Happy x-mas and wonderful new year!

Acupuncture and Chinese herbs as treatment for depression: An Australian pilot study

Source: http://www.ncbi.nlm.nih.gov/pubmed/23059435

Abstract

AIMS:

Aims were to determine the effectiveness of acupuncture and Chinese herbs as treatments for depression, and to assess beliefs, attitudes and treatment experience.

METHOD:

Participants received acupuncture or acupuncture and Chinese herbs combined for five weeks. Acupuncture was given for 30min twice a week and herbs taken three times a day. A Beliefs and Attitudes questionnaire was administered at baseline and Treatment Experience questionnaire post treatment. Outcome measure was improvement in depressive symptoms at the end of treatment period.

RESULTS:

Nineteen participants completed 5 weeks of treatment, 12 in the acupuncture group and 7 in the combined group. Treatment significantly improved depressive symptoms, however, there were no differences between groups. At baseline, participants were positive about the perceived effectiveness of treatment, and treatment experiences were positive.

CONCLUSIONS:

Acupuncture was effective in reducing depressive symptoms. However, herbs did not have an additional treatment effect. Beliefs and attitudes were positive.

Acupuncture may prevent muscle loss in elderly and patients

A team of researchers from Japan have found that acupuncture therapy may benefit the elderly

and patients who suffer from poor mobility due to loss of skeletal muscle mass, a condition

known as skeletal muscle atrophy.

Muscle atrophy is common in the elderly and patients who go through extended periods of

inactivity, such as when a limb is put in a cast or being bed-ridden due to a prolonged illness.

The condition can also be caused by many diseases such as cancer and liver failure.

Skeletal muscle loss prevents sufferers from performing certain tasks and increases the risk of

accidents while engaging in daily activities such as walking.

Although interventions such as exercise and an improved diet are recommended, these are

challenging to maintain as patients are often frail and have severe medical conditions.

This motivated Akiko Onda, a graduate student from Waseda University who has been studying

skeletal muscle atrophy for the last four years, and her team to turn to acupuncture.

In their study, which was presented last week at the Experimental Biology 2012 meeting in

San Diego, USA, the team found that acupuncture can reverse muscle mass loss in mice. Their

findings also suggest a molecular mechanism for this effect.

“The main focus of this study is changes in the mRNA expression levels of muscle-specific

atrophic genes such as atrogin-1,” said Onda.

They found that mRNA expression level of the E3 ubiquitin ligase atrogin-1 is lowered when

muscle mass is lossed, and this decrease is significantly reversed by acupuncture.

Although acupuncture has been endorsed by the World Health Organization and is used in

treating various diseases, it is still not widely accepted. Part of the reason is that many are

skeptical about whether acupuncture really works, as the underlying molecular mechanisms of

this traditional Chinese treatment are still largely unknown.

Onda hopes that her team’s findings will help pave the way for acupuncture to be recognized as

an efficacious treatment for muscle atrophy.

“Further investigations into its molecular mechanisms will help to decrease the medical

community’s suspicion of acupuncture and provide us with a better understanding of how

acupuncture treatment prevents skeletal muscle atrophy,” said Onda.

Acupuncture and Chinese herbs as treatments for depression: An Australian pilot study

Source: http://www.ncbi.nlm.nih.gov/pubmed/23059435

Abstract

AIMS:

Aims were to determine the effectiveness of acupuncture and Chinese herbs as treatments for depression, and to assess beliefs, attitudes and treatment experience.

METHOD:

Participants received acupuncture or acupuncture and Chinese herbs combined for five weeks. Acupuncture was given for 30min twice a week and herbs taken three times a day. A Beliefs and Attitudes questionnaire was administered at baseline and Treatment Experience questionnaire post treatment. Outcome measure was improvement in depressive symptoms at the end of treatment period.

RESULTS:

Nineteen participants completed 5 weeks of treatment, 12 in the acupuncture group and 7 in the combined group. Treatment significantly improved depressive symptoms, however, there were no differences between groups. At baseline, participants were positive about the perceived effectiveness of treatment, and treatment experiences were positive.

