A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

              [Sort by number of followers]   [Restore default list]

  Subjects -> ALTERNATIVE MEDICINE (Total: 111 journals)
Showing 1 - 15 of 15 Journals sorted alphabetically
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 8)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 10)
Acupuncture in Medicine     Hybrid Journal   (Followers: 19)
Advanced Herbal Medicine     Open Access   (Followers: 8)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 8)
African Journal of Traditional, Complementary and Alternative Medicines     Open Access   (Followers: 7)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 3)
Alternative & Integrative Medicine     Open Access   (Followers: 16)
Alternative and Complementary Therapies     Hybrid Journal   (Followers: 22)
Alternative Medicine     Full-text available via subscription   (Followers: 4)
Alternative Medicine Studies     Open Access   (Followers: 14)
Anales de Hidrología Médica     Open Access   (Followers: 2)
Ancient Science of Life     Open Access   (Followers: 6)
Arabian Journal of Medicinal and Aromatic Plants     Open Access   (Followers: 4)
Arteterapia. Papeles de arteterapia y educación artística para la inclusión social     Open Access   (Followers: 5)
Asian Journal of Plant Pathology     Open Access   (Followers: 4)
Australian Journal of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 4)
Australian Journal of Herbal Medicine     Full-text available via subscription   (Followers: 5)
Australian Journal of Music Therapy     Full-text available via subscription   (Followers: 11)
Avicenna Journal of Phytomedicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
BMC Complementary and Alternative Medicine     Open Access   (Followers: 23)
Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas     Open Access   (Followers: 2)
Botanics : Targets and Therapy     Open Access   (Followers: 6)
Cadernos de Naturologia e Terapias Complementares     Open Access   (Followers: 1)
Chinese Herbal Medicines     Full-text available via subscription   (Followers: 1)
Chinese Medicine     Open Access   (Followers: 5)
Cognitive Neuroscience     Hybrid Journal   (Followers: 31)
Complementary Therapies in Clinical Practice     Hybrid Journal   (Followers: 23)
Complementary Therapies in Medicine     Hybrid Journal   (Followers: 19)
Current Traditional Medicine     Hybrid Journal   (Followers: 5)
Deutsche Heilpraktiker-Zeitschrift     Hybrid Journal   (Followers: 3)
Deutsche Zeitschrift für Akupunktur     Full-text available via subscription   (Followers: 2)
Erfahrungsheilkunde     Hybrid Journal   (Followers: 1)
European Journal of Medicinal Plants     Open Access  
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 30)
Experimental and Therapeutic Medicine     Full-text available via subscription   (Followers: 1)
Fitoterapia     Hybrid Journal   (Followers: 9)
Focus on Alternative and Complementary Therapies     Hybrid Journal   (Followers: 12)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access   (Followers: 1)
Global Journal of Traditional Medicine     Open Access   (Followers: 2)
Herba Polonica     Open Access   (Followers: 1)
Herbal Medicines Journal     Open Access   (Followers: 1)
Indian Journal of Research in Homoeopathy     Open Access   (Followers: 2)
Indian Journal of Traditional Knowledge (IJTK)     Open Access   (Followers: 2)
Innovare Journal of Ayurvedic Sciences     Open Access   (Followers: 10)
Intas Polivet     Full-text available via subscription   (Followers: 5)
Integrative Medicine Research     Open Access   (Followers: 3)
International Journal of Health and Medicine     Open Access   (Followers: 1)
International Journal of High Dilution Research     Open Access  
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Yoga     Open Access   (Followers: 17)
International Journal of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 7)
Ipnosi     Full-text available via subscription  
Journal of Acupuncture and Herbs     Open Access   (Followers: 3)
Journal of Acupuncture and Meridian Studies     Open Access   (Followers: 1)
Journal of Acupuncture and Tuina Science     Hybrid Journal   (Followers: 4)
Journal of Alternative and Complementary Medicine     Hybrid Journal   (Followers: 17)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)
Journal of Applied Research on Medicinal and Aromatic Plants     Hybrid Journal   (Followers: 1)
Journal of Asian Natural Products Research     Hybrid Journal   (Followers: 5)
Journal of Ayurveda and Integrative Medicine     Open Access   (Followers: 7)
Journal of AYUSH :- Ayurveda, Yoga, Unani, Siddha and Homeopathy     Full-text available via subscription   (Followers: 10)
Journal of Bodywork and Movement Therapies     Hybrid Journal   (Followers: 18)
Journal of Complementary and Alternative Medical Research     Open Access   (Followers: 1)
Journal of Complementary and Integrative Medicine     Hybrid Journal   (Followers: 12)
Journal of Dance Medicine & Science     Full-text available via subscription   (Followers: 14)
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Fasting and Health     Open Access   (Followers: 1)
Journal of Ginseng Research     Open Access  
Journal of Health Science and Alternative Medicine     Open Access   (Followers: 1)
Journal of Health Sciences Scholarship     Open Access  
Journal of Herbal Drugs (An International Journal on Medicinal Herbs)     Open Access   (Followers: 1)
Journal of Herbal Medicine     Hybrid Journal   (Followers: 2)
Journal of Herbal Science     Full-text available via subscription   (Followers: 6)
Journal of Integrative Medicine     Full-text available via subscription   (Followers: 4)
Journal of Integrative Medicine & Therapy     Open Access   (Followers: 2)
Journal of Manual & Manipulative Therapy     Hybrid Journal   (Followers: 17)
Journal of Medicinal Plants for Economic Development     Open Access  
Journal of Medicinally Active Plants     Open Access   (Followers: 2)
Journal of Natural Remedies     Open Access   (Followers: 3)
Journal of Nutraceuticals and Herbal Medicine     Open Access   (Followers: 4)
Journal of Palliative Medicine     Hybrid Journal   (Followers: 48)
Journal of the Australian Traditional-Medicine Society     Full-text available via subscription   (Followers: 1)
Journal of Traditional and Complementary Medicine     Open Access   (Followers: 4)
Journal of Traditional Chinese Medical Sciences     Open Access   (Followers: 1)
Journal of Yoga & Physical Therapy     Open Access   (Followers: 9)
Lekovite Sirovine     Open Access  
Médecine Palliative : Soins de Support - Accompagnement - Éthique     Full-text available via subscription   (Followers: 2)
Medical Acupuncture     Hybrid Journal   (Followers: 6)
Medicines     Open Access   (Followers: 1)
Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi     Open Access  
Muller Journal of Medical Sciences and Research     Open Access  
Natural solutions     Full-text available via subscription  
Natural Volatiles & Essential Oils     Open Access   (Followers: 1)
Nigerian Journal of Natural Products and Medicine     Full-text available via subscription  
OA Alternative Medicine     Open Access   (Followers: 1)
Oriental Pharmacy and Experimental Medicine     Partially Free   (Followers: 3)
Research Journal of Medicinal Plant     Open Access   (Followers: 2)
Research Journal of Pharmacognosy     Open Access  
Revista Brasileira de Plantas Medicinais     Open Access   (Followers: 1)
Revista Internacional de Acupuntura     Full-text available via subscription  
South African Journal of Plant and Soil     Hybrid Journal   (Followers: 1)
Synfacts     Hybrid Journal   (Followers: 7)
Traditional & Kampo Medicine     Full-text available via subscription  
Traditional Medicine Journal     Open Access   (Followers: 2)
World Journal of Acupuncture - Moxibustion     Full-text available via subscription   (Followers: 1)
World Journal of Traditional Chinese Medicine     Open Access   (Followers: 1)
Yoga Mimamsa     Open Access   (Followers: 2)
Zeitschrift für Orthomolekulare Medizin     Hybrid Journal   (Followers: 2)

              [Sort by number of followers]   [Restore default list]

Similar Journals
Journal Cover
Acupuncture in Medicine
Journal Prestige (SJR): 0.702
Citation Impact (citeScore): 1
Number of Followers: 19  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0964-5284 - ISSN (Online) 1759-9873
Published by BMJ Publishing Group Homepage  [68 journals]
  • Effect of electroacupuncture on the kisspeptin system in a pubertal rat
           model of polycystic ovary syndrome
    • Authors: Zhi Wang, Li Yang, Hui Dong, Haoxu Dong, Ling Cheng, Ping Yi, Dongmei Huang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To explore the effects and mechanism of action of electroacupuncture (EA) in a rat model of pubertal polycystic ovary syndrome (PCOS).Methods:Female offspring of Sprague-Dawley rats receiving dihydrotestosterone (DHT) during pregnancy (days 16–19), as a model of prenatal androgenization, were divided randomly into three groups: model group (M), EA group, and sham acupuncture (SA) group (n = 8 each). A normal (N) group comprising female offspring of healthy pregnant rats not receiving DHT (n = 8) was added. EA was administered at CV6 and bilateral SP6/ST36 with 2 Hz frequency and 2 mA intensity. SA consisted of superficial needling at different locations without electrical stimulation.Results:EA improved the disturbed estrous cycles, while it could not be concluded that SA was effective in this respect. EA improved ovarian morphology including the number of corpora lutea and area of the ovary, whereas SA did not. However, both EA and SA attenuated the increased luteinizing hormone and decreased estradiol and gonadotropin-releasing hormone levels in the serum of PCOS model rats. Levels of testosterone, follicle-stimulating hormone, and progesterone did not significantly differ between groups. EA and SA alleviated the upregulation of kisspeptin protein and mRNA levels in the hypothalamus and kisspeptin protein level in the arcuate nucleus (ARC). No differences were found between groups in protein or mRNA expression of dynorphin (DYN) or neurokinin B (NKB) in the hypothalamus. Co-expression of kisspeptin, NKB, and DYN were observed in ARC. The GnRH level in the median eminence decreased and could be rescued by EA and SA. Intriguingly, kisspeptin levels in the granulosa cells of the ovary decreased in the model group and could be rescued by EA but not SA. Levels of kisspeptin, NKB, and DYN protein and mRNA in the ovary did not differ between any groups.Conclusion:Both EA and SA appeared to improve symptoms of PCOS at puberty by modulating the kisspeptin system in the hypothalamus. EA also had an effect on ovarian kisspeptin expression and a more comprehensive effect with respect to improving PCOS at puberty than SA.
      Citation: Acupuncture in Medicine
      PubDate: 2021-01-07T08:55:47Z
      DOI: 10.1177/0964528420971299
  • Effects of manual acupuncture and electroacupuncture for lateral
           epicondylalgia of musculoskeletal origin: a systematic review and
    • Authors: Marcos J Navarro-Santana, Jorge Sanchez-Infante, Guido F Gómez-Chiguano, Mike Cummings, César Fernández-de-las-Peñas, Gustavo Plaza-Manzano
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:The aim of this study was to evaluate the effect of acupuncture/electroacupuncture, alone or combined with other interventions, on pain intensity, pain-related disability, and strength in lateral epicondylalgia (LE) of musculoskeletal origin.Databases and data treatment:Electronic databases were searched for randomized clinical trials, where at least one group received acupuncture or electroacupuncture for LE of musculoskeletal origin. To be eligible, trials had to include humans and collect outcomes on pain intensity or pain-related disability in LE. Data were extracted by two reviewers. The risk of bias (RoB) of the trials was assessed using the Cochrane RoB tool, methodological quality was assessed with the Physiotherapy Evidence Database (PEDro) score, and the level of evidence was summarized using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Standardized mean differences (SMDs) using random effects were calculated.Results:A total of 14 trials (10 acupuncture) were included. The meta-analysis found a moderate effect size of acupuncture (SMD = −0.66, 95% confidence interval (CI) = −1.22 to −0.10), but not electroacupuncture (SMD = −0.08, 95% CI = −0.99 to 0.83), in the reduction of elbow pain as compared to a comparative group. Acupuncture exhibited a significant moderate effect size (SMD = −0.51, 95% CI = −0.91 to −0.11) in the improvement of related-disability. Acupuncture (SMD = 0.36, 95% CI = 0.16 to 0.57), but not electroacupuncture (SMD = 0.34, 95% CI = −0.29 to 0.98), exhibited a significant but small effect size on strength. Most significant effects were in the short term. The RoB was low but the heterogeneity of trial results led to a downgrading of the GRADE evidence level.Conclusion:Low-level evidence suggests positive effects of acupuncture, but not electroacupuncture, for pain, related-disability, and strength, in LE of musculoskeletal origin, in the short term.
