Acupuncture may play a key role in anti-depression through
various mechanisms in depression (2024 China)
https://pmc.ncbi.nlm.nih.gov/articles/PMC11451062/pdf/13020_2024_Article_990.pdf
https://pubmed.ncbi.nlm.nih.gov/39367470
Acupuncture exerts diverse physiological effects in animal models of depression,
encompassing modulation of the brain, serum, and brain-gut axis.
These effects are attributed to various mechanisms, including anti-inflammatory and
anti-oxidative actions, promotion of neuronal plasticity, neuroprotection, neurotrophic effects, modulation of neurotransmitters, regulation of endocrine and immune functions,
and modulation of cell signal pathways. The therapeutic mechanism of acupuncture
involves the engagement of multiple targets, pathways, and bidirectional regulation.
Acupuncture as adjuvant therapy in hospitalized patients with COVID-19
(2024 Iran, Canada, China)
This randomized controlled trial was performed on 70 moderate to severe hospitalized patients with COVID-19. Patients were randomized into two groups, receiving conventional treatment alone or in combination with acupuncture for 7 days.
Both groups were followed up for 28 days.
Results:
Acupuncture significantly improved respiratory rate and SpO2 after 3 days
(v. s . 7 days in control group).
SpO2 reached 93 % from the third day of conducting acupuncture.
Respiratory symptoms were relieved after 7 days in the both groups,
but were significant from day 3 in the acupuncture group.
Duration of hospitalization was less in the acupuncture group (3 days v. s . 11 days),
with no ICU admission, intubation or death.
In contrast,
8 patients in the control group were admitted to ICU, of whom 4 were intubated and died.
No adverse effect was reported.
Conclusion: Acupuncture can play a significant role as a safe and effective complementary treatment in the management of COVID-19.
Acupuncture Treatment of a Patient with Bradycardia and
Idioventricular Rhythm
(2022 Ukraine)
https://pubmed.ncbi.nlm.nih.gov/36537118/
A patient with bradycardia and an idioventricular rhythm was observed.
According to cardiologists, there is no reliable drug treatment for bradycardia with an idioventricular rhythm; instead, the sole treatment is a pacemaker. In the course of this case,
it was shown that acupuncture can restore the heart rhythm from bradycardia to normocardia, and from idioventricular with third-degree atrioventricular node block and
an average heart rate of 34 BPM, to normal sinus rhythm with a heart rate of 71 BPM. Additionally, at the end of the treatment, the patient’s number of episodes of ventricular extrasystole decreased 36 times (3289 versus 91 episodes).
These results show that research on this technique should be continued.
Uus kliiniline juhend mitteradikulaarse alaseljavalu käsitlemiseks
www.med24.ee
22. veebruar 2017
Piret Rospu
Ameerika Arstide Kolleegium (ACP – American College of Physicians) uuendas juhiseid mitteradikulaarse ägeda, alaägeda ja kroonilise alaseljavalu mitteinvasiivse käsitluse kohta esmatasandil. Esimese liini ravi peaks olema mittemedikamentoosne; selle ebaõnnestumisel peaks kaaluma NSAID-e või lihaslõõgasteid. Opioide soovitab juhend mitte kasutada.
Äge mitteradikulaarne alaseljavalu kestab üldiselt vähem kui 4 nädalat ja harilikult möödub ise. Alaäge alaseljavalu on defineeritud kestusega 4-12 nädalat ja krooniline üle 12 nädala.
Üle 30% patsientidest raporteerivad püsivat alaseljavalu kuni 1 aasta pärast ägeda episoodi vallandumist.
Ükski ravimeetod ei ole uuringute põhjal teistest selgelt paremaks osutunud, kuid uued uuringud toetavad teadvelolekul põhineva stressi maandamise ja tai chi kasutamist kroonilise alaseljavalu puhul ning akupunktuuri kasutamist ägeda valu puhul. Farmakoteraapia puhul on uuemad uuringud näidanud paratsetamooli ebaefektiivsust ägeda valu korral ning toetavad duloksetiini kasutamist kroonilise valu puhul. Tritsüklilised antidepressandid ei ole aga platseeboga võrreldes paremust näidanud.
ACP annab järgnevad soovitused: enamus patsientidel ägeda või alaägeda seljavaluga läheb valu aja jooksul paremaks sõltumata valitud ravimeetodist ning neil tuleks vältida potentsiaalselt kahjulikke ja kalleid uuringuid ja ravivõtteid.
Ägeda alaseljavalu raviks tuleks esimeses järjekorras kasutada mittemedikamentoosseid võtteid nagu pindmine soojendamine (mõõdukas tõendus), massaaž, akupunktuur või lülisamba manipulatsioonid (madal tõendus). Mittemedikamentoossete võtete ebaefektiivsuse korral kaaluda NSAID-ravi või lihaslõõgasteid (mõõdukas tõendus).
