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Electroacupuncture Reduces Uterine Artery Blood Flow Impedance in Infertile Women

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Abstract

To evaluate the effects of electroacupuncture (EA) on pregnancy rate and uterine artery blood flow impedance in patients undergoing in vitro fertilization (IVF). This prospective, randomized trial was carried out in the IVF center of China Medical University Hospital in Taiwan, from February 1, 2004 to January 30, 2005. A total of 44 patients were enrolled in the study. Of these, 30 were allocated to acupuncture, and 14 were allocated to no acupuncture. EA was performed four times, twice a week for 2 weeks, from day 2 of the study to the day before oocyte retrieval. After patients felt the needle reaction, the needles were attached to an electrical stimulator for 30 minutes. Clinical pregnancy and pulsatility index (PI) of right and left uterine arteries before and after EA were measured. There was no significant difference in pregnancy rate between the two groups (acupuncture group, 30%; non-acupuncture group, 28.6%). The mean PI of both uterine arteries was significantly reduced after EA (left uterine artery, 2.3 to 2.0; right uterine artery, 2.4 to 2.2). There was no significant change in PI in the group with no acupuncture (left uterine artery, 2.5 to 2.3; right uterine artery, 2.4 to 2.3). EA could be useful for reducing uterine artery blood flow impedance, but did not increase the pregnancy rate in patients undergoing IVF.
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... Thus, 14 RCTs with a total of 1,564 participants met the inclusion criteria. Twelve (14,16,20,(33)(34)(35)(36)(37)(38)(39)(40)(41) studies were conducted in China [ten studies (14,20,33,34,(36)(37)(38)(39)(40)(41) were from the mainland, China and two were (16,35) from Taiwan, China], and two (13,42) were from Germany. Table 1 shows the characteristics of RCTs included in the review. ...
... Thus, 14 RCTs with a total of 1,564 participants met the inclusion criteria. Twelve (14,16,20,(33)(34)(35)(36)(37)(38)(39)(40)(41) studies were conducted in China [ten studies (14,20,33,34,(36)(37)(38)(39)(40)(41) were from the mainland, China and two were (16,35) from Taiwan, China], and two (13,42) were from Germany. Table 1 shows the characteristics of RCTs included in the review. ...
... The duration of the acupuncture sessions differed among trials ( Table 1). Three studies (13,16,42) conducted two sessions around ET and one study (35) conducted 4 sessions during COH. Some women received acupuncture for almost one menstrual cycle [acupuncture was performed for 1 month before FET in one study (38) and during FET in three studies (36,39,40)]. ...
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Background Progress has been achieved by using acupuncture widely for poor endometrial receptivity (PER). However, different acupuncture dosages may lead to controversy over efficacy. Objective To evaluate the evidence-based conclusions of dose-related acupuncture on infertile women with PER. Method References were retrieved from nine databases from inception to 26 February 2022. This meta-analysis included randomized controlled trials (RCTs) that investigated the dose-related efficacy of acupuncture for PER with outcomes of endometrium receptivity (ER) parameters by transvaginal sonography (TVS) and the subsequent pregnancy outcomes in three acupuncture-dose groups: the high-dosage group (three menstrual cycles), the moderate-dosage group (one menstrual cycle), and the low-dosage group (two or four days). Since there remained sufficient heterogeneity among the three subsets, we prespecified seven subgroup variables (four clinical and three methodological) to investigate the heterogeneities. Results A total of 14 RCTs (1,564 women) of moderate or low overall quality were included. The results were different when the dosage of acupuncture was restricted. For the moderate or high-dosage group, CPR and part of ER parameters were improved in the acupuncture group (i.e., CPR: OR = 2.00, 95% CI [1.24, 3.22], p = 0.004, I ² = 0% in one menstrual cycle; OR = 2.49, 95%CI [1.67, 3.72], p < 0.05, I ² = 0% in three menstrual cycles). However, for the low-dosage group, no statistical difference was observed in CPR (OR = 0.07, 95% CI [−0.10, 0.23], p = 0.44, I ² = 82%) and a part of the ER parameters. In subgroup analysis, four subgroup variables (the routine treatment, risk of performance bias, duration of acupuncture treatment, and the age of participants) could explain some of the heterogeneities across all trials. Conclusion The finding indicated that the trend of relatively more acupuncture dosage showed better effects for poor endometrial receptivity among PER women. It remains a potential heterogeneity in our studies. Further high-quality trials with a homogeneity trial design need to be conducted.
