Objective: To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagn...Objective: To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagnoses of both Western medicine and traditional Chinese medicine (TCM) were used as inclusion criteria to allocate acupoints more precisely to the complaints of the patients. Secondly, objectively measurable parameters of pain relief in addition to usual Visual Analogue Scale (VAS) were chosen to quantify the effects of acupuncture. Methods: The study was prospective, randomized, controlled and single-blinded. Eighteen patients with chronic back pain and TCM diagnosis of a Taiyang/Yangming syndrome received one single session of acupuncture chosen according to TCM diagnosis or acupuncture on points outside the meridian system (controls). We evaluated pain via VAS and increased mobility via inclinometry of the back. Results: Although the sample size was small, there was a statistically significant improvement in pain and mobility in the intervention group (n=13), but not in the control group (n=5). The calculated sample size adequate power was lower for inclinometry than for VAS, indicating that VAS is less probable to discriminate acupuncture effects. Conclusion: Objectively measurable physical parameters such as the angle of flexion before and after acupuncture (inclinometry) may be more suitable to measure pain relief than subjective assessment by VAS in acupuncture studies. TCM diagnosis may be a helpful inclusion criterion in studies on acupuncture, so as to potentially allocate interventions better to the complaints of patients.展开更多
In recent years,the popularity increased for nutritional supplements and herbal products.Prescription drugs,but not herbal therapies are paid by health insurances.They are sold over-the-counter(OTC)on the patients’ow...In recent years,the popularity increased for nutritional supplements and herbal products.Prescription drugs,but not herbal therapies are paid by health insurances.They are sold over-the-counter(OTC)on the patients’own expense.However,there are potential risks of self-medication,e.g.incorrect self-diagnosis,severe adverse reactions,dangerous drug interactions,risk of addiction etc.They are often used by patients at their own discretion without knowledge of and control by their physicians.Certain users are at risk of intoxication.Multiple medications taken by older patients increase the risk for adverse drug reactions,drug-drug interactions,and compliance problems for this age group(polypharmacy).Herbals should be discontinued prior to operations to avoid interactions with anesthetics or anticoagulants.Herbal preparations may also be carcinogenic or interfere with cancer treatments.Pregnant women use various OTC preparations.However,in many cases,it is unclear whether their use is safe for mother or baby.Self-medication with herbals is also largely distributed among anxious and depressive patients,and patients with other conditions and symptoms.The popularity of herbal products has also brought concerns on quality,efficacy and safety.Cases of botanical misidentification,contaminations with heavy metals,pesticides,radioactivity,organic solvents,microbials as well as adulteration with chemical drugs necessitate the establishment of international quality control standards.Hepatotoxic effects have been reported for more than 300 plant species,and some commonly used herbs have been demonstrated to interact with Western medication.Health care professionals have a critical responsibility assessing the self-care ability of their patients.Databases are available for pharmacists with information on action,side effects and toxicities as well as herbdrug interactions.There is a need for established guidelines regarding the correct use of nutritional supplements and herbal OTC preparations(phytovigilance).Physicians,pharmacists,and other health care professionals have to counsel patients and the general public on the benefits and risks associated with herbal drugs.Information centers for consumers and general practitioners are needed,and convincing evidence on safety and efficacy of herbal products has to be demonstrated in placebo-controlled,double blind and randomized clinical trials.展开更多
The European Parliament and Council enacted a directive on traditional herbal medicinal products (THMPD;Directive 2004/24/EC) as an amendment to an earlier directive on the use of medicinal products(Directive 2001/83/...The European Parliament and Council enacted a directive on traditional herbal medicinal products (THMPD;Directive 2004/24/EC) as an amendment to an earlier directive on the use of medicinal products(Directive 2001/83/EC) on March 31st, 2004.Since April 30th,2011,all herbal展开更多
Defining the classical Chinese diagnosis such as by the Heidelberg model of TCM has shown that outcome of studies is largely dependent on classical diagnostic criteria. The quality of future studies in TCM will largel...Defining the classical Chinese diagnosis such as by the Heidelberg model of TCM has shown that outcome of studies is largely dependent on classical diagnostic criteria. The quality of future studies in TCM will largely depend on a variety of factors, such as （1） the classical Chinese diagnosis as an inclusion criterion, （2） objectively measurable parameters as the main criterion of outcome, （3） double blinding of controls. A common understanding of the diagnosis and functional criteria of TCM is therefore necessary, as well as a common understanding of the functional terminology and rationally accessible theory. This underlines the necessity of classical Chinese medical theory for modem scientific research, its proper definition and application in studies.展开更多
BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not sho...BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine（TCM） diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.METHODS/DESIGN： We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.DISCUSSION： The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.TRIAL REGISTRATION NUMBER： Clinical Trials.gov Identifier NCT02553005.展开更多
