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Acupuncture May Be a Stroke Defender in Rheumatoid Arthritis Patients

acupuncture on hands

Prepare for a groundbreaking revelation in the realm of healthcare! A recent study conducted in Taiwan has unveiled the extraordinary potential of acupuncture in reducing the risk of ischaemic strokes among individuals grappling with Rheumatoid Arthritis (RA).

Study Insights

Strategic Objective:

The primary aim of this study was to establish acupuncture as a preventive measure against ischaemic strokes for those combating RA.

Methodical Approach:

Researchers meticulously analyzed data from over 23,000 individuals newly diagnosed with RA, spanning the period from 1997 to 2010. The treasure trove of information was extracted from the National Health Insurance Research Database.

Key Finding:

The revelation is nothing short of extraordinary – individuals opting for acupuncture treatment showcased a significantly lower incidence of ischaemic strokes compared to their counterparts who did not opt for such therapy (log-rank test, p<0.001).

Statistical Snapshot:

Post a sophisticated matching process, the group availing acupuncture reported 341 stroke cases (5.95 per 1000 person-years), while the non-acupuncture group recorded 605 cases (12.4 per 1000 person-years). The adjusted Subhazard Ratio (SHR) underscored a noteworthy 0.57 (95% CI 0.50 to 0.65).

Universality of Impact:

Encouragingly, the positive influence of acupuncture extended across various demographic variables, including age, gender, and existing health conditions.

Implications and Future Exploration:

Significance Clarified:

By tapping into the expansive National Health Insurance Research Database, this study elevates acupuncture beyond pain management, positioning it as a formidable guardian against ischaemic strokes in RA patients.

On the Horizon:

The study not only beckons attention to the immediate benefits but also beckons further exploration. Could acupuncture emerge as a sustained ally for those navigating the complexities of RA in the long run? This opens avenues for redefining the management paradigm for this challenging arthritic condition.

Conclusion:

This study marks a pivotal moment, transcending the conventional understanding of acupuncture. It stands as a testament to the potential synergy between traditional practices and modern healthcare, providing a new perspective on safeguarding individuals grappling with RA from the perils of debilitating strokes.

In the Limelight:

News outlets are ablaze with discussions surrounding this groundbreaking study, heralding a paradigm shift in healthcare dynamics. Acupuncture is poised not merely as a therapeutic technique but as a transformative force in reshaping the narrative of health management.

https://bmjopen.bmj.com/content/14/2/e075218

Amyotrophic Lateral Sclerosis (ALS) and Chiese Medicine

Saturday last week (5th July 2023) American actress Sandra Bullock’s partner Bryan Randall passed away at 57. He battled Amyotrophic Lateral Sclerosis (ALS) privately for 3 years.

What is Amyotrophic Lateral Sclerosis (ALS)?

Amyotrophic Lateral Sclerosis (ALS) also known as Lou Gehrig’s disease, is a progressive and neurodegenerative disorder that affects the nerve cells (neurons) responsible for controlling voluntary muscle movements. ALS primarily involves the motor neurons in the brain and spinal cord, leading to their degeneration and eventual death. As these neurons die, the brain loses the ability to initiate and control muscle movement, leading to muscle weakness, paralysis, and, eventually, respiratory failure.

Main Symptoms of ALS

  1. Muscle weakness: Initial symptoms often include weakness in the limbs, which may affect the ability to walk, grasp objects, speak, or swallow.
  2. Muscle cramps and twitching: Individuals with ALS may experience muscle cramps and fasciculations (muscle twitching).
  3. Difficulty speaking and swallowing: As the disease progresses, speech and swallowing become challenging.
  4. Muscle atrophy: Affected muscles begin to shrink due to the lack of nerve stimulation.
  5. Difficulty breathing: In later stages, respiratory muscles become affected, leading to breathing difficulties.

Causes

The exact cause of ALS is not fully understood, but it is believed to be a combination of genetic and environmental factors. In some cases, ALS can be linked to specific genetic mutations. However, the majority of cases appear to be sporadic with no clear genetic inheritance pattern.

Diagnosis

Diagnosing ALS can be complex and involves ruling out other conditions with similar symptoms. The process usually includes a thorough neurological examination, electromyography (EMG), nerve conduction studies, MRI scans, and blood tests. A diagnosis of ALS is typically made based on clinical observations and the exclusion of other possible causes.

Treatment

As of my knowledge cutoff in September 2021, there is no cure for ALS, and treatment mainly focuses on managing symptoms and improving the patient’s quality of life. Medications, such as riluzole and edaravone, may help slow disease progression and provide some symptom relief. Physical therapy, occupational therapy, and speech therapy can assist in maintaining mobility and communication. Devices like ventilators may be used to support breathing in later stages of the disease.

ALS and Traditional Chinese medicine

There is limited scientific evidence to suggest that Traditional Chinese Medicine (TCM) may provide some symptom relief for individuals with Amyotrophic Lateral Sclerosis (ALS). It’s important to note that TCM is a holistic system that aims to restore balance and harmony within the body, and individual responses to TCM treatments can vary.