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-18T07:59:06Z
      DOI: 10.1177/0964528420967364
  • Does acupuncture combined with antidepressants have a better therapeutic
           effect on post-stroke depression' A systematic review and
    • Authors: Kun Zhang, Guangwei Cui, Yuan Gao, Weidong Shen
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To evaluate the effectiveness of acupuncture combined with antidepressants in the treatment of post-stroke depression (PSD).Methods:The following electronic databases were systematically searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Wanfang Data, China National Knowledge Infrastructure and Chongqing VIP database. The primary outcome was the Hamilton depression scale (HAMD) score. Two independent investigators screened for eligible clinical trials. The Cochrane risk of bias tool was used to assess the methodological quality, and RevMan 5.3 was applied for meta-analysis.Results:Thirteen randomized controlled trials (RCTs) involving 904 participants were included in the study. The results of this meta-analysis showed that, compared with antidepressants alone, acupuncture combined with antidepressants led to a significant decrease in the HAMD score (mean difference (MD): −3.60, 95% confidence interval (CI): −4.25 to −2.95, P 
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-18T07:58:24Z
      DOI: 10.1177/0964528420967675
  • Effects of low- and high-frequency electroacupuncture on protein
           expression and distribution of TRPV1 and P2X3 in rats with peripheral
           nerve injury
    • Authors: Junying Du, Junfan Fang, Xuaner Xiang, Jie Yu, Xiaoqin Le, Yi Liang, Xiaoming Jin, Jianqiao Fang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Whether electroacupuncture (EA) stimulation at different frequencies has a similar effect on spared nerve injury (SNI) as other neuropathic pain models, and how EA at different frequencies causes distinct analgesic effects on neuropathic pain is still not clear.Methods:Adult male Sprague-Dawley rats were randomly divided into sham SNI, SNI, 2 Hz, 100 Hz and sham EA groups. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were measured. EA was performed once a day on days 1 to 14 after SNI. The expressions of transient receptor potential cation subfamily V member 1 (TRPV1) and peripheral purinergic P2X receptor 3 (P2X3) were determined by western blotting and immunofluorescence. TRPV1 siRNA and P2X3 siRNA were administered by intrathecal injection. TRPV1 or P2X3 agonists were combined with EA.Results:There were significant decreases in PWT, but no changes in PWL in the 14 days after SNI. EA using 2- or 100-Hz stimulation similarly increased PWT at every time point. The cytosol protein expression of P2X3 in the L4–L6 dorsal root ganglia (DRG) increased, but the expression of TRPV1 decreased in the SNI model. Both these effects were ameliorated by EA, with 2-Hz stimulation having a stronger effect than 100-Hz stimulation. Blocking either TRPV1 or P2X3 specific siRNAs attenuated the decreased PWT induced by SNI. Administration of either a TRPV1 or P2X3 agonist inhibited EA analgesia.Conclusion:2- and 100-Hz EA similarly induced analgesic effects in SNI. This effect was related to up-regulation and down-regulation, respectively, of cytosol protein expression of P2X3 and TRPV1 in L4–L6 DRG, with 2 Hz having a better effect than 100 Hz.
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-18T07:58:02Z
      DOI: 10.1177/0964528420968845
  • Sacral electroacupuncture as a treatment for urge urinary incontinence: a
           prospective case series
    • Authors: Shan Chen, Siyou Wang, Lihua Xuan, Fu Xu, Hanti Lu, Jing Lu
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To examine the impact of electroacupuncture (EA) at the ‘four sacral points’ on urge urinary incontinence (UUI).Methods:Twenty-five patients diagnosed with UUI or urgency-predominant mixed urinary incontinence (MUI) were treated by EA at the ‘four sacral points’. EA was performed in the sacrococcygeal region using disposable sterile 0.40-mm-diameter acupuncture needles that were either 100 or 125 mm in length. Treatments were delivered once every other day. Before and after treatment, a questionnaire measuring symptom severity and quality of life associated with UUI was administered.Results:The median total score (interquartile range) from the severity of symptoms and the quality of life questionnaire (Q-score) of the participants was significantly reduced from 12 (7.5, 15) before treatment to 3 (0, 6) after 6 (6, 12) EA treatments. The Q-score of urgency-predominant MUI and UUI was 8 (5, 14.5) and 12.5 (11, 15), respectively, before treatment; after treatment these were reduced to 2 (0, 7.5) and 4.5 (2, 6), respectively. There was no statistically significant difference in the Q-score between urgency-predominant MUI and UUI before and after treatment. Upon treatment completion, seven patients (28%) were ‘cured’ (improvement rate 100%). Treatments were considered ‘markedly effective’ (improvement rate 75% to
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-18T07:57:20Z
      DOI: 10.1177/0964528420968846
  • Evaluation of improvement in quality of life after acupuncture in a
           patient with cervical dystonia: a case report
    • Authors: Go Horibe, Satoru Yamaguchi, Tomokazu Kikuchi, Asako Kubo, Ai Kouchi, Hideyuki Isobe, Nobuo Araki
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-16T09:51:30Z
      DOI: 10.1177/0964528420958721
  • Perspectives of physicians on medical acupuncture in Lebanon: a
           preliminary study
    • Authors: Fadila Bassem Naji, Kamal Wahab, Ghassan Hamadeh, Sani Hlais
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objectives:There are no regulations governing the practice of acupuncture in Lebanon as it is not yet registered as a profession. To our knowledge, no studies have ever been conducted in Lebanon regarding the practice of acupuncture. The purpose of this preliminary study was to explore the knowledge of Lebanese physicians about acupuncture, with the intent of conducting larger scale studies and developing strategies aimed at refining this knowledge in the future, and the ultimate goal of setting guidelines for acupuncture practice in Lebanon.Methods:An online survey looking into physicians’ knowledge of acupuncture, its mechanisms of action, effectiveness, indications and safety, and physicians’ understanding of its concepts, was circulated to 4651 physicians registered in the Lebanese orders of physicians.Results:One hundred forty-nine physicians (3.2%) completed the survey. Most study respondents stated that they were unaware of the difference between traditional Chinese acupuncture (TCA) and Western medical acupuncture (WMA). Overall, 30% of respondents had personally used and/or referred patients for acupuncture. Physicians who had personally tried acupuncture were more likely to refer patients for acupuncture (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-16T05:51:59Z
      DOI: 10.1177/0964528420968835
  • Identification of major traditional acupuncture points for pain control
           using network analysis
    • Authors: In-Seon Lee, Younbyoung Chae
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-15T12:12:19Z
      DOI: 10.1177/0964528420971309
  • A sham needling device for continuous direct-current acupuncture
    • Authors: Yiu Ming Wong
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-15T12:11:19Z
      DOI: 10.1177/0964528420970550
  • A scoping review of acupuncture insurance coverage in the United States
    • Authors: Roselle Bleck, Emma Marquez, Melanie A Gold, Carolyn L Westhoff
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Increasing access to non-pharmacologic pain management modalities, including acupuncture, has the potential to reduce opioid overuse. A lack of insurance coverage for acupuncture could present a barrier for both patients and providers. The objective of this scoping review was to assess the existing literature on acupuncture insurance coverage in the United States and to identify knowledge gaps and research priorities.Methods:We utilized the Arksey and O’Malley framework to guide our scoping review methodology. We followed a pre-determined study protocol for the level-one abstract and level-two full text screenings. We synthesized information into subject-area domains and identified knowledge gaps.Results:We found a lack of published data on acupuncture coverage in 44 states, especially in the Midwest and the South. Where data were available, a large proportion of acupuncture users did not have insurance coverage. Consumer demand, state mandates, and efforts to reduce opioid use were motivations to cover acupuncture. Licensed acupuncturists were less likely to be reimbursed and were reimbursed at lower rates compared to physicians. Reported barriers encountered when implementing coverage included a lack of providers, challenges determining when to offer non-pharmacologic treatments, and a lack of evidence for clinical efficacy and cost-effectiveness.Conclusion:We found a lack of recent publications and data comparing regional coverage in the United States. A key challenge is that commercial insurance plan data are not in the public domain. Further research should assess insurance coverage implementation for acupuncture and measure the impact of policy changes on acupuncture utilization and rates of opioid overuse.
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-14T06:18:47Z
      DOI: 10.1177/0964528420964214
  • Do the effects of acupuncture vary between acupuncturists' Analysis of
           the Acupuncture Trialists’ Collaboration individual patient data
    • Authors: Andrew J Vickers, Emily A Vertosick, George Lewith, Hugh MacPherson, Nadine E Foster, Karen J Sherman, Dominik Irnich, Claudia M Witt, Klaus Linde
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objectives:The degree to which the effects of acupuncture treatment vary between acupuncturists is unknown. We used a large individual patient dataset of trials of acupuncture for chronic pain to assess practitioner heterogeneity.Methods:Individual patient data linked to identifiable acupuncturists were drawn from a dataset of 39 high-quality trials of acupuncture, where the comparators were either sham acupuncture or non-acupuncture controls, such as standard care or waitlist. Heterogeneity among acupuncturists was assessed by meta-analysis.Results:A total of 1206 acupuncturists in 13 trials were included. Statistically significant heterogeneity was found in trials with sham-control groups (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-10T11:00:11Z
      DOI: 10.1177/0964528420959089
  • Acupuncture for post-operative cognitive dysfunction: a systematic review
           and meta-analysis of randomized controlled trials
    • Authors: Yidan Tang, Tao Wang, Lei Yang, Xuemei Zou, Jianxiong Zhou, Junmei Wu, Jing Yang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:Post-operative cognitive dysfunction (POCD) is a common post-surgical complication, which is associated with increased costs and extended hospital stays. Recently, interest in acupuncture as a potential therapy for POCD has grown. The objective of this meta-analysis was to assess the effectiveness of acupuncture for POCD.Methods:PubMed, Embase, CENTRAL, Medline, Web of Science, CNKI, Wanfang, and VIP databases were searched through March 2018. Randomized controlled trials (RCTs) in which patients with POCD treated with acupuncture (acupuncture group) were compared with those receiving a no treatment control were included. Meta-analyses were conducted using Review Manager 5.3.Results:Sixteen studies containing 1241 participants were included. POCD incidence in the acupuncture group was significantly lower than that in the control groups on the first (odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.23–0.45) and third (OR = 0.41, 95% CI = 0.30–0.56) post-operative days, with no statistically significant difference on the seventh day (OR = 0.58, 95% CI = 0.32–1.04). Acupuncture therapy also improved mini–mental state examination (MMSE) scores on the first (mean difference (MD) = 3.28, 95% CI = 2.79–3.77) and third (MD = 2.52, 95% CI = 2.18–2.87) post-operative days, with no effect on the seventh (MD = 0.14, 95% CI = –0.24 to 0.51). Visual analogue scale (VAS) scores on the first post-operative day were not impacted by acupuncture but were likely associated with post-operative nausea and vomiting on the seventh post-operative day. With respect to methodological quality, most RCTs were found to have an unclear risk of bias.Conclusion:Acupuncture may successfully treat/prevent POCD. However, the current evidence is limited and further research is needed.