Objective: To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life(HRQoL) in patients with rheumatoid arthritis(RA). ...Objective: To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life(HRQoL) in patients with rheumatoid arthritis(RA). Methods: A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials(RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Results: Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls. Conclusions: Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQo L in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.展开更多
Objective： To evaluate the effect of acupuncture on peripheral neuropathy （PN） as measured by changes in nerve conduction studies （NCS）. Methods： 192 patients with PN were evaluated over a period of 1 year. In 1...Objective： To evaluate the effect of acupuncture on peripheral neuropathy （PN） as measured by changes in nerve conduction studies （NCS）. Methods： 192 patients with PN were evaluated over a period of 1 year. In 17 patients diabetic neuropathy was found. 3 of these patients received acupuncture therapy according to classical Chinese medicine as defined by the Heidelberg model of TCM and all improved in NCS. Of the 14 non-specifically treated patients, 3 （21.4%） presented with improved NCS and 11 （78.6%） aggravated in NCS （P〈0.03）. An overall of 47 patients met the criteria for PN of undefined aetiology, 21 patients received acupuncture therapy, while 26 patients received no specific treatment. All groups were examined by NCS before treatment and 4 months later. Results： 1） Diabetic neuropathy, in the control-group 3 patients improved and 11 showed an aggravation. Comparison of groups was significantly different. 2） PN, 16 patients （76.2%） in the acupuncture group improved, while only 4 patients in the control group （15.4%） did so. 3 patients in the acupuncture group （14.3%） showed no change and 2 patients an aggravation （9.5%）, whereas in the control group 7 patients showed no change （26.9%） and 15 an aggravation （57.7%）.Comparison of the groups was significantly different. Conclusion： There is a positive effect of acupuncture on PN, as measured by objective parameters （NCS）.展开更多
BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, ...BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE： To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale （NVS）. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： We performed a prospective, controlled single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental （n = 39） and the control （n = 30） groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES： Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS： In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION： The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.展开更多
BACKGROUND：Musicians are a prone group to suffer from working-related musculoskeletal disorder（WRMD）.Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation progr...BACKGROUND：Musicians are a prone group to suffer from working-related musculoskeletal disorder（WRMD）.Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation programs but their effi ciency is sometimes disappointing.OBJECTIVE：The aim of this research is to study the immediate effects of Tuina techniques on WRMD of professional orchestra musicians from the north of Portugal.DESIGN,SETTING,PARTICIPANTS AND INTERVENTIONS：We performed a prospective,controlled,single-blinded,randomized study.Professional orchestra musicians with a diagnosis of WRMD were randomly distributed into the experimental group（n=39）and the control group（n=30）.During an individual interview,Chinese diagnosis took place and treatment points were chosen.Real acupoints were treated by Tuina techniques into the experimental group and non-specifi c skin points were treated into the control group.Pain was measured by verbal numerical scale before and immediately after intervention.RESULTS：After one treatment session,pain was reduced in 91.8%of the cases for the experimental group and 7.9%for the control group.CONCLUSION：Although results showed that Tuina techniques are effectively reducing WRMD in professional orchestra musicians of the north of Portugal,further investigations with stronger measurements,double-blinding designs and bigger simple sizes are needed.展开更多
文摘Objective: To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagnoses of both Western medicine and traditional Chinese medicine (TCM) were used as inclusion criteria to allocate acupoints more precisely to the complaints of the patients. Secondly, objectively measurable parameters of pain relief in addition to usual Visual Analogue Scale (VAS) were chosen to quantify the effects of acupuncture. Methods: The study was prospective, randomized, controlled and single-blinded. Eighteen patients with chronic back pain and TCM diagnosis of a Taiyang/Yangming syndrome received one single session of acupuncture chosen according to TCM diagnosis or acupuncture on points outside the meridian system (controls). We evaluated pain via VAS and increased mobility via inclinometry of the back. Results: Although the sample size was small, there was a statistically significant improvement in pain and mobility in the intervention group (n=13), but not in the control group (n=5). The calculated sample size adequate power was lower for inclinometry than for VAS, indicating that VAS is less probable to discriminate acupuncture effects. Conclusion: Objectively measurable physical parameters such as the angle of flexion before and after acupuncture (inclinometry) may be more suitable to measure pain relief than subjective assessment by VAS in acupuncture studies. TCM diagnosis may be a helpful inclusion criterion in studies on acupuncture, so as to potentially allocate interventions better to the complaints of patients.