Kroonilise alaseljavalu raviks kaaluda mittemedikamentoosseid võtteid nagu võimlemine, multidistsiplinaarne rehabilitatsioon, akupunktuur, teadvelolekul baseeruv stressi vähendamine (mõõdukas tõendus), tai chi, jooga, motoorse kontrolli treening, progresseeruv relaksaktsioon, elektromüograafia biotagasiside, madala intensiivsusega laserravi, kognitiiv-käitumisteraapia või lülisamba manipulatsioonid (madal tõendus). Mittemedikamentoossete võtete ebaefektiivsuse korral tuleks esimeses järjekorras kaaluda NSAID-ravi. Teise valikuna soovitatakse tramadooli või duloksetiini; opioide soovitatakse ainult esimese ja teise valiku ravimite ebaefektiivsuse korral patsientidel, kelle puhul kasu kaalub üles kahju.
Juhend ei käsitle toopilist ravi, epiduraalseid süsteid või COX-2 selektiivseid inhibiitoreid.
Soovitatakse ka kindlasti patsiente julgustada, et äge ja alaäge alaseljavalu möödub harilikult iseenesest.
Juhend on tasuta kättesaadav aadressil http://bit.ly/2kr2SUK.
Here’s something completely different for low back pain (2020 USA)
August 16, 2020
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
It’s a question that has challenged generations of patients and their doctors.
The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain.
This sometimes included hospital admission.
Then, research demonstrated that prolonged bedrest was actually a bad idea.
It was no better (and often worse) than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back.
Medications, including pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs),
and muscle relaxants were a standard part of the initial treatment of back pain.
But, recommendations released in February 2017 urge doctors to change
their approach to back pain once again.
Didn’t I hear that NSAIDs don’t work well for back pain?
You did. A 2017 study found that NSAIDs did not work well for back pain.
But, recommendations released that same year take that conclusion even further:
it may be best to avoid medications altogether — at least at the start.
The American College of Physicians’ 2017 guidelines for the treatment of low back pain based on a review of more than 150 studies. The big news?
Medications tend to have only temporary and modest benefits,
so it makes sense to try something other than a pill.
The specifics depend on the type and duration of back pain.
For new low back pain (lasting less than 12 weeks), try:
- heat
- massage
- acupuncture
- spinal manipulation, as with chiropractic care.
If these don’t work, NSAIDs or a muscle relaxant are reasonable options. But given their potential to cause side effects and their modest benefit, they aren’t the first choice.
For chronic low back pain (lasting 12 weeks or more), try:
- exercise (including stretching, improving balance, and strengthening core muscles)
- physical therapy
- acupuncture
- mindfulness-based programs intended to cope with or reduce stress.
Other approaches, such as tai chi, yoga, or progressive relaxation techniques
may also be helpful.
If these don’t work, treatment with NSAIDs, tramadol, or duloxetine is worth consideration. However, opioids should be avoided for chronic low back pain in most cases.
It’s important to emphasize these suggestions are for low back pain that might begin after
an unusually strenuous workout or shoveling snow. It’s not for serious causes of back pain such as a major injury, cancer, infection, or fractures (see “red flag” symptoms below).
What if the pain continues?
If pain persists despite these non-medication and medication-based treatments,
your doctor may want to consider additional tests (such as MRI) or treatments.
Remember, each person’s situation is a little different,
and even medications that don’t work well on average, may work well for you.
You could see this coming?
It’s been known for years that the vast majority of low back pain goes away on its own, regardless of treatment. So, the challenge has been to find something that safely eases symptoms while waiting for improvement.
How do I know it’s nothing serious?
You don’t. But, you should be reassured that the numbers are with you.
Ninety-nine percent or more of people with low back pain do not have a serious cause.
But to help make sure your back isn’t in that small sliver of dangerous causes,
doctors use the “red flag” questions:
- Have you ever been diagnosed with cancer?
- Have you experienced unexplained or unintentional weight loss?
- Do you have an abnormal immune system (due to disease or medications)?
- Do you use intravenous drugs?
- Have you had a fever recently?
- Have you had significant injury to your back recently?
- Have you had bladder or bowel incontinence?
These questions and a physical examination are intended to identify factors that would increase the chances that your back pain is due to infection, tumor, or other serious cause.
So, what?
These guidelines endorse an approach to treating a common ailment that only a few years ago would have seemed outrageous. The remedies recommended are not brand new;
but discouraging medication use as an initial step is a big departure from prior recommendations. An email alert I received just after these guidelines were published included the headline: “Take two yoga classes and call me next month?” It may not be such a bad idea!
Medical practice rarely changes right away, and these guidelines may have relatively little impact in the short run. But I would not be surprised if non-pharmacological treatment of back pain becomes the norm over time. Many of my patients already seek out these treatments regardless of whether I recommend them.
After all, the “usual” medications for low back pain are not all that effective and
often cause trouble. It’s time we recognize that there are other, better ways to help.
