Academic literature on the topic 'Electro-acupuncture'

9639 Background: Arthralgia is a common and debilitating symptom in a significant proportion of breast cancer patients receiving aromatase inhibitors (AIs). Methods: We conducted a randomized, placebo-controlled trial of electro-acupuncture compared to waitlist control (WLC) and sham acupuncture in postmenopausal women with breast cancer who self-attributed their arthralgia to taking AIs. Acupuncturists delivered ten treatments of tailored acupuncture with 2 Hz electro-stimulation via a TENS unit. Sham acupuncture used non-penetrating Streitberger needles at non-traditional acupuncture points and lacked electro-stimulation. The primary endpoint was pain severity measured by the Brief Pain Inventory (BPI) between electro-acupuncture and WLC at Week 8; durability of response at Week 12 and comparison of electro to sham acupuncture were secondary aims. Results: Sixty-seven patients were randomized to the three arms. The mean reduction in BPI pain severity was significantly greater in the electro-acupuncture group than WLC group at both Week 8 (-2.2 vs. -0.2 p=0.0004) and Week 12 (-2.4 vs. -0.2, p<0.0001). The BPI pain-related interference also improved significantly in the electro-acupuncture group compared to WLC group at Weeks 8 (-2.0 vs. +0.2, p=0.0006) and 12 (-2.1 vs. -0.1, p=0.0034). Sham acupuncture reduced pain severity (-2.3) and pain-related interference (-1.5) at Week 8 similar to electro-acupuncture (p= non-significant); however, the effect of sham acupuncture appeared to decrease at Week 12 for pain severity (-1.7) and pain-related inference (-1.3). Conclusions: Electro-acupuncture significantly improved AI-related arthralgia over “usual care” with clinically important and durable changes in symptoms. Treatment effects were similar between the electro and sham groups at Week 8, suggesting that a large component of acupuncture effect is mediated through the process of acupuncture delivery rather than the specificity of needle placement or needle penetration of skin. Research is needed to evaluate the long term effects of electro-acupuncture to improve AI-related arthralgia. Clinical trial information: NCT01013337.

Postoperative pain cannot be treated adequately in all patients, even though there are new developments in analgesic agents and treatment techniques. Thisstudy investigates the effect of pre-incisional and post-incisional electro- acupuncture on mechanical hyperalgesia in rat incisional pain model. This study was carried out with 40 healthy Sprague-Dawley male rats. The rats were divided into 5 groups: Group 1; first electro-acupuncture, then incision. Group 2; first incision, then electro-acupuncture. Group 3; first sham electro-acupuncture, then incision. Group 4; first incision, then sham electro-acupuncture. Group 5; control (incision only). Electro-acupuncture was applied to the ST36 and SP6 acupuncture points on the right hind paw. Sham electro- acupuncture was applied to the right thigh. Von Frey filaments were used to measure hyperalgesia at baseline and at 4th, 6th, 24th and 48th hours. Shapiro Wilk test was used to determine whether the distribution of continuous variables was close to normal. Levene's test was used for homogeneity of variances. Bonferroni Correction Wilcoxon Sign test was used to determine whether the differences between follow-up times were statistically significant or not. Bonferroni Correction on Kruskal Wallis test was used to determine whether there was any difference between groups. If the Kruskal Wallis test statistics were significant, analysis was performed using Conover's multiple comparison test. p<0.05 was considered statistically significant. This study found that electro-acupuncture decreases hyperalgesia, and there was no significant difference between pre-incisional and post-incisional application in terms of the anti-hyperalgesic effectiveness of electro-acupuncture, except for the duration of action. Pre-incisional applications are more effective than post-incisional applications. Pre-incisional sham electro-acupuncture has also been found to have anti-hyperalgesic effect. Our findings support the studies that electro-acupuncture can be used for preemptive purposes in surgical patients. We think that researches should be continued in order to provide alternative methods for pain treatment.

To study the efficacy of electro-acupuncture for the relief of labor pain, and to build a better understanding of how electro-acupuncture might influence the neuroendocrine system, 36 primiparas were randomly divided into an electro-acupuncture group and a control group. Assessments of pain intensity and degree of relaxation during labor were analyzed. The differences between the electro-acupuncture group and the control group on the concentration of β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) in the peripheral blood were compared. The electro-acupuncture group was found to exhibit a lower pain intensity and a better degree of relaxation than the control group (p = 0.018; p = 0.031). There existed a significant difference in the concentration of β-EP and 5-HT in the peripheral blood between the two groups at the end of the first stage (p = 0.037; p = 0.030). Electro-acupuncture was found to be an effective alternative or complementary therapy in the relief of pain during labor. The benefit of electro-acupuncture for relieving labor pain may be based on the mechanism of producing a synergism of the central nervous system (CNS) with a direct impact on the uterus through increasing the release of β-EP and 5-HT into the peripheral blood.