... Previously, Paulus et al. conducted a randomized trial (RCT), showing that acupuncture, compared with control treatment involving standard care, doubled the odds of becoming pregnant [6]. Acupuncture may improve pregnancy rates and reduce the levels of stress, anxiety, and depression [7][8][9][10]. However, systematic reviews have produced conflicting findings [11][12][13][14][15][16][17], likely due to patient and method heterogeneity or small sample sizes; finally, some studies lacked a placebo control group, which is essential to distinguish the impact of an intervention from that of other factors [18]. ...
... e characteristics of the included studies are summarized in Table 1. A total of 27 RCTs evaluated a total of 7676 cases (4375 cases and 3301 controls); these studies included 25 full-text articles [6,7,9,10, and 2 conference abstracts [46,47]. Twenty-five studies comprehensively examined the causes of infertility, including male-related and tubal factors, endometriosis, and other factors, including PCOS and unclear causes [6, 7, 9, 10, 25-32, 34-38, 40-47]; two studies reported PCOS as the cause of infertility [33,39]. ...
... One trial used MA + moxibustion [35]. Nine studies compared real acupuncture vs. sham acupuncture [26,28,29,37,39,[41][42][43]47], twelve used blank groups as controls [6,9,10,27,30,33,34,36,41,[44][45][46], and five observed the impact of acupuncture at different stages before and after transplantation [6,10,30,31,44]. ree forms of placebo acupuncture were used. ...
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Background: The effects of acupuncture on female infertility remain controversial. Also, the variation in the participant, interventions, outcomes studied, and trial design may relate to the efficacy of adjuvant acupuncture. The aim of the study is to systematically evaluate the efficacy and safety of acupuncture for female with infertility and hopefully provide reliable guidance for clinicians and patients. Methods: We searched digital databases for relevant studies, including EMBASE, PubMed, Cochrane Library, and Web of Science, and the Cochrane Library up to April 2021, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF and other treatment. We included studies with intervention groups using acupuncture and control groups consisting of no acupuncture or sham (placebo) acupuncture. Primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Meta-regression and subgroup analysis were conducted on the basis of ten prespecified covariates to investigate the variances of the effects of adjuvant acupuncture on pregnancy rates and the sources of heterogeneity. Results: Twenty-seven studies with 7676 participants were included. The results showed that the intervention group contributes more in outcomes including live birth rate (RR = 1.34; 95% CI (1.07, 1.67); P < 0.05), clinical pregnancy rate (RR = 1.43; 95% CI (1.21, 1.69); P < 0.05), biochemical pregnancy rate (RR = 1.42; 95% CI (1.05, 1.91); P < 0.05), ongoing pregnancy rate (RR = 1.25; 95% CI (0.88, 1.79); P < 0.05), adverse events (RR = 1.65; 95% CI (1.15, 2.36); P < 0.05), and implantation rate (MD = 1.19; 95% CI (1.07, 1.33); P < 0.05) when compared with the control group, and the difference is statistically significant. In terms of the number of oocytes retrieved, good-quality embryo rate, miscarriages, and ectopic pregnancy rate, the difference between the acupuncture group and the control group was not statistically significant. Conclusions: Our analysis finds a benefit of acupuncture for outcomes in women with infertility, and the number of acupuncture treatments is a potential influential factor. Given the poor reporting and methodological flaws of existing studies, studies with larger scales and better methodologies are needed to verify these findings. More double-blind RCTs equipped with high quality and large samples are expected for the improvement of the level of evidence.
... Study characteristics were showed in Table 1 . Eighteen studies used TA alone (30, 32, 33, 43-46, 51-53, 58, 61, 62, 64, 67, 74, 75, 77), 6 studies involved the administration of WA alone (59,60,66,70,71,73), 6 for EA alone (7,39,49,50,63,76), 5 for TEAS alone (33,34,37,38,41) and the remaining fourteen studies had two treatment groups or combined with two interventions in a treatment group. Only sham or placebo acupuncture was administered in 11 studies (30,33,38,41,43,44,46,51,53,54,70), and 24 studies used only a no treatment control (7, 25, 31, 32, 34, 39, 45, 47, 49, 50, 52, 58-63, 65, 66, 71-73, 75, 76 ). ...