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-07T05:42:41Z
      DOI: 10.1177/0964528420961393
  • Effectiveness of self-applied acupressure for cervical pain of benign
           origin (EDIDO-CUH): a randomized controlled clinical trial
    • Authors: Calvo Trujillo Susana, Toribio Martín Luisa Maria, Domenech Senra Pilar, Mingo Moreno Teresa María, Marín Solano Pilar, Martín González Valentín
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Cervical pain is a problem with a high prevalence of ~13% of the population, and is more common in women (16.5%). The most affected age group is 65–74 years. Our aim was to assess the effectiveness of self-applied acupressure for decreasing benign-origin cervical pain, under the supervision of a health professional and in combination with usual treatment, as well as to examine its impact on the patient’s self-perceived health condition and their opinion of the technique.Methods:Pragmatic, multicenter, controlled clinical trial randomized by healthcare center. A total of 160 patients with benign-origin cervical pain between 18 and 65 years of age who attended primary care were included from 12 healthcare centers in the autonomous community of Madrid by consecutive sampling, and randomly assigned to a control or intervention group. The main outcome variable was pain intensity measured on a visual analogue scale (VAS) and secondary variables were self-perceived quality of life (EuroQol-5D utility index) and functional ability (neck disability index). An explanative model of generalized estimating equations was built taking into account the lack of independence among observations. The analysis was performed over 6 months.Results:In total, 150 patients completed the study. Mean age was 45 years (SD: 10.7), 86.7% were women, 86.2% were currently employed, and 57.9% did not perform any physical exercise. Average days experiencing pain was 32.9 (SD: 2.8) and 80% were undergoing previous pharmacological treatment. The quality of life utility index after 3 months was 1.6 points (95% CI: 0.54–2.71) higher in the intervention group. The pain score on the VAS was 0.16 points (95% CI: 0.80–0.48) lower in the intervention group. The health professional explained 10.4% of the reduction in pain observed on the VAS throughout the medical visits.Conclusion:Acupressure applied in addition to usual practice appeared to improve cervical pain in the long term. The effectiveness of this technique was partially explained by the health professional that trained the participants on technique application.Trial registration number::NCT01855893
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-07T05:42:21Z
      DOI: 10.1177/0964528420961398
  • Tackling health inequity: a commentary on the potential of acupuncture to
           improve health outcomes of marginalised populations
    • Authors: Kirsten Baker, John McDonald, Amie Steel
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society’s marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage.Discussion:Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups.Conclusion:Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-07T05:42:01Z
      DOI: 10.1177/0964528420961404
  • Effects of transcutaneous electrical acupuncture point stimulation on
           peripheral capillary oxygen saturation in elderly patients undergoing
           colonoscopy with sedation: a prospective randomized controlled trial
    • Authors: Yongming Chen, Yin Gong, Xiaorong Huai, Xiyao Gu, Diansan Su, Weifeng Yu, Hong Xie
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Introduction:This study investigated whether transcutaneous electrical acupuncture point stimulation (TEAS) at PC6 can reduce the proportion of elderly patients experiencing a drop of ⩾4% in peripheral capillary oxygen saturation (SpO2) while undergoing colonoscopy under sedation.Methods:A total of 32 elderly patients (aged ⩾ 65 years) scheduled for colonoscopy were randomly assigned in a 1:1 ratio to receive either real or sham TEAS (treatment or control groups, respectively). Each patient received oxygen (2 L/min) delivered routinely via nasal cannula. The treatment group was given TEAS at PC6 for 20 min at 2 Hz frequency and 6 mA intensity; the control group underwent the same procedures but with zero frequency/intensity. SpO2 and other physiological parameters were measured prior to sedation and colonoscopy (baseline) and at seven other timepoints through departure from recovery. Depth of anesthesia was measured using a Narcotrend monitor.Results:Significantly fewer patients in the treatment group experienced a ⩾4% decrease from baseline SpO2 (2/16) than patients in the control group (10/16; p = 0.004). The two groups were comparable with regard to respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, and heart rate.Conclusion:TEAS applied at PC6 with 2 Hz frequency was feasible and may be helpful in reducing the rate of hypoxia in elderly patients during colonoscopy.Trial registration number: NCT03775122 (ClinicalTrials.gov).
      Citation: Acupuncture in Medicine
      PubDate: 2020-12-01T06:26:05Z
      DOI: 10.1177/0964528420960479
  • Myofascial trigger point dry needling for complex regional pain syndrome:
           a case report
    • Authors: Wen-qin Sun, Ai-guo Zhou, Dao-bo Pan, Qiang-min Huang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-01T06:25:45Z
      DOI: 10.1177/0964528420959334
  • Flexor pollicis longus rupture following acupuncture for trigger thumb: a
           case report
    • Authors: Siew Khei Liew, Kok Kheng Teh
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-01T06:25:25Z
      DOI: 10.1177/0964528420959085
  • Acupuncture treatment for recurrent laryngeal nerve paralysis after
           thyroid surgery: a case report
    • Authors: Weiqi Feng, Min Ding, Sixiu Ren, Jun Zhang, Hua Feng
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-12-01T06:25:05Z
      DOI: 10.1177/0964528420958715
  • Acupuncture versus placebo acupuncture for in vitro fertilisation: a
           systematic review and meta-analysis
    • Authors: Meaghan E Coyle, Ieva Stupans, Katherine Abdel-Nour, Hiba Ali, Michelle Kotlyarsky, Phillip Lie, Sinan Tekin, Thilini Thrimawithana
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To evaluate the efficacy of acupuncture compared to placebo acupuncture for women undergoing in vitro fertilisation (IVF) in a systematic review and meta-analysis.Methods:A search was conducted in seven English-language biomedical databases from their inception to 3 April 2019 to identify studies evaluating acupuncture as an adjunct to IVF treatment. Randomised controlled trials (RCTs) that compared acupuncture with placebo acupuncture using a non-invasive placebo acupuncture device in women undergoing a fresh or frozen IVF cycle were eligible, as were studies that tested placebo acupuncture as the intervention. Outcomes were clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, live birth rate and adverse events.Results:Eight RCTs involving 3607 women were included. Studies were judged to be low risk for most of the risk of bias domains. Acupuncture around the time of embryo transfer was not significantly different to placebo acupuncture in terms of the clinical pregnancy rate (6 RCTs, 2473 women, risk ratio (RR) = 0.99 (95% confidence interval (CI) = 0.88, 1.11), I2 = 51%, moderate certainty evidence), ongoing pregnancy rate (4 RCTs, 1459 women, RR = 0.88 (95% CI = 0.75, 1.02), I2 = 50%, moderate certainty evidence), miscarriage rate (4 RCTs, 502 women, RR = 1.23 (95% CI = 0.89, 1.71), I2 = 30%, high certainty evidence) or live birth rate (4 RCTs, 1835 women, RR = 0.87 (95% CI = 0.75, 1.01), I2 = 0%, high certainty evidence). Outcomes with placebo acupuncture were not significantly different to usual care. Adverse events relating to acupuncture, such as discomfort and bruising, were mild to moderate.Conclusion:Acupuncture administered around the time of embryo transfer did not have a statistically significant effect on IVF outcomes compared with placebo acupuncture.
      Citation: Acupuncture in Medicine
      PubDate: 2020-10-11T06:53:06Z
      DOI: 10.1177/0964528420958711
  • Magnetic resonance imaging study of safe needling depth and angulation for
           acupuncture at BL40
    • Authors: Hai-Kun Hou, Cun-Zhi Liu, Lu-Lu Lin
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objectives:The objectives of this study were to identify the mean safe needling depth and angle at BL40 between subjects, taking into account variables including sex and body mass index (BMI).Methods:One hundred and twenty-four participants who had undergone magnetic resonance imaging (MRI) examination of the knee region for clinical indications were included in this study. BL40 needling sites were localized by World Health Organization (WHO) standards and were measured by MRI. As much as 70% of the value of AN (from the needle insertion point to the popliteal artery) was considered to represent the safe depth, and angle alpha between the BL40 straight line and the AN line was regarded as the safe angle.Results:Overall, mean safe depth regardless of BMI and sex was 18.51 ± 3.56 mm (95% confidence interval (CI), 17.88%–19.14%). Mean safe depth was 17.24 ± 3.14 mm in the low and normal BMI group, 18.76 ± 2.90 mm in the overweight group, and 22.01 ± 3.71 mm in the obese group. Thirteen patients (10.5%) had internal deviation of angle alpha (95% CI, 5.6%–15.3%), while 111 patients (89.5%) had external deviation (95% CI, 84.7%–94.4%). The mean internal and external deviations of angle alpha were 8.78° ± 2.92° (95% CI, 7.01°–10.55°) and 9.75° ± 3.46° (95% CI, 9.10°–10.41°), respectively.Conclusion:We would suggest that, when using a straight needle insertion at BL40, it is safe to advance a 25-mm needle approximately 12.5 mm, and 17.5 mm should be safe for patients with BMI greater than 28 kg/m2. Practitioners should decrease the depth of penetration when treating patients of low body weight or height.