Spinal cord injury is a devastating neurological disease in desperate need of a cure. We have previously shown that overexpression of the adhesion molecule L1 contributes to locomotor recovery after injury and were therefore interested in how electro-acupuncture would influence the expression of this molecule. Here, we investigated the effects of electro-acupuncture at “Jiaji” points (EX-B2), newly established by us, in young adult mice to determine whether improved recovery via electro-acupuncture could be due to enhanced L1 expression. Locomotor function, as evaluated by the Basso Mouse Scale score and by catwalk gait parameters, was improved by electro-acupuncture at different time points after injury in parallel with enhanced levels of L1 expression. Interestingly, the levels of the astrocytic marker glial fibrillary acidic protein (GFAP) were also increased, but only in the early phase after injury, being reduced at later stages during recovery. Acupuncture alone showed less pronounced changes in expression of these molecules. We propose that electro-acupuncture improves regeneration in part by promoting the L1 expression and beneficial activation of stem cells, and by differentially modulating the expression of GFAP by promoting regeneration-conductive astrocytic responses at initial stages and reducing regeneration-adversive activation in the secondary stages. Expression of the stem cell marker nestin was upregulated by electro-acupuncture in the acute stage. The combined observations show for the first time in mice the beneficial functions of electro-acupuncture at Jiaji points in the spinal cord injury mouse model and provide novel insights into some molecular mechanisms underlying electro-acupuncture in spinal cord injury.

The objective of this study was to assess the efficacy and safety of electroacupuncture in 138 patients with earthquake-caused PTSD using Randomized Controlled Trials (RCTs). 138 cases enrolled were randomly assigned to an electro-acupuncture group and a paroxetine group. The electro-acupuncture group was treated by scalp electro-acupuncture on Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), and Fengchi (GB 20), and the paroxetine group was treated with simple oral administration of paroxetine. The efficacy and safety of the electro-acupuncture on treatment of 69 PTSD patients were evaluated using Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Treatment Emergent Symptom Scale (TESS) according to clinical data. The total scores of CAPS, HAMD, and HAMA in the two groups after treatment showed significant efficacy compared to those before treatment. The comparison of reduction in the scores of CAPS, HAMD, and HAMA between the two groups suggested that the efficacy in the treated group was better than that in the paroxetine group. The present study suggested that the electro-acupuncture and paroxetine groups have significant changes in test PTSD, but the electro-acupuncture 2 group was more significant.

Electro-thermal acupuncture treatment instrument heats the needle by heat transfer effect, instead of the traditional Chinese thermal needle for acupuncture. It achieves better healing effect on acupuncture points of the human body through the intelligent control of MCU and temperature control device on the needle temperature, vibration frequency, and thermal efficiency and so on. This paper introduces software design of the electro-thermal acupuncture treatment instrument, which is mainly composed of the main program module, temperature acquisition module, timer module, display module, keyboard module and calculation control module. Temperature and vibration frequency of needle body, thermal efficiency, and time of acupuncture are intelligently regulated by MCU, so that treatment effect using electro-thermal acupuncture is better than using traditional Chinese thermal needle.

Many treatment options for chronic low back pain are available, including varied forms of electric stimulation. But little is known about the electricity effect between electro-acupuncture and pulsed radiofrequency. The objective of this study is to assess the difference in effectiveness of pain relief between pulsed radiofrequency and electro-acupuncture. Visual analog score (VAS) pain score, the Oswestry disability index (ODI) to measure a patient's permanent functional disability, and Short form 36 (SF-36) which is a survey used in health assessment to determine the cost-effectiveness of a health treatment, were used as rating systems to measure the pain relief and functional improvement effect of pulsed radiofrequency and electro-acupuncture, based on the methodological quality of the randomized controlled trials, the relevance between the study groups, and the consistency of the outcome evaluation. First, the baseline status before therapy shows no age and gender influence in the SF-36 and VAS score but it is significant in the ODI questionnaire. From ANOVA analyses, it is apparent that radiofrequency therapy is a significant improvement over electro-acupuncture therapy after one month. But electro-acupuncture also showed functional improvement in the lumbar spine from the ODI. This study provides sufficient evidence of the superiority of pulsed radiofrequency (PRF) therapy for low back pain relief compared with both electro-acupuncture (EA) therapy and the control group. But the functional improvement of the lumbar spine was proved under EA therapy only. Both therapies are related to electricity effects.