Acupuncture impacts same biologic pathways in rats
that pain drugs target in humans (2015 USA)
http://www.sciencedaily.com/releases/2015/07/150721134820.htm
In animal models, acupuncture appears to impact the same biologic pathways ramped up
by pain and stress, analogous to what drugs do in humans.
The researchers say their animal study provides the strongest evidence to date
on the mechanism of this ancient Chinese therapy in chronic stress.
Acupuncture improves effectiveness of standard treatment
for chronic pain and depression (2017 UK)
https://www.news-medical.net/news/20170130/Acupuncture-improves-effectiveness-of-standard-treatment-for-chronic-pain-and-depression.aspx
Health specialists at the University of York have found than acupuncture treatment
can boost the effectiveness of standard medical care,
lessening the severity of chronic pain and depression.
Nõelravi aitab leevendada kroonilist valu (2013 USA)
USA: Nõelravi lisamine tavaravile võimaldab vähendada valu ja parandada elukvaliteeti.
495 patsiendist sai nõelravi 226; kõige sagedasem põhjus alaseljavalu, järgnes osteoartriit. Patsiendid olid eakad, said sageli puude tõttu abiraha, neil oli halb tervislik üldseisund ja
kõrge valufoon. Nõelraviseansid toimusid 1 x nädalas, tehti keskmiseselt 9, 7 raviseanssi.
Nii 12 kui ka 24 nädalat hiljem oli seisund oluliselt algfoonist parem- valu tunduvalt nõrgem
ja füüsiline üldseisund parem.
Outcomes of acupuncture for chronic pain in urban primary care.
J Am Board Fam Med. 2013 Nov-Dec;26(6):692-700.
www.ncbi.nlm.nih.gov/pubmed/24793257
Nõelravi on efektiivsem kui ravivõimlemine
Achilleuse kõõluse põletiku puhul (2012 Hiina)
Hiina uuringus osales 64 patsienti, kes jagati randomiseeritult nõelravi- või ravivõimlemisgruppi.
Nõelravi toimel taandus valu ja paranes kõõlusefunktsioon oluliselt paremini.
Acupuncture for chronic achilles tendinopathy: A randomized controlled study.
Chin J Integr Med. 2012 Dec 21. [Epub ahead of print]).
Nõelravi ja taimravi aitavad kehakaalu langetada (2012)
Nõelravi ja hiina taimravi toime kehakaalu langetamisele ületab platseebo ja elustiili muudatuste oma. 49 hiina taimravi uuringu, 44 nõelravi uuringu ja 3 kombineeritud ravi uuringu analüüs näitas, et hiina taimravi ja nõelravi mõju sarnaneb
nn lääne rasvumisvastaste ravimite mõjule, kuid kõrvaltoimeid on vähem.
A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. Obes Rev. 2012 May;13(5):409-430.
Nõelravi leevendab ebaselgeid sümptomeid (2011)
Inglismaal läbiviidud uuring näitas, et nõelravi võib anda märgatava ja püsiva kergenduse haigetele, kes pöörduvad sageli esmatasandi arsti poole meditsiiniliselt raskestiselgitatavate kehaliste sümptomite tõttu.
Tavameditsiinile nõelravi lisamisel püsis paranenud tervislik seisund ja heaolu 12 kuu vältel.
Acupuncture for ‘frequent attenders’ with medically unexplained symptoms:
a randomised controlled trial (CACTUS study).
Br J Gen Pract. 2011 Jun;61(587):295-305.
Teine artikkel kirjeldas uuringust osavõtnute suhtumist. Patsiendid hindasid, et võeti aega nendega suhtlemiseks, raviseansid olid interaktiivsed ja holistilised. Paljusid patsienti aktiveeriti võtmaks osa oma ravist ja muutma oma elustiili. Osalejad tõid välja laialdase spektriga positiivsed muutused tervises k.a suurenenud füüsiline ja mentaalne aktiivsus, suurenenud enesekontrolli võime, rahulikkus ja relaksatsioon.
Traditional acupuncture for people with medically unexplained symptoms:
a longitudinal qualitative study of patients’ experiences.
Br J Gen Pract. 2011 Jun;61(587):306-315.
Põlveliigese osteoartriit (2004 USA)
Marylandi Ülikooli Meditsiinikoolis 570 põlveliigese artriiti põdeval patsiendil läbiviidud pikaajaline uuring näitas, et nõelravi toimel vähenes valu põlves 40 % ja
põlveliigese funktsioon paranes ligikaudu 40 %.
Uuringut rahastasid NCCAM ja National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), mis mõlemad kuuluvad US National Institutes of Health koosseisu.
Stephen E. Strauss, NCCAM Director:
“Need tulemused näitavad, et akupunktuur võib olla efektiivseks täienduseks tavaravile
ja parandada põlveliigese osteoartriidi käes vaevlejate elukvaliteeti.”
Ann Intern Med, Dec 2004; 141: 901-910.