Article

Acupuncture is effective to attenuate stress and stimulate lymphocyte proliferation in the elderly

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Abstract

Acupuncture has increasingly been used to treat many conditions, including psychiatric disorders and immunological-related disorders. However, the effects of acupuncture as stress management and immune functions in the elderly are largely unclear. Here we investigated the effects of acupuncture on stress-related psychological symptoms and cellular immunity in young adults and elderly subjects. The acupuncture treatment consisted of six sessions and the procedures included the insertion of needles at bilateral acupoints LI4, SP6 and ST36. Psychological variables (depression, anxiety and stress) were investigated by means of self-assessment inventories. Peripheral blood mononuclear cells were isolated and cultured in vitro to measure mitogen-induced T-cell proliferation as well as cellular sensitivity to dexamethasone. All data were assessed before and after the intervention. Acupuncture was able to significantly reduce depression (p<0.001), anxiety (p<0.001) and stress (p<0.001) scores. The intervention also increased T-cell proliferation, with greater intensity in the elderly group (p=0.004). No changes in cellular sensitivity to dexamethasone were observed following acupuncture. We conclude that acupuncture was efficient to attenuate the psychological distress as well as to increase an important feature of cellular immunosenescence.

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... Acupuncture was shown to be beneficial for immune functions, including T, B and NK cells [24,44]. We have previously reported beneficial effects of acupuncture in attenuating psychological distress and immunosenescence [38]. However, the main effects were not duly controlled as no placebo group was employed. ...
... Consisted of 25 min session, twice a week, in a total of ten sessions. Treatment duration was chosen to examine short-term effects of acupuncture [38]. Sterile disposable needles were inserted at points SP6 (sanyinjiao), LI4 (hegu), ST36 (zusanli), LR3 (taichong), PC6 (neiguan), and EX-NH3 (yintang) ( Fig. 1) and were frequently stimulated. ...
... A randomized, placebo-controlled study allowed us to demonstrate the real effects of acupuncture. Our findings are in accordance with literature, indicating that acupuncture is effective in improving sleep quality and promoting relaxation in healthy elderly [1,38,46] and young adults with sleep disturbances including residual or primary insomnia [9,17,22,46]. ...
Article
Poor sleep in elderly populations is associated with detrimental neuropsychological, and physiological changes including premature immunosenescence and reduced brain derived neurotrophic factor (BDNF). Here, we evaluated the effects of acupuncture on sleep quality, psychological distress and immunosenescence in elderly, as well as effects on BDNF levels. Forty-eight community-dwelling elderly were randomized into true or placebo acupuncture, and intervention consisted of ten sessions. Sleep quality, depression and stress scores were evaluated by the Pittsburgh sleep quality index (PSQI), beck depression inventory (BDI II) and perceived stress scale (PSS), respectively, before and after the intervention. Lymphocyte subsets commonly associated with stress, sleep impairment and immunosenescence were phenotyped by flow cytometry. BDNF plasma levels were assessed by ELISAs. Acupuncture was highly effective for improving sleep quality (-53.23%; p<0.01), depression (-48.41%; p<0.01), and stress (-25.46%; p<0.01). However, neither lymphocyte subpopulations nor BDNF levels changed following the intervention. Copyright © 2014. Published by Elsevier Ireland Ltd.
... Acupuncture is accomplished by the insertion the tips of thin, stainless steel needle on specific points(called acupoints) and induces marked changes close to the needle in all the different tissues that are penetrated 4,5) . SP 6 is the commonly used acupoints in many disorders including gynecologic, genitourinary, allergic, insomnia, immunological and psychosomatic diseases and pain control [6][7][8] . In addition, the SP6 treatment also exerted the anti-inflammatory effect in a model of carrageenan-induced peritonitis and the antioxidative effect in a mouse model of Parkinson's disease 9,10) . ...
... Acupuncture is accomplished by the insertion the tips of thin, stainless steel needle on specific points(called acupoints) and induces marked changes close to the needle in all the different tissues that are penetrated 4,5) . SP 6 is the commonly used acupoints in many disorders including gynecologic, genitourinary, allergic, insomnia, immunological and psychosomatic diseases and pain control [6][7][8] . In addition, the SP6 treatment also exerted the anti-inflammatory effect in a model of carrageenan-induced peritonitis and the antioxidative effect in a mouse model of Parkinson's disease 9,10) . ...
... This alternative therapy is known to modulate biochemical balances in the central nervous system (CNS) and to maintain homeostasis [13]. SP6 (Sanyinjiao) is one of the most commonly used acupoints in acupuncture treatment to alleviate psychic and psychosomatic dysfunction such as depressive symptoms and anxiety disorders [14]. Recent animal studies have found that acupuncture and low frequency electroacupuncture stimulation exhibit antidepressant-like activity in the forced swimming test (FST), reduce anxiety-like behavior in the elevated plus maze (EPM) test, and restore the expression levels of neuropeptide Y and c-Fos in the brain [15][16][17]. ...
... Additionally, only acupuncture stimulation to the SP6 acupoint elicited significant responses, in contrast to an acupoint on a different meridian, TE5, or a nonacupoint on the tail. SP6 has been used clinically to treat mental and psychosomatic disorders and is known to produce a sedative, tranquilizing, and antiemetic effect under a variety of stresses [14]. These results suggest that stimulation of the acupuncture point spreads throughout the body at a rapid rate and its effect is highly point specific, at least for modulating the depression-and anxiety-like symptoms associated with morphine discontinuation [12,57]. ...
Article
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The purpose of this study was to evaluate whether acupuncture stimulation attenuates withdrawal-induced behaviors in the rats during protracted abstinence following chronic morphine exposure. To do this, male rats were first exposed to morphine gradually from 20 to 100 mg/kg for 5 days, and subsequently naloxone was injected once to extend despair-related withdrawal behaviors for 4 weeks. Acupuncture stimulation was performed once at the SP6 (Sanyinjiao) acupoint on rat's; hind leg for 5 min during protracted abstinence from morphine. The acupuncture stimulation significantly decreased despair-like behavior deficits in the forced swimming test and low sociability in the open-field test as well as increased open-arm exploration in the elevated plus maze test in the last week of 4-week withdrawal period. Also the acupuncture stimulation significantly suppressed the increase in the hypothalamic corticotropin-releasing factor (CRF) expression, the decrease in the tyrosine hydroxylase expression in the locus coeruleus, and the decrease in the hippocampal brain-derived neurotrophic factor mRNA expression, induced by repeated injection of morphine. Taken together, these findings demonstrate that the acupuncture stimulation of SP6 significantly reduces withdrawal-induced behaviors, induced by repeated administration of morphine in rats, possibly through the modulation of hypothalamic CRF and the central noradrenergic system.
... It was observed on study made by Pernambuco et al. who analyzed the acute changes promoted by acupuncture on glucose, rate-pressure product of normal tension on cycle ergometer. The subjects were submitted an acupuncture stimuli on spleen 3 -SP3 and were oriented to maintain the intensity as someone hardhard [13][14][15] at the Borg`s visual scale and 70% of maximum heart frequency [MHF], that was obtained by estimate formula 220 -age. The study conclude that the Acupuncture procedures promoted acute reduction on blood pressure, heart frequency during and after the exercise, did not found significative modifications on glucose levels on observed group. ...
... A scientific interest to understand how the physiological mechanism works and modifications promoted by acupuncture. First let try to understand what happens when the needle is inserted on skin, basically: 1) The acupuncture point is an area which has a particular afferent activity in peripheral sensory nerves fibers A and C types; 2) When the needle is penetrated, based on animal and human studies, it increases generation of nitric oxide that increases blood circulation [12,13], 3) Promote T cell proliferation [14]. ...
... EA treatment leads to the production of a series of factors involved in the regulation of cartilage inflammation. These factors are translocated to tissues and cells through the blood circulation; therefore, cells treated with EAS in vitro are in a similar condition to in vivo cells (27,28). The treatment of cells in vitro with EAS is easily regulated and effects are easily detected; therefore, EAS treatment is convenient in cell and molecular biology, as it can reveal the mechanisms underlying acupuncture treatment (29,30). ...
Article
Full-text available
The Ras‑Raf‑mitogen‑activated protein kinase kinase (MEK)1/2‑extracellular signal‑regulated kinase (ERK)1/2 signaling pathway contributes to the release of chondral matrix‑degrading enzymes and accelerates the degradation of articular cartilage. Electroacupuncture (EA) treatment has been widely used for the treatment of osteoarthritis (OA); however, the mechanism underlying the effects of EA on OA remains unclear. Therefore, the present study evaluated the anti‑inflammatory effects and potential underlying mechanisms of EA serum (EAS) on tumor necrosis factor (TNF)‑α‑mediated chondrocyte inflammation. A total of 30 Sprague Dawley rats were randomly divided into three groups: The blank group; experimental group I, which received 15 min of EA treatment; and experimental group II, which received 30 min of EA treatment. Subsequently, serum samples were obtained. Chondrocytes were isolated from the knee cartilage of Sprague Dawley rats, and were identified using collagen type II immunohistochemistry. TNF‑α‑treated chondrocytes were used as a cell model, and subsequently the cells were treated with EAS from each group for various durations. The results demonstrated that EAS treatment significantly promoted the viability and inhibited the apoptosis of TNF‑α‑treated chondrocytes. In addition, interleukin (IL)‑1β concentration was significantly increased in the model group compared with in the control group, whereas EAS significantly reduced IL‑1β concentration in TNF‑α‑treated chondrocytes. Furthermore, the protein expression levels of Ras, Raf and MEK1/2 were reduced in the EAS groups compared with in the model group. EAS also significantly inhibited the phosphorylation of ERK1/2, and the expression of downstream regulators matrix metalloproteinase (MMP)‑3 and MMP‑13. In conclusion, these results indicated that EAS may inhibit TNF‑α‑mediated chondrocyte inflammation via the Ras‑Raf‑MEK1/2‑ERK1/2 signaling pathway in vitro, thus suggesting that EAS may be considered a potential therapeutic strategy for the treatment of OA.
... Well-designed studies have demonstrated that manual acupuncture (Allen et al., 1998; and electroacupuncture (Luo et al., 1985;1988a;1988b; are efficacious for treating major depressive disorder (MDD) (Wu et al., in press), and benefits have been demonstrated in populations including women with perinatal depression (Manber et al., 2004;, menopausal women (Wang et al., 2010), geriatric patients (Pavao et al., 2010), and post-stroke patients (Li et al., 2011). ...