The severity of postoperative pain is affected by many factors including the patient’s age, sex, personality, knowledge of and confidence in the procedure, attitude of the staff, and the individual's physiological condition. The same procedure can produce different degrees of postoperative pain in different patients. Even though, in most cases, upper abdominal or thoracic surgery causes severe postoperative pain, superficial operations still cause mild postoperative pain. Patients usually feel the most pain in the first few hours after surgery. Postoperative pain can result in irritability, insomnia, increased heart rate, hypertension, excessive perspiration, overactive metabolism, tachycardia, diaphoresis, mydriasis, pallor and increased myocardial oxygen consumption. In patients with coronary artery disease, postoperative pain can result in myocardial ischemia and possible infarction that in turn may delay postoperative recovery. Intravenous patient-controlled analgesia (PCA) is an accepted method to relieve postoperative pain. Opioids are often used as an analgesic for severe pain management. Possible adverse effects are respiratory depression, constipation, vomiting, gastroparesis, and central nervous system depression including somnolence and consciousness disturbance. Opioid-related side effects often occur post-operatively, and are related to the total dosage of opioid medication. Non-pharmaceutical products can be an alternative in the treatment of post-operative pain and produce less adverse effects. Acupuncture’s ability to control pain has been documented for thousands of years and has become well-accepted in modern Western medicine. Electro-stimulation has a postoperative pain relieving effect when applied as either electro-acupuncture (EA), transcutaneous nerve stimulation (TENS) or Silver Spike Point (SSP) therapy. SSP as needle-free EA and has been shown to have a similar analgesic effect to standard EA, where electrical stimulation is applied to needles that have been inserted into acupuncture points, and a superior effect than TENS. The acupuncture analgesic mechanism remains unclear in spite of successful clinical applications and recognition by WHO. This study investigated SSP needle-free EA's role in managing of postoperative pain and in reducing the adverse side effects of opioids. Acupuncture has generated much interest in western countries like Australia, and is considered a rather safe clinical treatment method for a wide range of disorders. However, in clinical applications, there are some contraindications and complications with using needles. SSP needle-free EA offers many benefits over standard acupuncture treatment such as: reduced hazardous waste, no skin penetration and therefore a reduced risk of infection. SSP EA provides a range of stimulation types that are particularly suitable for sensitive patients including young children and the elderly. A particular advantage of SSP EA is that it can be safely used on acupuncture points all over the body, whereas incorrect acupuncture needling over major organs and the spinal cord can cause serious problems. In this study, we examined the effects of Silver Spike Point (SSP) therapy, also known as needle-free electro-acupuncture (EA), at the classical bilateral acupuncture point Zusanli (ST36) on postoperative pain and opioid-related side effects following hysterectomy. Based on a double blind, sham and different intervention controlled clinical experimental design, four groups of randomised patients were enrolled into the study as subjects. Group 1 was assigned as the control group; Subjects in group 2 were applied SSP electrode at a sham acupuncture point; Group 3 received SSP stimulation at 100 Hz and Group 4 received SSP stimulation by a mixture of at 3 Hz, 10 Hz, and 20 Hz on Zusanli (ST36). It was planned that each group was to consist of 25 women who had undergone hysterectomy. The research evaluated the analgesic effect of SSP needle-free EA for post-operative pain relief of women who had been given a hysterectomy, and comparing the difference between high frequency and low frequency stimulation. The hypothesis was that the groups that received the double treatment of SSP needle-free EA (both pre- and post-surgery) at acupuncture point Zusanli (ST36) would demonstrate increased analgesic relief over a longer period of time, i.e. longer duration before requiring the first PCA dose, fewer PCA doses required, and fewer opioid related side effects compared to the sham and control groups. In addition, the group that received the low frequency treatment would achieve better analgesic relief compared to the high frequency treatment, the sham, and the control groups. The Results were analyzed using a One-way analysis of variance (ANOVA) for Visual Analogue Scale (VAS) of Patient Controlled Analgesia (PCA) doses delivered, and PCA doses demanded by the patients. This method is for testing the differences between means of independent samples. In this case, using SPSS and Student-Newman-Keuls (SNK) and Tukey post-hoc analysis performed a One-way ANOVA. F-tests were also carried out to determine significance between means of the variables, time of first ambulation, bowel movement, total PCA demand and total PCA doses. Statistical significance is based on P value with P < 0.05; clinical beneficial is based on P < 0.10. The results indicated that the means and standard deviations of the four groups were within a close range. Forty-seven women who had hysterectomies met the criteria. The women were randomly allocated to four different groups. Except for those in the control group, treatment was given by an acupuncturist preoperatively and consisted of a course of either sham, low or high frequency stimulation. All groups were assessed during the postoperative period for 24 hours. The Visual Analogue Scale (VAS) was used to determine the amount of perceived pain felt by each subject. It was a 0-10 scale with 0 being no pain and 10 being most severe pain. The data was collected over a 24-hour period commencing post operatively. The significant differences between the groups at each specific time interval were examined. Results showed a clearly decreasing trend in the amount of pain felt over the 24-hour period for all the four groups with respect to the PCA and time. Significant differences or clinical benefits were found between the means at two hours post-operatively with F(3,42) = 2.66 at p<0.10; three hours post-operatively, F(3,42) = 3.68; p<0.05, four hours post-operatively, F(3,42) = 4.33, p<0.05; eight hours post-op, F(3,42) = 3.33, p<0.05; sixteen hours post-op, F(3,42) = 4.25, p<0.05; and twenty-four hours, F(3,42) = 4.67, p<0.01. Further post-hoc analysis showed that at one hour post-operatively, groups one and four were different to each other at the p<0.10 level. At three hours, group 1 (M=6.05) was significantly higher, at the p<0.05 level, than group 4 (M=3.00). This difference was also found at four hours, group 1 (M=5.65) and group four (M=2.71); eight hours, group 1 (M=4.808) and group four (M=2.57); sixteen hours, group 1 (M=4.46) and group 4 (M=2.0); and twenty - four hours, group1 (M= 3.50) and group 4 (M=1.21). Both post-hoc comparison tests indicate that group 4 was significantly different from groups 1, 2, and 3 at twenty-four hours. Differences between the means (M) over the four time intervals for Patient Controlled Analgesia (PCA) doses requirement were also examined. Significant differences were found with F(3,43) = 3.69 at p<0.05, in the Post Operative Room (POR) between the groups. Post-hoc analysis confirmed that group 4 (M=2.30) was significantly lower than groups 2 (M=5.17), and 3 (M=4.58). Post-hoc comparison tests indicate that mean PCA doses in the POR, for group 4 was significantly different from group 2 and 3. Mean PCA doses between groups 1 and 4 have no differences. Differences between the groups between one and eight hours post-operatively were also found with F(3,43)=2.33 at p<0.10. However, post-hoc analysis did not confirm this finding between any of the four groups. To compare the mean amount of Patient Controlled Analgesia (PCA) demands of the four groups over the 24 hours post-operative, a one-way ANOVA with S.N.K and Tukey-HSD post-hoc tests were applied. The results showed that the four groups had a similar trend within 24 hours postoperatively. However, significant differences were found between the means at the Post Operating room with F(3,43) = 4.80 at p<0.01, and 1 to 8 hours postoperative with F(3,43) = 3.49 at p<0.05. Post-hoc analysis confirmed the significant difference between the means at 1 to 8 hours postoperative as group 2 (M=55.75) was significantly higher than group 4 (M=22.30). Post-hoc analysis also confirmed that group 2 (M=30.83) was significantly higher than group 3 (M=13.00) and group 4 (M=5.90) at the POR. No other significance was found between means. The results of PCA doses demanded by subjects indicated that there was no significant difference between the total PCA doses given for the four groups over twenty-four hour period post-operatively. However, a one way ANOVA was applied to compare the groups for total PCA doses demanded and significant differences were found between the groups with F(3,42) = 3.59 at p<0.05. Post-hoc analysis confirmed the difference between groups 1 (M=84.54) and 4 (M=41.60). Moreover, differences were found between the four groups for the amount of analgesia delivered in mg, F(3,43)=2.45, p<0.10. Post-hoc analysis confirmed this finding between group one (M=38.63) and four (M=29.29). The thesis concludes with a discussion of methodological issues related to conducting randomized, placebo-controlled trials of electro-acupuncture and goals for future research in this area of pain management. Treatment outcome of SSP needless electro-acupuncture showed an improvement of the time of first bowel movement and ambulation, opioid related side effects, total amount of PCA demand, and total amount of PCA doses. The clinical significance of this particular study is of great interest, especially for those patients who wish for a non-pharmacological analgesia without side effects. Although further study is needed to ultimately determine whether SSP needle-free electro-acupuncture (EA) has a place in postoperative pain treatment, this study has suggested that SSP needle-free EA does have a place as an adjunct to standard medical care for post-operative surgical pain. Arguably this ‘needle free approach’ has benefits for patients who have difficulties with traditional acupuncture needling and at the same time are interested in a non-pharmacological approach to treating pain.