... (15), we included the largest sample size and most comprehensive trials. Twenty trials were added in our reviews; eleven had positive results (6,35,39,40,46,47,49,51,52,57,77), and nine had negative results (30,(42)(43)(44)(45)(53)(54)(55)(56). In addition, we defined both CPR and LBR as primary outcomes, which were stricter than CPR alone used in almost all previous reviews. ...
Preprint
Background: The evidence of acupuncture for in vitro fertilization (IVF) remains debatable. Objectives: To evaluate the efficacy of acupuncture on embryo transfer in women undergoing IVF. Search Strategy: PubMed, MEDLINE, Web of Science, EMBASE, CENTRAL, Wanfang, Chinese National Knowledge Infrastructure, VIP were searched up to 6 September 2021. Selection Criteria: Randomized controlled trials (RCTs) of acupuncture evaluating IVF’s effects were included. Data Collection and Analysis: Clinical pregnancy rate (CPR) and live birth rate (LBR) were quantitatively summarized by the random-effect model. Variations in pooled estimates were examined by subgroup analyses and I2 was measured to quantify statistical heterogeneity. Main Results: Forty-nine eligible RCTs representing 9422 women undergoing IVF for pregnant success were identified. Pooled CPR and LBR showed a significant difference between acupuncture and control groups (odds ratio [OR]=1.65, 95% confidence interval [CI]: 1.45 to 1.88; OR=1.34, 95% CI: 1.08 to 1.66). Subgroup analysis showed a benefit of traditional acupuncture for women aged < 35 years (CPR: OR=1.57, 95% CI: 1.23 to 2.03; LBR: OR=1.34, 95% CI:1.23 to 1.48), treatment with  3 sessions (CPR: OR=2.37, 95% CI: 1.46 to 3.85; LBR: OR=1.99, 95% CI:1.52 to 2.60), and lower baseline control group rates of CPR (CPR: OR=2.14, 95% CI: 1.22 to 2.13; LBR: OR=2.23, 95% CI:1.07 to 4.62). Heterogeneity across studies were found (CPR: I2=47.4, p <0.001; LBR: I2=62.9, p <0.001). Conclusions: Although benefits of acupuncture in CPR and LBR among IVF women existed, no robust associations were found and which might be limited by the heterogeneity of current evidence
... Acupuncture has been proven to encourage the circulation of blood in the pelvic cavity and improve ovarian function [5]. Some studies have recommended that acupuncture can be beneficial in promoting follicle production [6], enhancing uterine blood flow, [7,8] improving uterine lining thickness9,, 10 and increasing endometrial receptivity during the implantation period [11,12] Acupuncture has also been counselled as a valuable alternative therapy for female infertility due to hormone disorders [13]. Acupuncture helps the woman's natural hormone cycle by influencing the hypothalamic pituitary gonadal axis (HPG axi--ovarian hormone feedback loops). ...
... The thin endometrium is not responsive to standard treatments, and it's still a challenge for assisted reproductive techniques (ART) which usually leads to cycle cessation and unplanned embryo freezing [1,2]. So far, various strategies have been developed for the treatment of thin endometrium, including the long-term exogenous estrogen therapy [3], use of low dose aspirin [4], vitamin E [5], sildenafil citrate (vaginal) [6], electroacupuncture [7], and use of granulocyte colony-stimulating factor (G-CSF) [8]. However, the mentioned treatments are not successful in a number of women with a thin endometrium. ...
Article
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Purpose: Evaluation of the e fect of platelet-rich plasma (PRP) containing platelet-derived growth factor on in vitro fertilization (IVF) failure patients. Methods: In this clinical trial, 80 eligible patients (in-fertile women with at least two IVF failures) were randomly assigned into two groups, including patients who received an intrauterine infusion of PRP (n: 40) and controls (n: 40). Before PRP therapy, standard hormone replacement therapy was performed for all patients to endometrial thickness preparation. A ter sonographic assessment of endometrium, PRP was injected into all patients' endometrium whether they had an appropriate endometrial thickness or not. Then, the embryo transferring was done through IVF. Eventually, the consequences of fertility, embryo implantation, and pregnancy were evaluated. Data analysis was performed using SPSS version 22. Results: The rate of successful IVF [6 (15%)], pregnancy rate [5 (12.5%)], and live birth [5 (12.5%)] were relatively higher in patients undergoing PRP therapy compared with controls [2 (5%), 1 (2.5%) and 0, respec-tively]. However, their statistical di ference was not significant between the two groups (P > 0.05). Conclusion: Our findings suggest that endometrial injection of platelet-rich plasma for IVF failure patients did not significantly improve the IVF process, pregnancy, and live birth rates.