      Citation: Acupuncture in Medicine
      PubDate: 2020-10-09T07:29:16Z
      DOI: 10.1177/0964528420958714
  • Acupuncture for metabolic syndrome: systematic review and meta-analysis
    • Authors: Xue Li, Hong-Xiao Jia, Dong-Qing Yin, Zhang-Jin Zhang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Metabolic syndrome (MetS) is a cluster of conditions associated with an increased risk of cardiovascular disease and diabetes mellitus. Acupuncture may have benefits in the treatment of MetS. This systematic review with meta-analysis aimed to determine the effectiveness and safety of acupuncture therapy in the treatment of MetS.Methods:Large-sample randomized controlled trials (RCTs) of acupuncture treatment for MetS were extracted from multiple Chinese and English databases and analyzed using meta-analysis to evaluate the efficacy/effectiveness of acupuncture with respect to various MetS indices in comparison with control treatments including conventional medications (CMs) and lifestyle intervention (LI), together and separately.Results:A total of 13 RCTs were identified with 423 subjects undergoing acupuncture regimens and 411 receiving control interventions. Active acupuncture yielded better outcomes than sham acupuncture with respect to improving multiple MetS indices. Acupuncture monotherapy had similar effectiveness in controlling triglyceride levels and high-density lipoprotein levels compared to CMs. The overall effects of adjunctive acupuncture were markedly greater than those of controls (CMs + LI, CMs, and LI) with respect to waist circumference with a mean difference of −5.11 cm (Z = 4.57, p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-10-09T07:28:56Z
      DOI: 10.1177/0964528420960485
  • Effect of acupuncture in the treatment of lymphangioma: a case report
    • Authors: Ying Huang, Qi Min, Yongjie Zhang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-10-08T09:13:01Z
      DOI: 10.1177/0964528420957016
  • The management of hot flushes for men treated with androgen deprivation
           therapy for prostate cancer: a survey of UK practice
    • Authors: William Kinnaird, Ami Mehta, Carina Guo, Heather Payne, Valerie Jenkins, Susan Catt
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-10-07T07:12:16Z
      DOI: 10.1177/0964528420959078
  • Myofascial trigger point electroacupuncture for perineal pain: a case
    • Authors: Yifeng Shen, Feng Zhang, Yuanjie Xu, Xiaopeng Huang, Yaodong You, Xujun Yu, Degui Chang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-10-07T07:11:36Z
      DOI: 10.1177/0964528420959081
  • Oral mucocele treated with acupuncture: a case report
    • Authors: So Young Park, Min Hee Kim, Inhwa Choi
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-10-07T07:09:03Z
      DOI: 10.1177/0964528420959340
  • Electroacupuncture for ileus following laparoscopic radical cystectomy and
           Bricker urinary diversion: a case report
    • Authors: Yuan-Zheng Wang, Jin-Xia Yang, Jun-Xiang Wang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-10-07T07:08:33Z
      DOI: 10.1177/0964528420959333
  • Quality of moxa wool contained in commercial moxibustion devices: test
           method and examples of waste particle concentration
    • Authors: O Sang Kwon, Seong Jin Cho, Kwang-Ho Choi, Suk-Yun Kang, Suyeon Seo, Yeonhee Ryu
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Moxibustion treatment involves a combination of thermal and chemical stimulation applied by the combustion of moxa wool. The quality of moxa wool is considered to be an important factor in moxibustion treatment traditionally and clinically. However, despite its importance, quantitative and objective methods for determining moxa wool quality are lacking.Methods:Moxa wool and commercial indirect moxibustion (CIM) device specimens were randomly collected, dried and strained through sieves of various sizes for 10 h. After sieving, the residues remaining on each sieve were collected. The collected samples were weighed and microscopically observed.Results:In this study, we observed that fibres mainly remained on sieves sized 425 μm, and particles were smaller than 300 μm. The residues between 425 and 300 μm varied between the products. In addition, moxa wool for direct moxibustion (DMW) exhibited significantly more fibres than moxa wool for indirect moxibustion (IMW). Most of the CIM devices using moxa wool had a quality similar to IMW, except for one CIM brand using moxa wool that contained three times more waste particles than IMW.Conclusion:Based on the results of this study, we conclude that the sieving method is useful for testing the quality of moxa wool even after the CIM manufacturing process. The sieve sizes of 425 and 300 μm could be used as a yardstick to determine the quality of moxa wool. Although this approach requires larger scale validation against existing standard methodologies, we believe it has great potential to be used to improve and safeguard the quality of moxa wool contained in commercial moxibustion devices.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-29T08:38:57Z
      DOI: 10.1177/0964528420946046
  • Efficacy of electroacupuncture plus warm needling therapy for plantar heel
           pain: a randomised waitlist-controlled trial
    • Authors: Lai Fun Ho, Yuanqi Guo, Jessica Yuet-Ling Ching, Kam Leung Chan, Ping Him Tsang, Man Hin Wong, Min Chen, Liyi Chen, Bacon Fung-Leung Ng, Zhi Xiu Lin
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP).Methods:This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis.Results:Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P 
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-20T10:23:45Z
      DOI: 10.1177/0964528420946048
  • Effectiveness of dry needling for upper extremity spasticity, quality of
           life and function in subacute phase stroke patients
    • Authors: Juan Nicolás Cuenca Zaldívar, Sandra Calvo, Elisabeth Bravo-Esteban, Petronila Oliva Ruiz, Maria José Santi-Cano, Pablo Herrero
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Stroke is the fourth leading cause of death in Europe, represents one of the most common causes of disability in adult patients, and involves considerable short- and long-term social and healthcare costs. The effectiveness of deep dry needling (DDN) on affected arm functionality was assessed throughout 8 weeks of treatment in patients with stroke in the subacute phase.Methods:Eighty patients were included in this two-group non-randomised study after a propensity score analysis was carried out. Both groups received standard physiotherapy treatment on the affected arm. The needling group also received six sessions of DDN during the 8-week period. Patients were evaluated before and after each session using the Fugl-Meyer upper extremity (FM UE) scale, the modified modified Ashworth scale (MMAS), the resistance to passive movement scale (REPAS) and a 10-point numeric pain rating scale (NPRS 10). The Brunnstrom recovery stage was recorded at the beginning and at the end of the study, and the EuroQoL quality of life survey was completed at the beginning of the study, after the first month of treatment and at the end of the study.Results:Patients treated with DDN showed a reduction in spasticity measured using the REPAS (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-20T10:23:45Z
      DOI: 10.1177/0964528420947426
  • Electroacupuncture pretreatment promotes angiogenesis via
           hypoxia-inducible factor 1α and vascular endothelial growth factor in a
           rat model of chronic myocardial ischemia
    • Authors: Yimeng Fu, Jia Li, Song Wu, Hua Wang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:Electroacupuncture (EA) pretreatment appears useful in the treatment of chronic myocardial ischemia (CMI). The goal of this study was to investigate the effect of EA preconditioning on the regulation of hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) proteins in a CMI model of vascular regeneration.Methods:A CMI model was established by subcutaneous injection of isoprinosine hydrochloride (ISO) for 14 days in 45 Wistar rats, which had been randomly divided into a model group (n = 15), a CMI group pretreated with sham EA for 21 days (CMI + Sham group, n = 15) and a CMI group pretreated with verum EA for 21 days (CMI + EA, n = 15) prior to modeling. An additional 15 Wistar rats received 0.9% sodium chloride via intraperitoneal injection for 14 consecutive days (control group). Serum levels of VEGF and HIF-1α were measured by ELISA, while protein expression of VEGF and HIF-1α in the area of myocardial infarction was measured by Western blotting. The area of myocardial infarction and fibrosis of the myocardial tissue in the study groups were visualized by hematoxylin-eosin (HE) staining and Masson staining, respectively.Results:EA pretreatment improved cardiac function by regulating left ventricular end-diastolic diameter and left ventricular end-systolic diameter, left ventricular ejection fraction and the ST segment voltage of the electrocardiogram. EA pretreatment promoted vascular regeneration by increasing serum levels of VEGF and HIF-1α and by increasing protein expression of HIF-1α and VEGF in the infarcted region of the myocardium, leading to a reduction in the area of myocardial infarction on HE staining and reduction of myocardial fibrosis on Masson staining.Conclusion:EA pretreatment promotes protein expression of HIF-1α and VEGF in areas of ischemic myocardium, which may represent useful biomarkers for coronary collateral establishment and offer potential targets for therapeutic angiogenesis in patients with CMI.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-19T04:26:54Z
      DOI: 10.1177/0964528420938378
  • Use and reporting of risk of bias tools in 825 systematic reviews of
           acupuncture: a cross-sectional study
    • Authors: Youlin Long, Xin Wang, Wenzhe Xiao, Rui Chen, Qiong Guo, Jia Liu, Ruochen Shao, Jin Huang, Liang Du
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To assess the use and reporting of risk of bias (RoB) tools in systematic reviews (SRs) of acupuncture.Study design and setting:We extracted and analyzed information relating to RoB in acupuncture SRs via Medline, Embase and the Chinese CNKI (Chinese National Knowledge Infrastructure), WanFang and VIP databases from their inception to 24 November 2017. Three subgroup analyses were used to check the influence of language, journal type and impact factor, following which we used descriptive analysis.Results:We included 825 acupuncture SRs, of which 48% used the Cochrane RoB tool. Only 36% used the latest version of the Cochrane Handbook (version 5.1.0 at time of writing) with higher proportions among Cochrane SRs (65%) versus non-Cochrane SRs (34%), and high impact factor journals (58%) versus low or no impact factor journals (28% and 38%, respectively). In the last decade, there were notable increases in the use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0, of 43% and 19%, respectively. Chinese-language SRs demonstrated proportionally higher tendencies to report an incorrect Cochrane Handbook version, increasing by 14% in the last 5 years. Additionally, 7% SRs did not report any results, and only 10% reported relatively complete and adequate RoB assessment. Cochrane SRs reported more complete assessments than Chinese-language or non-Cochrane English-language SRs.Conclusion:Use and reporting of RoB tools were suboptimal. Proportionally, use of the Cochrane RoB tool and Cochrane Handbook version 5.1.0 was low but rising. Our results highlight the prevalence and concerns of using unsuitable tools and the issue of incomplete RoB reporting. RoB tool application requires further improvement.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-19T04:26:54Z
      DOI: 10.1177/0964528420946043
  • Acupressure for labor pain management: a systematic review and
           meta-analysis of randomized controlled trials
    • Authors: Yao Chen, Xiang-Yin Xiang, Kien Howe Robert Chin, Jing Gao, Junmei Wu, Lixing Lao, Haiyong Chen
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To evaluate the efficacy/effectiveness of acupressure as an adjunct to standard procedures during labor and delivery, compared with standard procedures with/without sham acupressure, in randomized controlled trials (RCTs).Methods:Ten main databases were searched from their inception until 31 January 2018. Two reviewers independently extracted data concerning the effects of acupressure on pain intensity, labor duration, mode of delivery, use of medications and adverse events. A meta-analysis of these measures was performed using RevMan 5.3. Pooled standardized mean differences (SMDs) or odds ratios (ORs) for the above outcomes were estimated with a fixed or random effects model, according to the heterogeneity.Results:A total of 13 RCTs including 1586 enrolled patients met the eligibility criteria. Acupressure plus standard procedures (ASP) for labor management significantly reduced pain sensation, compared with sham acupressure plus standard procedures (SASP) and standard procedures (SP) alone. The analgesic effect of acupressure was immediate and persisted for at least 60 min (all p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-19T04:26:53Z
      DOI: 10.1177/0964528420946044
  • Comparison of electroacupuncture and manual acupuncture for patients with
           plantar heel pain syndrome: a randomized controlled trial
    • Authors: Weiming Wang, Yan Liu, Ruimin Jiao, Sixing Liu, Jie Zhao, Zhishun Liu
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Plantar heel pain syndrome (PHPS), also known as plantar fasciitis, affects millions of people worldwide. Electroacupuncture (EA) and manual acupuncture (MA) are the two acupuncture modalities frequently used for PHPS in the clinical setting. However, which modality is more effective has yet to be determined.Objective:To examine whether EA is more effective than MA with regards to pain relief for patients with PHPS.Methods:Participants were randomly assigned (1:1) to receive 12 treatment sessions of EA or MA over 4 weeks with 24 weeks of follow-up. The primary outcome was the proportion of treatment responders, defined as patients with at least a 50% reduction from baseline in the worst pain intensity experienced during the first steps in the morning after a 4-week treatment, measured using a visual analogue scale (VAS, 0–100; higher scores signify worse pain). Analysis was by intention-to-treat.Results:Ninety-two patients with a clinical diagnosis of PHPS were enrolled from 29 July 2018 through 28 June 2019. Of the patients, 78 (85%) completed the treatment and follow-up. The primary outcome occurred in 54.8% (23/42) of the EA group compared to 50.0% (21/42) of the MA group after the 4-week treatment (difference –4.76, 95% confidence interval, –26.10 to 16.57, P = 0.662). There were no significant between-group differences for any secondary outcomes after 4 weeks of treatment and at 16 weeks and 28 weeks of follow-up. There were no serious treatment-related adverse events in either group.Conclusion:Among patients with PHPS, EA did not have a better effect with respect to relieving pain intensity than MA at week 4, although both EA and MA appeared to have positive temporal effects, with decreased heel pain and improved plantar function.Trial registration number:ChiCTR1800016531 (Chinese Clinical Trial Registry).
