Predicting adherence to acupuncture appointments for low back pain: a prospective observational study.
Bishop FL, Yardley L, Cooper C, Little P, Lewith G. BMC Complement Altern Med. 2017;17(1):5.
This study was conducted by 5 researchers from the University of Southampton, in the United Kingdom. Acupuncture is popular, but it is not clear why patients do (or do not) follow acupuncturists' treatment recommendations. This study was aimed to investigate theoretically derived predictors of adherence to acupuncture. In a prospective study, adults receiving acupuncture for low-back pain completed validated questionnaires at baseline, 2 weeks, 3 months, and 6 months. Patients and acupuncturists reported attendance. Logistic regression tested whether illness perceptions, treatment beliefs, and treatment appraisals, measured at 2 weeks, predicted attendance at all recommended acupuncture appointments. Altogether 324 people participated (ages: 18–89; 70% female) and 165 (51%) attended all recommended acupuncture appointments. Adherence was predicted by appraising acupuncture as credible, appraising the acupuncturist positively, appraising practicalities of treatment positively, and holding pro-acupuncture–treatment beliefs. A multivariable logistic regression model—including demographic, clinical, and psychologic predictors—fit the data well (χ 2 [21] = 52.723; P < .001), explained 20% of the variance, and correctly classified 65.4% of participants as adherent/nonadherent.
As hypothesized, attending all recommended acupuncture appointments was predicted by illness perceptions, treatment beliefs, and treatment appraisals. However, experiencing early changes in symptoms did not predict attendance. Acupuncturists could make small changes to consultations and service organization to encourage attendance at recommended appointments and thus potentially improve patient outcomes.
Acupuncture ameliorates inflammatory response in a chronic unpredictable stress rat model of depression.
Lu J, Shao RH, Jin SY, Hu L, Tu Y, Guo JY. Brain Res Bull. 2017;128:106–112.
Researchers from different institutions in Beijing, China, performed this animal experimental study. Depression is one of the most common psychiatric disorders. Chronic inflammatory response has been viewed as one key factor in depression. Acupuncture in Chinese medicine has been shown to be an effective treatment for depression. In the present study, the researchers investigated the mechanism underlying the antidepressant effect of acupuncture. The rats were subjected to chronic unpredictable mild stress (CUMS) for 28 days to induce depressive-like behaviors. Acupuncture treatment was applied once every other day during the 28-day stress period. Behavioral tests (body weight, sucrose consumption, and locomotor activity) were performed. Expressions of nitric oxide (NO), prostaglandin E2 (PGE2), inducible NO synthase (iNOS), cyclo-oxygenase-2 (COX-2), and nuclear factor kappa B (NF-κB) were determined in the rats' hippocampi and prefrontal cortices.
CUMS induced depressive-like behavior in rats, which was alleviated by acupuncture treatment. The increased levels of NO, PGE2, iNOS, and COX-2 induced by CUMS, were all significantly decreased in the hippocampi and prefrontal cortices by acupuncture. Moreover, acupuncture markedly inhibited the activation of NF-κB in the rats. These findings showed that the antidepressant-like effect of acupuncture might be mediated by inhibition of inflammatory mediators via modulation of NF-κB in the brain regions.
Evaluation of the improvement effect of laser acupuncture biostimulation in asthmatic children by exhaled inflammatory biomarker level of nitric oxide.
Dabbous OA, Soliman MM, Mohamed NH, Elseify MY, Elsheikh MS, Alsharkawy AA, Abd Al Aziz MM. Lasers Med Sci. 2017;32(1):53–59.
This study was published in Lasers Medical Sciences and was conducted by 7 researchers from Cairo, Egypt. Variable therapy of asthma is not sufficient yet to achieve good asthma control. Therapy decision-making requires serial investigations. Low-level laser acupuncture is a suitable noninvasive modality of complementary medicine. Exhaled breath condensate (EBC) is easy and useful for evaluating the efficacy of drugs or novel therapies. This study was aimed to evaluate the effectiveness of low-level laser biostimulation of acupuncture points on asthma control in children.