Objectives: Electro-acupuncture (EA) has been demonstrated to be effective in reducing post-operative acute consumption of opioid-like medications (OLM) by previous studies. This effect has not been examined in patients with chronic pain. In this thesis, a randomised, double-blind, sham acupuncture-controlled study was reported. The trial aimed to evaluate the effect of EA in reducing OLM consumption in patients with chronic non-malignant pain. Methods: Thirty-five patients were recruited from a multidisciplinary pain management clinic in Melbourne. After a two-week baseline assessment, participants were randomly assigned to one of the two groups by a computer generated randomisation sequence: real EA (REA, n = 17) or sham EA (SEA, n = 18). The REA group received 2/100 Hz EA stimulation on two pairs of acupoints (Zusanli ST36 and Fenglong ST40 on one leg and Hegu LI4 and Quchi LI11 on one arm) and manual acupuncture on an additional five chosen acupoints for 30 minutes. The SEA group received superficial needling on non-acupoints without Deqi sensation or electrical stimulation. Both groups received treatment twice a week for six weeks. Participants were followed up for 12 weeks at intervals of four weeks. During the trial, participants were given clear instructions on how to reduce their OLM usage. A researcher telephoned the participants three times during the trial to encourage them to reduce OLM intake. The assessor, researcher and participants were blinded to treatment allocation. Outcome measures: The primary outcome measures included OLM consumption, related side effects, dosage of non-opioid analgesics and the intensity and unpleasantness of pain. These measures were recorded daily for two weeks before the intervention, six weeks during the treatment period and three times during the follow up period. Secondary outcome measures were depression and quality of life as assessed by the Beck Depression Inventory-II (BDI-II) and the Medical Outcome Study 36-Item Short Form (SF-36), respectively. Data were analysed with independent t-tests or analysis of variance (ANOVA) where appropriate and per protocol analysis was employed. Results: Nine participants withdrew from the study. At baseline, the two groups were comparable on all demographic characteristics and major outcome variables except for the average intensity of pain. During the treatment period, the reduction of OLM consumption was more rapid in the REA group (64%) than in the SEA (46%) (ANOVA, p less than 0.05). The effect was maintained for four weeks in the REA group. There were no differences in the improvement of all other measures between the two groups. The incidence of EA-related adverse events (AEs) per treatment was 21% and 10% in the REA and SEA groups, respectively. All AEs were minor. Over 90% of the participants were satisfied with the treatments given and would recommend EA to others. The blinding was successful. Conclusions: EA could be an effective and safe treatment for reducing OLM consumption for patients with chronic pain, and may be used as an adjunct therapy in chronic pain management. Further studies with larger sample sizes are warranted.