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-19T04:26:41Z
      DOI: 10.1177/0964528420947739
  • Training hour requirements to provide acupuncture in the United States
    • Authors: Roselle R Bleck, Melanie A Gold, Carolyn L Westhoff
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Introduction:The National Academy of Medicine recommends, and Joint Commission requires, offering non-pharmacologic approaches to pain management, including acupuncture, to reduce opioid overuse in the United States. This study describes 2019 state training requirements to evaluate how they represent opportunities and barriers to increasing access to acupuncture.Methods:We searched publicly available databases to identify Acupuncture Practice Acts and additional statutes and regulations pertaining to acupuncture training requirements on state licensure board websites. We then extracted state-specific acupuncture training requirements for individuals with and without a healthcare-related professional license.Results:Thirty-three states allow physicians to provide acupuncture without requiring any additional training requirements, 11 states and the District of Columbia (DC) require 200–300 training hours, and three require physicians to obtain a separate acupuncture license. Three states have no regulatory agency ruling. Forty states require non-healthcare professionals to complete an accredited program of more than 1900 h and pass an examination. Twenty-three states have an Acupuncture Detoxification Specialist designation allowing individuals without a clinical professional license to provide auricular acupuncture for substance use disorder treatment after a 70-h training course.Discussion:State-level training requirements are intended to increase safe and effective care, but variations represent a potential barrier to increasing the number of acupuncture providers in the United States. Allowing non-physician medical professionals to complete reduced training requirements for specific indications could be a model to increase access to acupuncture. The influence of training requirements on acupuncture access and opioid overuse needs examination.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-12T11:03:47Z
      DOI: 10.1177/0964528420939576
  • Acupuncture for tinnitus: a systematic review and meta-analysis of
           randomized controlled trials
    • Authors: Kaiyu Huang, Shuang Liang, Lei Chen, Antoine Grellet
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus.Methods:Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692).Results:Eight studies involving 504 participants were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = −1.81, 95% confidence interval (CI) = −3.69 to 0.07; p = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = −10.11, 95% CI = −12.74 to −7.48; p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-10T01:08:15Z
      DOI: 10.1177/0964528420938380
  • Acupuncture reduces peripheral and brainstem cytokines in rats subjected
           to lipopolysaccharide-induced inflammation
    • Authors: Caroline C Ramires, Daniela TL Balbinot, Francisco J Cidral-Filho, Daniel Ventura Dias, Adair RS dos Santos, Morgana Duarte da Silva
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Lipopolysaccharide (LPS) endotoxins are activators of innate immunity inducing infection and inflammatory responses. Anti-inflammatory drugs can have undesirable side effects. Acupuncture may be an alternative for the treatment of inflammatory processes.Objective:We investigated the potential anti-inflammatory effect of manual acupuncture (MA) at SP6 upon LPS-induced peritonitis in rats.Methods:Peritonitis was induced in rats with an intraperitoneal injection of LPS (0.002, 0.02, 0.2 or 2 µg/kg) in four experimental groups (n = 6 each). A fifth group was injected with sterile saline solution (saline group, n = 6). Four hours after the procedure, peritoneal fluid was collected to determine total cell counts for inflammatory cells, differential leukocyte counts and peritoneal capillary permeability. The LPS dose of 0.02 µg/kg was used in the subsequent experiments as it most successfully induced peritoneal inflammation. Subsequently, five experimental groups (n = 12 rats each) were used: (1) saline, (2) control (untreated LPS group), (3) indomethacin (LPS group treated with indomethacin), (4) NA (LPS group treated with MA at a location not corresponding to any traditional acupuncture point), and (5) SP6 (LPS group treated with verum MA at SP6). Ten minutes after MA or 30 min after indomethacin treatment, the rats received an intraperitoneal injection of LPS. After 4 h, total leukocyte and differential cell counts, myeloperoxidase (MPO) activity, vascular permeability and cytokine levels were evaluated in the peritoneal fluid. Cytokine levels were additionally evaluated in the brainstem.Results:SP6 MA and indomethacin treatments reduced inflammatory cell infiltration, vascular permeability and MPO activity in the LPS-exposed rats. Pre-treatment with indomethacin and SP6 MA decreased tumor necrosis factor (TNF)-α levels and preserved interleukin (IL)-10 in the peritoneal fluid. Indomethacin also reduced IL-6 in the peritoneal fluid. In the brainstem, indomethacin reduced IL-1β, IL-6, TNFα and IL-10, whereas SP6 MA reduced only TNFα and IL-6 levels.Conclusions:This study clearly demonstrates the anti-inflammatory effect of acupuncture, which we believe may involve the activation of anti-inflammatory neural reflexes in the regulation of peritonitis.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-03T05:01:41Z
      DOI: 10.1177/0964528420938379
  • Electroacupuncture ameliorates mechanical hypersensitivity by
           down-regulating spinal Janus kinase 2/signal transducer and activation of
           transcription 3 and interleukin 6 in rats with spared nerve injury
    • Authors: Ying Wang, Yang-yang Xia, Meng Xue, Qian Jiang, Zhihua Huang, Cheng Huang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Evidence shows that the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway participates in the pathogenesis of neuropathic pain. Our previous study revealed that electroacupuncture (EA) attenuated neuropathic pain via activation of alpha-7 nicotinic acetylcholine receptor (α7nAChR) in the spinal cord. However, whether 2 Hz EA alleviates neuropathic pain by regulating the downstream molecules JAK2/STAT3 has not been fully clarified.Methods:Paw withdrawal threshold (PWT) was used as a marker of mechanical allodynia in rats with spared nerve injury (SNI). After applying 2 Hz EA on day 3, 7, 14 and 21 post-surgery, spinal expression of JAK2, STAT3 and pro-inflammatory cytokine interleukin (IL)-6 was examined using quantitative reverse transcription and real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. Intrathecal injection of the α7nAChR antagonist alpha-bungarotoxin (α-Bgtx) was used to further explore the mechanism underlying the effects of 2 Hz EA on expression of JAK2/STAT3 in SNI rats.Results:It was found that levels of spinal STAT3 and IL-6 mRNA, as well as levels of phosphorylated (p)-JAK2, p-STAT3 and IL-6 protein, were markedly increased in SNI rats. 2 Hz EA attenuated the SNI-induced up-regulation of p-JAK2, p-STAT3 and IL-6 expression in the spinal cord. Furthermore, intrathecal injection of α-Bgtx (1.0 μg/kg) not only inhibited the effect of 2 Hz EA on mechanical hypersensitivity but also ameliorated the down-regulation of p-JAK2, p-STAT3 and IL-6 expression induced by 2 Hz EA.Conclusion:This study revealed that 2 Hz EA attenuated SNI-induced mechanical hypersensitivity and the concomitant up-regulation of spinal JAK2, STAT3 and IL-6 in SNI rats, suggesting that suppression of the JAK2/STAT3 signaling pathway might be the mechanism underlying the therapeutic effect of 2 Hz EA on neuropathic pain.
      Citation: Acupuncture in Medicine
      PubDate: 2020-08-03T05:01:01Z
      DOI: 10.1177/0964528420938376
  • Electroacupuncture for intensive care unit acquired weakness: review and
    • Authors: Zixiang Geng, Bimeng Zhang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-07-31T05:28:03Z
      DOI: 10.1177/0964528420938390
  • Neuroanatomical relationship between Jingbi and the brachial plexus
    • Authors: Kwan Leung Chia, Jian Hung Teoh, Rainer Viktor Haberberger
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:This study examined the stratified anatomy of the traditional acupuncture point Jingbi and the neuroanatomical relationship between Jingbi and the brachial plexus, and investigated neural pathways that could be affected by acupuncture stimulation at Jingbi.Methods:Twelve dissected specimens were used to study the pathway of an acupuncture needle inserted at Jingbi. The stratified anatomy and the neuroanatomical relationship between Jingbi and the brachial plexus were studied. Our samples were grouped by gender and cause of death for comparative analysis.Results:All needles (n = 24, on both sides of a total of 12 cadavers) punctured the anterior scalene muscle medial to the brachial plexus and external jugular vein, lateral to the phrenic nerve and internal jugular vein, and superior to the clavicle and subclavian artery/vein. The depth of needle insertion at Jingbi on the right side of male samples was 28.0 (interquartile range (IQR), 22.5–30.8) mm, which was approximately 8 mm deeper than for female subjects (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-07-31T05:28:02Z
      DOI: 10.1177/0964528420938373
  • Electroacupuncture for post-stroke overactive bladder: a multi-centre
           pilot randomized controlled trial
    • Authors: Haiyong Chen, Changde Wang, Minjie Zhou, Pui Yan Chan, Lo Lo Yam, Wing Lok Lam, Kwok-Pui Leung, Sheung-Wai Li, Wai-Yin Tsang, Bacon Fung-Leung Ng, Eric Tat-Chi Ziea, Wing-Fai Yeung, Lixing Lao
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundAlthough acupuncture has been shown to be effective at treating overactive bladder (OAB) following stroke, to our knowledge, no randomized controlled trial (RCT) examining the effects of acupuncture on patients with post-stroke OAB has been conducted. The aim of this preliminary study was to explore the effects of electroacupuncture (EA) in the treatment of post-stroke OAB.MethodsThis study was a multi-site randomized, assessor-blind, controlled pilot trial of patients with post-stroke OAB. In all, 34 post-stroke subjects (mean age: 71.0 years; 32.4% female) with OAB symptoms were randomly assigned to the treatment group or control group in a 1:1 ratio. The subjects in the treatment group were treated with six sessions of EA for 4 weeks, while the subjects in the control group received usual care. The primary outcome measure was the overactive bladder symptom scale (OABSS). Secondary outcome measures included a three day bladder diary and the stroke-specific quality-of-life scale (SSQoL).ResultsEA showed a moderate effect size (ES) on the perceived severity of OAB symptoms as measured by the OABSS at week 5 (one week post-treatment, ES 0.57; p = 0.034) and week 8 (three weeks post-treatment, ES 0.60; p = 0.021), although the results did not remain statistically significant after Bonferroni correction for multiple testing. No significant differences in bladder diary parameters or SSQoL score were found. The EA treatment was well tolerated by the post-stroke subjects.ConclusionA six-session EA treatment was feasible and appeared to reduce OAB symptoms in post-stroke patients. Further fully powered trials are warranted to confirm the efficacy of EA for those with post-stroke OAB.