... Meanwhile, Stener-Victorin et al. confirmed that the uterine artery pulsatility index decreased after a series of acupuncture treatments [69]. e results of Ho et al. also confirmed that the pulsatility index of the uterine artery in the acupuncture group was significantly reduced [70]. Besides, acupuncture can also regulate estrogen and progesterone and their receptors. ...
Article
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Female infertility is a state of fertility disorder caused by multiple reasons. The incidence of infertility for females has significantly increased due to various factors such as social pressure, late marriage, and late childbirth, and its harm includes heavy economic burden, psychological shadow, and even marriage failure. Conventional solutions, such as hormone therapy, in vitro fertilization (IVF), and embryo transfer, have the limitations of unsatisfied obstetric outcomes and serious adverse events. Currently, complementary and alternative medicine (CAM), as a new treatment for infertility, is gradually challenging the dominant position of traditional therapies in the treatment of infertility. CAM claims that it can adjust and harmonize the state of the female body from a holistic approach to achieve a better therapeutic effect and has been increasingly used by infertile women. Meanwhile, some controversial issues also appeared; that is, some randomized controlled trials (RCTs) confirmed that CAM had no obvious effect on infertility, and the mechanism of its effect could not reach a consensus. To clarify CAM effectiveness, safety, and mechanism, this paper systematically reviewed the literature about its treatment of female infertility collected from PubMed and CNKI databases and mainly introduced acupuncture, moxibustion, and oral Chinese herbal medicine. In addition, we also briefly summarized psychological intervention, biosimilar electrical stimulation, homeopathy, hyperbaric oxygen therapy, etc.
... Only a few websites stated that studies had shown improvements, or referenced specific studies (3/16 clinic websites, 4/15 affiliated practitioner websites). The papers referenced included, for example, Ho et al. (2009) and Paulus et al. (2009). The role of qualified acupuncturists was emphasized, with Clinic 37 stating that 'acupuncture is a safe therapy when given by qualified acupuncturists' and '[a]dverse effects are rare'. ...
Article
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Complementary therapies are often used during in-vitro fertilization (IVF) treatment. The aim of this study was to determine how UK fertility clinic websites are advertising complementary therapy add-ons. The Human Fertilisation and Embryology Authority’s (HFEA) ‘Choose a Fertility Clinic’ website was used to identify fertility clinics and their websites. Acupuncture, reflexology, nutritional advice and miscellaneous complementary therapies were examined to determine treatment provision and costs. Treatment claims for acupuncture and reflexology were analysed using an inductive coding approach, and categorized depending on whether they pertained to holistic benefits, physiological benefits or improvements to IVF treatment outcome. At least one complementary therapy was advertised by 17 of 66 (26%) websites. Acupuncture was the most commonly advertised complementary therapy (16/66 clinic websites, 24%), followed by nutritionist services (11/66, 17%), reflexology (10/66, 15%) and other miscellaneous complementary therapies (9/66, 14%). Treatment costs were found to range from less than £50 for individual appointments to hundreds of pounds for treatment packages. Treatments were not always offered in-house at the fertility clinic, but rather patients were referred to an affiliated practitioner. Analysing claims relating to the complementary therapies highlighted that there were differences in the extent to which clinics claimed that complementary therapies benefited IVF, and that information occasionally acknowledged scientific research evidence but did not always present resources in an unbiased manner. Fertility clinic websites should provide accurate information for patients for complementary therapy add-ons. HFEA should add acupuncture and reflexology to their traffic-light system with amber and red ratings, respectively.