Some of the ALS symptoms that TCM may potentially address include:

  1. Muscle Cramps and Twitching: Certain herbal remedies and acupuncture may help alleviate muscle cramps and fasciculations.
  2. Pain: TCM treatments, such as acupuncture and herbal medicines, have been used traditionally to manage pain associated with various conditions, including neurological disorders like ALS.
  3. Stress and Anxiety: TCM practices, such as acupuncture and meditation techniques, may help reduce stress and anxiety levels, providing some relief to individuals with ALS who may experience emotional distress.
  4. Improving General Well-Being: TCM treatments often focus on supporting the overall well-being of an individual, which may contribute to an improved sense of quality of life.

It is essential to understand that TCM should not be considered a substitute for evidence-based medical treatments for ALS. ALS is a severe and progressive neurological disorder, and while TCM practices may offer some symptomatic relief or complementary support, there is no cure for the disease through TCM alone.

If someone with ALS is interested in exploring TCM or other complementary therapies, it is crucial that they consult with their healthcare team, including a qualified TCM practitioner, to ensure that these treatments are safe and do not interfere with any existing medical interventions.

Since research and medical knowledge are continuously evolving, it is advisable to consult updated sources and medical professionals for the most recent information regarding ALS treatments and complementary therapies.

How to choose TCM for ALS

When considering the use of Chinese herbal tea as a complementary approach for managing ALS symptoms, it’s crucial to work with a qualified and experienced TCM practitioner. They will take into account the individual’s overall health, specific symptoms, constitution, and any other relevant factors before recommending specific herbs or herbal formulas.

Here are some points to keep in mind:

Consultation with a TCM Practitioner

A TCM practitioner will conduct a thorough assessment to determine the pattern of disharmony or syndrome that best matches the individual’s condition. This involves examining symptoms, pulse, tongue appearance, and other diagnostic methods.

Herb Selection and Formula Creation

Based on the assessment, the TCM practitioner will select appropriate herbs and create a herbal formula tailored to the individual’s needs. The formula may consist of multiple herbs that work synergistically to address specific imbalances.

Quality and Safety

It’s crucial to use high-quality herbs from reputable sources to ensure their safety and effectiveness. Working with a qualified TCM practitioner helps ensure that the herbs are properly sourced and prepared.

Monitoring and Adjustment

TCM treatments are often adjusted over time as the individual’s condition changes. Regular follow-ups with the TCM practitioner are important to assess progress and make any necessary modifications to the treatment plan.

Integration with Conventional Care

TCM should not replace conventional medical treatments for ALS. It can be considered a complementary approach to help manage symptoms and improve well-being alongside standard medical care.

Communication with Medical Team

It’s important for individuals with ALS to maintain open communication between their TCM practitioner and their medical doctors. This ensures that all healthcare providers are aware of the treatments being pursued and can collaborate to provide comprehensive care.

Reference

Significant Neurological Improvement in Two Patients with Amyotrophic Lateral Sclerosis After 4 Weeks of Treatment with Acupuncture Injection Point Therapy Using Enercel
Author links open overlay panelShan Liang 1, David Christner 2, Stephanie Du Laux 2, Dariel Laurent. Journal of Acupuncture and Meridian Studies. Volume 4, Issue 4, December 2011, Pages 257-261

Erik K Koda, Acupuncture for Managing Amyotrophic Lateral Sclerosis. Med Acupunct 2021 Feb 1;33(1):103-106. doi: 10.1089/acu.2020.1474. Epub 2021 Feb 16.

Poovadan Sudhakaran, Amyotrophic Lateral Sclerosis: An Acupuncture Approach, Med Acupunct. 2017 Oct 1; 29(5): 260–268.

Mudan Cai , Eun Jin Yang, Complementary and alternative medicine for treating amyotrophic lateral sclerosis: A narrative review. Integr Med Res. 2019 Dec;8(4):234-239

Acupuncture for preventing migraine attacks – research reviews

Acupuncture migraine researchBased on the available evidence, acupuncture can be a valuable option for individuals with migraines.

Review

A review of 22 trials involving 4,985 people found that acupuncture reduced the frequency of migraine episodes. In trials where acupuncture was added to usual care, it resulted in a significant reduction in headache frequency compared to usual care alone. When acupuncture was compared to “fake” acupuncture, the true acupuncture group had a higher rate of halving headache frequency. Acupuncture was also found to be similarly effective as prophylactic drugs in reducing migraine frequency. Side effects were minimal, and dropout rates were lower compared to drug treatments.

The findings suggest that acupuncture can reduce the number of migraine days per month, with an average reduction from six days to three and a half days for those receiving true acupuncture. The quality of the evidence was considered moderate.

Conclusion

In conclusion, acupuncture can be considered as a treatment option for individuals with migraines who are willing to undergo this therapy. However, more long-term studies are needed to further evaluate its effectiveness compared to other migraine treatments.

Reference

Klaus Linde, etc, Acupuncture for the prevention of episodic migraine, Cochrane Database of Systematic Reviews Review, June 2016

Why double-blind, placebo-controlled trials for acupuncture are difficult even impossible?