      Citation: Acupuncture in Medicine
      PubDate: 2020-07-10T05:00:30Z
      DOI: 10.1177/0964528420925488
  • Bilateral pneumothorax and pulmonary embolism after acupuncture: a case
    • Authors: Meiling Cao, Baoyi Liu
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-07-07T03:51:46Z
      DOI: 10.1177/0964528420929343
  • Navigating the path: a qualitative exploration of New Zealand general
           practitioners’ views on integration of care with acupuncturists
    • Authors: Kate Roberts, Debra Betts, Jing-Bao Nie, Anthony Dowell
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundIncreasingly, many patients believe that a combined approach of complementary and alternative medicine (CAM), including acupuncture, and conventional medicine is better than either on its own, and more patients now have the desire to discuss CAM with well-informed general practitioners (GPs). However, to our knowledge, the interaction and collaboration between GPs and acupuncturists specifically in relation to shared care have not been investigated. This research explored interprofessional communication between GPs and acupuncturists in New Zealand. This article specifically reports the GPs’ viewpoints.MethodsThis study was part of a larger mixed-methods research project. Semi-structured interviews of 14 purposively sampled GP participants were conducted and analysed using thematic analysis.ResultsThe data analysis identified both facilitators of and barriers to integrative health care. Facilitators included the willingness of GPs to engage in communication and a recognition of the importance of patient choice. Barriers included the limited opportunities for sharing information and the lack of current established pathways for communication or direct referrals. GPs also highlighted the confusion around scopes of practice in terms of the different styles of and approaches to acupuncture.ConclusionThis research contributes to the body of knowledge concerning interprofessional communication and collaboration between GPs and acupuncturists and suggests that while there are significant barriers to collaboration, there is also the potential to impact provider satisfaction and patient well-being. It provides context within a New Zealand health care setting and also provides additional insights regarding acupuncture, specifically through the disaggregation of specific CAM modalities.
      Citation: Acupuncture in Medicine
      PubDate: 2020-07-07T03:51:44Z
      DOI: 10.1177/0964528420929341
  • Opioid weaning made possible by pain control with Battlefield Acupuncture
    • Authors: Hans L Tillmann, Walter R Nelson, Michael Freedman
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-07-06T03:47:33Z
      DOI: 10.1177/0964528420929342
  • Treatment of Henoch–Schönlein purpura using acupuncture: a case
    • Authors: Feng Zhang, Lin Liu, Qingqing Ye, Mingyi Jing, Jingxian Huang, Yue Zeng, Chaoran Pan, Chao Wang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-07-06T03:47:33Z
      DOI: 10.1177/0964528420929350
  • Electroacupuncture ameliorates corticotrophin-releasing factor-induced
           jejunal dysmotility in a rat model of stress
    • Authors: Yu-Xue Zhao, Chang-Xiang Cui, Jun-Hong Gao, Jun Liu, Qun Liu, Feng-Yan Lu, Juan-Juan Xin, Xiao-Chun Yu, Bing Zhu
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundCentral injection of corticotrophin-releasing factor (CRF) mimics the effect of stress on gastrointestinal (GI) responses, including inhibition of GI motility. This study was designed to explore the effects of electroacupuncture (EA) on disordered jejunal motility in a rat model of stress induced by intracisternal (IC) injection of CRF.MethodsA stress model was established by IC injection of CRF in Sprague–Dawley rats. GI motility was evaluated by assessing gastric emptying (GE), gastrointestinal transit (GIT) and jejunal motility in vivo. EA was performed at ST36. The functional roles of CRF receptor subtype 1 and subtype 2 (CRFr1 and CRFr2) were examined by IC administration of the corresponding selective CRF antagonists. Protein expression of CRFr1 and CRFr2 in the hypothalamus and jejunum was detected by Western blotting.ResultsIC injection of CRF significantly inhibited GE, GIT and jejunal motility. EA treatment remarkably improved the disturbed GI motility. Intriguingly, the disordered jejunal motility induced by central CRF was abolished by IC injection of a selective CRFr2 antagonist, indicating the essential role of central CRFr2 in mediating the stress-induced jejunal motor disorder. EA at ST36 decreased central and peripheral expression of CRFr2, which might be one of the potential mechanisms underlying the beneficial effect of EA on jejunal dysmotility in this rat model of stress.ConclusionThis study suggested that EA at ST36 could ameliorate disordered jejunal motility induced by stress, and that this might be associated with the down-regulation of CRFr2.
      Citation: Acupuncture in Medicine
      PubDate: 2020-07-01T04:52:03Z
      DOI: 10.1177/0964528420920288
  • Electroacupuncture promotes motor function and functional connectivity in
           rats with ischemic stroke: an animal resting-state functional magnetic
           resonance imaging study
    • Authors: Zuanfang Li, Minguang Yang, Yunjiao Lin, Shengxiang Liang, Weilin Liu, Bin Chen, Sheng Huang, Jianhong Li, Jing Tao, Lidian Chen
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundTo evaluate whether electroacupuncture (EA) treatment at LI11 and ST36 could reduce motor impairments and enhance brain functional recovery in a rat model of ischemic stroke.MethodsA rat model of middle cerebral artery occlusion (MCAO) was established. EA at LI11 and ST36 was started at 24 h (MCAO + EA group) after ischemic stroke modeling. Untreated model (MCAO) and sham-operated (Sham) groups were included as controls. The neurological deficits of all groups were assessed using modified neurologic severity scores (mNSS) at 24 h and 14 days after MCAO. To further investigate the effect of EA on infarct volume and brain function, functional magnetic resonance imaging was used to estimate the size of the brain lesions and neural activities of each group at 14 days after ischemic stroke.ResultsEA treatment of MCAO rats led to a significant reduction in the infarct volumes accompanied by functional recovery, reflected in improved mNSS outcomes and motor functional performances. Furthermore, functional connectivity between the left motor cortex and left cerebellum posterior lobe, right motor cortex, left striatum and bilateral sensory cortex were decreased in MCAO group but increased after EA treatment.ConclusionEA at LI11 and ST36 could enhance the functional connectivity between the left motor cortex and the motor function-related brain regions, including the motor cortex, sensory cortex and striatum, in rats. EA exhibits potential as a treatment for ischemic stroke.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-24T05:41:47Z
      DOI: 10.1177/0964528420920297
  • Identifying patients with chronic pain who respond to acupuncture: results
           from an individual patient data meta-analysis
    • Authors: Nadine E Foster, Emily A Vertosick, George Lewith, Klaus Linde, Hugh MacPherson, Karen J Sherman, Claudia M Witt, Andrew J Vickers
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundIn a recent individual patient data meta-analysis, acupuncture was found to be superior to sham and non-sham controls in patients with chronic pain. It has been suggested that a subgroup of patients has an exceptional response to acupuncture. We hypothesized the presence of exceptional acupuncture responders would lead to a different distribution of pain scores in acupuncture versus control groups, with the former being skewed to the right.MethodsThis individual patient data meta-analysis included 39 high-quality randomized trials of acupuncture for chronic headache, migraine, osteoarthritis, low back pain, neck pain and shoulder pain published before December 2015 (n = 20,827). In all, 25 involved sham acupuncture controls (n = 7097) and 25 non-acupuncture controls (n = 16,041). We analyzed the distribution of change scores and calculated the difference in the skewness statistic—which assesses asymmetry in the data distribution—between acupuncture and either sham or non-acupuncture control groups. We then entered the difference in skewness along with standard error into a meta-analysis.FindingsControl groups were more right-skewed than acupuncture groups, although this difference was very small. The difference in skew was 0.124 for non-acupuncture-controlled trials (p = 0.047) and 0.141 for sham-controlled trials (p = 0.029). In a pre-specified sensitivity analysis excluding three trials with outlying results known a priori, the difference in skew between acupuncture and sham was no longer statistically significant (p = 0.2).ConclusionWe did not find evidence to support the notion that there are exceptional acupuncture responders. The challenge remains to identify features of chronic pain patients that can be used to distinguish those that have a good response to acupuncture treatment.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-23T06:06:53Z
      DOI: 10.1177/0964528420920303
  • Effects of acupuncture on cardiovascular risks in patients with
           hypertension: a Korean cohort study
    • Authors: Hyejin Jung, Sujung Yeo, Sabina Lim
      Abstract: Acupuncture in Medicine, Ahead of Print.