... Another study revealed that transcutaneous electrical acupuncture point stimulation (TEAS) at RN3 (CV3), RN4 (CV4), SP6, and EX-CA1 could have beneficial effects on ultrasound markers of endometrial receptivity [67]. EA at LR3, SP6, ST28, EX-CA1, RN6, and RN4 was able to reduce uterine artery blood flow impedance in patients undergoing in vitro fertilization [68]. Warm needling at ST25, CV4, CV3, EX-CA1, and ST36 could regulate endometrial morphology and blood flow to improve endometrial receptivity, embryo transplantation rate, and pregnancy rate as well as decrease early abortion rate [69]. ...
Article
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Background Thin endometrium negatively impacts the reproductive function. Current treatments for thin endometrium do not always improve endometrial receptivity. Preliminary evidence suggests that electroacupuncture could have potential therapy for thin endometrium in infertile women. Thus, this randomized controlled trial was designed to test whether electroacupuncture can improve endometrial receptivity in infertile women with thin endometrium. Methods This study is a randomized, single-blinded, controlled, clinical trial. A total of 142 eligible patients will be recruited and randomly assigned to the electroacupuncture (EA) group or the sham electroacupuncture (SEA) group in a 1:1 ratio. Participants will receive 36 sessions over three menstrual cycles (12 weeks in total), with the same acupoint prescription. The primary outcome of this trial is endometrial thickness in the midluteal phase. The secondary outcomes include endometrial pattern, resistance index (RI) and pulsatility index (PI) of bilateral uterine artery and endometrium blood flow, serum estradiol (E2) and progesterone (P), and pregnancy rate. The pregnancy rate will be evaluated during a 6-month follow-up after completion of the trial. All other outcomes will be evaluated before treatment, during the treatment of 1st, 2nd, and 3rd menstrual cycle, and 6 months after treatment. Discussion If the outcome confirms the effectiveness of electroacupuncture for thin endometrium in infertile women, this treatment will be proposed for application in clinical practice. Trial registration Chinese Clinical Trials Registry ChiCTR2 000029983. Registered on 18 February 2020
Chapter
While assisted reproductive technology has given so many people the ability to bear children, it is still far from a cure-all for fertility issues. Two traditional medical systems, traditional Chinese medicine (TCM) and Ayurveda have been using a very different, more holistic approach to help couples enhance fertility for millennia. This chapter explains how TCM and Ayurveda approach infertility issues. Specifically, it discusses the fundamental principles of both systems, the importance of focusing on foundation health and creating balance in the body, and how these systems personalize treatment. Both systems believe that proper preparation for pregnancy can set the stage for a healthier pregnancy and better long-term health for the future child. TCM refers to this as “tilling the soil before planting the seed.” The basic elements of diagnosis, patterns of imbalance, treatment approaches including acupuncture, herbal medicine, diet, panchakarma, and research on the efficacy of these approaches are discussed.
Article
Background The effects of acupuncture on in-vitro fertilization outcomes remain controversial. This study aimed to perform a meta-analysis to assess the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Methods A systematic literature search up to January 2021 was performed and 29 studies included 6623 individuals undergoing in-vitro fertilization at the baseline of the study; 3091 of them were using acupuncture as an adjuvant therapy to embryo transfer, 1559 of them were using sham-controls, and 1441 of them were using no adjuvant therapy controls. They reported a comparison between the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls on improving pregnancy outcomes in women undergoing in-vitro fertilization. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated assessing the effectiveness of acupuncture as an adjuvant therapy to embryo transfer compared to sham-controls or no adjuvant therapy controls using the dichotomous method with a random or fixed-effect model. Results Significantly higher outcomes with acupuncture were observed in biochemical pregnancy (OR, 1.98; 95% CI, 1.55–2.53, p < 0.001); clinical pregnancy (OR, 1.70; 95% CI, 1.46–1.98, p < 0.001); ongoing pregnancy (OR, 1.78; 95% CI, 1.41–2.26, p < 0.001); and live birth (OR, 1.58; 95% CI, 1.15–2.18, p = 0.005) compared to no adjuvant therapy controls. However, no significant difference were found between acupuncture and no adjuvant therapy controls in miscarriage (OR, 0.96; 95% CI, 0.48–1.92, p = 0.91). No significant difference was observed with acupuncture in biochemical pregnancy (OR, 1.16; 95% CI, 0.65–2.08, p = 0.62); clinical pregnancy (OR, 1.13; 95% CI, 0.83–1.54, p = 0.43); ongoing pregnancy (OR, 1.04; 95% CI, 0.66–1.62, p = 0.87); live birth (OR, 1.02; 95% CI, 0.73–1.42, p = 0.90), and miscarriage (OR, 1.16; 95% CI, 0.86–1.55, p = 0.34) compared to sham-controls. Conclusions Using acupuncture as an adjuvant therapy to embryo transfer may improve the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth outcomes compared to no adjuvant therapy controls. However, no significant difference was found between acupuncture as an adjuvant therapy to embryo transfer and sham-controls in any of the measured outcomes. This relationship forces us to recommend the use of acupuncture as adjuvant therapy in women undergoing in-vitro fertilization and inquire further studies comparing acupuncture and sham-controls to reach the best procedure.
