Acupuncture

ACUPUNCTURE

Conclusions: Acupuncture may be a therapeutic alternative in men with hot flushes after castration therapy and merits further evaluation.

Nielsen O J, Moiler K, Jorgensen KE. The effect of traditional Chinese acupuncture on severe tinnitus. A double-blind, placebo-controlled clinical study with an open therapeutic surveillance. [Danish] Ugeskrifl for Laeger 1999; 161(4):

Bullock ML, Kiresuk T J, Pheley AM, Culliton PD, Lenz S K Institution: Center for Addiction and Alternative

424--429 The aim of the present study was to determine the effect of intensive acupuncture on severe tinnitus. The structure of the study was a randomized, double-blind, clinical investigation with open therapeutic surveillance and included 54 patients. All were subjected to 25 treatment sessions over a period of 2 months, each treatment lasting 30 minutes. Fifty-two patients completed the study. The variables used for self-registration were based on the Visual Analogue Scale, where annoyance, loudness and awareness of the tinnitus were assessed. These were recorded twice daily over a 4-month period starting 1 month before the first treatment and ending 1 month after the last treatment. Questionnaires, interviews and audiometry were carded out repeatedly. No statistically significant differences were found between the acupuncture group and the placebo group.

Medicine Research, Minneapolis, MN, USA.

Auricular acupuncture in the treatment of cocaine abuse. A study of efficacy and dosing.

AC, Wyon Y. Institution: Department of Health and Environment, Faculty of Health Sciences, University of Linkoping, Sweden.

Journal of Substance Abuse Treatment 1999; 16(1 ): 31-38 A single-blind, randomized, placebo-controlled study was performed to evaluate auricular acupuncture (AAc) in the treatment of cocaine addiction. Two linked but concurrent studies were done. In Study 1, residential clients (n = 236) were randomized to true acupuncture (Ac), sham Ac, and conventional treatment without Ac. Treatment group subjects received Ac at three ear points considered to be specific for the treatment of substance abuse (SA). Control subjects received three non-specific (sham) points. In Study 2, day treatment clients (n = 202) were randomized to one of three dose levels of true Ac (28, 16, or 8 treatments). Subjects received Ac at five, rather than three, specific ear points. Non-specific (sham) points were not used in Study 2. With rare exception, the data failed to identify significant treatment differences among the true and sham Ac, and psychosocial groups. Furthermore, no differences were observed among the three dose levels of true Ac.

Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma: a pilot study.

Wong AM, Su TY, Tang FT, Cheng PT, Liaw

Hammar M, Frisk J, Grimas O, Hook M, Spetz

MY. Institution: Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.

Journal of Urology 1999: 161(3): 853-856 Pulpose: Most men who undergo castration therapy for prostatic carcinoma will have vasomotor symptoms that usually persist for years. Vasomotor symptoms are elicited from the thermoregulatory center, possibly due to a decrease in hypothalamic opioid activity induced by low sex steroid concentrations. Acupuncture treatment in women, which stimulates hypothalamic opioid activity, alleviates vasomotor symptoms. We report on men treated with acupuncture for relief of vasomotor symptoms after castration therapy. Materials and methods: We asked seven men with vasomotor symptoms due to castration therapy to receive acupuncture treatment 30 minutes twice weekly for 2 weeks and once a week for 10 weeks. Effects on flushes were recorded in logbooks. Results: Of the seven men six completed at least 10 weeks of acupuncture therapy and all had a substantial decrease in the number of hot flushes (average 70% after 10 weeks). At 3 months after the last treatment the number of flushes was 50% lower than before therapy. Therapy was discontinued after 10 weeks because of a femoral neck fracture in one man and after 3 weeks due to severe back pain in another. Complementor¥Therapiesin Medicine(2000). 8, 61-64 © 2000 Harcourt Publishers Ltd

Clinical trial of electrical acupuncture on hemiplegic stroke patients. American Journal of Physical Medicine & Rehabilitation 1999; 78(2): 117-122 To assess the efficacy of electrical acupuncture in the rehabilitation of patients with hemiplegia in stroke, we randomized 128 patients within 2 week of stroke onset to receive either comprehensive rehabilitation plus electrical acupuncture (n = 59) or comprehensive rehabilitation only (n = 59). Electrical acupuncture was administered by electrical stimulation of acupuncture points through adhesive surface electrodes five times per week. Neurological status (Brunnstrom's stage) and the Chinese version of the Functional Independence Measure were assessed before treatment and at discharge. Patients treated with electrical acupuncture had a shorter duration of hospital stay for rehabilitation, and better neurological and functional outcomes than the control group had, with a significant difference in scores for self-care and locomotion 6|

62 ComplementaryTherapies in Medicine (P = 0.02). This result did not postulate the previous study that acupuncture therapy for stroke patients should depend on needle manual and 'de qi' response. We suggest that electrical acupuncture through adhesive surface electrodes in conjunction with current optimal rehabilitation programmes is a convenient and effective therapy for stroke patients.