      ObjectivesThe aim of this study was to investigate the effects of acupuncture on major adverse cardiovascular events (MACE), myocardial infarction, stroke and death in hypertensive patients taking anti-hypertensives.MethodsUsing the Korean National Health Insurance Service—National Sample Cohort (NHIS-NSC) database, this study identified 59,370 patients taking anti-hypertensives who had been diagnosed with hypertension between 2003 and 2006. They were divided into acupuncture and non-acupuncture groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke or death. After propensity score matching (PSM), there were 18,011 patients each in the non-acupuncture and acupuncture groups. We calculated the incidence rate, hazard ratio (HR) and 95% confidence interval (CI) for MACE, myocardial infarction, stroke and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed.ResultsAfter PSM, the HRs for MACE (0.83, 95% CI 0.80–0.86), all-cause mortality (0.73, 95% CI 0.70–0.76) and myocardial infarction (0.85, 95% CI 0.79–0.92) were significantly lower in the acupuncture group than in the non-acupuncture group. Moreover, the HRs for stroke-related mortality, hemorrhage stroke–related mortality, ischemic stroke–related mortality, ischemic heart disease–related mortality and circulatory system disease–related mortality were significantly lower in the acupuncture group than in the non-acupuncture group.ConclusionThis observational study with long-term follow-up extends the evidence base in support of the effectiveness of acupuncture for the management of hypertension and potentially reduce the burden of cardiovascular disease.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-21T05:40:18Z
      DOI: 10.1177/0964528420920290
  • A comparison of the effects of electroacupuncture versus transcutaneous
           electrical nerve stimulation for pain control in knee osteoarthritis: a
           Bayesian network meta-analysis of randomized controlled trials
    • Authors: Xiaowei Shi, Wenjing Yu, Wei Zhang, Tong Wang, Oyunerdene Battulga, Lijuan Wang, Changqing Guo
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundTo compare the effectiveness of electroacupuncture (EA) and transcutaneous electrical nerve stimulation (TENS) for pain control in knee osteoarthritis (KOA).MethodsFour English (MEDLINE, EMBASE, Cochrane Library and Web of Science) and three Chinese (China Science Journal Citation Report (VIP), Wanfang and China National Knowledge Infrastructure (CNKI)) language databases were searched for eligible randomized controlled trials (RCTs), comparing four approaches: EA, TENS, medication and sham/placebo controls. The primary outcome was pain intensity, measured by visual analogue scale (VAS), numeric-rating scale (NRS) or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale. Classic pairwise and Bayesian network meta-analyses were conducted to integrate the treatment efficacy/effectiveness through direct and indirect evidence.ResultsThirteen studies were included. In the direct meta-analyses, there was no statistically significant overall effect of EA (mean difference (MD) −4.77, 95% confidence interval (CI) −12.51 to 2.96), while the overall effects of high-frequency transcutaneous electrical nerve stimulation (H-TENS) (MD −16.63, 95% CI −24.57 to −8.69) and medication (MD −7.12, 95% CI −12.07 to −2.17) were statistically significant. In the network meta-analyses, the relative effect of the EA and H-TENS groups (MD 5.07, 95% CI −11.33 to 21.93) on pain control did not differ. Meanwhile, H-TENS demonstrated the highest probability of being the first best treatment, and EA had the second highest probability.ConclusionThe present analysis indicated that both EA and TENS exert significant pain relieving effects in KOA. Among the four treatments, H-TENS was found to be the optimal treatment choice for the management of KOA pain in the short-term, and EA the second best treatment option. Given that the application of TENS is recommended by various international guidelines for the treatment of KOA, EA may also represent a potentially effective non-pharmacologic therapy.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-21T05:40:17Z
      DOI: 10.1177/0964528420921193
  • Exploring traditional acupuncture point selection patterns for pain
           control: data mining of randomised controlled clinical trials
    • Authors: Ye-Chae Hwang, In-Seon Lee, Yeonhee Ryu, Myeong Soo Lee, Younbyoung Chae
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundThe underlying principles of traditional acupuncture point selection for pain control are complex. Analysis of acupuncture treatments from clinical studies may provide us with a potential rule when selecting traditional acupuncture points (hereafter abbreviated as “points”) in treatment protocols for pain control. The aim of this study was to investigate which points were most commonly used to treat pain in randomised controlled clinical trials (RCTs).MethodsWe searched acupuncture treatment regimens in RCTs included in the Cochrane Database of Systematic Reviews for pain management. We analysed information on point selection (more than 10 RCTs included) from seven eligible systematic reviews on pain control. The frequency of the points used was calculated and visualised using a human body template.ResultsThe points most commonly used across diseases were SP6, ST36, LI4 and LR3. However, the most frequently used points varied across individual conditions. For example, the most frequently used points to treat migraine were GB20, LR3, GV20, Taiyang, LI4 and TE5, while the most frequently used points to manage dysmenorrhoea were SP6, CV4, SP8, LR3 and BL32. Both regional and distal points were used for pain management with acupuncture.ConclusionsOur findings suggest that local and segmental/extra-segmental neuromodulation appear to be the most common phenomena for pain control in acupuncture research. Analysis of information on point selection using a data-driven approach may unveil the hidden patterns of traditional acupuncture point utilisation in clinical practice.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-21T05:40:17Z
      DOI: 10.1177/0964528420926173
  • Safe needling depth at abdominal traditional acupuncture points: a
           ultrasonographic study of cadavers
    • Authors: Yifeng Shen, Qiaoyin Zhou, Xiaojie Sun, Zuyun Qiu, Yan Jia, Shiliang Li, Weiguang Zhang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-17T11:07:03Z
      DOI: 10.1177/0964528420922241
  • Acupuncture inhibited airway inflammation and group 2 innate lymphoid
           cells in the lung in an ovalbumin-induced murine asthma model
    • Authors: Jie Cui, Ming Dong, La Yi, Ying Wei, Weifeng Tang, Xueyi Zhu, Jingcheng Dong, Wenqian Wang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundGroup 2 innate lymphoid cells (ILC2s) are known to serve important functions in the pathogenesis of allergic airway inflammation. Studies have shown that acupuncture has an anti-inflammatory effect in the airways. However, how acupuncture treatment affects innate immunity, especially with regard to the function of ILC2s in ovalbumin (OVA)-induced allergic airway inflammation, is poorly understood.MethodsBALB/c mice were injected and subsequently challenged with OVA ± treated with manual acupuncture. At the end of the experimental course, lung function was assessed by measurement of airway resistance (RL) and lung dynamic compliance (Cdyn). Cytokine levels were detected by enzyme-linked immunosorbent assay (ELISA). ILC2 proportions in the lung were analyzed by flow cytometry.ResultsThe results showed that airway inflammation and mucus secretion were significantly suppressed by acupuncture treatment. RL decreased while Cdyn increased after acupuncture treatment. There was an apparent decrease in the bronchoalveolar lavage fluid (BALF) concentrations of interleukin (IL)-5, IL-13, IL-9, IL-25 and IL-33 and an increase in soluble IL-33 receptor (sST2) levels compared with untreated asthmatic mice. Acupuncture also reduced the lin–CD45+KLRG1+ST2+ cell proportion in the lung.ConclusionIn conclusion, this study has demonstrated that acupuncture treatment alleviates allergic airway inflammation and inhibits pulmonary ILC2 influx and IL-5, IL-9 and IL-13 production. The inhibition of ILC2s by acupuncture may be associated with the IL-33/ST2-signaling pathway and IL-25 levels, thereby offering protection from the respiratory inflammation associated with asthma.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-16T02:12:54Z
      DOI: 10.1177/0964528420924033
  • Electroacupuncture-induced plasticity between face and hand
           representations in motor cortex is associated with recovery of function
           after facial nerve injury
    • Authors: Wenting Li, Yiling Yang, Jianpeng Huang, Hui Zhang, Dian Zeng, Li Jiang, Jianhua Liu
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-16T02:12:53Z
      DOI: 10.1177/0964528420920298
  • A Malaysian retrospective study of acupuncture-assisted anesthesia in
           breast lump excision
    • Authors: Ju-Ying Ang, Kavita Bhojwani, Huan-Keat Chan, Ai-Chen Chan
      Abstract: Acupuncture in Medicine, Ahead of Print.
      IntroductionThe objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture-assisted anesthesia (AAA) in breast lump excision.MethodsThe medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n = 17) received electrostimulation (2–4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency.ResultsAll surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) = 2/10) at the first hour, and slightly increased to 2/10 (IQR = 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case.ConclusionAAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-16T02:12:53Z
      DOI: 10.1177/0964528420920307
  • Establishment of appropriate sham acupuncture and successful patient
    • Authors: Hantong Hu, Tianye Hu, Dexiong Han, Hong Gao
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:34Z
      DOI: 10.1177/0964528420924035
  • Effects of dry needling on post-stroke brain activity and muscle
           spasticity of the upper limb: a case report
    • Authors: Fatemeh Mohammadpour, Mohammad Ali Oghabian, Noureddin Nakhostin Ansari, Soofia Naghdi, Jan Dommerholt
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:33Z
      DOI: 10.1177/0964528420920294
  • Successful treatment of persistent hiccups with myofascial trigger point
           dry needling: a case report
    • Authors: Wen-qin Sun, Dao-bo Pan, Qiang-min Huang
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:33Z
      DOI: 10.1177/0964528420920296
  • Acupuncture at LR3 and KI3 shows a control effect on essential
           hypertension and targeted action on cerebral regions related to blood
           pressure regulation: a resting state functional magnetic resonance imaging
    • Authors: Jiping Zhang, Taibiao Lyu, Yicheng Yang, Yanjie Wang, Yu Zheng, Shanshan Qu, Zhinan Zhang, Xiaowen Cai, Chunzhi Tang, Yong Huang
      Abstract: Acupuncture in Medicine, Ahead of Print.
      ObjectiveThe aim of this study was to investigate the effects of acupuncture at LR3 and KI3 on hypertension at different time points and on related cerebral regions using resting-state functional magnetic resonance imaging (rs-fMRI).MethodsWe randomly divided 29 subjects into two groups: Group A (receiving acupuncture at LR3 + KI3; 15 subjects) and group B (receiving acupuncture at LR3 and a sham location not corresponding to any traditional acupuncture point; 14 subjects). Acupuncture was performed. Blood pressure (BP) changes were recorded and analyzed using SPSS 20.0 statistical software. We used a 3.0T MRI scanner and standard GE 8 channel head coil to collect whole brain fMRI data in both groups. Data analysis and processing was based on the R2009a MATLAB platform. REST 1.8 software was used to analyze the whole brain amplitude of low-frequency fluctuation (ALFF).ResultsAfter acupuncture, a statistically significant reduction in BP at different time points was observed in group A. In group B, a statistically significant reduction was found only in diastolic blood pressure (DBP) and was not sustained. Acupuncture at LR3 + KI3 specifically affected brain areas involved in BP regulation, as well as those involved in auditory sense, speech, vision, movement and sensation.ConclusionAcupuncture at LR3 + KI3 showed positive immediate and long-term effects on BP, particularly systolic blood pressure (SBP). After ALFF analysis, we concluded that LR3 + KI3 activates brain areas related to BP regulation. In addition, after acupuncture at LR3 + KI3, a highly targeted effect was observed in brain areas associated with BP. In addition, extracerebral areas involving vision, motion control, cognition and hearing were activated, which could potentially contribute to the mitigation of hypertensive complications in patients in an advanced stage of the disease.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:32Z
      DOI: 10.1177/0964528420920282
  • Atraumatic glenohumeral dislocation associated with silent abscess
           formation following acupuncture
    • Authors: De-an Qin, Zhong-tao Zhao, Jie-fu Song
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:32Z
      DOI: 10.1177/0964528420920301
  • Functional connectivity of the retrosplenial cortex in rats with ischemic
           stroke is improved by electroacupuncture
    • Authors: Qingqing Zhang, Jianhong Li, Sheng Huang, Minguang Yang, Shengxiang Liang, Weilin Liu, Lidian Chen, Jing Tao
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundThe aim of this study was to investigate the central mechanism underlying the putative beneficial effects of electroacupuncture (EA) on learning and memory ability of rats with ischemic stroke-induced cognitive deficits by resting-state functional magnetic resonance imaging (fMRI).MethodsA rat model of middle cerebral artery occlusion (MCAO)-induced cognitive deficit (MICD) was established. Rats were randomly assigned into a sham-operated control group (SC group, n = 12), untreated MICD model group (MICD group, n = 12), and MICD group receiving EA treatment at GV20 and GV24 (MICD + EA group, n = 12).ResultsCompared to the MICD group, rats in the MICD + EA group receiving EA at GV20 and GV24 exhibited significantly shortened escape latency times and crossed the position of the platform a significantly increased number of times during the Morris water maze test on the 14th day after EA, which suggested EA could significantly improve spatial learning and memory ability. Furthermore, compared to the MICD group, functional connectivity of the left retrosplenial cortex (RSC) with the left hippocampus, left RSC, right RSC, left cingulate gyrus, right cingulate gyrus, right tegmentum of midbrain, and right visual cortex was increased in the MICD + EA group; the MICD group showed decreased functional connectivity of the left RSC with the left hippocampus, right hippocampus, left RSC, right RSC, right amygdaloid body, left visual cortex, and right visual cortex.ConclusionThese findings suggest that EA at GV20 and GV24 might improve the learning and memory ability of MICD rats by increasing the functional connectivity between the RSC and hippocampus, cingulate gyrus and midbrain, which is encouraging for the potential treatment for cognitive impairment secondary to ischemia stroke.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-12T10:01:31Z
      DOI: 10.1177/0964528420921190
  • Acupuncture in the management of trigeminal neuralgia
    • Authors: James W Edwards, Vivien Shaw
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundWe aimed to assess the standing of acupuncture as a clinical tool in the management of trigeminal neuralgia against the current first-line drug treatment (carbamazepine) and the most effective surgery (microvascular decompression (MVD)).MethodsData regarding efficacy, side effects and cost were compiled for each of these three modalities from the PubMed and Cochrane Library databases. Patient stress was estimated according to Holmes and Rahe’s Social Readjustment Rating Scale (SRRS).ResultsAcupuncture was not significantly more effective than its corresponding control (p = 0.088), but had the greatest efficacy (mean ± 95% confidence interval) of the modalities considered (86.5% ± 5.6% compared to surgery (79.3% ± 7.7%) and pharmacotherapy (71.7% ± 2.5%), respectively). Acupuncture also had fewer mean reported side effects (22.7% ± 5.9%) compared with surgery (25.3% ± 12.6%) and pharmacotherapy (88.8% ± 25.0%), and the lowest cost; after 5 years, the cost of acupuncture was estimated to be £750, compared to £1507.73 for carbamazepine and £4878.42 for MVD. Acupuncture was the least stressful according to the SRRS (53 points), whereas surgery was second most stressful (153 points) and pharmacotherapy was the most stressful intervention to patients (217 points).ConclusionAcupuncture appears more effective than pharmacotherapy or surgery. Statistical analysis of side effects was not possible due to inconsistent reporting protocols, but the data suggest that acupuncture is considerably safer than pharmacotherapy or surgery. Acupuncture also appears to be the least expensive therapeutic modality to deliver long-term (65 weeks onwards), and our analysis indicated that it was less stressful to patients than pharmacotherapy or surgery. Further study into these areas and the practicality of its availability in the UK National Health Service (NHS) and other health systems is recommended.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-10T08:02:44Z
      DOI: 10.1177/0964528420924042
  • Electroacupuncture alleviates intestinal inflammation and barrier
    • Authors: Yumeng Li, Guochen Xu, Sen Hu, Hong Wu, Yuelong Dai, Wenhua Zhang, Fubo Tang, Hongmin Luo, Xian Shi
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundTo investigate whether the mechanism underlying the anti-inflammatory effects of electroacupuncture (EA) at ST36 involves dopamine (DA) and its receptor and whether it is mediated by the vagus nerve in a rat model of intestinal ischaemia-reperfusion (I/R) injury.MethodsRats were subjected to gut ischaemia for 30 min and then received EA for 30 min with or without abdominal vagotomy or intraperitoneal administration of butaclamol (D1 receptor antagonist) or spiperone (D2 receptor antagonist). Plasma levels of DA and tumour necrosis factor (TNF)-α were assessed 1 or 4 h after reperfusion. Myeloperoxidase (MPO) activity and malondialdehyde (MDA) content in intestinal tissues were assessed using enzyme-linked immunosorbent assay (ELISA) kits. Intestinal tissue injury was assessed by observation of the pathological lesions and permeability to 4 kDa fluorescein isothiocyanate (FITC)-dextran.ResultsEA significantly increased levels of DA and lowered levels of TNF-α. EA also inhibited intestinal levels of MPO and MDA and intestinal tissue injury and decreased intestinal permeability to FITC-dextran. Abdominal vagotomy and intraperitoneal administration of butaclamol (but not spiperone) inhibited the effects of EA.ConclusionThese findings suggest that EA at ST36 could attenuate intestinal I/R-induced inflammatory injury and that the underlying mechanism may involve EA-induced increases in levels of DA, mediated by the vagus nerve and D1 receptors.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-10T04:10:07Z
      DOI: 10.1177/0964528420922232
  • Economic evaluation alongside a randomised controlled trial to assess the
           effectiveness and cost-effectiveness of acupuncture in the management of
           chemotherapy-induced peripheral neuropathy
    • Authors: Alex Molassiotis, Bryony Dawkins, Roberta Longo, Lorna KP Suen, Hui Lin Cheng, Tony Mok, Claire T Hulme, Winnie Yeo
      Abstract: Acupuncture in Medicine, Ahead of Print.