Stroke is a serious cerebral vascular event and a leading cause of death and disability worldwide, and ischemic stroke is the most common type. Evidence from animal research in acute cerebral ischemia shows that a combination of neuroprotectants might be more efficacious than the single agent given individually. Both melatonin and electro-acupuncture (EA) have been suggested to be effective treatments against cerebral ischemia. However, it is unknown whether a combination of these two therapies could be beneficial against focal cerebral ischemia. In the first study, the effect of post-treatment with a combination of melatonin and EA on regional cerebral blood flow (rCBF), neurological deficit score and infarct volume was investigated in both permanent and transient middle cerebral artery occlusion (MCAO) models in rats. When compared with the single treatment of melatonin or EA, the combination therapy resulted in a significant improvement of neurological function and a dramatic reduction of infarct volume at 72 hr after transient MCAO. A significant upregulatory effect on rCBF has been exerted by the combined treatment. The effect of a combination of melatonin and EA on inflammatory reaction was investigated in the second study. Post-treatment of the combination therapy effectively inhibited neutrophil infiltration as well as the expression of some pro-inflammatory mediators, and increased the anti-inflammatory protein expression at 72 hr after transient MCAO. This beneficial effect may be due to the respective anti-inflammatory effects of melatonin and EA. In the third study, the effect of a combination of melatonin and EA on apoptosis was examined. When compared with the EA treatment alone, post-treatment of the combination therapy exerted a greater inhibitory effect on tissue apoptosis and expression of the pro-apoptotic proteins as well as an upregulatory effect on the anti-apoptotic protein expression. In the fourth study, the effect of continuous post-treatment of a combination of melatonin and EA on transient MCAO was investigated. The combination treatment significantly improved neurological function and decreased infarct volume at 7 days after transient MCAO. Cell proliferation and expression of the neurotrophic factor were increased by the combined treatment. The effect of pretreatment with a combination of melatonin and EA was examined in the fifth study. Neurological function was improved and infarct volume was reduced by the combination pretreatment at 24 hr after transient MCAO. The inflammatory and apoptotic reaction were inhibited by the combined pretreatment through the modulatory effect of the related proteins. In summary, our results show that, when compared with the single treatment of either melatonin or EA, post-treatment with a combination of melatonin and EA induced a complementary neuroprotective effect on improvement of neurological function and a dramatic reduction of infarct volume after transient MCAO. The complementary protection may be partially mediated via anti-inflammation and anti-apoptosis after transient cerebral ischemia. Pretreatment with a combination of melatonin and EA may be more effective in preventing ischemic brain injury after transient focal cerebral ischemia.
published_or_final_version
Medicine
Doctoral
Doctor of Philosophy