Article
We have previously shown that a standardized acupuncture augmentation was effective for antidepressant partial responders with major depressive disorder (MDD). This pilot study examines the efficacy and safety of this protocol as monotherapy for MDD. Thirty outpatients (73% female, mean age 47±12yrs) with SCID-diagnosed MDD were recruited and received 8weeks of standardized 30-minute open acupuncture treatment using 5 specific body points on the arms and legs bilaterally, with manual stimulation every 10min, and concurrent electroacupuncture (2Hz current) at two points along the midline of the head. Subjects were assigned to once-weekly (n=21) or twice-weekly (n=9) treatment, depending on preference. Change in Hamilton-D-17 score was the primary outcome measure, and positive response to treatment (defined as ≥50% improvement in HAM-D-17 scores compared to baseline) was the secondary outcome measure. HAM-D-17 scores decreased from 19.1±4.4 to 9.9±6.3 (p<0.001) in the once-weekly acupuncture group, and from 21.9±5.3 to 14.3±6.1 (p=0.012) in the twice-weekly acupuncture group. Improvement did not differ significantly between treatment arms. Response rates were 62% for the once-weekly acupuncture group and 22% for the twice-weekly acupuncture group (NS). Twenty patients (14 in weekly treatment group and 6 in twice-weekly treatment group) completed the study. The most common side effects included mild soreness/pain (n=13), and mild bleeding (n=16) at the needle site. Open design and small sample. Standardized acupuncture treatment was safe, well-tolerated and effective, suggesting good feasibility in outpatient settings. Replication in controlled trials is warranted.
... Acupuncture as a Monotherapy for Geriatric Depression. Some researchers 60 have investigated the effects of acupuncture on stress-related psychological symptoms and cellular immunity in young adults and elderly subjects. Subjects received 6 acupuncture sessions, with bilateral needling at acupoints LI4, SP6, and ST36. ...
Article
While increasing numbers of patients are seeking acupuncture treatment for depression in recent years, there is limited evidence of the antidepressant (AD) effectiveness of acupuncture. Given the unsatisfactory response rates of many Food and Drug Administration-approved ADs, research on acupuncture remains of potential value. Therefore, we sought to review the efficacy and safety of acupuncture treatment for depression in clinical applications. We conducted a PubMed search for publications through 2011. We assessed the adequacy of each report and abstracted information on reported effectiveness or efficacy of acupuncture as monotherapy for major depressive disorder (MDD) and as augmentation of ADs. We also examined adverse events associated with acupuncture, and evidence for acupuncture as a means of reducing side effects of ADs. Published data suggest that acupuncture, including manual-, electrical-, and laser-based, is a generally beneficial, well-tolerated, and safe monotherapy for depression. However, acupuncture augmentation in AD partial responders and nonresponders is not as well studied as monotherapy; and available studies have only investigated MDD, but not other depressive spectrum disorders. Manual acupuncture reduced side effects of ADs in MDD. We found no data on depressive recurrence rates after recovery with acupuncture treatment. Acupuncture is a potential effective monotherapy for depression, and a safe, well-tolerated augmentation in AD partial responders and nonresponders. However, the body of evidence based on well-designed studies is limited, and further investigation is called for.
... Conversely, higher levels of anxiety may reduce the likelihood of participation in physical activity following cancer treatment. Acupuncture, a mind-body technique that is also classified as manipulative body-based technique and energy-based technique, has been shown to ameliorate distress in healthy adults [107]. It has also been found to reduce fatigue and distress in patients with advanced breast and ovarian cancer [108]. ...
Article
Full-text available
A cancer diagnosis elicits strong psychophysiological reactions that characterize stress. Stress is experienced by all patients but is usually not discussed during patient-healthcare professional interaction; thus underdiagnosed, very few are referred to support services. The prevalence of CAM use in patients with history of cancer is growing. The purpose of the paper is to review the aspects of cancer-related stress and interventions of commonly used complementary and alternative techniques/products for amelioration of cancer-related stress. Feasibility of intervention of several CAM techniques and products commonly used by cancer patients and survivors has been established in some cancer populations. Efficacy of some CAM techniques and products in reducing stress has been documented as well as stress-related symptoms in patients with cancer such as mindfulness-based stress reduction, yoga, Tai Chi Chuan, acupuncture, energy-based techniques, and physical activity. Much of the research limitations include small study samples and variety of intervention length and content. Efficacy and safety of many CAM techniques and some herbs and vitamin B and D supplements need to be confirmed in further studies using scientific methodology. Several complementary and alternative medicine therapies could be integrated into standard cancer care to ameliorate cancer-related stress.
... Previous acupuncture research has been carried out with the aim of understanding pain control (8). In addition to analgesic evidence, clinical and experimental evidence has demonstrated that electroacupuncture (EA) treatment is effective for numerous immunological diseases, including infections, autoimmune diseases and immunodeficiency-syndromes (9,10). Previous evidence has suggested that EA may increase splenic lymphocyte proliferation and IL-2 production in rats following surgical trauma (11,12). ...
Article
Surgical trauma leads to a severe deterioration of the immune system. Electroacupuncture (EA) may improve the immunodeficiency that occurs following surgery; however, the underlying signaling mechanisms require further study. In the present study, 40 rats were equally randomized into four groups: Control; Control + EA; Trauma; Trauma + EA. EA was applied at the 'Zusanli' (ST36) and 'Lanwei' (Extra37) acupoints, immediately following surgery. The splenic T cells were isolated from the rats 24 h after surgery. The apoptotic rate of the lymphocytes was measured by flow cytometric analysis, and western blotting was used to determine the protein expression levels of caspase‑3, caspase‑8, tumor necrosis factor (TNF)‑α and TNF receptor 1 (TNFR1). The DNA binding activity of nuclear factor (NF)‑κB was determined using Trans‑AM® ELISA‑based kits. The results of the present study showed that surgical trauma induced apoptosis of splenic lymphocytes, and significantly increased the protein expression levels of caspase‑3 and caspase‑8. This was accompanied by increased expression levels of TNF‑α and TNFR1, and a marked reduction in the activity of NF‑κB in splenic T cells. Administration of EA significantly decreased the expression levels of caspase‑3, caspase‑8, TNF‑α and TNFR1, elevated the activity of NF‑κB, and suppressed the apoptotic rate of the lymphocytes. The data suggests that EA may inhibit the apoptosis of splenic lymphocytes induced by surgical trauma, and ameliorate the postoperative immunosuppression. This may be mediated by the downregulation of TNF‑α expression levels and upregulation of the activity of NF‑κB.
... Stress-related psychologic conditions that have demonstrated improvements include post-traumatic stress disorder, insomnia, depression, and anxiety (Cao, Pan, Li, & Liu, 2009;Kim et al., 2013;Pilkington et al., 2007;Smith et al., 2018;Sok et al., 2003). Needle acupuncture specifically has demonstrated significant reductions in depression, anxiety, and stress related symptoms among older adults (Pavão et al., 2010). ...
Thesis
People living with dementia (PLWD) often experience behavioral and psychological symptoms of dementia (BPSD) which are burdensome to those diagnosed, their families, and society. Many non-pharmacologic interventions have demonstrated efficacy in reducing BPSD in research but have had limited uptake in the community, possibly due to lack of feasibility and limited acceptance by PLWD and their family caregivers. Acutherapy and weighted blankets are non-pharmacologic interventions that have improved outcomes among older adults, but few studies have focused on PLWD and BPSD. The purpose of this research was to explore the potential of acutherapy and weighted blankets as non-pharmacologic interventions to reduce BPSD in PLWD. The research presented in this 3-paper dissertation was guided by 6 specific aims: 1. Identify, examine, and synthesize the state of the science relating to the effects of acutherapy on BPSD. (Paper 1) 2. Explore perspectives of family caregivers of community dwelling older adults with Alzheimer’s disease or related dementias (ADRD) regarding BPSD and use of non-pharmacologic interventions for BPSD management. (Paper 2) 3. Explore perspectives of family caregivers of community dwelling older adult family members with ADRD regarding changes in their caregiving experiences, BPSD displayed by their relatives with ADRD and BPSD management strategies used during the COVID-19 pandemic. (Paper 2) 4. Explore initial perceptions of family caregivers regarding weighted blankets as an in-home care strategy for community dwelling PLWD following a brief description and visual presentation of weighted blankets. (Paper 3) 5. Examine feasibility and acceptability of a virtually delivered, in-home weighted blanket intervention for older adults with ADRD living in the community as perceived by the family caregiver and the person with ADRD. (Paper 3) 6. Examine feasibility of collecting outcome measures of BPSD, cognitive function, and quality of life of care recipients with ADRD, and well-being and self-reported health status of family caregivers. (Paper 3) Aims were addressed using: a scoping review methodology (Aim 1); a qualitative approach using semi-structured interviews with 21 family caregivers living with community dwelling PLWD (Aims 2, 3, and 4); a prospective, within subjects, pre-post design study with 21 community dwelling PLWD and their family caregivers (Aims 5 and 6). This dissertation research had 6 key findings: 1) Acutherapy is a safe non-pharmacologic care strategy for PLWD and a potential treatment for BPSD, but additional research is needed to determine efficacy; 2) The caregiving experience of family caregivers of community dwelling PLWD was described as an interdependent partnership between the caregiver and the PLWD; 3) Family caregivers and PLWD experienced challenges to in-home care prior to the COVID-19 pandemic, many of which were compounded by it; 4) The virtually delivered, in-home weighted blanket intervention was feasible and acceptable to PLWD and their family caregivers; 5) Collecting outcome measures of care recipient cognitive function, caregiver well-being and caregiver self-reported health was feasible; 6) Collecting outcome measures of care recipient BPSD and quality of life was feasible through measures completed by caregiver report, but not by care recipient self-report. The efficacy of feasible and acceptable care strategies for community dwelling PLWD must be determined to promote broader uptake by clinicians, support service providers, and families. As BPSD are overwhelming for PLWD, their families, and society, we are in dire need of evidence-based non-pharmacological interventions to reduce the burden and improve the quality of life of PLWD and their families.
... 41 Use of acupuncture for these conditions is justified by several studies reporting positive effects of acupuncture on stress and immune response in diverse patient populations. [42][43][44] In addition to the conditions mentioned above, general wellness, such as feeling worried, having trouble sleeping, and lack of energy, as well as gastrointestinal issues, such as heartburn, nausea, and vomiting, were among the most prevalent conditions reported by acupuncture users. This finding is consistent with previous studies reporting acupuncture use for general wellness, stress, and/or functional gastrointestinal disorders. ...
Article
Objectives: To determine whether acupuncture use, sociodemographic characteristics, and existing health conditions differ between acupuncture-preferred consumers (i.e., those who deem acupuncture to be one of the three most important complementary and alternative medicine [CAM] modalities used) and non-acupuncture-preferred consumers who used acupuncture in the past 12 months Methods: This is a secondary analysis of the National Health Interview Survey Sample Adult File and Adult Alternative Medicine datasets collected by the Centers for Disease Control and Prevention during 2012. The sample was drawn from the noninstitutionalized civilian population of the United States. The datasets yielded 34,525 respondents aged 18 years and older. Measures included in the analysis were acupuncture use in the past 12 months, sociodemographic characteristics, and existing health conditions. Analyses were performed by using Stata software, version 9.0 (Stata Corp., College Station, TX). Results: Of the 10,158 adults who responded to the question regarding the "three most important" CAM modalities used, 572 (5.6%) had used acupuncture in the past 12 months. Of these, 456 (79.7%) chose acupuncture as one of the top three CAM modalities most important to their health. Acupuncture-preferred consumers reported significantly more visits to acupuncturists (7.46 versus 3.99 visits; p < 0.001), as well as higher out-of-pocket costs ($342.8 versus $246.4; p < 0.001), compared with non-acupuncture-preferred consumers. The logistic regression model revealed that with every additional CAM modality used, the likelihood of deeming acupuncture as one of the three CAM modalities most important to one's health decreased by 39% (odds ratio, 0.61; 95% confidence interval, 0.52-0.71; p < 0.001). Health conditions were not statistically significant predictors. Conclusions: A consumer's preference for acupuncture appeared not to be driven by health conditions but rather was related to sociodemographic factors. This suggests that health education regarding acupuncture may need to be tailored to certain consumer groups, such as those residing in the South, and could provide more information on the comparative effectiveness of acupuncture for various health conditions.
