The greatest worth is self-mastery.
The greatest quality is seeking to serve others.
The greatest precept is continual awareness.
The greatest medicine is the emptiness of everything.
The greatest action is not conforming with the worlds ways.
The greatest magic is transmuting the passions.
The greatest generosity is non-attachment.
The greatest goodness is a peaceful mind.
The greatest patience is humility.
The greatest effort is not concerned with results.
The greatest meditation is a mind that lets go.
The greatest wisdom is seeing through appearances.” —Atisha (11th century Tibetan Buddhist master)
Wall Street Journal,High-Tech Tools Show How Acupuncture Works in Treating Arthritis, Back Pain, Other Ills
Did you hear that winter’s over? The basil and the carnations cannot control their
The nightingale, back from his wandering, has been made singing master over the birds.
The trees reach out their congratulations.
The soul goes dancing through the king’s doorway.
Anemones blush because they have seen the rose naked.
Spring, the only fair judge, walks in the courtroom, and several December thieves steal
Last year’s miracles will soon be forgotten.
New creatures whirl in from non-existence, galaxies scattered around their
Have you met them? Do you hear the bud of Jesus crooning in the cradle?
A single narcissus flower has been appointed Inspector
A feast is set.
Listen: the wind is pouring wine!
Love used to hide inside images: no more!
The orchard hangs out its lanterns.
The dead come stumbling by in shrouds.
Nothing can stay bound or be imprisoned. You say, “End this poem here,
and wait for what’s next.”
Poems are rough notations for the music we are.” —Rumi
OBJECTIVE: To review strategies and recommendations to improve utilization of acupuncture treatment for side effects of chemoradiation therapy in cancer centers.
DATA SOURCES: Research studies and articles, government reports, and author experience.
CONCLUSION: Recent evidence in clinical research indicates that acupuncture is beneficial for chemotherapy-induced nausea, vomiting, and cancer pain. Other preliminary data also suggests acupuncture might be effective for chemotherapy-induced leukopenia, postchemotherapy fatigue, radiation therapy-induced xerostomia, insomnia, and anxiety. However, the utilization rate of acupuncture remains low despite the wide use of other complementary and alternative medical therapies among cancer patients. This low usage of acupuncture in cancer patients indicates a health care quality issue.
IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to increase their awareness of the available evidence in the use of acupuncture in the supportive care of cancer patients.
Seminars in oncology nursing 2005; 21:190-5.
Note: Migraines are helped by Acupuncture: This study shows that for physical role functioning, energy, and change in health, acupuncture was more effective than “usual care” by General Practitioners in the UK and Wales.
OBJECTIVE: To determine the effects of a policy of “use acupuncture” on headache, health status, days off sick, and use of resources in patients with chronic headache compared with a policy of “avoid acupuncture.”
DESIGN: Randomised, controlled trial.
SETTING: General practices in England and Wales.
PARTICIPANTS: 401 patients with chronic headache, predominantly migraine. Interventions Patients were randomly allocated to receive up to 12 acupuncture treatments over three months or to a control intervention offering usual care.
OUTCOME MEASURES: Headache score, SF-36 health status, and use of medication were assessed at baseline, three, and 12 months. Use of resources was assessed every three months.
RESULTS: Headache score at 12 months, the primary end point, was lower in the acupuncture group (16.2, SD 13.7, n = 161, 34% reduction from baseline) than in controls (22.3, SD 17.0, n = 140, 16% reduction from baseline). The adjusted difference between means is 4.6 (95% confidence interval 2.2 to 7.0; P = 0.0002). This result is robust to sensitivity analysis incorporating imputation for missing data. Patients in the acupuncture group experienced the equivalent of 22 fewer days of headache per year (8 to 38). SF-36 data favoured acupuncture, although differences reached significance only for physical role functioning, energy, and change in health. Compared with controls, patients randomised to acupuncture used 15% less medication (P = 0.02), made 25% fewer visits to general practitioners (P = 0.10), and took 15% fewer days off sick (P = 0.2).
CONCLUSIONS: Acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine. Expansion of NHS acupuncture services should be considered.
British Medical Journal 2004; 328:744.
Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith CM, Ellis N, Fisher P, Van Haselen R
PURPOSE: During the last 30 years, auricular acupuncture has been used as complementary treatment of cancer pain when analgesic drugs do not suffice. The purpose of this study is to examine the efficacy of auricular acupuncture in decreasing pain intensity in cancer patients.