Chronic pelvic pain (CPP) is defined as constant or intermittent lower, cyclical or non-cyclical abdominal pain of at least six months’ duration. In the United Kingdom, over 1 million women suffer from CPP, with an estimated annual healthcare cost above £150 million. The aetiology of CPP is unknown in up to 50% of women, and in the remainder, the symptoms of CPP is associated with endometriosis, pelvic adhesions, irritable bowel syndrome or painful bladder syndrome. CPP is often accompanied by painful periods, pain during sexual intercourse and defaecation. Fatigue, sleep disturbances and depression are also common among this group of women. CPP asserts a heavy emotional, social and economic burden. Standard treatments such as hormonal and analgesic regimens are often associated with unacceptable side effects, even if helpful for the pain, underlining an urgent need for a satisfactory treatment. The meridian balanced method (BM) electro-acupuncture (EA) treatment (acupuncture needling + traditional Chinese medicine health consultation [TCM HC]) may be effective in managing CPP symptoms. Thus, I have completed a pilot study comprising of a three-armed randomised controlled trial (RCT), using a mixed methods research (MMR) approach, to assess the feasibility of a future large-scale RCT to determine the effectiveness of the meridian BMEA treatment on CPP in women. My hypothesis is that it is feasible to conduct such a large-scale RCT for CPP in women. The primary objectives were to determine recruitment and retention rates. The secondary objectives were to evaluate the, acceptability of the methods of recruitment, randomisation, interventions and assessment tools and any signals of effectiveness of the interventions. Thirty (30) women with CPP were randomised into three groups: BMEA treatment, TCM HC, or National Health Service standard care (NHS SC) group. The effects of my interventions were assessed by validated pain, physical and emotional functioning questionnaires, completed at weeks 0, 4, 8 and 12 of the study. Semi-structured telephone interviews and focus group discussions to explore participants’ experience of the study were conducted. Of the 59 women who were referred to the study, 30 women (51%) were randomised. There was a statistically significant difference in retention rates between the three groups. The retention rates were 80% (95% CI 74-96), in the BMEA treatment group, 53 % (95% CI 36- 70) in the TCM HC group and 87% (95% CI 63-90) in the NHS SC group. (Chi-square test, p=0.08) The attendance rates of the BMEA treatment group were 90% compared to 56% in the TCM HC group. There was a statistically significant difference (Mann-Whitney test, p=0.023) in attendance between the two intervention groups. Telephone interviews regarding the acceptability of the methods of recruitment, randomisation, assessment tools and interventions were positive. No adverse effects that were directly related to BMEA treatments were reported or observed. A higher proportion of the BMEA treatment group achieved clinical significance in the VAS-pain, BPI-pain severity, interference, and sleep scores, when compared to the other two groups. Due to small sample sizes, there was insufficient power to show statistically significant difference. (Fishers Exact Test, p=1.0) Analyses of the questionnaire data per group showed statistically significant differences in the following: the BMEA treatment group experienced less in pain at weeks 4 (p=0.01) and 8 (p=0.005); less helplessness (p=0.03) and their anxiety and depression scores declined at week 4 (p=0.04). The NHS SC group also reported less pain at week 4 (p=0.04). However, this group scored higher in anxiety and depression at weeks 8 and 12 (p=0.04). No statistically significant differences were achieved between the three groups at baseline, weeks 4, 8 and 12 in all scores. The therapeutic benefits gained by the TCM HC group were less compared to those of the BMEA treatment group, but better when compared to the NHS SC group. The BMEA treatment and TCM HC groups showed lower scores in anxiety and depression while the NHS SC group showed higher scores in anxiety and depression. The NHS SC group also tended to ruminate and magnify their problems as well as feeling more helpless than the other two groups. The three key themes that emerged from thematic analysis of focus group discussions were the “whole person effects” where participants reported an improvement in pain, sleep and a general sense of wellbeing in the two intervention groups; the “experience of standard care” and “impact of living with CPP”. In conclusion, the results of my pilot study are supportive of the feasibility of a future large-scale study. There were signals of effectiveness of interventions but the sample size was too small to make a definitive conclusion.