... Bell's palsy (BP), an acute unilateral facial paralysis, is a frequent facial movement dysfunction caused by the impaired facial nerve that controls movement of facial muscles [1][2][3]. Acupuncture, a traditional Chinese medicine [4,5], has been considered to have a beneficial effect on the acute state of BP in the last few years [6]. Although acupuncture is used in treatment of BP in East Asia, the mechanism has not been completely elucidated so far [7]. ...
Article
Full-text available
Bell’s palsy (BP), an acute unilateral facial paralysis, is frequently treated with acupuncture in many countries. However, the mechanism of treatment is not clear so far. In order to explore the potential mechanism, 22 healthy volunteers and 17 BP patients with different clinical duration were recruited. The resting-state functional magnetic resonance imaging scans were conducted before and after acupuncture at LI4 (Hegu), respectively. By comparing BP-induced functional connectivity (FC) changes with acupuncture-induced FC changes in the patients, the abnormal increased FC that could be reduced by acupuncture was selected. The FC strength of the selected FC at various stages was analyzed subsequently. Our results show that FC modulation of acupuncture is specific and consistent with the tendency of recovery. Therefore, we propose that FC modulation by acupuncture may be beneficial to recovery from the disease.
... Chronic administration of opioid compounds can result in immune suppression [1,2] and increased susceptibility to virus [3,4] and bacteria [2] in heroin addicts. Several lines of evidence showed that acupuncture had positive immune modulation effects in human and animals [5][6][7]. Our previous studies showed that transcutaneous acupoint nerve electrical stimulation or electroacupuncture (EA) could ameliorate the withdrawal syndrome and increase the appetite, sleep, and body weight in heroin addicts [8] or opioid-dependent animals [9]. ...
Article
Full-text available
In a previous paper we reported that electroacupuncture (EA) could suppress opioid withdrawal syndrome and increase the appetite, sleep, and body weight in heroin addicts or morphine dependent animals. Considering that opioids were known to inhibit immune function, the present study was designed to observe whether EA could modulate the immune status of morphine dependent and withdrawal mice. We found that chronic morphine-induced decrease of splenic T lymphocyte proliferation and IL-2 production can be significantly raised by 2 Hz EA, and the fluctuation of CD4(+)/CD8(+) ratio was also run to the baseline level by the EA. These findings indicated that chronic morphine exposure-induced immune dysfunction in mice could be normalized by 2 Hz EA.
... It was shown that the overly expressed IgG was significantly reduced to a normal level and hepatitis B induced liver damage was repaired following acupuncture at ST36 11 . For older patients acupuncture at the ST36 point could increase their serum levels of IgA, IgG and IgM, thereby enhancing the immune functions to prevent the invasion of pathogens and to speed up recovery 1,12 . The stimulation at ST36 site was found to significantly increase the levels of white blood cells, neutrophils, erythrocytes and thrombocytes caused by conventional chemotherapy in patients with malignant tumors 13 . ...
Article
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Dissolving microneedles carried drug molecules can effectively penetrate the stratum corneum of skin to improve the transdermal drug delivery. The traditional Chinese medicine acupuncture is based on the needle stimulation at a specific location (acupoint) to generate and transmit biochemical and physiological signals which alter the pathophysiological state of patients. However, the pain associated with conventional acupuncture needles and the requirement of highly trained professionals limit the development of acupuncture in non-Asian countries. The purpose of this study is to investigate whether the dissolving microneedles can be utilized as a self-administered painless replacement for acupuncture and locally released drug molecules can achieve expected therapeutic outcomes. Immunosuppressive rats were treated with acupuncture at Zusanli (ST36) acupoint using microneedles containing thymopentin. The immune functions and psychological mood of the immunosuppressed animals were examined. The proliferation of splenocytes was examined by CCK-8 assay. CD4 and CD8 expression patterns in spleen cells were detected by flow cytometry. The current study showed that use of either microneedles containing thymopentin or conventional acupuncture both resulted in immune cell proliferation, which was confirmed by flow cytometry. Furthermore, either conventional acupuncture or microneedles were able to effectively mitigate the anxiety caused by immune-suppression when applied on the ST36. © 2018 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences.
... Many breast cancer patients experience treatment-induced hot flashes and menopausal symptoms and instead of relying on medications, some seek other non-medical options. Acupuncture is one of the techniques that have shown advantages in distressed healthy adults [112]. A literature review reported that acupuncture enhances immune function through NK cell activity [113], based on stimulation of the acupoints, also known as "immuno-enhancing acupoint," thus enhancing nitric oxide production which promotes secretion of β-endorphin [113,114]. ...
Article
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Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.
... Die Freisetzung des Glucocorticoids Cortisol ermöglicht eine Feinabstimmung der Immunreaktion und verhindert gleichzeitig eine Überreaktion(MÜLLER und FRINGS, 2009). Dabei kommt es zu einer Regulation der T-Helferzellen, zytotoxischer T-Zellen und der T-Supressorzellen(FUJIWARA et al., 1991;PAVÃO et al., 2010).Wenn es möglich ist, einen Einfluss auf T-Zellen durch gezielte Nadelsetzung zu erreichen, so ist die Linderung der Symptomatiken einer Allergie durch eine Reduktion des IgE wahrscheinlich. Einen entscheidenden Faktor stellt an dieser Stelle der Zeitpunkt der Behandlung dar. ...
Thesis
Im Rahmen dieser wissenschaftlichen Arbeit gilt es aus dem großen Anwendungsspektrum der Akupunktur, ihren immunmodulatorischen Effekt detailliert zu analysieren. Für diesen Zweck wurden im Rahmen der vorliegenden Literaturstudie 69 Publikationen herangezogen, die in vergleichender Gegenüberstellung einen immunstimulierenden Effekt durch die Akupunktur belegen und hinterfragen. Dabei erfolgte eine Differenzierung zwischen Studien die auf Fallbeispielen beruhen und Studien, die in ihrer Methodik den wissenschaftlich-klinischen Aspekt berücksichtigen. Diese Publikationen entstammen den Literatur- und Abstractdatenbanken Scopus (Elsevier), Web of Science (Clarivate Analytics) und der Hindawi Publishing Corporation. Klinische Studien belegen einen immunstimulierenden Effekt der (Elektro-) Akupunktur bei Hypersensitivitäten, Autoimmunerkrankungen und Infektionen, vorwiegend am humanen Model, Mäusen, Ratten und Kaninchen. Darüber hinaus zeigen die Studienergebnisse einen regulativen Effekt der Akupunktur auf Immunzellen mit Fokus auf unspezifische, vorwiegend zellulär vermittelte Abwehrmechanismen (NK-Zellen, Makrophagen, Granulozyten und Lymphozyten). Ebenfalls wird eine Wiederherstellung des Th1/Th2-Zell-Gleichgewichtes erreicht. Im Verlauf des Wirkungsmechanismus nimmt der Hypothalamus die oberste Kontroll- und Regulationsinstanz mit entsprechender Einflussnahme auf das Vegetativum und Endokrinium ein. Zur Feinabstimmung der Mechanismen werden opioide und nicht-opioide Substanzen sezerniert. Ein deutlicher Effekt hin zu einer Immunmodulation geht besonders vom Punkt Ma36 aus. Keywords: Acupuncture; Animals; Immune system; Neural-immune interaction; Immunodeficiency; Allergy; Autoimmune; Immune cells; Cytokines
... Son múltiples los estudios que se han realizado sobre acupuntura y ansiedad y todos ellos tienen en común, que tras el tratamiento, se registran resultados positivos a nivel cognitivo [22][23][24][25][26][27] . Se han realizado trabajos con electroacupuntura (buscando el efecto en los síntomas relacionados con el estrés en estudiantes de medicina 28 ) y con auriculopuntura 29,30 para la ansiedad ante los exámenes en estudiantes de medicina, pero ninguno con acupuntura. ...
Article
Resumen Objetivo Evidenciar la eficacia de la acupuntura en la ansiedad ante los exámenes, en alumnos universitarios. Diseño Estudio experimental sin asignación aleatoria. Emplazamiento Universidad CEU Cardenal Herrera, Elche, Alicante. Participantes Estudiantes universitario sanos de edad ≥ 18 años: 23 sujetos en el grupo de intervención y 21 en el grupo control. Intervenciones El estudio consistió en 10 sesiones de acupuntura (2 por semana) de 30 min cada una, durante las 5 semanas anteriores a los exámenes. Al grupo control se le pasó el Inventario de Ansiedad de Beck (BAI, Beck Anxiety Inventory) en los mismos tiempos (T1, T2 y T3) en que se realizó las sesiones al grupo de intervención. Mediciones principales Para la evaluación de la ansiedad se ha utilizado el BAI, que evalúa sobre todo síntomas fisiológicos: 14 de sus 21 ítems se refieren a síntomas fisiológicos, 4 evalúan aspectos cognitivos y 3 aspectos afectivos. El cuestionario consta de 21 preguntas, con un rango de puntuación entre 0 y 63. Los puntos de corte son: ansiedad muy baja (0-21), ansiedad moderada (22-35) y ansiedad grave (> 35). Si la puntuación del BAI es igual o mayor de 22 puntos, la ansiedad es probable. Resultados Tras 5 sesiones de tratamiento se confirma que los niveles de ansiedad disminuyen respecto a la puntuación obtenida en el BAI antes de comenzar el tratamiento. Después de 10 sesiones, el grupo de intervención mantiene los niveles de ansiedad y en el grupo control sin tratamiento se disparan los niveles de ansiedad de forma significativa. Conclusiones La acupuntura ha demostrado ser efectiva para reducir los niveles de ansiedad antes de los exámenes en estudiantes de fisioterapia.
... Blind sampling was administered. The washout period of 30 days was estimated according to a previous study of the effectiveness of acupuncture on lymphocyte proliferation in the elderly [29]. All participants were randomly allocated into different starting sessions: 6 for TTM and 6 resting. ...
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The beneficial physiological effects of traditional Thai massage (TTM) have been previously documented. However, its effect on immune status, particularly in the elderly, has not been explored. This study aimed to investigate the effects of multiple rounds of TTM on senescent CD4+ T cell subsets in the elderly. The study recruited 12 volunteers (61–75 years), with senescent CD4+ T cell subsets, who received six weekly 1-h TTM sessions or rest, using a randomized controlled crossover study with a 30-day washout period. Flow cytometry analysis of surface markers and intracellular cytokine staining was performed. TTM could attenuate the senescent CD4+ T cell subsets, especially in CD4+28null NKG2D+ T cells (n = 12; p < 0.001). The participants were allocated into two groups (low < 2.75% or high ≥ 2.75%) depending on the number of CD4+28null NKG2D+ T cells. After receiving TTM over 6 sessions, the cell population of the high group had significantly decreased (p < 0.001), but the low group had no significant changes. In conclusion, multiple rounds of TTM may promote immunity through the attenuation of aberrant CD4+ T subsets. TTM may be provided as a complementary therapy to improve the immune system in elderly populations.
