Medical Acupuncture

Acupuncture for Neck Disorders: A Systematic Review Trinh KV*, Graham N, Goldsmith CH, Gross AR, Wang E, Cameron ID, Kay T *Associate Clinical Professor, Chair, Interviews, MD Admissions, McMaster University, DeGroote School of Medicine, Hamilton, Ontario, Canada Objectives: To determine the effects of acupuncture for individuals with neck pain. Method: We searched MEDLINE, EMBASE, MANTIS, CINHAL from their beginning to the September 2004 and Cochrane CENTRAL. We searched reference lists and the acupuncture database in China. We included any published randomised controlled trial (RCT), quasi-RCT or quasi-controlled clinical trial (CCT), either in full text or abstract form. Study quality was assessed using the Jadad criteria. When clinical heterogeneity was absent, we combined studies using random-effects meta-analysis models. Results: We found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodological quality had a mean of 2.3/5 on the Jadad Scale. For chronic mechanical neck disorders, there are moderate evidence that acupuncture treatment is more effective compared to some type of sham controls at the end of the treatment for pain relief. However, this effect is short lived. There is moderate evidence that acupuncture is more effective than inactive treatment post-treatment and there is moderate evidence that acupuncture is more effective than inactive treatment at short term follow-up by meta-analysis (Pooled SMD -0.37, 95% CI -0.61 to -0.12). There is limited evidence that acupuncture is more effective than massage at short term follow-up. For neck disorders with radicular symptoms, there is moderate evidence that acupuncture is more effective compared to a wait-list control at short term follow-up. Conclusions: There is moderate evidence that acupuncture is more effective compared to some type of sham controls, to a wait-list control and to inactive treatments for pain relief .

The Very-Point-Technique in chronic pain Gleditsch Jochen, MD, Lecturer Pain Clinic University Munich, Germany. The VERY-POINT-TECHNIQUE was developed by myself 30 years ago, because, especially in microsystem therapy, it is essential to hit the eligible points most exactly. This technique enables to locate the very (veritable!) therapy-spot most precisely, by using the needle for both point-determinating as well as pricking the point. To start with, the surroundings of the suspected point have to be tapped and dabbed gently, tangentially, by the needle, that is held slantwise. In the very moment that the point is met precisely in its center, the patient invariably gives a response: mimically or verbally, e.g. ‘Here!’ or ‘Yes! At this very moment, without losing touch, the needle is to be erected and inserted. This Very-Point.Technique does not only guarantee maximal accuracy but also evokes the patient’s (subconscious) consent to the operation. It is well-tried to start the therapy by three checking steps 1. Very-point--detection at microsystemareas and points which are correlated to the brain stem (e.g. auricle, skull-YNSA and/or retromolar enoral points), to the craniocervica1 and/or the craniomandibular and/or neck receptor fields. When precise needle touch and/or insertion has evoked very spontaneous mimical or verbal response of the patient, when ON-points are being changed to total OFF-state, this can be interpreted as an affirmation of the subconscious subcortical level. In this way the patient’s acceptance is positively integrated in the procedure. 2. Very-point-detection at microsystemareas and points that are correlated to the pain condition in question: the most sensitive hyperactive points are to be treated by very-point-needle-insertion. After that, pre-detected but not yet treated points of other microsystem should be re-checked, whether ON-points now have changed to OFF-state, or prove significantly reduced in their sensitivity. If so, this is to be interpreted as that the cybernetic-informative autoregulating system is now being “opened”. 3. Very-point-detection and pricking of contralateral points at the precise symmetrical location to the actual pain. If in this way pain can be reduced to some remarkable percentage, this may be interpreted as that the segmental/ neuronal pathways will respond further with their pain modulating mechanisms. These three initial steps of getting ‘RESPONSE’ have proven to be good in order to acquire the best results in chronic and psycho-involved ill-conditions. It is for both traditional and microsystem acupuncture, as herewith the therapy obstacles are being alleviated, whereas the patient himself can feel more integrated in the whole therapy procedure.