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Context.— Peripheral neuropathy is common in persons infected with the human immunodeficiency virus (HIV) but few data on symptomatic treatment are available.Objective.— To evaluate the efficacy of a standardized acupuncture regimen (SAR) and amitriptyline hydrochloride for the relief of pain due to HIV-related peripheral neuropathy in HIV-infected patients.Design.— Randomized, placebo-controlled, multicenter clinical trial. Each site enrolled patients into 1 of the following 3 options: (1) a modified double-blind 2 × 2 factorial design of SAR, amitriptyline, or the combination compared with placebo, (2) a modified double-blind design of an SAR vs control points, or (3) a double-blind design of amitriptyline vs placebo.Setting.— Terry Beirn Community Programs for Clinical Research on AIDS (HIV primary care providers) in 10 US cities.Patients.— Patients with HIV-associated, symptomatic, lower-extremity peripheral neuropathy. Of 250 patients enrolled, 239 were in the acupuncture comparison (125 in the factorial option and 114 in the SAR option vs control points option), and 136 patients were in the amitriptyline comparison (125 in the factorial option and 11 in amitriptyline option vs placebo option).Interventions.— Standarized acupuncture regimen vs control points, amitriptyline (75 mg/d) vs placebo, or both for 14 weeks.Main Outcome Measure.— Changes in mean pain scores at 6 and 14 weeks, using a pain scale ranging from 0.0 (no pain) to 1.75 (extremely intense), recorded daily.Results.— Patients in all 4 groups showed reduction in mean pain scores at 6 and 14 weeks compared with baseline values. For both the acupuncture and amitriptyline comparisons, changes in pain score were not significantly different between the 2 groups. At 6 weeks, the estimated difference in pain reduction for patients in the SAR group compared with those in the control points group (a negative value indicates a greater reduction for the "active" treatment) was 0.01 (95% confidence interval [CI], −0.11 to 0.12; P =.88) and for patients in the amitriptyline group vs those in the placebo group was −0.07 (95% CI, −0.22 to 0.08; P=.38). At 14 weeks, the difference for those in the SAR group compared with those in the control points group was −0.08 (95% CI, −0.21 to 0.06; P=.26) and for amitriptyline compared with placebo was 0.00 (95% CI, −0.18 to 0.19; P=.99).Conclusions.— In this study, neither acupuncture nor amitriptyline was more effective than placebo in relieving pain caused by HIV-related peripheral neuropathy. Figures in this Article PERIPHERAL NEUROPATHIES are diagnosed in 30% to 35% of patients with human immunodeficiency virus (HIV) and cause pain and dysesthesias.1- 2 Symptomatic treatment includes antidepressants, nonnarcotic and narcotic analgesics, anticonvulsants, and acupuncture.2- 3 The use of these treatments is based on anecdotal4 information and trials in other disease conditions.5 We chose to examine the efficacy of 2 commonly used treatments, amitriptyline hydrochloride and acupuncture, for HIV-related peripheral neuropathy. Amitriptyline is frequently prescribed for neuropathic pain and has been shown to be an effective treatment for diabetic, hereditary, toxic, and idiopathic neuropathies.6- 7 Although several trials that reported examining acupuncture for chronic painful conditions claim efficacy,8- 9 these studies have methodological limitations, including small sample sizes and inadequate controls for the nonspecific effects of acupuncture.9- 11 Meta-analyses of studies of acupuncture for chronic pain show a response rate of approximately 70% for acupuncture, 50% for "sham" acupuncture (needling points not considered effective), and 30% for control treatments, such as sham transcutaneous electrical nerve stimulation.9- 10,12- 13 To evaluate the effect of both a nonstandard and standard medical therapy for peripheral neuropathy, we performed a multicenter, modified double-blind, randomized, placebo-controlled study of the separate and combined efficacy of a standardized acupuncture regimen (SAR) and amitriptyline for the relief of pain caused by HIV-related peripheral neuropathy.