碩士
義守大學
電子工程學系
90
Acupuncture has played an important role in pain research. Besides traditional acupuncture and related stimulation, including the filiform needle, intradermal needle, “seven-star” needle, moxa and cups, different forms of acupuncture stimulation have also become popular in recent years. Recently ultrasound and laser, is the newest therapeutic way in the field of acupuncture. Ledergerber found the most gratifying results with TENS (Transcutaneous Electrical Nerve Stimulation) in elderly patients with osteoarthritis. There was not only pain relief, but also decreased joint swelling. Needles tend to have an overall balancing action that can be controlled through manipulation techniques. E.A. stimulates and moves the Ch’i (or Qi), and laser energizes Ch’i and Yang. As in electro acupuncture, diode laser can control the pain relief through endorphin or serotonin release by changing the frequency of pulsation. A specialized laser that has been used effectively for acupuncture is the Neodymium laser for arthritis and operated at infrared (1064nm) wavelength. Acute inflammation was produced by the injection of carrageenan into the principal limb-joint of the rabbit. Immediately after injection, 「Housanli(S36)」 and 「Yangfu(G38)」 were treated with acupuncture, Electro-Acupuncture, Laser stimulation and the Diclofenac. The purpose of the present study was to compare therapeutic effects of the above methods on acute arthritis.

碩士
中國醫藥學院
中國醫學研究所
91
Gait Analysis in Knee Osteoarthritis Patients After Electro-Acupuncture Treatment Po-Hsin Lin Institute of Chinese Medical Sciences, China Medical College, Taiwan, ROC ABSTRACT Osteoarthritis (OA), a common type of arthritis, is mostly seen at the knee joint. Pain caused by OA is a major factor that affects patients’ quality of life and hence convinces patients to seek medical assistance. Clinically, pain relief is the first step in the treatment of OA. OA also has huge impact on patients’ financial and psychological situation. Therefore, accurate diagnosis and effective treatments at early stage can save a lot of unnecessary suffering to patients and resources later used on treatments. The currently prevailing medicine treatments for OA are painkiller and antibiotic prescriptions, including non-steroid anti inflammation drugs（NSAIDs）and new generation cyclooxygenase-2（COX-2）inhibitors. Yet, both prescriptions have inevitable side effects. In addition, these prescriptions do not stop the progression of the disease or help increase or restore the capability and mobility of limbs. Knee joint replacements are thus necessary for advanced OA. In past thirty years, many researches have proved that electro-acupuncture treatments are effective in general pain relief, anesthesia, and treatment of functional disorders. It has also been shown very effective in the treatment of OA with almost no side effects. Gait analysis has been widely used in human ambulation research, contributing to the diagnosis of neuromusculoskeletal pathology and the evaluation of subsequent treatment. Among the measurement equipment in gait analysis, force plates were used to measure the Ground Reaction Forces (GRF) of patients with knee OA during movements before and after treatment, giving quantitative data on the efficacy of the treatment. Sixty-three OA patients were selected as subjects from Department of Acupuncture, Taipei Traditional Chinese Medicine Hospital. The subjects were randomized into electro-acupuncture group（n=37）and sham electro-acupuncture group（n=26）. X-ray was taken for each subject and used to categorize them into 4 K/L grades. A force plate was used to measure changes in the GRF during level walking before and after treatments. The visual analogue scale（VAS）and Pain Index of the Knee（PIK）scores were also used to measure the levels of improvement on pain and movements. Typical curve patterns of the vertical component of the GRF for patients with same K/L grade were first established for all grades. The results showed that the worse the joint as indicated by the K/L grading, the more abnormal the curve pattern. These unique pathological curve patterns can serve as good clinical reference. The abnormal curve patterns of about thirty percent of the subjects became normal after treatment in the electro-acupuncture group. The statistical analysis also showed that the center of the foot pressure (COP) moved more rapidly after the electro-acupuncture treatment. The lower limbs were also more capable of body weight bearing, the stance phase time lasted longer, more body weight sustained, more energy generated, and the capability of joint and muscles to manage sudden changes of forces increases in electro-acupuncture group after treatment. The results of sham electro-acupuncture group did not show any statistically significant difference between before and after treatment. The parameters did not show any regular pattern either. The VAS assessment showed that electro-acupuncture was indeed effective in pain relief. Nevertheless, the psychological influences on patients should be considered when using VAS assessment. PIK measurement results showed that electro-acupuncture was effective in pain relief and the method was more sensitive in less severe joints. In conclusion, the electro-acupuncture has been shown to be capable of easing the pain and stiffness symptoms of the OA patients, improving their gait performance. For patients with more severe symptoms and degeneration, electro-acupuncture seems to be a good choice, but prolonged treatments may be necessary to achieve good outcome. Key words：osteoarthritis (OA), acupuncture, electro-acupuncture, gait analysis, ground reaction force (GRF), knee joint