PATIENTS AND METHODS: Ninety patients were randomly divided in three groups; one group received two courses of auricular acupuncture at points where an electrodermal signal had been detected, and two placebo groups received auricular acupuncture at points with no electrodermal signal (placebo points) and one with auricular seeds fixed at placebo points. Patients had to be in pain, attaining a visual analog score (VAS) of 30 mm or more after having received analgesic treatment adapted to both intensity and type of pain, for at least 1 month of therapy. Treatment efficacy was based on the absolute decrease in pain intensity measured 2 months after randomization using the VAS.
RESULTS: The main outcome was pain assessed at 2 months, with the assessment at 1 month carried over to 2 months for the eight patients who interrupted treatment after 1 month. For three patients, no data were available because they withdrew from the study during the first month. Pain intensity decreased by 36% at 2 months from baseline in the group receiving acupuncture; there was little change for patients receiving placebo (2%). The difference between groups was statistically significant (P <.0001).
CONCLUSION: The observed reduction in pain intensity measured on the VAS represents a clear benefit from auricular acupuncture for these cancer patients who are in pain, despite stable analgesic treatment.
Journal of Clinical Oncology 2003; 21:4120-6.
PURPOSE: To determine whether improvement in postchemotherapy fatigue following acupuncture treatment is substantial enough to warrant a controlled trial.
PATIENTS AND METHODS: We accrued patients at Memorial Sloan-Kettering Cancer Center who had completed cytotoxic chemotherapy but experienced persisting fatigue. Patients with severe anemia, clinical depression, or Karnofsky performance status score less than 70 were excluded. Thirty-seven patients were registered in two cohorts; 31 provided follow-up data. Patients received acupuncture either twice per week for 4 weeks (25 patients) or once per week for 6 weeks (12 patients). The primary end point was change in score on the Brief Fatigue Inventory between baseline and 2 weeks after the final treatment. A baseline Brief Fatigue Inventory score of four or greater was an eligibility requirement for the trial.
RESULTS: Patients had completed cytotoxic chemotherapy an average of more than 2 years previously. Baseline fatigue scores were high, with approximately half of the sample scoring in the “severe” range. Mean improvement following acupuncture was 31.1% (95% CI, 20.6% to 41.5%), meeting our prespecified criterion for declaring acupuncture worthy of further study. Increasing age was associated with poorer response and failure to complete the study. There was no important difference in improvement following once-weekly and twice-weekly treatments.
CONCLUSION: Acupuncture is worthy of further study in the treatment of postchemotherapy fatigue.
Journal of Clinical Oncology 2004; 22:1731-5.
OBJECTIVE: To observe the clinical effects of acupuncture for allergic rhinitis.
METHODS: The body acupuncture, auricular seed-embedding and microwave irradiation were adopted for treatment of allergic rhinitis due to various causative factors, such as cold and insufficiency of the lung-qi weakening the body resistance, insufficiency of the spleen-qi with lucid yang failing to rise, insufficiency of the kidney-yang failing to warm the body surface, and the heat accumulated in the lung channels giving invading the nose.
RESULTS: After treatment, the symptoms and signs disappeared in all illustrative cases, with no recurrence found after a one-year follow-up.
CONCLUSION: Acupuncture may help to improve the blood histology indexes with an increased volume of blood flow, and regulate the immunological function of the human body, thus giving therapeutic effects for allergic rhinitis.
Journal of Traditional Chinese Medicine. 2009 Sep;29(3):186-9.
Ear-Nose-Throat Department, Panshi Municipal Hospital of TCM, Panshi 132300, China.
BACKGROUND: Acupuncture is widely used in patients with allergic rhinitis, but the available evidence of its effectiveness is insufficient.
OBJECTIVE: To evaluate the effectiveness of acupuncture in addition to routine care in patients with allergic rhinitis compared with treatment with routine care alone.
METHODS: In a randomized controlled trial, patients with allergic rhinitis were randomly allocated to receive up to 15 acupuncture sessions during a period of 3 months or to a control group receiving no acupuncture. Patients who did not consent to random assignment received acupuncture treatment. All patients were allowed to receive usual medical care. The Rhinitis Quality of Life Questionnaire (RQLQ) and general health-related quality of life (36-Item Short-Form Health Survey) were evaluated at baseline and after 3 and 6 months.
RESULTS: Of 5,237 patients (mean [SD] age, 40  years; 62% women), 487 were randomly assigned to acupuncture and 494 to control, and 4,256 were included in the nonrandomized acupuncture group. At 3 months, the RQLQ improved by a mean (SE) of 1.48 (0.06) in the acupuncture group and by 0.50 (0.06) in the control group (3-month scores, 1.44 [0.06] and 2.42 [0.06], respectively; difference in improvement, 0.98 [0.08]; P < .001). Similarly, quality-of-life improvements were more pronounced in the acupuncture vs the control group (P < .001). Six-month improvements in both acupuncture groups were lower than they had been at 3 months.