Berman BM, Ezzo J, Hadhazy V, Swyers JP. Institution: Complementary Medicine Program, University of Maryland School of Medicine, Baltimore 21207, USA.

Is acupuncture effective in the treatment of fibromyalgia? Journal of Family Practice 1999: 48(3): 213-218 Background: We conducted this study to assess the effectiveness of acupuncture in the treatment of fibromyalgia syndrome (FMS), report any adverse effects, and generate hypotheses for future investigation. Methods: We searched MEDILINE, EMBASE, Manual Therapy Information System, the Cochrane registry, the University of Maryland Complementary and Alternative Medicine in Pain, the Centralized Information Service for Complementary Medicine, and the National Institutes of Health Office of Alternative Medicine databases for the key words "acupuncture' and 'fibromyalgia'. Conference abstracts, citation lists, and letters: supplemented the search. We selected all randomized or quasi-randomized controlled trials, or cohort studies of patients with FMS who were treated with acupuncture. Methodologic quality, sample characteristics, type of acupuncture treatment, and outcomes were extracted. Statistical pooling was not performed because of the differences in control groups. Results: Seven studies (three randomized controlled trials and four cohort studies) were included; only one was of high methodologic quality. The high-quality study suggests that real acupuncture is more effective than sham acupuncture for relieving pain, increasing pain thresholds, improving global ratings, and reducing morning stiffness of FMS, but the duration of benefit following the acupuncture treatment series is not known. Some patients report no benefit, and a few report an exacerbation of FMS-related pain. Lower-quality studies were consistent with these findings. Booster doses of acupuncture to maintain benefit once regular treatments have stopped have been described anecdotally, but not investigated in controlled trials. Conclusions: The limited amount of high-quality evidence suggests that real acupuncture is more effective than shana acupuncture for improving symptoms of patients with FMS. However, because this conclusion is based on a single highquality study, further high-quality randomized trials are needed to provide more robust data on effectiveness.

CAM USAGE MehI-Madrona LE. Institution: Center for Complementary Medicine, University of Pittsburgh Medical Center, USA.

Native American medicine in the treatment of chronic illness: developing an integrated program and evaluating its effectiveness. Alternative Therapies in Health & Medicine 1999; 5(1): 36 44 Traditional Native American healing practices are increasingly sought after by Native Americans as well as non-Natives. A series of meetings between traditional Native American healers and the author resulted in dialogues on the Native American worldview and biomedicine. Recommendations arose for how Native American treatment should proceed in the modern world and how to effectively introduce interested non-Natives to Native American healing practices. An approach for bridging cultures to facilitate the interaction of nonNatives with traditional healers was developed. A total of 116 patients were treated by the author in conjunction with traditional Native American healers. More than 80% of patients showed significant, persistent benefits from a time-intensive treatment programme. A comparison group consisting of patients from the author's emergency room practice had significantly lower rates of improvement. An intensive progranune inspired by Native American practices lasting 7 to 10 days can achieve both health benefits and improved cost-effectiveness in the treatment of chronic physical illness. The treatment philosophy underlying this approach is best described as a dynamic energy system. Within this theoretical framework, physical illness, which is viewed as simultaneously spiritual, mental, and physical, can be treated by counseling and ceremony. Due to the interaction and hierarchical nature of these levels, intervention at any one level affects the others.

Cassileth BR. Institution: University of North Carolina Chapel Hill, USA. Complementary therapies: overview and state of the art. Cancer Nursing 1999: 22( 1): 85-90 Studies to determine the prevalence of complementary and alternative medicine (CAM) use among cancer patients show international interest in a wide collection of therapies and a broad span of use, ranging from 7 to 64% of patients sampled. The absence of consistent results across studies is due primarily to differing definitions of unconventional cancer therapies from study to study. Treatments promoted as alternatives to mainstream cancer cures (e.g. the recently disproved 'cancer cure' of Italy's Dr Di Bella) should be distinguished from complementary therapies, which are applied as adjuncts to mainstream care in an integrated fashion. The latter