... Wu Command Point and Ma Dan-yang Heavenly Star Point [5]. In addition to previous reports with evidence showing it can enhance cell proliferation and neuronal differentiation, affect the limbic and paralimbic systems in the brain that may affect the body's response to stress [6][7][8], ST36 is commonly recommended and traditionally used in clinic with the features of Command point of the Abdomen, ...
... Stimulation of GB34 activates the prefrontal cortex, the precentral gyrus and putamen in patients with Parkinson's disease; areas of the brain that exhibit dysfunction due to nigral dopamine depletion (Yeo et al., 2014). LI4 (Hegu) is located on the dorsum of the hand and LI11 (Quchi) at the elbow; both are suggested to be particularly useful for improving neck-shoulder-arm disorders (Shiro et al., 2014), with clinical evidence describing the relief of stress, facial pain, headache, toothache, neck, and shoulder pain (LI4) (He et al., 2004;Shen et al., 2009;Pavão et al., 2010;Grillo et al., 2014;Wang et al., 2015), pain-related conditions, and common fever (LI11) (Choi et al., 2018). Acupoints ST34 (Liangqiu, above the laterosuperior border of the patella), ST35 (Dubi, at the lower border of the patellar) and ST36 (Zusanli, on the anterior of the leg lateral to the edge of the tibia, below ST35) are effective for postoperative pain control (Liu et al., 2015); stimulation of ST36 is frequently used to treat dyskinesia and facilitate motor recovery after stroke, to treat pain, hypertension, and other physiological dysfunctions (Sun et al., 2019) such as migraine . ...
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The extensive involvement of the endocannabinoid system (ECS) in vital physiological and cognitive processes of the human body has inspired many investigations into the role of the ECS and drugs, and therapies that target this system and its receptors. Activation of cannabinoid receptors 1 and 2 (CB1 and CB2) by cannabinoid treatments, including synthetic cannabinoids, alleviates behavioral responses to inflammatory and neuropathic pain. An increasing body of scientific evidence details how electroacupuncture (EA) treatments achieve effective analgesia and reduce inflammation by modulating cannabinoid signaling, without the adverse effects resulting from synthetic cannabinoid administration. CB1 receptors in the ventrolateral area of the periaqueductal gray are critically important for the mechanisms of the EA antinociceptive effect, while peripheral CB2 receptors are related to the anti-inflammatory effects of EA. This review explores the evidence detailing the endocannabinoid mechanisms involved in EA antinociception.
... SP6 is one of the most generally used acupuncture points in acupuncture treatment to alleviate psychic and psychosomatic dysfunction, such as depressive symptoms and anxiety disorders. 31,32 Our results also demonstrated that stimulation of acupuncture point SP6 reduced OVX-induced depression-like behavior via alleviation of the ER stress and oxidative stress in the amygdala. ...
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Background: Acupuncture has become a common complementary and alternative treatment approach for anxiety and depression. However, there is little research on the detailed mechanism of acupuncture therapy relieving depression. Previously, 17β-estradiol (E2) was shown to prevent oxidative stress and endoplasmic reticulum (ER) stress in ovariectomized (OVX) rats. This study investigated whether stimulation of Sanyinjiao (SP6) using a mechanical acupuncture instrument can alleviate depression-like behavior caused by estrogen deficiency in OVX rats. Furthermore, we found that acupuncture reduced ER stress and oxidative stress-related proteins expression. Methods: The OVX operation was performed on female SD rats that were separated into four groups: The E2 (2.5 μg/kg, i.p.) injection group (OVX + E2), the OVX group (OVX), and the OVX with acupuncture stimulation group (OVX + SP6). Non-acupoint stimulation group (OVX + NonAcu). The acupuncture point stimulation began three weeks after surgery. The depressive behavior was analyzed by the forced swim test and open field test. The 8-OHDG, BiP, Sigma receptor 1, pJNK, PDI, Ero1-Iα and Calnexin protein levels were evaluated by immunoreactivity in the amygdala. Results: Acupuncture stimulation reduced depressive behavior and altered depression-related proteins. Stimulation of SP6 decreased the immobility time of the FST and altered the ER stress and oxidative stress marker proteins, such as 8-OHDG, BiP, pJNK, PDI, Ero1-Ia and Calnexin. Conclusion: Our results indicated that acupuncture at SP6 showed a significant antidepressant-like effect on an OVX-induced depression rat model by mitigation of ER stress and oxidative stress in amygdala.
Thesis
A mixed-methods study evaluating the effects of acupuncture as an adjunct intervention for antenatal depression.
Article
Depression associated with inflammatory immune responses may be an important medical problem from the perspective of quality of life in old age because chronic inflammation is recognized to have a close connection with the aging process. Activated proinflammatory cytokines induce depression-like behavior by stimulating the expression of indoleamine-2,3-dioxygenase, an enzyme catalyzing the conversion of tryptophan to kynurenine, and by reducing brain synaptic activities of serotonin and dopamine. Experimental inoculation of Bacillus Calmette-Guérin vaccine (BCG) in the mouse gradually and continuously elicits chronic inflammation-associated depression-like behavior. Despite extensive use of acupuncture therapy for treating various psychosomatic disorders in the Oriental medicine, an experimental study showing antidepressant-like activity of acupuncture stimulation has not been performed in the inflammation-associated depression-like animal behavior yet. In the present study, the antidepressant-like activity of acupuncture and its mechanism of action were investigated in BCG-inoculated mice. We confirmed that acupuncture stimulation significantly reduced depression-like behavior and that it lowered the kynurenine/tryptophan ratio and raised the serum kynurenic acid/3-hydroxykynurenine ratio. Acupuncture also relieved the hippocampal dopamine level that was lowered by BCG inoculation. Taken together, these findings may indicate that acupuncture has antidepressant-like effects on murine chronic inflammation-associated depression-like behavior due to its modulatory effects on tryptophan-kynurenine metabolism and dopamine metabolism in the brain.
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Stress factors impair physiological and psychological balance state of the individuals. This situation can cause various diseases. Today, diseases caused by stress are treated with methods like educational program for coping with stress, psychotherapy, drug therapy. Recently, acupuncture treatment is added to these methods. Acupuncture treatment effects to modulate various neurophysiologic mechanisms in during resistance period of stress. This mechanism provides support for the person's psychological state. Acupuncture treatment increases the secretion of hormones such as endomorphine, beta endorphine, enkephalin, serotonin and cortisol from central nervous system. Stress factors increase endomorphin, beta endorphin, enkephalin, serotonin and oxytocin levels in the central nervous system and plasma in the resistance period to stress. Acupuncture applications increase the synthesis and release of endomorphin, beta endorphin, enkephalin, serotonin and oxytocin from the central nervous system which strengthens the individual's resistance period to cope with stress. Therefore, method of acupuncture is also used in the treatment of diseases caused by stress.
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Most lung cancer patients experience multiple symptoms related either to the disease or its treatment. The commonly reported symptoms are pain, depression, anxiety, nausea, and poor well-being. The aim of the present study was to evaluate the effect of acupuncture as a potential treatment modality in symptomatic lung cancer patients. This prospective observational study enrolled 33 lung cancer patients from the Peter Brojde Lung Cancer Centre between August 2010 and May 2012. All patients received 45-minute sessions of acupuncture, 1-2 times weekly for a minimum of 4 sessions. Symptom severity was assessed using the Edmonton Symptom Assessment System (esas) before and after completion of acupuncture. The study cohort included 30 patients with non-small- cell lung cancer and 3 with small-cell lung cancer. Mean age was 62 years (range: 36-88 years); 17 of the patients were women. Most of the patients had advanced-stage cancer (73%) and good performance status (Eastern Cooperative Oncology Group 0-1: 88%). Of these patients, 67% received anticancer treatment (chemotherapy or radiotherapy, or both) with acupuncture. Of the remaining 10 patients, 8 received acupuncture after a complete surgical resection of their tumour, and because of their advanced age, 2 received acupuncture and best supportive care. The median number of acupuncture sessions was 7 (interquartile range: 4-13 sessions). Statistically significant improvements in pain, appetite, nausea, nervousness, and well-being were observed. A clinically important improvement (2 points on the esas) was reported by 61% of patients for pain and by 33% for well-being. A significant positive correlation between improved well-being and the number of acupuncture sessions was observed. This correlation remained significant even after controlling for treatment and narcotic use. Receiver operating characteristic analysis demonstrated that a minimum of 6 acupuncture sessions are required for a 70% chance of a clinically important improvement in well-being. The present study is the first to demonstrate that acupuncture may be an effective approach for improving symptoms-in particular, pain and well-being-in lung cancer patients. Acupuncture is a safe and minimally invasive procedure, and it is potentially useful even in patients undergoing anticancer treatment.
Article
The aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment. Fifty-six individuals (16 males and 40 females), age 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values obtained. Pain intensity was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment. NK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups. This study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.
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Le risque psychosocial est élevé chez les professionnels de santé, particulièrement chez les chirurgiens dentistes. Les données de la littérature internationale précisent les notions de stress et de burnout, particulièrement chez les soignants et pour quelques rares études chez les odontologistes. Le stress chronique, le burnout cousin de la dépression grave, peuvent conduire au suicide ou ses équivalents (alcoolisme, renoncement, relationnel perturbé dans le cadre professionnel mais aussi personnel et familial). L’auteur a enquêté par questionnaire les chirurgiens dentistes de Lorraine et du Bas-Rhin en 2011 soit 692 réponses. Le questionnaire intègre celui de la thèse du Dr ENGELS-DEUTSCH (Le stress en chirurgie dentaire – 1987). Les résultats de ce travail sont édifiants : il permet d’identifier un groupe de professionnels à risque associant une surcharge de travail, des difficultés relationnelles autant avec les collègues et collaborateurs qu’avec leur famille, une tendance nette à la gestion de l’anxiété par les addictions communes. La comparaison des données avec celles relevées il y a 25 ans, indique que les chirurgiens dentistes sont plus inquiets et plus anxieux aujourd’hui alors que les conditions psychosociales n’ont pas l’air de se dégrader de manière significative. Des pistes de réflexions sont ensuite développées afin de prévenir le risque de burnout dès la formation initiale et d’adapter des thérapeutiques qui pourraient soulager le stress professionnel.