文摘In recent years,the popularity increased for nutritional supplements and herbal products.Prescription drugs,but not herbal therapies are paid by health insurances.They are sold over-the-counter(OTC)on the patients’own expense.However,there are potential risks of self-medication,e.g.incorrect self-diagnosis,severe adverse reactions,dangerous drug interactions,risk of addiction etc.They are often used by patients at their own discretion without knowledge of and control by their physicians.Certain users are at risk of intoxication.Multiple medications taken by older patients increase the risk for adverse drug reactions,drug-drug interactions,and compliance problems for this age group(polypharmacy).Herbals should be discontinued prior to operations to avoid interactions with anesthetics or anticoagulants.Herbal preparations may also be carcinogenic or interfere with cancer treatments.Pregnant women use various OTC preparations.However,in many cases,it is unclear whether their use is safe for mother or baby.Self-medication with herbals is also largely distributed among anxious and depressive patients,and patients with other conditions and symptoms.The popularity of herbal products has also brought concerns on quality,efficacy and safety.Cases of botanical misidentification,contaminations with heavy metals,pesticides,radioactivity,organic solvents,microbials as well as adulteration with chemical drugs necessitate the establishment of international quality control standards.Hepatotoxic effects have been reported for more than 300 plant species,and some commonly used herbs have been demonstrated to interact with Western medication.Health care professionals have a critical responsibility assessing the self-care ability of their patients.Databases are available for pharmacists with information on action,side effects and toxicities as well as herbdrug interactions.There is a need for established guidelines regarding the correct use of nutritional supplements and herbal OTC preparations(phytovigilance).Physicians,pharmacists,and other health care professionals have to counsel patients and the general public on the benefits and risks associated with herbal drugs.Information centers for consumers and general practitioners are needed,and convincing evidence on safety and efficacy of herbal products has to be demonstrated in placebo-controlled,double blind and randomized clinical trials.
文摘The European Parliament and Council enacted a directive on traditional herbal medicinal products (THMPD;Directive 2004/24/EC) as an amendment to an earlier directive on the use of medicinal products(Directive 2001/83/EC) on March 31st, 2004.Since April 30th,2011,all herbal
文摘Defining the classical Chinese diagnosis such as by the Heidelberg model of TCM has shown that outcome of studies is largely dependent on classical diagnostic criteria. The quality of future studies in TCM will largely depend on a variety of factors, such as （1） the classical Chinese diagnosis as an inclusion criterion, （2） objectively measurable parameters as the main criterion of outcome, （3） double blinding of controls. A common understanding of the diagnosis and functional criteria of TCM is therefore necessary, as well as a common understanding of the functional terminology and rationally accessible theory. This underlines the necessity of classical Chinese medical theory for modem scientific research, its proper definition and application in studies.
文摘BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine（TCM） diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.METHODS/DESIGN： We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.DISCUSSION： The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.TRIAL REGISTRATION NUMBER： Clinical Trials.gov Identifier NCT02553005.
文摘Objective: To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life(HRQoL) in patients with rheumatoid arthritis(RA). Methods: A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials(RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Results: Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls. Conclusions: Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQo L in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.
文摘Objective： To evaluate the effect of acupuncture on peripheral neuropathy （PN） as measured by changes in nerve conduction studies （NCS）. Methods： 192 patients with PN were evaluated over a period of 1 year. In 17 patients diabetic neuropathy was found. 3 of these patients received acupuncture therapy according to classical Chinese medicine as defined by the Heidelberg model of TCM and all improved in NCS. Of the 14 non-specifically treated patients, 3 （21.4%） presented with improved NCS and 11 （78.6%） aggravated in NCS （P〈0.03）. An overall of 47 patients met the criteria for PN of undefined aetiology, 21 patients received acupuncture therapy, while 26 patients received no specific treatment. All groups were examined by NCS before treatment and 4 months later. Results： 1） Diabetic neuropathy, in the control-group 3 patients improved and 11 showed an aggravation. Comparison of groups was significantly different. 2） PN, 16 patients （76.2%） in the acupuncture group improved, while only 4 patients in the control group （15.4%） did so. 3 patients in the acupuncture group （14.3%） showed no change and 2 patients an aggravation （9.5%）, whereas in the control group 7 patients showed no change （26.9%） and 15 an aggravation （57.7%）.Comparison of the groups was significantly different. Conclusion： There is a positive effect of acupuncture on PN, as measured by objective parameters （NCS）.
文摘BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE： To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale （NVS）. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： We performed a prospective, controlled single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental （n = 39） and the control （n = 30） groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES： Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS： In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION： The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.
文摘BACKGROUND：Musicians are a prone group to suffer from working-related musculoskeletal disorder（WRMD）.Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation programs but their effi ciency is sometimes disappointing.OBJECTIVE：The aim of this research is to study the immediate effects of Tuina techniques on WRMD of professional orchestra musicians from the north of Portugal.DESIGN,SETTING,PARTICIPANTS AND INTERVENTIONS：We performed a prospective,controlled,single-blinded,randomized study.Professional orchestra musicians with a diagnosis of WRMD were randomly distributed into the experimental group（n=39）and the control group（n=30）.During an individual interview,Chinese diagnosis took place and treatment points were chosen.Real acupoints were treated by Tuina techniques into the experimental group and non-specifi c skin points were treated into the control group.Pain was measured by verbal numerical scale before and immediately after intervention.RESULTS：After one treatment session,pain was reduced in 91.8%of the cases for the experimental group and 7.9%for the control group.CONCLUSION：Although results showed that Tuina techniques are effectively reducing WRMD in professional orchestra musicians of the north of Portugal,further investigations with stronger measurements,double-blinding designs and bigger simple sizes are needed.