CONCLUSIONS:

Acupuncture was effective in reducing depressive symptoms. However, herbs did not have an additional treatment effect. Beliefs and attitudes were positive

Acupuncture another option when facing depression

Source: http://www.dailyherald.com/article/20120903/entlife/709039967
Last week, I had an interesting discussion with several friends. The topic was "depression.” The questions asked were do antidepressants really work, what are the alternatives to prescription medications and do they work as well as medications. Depression has become so widespread that antidepressants are now the most commonly prescribed class of medication in the U.S. Over the past 20 years, the percent of Americans taking antidepressants doubled. Currently, 1 in 10 Americans is taking one or more antidepressants.
Depression is believed to be the result of chemical imbalances in the brain, especially low levels of the neurotransmitter serotonin. Depression is commonly divided into three subdivisions: mild, moderate and severe. Recent published medical research has demonstrated that prescription antidepressants work best for those who have severe depression but for mild to moderate depression, antidepressants do not seem to be any more effective than a "sugar pill” or placebo. That does not mean that antidepressants are not effective, but it does suggest that there are many factors that contribute to depression, not just changes in brain neurotransmitters. For many, antidepressant medications may not be the best option.
A recent study in the Canadian Journal of Psychiatry suggests that acupuncture, as a stand-alone therapy, may be quite effective for mild to moderate depression. This particular study was a compilation of several different studies looking at the effectiveness of acupuncture at relieving the symptoms of mild to moderate depression. These studies looked at many different kinds of acupuncture including traditional acupuncture with needles, electro-acupuncture as well as laser acupuncture.
It also included a wide segment of the population from very young to very old. Putting all these studies together they found that acupuncture is at least as effective as antidepressant medications and when used in conjunction with antidepressants, acupuncture may also reduce many of the medication side effects.
How acupuncture works is a topic of much conjecture. From a Western medicine perspective, acupuncture can increase the levels of a number of different neurotransmitters and, theoretically, changes in neurotransmitter levels influence the length and duration of a depressive episode.
According to traditional Chinese medicine however, depression may be the result of a "dysregulation” of the seven emotions — joy, anger, worry, contemplation, grief, fear and shock. If acupuncture is able to reestablish a balance among these emotions, the symptoms of depression are relieved. Either way, the current medical literature suggests that acupuncture is an effective therapy for mild to moderate depression.
Although the medical research is compelling, the weight of medical research on acupuncture and depression is not conclusive. However, medical research has also demonstrated that other simple approaches such as relaxing exercise, stress reduction, meditation and yoga can be beneficial in mild to moderate depression.
An ancient Chinese curse is "May you live in interesting times.” These certainly are interesting times and it is not surprising that mild to moderate depression is increasingly seen in many medical practices (including mine). It is good to have effective alternatives to more medication.

TREATING PERIPHERAL NEUROPATHIES WITH ACUPUNCTURE

Peripheral Neuropathies, also called Polyneuropathies include all disorders in which nerve structures outside the spinal cord are affected. With more than 100 types of Peripheral neuropathies in existence, each with its own characteristic set of  symptoms, pattern of development, and prognosis, the symptoms can vary as much as the cause.

In most cases, Peripheral neuropathy is secondary to other conditions such as, diabetes, lupus, rheumatoid arthritis, alcoholism, nutritional deficiencies, AIDS, chemotherapy, and various drugs.

Other causes include compression or entrapment (carpal tunnel syndrome), direct physical injury to a nerve (trauma), fractures or dislocated bones, tumors, radiation and even exposure to cold.

For some people it is experienced as the uncomfortable sensation of “ pins and needles” or burning pain (especially at night) of their hands and/or feet, a loss of feeling, others may suffer more extreme symptoms such as muscle wasting, paralyses, or organ dysfunction.

Sensory symptoms:

Sensory symptoms arte the most common presentation of peripheral neuropathy and can be considered as positive ( tingling, burning and pain) or negative (loss of touch and temperature) in general feet and legs are involved before hands and arms.

 Motor symptoms:

Motor symptoms such as weakness are less common than sensory symptoms. Most motor symptoms begin as gait and balance difficulties. When weakness becomes significant, people tend to develop loss of dorsiflexion (dropfoot).

As many as 60-90% of diabetics suffer from peripheral neuropathy, however, western medicine does not have a truly effective treatment for this condition.

One of the most common treatments for  peripheral neuropathy is the administration of amitriptyline (An antidepressant). Some of its side effects are headaches, dizziness, skin rashes, hepatitis, fluctuations in blood sugar levels, palpitations and even Peripheral neuritis! Clearly not the best treatment option.

Other treatments tend to concentrate on pain management and include analgesics such as Aspirin, paracetemol and NSAIDS.

Chinese medicine approach:

As I have written many times before, in Chinese medicine, no matter what the disease, a patient will be treated according to his or her specific pattern of disharmony. We treat a person with a disorder, not the disorder the person has.

Common patterns of disharmony in Peripheral neuropathy are obstruction of Qi and blood and dampness in the limbs. This can be due to irregular eating, wrong diet, too much alcohol, excessive tiredness or chronic diseases.

Acupuncture helps peripheral Neuropathy by improving the circulation and moving Qi and blood to the extremities. The nerve tissue can be nourished and nerve function improved. Chinese herbs quite often form part of the standard treatment.