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Ondansetron, sometimes combined with acustimulation at PC6 (Neiguan), is commonly used for preventing postoperative nausea and vomiting, but PC6 is not the only point that can be used for this purpose. To evaluate the combined effects of ondansetron and ST36 (Zusanli) acupuncture point injection on postoperative vomiting (POV) after laparoscopic surgery. A randomised, patient and assessor-blinded, placebo-controlled clinical study was conducted. One hundred and sixty patients undergoing laparoscopic surgery were randomly assigned to one of four groups: (1) group P (placebo-control): intravenous normal saline+bilateral non-acupuncture point injection of vitamin B1 (n=40); (2) group O (ondansetron): intravenous ondansetron+bilateral ST36 sham injection (n=40); (3) group A (acupuncture point injection): intravenous normal saline+bilateral acupuncture point injection at ST36 of vitamin B1 (n=40); (4) group C (combination): intravenous ondansetron+bilateral acupuncture point injection at ST36 of vitamin B1 (n=40). Interventions were made on arrival at the postanaesthesia care unit. The primary outcome was the incidence of POV within 24 h after the operation. Secondary outcomes included severity of vomiting, incidence of rescue treatment, patients' satisfaction and the first anal exsufflation time 24 h after the operation. The incidence of POV within 24 h postoperative period in each group was P 33%; O 11%, A 9% and C 6%. Outcomes for all intervention groups were significantly better than that for placebo (p<0.01). For the three interventions compared with placebo, the numbers needed to treat (NNTs) were O, NNT=5; A, NNT=5 and C, NNT=4. The secondary outcomes also demonstrated greater benefits of the combined regimen, with improvement seen in all the measures. Ondansetron, acupuncture, and ondansetron and acupuncture combined are effective prophylaxis for POV.
Conference Paper
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This research examines the discrepancy between research findings on acupuncture and news articles on its effectiveness. A number of evidence-based studies have been published about acupuncture and underlying mechanisms for treating a range of diseases. However, news articles reporting about acupuncture often overlook the evidence. Method Content-analyzing information about the discrepancy includes examining research about acupuncture contained in scientific data bases (PubMed, PsycInfo) and analyzing the contents of relevant news articles in google.com. Results: Searching PubMed with the keyword acupuncturehas yelled142 reports based on clinical trials and 292 review articles about acupuncture. All the research showed acupuncture's benefits. PsycInfo database has generated total 246 articles showing acupuncture’s effectiveness and no article about its ineffectiveness. On the other hand, the keywords “acupuncture news” in google.com have generated 23,900 articles or websites. With judgmental sampling, the focus is then on analyzing the manifest contents of the selected publications. Although most of the news are objective, there are many biased statements against acupuncture in the news, which can be put into five categories: (1) “Traditional acupuncture as sham procedures,”(2)” Existing evidence is consistent with acupuncture being no more effective than a placebo,”(3) “Even fake acupuncture eases headaches,” (4)” Acupuncture can spread serious diseases,” and (5)” researching acupuncture's effectiveness is a controversial activity.” Discussions: Three factors may explain the discrepancy between the evidence-based research and the news reports about acupuncture’s effectiveness: cognitive factors (ignorance about acupuncture), motivational and cultural factors (e.g., selectively processing evidence, a belief that the Western approach to illness is the only scientific way to understand and treat diseases).
Article
Cumulative evidences addressed that electroacupuncture (EA) was favorably effective in the treatment of trauma stress-induced immunodeficiency and physical disorders. However, the salutary effects of EA under operation trauma conditions mediated via p38 MAPK remain unknown. Hence, our study aimed to further investigate the effects of EA on CD4(+)/CD8(+) homeostasis and cytokine expressions, and evaluate the p38 MAPK signaling regulatory mechanism of EA effects.
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Major depressive disorder (MDD) is a prevalent condition associated with significant burden in terms of reduced quality of life, lower productivity, increased prevalence of other conditions and increased health care costs. We conducted a systematic review and qualitative summary of randomized controlled trials (RCTs) that assessed the effectiveness and safety of acupuncture for the treatment of MDD. We searched the databases PubMed, CINAHL, PsycINFO, Web of Science, Embase, CDSR, CENTRAL, clinicaltrials.gov, DARE, and PILOTS for English-language RCTs published through January 2015. Two independent reviewers screened the identified literature against inclusion and exclusion criteria, abstracted study level data, and assessed the risk of bias and methodological quality of included studies. The quality of the evidence was assessed using GRADE. Eighteen studies met inclusion criteria. Eleven assessed acupuncture as monotherapy, seven as adjunct depression treatment. Intervention approaches and comparators varied. Evidence on the effectiveness and comparative effectiveness of acupuncture to treat MDD for the outcomes depression improvement, measured as scale score differences and the number of responders, is very weak. Acupuncture may be superior to waitlist (low quality of evidence) but findings for effect estimates compared to other comparators are inconclusive. Few studies reported on patients achieving remission. The effect of acupuncture on relapse rates could not be determined. Too few studies assessed quality of life to estimate treatment effects. Reported adverse events were typically mild in nature, but the assessment lacked rigor and studies were not designed to detect rare events.
Article
Zusammenfassung: Im Rahmen der vorliegenden Literaturstudie wurden die aktuellen Kenntnisse über den Zusammenhang zwischen Akupunkturbehandlung und Reaktion des Immunsystems zusammengefasst. Die Akupunktur spricht über eine Kopplung von Nerven- und Immunsystem sowohl unspezifische angeborene als auch spezifische Abwehrmechanismen an. Diesbezüglich wurden 69 wissenschaftliche Studien herangezogen und ausgewertet. Die Ergebnisse lassen darauf schließen, dass über eine Stimulation peripherer Nervenbahnen an definierten Punkten eine Immunmodulation erfolgt. Primär wird dabei der angeborene unspezifische Teil des Immunsystems angesprochen. Einer der zu diesem Zweck häufig genannten Akupunkturpunkte ist Ma 36.
Article
Background: Pediatric chronic pain not only affects the child but also has a ripple effect on the entire family. While several studies have shown that acupuncture is beneficial for decreasing pain intensity in adults, few studies have examined the effectiveness of acupuncture in children and adolescence as well as the impact of acupuncture on the association between parent stress and child pain. Objective: This study examined whether two acupuncture treatments may help reduce child pain and parent stress as well as examining the bidirectional relationship between parent stress and child pain across the two treatments. Design: The study was a pre/post test design. Participants completed the Pediatric Inventory for Parents and Faces Pain Scale-Revised at baseline and at the conclusion of the second acupuncture treatment (at Time 2). Setting: Participants were recruited from a pain clinic at an academic pediatric hospital. Patients: Parent-child dyads (N=29; Mage=14.13; standard deviation=2.43) participated in the study. Results: Child pain and parent stress significantly decreased after two acupuncture treatments. Child pain significantly predicted parent stress frequency, difficulty, and stress frequency, while parent stress difficulty significantly predicted child pain at baseline. At T2, there was a bidirectional relationship between parent stress frequency, difficulty and child pain. Conclusions: These findings suggest that acupuncture is beneficial for reducing child pain and parent stress. The results also emphasize the bidirectional relationship between parent stress frequency and the child's perception of pain.
Article
Background: Chinese medicine, when applied as a whole system of care, traditionally incorporates self-care techniques and patient understanding as key aspects of patient recovery and health maintenance. Objectives: This review aims to explore the literature to date on Traditional Chinese Medicine (TCM) self-care in settings outside of Asia, beyond the sole application of t'ai chi or qigong, to consider simple self-care techniques as health care interventions that may be generalized to a wider population. Design: AMED, CINAHL, EMBASE, PubMed, and MEDLINE databases were searched for articles from inception to July 2018. Studies were included, which were undertaken in settings outside of Asia and/or Asian communities, and were excluded if they solely examined t'ai chi or qigong. Results: Findings of the included studies (n = 37) were categorized into four key areas in relation to the TCM self-care component evaluated: self-acupressure, self-acupuncture, self-moxibustion, and the adoption of prescribed lifestyle, diet, and exercise advice based on a TCM diagnosis. The studies included randomized clinical trials, case studies, hospital audits, and qualitative evaluations. The studies assessed TCM self-care in relation to a wide range of health conditions, with the majority of studies concluding positive findings. Conclusion: This review draws attention to the potential role of TCM self-care techniques, in settings outside of Asia, beyond the sole practices of t'ai chi and qigong, as an adjunct to health maintenance and recovery. Only tentative conclusions can be drawn from the existing research, however, due to variability across studies in reporting transparency and the overall low number of studies retrieved. Further research is warranted.
Article
BACKGROUND: The acupuncture and moxibustion is an effective method to regulate the immunosenescence. The epigenetic modification has become a focus in the research of immunosenescence regulation. OBJECTIVE: To summarize the relationship between epigenetic regulation and the regulatory role of acupuncture and moxibustion on immunosenescence, and to explore the relevant mechanisms. METHODS: We searched CNKI, VIP, WANFANG DATA, SinoMed, Ebsco Medline, Springer, ScienceDirect and Embase by computer for relevant articles published from January 1999 to August 2014. The keywords were “acupuncture”, “moxibustion”, “aging”, “immunosenescence” and “epigenetic” in Chinese and English. All databases were cross-searched to minimize missing data. We excluded documents based on inclusion and exclusion criteria thereby checking the title and abstract. RESULTS AND CONCLUSION: Finally 64 articles were included, including 8 Chinese publications and 56 English publications. The innate immune system and the adaptive immune system can vary with aging, which is the most obvious feature in immunosenescence. The acupuncture and moxibustion can improve immunosenescence overall. The epigenetic modification plays an important role in immunosenescence. The acupuncture and moxibustion can affect the epigenetic modification directly. However, the epigenetic mechanism underlying the regulatory role of acupuncture and moxibustion in immunosenescence needs further studies. © 2015, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.
Article
Ageing is a continuous and slow process that compromises the normal functioning of various organs and systems in both qualitative and quantitative terms. During recent years, a growing body of studies has demonstrated that ageing remodels immune functions, a process known as immunosenescence. The clinical consequences of immunosenescence may include increased susceptibility to infectious diseases, neoplasias, metabolic diseases, osteoporosis and autoimmune diseases (Castle, Clin Infect Dis 31(2):578-585 2000; Pawelec et al., Crit Rev Oncol Hematol 75(2):165-172, 2010). This increased morbidity is not evenly distributed and seems to be influenced by other immune-modulating factors, including genetic background and chronic stress exposure (Bauer, Stress 8(1):69-83, 2005). Indeed, psychological stress appears to be an important factor leading to earlier onset of many age-related diseases (McEwen, New Engl J Med 338:171-179, 1998). Therefore, a better understanding of how stress is likely to promote 'biological ageing' may lead to clinical interventions or policies with a broad public health impact. © 2013 Springer Science+Business Media New York. All rights are reserved.
