp., $48.95.

Back to table of contents Previous article Next article Book ForumFull AccessClinical Manual of Pain Management in PsychiatryJAY M. GRIFFITH M.D.,JAY M. GRIFFITH M.D.Search for more papers by this author,Published Online:1 Jan 2008https://doi.org/10.1176/appi.ajp.2007.07101646AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Chronic pain and mental illness are inexorably linked, both initiating and exacerbating one another. Indeed, all psychiatrists ultimately treat chronic pain, either unwittingly or intentionally, because it occurs so frequently in psychiatric patients, complicating their recovery. Furthermore, given recent evidence indicating that chronic pain promotes impulsivity and brain degeneration, it is likely that some forms of chronic pain will ultimately be considered as neuropsychiatric disorders. Because of these issues, there is considerable need for practical texts which educate and support psychiatrists in treating pain in patients. The author of this book, Dr. Raphael J. Leo, is one of few academic psychiatrists who have focused their efforts on chronic pain. Dr. Leo’s previous work, Concise Guide to Pain Management for Psychiatrists , published in 2003, is a well written and useful clinical reference for psychiatrists. His most recent book is an expanded and updated version of the earlier text. There are ten chapters, which can be divided into three sections according to content. The first third of the book provides an overview of the field and creates a knowledge base for pain management, reviewing relevant topics in the neurobiology and assessment of pain. Psychiatric comorbidities associated with chronic pain, including depression, anxiety, and somatoform and psychotic disorders, are reviewed. Readers learn that the majority of psychiatric disorders interact with pain in a mutually exacerbating manner, but that psychotic disorders may decrease pain sensitivity.The next third, and lengthiest portion, of the book reviews pharmacologic, psychotherapeutic, and interventional modes of pain management. The chapter on pharmacology covers opioid and non-opioid analgesics, antidepressants, anticonvulsants, and medications from other classes including benzodiazepines, muscle relaxants, and antihistamines. This section imparts a better understanding of how to use standard psychiatric medications to treat pain. For example, relevant studies comparing the use of antidepressants and anticonvulsants are presented to provide a rationale for their use in pain management. The section on opioids serves as a useful introduction for those new to pain management.The chapter on psychotherapy provides an overview of behavioral, cognitive behavioral, and psychodynamic treatments, with brief comments on group and family therapies. This chapter provides a helpful overview of these therapies, particularly for trainees and non-psychiatrist pain specialists. One consideration is that it would have been useful to provide an evidence-based review of these therapies, similar to that provided for antidepressants. For example, because cognitive behavioral therapy in the treatment of pain is more thoroughly studied than psychodynamic therapy, there is better evidence to support that approach.Interventional techniques commonly employed in pain management are next reviewed, and methods covered range from minimally invasive acupuncture to more invasive techniques such as spine decompression surgery and implanted spinal cord stimulation. I would have appreciated a more extensive discussion on the pitfalls of using implanted pumps in complex cases, in particular for those patients with histories of substance use.The final third of the book covers specific pain disorders and special topics. Chapter 8 reviews the pain disorders that psychiatrists are most likely to treat, including headaches and lower back and myofascial pain, including fibromyalgia, arthritis, and neuropathy. These reviews contain the clinically relevant information needed to address the use of single or combined medications in treating co-occurring pain and psychiatric disorders. Chapters 9 and 10 discuss additional topics in pain management, including pediatric and geriatric pain, end-of-life pain, and one of the most challenging patient populations: patients with co-occurring pain and addiction. The chapter on forensic issues reviews topics ranging from capacity examinations to confidentiality.I like this book and find it helpful in the clinic. It is well written, concise, and accurate. It is a useful clinical manual, and with its expanded references and enhanced sections on psychopharmacology, special patient populations, and forensics, it is both an excellent primer and update of the field. Medical students, residents, and psychiatrists new to chronic pain issues will benefit by reading it. Psychiatrists specializing in pain medicine will find it a useful reference. Finally, medical practitioners from other specialties will find the sections on pain assessment and the use of psychotherapy in pain management informative.Denver, Colo.Book review accepted for publication October 2007 (doi: 10.1176/appi.ajp.2007.07101646).Reprints are not available; however, Book Forum reviews can be downloaded at http://ajp.psychiatryonline.org. FiguresReferencesCited byDetailsCited BySpherical Latent Factor ModelSSRN Electronic Journal Volume 165Issue 1 January, 2008Pages 143-144THE AMERICAN JOURNAL OF PSYCHIATRY January 2008 Volume 165 Number 1 Metrics PDF download History Published online 1 January 2008 Published in print 1 January 2008

1103 POSTER Invasive acupuncture for radiotherapy-induced nausea and vomiting is not more effective than placebo acupuncture