CONCLUSIONS: The results of this trial suggest that treating patients with allergic rhinitis in routine care with additional acupuncture leads to clinically relevant and persistent benefits. In addition, it seems that physician characteristics play a minor role in the effectiveness of acupuncture treatment, although this idea needs further investigation.
Annals of Allergy Asthma Immunology. 2008 Nov;101(5):535-43.
Brinkhaus B, Witt CM, Jena S, Liecker B, Wegscheider K, Willich SN.
Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
OBJECTIVE: To investigate the effectiveness and safety of acupuncture in persistent allergic rhinitis (PAR)
DESIGN: Randomised, single-blind, sham-controlled trial conducted from May 2004 to February 2005.
PARTICIPANTS AND INTERVENTION: 80 patients with PAR (age, 16-70 years) were randomly assigned to receive real or sham acupuncture. After a 1-week baseline period, participants were treated twice weekly for 8 weeks and followed up for another 12 weeks. MAIN
OUTCOME MEASURES: Nasal obstruction, sneezing, rhinorrhoea and nasal itch were each self-assessed daily on a 5-point scale, and scores were aggregated weekly. The sum of the symptom scores (total nasal symptom score, TNSS) was also determined. A secondary outcome was use of PAR relief medication.
RESULTS: After 8 weeks’ treatment, the weekly mean difference in TNSS from baseline was greater with real (-17.2; 95% CI, -24.6 to -9.8) than with sham acupuncture (-4.2; 95% CI, -11.0 to 2.7) (P = 0.01). The decrease in individual symptom score was also greater with real acupuncture for rhinorrhoea (P < 0.01) but not the other symptoms. At the end of follow-up, the greater difference in TNSS from baseline in the real acupuncture group was still apparent: real, -21.0 (95% CI, -29.1 to -12.9) versus sham, - 2.3 (95% CI, -10.2 to 5.6) (P = 0.001). Moreover, the differences from baseline in all four individual symptom scores were greater for the real than for the sham group (P < 0.05). Real and sham acupuncture were both well tolerated.
CONCLUSION: Our findings suggest that acupuncture is effective in the symptomatic treatment of Persistent Allergic Rhinitis (PAR).
Medical Journal of Australia. 2007 Sep 17;187(6):337-41.
Xue CC, An X, Cheung TP, Da Costa C, Lenon GB, Thien FC, Story DF.
Division of Chinese Medicine, School of Health Sciences, World Health Organization Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, VIC, Australia.
Acupuncture has been used therapeutically in China for thousands of years and is growing in prominence in Europe and the United States. In a recent review of complementary and alternative medicine use in the US population, an estimated 2.1 million people or 1.1% of the population sought acupuncture care during the past 12 months. Four percent of the US population used acupuncture at any time in their lives.
We reviewed 31 different published journal articles, including 23 randomized controlled clinical trials and 8 meta-analysis/systematic reviews. We found evidence of some efficacy and low risk associated with acupuncture in pediatrics.
From all the conditions we reviewed, the most extensive research has looked into acupuncture’s role in managing postoperative and chemotherapy-induced nausea/vomiting. Postoperatively, there is far more evidence of acupuncture’s efficacy for pediatrics than for children treated with chemotherapy. Acupuncture seems to be most effective in preventing postoperative induced nausea in children. For adults, research shows that acupuncture can inhibit chemotherapy-related acute vomiting, but conclusions about its effects in pediatrics cannot be made on the basis of the available published clinical trials data to date. Besides nausea and vomiting, research conducted in pain has yielded the most convincing results on acupuncture efficacy.
Musculoskeletal and cancer-related pain commonly affects children and adults, but unfortunately, mostly adult studies have been conducted thus far. Because the manifestations of pain can be different in children than in adults, data cannot be extrapolated from adult research.
Systematic reviews have shown that existing data often lack adequate control groups and sample sizes. Vas et al, Alimi et al, and Mehling et al demonstrated some relief for adults treated with acupuncture but we could not find any well-conducted randomized controlled studies that looked at pediatrics and acupuncture exclusively. Pain is often unresolved from drug therapy, thus there is a need for more studies in this setting.
For seasonal allergic rhinitis, we reviewed studies conducted by Ng et al and Xue et al in children and adults, respectively. Both populations showed some relief of symptoms through acupuncture, but questions remain about treatment logistics. Additionally, there are limited indications that acupuncture may help cure children afflicted with nocturnal enuresis. Systematic reviews show that current published trials have suffered from low trial quality, including small sample sizes.