Forty-eight children with asthma were subdivided into two groups. A case (laser) group received 12 direct contact low-power laser acupuncture sessions (three sessions/week) on specific traditional Chinese acupoints for bronchial asthma. A control asthmatic group received sham laser acupuncture on the same acupoints and number of sessions as the case (laser) group. A low-power Multichannel Aculas-AM laser (grade II), with a wavelength of 780 nm, an output power of 800 mW, and a beam spot size 0.1 cm2, with a continuous mode was used. Eighteen acupoints were stimulated for 2 minutes, giving energy of 9.6 J/cm2/acupoint. The total session time was 3 minutes. Both groups were evaluated pre and post laser acupuncture intervention by recording levels of asthma control, pulmonary function, and EBC nitric oxide (NO).
In the case (laser) group, 91.7% of patients experienced an improvement in level of asthma control versus 25% in the control group (P < 0.001). This was associated with a significant decrease of breath condensate fractional exhaled NO concentration (P < 0.001) and a significant increase of spirometry parameters (P < 0.001) in the case (laser) group. Application of laser acupuncture treatment, given with conventional therapy, can improve control of bronchial asthma more effectively than prescription of medications alone could do.
Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial.
Oates A, Benedict KA, Sun K, Brakeman PR, Lim J, Kim C. Pain. 2017;158(1):103–109.
This randomized controlled trial (RCT) was performed by researchers from the United States to evaluate laser acupuncture as an adjuvant therapy in pain management during percutaneous kidney biopsy procedures in children and adolescents. This prospective, double-blinded, RCT enrolled patients (children, adolescents and young adults) ages 7–26, who had been admitted to a children's hospital for percutaneous kidney biopsy. Patients received laser acupuncture to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm2 over 10 acupoints. Patients and parents rated the patients' pain during and after the biopsies, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis.
Patients in the acupuncture group reported a significantly improved change in their pain scores after the biopsy, compared with the controls (0.8 versus −0.5; P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (−1.8 versus 5.6; P = 0.043) and respiratory rate (−2.4 versus 0.4; P = 0.045), compared with controls. Parents also perceived a correspondingly greater reduction in their children's pain for those in the acupuncture group, compared with the controls (2.3 versus 0.3; P = 0.04). Adjunctive laser acupuncture reduced pain significantly after pediatric percutaneous kidney biopsies.
Acupuncture and moxibustion have different effects on fatigue by regulating the autonomic nervous system: a pilot controlled clinical trial.
Shu Q, Wang H, Litscher D, et al. Sci Rep. 2016; 6:37846.
This study was performed by researchers from the Hubei University of Chinese Medicine and the Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture & Moxibustion (both in China) in cooperation with the Medical University of Graz (in Austria). The study investigated different effects of acupuncture and moxibustion on chronic fatigue syndrome (CFS) and alterations in the autonomic nervous system (ANS) by measuring heart rate variability (HRV). Forty-five participants were recruited and randomly divided into 3 groups using a randomization schedule. The control group (CG; n = 15) and the acupuncture group (AG; n = 15) were treated by manipulation acupuncture, and the moxibustion group (MG; n = 15) was treated by indirect moxibustion. Primary outcomes were the scores of the Fatigue Assessment Instrument (FAI). Secondary outcomes were the HRV parameters that can reflect activity of the ANS. This trial considered both instantaneous changes and long-term effectiveness.
FAI scores decreased after the fourth and tenth treatments in the 3 groups. The decrease in FAI in the MG was greater than that in the AG. Acupuncture was more effective for instantaneous changes of HRV and moxibustion was more effective for long-term aspects. Both acupuncture and moxibustion reduced fatigue in patients with CFS, but moxibustion was more effective. The possible mechanism of the intervention might be through activation of the vagus nerve. Moxibustion was more effective than acupuncture for long-term treatment of CFS.