碩士
中國醫藥學院
中西醫結合研究所
91
Abstract : BACKGROUND : Electrical stimulation of meridian points in the rat inhibits the nociceptive tail withdrawal reflex. It’s pain mechanisms are well documented, but the changes of extracellular glucose and lactate metabolites at cellular level are still unclear. The aim of the study was to evaluate these changes using a rat model in combination with the microdialysis technique for the analysis of extracellular neurochemicals. METHODS: Electrical stimulation was applied in anaesthetized intact rats (n =7) with 2 ms square pulses, 2Hz at the Zusanli points. A second electrical stimulation (2-Hz pulses) was delivered in 2 of them in the same spot. A second electrical stimulation of a different pulse (100-Hz pulses) was delivered. in another 1 in the same spot. A second electrical stimulation of 2-Hz pulses was delivered in another 3 rats in non-acpoints to compare the difference due to the different locations of stimulation. The stimulation lasted for 30 min each time it was delivered. A 90-min recovery period was allowed between the first electrical stimulation and the later treatment to avoid interruption. An automated micro-blood sample collector was used for examining the glucose, pyruvate and lactate value. CONCLUSIONS: electro-acupunctural signal has an influence on the biologic process of energy metabolism by mediating dynamic extracellular neuro-chemical changes. EA on limb acupoints of lower limbs could induce obvious decrease in glucose, increases in lactate metabolites and decrease in lactate/glucose ratio. Moreover, the high lactate/glucose ratio suggests that the cell have an increased anaerobic glucose metabolism.

碩士
國立東華大學
諮商與臨床心理學系
102
Chinese acupuncture has been used to treat a wide range of disease for approximately 3000 years. A clinical study has shown that the acupuncture therapy could elevate the therapeutic effect for the patient with ADHD (Attention Deficit Hyperactivity Disease) (Li, Yu, & Lin, 2010). A study employed the visual attention task showed that electro-acupuncture stimulation resulted in significantly better sustained attention performance (Chen, Thompson, Kropotov, & Gruzelier, 2011). Although these works revealed that the acupuncture can influence the attention, but how it works is still unknown. Posner and Petersen (1990) proposed three attentional networks, alerting, orienting, and executive control, as the underlying mechanisms of visual attention. The Attention Network Test (ANT), propose by Fan, McCandliss, Sommer, Raz, & Posner (2002) became an important paradigm to investigate the attention till now. The aim of the present study is to evaluate the impact of electro-acustimulation and acupuncture on the efficiency of three attention networks. In the experiment 1, 60 participants, age between 20 to 35 years old, divided into two groups, electro-acustimulation (EA) group and sham-electro-acustimulation (SEA) group. In the experiment 2, 75 participants, age between 60 to 80 years old, divided into three groups, acupuncture (A) group, EA group and SEA group. The results of experiment 1 revealed the EA can facilitate the alerting effect but reduced the orienting effect simultaneously during and after the acupoint stimulation, while the SEA can only facilitate the alerting effect during the acupoint stimulation and disappeared immediately after the stimulation. The results of experiment 2 revealed the EA can facilitate the alerting effect of elderly after the acupoint stimulation, while the A and SEA had no effect on the attention network of the elderly.

The first half of this chapter paints a broad overview of TCM (traditional Chinese medicine) with a focus on addiction. The second half details the Western studies, which address specific addictive substances. A glimpse of TCM’s history in the context of the medical models is discussed. The Western medical model is compared to and differentiated from TCM. Yin-yang and 5-element theory are detailed. The Zang Fu patterns are examined along with the principles of treatment and recognition of patterns. The 3 treasures (jing, qi, and shen) are discussed. Acupuncture was serendipitously found to be an addiction treatment with EA (electro acupuncture) and auricular points in 1972, which suggested a neuroendocrinological basis. Animal studies pointed toward involvement of different neurotransmitters in the basic mechanism of acupuncture, which are: the dopamine, GABAeric, and serotonergic systems. Most of the quality Western studies use the NADA (National Acupuncture Detoxification Association) protocols, which use 5 auricular points: shen men, kidney, liver, and lung. This protocol treats opiates, cocaine, nicotine, and AUDs. Regarding opiate detoxification, addicts assigned to the treatment groups were more consistent and more frequently attended treatment. Regarding alcohol, female participants (N = 185) who received acupuncture reported a decrease in cravings, depression, and anxiety with an increase in problem solving, when compared to controls (N = 101). There is less evidence that acupuncture is helpful for cocaine and nicotine. Acupuncture appears most helpful as an adjunct therapy, which keeps people more engaged in therapy longer, resulting in better outcomes.