Other areas of pediatric afflictions we reviewed that suffer from lack of research include asthma, other neurologic conditions, gastrointestinal disorders, and addiction.
Acupuncture has become a dominant complementary and alternative modality in clinical practice today, but its associated risk has been questioned. The National Institutes of Health Consensus Statement states “one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same conditions.” A review of serious adverse events by White et al found the risk of a major complication occurring to have an incidence between 1:10,000 and 1:100,000, which is considered “very low.” Another study found that the risk of a serious adverse event occurring from acupuncture therapy is the same as taking penicillin. The safety of acupuncture is a serious concern, particularly in pediatrics.
Because acupuncture’s mechanism is not known, the use of needles in children becomes questionable. For example, acupoints on the vertex of infants should not be needled when the fontanel is not closed. It is also advisable to apply few needles or delay treatment to the children who have overeaten, are overfatigued, or are very weak.
Through our review of pediatric adverse events, we found a 1.55 risk of adverse events occurring in 100 treatments of acupuncture that coincides with the low risk detailed in the studies mentioned previously. The actual risk to an individual patient is hard to determine because certain patients, such as an immunosuppressed patient, can be predisposed to an increased risk, acupuncturist’s qualifications differ, and practices vary in certain parts of the world. Nevertheless, it seems acupuncture is a safe complementary/alternative medicine modality for pediatric patients on the basis of the data we reviewed.
The Journal of Pediatric Hematologic Oncology. 2008 Jun;30(6):431-42.
Jindal V, Ge A, Mansky PJ.
Division of Intramural Research, National Center for Complementary Medicine, National Institutes of Health, DHHS, Bethesda, MD, USA.
There’s this really great National Organization called “Resolve” that supports women who are struggling with infertility. Apparently a major focus is on women who are undergoing ART - Artificial Reproductive Therapy. I found that as someone who was not herself suffering from fertility issues, it was difficult to get invited to a Resolve meeting. I finally managed to attend one earlier this week in order to understand whether I’d feel comfortable sending my patients to such a meeting.
The spirit of the meeting was to me like a cult of medical technology. The references to natural reproductive therapies such as acupuncture were dismissive and minimal (I didn’t speak about acupuncture at all, as I was only there to observe). I was a bit horrified at the ‘culture’ of the meeting, to be honest. The major thrust was submitting the woman’s body to the reproductive science. The woman takes a series of drugs, starting ironically with birth control, then is put into an artificial menopause, and then hyperstimulating the follicles. (I might not have it exactly right but you have to admit, it is not really a ‘natural’ process in the IVF setting).
The women talked about the intrusive, time consuming, and expensive techniques as if everyone had great insurance coverage that would permit them to do eight (the highest number represented by a person attending the meeting) consecutive IVFs after having done multiple IUI’s.
I was overwhelmed a bit in considering how much they were spending and the impact on their poor bodies!
And then, they discussed acupuncture, and I was amazed at what they said. One woman asked if it hurt - and these were the same women who discussed this enormous syringe that is a huge gauge and 2 inches, used to deliver ‘oil’ (with progesterone?) into the buttocks or the thigh after you’ve destroyed your butt with so many injections. One woman described ‘nerve damage’ from her husband’s injecting her with the warm oil. And described a technique to numb the area with ice - but the oil has to be warm, so this is uncomfortable!
in the end, the advice from the more ‘senior’ women to the neophytes was that acupuncture was all well and good if your insurance covered it for infertility, and do be sure to have it before and after implantation because of the so-called German study, but otherwise, acupuncture is additional time and unnecessary expense.
What? Acupuncture is too expensive??? Most sessions of acupuncture might cost between $55 to $150 per session, depending on the type of establishment you select. The more upscale spa-type environment and perhaps inside a fertility clinic might be more expensive. School clinics are in the $70 range, with some discounting possible. Community acupuncture is more in the sliding scale of $15-$40 for a group session.
These women were spending roughly $10,000 - $15,000 or more on each IVF cycle, and during some parts of the process, they had to go daily to the ART clinic. Appointments were frequent and the timing so critical that even the recent DC area blizzard did not close this facility. (“They sleep there” is what the women agreed on about the staff of the clinic, when there is 3 feet of snow or other inclement weather.)