Author: Dr. Richard Zeng (Chinese Med)

Double-blind, placebo-controlled trials are the golden standard for high quality of research. However, it can be very challenging to design and implement to acupuncture trials. Here are several factors affect the design of trials :

Needle insertion and sensation

Acupuncture involves the insertion of needles into specific points on the body, which creates a unique sensory experience. It can be challenging to create a placebo treatment that mimics the sensation of needle insertion convincingly. Sham acupuncture controls attempt to simulate the sensation, but it is difficult to completely mask the difference between real acupuncture and a placebo treatment.

Acupuncturist involvement

In traditional acupuncture practice, the acupuncturist plays an active role in the treatment. They may have specific training, techniques, and interactions with the patient that contribute to the therapeutic process. It can be difficult to blind the acupuncturist to the treatment being administered, which can introduce bias and affect the blinding of the study.

Expectations and beliefs

Acupuncture has a strong placebo component, and patient expectations and beliefs can significantly influence their perception of the treatment’s effectiveness. It is challenging to completely blind participants to their treatment group, as they may have prior knowledge or beliefs about acupuncture that can affect their responses.

Variability in treatment protocols

Acupuncture encompasses various techniques, styles, and individualised treatment approaches. There is significant variation in the choice of acupuncture points, needling techniques, and treatment durations among practitioners. Standardising treatment protocols for a placebo-controlled trial can be difficult due to these variations, which may limit the ability to compare results across studies.

Despite these challenges, researchers have made efforts to develop sham acupuncture controls to create placebo-like experiences. These sham controls may involve superficial needle insertion, non-penetrating needles, or non-specific needling locations. However, sham acupuncture is not real placebo. These methods may still provide some therapeutic effects or fail to fully replicate the specific physiological effects of true acupuncture.

While may be not impossible achieving complete blinding in acupuncture trials remains a complex task, and studies may still face limitations in achieving a fully placebo-controlled design.

Sham acupuncture is not real placebo

author:  Dr. Richard Zeng C.M.

What is a sham acupuncture needle?

A sham acupuncture needle is a type of placebo device used in research studies to create a control group for acupuncture trials. A sham needle is designed to mimic the sensation of needle insertion without penetrating the skin or stimulating specific acupuncture points.

There are different types of sham needles. They have their own method of simulating acupuncture without delivering the therapeutic effects with real needling. Here are a few examples:

Streitberger Placebo Acupuncture Needle

Streitberger placebo needles

Streitberger placebo needle: This type of sham needle consists of a blunt tip that retracts into the handle upon contact with the skin. It gives the sensation of needle penetration without actually piercing the skin.

park device - sham acupuncture needlesPark sham device: The Park sham device resembles a real acupuncture needle, but it has a blunt tip and a sheath that covers the needle, preventing skin penetration during insertion.

Non-penetrating needle: This type of sham needle has a blunt tip and does not penetrate the skin. It may have a collapsible handle or other mechanisms to create the sensation of needle insertion.

non-penetrating needles

non-penetrating needles

Toothpick or placebo needle: In some cases, a toothpick or a specifically designed placebo needle that does not penetrate the skin is used as a sham control. This provides a tactile sensation similar to acupuncture but without actual needling.

What are shame needles used for?

The purpose of using sham acupuncture needles is to create a control group that experiences a placebo treatment closely resembling real acupuncture. By comparing the outcomes of the real acupuncture group with the sham acupuncture group, researchers can assess the specific effects of acupuncture beyond placebo or non-specific effects. The use of sham needles helps control for placebo responses and improves the validity of the study results.

Sham needles creates some stimulation as real needles too

Sham acupuncture needles are designed to create a sensory experience similar to real needles. They provide a placebo-like stimulation. While they do not penetrate the skin or stimulate specific acupuncture points, they are intended to mimic the sensation of needle insertion and create a tactile experience for the recipient.

As sham acupuncture needles contact the skin, the sensation they created can be part of acupuncture sensation

The sensory experience created by sham needles, including the tactile sensation when they come into contact with the skin, can be considered part of the overall acupuncture sensation. Sham acupuncture is designed to mimic the physical aspects of real acupuncture, including the feeling of needle insertion and the associated sensations that patients may expect during an acupuncture treatment.

Sham acupuncture is not real placebo

While sham acupuncture is designed to serve as a placebo control in research studies, it is not a true placebo in the strict sense.

A true placebo would be an inert substance or intervention that has no specific physiological effects.

While sham acupuncture is intended to mimic certain aspects of real acupuncture, it does have some similar sensory experience and the ritualistic aspects of real treatment.

Sham acupuncture may still elicit non-specific effects, such as the placebo response, which can influence participants’ perception of the treatment’s effectiveness. Additionally, the sensory experience of sham needles, even though it does not involve needle penetration or stimulation of specific acupuncture points, can have its own distinct effects on the body and may activate certain physiological responses.

While sham acupuncture attempts to control for placebo effects and other non-specific factors, it is important to recognise that it is not a true placebo. It serves as a method to isolate and evaluate the specific effects of acupuncture beyond these non-specific influences, but it does not completely eliminate all potential confounding factors.