Technical Report
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This systematic review synthesized evidence from randomized controlled trials (RCTs) to determine the efficacy of needle acupuncture for posttraumatic stress disorder (PTSD; PROSPERO record CRD42015026766). Through January 2016, we searched nine databases, as well as trial registries and existing systematic reviews, to identify RCTs evaluating the efficacy and safety of needle acupuncture—used adjunctively or as monotherapy—to treat adults with PTSD. Two independent reviewers screened identified literature using predetermined eligibility criteria, extracted study-level information, and assessed the methodological quality of included studies. Outcomes of interest included PTSD symptoms (primary outcome), health-related quality of life, functional status, anxiety and depression symptoms, sleep quality, and adverse events. Meta-analyses were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of the body of evidence was assessed using the GRADE approach. Seven studies (reported in ten publications) with 709 total participants were included. Studies compared acupuncture with treatment as usual (TAU), sham acupuncture, a passive waitlist control, cognitive behavioral therapy, and paroxetine. We found statistically significant effects in favor of acupuncture (as adjunctive or monotherapy) versus any comparator for PTSD symptoms at postintervention (standardized mean difference [SMD] −0.80; 95% confidence interval [CI] −1.59 to −0.01; 6 RCTs; very low quality of evidence) and at a follow-up between one and six months (SMD −0.46; CI −0.85 to −0.06; 4 RCTs; low quality of evidence). No statistically significant effect was identified for depression symptoms at postintervention (SMD −0.58; CI −1.17 to 0.01; 6 RCTs; very low quality of evidence), but the effect was significant at the one- to six-month follow-up (SMD −0.56; CI −0.88 to −0.23; 4 RCTs; low quality of evidence). No significant effects of acupuncture were identified for anxiety symptoms at postintervention (SMD −0.82; CI −2.16 to 0.53; 4 RCTs; very low quality of evidence) and one- to six-month follow-up (SMD −0.35; CI −1.17 to 0.47; 3 RCTs; very low quality of evidence) or for sleep quality (compared with TAU or sham acupuncture) at postintervention (SMD −0.46; CI −3.95 to 3.03; 2 RCTs; low quality of evidence). All other outcomes were reported only in single studies without replication. Safety data suggest that acupuncture is not associated with any serious adverse events, though some participants reported minor or moderate needle pain, superficial bleeding, and hematoma; however, safety was not systematically collected in most studies. We did not detect systematic differences by type of acupuncture, but there were only a few studies in each category and no head-to-head trials were identified. We did not detect systematic differences in effects comparing adjunctive and monotherapy studies, but the number of RCTs was insufficient for robust analyses. We did not detect systematic differences by comparator, but very few studies reported on the same comparator, hindering analyses. We identified potential benefits of acupuncture for PTSD and depression symptoms compared with control groups in the months following treatment. However, the number of available studies is small, and the quality of evidence is low to very low. Few minor adverse events and no serious adverse events were reported, but safety assessments were limited. Additional well-designed, rigorous, and large RCTs have the potential to further develop the evidence base to provide more-conclusive evidence.
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2 ، ‫محمدخانی‬ ‫پروانه‬ 3 ، ‫آ‬ ‫باغداساریانس‬ ‫نیتا‬ 4 1. ‫ایران‬ ، ‫تهران‬ ‫اسالمی،‬ ‫آزاد‬ ‫دانشگاه‬ ‫مرکزی،‬ ‫تهران‬ ‫واحد‬ ‫روانشناسی،‬ ‫گروه‬ ‫ایران‬ ، ‫تهران‬ ‫اسالمی،‬ ‫آزاد‬ ‫دانشگاه‬ ‫مرکزی،‬ ‫تهران‬ ‫واحد‬ ‫روانشناسی،‬ ‫گروه‬ ‫مدعو‬ ‫(استاد‬ ‫ایران‬ ‫تهران،‬ ‫توانبخشی‬ ‫و‬ ‫بهزیستی‬ ‫علوم‬ ‫دانشگاه‬ ‫بالینی،‬ ‫روانشناسی‬ ‫گروه‬) ‫گر‬ ، ‫آزاد‬ ‫دانشگاه‬ ‫مرکزی‬ ‫تهران‬ ‫واحد‬ ‫روانشناسی،‬ ‫وه‬ ‫ایران.‬ ‫تهران،‬ ‫اسالمی،‬ ‫ایران‬ ، ‫تهران‬ ‫اسالمی،‬ ‫آزاد‬ ‫دانشگاه‬ ‫مرکزی،‬ ‫تهران‬ ‫واحد‬ ‫روانشناسی،‬ ‫گروه‬ * ‫نویسنده‬ ‫مسئول:‬ F.keshavarzi@iauctb.ac.ir ‫چکیده‬ ‫مقدمه‬ ‫توجه‬ ‫با‬ : ‫محققان‬ ‫اینکه‬ ‫به‬ ‫کوتاه‬ ‫درمانی‬ ‫رویکردهای‬ ‫دنبال‬ ‫به‬ ‫هستند‬ ‫شناختی‬ ‫روان‬ ‫و‬ ‫جسمانی‬ ‫اختالالت‬ ‫زمینه‬ ‫در‬ ‫موثرتر‬ ‫و‬ ‫تر‬ ‫؛‬ ‫مقایسه‬ ‫تحقیق‬ ‫این‬ ‫از‬ ‫هدف‬ ‫بنابراین‬ ‫اثربخش‬ ‫ی‬ ‫درمان‬ ‫شناخت‬ ‫ی‬ ‫مبتن‬ ‫ی‬ ‫آگاه‬ ‫ذهن‬ ‫بر‬ ‫سوزنی‬ ‫طب‬ ‫و‬ ‫ی‬ ‫بر‬ ‫شده‬ ‫ادراک‬ ‫استرس‬ ‫ورزشکاران‬ ‫حرفه‬ ‫ا‬ ‫بود.‬ ‫جسمانی‬ ‫آسیب‬ ‫دارای‬ ‫ی‬ ‫کا‬ ‫روش‬ ‫ر:‬ ‫تجربی‬ ‫نیمه‬ ‫تحقیق‬ ‫روش‬ ‫می‬ ‫ورزشکاران‬ ‫تمامی‬ ‫را‬ ‫تحقیق‬ ‫آماری‬ ‫جامعه‬ ‫باشد.‬ ‫حرفه‬ ‫ا‬ ‫مرد‬ ‫ی‬ 20 ‫تا‬ 25 ‫آسیب‬ ‫دارای‬ ‫سال‬ ‫سال‬ ‫ورزشی‬ ‫جسمانی‬ 1398 ‫و‬) ‫ورزشی‬ ‫ـ‬ ‫پزشکی‬ ‫(فدراسیون‬ ‫المپیک‬ ‫ملی‬ ‫کمیته‬ ‫به‬ ‫مراجعه‬ ‫با‬ ‫که‬ ‫دادند‬ ‫تشکیل‬ ‫به‬ ‫صورت‬ ‫دسترس‬ ‫در‬ ‫نمونه‬ ‫شدند.‬ ‫انتخاب‬ ‫هدفمند‬ ‫و‬ ‫آماری‬ ‫تحقی‬ ‫تحقیق‬ ‫به‬ ‫ورود‬ ‫معیارهای‬ ‫براساس‬ ‫ق‬ 36 ‫که‬ ‫بودند‬ ‫نفر‬ ‫به‬ ‫صورت‬ ‫به‬ ‫ساده‬ ‫تصادفی‬ 3 ‫گروه‬ 12 ‫تحقیق‬ ‫از‬ ‫خروج‬ ‫معیارهای‬ ‫براساس‬ ‫بعد‬ ‫مرحله‬ ‫در‬ ‫و‬ ‫شدند‬ ‫تقسیم‬ ‫نفری‬ 33 ‫استرس‬ ‫مقیاس‬ ‫شامل‬ ‫تحقیق‬ ‫ابزارهای‬ ‫ماندند.‬ ‫باقی‬ ‫نفر‬ ‫تحلی‬ ‫آزمون‬ ‫از‬ ‫استفاده‬ ‫با‬ ‫اطالعات‬ ‫تحلیل‬ ‫و‬ ‫تجزیه‬ ‫بود.‬ ‫شده‬ ‫ادراک‬ ‫چندگانه‬ ‫واریانس‬ ‫ل‬ ANOVA ‫اندازه‬ ‫آزمون‬ ،) ‫و‬ ‫مکرر‬ ‫گیری‬ ‫شد.‬ ‫انجام‬ ‫تعقیبی‬ ‫آزمونهای‬ ‫نتایج:‬ ‫تفاوت‬ ‫پیگیری‬ ‫و‬ ‫آزمون‬ ‫پس‬ ‫و‬ ‫پیگیری‬ ‫و‬ ‫آزمون‬ ‫پیش‬ ‫و‬ ‫آزمون‬ ‫پس‬ ‫و‬ ‫آزمون‬ ‫پیش‬ ‫بین‬ ‫آگاهی‬ ‫ذهن‬ ‫گروه‬ ‫در‬ ‫گه‬ ‫داد‬ ‫نشان‬ ‫نتایج‬ (‫دارد‬ ‫وجود‬ ‫معناداری‬ 001 / 0 > p ‫آزم‬ ‫پیش‬ ‫بین‬ ‫نیز‬ ‫سوزنی‬ ‫طب‬ ‫گروه‬ ‫در‬ .) ‫دارد(‬ ‫وجود‬ ‫معناداری‬ ‫تفاوت‬ ‫آزمون‬ ‫پس‬ ‫و‬ ‫ون‬ 001 / 0 > p .) (‫نداشت‬ ‫وجود‬ ‫معناداری‬ ‫تفاوت‬ ‫پیگیری‬ ‫و‬ ‫آزمون‬ ‫پس‬ ‫بین‬ ‫ولی‬ 551 / 0 = p .) ‫گیری:‬ ‫نتیجه‬ ‫می‬ ‫نظر‬ ‫به‬ ‫آگاهی‬ ‫ذهن‬ ‫ولی‬ ‫گذارند‬ ‫تاثیر‬ ‫شده‬ ‫ادراک‬ ‫استرس‬ ‫بر‬ ‫سورنی‬ ‫طب‬ ‫و‬ ‫آگاهی‬ ‫ذهن‬ ‫درمانی‬ ‫رویکرد‬ ‫دو‬ ‫هر‬ ‫که‬ ‫رسد‬ ‫طول‬ ‫در‬ ‫ماندگارتری‬ ‫تاثیرات‬ ‫دارد.‬ ‫سوزنی‬ ‫طب‬ ‫به‬ ‫نسبت‬ ‫زمان‬ ‫واژگان‬ ‫کلیدی:‬ ‫درمان‬ ‫شناخت‬ ‫ی‬ ‫مبتن‬ ‫ی‬ ‫آگاه‬ ‫ذهن‬ ‫بر‬ ‫سوزنی،‬ ‫طب‬ ‫ی،‬ ‫شده،‬ ‫ادراک‬ ‫استرس‬ ‫ورزشکاران‬ ‫جسمانی‬ ‫آسیب‬ ،
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Chronic stress has been associated with detrimental or maladaptive neuroendocrine and immunological changes. We assessed the neuroendocrine and immunological correlates of a realistic chronic stress experienced by strictly healthy caregivers of Alzheimer's disease patients and age-matched controls. We screened 330 caregivers and 206 non-caregivers according to the 'strictly healthy' conditions established by the SENIEUR protocol. Forty-one strictly healthy caregivers (60.56 +/- 16.56 years) and 33 non-stressed controls (60.27 +/- 14.11 years) were selected for this study. Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were assessed at multiple points by radioimmunoassay. Peripheral T cell proliferation and cellular sensitivity to glucocorticoids (corticosterone and dexamethasone, DEX) were evaluated by colorimetric assays. We also examined the hypothalamic-pituitary-adrenal (HPA) axis response to the administration of a low-dose DEX in vivo. The caregivers were significantly more stressed, anxious and depressed than non-caregivers (all p < 0.0001), in contrast to similar cortisol levels. Caregivers had reduced DHEAS levels (-32%, p < 0.0001), an increased cortisol/DHEAS ratio (39.7%, p < 0.0001) and impaired HPA axis response to DEX intake. Caregivers had a higher T cell proliferation (p < 0.0001) and increased sensitivity to glucocorticoids in vitro (p < 0.01) as compared to non-stressed controls. Our results suggest that the maintenance of health in chronically stressed populations may be associated with both protective and detrimental neuroendocrine and immunological changes.