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Thirteen cycles of anovulation menstruation in 11 cases were treated with Electro-Acupuncture (EA) ovulation induction. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EA treatment. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-endorphin (r beta-E) fluctuated, and returned to the preacupunctural level in 30 min. after withdrawal of needles in normal subjects. After EA, the level of blood r beta-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood r beta-E in cycles in which the induction failed to cause ovulation was kept higher that that of normal. (P less than 0.05). There was a negative correlation in the decrease of blood r beta-E and increase of HST after EA (r = 0.677, P less than 0.01). EA is able to regulate the function of the hypothalamic-pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method for predicting the curative effect of EA. The role of r beta-E in the mechanism of EA ovulation induction was discussed.
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In a multi-facet study we evaluated the efficacy of P6 electroacupuncture (10 Hz applied for 5 min) as an antiemetic in patients receiving a variety of cancer chemotherapy drugs. The study involved 130 (15 in an open pilot study, 10 in a randomized placebo controlled crossover study and 105 in a definitive study) patients who had a history of distressing sickness after previous treatment, and who, on the basis of a previous survey, would be expected to have a 96% chance of this with subsequent therapy. Sickness was either completely absent or reduced considerably in 97% of patients and no side effects were encountered. The limited crossover study, using a 'dummy' acupuncture (ACP) point showed that the beneficial effects were limited to the P6 point. Logistic and ethical considerations excluded the possibility of carrying out a larger placebo-controlled study. While in our hands P6 ACP was an effective antiemetic in patients having cancer chemotherapy, because of the time involved and the brevity of the action (8 h) an alternative approach to electro-ACP is required before this technique is adopted clinically.
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In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow impedance, 10 infertile but otherwise healthy women with a pulsatility index (PI) ≥3.0 in the uterine arteries were treated with EA in a prospective, non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects on the PL The baseline PI was measured when the serum oestradiol was ≤0.1 nmol/1, and thereafter the women were given EA eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10–14 days after the EA period. Skin temperature on the forehead (STFH) and in the lumbosacral area (STLS) was measured during the first, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both shortly after the eighth EA treatment (P < 0.0001) and 10–14 days after the EA period (P < 0.0001). STFH increased significantly during the EA treatments. It is suggested that both of these effects are due to a central inhibition of the sympathetic activity.
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This article summarizes the studies of the mechanism of electroacupuncture (EA) in the regulation of the abnormal function of hypothalamic-pituitary-ovarian axis (HPOA) in our laboratory. Clinical observation showed that EA with the effective acupoints could cure some anovulatory patients in a highly effective rate and the experimental results suggested that EA might regulate the dysfunction of HPOA in several ways, which means EA could influence some gene expression of brain, thereby, normalizing secretion of some hormones, such as GnRH, LH and E2. The effects of EA might possess a relative specificity on acupoints.
Article
Objective To assess whether a measure of uterine blood flow impedance (the pulsatility index, PI) as determined by transvaginal ultrasonography with color blood flow imaging, may be used to assess endometrial receptivity immediately before the time of embryo transfer (ET) after assisted conception. Design A prospective study of infertile women who had undergone treatment to induce multiple follicular development followed by ultrasound-guided oocyte retrieval. The oocytes were fertilized in vitro. Setting The Hallam Medical Centre. Patients Eighty-two women (22 to 44 years of age) who all had three or four good quality embryos available for transfer to the uterus. Interventions All women were examined by transvaginal ultrasonography, with color flow imaging and blood flow analysis, immediately before ET. Main Outcome Measures The mean PI of the left and right uterine arteries, the pregnancy rate (PR) (%), the embryo implantation rate (%), and the multiple PR (%). Results The patients were grouped according to whether the PI was low (1.00 to 1.99), medium (2.00 to 2.99), or high (3 +). There were 27 women in the low PI group, 36 in the medium, and 19 in the high. The PR (%), embryo implantation rate (%), and multiple PR (%) were 41%, 15.3%, and 27.3% for the low PI group and 47%, 22.2%, and 47.1% for the medium PI group. There were no pregnancies in the high PI group. Thus 35% (19/54) of women who failed to become pregnant had a PI value > 3.0. Conclusions These data suggest that the PI value on the day of ET could be used to: (1) increase the implantation rate by showing which embryos should be cryopreserved until the uterus is more receptive and (2) reduce the multiple PR by indicating that the number of embryos transferred should be limited when the uterus is most receptive.