In a study involving 46 diabetic patients with Peripheral neuropathy, 34 of them reported significant improvement in their symptoms after a series of acupuncture treatments.

A larger study of 250 patients with HIV related Peripheral neuropathy (PN) found similar results.

If you suffer from PN, maybe you should give  Chinese medicine a go. It may help you or it may not. At least there are no significant side effects!

Chinese medicine and research

Over the last twenty five years there has been a lot of research on the effects of Acupuncture, Chinese herbs and even disciplines like ¨Qi Gong¨. Some of the research tells us the things that we in the Chinese Medicine community want to hear, that it works for a given condition.

Other times, the research does not support the time tested approaches that have arrived here from the East.

It should be noted however that research has also been going on in the East over the past 2.000 years in the form of time testing and the wisdom of the marketplace. There are many therapeutic approaches that have fallen out of favour over the past 2.000 years because they simply did not produce the intended results. In some ways, this long-term approach is actually more scientific than the unnatural short-term placebo-controlled research made famous by the pharmaceutical companies.

This kind of research of long-term research is really closer to economics or Darwinian evolution than biomedicine.  Essentially, over the past 2.000 years, the therapies that worked withstood the test of time. If they did not work, we wouldn’t get any patients, colleges would have no students and the therapy would simply disappear.

When we give an Acupuncture treatment that is designed only to stimulate the movement of Qi (energy) in the body, many aches and pains will be ameliorated. When modern Western medicine attempts to determine when to take away the pain they’ll look towards the brain’s release of endorphins, the body’s own painkillers. They’ll take pictures of more active areas of the brain during an Acupuncture treatment, they’ll chemically block certain pain relieving tracts in the spinal cord or on a cell’s surface to see if that effects the Acupuncture treatment. What is really strange for them is that wherever they look, they find something! There is seemingly no end to the scientific mechanism of Acupuncture.

I believe that this is consistent with the holistic idea that maintains the coherence of Chinese Medicine. Acupuncture’s effect is not limited to any given system, whether we are talking about the nervous system, cardiovascular, hormonal or any other. Acupuncture affects them all at the same time! Again, that is because Chinese Medicine doesn’t act exclusively on the tiniest of human structures, but the larger whole person.

Chinese Medicine also has a great deal to offer the Western discipline of internal medicine. In fact, a whole lot more than the ¨pain control¨ applications that have been accepted over the last 25 years or so in the Western Medical community. Bearing in mind that 32 years ago when I started practicing that was even looked at as silly. Hopefully, in another 10 years we will see greater acceptance of Chinese Medicine’s true genius, and that is in the area of internal medicine.

Within both Chinese Medicine and Western Medicine there is an enormous amount of time tested information that has its own logic and usefulness. Both Western and Chinese Medicine have their place. Some believe that the greatest strength of Western Medicine is in it’s trauma care and treating acute conditions, where as Chinese Medicine excels in the area of chronic conditions and preventative medicine.

Using both Western and Chinese Medicine complimentary provides for better clinical outcomes then using either of them separately.

Acne in Chinese medicine

General information:

Acne is an unpleasant disorder of the skin that usually occurs during adolescence. It begins at puberty when, due to hormonal changes, the oil-secreting glands in the skin increase in size and become more active. The oil released by the glands helps remove old skin and keeps your skin soft.

Some of these glands become blocked, and the normal secretion (sebum) is trapped inside. It becomes thick and hard as it dries out and may also become infected. The gland, along with the surrounding tissue becomes swollen, red and itchy or painful and develops a pus- filled ¨head¨ This is the typical whitehead.

The other type is the blackhead , which is usually smaller and is simply the swollen outer opening of the gland filled with dried sebum.

Acne usually occurs on the face, neck and shoulders and tends to clear up during late adolescence or early adulthood.

Acne tends to run in families. It may be triggered by:

Greasy or  oily cosmetics and hair products, certain drugs like steroids,estrogen and phenytoin and humidity and sweating.

 Some other aggravating factors include: Food allergies, other diseases, cortisone therapy, vitamin deficiency, ingestion of halogens (chlorine, fluorine, or iodine), contact with various chemicals (such as tar or chlorinated hydrocarbons) and psychological factors such as stress, worry and depression.

Traditional Chinese perspective:

According to Traditional Chinese Medicine (TCM) there are several different types of Acne; it is not simply a single disease that requires a uniform treatment. Two major factors are taken into consideration: one is the person’s body type or constitution, and the other includes all of the different external influences which affect the development of the disorder such as diet, environment, climate, life-style, mental and emotional state and medications.