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We have validated a Portuguese version of the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) tests by obtaining profiles for three Brazilian samples: 270 university students, 117 panic patients and 30 depressed patients. The mean BDI scores were higher for depressed patients (25.2 +/- 12.6), intermediate for anxious patients (15.8 +/- 10.3) and lower for students (8.5 +/- 7.0). Mean STAI scores for anxious (52.8 +/- 11.4) and depressed patients (56.4 +/- 10.5) were higher than for the student sample (40.7 +/- 8.6). BDI and STAI scores were correlated significantly in all samples. The internal consistency of the Portuguese version of BDI is in agreement with the literature (0.81 for students and 0.88 for depressed patients). The present data demonstrate that the psychometric properties of the Portuguese versions of the BDI and STAI are comparable to the original English language versions of these questionnaires, thereby indicating their use in clinical situations.
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Both endocrine and immune systems are continuously remodeled during aging. Objective: Here, we investigated to what extent adrenal and somatosenescence are associated reciprocal changes in the immune system during strictly healthy aging. Forty-six elderly subjects and 33 young adults were recruited according to the health criteria of the SENIEUR protocol. Peripheral blood mononuclear cells were isolated and stimulated in vitro with lipopolysaccharide or phytohemagglutinin to assess the production of immunoreactive growth hormone (GH). Peripheral sensitivity to steroids was assessed in vitro by dexamethasone-, cortisol- or dehydroepiandrosterone (DHEA)-induced inhibition of T-cell proliferation. DHEA and GH levels were measured by radioimmunoassays. Healthy elderly had lower salivary DHEA and serum GH levels (somatosenescence). They presented reduced T-cell sensitivity to dexamethasone but similar cellular sensitivities to cortisol and DHEA. Their cells produced similar levels of immunoreactive GH compared to the cells of young adults. These data indicate that healthy aging is associated with adrenal and somatosenescence as well as impaired neuroendocrine immunoregulation at the level of the lymphocyte. In addition, somatosenescence may not be associated with a reciprocal decline in immunoreactive GH.
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Treatment advances have transformed human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) into a chronic manageable disease; quality of life (QoL) has become an important health outcome. Some studies have shown the individual effects of acupuncture and the relaxation response (RR) in improving QoL of patients with HIV/AIDS. In light of the presumed shared features of acupuncture and the RR, we conducted a pilot study to examine the effects of adding the RR to usual acupuncture treatment on improving the QoL of HIV/AIDS patients. Two-arm double-blind randomized controlled trial. SETTINGS/LOCATION AND SUBJECTS: We enrolled 119 patients with HIV/AIDS (mean age 46 years, 85% male) who had at least 1 of the highly prevalent HIV-related symptoms and who were receiving acupuncture treatment in an acupuncture clinic in Boston, MA. We randomized patients into intervention (N = 58) and control (N = 61) groups. All participants received individualized acupuncture treatments prescribed by their acupuncturists. While receiving acupuncture treatment, the intervention group wore earphones to listen to tapes with instructions to elicit the RR followed by soft music that was routinely played in the clinic; the control group listened only to soft music. Three (3) QoL scales: the Medical Outcomes Study HIV health survey, the Functional Assessment of HIV Infection, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, measured at baseline, 4-week, 8-week, and 12-week follow-ups. At the 12-week follow-up, the intervention group showed significant improvements in emotional (p = 0.0002), spiritual/peace (p = 0.02), physical (p = 0.003) and mental health (p = 0.0003) QoL from baseline. Results of mixed effects regression models indicated linear trends of improvement over time in these dimensions of QoL for the intervention group (p < 0.02). In the control group, the only significant improvement was observed in the emotional QoL (p < 0.01). The intervention group showed trends of greater improvements than the control group (p = 0.07 for 12-week physical health QoL). Data from this pilot trial suggested that adding the RR to acupuncture may enhance improvement in QoL of patients with HIV/AIDS. Further investigation on this putative synergistic effect is warranted.
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Acupuncture has recently been attracting more and more people throughout the world as an alternative treatment, however little is known about its physiological activities (i.e. immune system). We examined acupuncture both quantitatively and qualitatively by measuring CD-positive cell counts and cytokine expression levels in the blood, to determine the activity of T cells, B cells, macrophages and natural killer (NK) cells. Fifteen milliliters of peripheral blood obtained from 17 healthy volunteers aged 21-51 years, were analyzed using flow cytometry before and after acupuncture treatment. There was a statistically significant increase in the number of CD2(+), CD4(+), CD8(+), CD11b(+), CD16(+), CD19(+), CD56(+) cells as well as IL-4, IL-1beta and IFN-gamma levels in the cells after acupuncture stimulation of meridian points. These observations indicate that acupuncture may regulate the immune system and promote the activities of humoral and cellular immunity as well as NK cell activity. In this article, we discussed how acupuncture regulated leukocyte numbers and functions since they are considered to be potential indicators for evaluating complementary and alternative medicine.
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This manuscript reviews current evidence suggesting that aging of the immune system (immunosenescence) may be closely related to chronic stress and stress factors. Healthy aging has been associated with emotional distress in parallel to increased cortisol to dehydroepiandrosterone (DHEA) ratio. The impaired DHEA secretion together with the increase of cortisol results in an enhanced exposure of lymphoid cells to deleterious glucocorticoid actions. The lack of appropriated growth hormone signaling during immunosenescence is also discussed. It follows that altered neuroendocrine functions could be underlying several immunosenescence features. Indeed, changes in both innate and adaptive immune responses during aging are also similarly reported during chronic glucocorticoid exposure. In addition, chronically stressed elderly subjects may be particularly at risk of stress-related pathology because of further alterations in both neuroendocrine and immune systems. The accelerated senescent features induced by chronic stress include higher oxidative stress, reduced telomere length, chronic glucocorticoid exposure, thymic involution, changes in cellular trafficking, reduced cell-mediated immunity, steroid resistance, and chronic low-grade inflammation. These senescent features are related to increased morbidity and mortality among chronically stressed elderly people. Overall, these data suggest that chronic stress leads to premature aging of key allostatic systems involved in the adaptation of the organisms to environmental changes. Stress management and psychosocial support may thus promote a better quality of life for elderly people and at the same time reduce hospitalization costs.
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In the course of treatment by Dr. H.L. Wen's technique of acupuncture for the withdrawal symptoms of various drugs, it was noted that there was a relief of neurotic symptoms, tension, restlessness and depression. Therefore, this treatment was used on neurotic patients. Forty patients ranging in age from 22 to 61 years were treated. Case reports are given on four patients. The degree of relief from neurotic symptoms was most marked in symptoms of restlessness, tension, mental and physical fatigue, loss of appetite and irritability, in that order. Obsessional symptoms showed a poor response. It is concluded that electro-acupuncture is useful in the treatment of neurotic symptoms, that it is cheaper and safer than other methods of treatment in use at this time, and that it is a useful adjunct in the treatment of psychoneurosis.
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The National Institutes of Health recently recommended acupuncture as an effective tool for the treatment of various health problems. Acupuncture is an old technique but has been popular in the United States only since 1972. Its history, theories, and indications are not well known to the medical community. We reviewed the literature to gather information on the history, techniques, physiology, indications, adverse effects, and opposing views to acupuncture. The mechanism by which acupuncture works involves neurotransmitters and adrenocorticotropic hormones. It appears to be effective in the treatment of pain, nausea, and drug detoxification and in stroke victims. Studies suggest acupuncture is no more effective than placebo. Acupuncture side effects have rarely been reported. Acupuncture appears to be a safe and effective alternative medical therapy for certain health problems. More controlled research is necessary to better understand the range of its clinical application.
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Electroacupuncture (EA) stimulation has been found to influence the brain (norepinephrine metabolism in experimental animals). Preliminary clinical research has shown that EA treatment is as effective as amitriptyline for patients with depression. In this study, two consecutive clinical studies on the treatment of depression with EA are conducted. The first study was double blind placebo controlled, in which 29 depressed inpatients were recruited. Patients were randomly divided into three groups: EA + placebo; amitriptyline; and EA + amitriptyline. They received EA and/or amitriptyline treatment for 6 weeks. The Hamilton Rating Scale for Depression, Clinical Global Impression and ASBERG scales for the side effect of antidepressants were used to evaluate the therapeutic efficacy and side effects. Based on the results and research protocol of the first study, a multi-centered collaborative study was conducted, in which 241 inpatients with depression were recruited. Patients were randomly divided into two treatment groups: the EA + placebo and the amitriptyline groups. The results from both studies showed that the therapeutic efficacy of EA was equal to that of amitriptyline for depressive disorders (P > 0.05). Electro-acupuncture had a better therapeutic effect for anxiety somatization and cognitive process disturbance of depressed patients than amitriptyline (P < 0.05). Moreover, the side effects of EA were much less than that of amitriptyline (P < 0.001). The article suggested that EA treatment was an effective therapeutic method for depressive disorders. Particularly, it was a treatment of choice for depressed patients who were unable to comply with the classic tricyclic antidepressants because of their anticholinergic side effects. The possible mechanism of EA treatment is discussed.
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Cumulative evidence suggests that immunologic responses are under the regulation of the autonomic nervous system. Since acupuncture has recently been reported to modulate the autonomic nervous system, we investigated the possibility that acupuncture eventually modulates the immune system. In the present study, electro-acupuncture was applied in young volunteer subjects. As for the proportions of granulocytes and lymphocytes in the blood, there were three groups: (1) granulocytosis and lymphocytopenia; (2) granulocytopenia and lymphocytosis; and (3) normal pattern. Interestingly, with the administration of acupuncture, the status of subjects with relatively low levels of granulocytes and high levels of lymphocytes shifted to Group 1, whereas that of subjects with high levels of granulocytes and low levels of lymphocytes shifted to Group 2. In other words, acupuncture tended to normalize the pattern of leukocytes. We confirmed that acupuncture induced parasympathetic nerve stimulation, resulting in a decrease in the heart rate. These results suggest possible mechanisms underlying how acupuncture ameliorates the condition of patients with many chronic diseases.