Article
Background. The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). Methods. Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10–14 treatments), in total 8–9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. Results. Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. Conclusion. Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.
Article
To assess whether a measure of uterine blood flow impedance (the pulsatility index, PI) as determined by transvaginal ultrasonography with color blood flow imaging, may be used to assess endometrial receptivity immediately before the time of embryo transfer (ET) after assisted conception. A prospective study of infertile women who had undergone treatment to induce multiple follicular development followed by ultrasound-guided oocyte retrieval. The oocytes were fertilized in vitro. The Hallam Medical Centre. Eight-two women (22 to 44 years of age) who all had three or four good quality embryos available for transfer to the uterus. All women were examined by transvaginal ultrasonography, with color flow imaging and blood flow analysis, immediately before ET. The mean PI of the left and right uterine arteries, the pregnancy rate (PR) (%), the embryo implantation rate (%), and the multiple PR (%). The patients were grouped according to whether the PI was low (1.00 to 1.99), medium (2.00 to 2.99), or high (3+). There were 27 women in the low PI group, 36 in the medium, and 19 in the high. The PR (%), embryo implantation rate (%), and multiple PR (%) were 41%, 15.3%, and 27.3% for the low PI group and 47%, 22.2%, and 47.1% for the medium PI group. There were no pregnancies in the high PI group. Thus 35% (19/54) of women who failed to become pregnant had a PI value greater than 3.0. These data suggest that the PI value on the day of ET could be used to: (1) increase the implantation rate by showing which embryos should be cryopreserved until the uterus is more receptive and (2) reduce the multiple PR by indicating that the number of embryos transferred should be limited when the uterus is most receptive.
Article
We studied 20 otherwise healthy women undergoing lower abdominal surgery. Immediately after wound closure, while still anaesthetized, they received either electroacupuncture (EA) or no further treatment. They were allowed pethidine for postoperative analgesia by patientcontrolled infusion pump. Signs of postoperative distress (pain, nausea, drowsiness) were evaluated after 2 and 6 h by visual analogue scale scores. The group receiving EA consumed half the quantity of pethidine as that used used by the no treatment group. Two patients in the EA group had no postoperative analgesia in the first 2 h. There was no difference in the assessments of postoperative distress between groups. No patient was aware of having received EA or not.
Article
This study was undertaken to examine the effects of acupuncture on smoking reduction and possibly also cessation and to examine whether some acupoints are more effective than others for smoking cessation. A total of 46 healthy men and women, 39 +/- 9 years of age (mean +/- SD), who smoked 20 +/- 6 cigarettes per day and had smoked for 23 +/- 8 years, and who wanted to quit smoking, volunteered to participate. The subjects were randomly assigned to two groups. One group was given acupuncture treatment at points previously used for anti-smoking (test group, TG). The other group was given acupuncture treatment at points assumed to have no effect for smoking cessation (control group, CG). Before each treatment and after the last treatment each subject answered questionnaires about his or her smoking habits and attitudes. In addition the concentrations of serum cotinine, serum thiocyanate, serum peroxides, and plasma fibrinogen were measured before the first and after the last acupuncture treatment. The daily cigarette consumption fell during the treatment period in both groups, but the reduction was larger for TG than for CG (P < 0.002). Altogether 31% of subjects in TG had quit smoking completely at the end of the treatment, compared with none in CG. For TG the concentrations of cotinine and thiocyanate were reduced significantly after the treatment period (P < 0.001), but no significant reductions were observed for CG. For both groups the taste of tobacco worsened during the treatment period, but the effect was more pronounced for TG than for CG (P < 0.05). The desire to smoke fell significantly in both groups after treatment, and the reduction was larger for TG than for CG (P < 0.001). No significant changes in serum peroxides and plasma fibrinogen concentrations were observed during the treatment period for either group. This study suggests that acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely. Different acupoints appear to have different effects for smoking cessation and reduction.