Each individual’s body has different strengths and weaknesses and different tendencies towards imbalance. Often two people will react in completely different ways to the same thing, e.g. eating a bar of chocolate or being exposed to hot humid conditions like we sometimes have here. Therefore the TCM practitioner aims to understand the root of the problem (which is the individual’s basic constitutional make-up) as well as to distinguish which particular type of Acne the patient has.

In terms of TCM, Acne develops usually because of an excessive build up of internal heat. This heat may arise due to a combination of internal and external factors. Those who suffer most from acne generally have a constitution which predisposes them to become “overheated”. This may show itself in different ways, e.g. a low tolerance for hot temperatures, strong reaction to certain foods (such as hot spices, seafood or chocolate), or often having high temperatures when ill.

TCM treatment addresses both the Acne and the person’s underlying constitution, concentrating mainly on the symptoms in the beginning. Later on, once the symptoms have been relieved, treatment is aimed mainly at correcting the underlying constitutional imbalance and preventing recurrence.

The time it takes for successful treatment varies from person to person, but, like all skin conditions takes time and patience. In my practice I treat this condition with a combination of Acupuncture and Chinese Herbal medicine.

ACUPUNCTURE  DURING PREGNANCY AND LABOUR:

You may be thinking of falling pregnant, are pregnant, or know someone special who is pregnant. This is an extremely exciting period during which the body undergoes major changes, nurtures a precious life and prepares for a healthy delivery of a baby. Research has shown that Acupuncture can be very beneficial during pregnancy and labour. According to the World Health Organisation (WHO) Acupuncture has been found useful for nausea, vomiting and significantly reduces the duration of labour  and labour pains. There is also strong evidence that Acupuncture can help with a breached birth.

The most common complaints pregnant women present to our clinic are:

-          Morning sickness                             - Recurrent miscarriage

-          Heartburn                                           - Threatened miscarriage

-          Haemorrhoids                                   - Oedema (fluid retention)

-          Sinus and mucosal congestion    - Hypertension

-          Anxiety, depression                       - Insomnia

-          Musculoskeletal conditions         - Constipation

(low back pain, sciatica, pubic symphysis pain etc.)

ACUPUNCTURE DURING PREGNANCY:

During the first trimester, the focus of the treatment is to reduce the likelihood of miscarriage and to address any early pregnancy symptoms such as nausea, morning sickness and fatigue.

Acupuncture during the second semester aims to maintain the balance and address  many of the common complaints of pregnancy mentioned above.

Acupuncture during the third trimester prepares the body for labour and delivery by relaxing and softening ligaments, aiding cervical dilation, nourishing the body’s ‘’Qi’’ and blood, as well as relieving any muscular pain or discomfort. This is also the time where Acupuncture is used to turn breach babies.

It is recommended to start this treatment as soon as you learn that the baby is in breach position (around 33-36 weeks)

During the whole pregnancy, special attention will be given at diet and lifestyle.

ACUPUNCTURE  FOR LABOUR INDUCTION:

Treatment for labour induction can be given any time after 39 weeks if there are no complications with the pregnancy.

Acupuncture for delayed labour has been used in China for at least 2300 years, but Acupuncture for labour pain was rarely used because, according to Chinese culture and oriental tradition, women were expected to experience the pain of childbirth! The first occurrence in Chinese medical literature was in 1970 in ‘A barefoot doctor’s manual’ (my first book on Acupuncture),

The manual drew on the practical expertise of local health workers, often self-taught, who went from house to house to administer medical attention in the form of Acupuncture and herbal medicine.

It was around the same time the interest in Acupuncture Analgesia became the focus of much research in Europe and the western world in general.

In 1972 Christian Ehrstroem performed the first Acupuncture delivery in the west in Stockholm.

In 1974 Darras in France reported 20 electro-acupuncture deliveries by  primiparea and multiparea.

Since then, Acupuncture has rapidly become more popular for women in childbirth, mainly because it is a natural pain-reliever with no harmful side effects for mother or baby. Moreover, women like to feel in control during their labour and delivery, a feeling of which they may be deprived by some of the more potent conventional analgesic techniques used in today’s maternity units.

ACUPUNCTURE FOR DIFFICULT LABOUR

Acupuncture  is also used in difficult labour. Difficult labour can result from abnormality of the uterine contractions, cephalo-pelvic disproportion (that is imbalance between the size of the maternal pelvis and the baby’s head), or malposition and malpresentation of the baby.

Acupuncture can be of help in the first of these, but not the others. It is important to note that ‘malposition’ of the baby should not be confused with ‘malpresentation’, the latter occurs  when the baby’s bottom (breach), shoulder, face or brows present first, as opposed to the head as in normal cephalic presentation. ‘malposition’ means incorrect positioning of the head, which includes occipito-posterior position and deflection of the head. Acupuncture can help in ‘malpresentation’, but not ‘malposition’!!