Cancer-related fatigue is a symptom with great implications for the quality of life of those that experience it. It is regarded as one of the most distressing symptoms that people with cancer develop. Its aetiology is complex, and although the mechanisms underlying fatigue have not been fully clarified it is evident that it is exacerbated by treatments intended to cure or palliate the disease.Patients at risk of cancer-related fatigue need access to information that will enable them to manage it effectively. There are a growing number of materials available to patients in different European countries on this topic, but it is unclear how useful patients find these. This study was undertaken to explore this through conducting focus groups with patients in the United Kingdom and Switzerland. One focus group was conducted in each country. Findings from these determined that individuals voiced common concerns: fatigue had not been addressed in the clinical setting – individuals surmised why this occurred; participants had not accessed materials on cancer-related fatigue previously; they made recommendations for future resources for patients. However, what was evident was that unless patients can access materials on this topic, their quality becomes purely an academic issue.Erschöpfungszustände (Fatigue), die durch Erkrankung an Krebs hervorgerufen werden, stellen ein Symptom mit weitreichenden Auswirkungen auf die Lebensqualität der Betroffenen dar. Es gilt als eines der belastendsten Symptome bei Krebspatienten. Die Ätiologie dieser Erschöpfungszustände ist vielschichtig, und obwohl die zugrunde liegenden Mechanismen noch nicht vollständig geklärt worden sind, wird die Erschöpfung offenbar noch durch die Behandlung welche die Linderung oder Heilung der Krebskrankheit zum Ziel hat verstärkt.Patienten mit der Neigung zu krebsbedingten Erschöpfungszuständen brauchen Zugang zu Informationen, die ihnen einen wirksamen Umgang mit dem Symptom eröffnen. Zu diesem Thema gibt es in steigendem Maβe Materialien für Patienten in verschiedenen europäischen Ländern, es ist aber noch unklar, für wie hilfreich die Betroffenen sie halten. Zur Untersuchung dieser Frage wurde die vorliegende Studie bei Patientenruppen im Vereinigten Königreich und in der Schweiz durchgeführt. In jedem Land wurde eine Gruppe untersucht. Die Ergebnisse lieβen erkennen, dass die Betroffenen gemeinhin bekannte probleme äuβerten; Die Beschäfligung mit dem Fatiguesymptom war nicht im Klinikprogramm vorgesehen, und man stellte Vermutungen an, warum dies nicht geschah; Gruppenteilnehmer hatten zuvor keinen Zugang zu Informationsmaterial über krebsbedingte Erschöpfungszustände gehabt, und sie gaben Empfehlungen ab, wie man in Zukunft Patienten damit versorgen könnte. Es wurde klar, dass die Qualität dieser Materialien so lange eine rein akademische Frage bleibt, wie sie den Patienten vorenthalten bleiben.

Non-invasive Stimulation of the P6 (Neiguan) Antiemetic Acupuncture Point in Cancer Chemotherapy

The beneficial effects of transcutaneous electrical stimulation of the P6 antiemetic point (Neiguan) as an adjuvant to standard antiemetics was studied in over 100 patients in whom chemotherapy-induced sickness was not adequately controlled by antiemetics alone. Although the results were not quite as good as with invasive acupuncture, more than 75% patients achieved considerable benefit from what was a non-toxic procedure. The use of large diffuse low impedence electrodes simplifies the technique. The 2 hourly application of Sea Bands prolongs the antiemetic action. Best results were obtained from the 2 hourly self-administration of 5 min of transcutaneous electrical stimulation of P6 using a simple battery-operated TENS machine (15 Hz) to activate a large, easy-to-place surface electrode and increasing current until Qi is elicited.

EFFECT OF STIMULATION OF THE P6 ANTIEMETIC POINT ON POSTOPERATIVE NAUSEA AND VOMITING

The antiemetic action of stimulation of the P6 (Neiguan) acupuncture (ACP) point has been studied in women, premedicated with nalbuphine 10 mg, undergoing minor gynaecological operations under methohexitone-nitrous oxide-oxygen anaesthesia. Invasive ACP--manual or electrical at 10 Hz--applied for 5 min at the time of administration of the premedication markedly reduced the incidence of vomiting and nausea in the first 6 h after operation, compared with untreated controls. This did not occur with stimulation of a "dummy" ACP point outside the recognized ACP meridians. Non-invasive methods (stimulation via a conducting stud or by pressure) were equally as effective as invasive ACP during the early postoperative period. However, both these non-invasive approaches were less effective than invasive ACP in the 1-6 h postoperative period, although each was as effective as two standard antiemetics (cyclizine 50 mg, metoclopramide 10 mg). In view of the total absence of any side effects in more than 500 ACP procedures, the clinical applications of this finding are worthy of further study.