Acupuncture and psychotherapy in phobic disorders Nepp Johannes, MD, Department of Ophthalmology, Medical University Vienna, Johannes Bischko-Institut of Acupuncture; Academy of Psychotherapy, Austria. Introduction Anxiety is common in patients with dry eyes. In ICD-10 there exist several kinds of anxiety: Panic, claustrophobia, social phobia, specific phobia and general phobia. In TCM anxiety is well known in organ syndromes, like heart and kidney syndromes. Our question was, which effect could be observed after acupuncture in any kind of anxiety. Our second question was, if there is a difference between psychotherapy and acupuncture. Patients and methods In an open controlled study 20 patients with phobia were observed. Questionaires of anxiety (TRIPS) were used to find symptoms and diagnosis. To measure subjective severity of complaints the visual analogue scale was used. All patients were treated with Acupuncture: Laser (5mW), 20 Sec at each point, 10 sessions 1/week. Point selection was individually determined, but every patient was treated at points that have influence on phobic symptoms: heart 5-7, kidney 2-8- 27, UB15, 23 and the ear point “anxiety”. Half of the patients additionally were treated with psychotherapy, the guided affective imagery (GAI). The pictures should illustrate the emotional stress and the subconscious facts of anxiety. One single patient was treated with psychotherapy without acupuncture to compare the effect with that of acupuncture. Results All patients had subjective reduction of symptoms, but only in 6/10 patients the diagnosis was reduced. Best effect was seen in panic and general anxiety. There was minimal effect in patients with current troubles and negative events. The pictures showed emotional stress and facts, which influence the emotion. There was an improvement of emotion in pictures after acupuncture. The best effect was seen in GAI combined with acupuncture. GAI alone improved the mental disorders but not the somatic complaints. Acupuncture reduced those somatic problems and therefore calmed the emotional stress. Conclusion Anxiety is a deep psychological malfunction, which affects the somatic functions. Psychotherapeutic methods have an influence on psychic troubles, calm the emotional stress and elaborate subconscious disorders. Acupuncture influences the deep nerval functions and therefore somatic complaints. Best effect was seen after combination of both methods because of the two different mechanisms that affect the phobic disorders.

Clinical use Of acupuncture In mental health Aung Steven K.H., MD, PhD, Clinical Professor, Faculty of Medicine and Dentistry, University of Alberta, Adjunct Professor of Extension, Rehabilitation Medicine, Public Health, and Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada, Associate Clinical Professor, College of Dentistry, New York University, USA. Acupuncture is an excellent modality for treating mental health, especially physical, mental, and spiritual imbalances. There are seven emotional conditions which are connected to every zang fu organ system. They are as follows: anxiety (heart and small intestines), worry (spleen and stomach), fear and fright (kidneys and bladder), anger (liver and gallbladder), sadness (lungs and large intestine), and depression (pericardium and triple energizer). Each organ system is associated with positive and negative types of emotions. When the organ system is healthy – they have a positive emotional factor. There are two gates of human consciousness in the upper extremities. These spiritual gates are: TE.5x2 (outer gate for emotional ventilation), PC.6x2 (inner gate for human consciousness). Other categories include: HT.7x2 (deep relaxation and sleep), BL.14x2, BL.15x2 with cupping (deep relaxation). Cupping and moxibustion on the back shu points are used for sedation and tonification of emotions of the corresponding organ system: CV.5 (subconscious childhood trauma), usually combined with TE.5 (to further explore childhood trauma), GV.4 (a life gate point to increase patient’s spirit), GB.41x2 (reunion of inner and outer spirits), GV.20 (the most powerful point for harmonization known as one-hundred points meet each other), and EXHN.1x4 (four wisemen is for mental alignment of vital energy). One of the bladder meridians (three tsun away from the midline ) is mainly used for treating psychosomatic disorders. Overall our bodies have everything that is necessary to ultimately be balanced and harmonized.