Acupuncture was even painted, obliquely, as possibly harmful to fertility. (This is not true if you are dealing with a Licensed Acupuncturist). One woman swore that her ability to even do IVF was compromised by taking over-the-counter Primrose Oil, which she declared was due to its was ‘estrogenic’ qualities. This she blamed for creating ovarian cysts which had to be aspirated, and she had to wait like 3-6 months before resuming the IVF treatments because her estrogen levels stayed too high. She had been taking it ‘forever’ she said, but it was never a problem before. (This answer was in response to a question about whether herbs suggested by an acupuncturist would be beneficial). Keep in mind that it wasn’t that her acupuncturist even suggested the Evening Primrose Oil! It was an over-the-counter home remedy she chose on her own. She used this however as an illustration of why herbal medicine might be bad.
I am sure that Resolve provides needed support to this community afflicted with infertility. I’m sad for these women, though, because I believe that acupuncture could less traumatically and much less expensively help many of these women conceive naturally within a year if not 6 months. The reason I’m sad I didn’t feel that they were in any way open to hearing about this possibility. I strongly felt that were I to suggest at any point that this was so, that they would laugh me out of the room, dismiss my statements, or throw me out!
I only made one comment - that I had read that acupuncture was thought to enhance the chances of successful implantation of IVF, and to reduce the chances of multiples (twins, triplets, etc.). I was met with a hostile glare from the woman leading the group. “I’ve never heard that!” she said. Too late, I remembered that she had twins after one round of IVF. But, with acupuncture, she didn’t have triplets or six embryos, or have to do a ‘reduction’ on the number of eggs, and she had already said that her follicles had been all-too-prolific.
I definitely found out for me that there are certain populations I am not going to pursue to persuade them about acupuncture. I do fervently believe that acupuncture can help many women labeled ‘infertile’, and even common sense natural advice (as in the book, “Making Babies”) can make a big difference for some couples. Such as, drink more water (which increases the cervical fluid’s ability to allow the sperm to swim to their destination). There’s tons of research elsewhere in my blog, which is searchable using the search bar on the right-hand side of the page.
Admittedly, this may have little to do with acupuncture. Given the apparent link, however, between the body’s past and any present disease, I started thinking, what if this is true? What if the future impacts the past and the present? It is healthy to occasionally question our assumptions.
In a controlled trial the effect of traditional Chinese acupuncture v. placebo acupuncture was evaluated in 18 patients with chronic tension headache (mean disease duration 15 years). All patients suffered from daily or frequently recurring headache, the intensity of which was recorded by the patient over a period of 15 weeks. Each patient was treated by traditional Chinese acupuncture as well as by placebo acupuncture in a cross-over design following randomization. Each period of treatment comprised six treatments. Traditional Chinese acupuncture was found to be significantly more pain-relieving than placebo acupuncture, according to the pain registration of the patients themselves. The pain reduction was 31%. Acupuncture is therefore found to be a reasonable treatment for chronic tension headache.” —
Acupuncture treatment of chronic tension headache—a controlled cross-over trial
Previous studies of acupuncture used to treat IBS indicated that quality of life had improved for IBS patients. This study measured Autonomic Nervous System (ANS) Response looking at indicators of salivary cortisol and by cardiovascular responses on a tilt table before and after 10 AC treatments. It was found that the indicators showed significant improvement in the Acupuncture group as opposed to the control (SAC = Sham ACupuncture group).
Patients with IBS were randomly assigned to receive either acupuncture (AC) or sham acupuncture (SAC) using the so-called “Streitberger needle”. QoL was measured with the functional quality of life diseases quality of life questionnaire (FDDQL) and SF-36. The effect on ANS was evaluated by measuring salivary cortisol and by cardiovascular responses on a tilt table before and after 10 AC treatments. Complete data sets of tilt table and salivary morning cortisol were available for 9 patients in the AC and 12 in SAC group.
Note that “N” is a small number, which to me means that that a larger study is needed.Results
QoL increased in both groups (p
0.001) with no group differences. Salivary cortisol decreased in all groups (F
0.006). However, the decrease was more pronounced in the AC group (F
0.033) (ANOVA repeated measures model). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (F
0.005), indicating an increased parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (F
0.006), but not in the SAC group.
In a small randomized clinical trial, breast cancer patients experiencing joint pain and stiffness from aromatase inhibitor (AI) treatment reported an improvement in pain from acupuncture. Eighty percent of women receiving acupuncture reported at least a 2-point improvement on a 10-point pain scale, compared with 22 percent of women who received a sham treatment. These results were published January 25 in the Journal of Clinical Oncology.
“To our knowledge,” concluded the authors, “this report is the first randomized, placebo-controlled trial establishing the use of an intervention to control AI-related joint symptoms, which should be confirmed in a larger randomized trial.”” —Journal of Clinical Oncology