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Human ageing has been associated with immunological changes including blunted T-cell responses and increased production of pro-inflammatory cytokines. Here, we investigated the role of psychological and endocrine factors in the production of pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin (IL)-6) as well as soluble IL-2Ralpha, associated with T-cell activation. Forty-six elderly subjects (60-91 yrs) and 33 young adults (20-40 yrs) were recruited accordingly the SENIEUR protocol. The emotional status was measured by structured clinical interviews. Salivary cortisol levels (9, 12 and 22 h) and serum dehydroepiandrosterone (DHEA) were assessed by radioimmunoassays. The elderly were more stressed, depressed and anxious than the young subjects. Cortisol levels were increased whereas DHEA levels were significantly reduced in the elderly. Both groups showed equivalent production of pro-inflammatory cytokines as well as soluble IL-2Ralpha. Psychological scores were positively correlated to evening cortisol levels and negatively correlated to morning DHEA levels. No relationships were noted between psychological factors and cytokines studied. However, evening cortisol levels were found positively correlated to TNF-alpha and sIL-2Ralpha levels. These data indicate that healthy ageing is associated with significant distress and activation of the hypothalamic-pituitary-adrenal axis. Our data also suggest that there are complex psychoneuroendocrine relationships involved with cytokine production during ageing.
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This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls. Dysmenorrhoea is the most common gynaecological disorder among adolescents. Traditional Chinese acupressure derived from acupuncture is a non-invasive technique. Despite renewed interest in the use of acupressure, relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea. An experimental study was conducted between December 2000 and August 2001. Participants were female students attending a technical college in Taiwan. None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea, and all were rated higher than five for pain on a visual analogue scale from 0 to 10. The experimental group (n = 35) received acupressure at Sanyinjiao (above the ankle) while the control group (n = 34) rested for 20 min, while the control group underwent rest in the school health centre for 20 min without receiving acupressure. Fifty participants (30 experimental, 20 control) completed the 4-6-week follow-up session. Five instruments were used to collect pretest and post-test data at each session: (1) Visual Analogue Scale for pain; (2) the Short-Form McGill Pain Questionnaire; (3) the Menstrual Distress Questionnaire; (4) the Visual Analogue Scale for anxiety; and, for the experimental group only, (5) the Acupressure Self-Assessment Form. Data were analysed using the chi-square test, two-sample t-test and repeated measures two-way anova. Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea. In the self-treatment follow-up session, acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety. Thirty-one (87%) of the 35 experimental participants reported that acupressure was helpful, and 33 (94%) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea. The findings suggest that acupressure at Sanyinjiao can be an effective, cost-free intervention for reducing pain and anxiety during dysmenorrhoea, and we recommend its use for self-care of primary dysmenorrhoea.
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Acupuncture is the most popular component of traditional Chinese medicine in western countries, which has been widely used in the treatment of numerous medical conditions, e.g., pain, emesis or asthma. However, the effects of acupuncture on neuroendocrine and immune functions in humans remain unclear. Therefore, the present study was performed to analyse whether acupuncture treatment affects leukocyte circulation as well as plasma levels of cortisol and norepinephrine in humans. Ten healthy young male subjects were enrolled in a randomized single-blind two-period crossover study. Each period contained three sessions of either acupuncture or sham acupuncture (placebo) treatment. After randomisation, the group 1 (n=5) received acupuncture treatment at acu-points ST36, LI11, SP10, and GV14, while sham acupuncture was performed for group 2 (n=5). Two weeks later, each group received the alternative treatment. Blood samples were taken before needling, 10 min after, and 30 min after removing the needles in the first and the third session. In addition, blood pressure and heart rate were determined simultaneously. Although acupuncture treatment did not affect leukocyte circulation in peripheral blood after the first session, we observed a significant decrease in leukocyte and lymphocyte values after the third session. In contrast, cortisol and norepinephrine plasma levels remained unchanged by acupuncture. These data indicate that repeated acupuncture treatment can affect leukocyte circulation in healthy humans by still unknown mechanisms.
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Ageing has been associated with immunological changes (immunosenescence) that resemble those observed following chronic stress or glucocorticoid (GC) treatment. These changes include thymic involution, lower number of naïve T cells, reduced cell-mediated immunity, and poor vaccination response to new antigens. It follows that immunosenescence could be associated with changes of peripheral GC levels. Indeed, when compared with young subjects, healthy elders are more stressed and show activation of the hypothalamus-pituitary-adrenal (HPA) axis. However, both beneficial and undesirable effects of GCs ultimately depend on the target tissue sensitivity to these steroids. Recent data indicate that peripheral lymphocytes from elders respond poorly to GC treatment in vitro. The present review summarizes recent findings which suggest that immunosenescence may be closely related to both psychological distress and stress hormones. Furthermore, chronically stressed elderly subjects may be particularly at risk of stress-related pathology because of further alterations in GC-immune signalling. Finally, the neuroendocrine hypothesis of immunosenescence is finally reconsidered in which the age-related increase in the cortisol/DHEA ratio is major determinant of immunological changes observed during ageing.
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Acupuncture has become a popular complementary and alternative treatment approach. This review examined the randomized controlled trials (RCTs) examining the effects of acupuncture treatment of depression. RCTs of the treatment of depression with acupuncture were located using MEDLINE, Allied and Complementary Medicine and the Cochrane Central Register of Controlled Trials. The methodology of RCTs was assessed using the Jadad criteria, and elements of research design, i.e., randomization, blinding, assessment of attrition rates, were quantified for systematic comparisons among studies. Among the 9 RCTs examined, five were deemed to be of low quality based upon Jadad criteria. The odds ratios derived from comparing acupuncture with control conditions within the RCTs suggests some evidence for the utility of acupuncture in depression. General trends suggest that acupuncture modalities were as effective as antidepressants employed for treatment of depression in the limited studies available for comparison. However, placebo acupuncture treatment was often no different from intended verum acupuncture. The RCTs extracted were limited by small sample sizes, imprecise enrollment criteria, problems with randomization, blinding, brief duration of study and lack of longitudinal follow-up. Despite the findings that the odds ratios of existing literature suggest a role for acupuncture in the treatment of depression, the evidence thus far is inconclusive. However, efforts are being made to standardize complementary approaches to treat depression, and further systematized research into their use is warranted.
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Ageing has been associated with increased cortisol levels and absolute counts of T lymphocytes with memory phenotype. Although the mechanisms underlying these changes are still unknown, it has been speculated that this could be related to a dysfunction in FAS/CD95 expression in naive or memory cells. In this study, we investigated the role of psychoneuroendocrine variables in regulating CD95 expression on lymphocyte subsets. Forty-six elderly subjects (65-91 years) and 33 young adults (20-40 years) were recruited accordingly the SENIEUR protocol. The psychological status was measured by structured clinical interviews, salivary cortisol was assessed along the day (9, 12 and 22h) and peripheral blood lymphocytes were immunophenotyped. The elderly were more stressed, depressed and anxious than the young subjects. Cortisol levels were increased in the elderly, indicating an activation of the hypothalamic-pituitary-adrenal (HPA) axis. We observed reduced counts of CD45RA+CD95+ cells in the elderly compared to young adults. The elderly subjects also showed a reduced expression of CD3 and CD62L in contrast to increased CD95 expression in CD45RA+ cells. The emotional state was positively correlated with the lymphocyte markers. Our data suggest the healthy ageing is associated with psychoneuroendocrine alterations that may be implicated in the regulation of CD95 expression on peripheral T cells.
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To assess the efficacy of acupuncture as an intervention for major depressive disorder (MDD). Acupuncture was examined in 151 patients with MDD (DSM-IV) who were randomly assigned to 1 of 3 groups in a double-blind randomized controlled trial. The specific intervention involved Traditional Chinese Medicine (TCM)-style acupuncture with manual stimulation for depression; the control conditions consisted of (1) a nonspecific intervention using a comparable number of legitimate acupuncture points not specifically targeted to depressive symptoms and (2) a waitlist condition, which involved waiting without intervention for 8 weeks. After 8 weeks, all patients received the depression-specific acupuncture. Each 8-week intervention regimen consisted of 12 acupuncture sessions delivered in an acupuncturist's office in the community. The primary outcome measure was the 17-item Hamilton Rating Scale for Depression. The study was conducted from February 1998 to April 2002. Twenty patients terminated treatment before the completion of the 8-week intervention (13%) but not differentially by study group. Random regression models of the intent-to-treat sample revealed that although patients receiving acupuncture improved more than those awaiting intervention, no evidence of differential efficacy of the depression-specific over nonspecific intervention was found. Response rates in acupuncture-treated patients were relatively low after 8 weeks (22% and 39% for specific and nonspecific intervention groups, respectively), with the response rate after the entire 16-week trial reaching 50%. Although TCM manual acupuncture is a well-tolerated intervention, results fail to support its efficacy as a monotherapy for MDD. It can't be ruled out that factors unique to the implementation of acupuncture in this research study may have limited the efficacy of interventions compared to those provided in naturalistic settings. ClinicalTrials.gov identifier NCT00010517.
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It is presently accepted that emotional disturbances lead to immune system impairment, and that therefore their treatment could restore the immune response. Thus, the aim of the present work was to study the effect of an acupuncture treatment, designed specifically to relieve the emotional symptoms stemming from anxiety, on several functions (adherence, chemotaxis, phagocytosis, basal and stimulated superoxide anion levels, lymphocyte proliferation in response to phytohemagglutinin A (PHA) and natural killer (NK) activity) of leukocytes (neutrophils and lymphocytes) from anxious women. The acupuncture protocol consisted of manual needle stimulation of 19 acupoints, with each session lasting 30 min. It was performed on 34 female 30-60 year old patients, suffering from anxiety, as determined by the Beck Anxiety Inventory (BAI). Before and 72 hours after receiving the first acupuncture session, peripheral blood samples were drawn. In 12 patients, samples were also collected immediately after the first single acupuncture session and one month after the end of the whole acupuncture treatment, which consisted of 10 sessions during a year, until the complete remission of anxiety. Twenty healthy non-anxious women in the same age range were used as controls. The results showed that the most favorable effects of acupuncture on the immune functions appear 72 hours after the single session and persist one month after the end of the complete treatment. Impaired immune functions in anxious women (chemotaxis, phagocytosis, lymphoproliferation and NK activity) were significantly improved by acupuncture, and augmented immune parameters (superoxide anion levels and lymphoproliferation of the patient subgroup whose values had been too high) were significantly diminished. Acupuncture brought the above mentioned parameters to values closer to those of healthy controls, exerting a modulatory effect on the immune system.
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Treatment of breast cancer is usually associated with significant psychological stress. In this study, we examined the effects of relaxation and visualization therapy (RVT) on psychological distress, cortisol levels, and immunological parameters of breast cancer patients undergoing radiotherapy. Participants were randomly assigned to either the experimental (n=20) who underwent group RVT for 24 consecutive days or control group (n=14) who were on radiotherapy only. Psychological scores (stress, anxiety, and depression) were measured by structured clinical interviews. Salivary cortisol was assessed along the day. Lymphocytes were isolated and cultured to measure T-cell proliferation and sensitivity to glucocorticoids (GCs). RVT was effective to reduce stress, anxiety, and depression scores (all P<.05). However, cortisol levels as well as proliferation remained unchanged following RVT. Although T cells of experimental group were more sensitive to GCs than cells of controls at baseline, no changes were noted following RVT. Cortisol levels were positively correlated to anxiety and depression scores and inversely correlated to T-cell proliferation and sensitivity to GCs. We conclude that the psychological intervention was capable to attenuate the emotional distress presented during radiotherapy treatment. A longer RVT or worse psychological morbidity at baseline may be necessary to translate psychological into biological changes.