      ObjectiveTo assess the cost-effectiveness of acupuncture in the management of chemotherapy-induced peripheral neuropathy (CIPN) in Hong Kong.MethodsA within trial cost-utility analysis with the primary endpoint for the economic evaluation being the Quality Adjusted Life Year (QALY) and associated Incremental Cost Effectiveness Ratio (ICER) over 14 weeks of treatment. A secondary cost-effectiveness analysis was undertaken with the endpoint being change in pain as measured on the Brief Pain Inventory (BPI).ResultsEighty-seven patients were randomised to acupuncture or usual care. Acupuncture resulted in significant improvements in pain intensity (8- and 14-week mean changes compared to usual care of −1.8 and −1.8, respectively), pain interference (8- and 14-week mean changes compared to usual care of −1.5 and −0.9, respectively) and indicators of quality of life and neurotoxicity-related symptoms. However, in the economic evaluation there was little difference in QALYs between the two arms (mean change 0.209 and 0.200 in the acupuncture and usual care arms, respectively). Also, costs yielded deterministic ICERs of HK$616,965.62, HK$824,083.44 and HK$540,727.56 per QALY gained from the health care provider perspective, the societal perspective and the patient perspective, respectively. These costs are significantly higher than the cost-effectiveness threshold of HK$180,450 that was used for the base case analysis.ConclusionWhile acupuncture can improve symptoms and quality of life indicators related to CIPN, it is unlikely to be a cost-effective treatment for CIPN-related pain in health care systems with limited resources.Trial registration numberNCT02553863 (ClinicalTrials.gov) post-results.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-14T03:27:42Z
      DOI: 10.1177/0964528420920285
  • Crossover effects of ultrasound-guided percutaneous neuromodulation on
           contralateral hamstring flexibility
    • Authors: Blanca De-la-Cruz-Torres, Carlos Carrasco-Iglesias, Francisco Minaya-Muñoz, Carlos Romero-Morales
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundCrossover effects refer to the responses of a non-exercised contralateral limb. There is evidence of this effect, as it relates to muscle fatigue, strength, and stretch, but not as it relates to neuromodulation.ObjectivesTo compare the crossover effects of percutaneous neuromodulation (PNM) on hip range of motion (ROM), observed in a straight leg raise (SLR) test, in asymptomatic participants with bilateral reduced hamstring flexibility, versus the neurodynamic sciatic sliding technique, hamstring stretching and mechanical stimulation of the sciatic nerve using a needle (without electrical stimulation). To evaluate the tensiomyographic changes between the two lower limbs after these interventions.Methods80 participants with bilateral reduced hamstring flexibility were randomized into four groups: Stretching, Neurodynamic, PNM, and Needle groups. All interventions were performed on the right limb. Each participant’s leg was subjected to SLR testing and tensiomyography before and after the interventions.ResultsEach group improved their SLR values in the non-intervention limb compared to baseline values, but the PNM and Needle groups obtained higher values for the SLR test in the non-intervention limb compared with the Neurodynamic and Stretching groups. There were statistically significant differences for mean SLR measures between limbs pre- and post-intervention for all groups except the PNM group, suggesting crossover effects for PNM but not the other techniques studied. There were no differences in tensiomyographic assessments between groups or between sides, at baseline or upon completion of the study.ConclusionPNM produced benefits in the SLR test in the non-intervention limb and only 1.5 min was enough to obtain this effect. In addition, no technique interfered with muscle activation.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-14T03:27:41Z
      DOI: 10.1177/0964528420920283
  • Accuracy of acupuncture point location among first-year acupuncture
           students: A pilot study evaluating the impact of training and use of an
           adjustable ruler
    • Authors: Debra R Godson, Jonathan L Wardle
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundThe proportional method of acupuncture point location (APL) currently taught at Endeavor College of Natural Health and advocated by the World Health Organization Regional Office for the Western Pacific (WPRO) was found to be imprecise and/or inaccurate in previous student studies. The ruler and elastic methods of APL were identified as more accurate or precise than the proportional method of APL but were not well received by student participants. Use of an adjustable ruler may overcome barriers to uptake of the more accurate APL methods. This pilot study was the first to evaluate the comparative accuracy of the adjustable ruler and the proportional methods of APL in first-year students at a major Australian acupuncture training college.MethodsAfter 10 weeks of in-class instruction in both proportional and adjustable ruler methods of APL, student participants (n = 14) attempted location of three acupuncture points (LI10, SP6 and ST38) on a volunteer using both APL methods of interest. A self-administered questionnaire and lecturer field notes elucidated attitudes to implementation of both APL methods.ResultsPoints marked using the adjustable ruler were closer to the correct location than those marked using the proportional method across all three acupuncture points. Students and lecturers rated the adjustable ruler more highly than the proportional method for ease of learning and ease of use.ConclusionEncouraging results with the adjustable ruler method warrant further larger scale studies. Use of the adjustable ruler method of APL should be considered for use in point location training at educational institutions teaching traditional acupuncture.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-14T03:27:41Z
      DOI: 10.1177/0964528420920302
  • Non-specific effects of acupuncture and sham acupuncture in clinical
           trials from the patient’s perspective: a systematic review of
           qualitative evidence
    • Authors: Robin ST Ho, Charlene HL Wong, Justin CY Wu, Samuel YS Wong, Vincent CH Chung
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundPrevious clinical trials have demonstrated that both acupuncture and sham acupuncture exert significant, non-specific effects on treatment outcomes when compared to no-treatment controls. A recently developed framework (mechanisms in orthodox and complementary and alternative medicine—MOCAM) suggests that the non-specific effects of acupuncture originate from multiple domains (e.g. patient characteristics, acupuncturist skill/technique, the patient–acupuncturist relationship, and the acupuncture environment). However, it remains to be determined precisely how these domains influence the non-specific effects of treatment among patients receiving acupuncture and sham acupuncture in clinical trials. Therefore, we conducted a systematic review to synthesize existing qualitative evidence on how trial participants randomized to acupuncture and sham acupuncture groups experience non-specific effects, regardless of the types of medical condition investigated.MethodsThis systematic review included primary qualitative studies embedded in randomized controlled trials designed to investigate acupuncture or sham acupuncture interventions. Eligible studies published in English were derived from a search of five international databases. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme (CASP) tool. Using a framework synthesis approach, the identified MOCAM framework was adapted based on the synthesis of the available qualitative evidence.ResultsA total of 20 studies of high methodological quality were included. Our proposed model indicated that the effects of acupuncture may be increased by maintaining a professional status, applying a holistic treatment approach, practicing empathy, and providing patients with an appropriate explanation of the theory behind acupuncture and sham acupuncture. From the patient’s perspective, the efficacy of treatment can be increased by following the lifestyle modification advice provided by acupuncturists, maintaining a positive attitude toward treatment efficacy, actively engaging with acupuncturists during consultation, and making behavioral changes based on experience gained during the trial.ConclusionThe results of this study may provide a basis for improving and standardizing key components of non-specific effects in acupuncture treatment, and for improving the isolation of specific effects in future clinical trials involving acupuncture and sham acupuncture.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-07T01:25:03Z
      DOI: 10.1177/0964528420920299
  • The effect of two types of minimal acupuncture on stooling, sleeping and
           feeding in infants with colic: secondary analysis of a multicentre RCT in
           Sweden (ACU-COL)
    • Authors: Kajsa Landgren, Inger Hallström, Iren Tiberg
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundEvidence for the effect of minimal acupuncture in infants with colic is limited.AimTo compare the effect of standardized minimal acupuncture, individualized acupuncture (where traditional acupuncture points were chosen according to the infant’s symptoms) and no acupuncture on objective measures of stooling, feeding and sleeping in infants with colic (based on diaries) and perceived changes in these parameters (based on parental questionnaires).MethodsThis was a secondary analysis of a multicentre randomized controlled three-armed trial conducted in four counties in Sweden between January 2013 and May 2015 (ACU-COL). The effect on crying has already been published and showed a decrease in crying time for the acupuncture groups. Infants, 2–8 weeks old, who cried and fussed for more than 3 h/day for more than 3 days/week, and thereby fulfilled the criteria for infantile colic, received four extra visits to their ordinary child health centre. The infants (n = 147) were randomly allocated via a computer-generated list to standardized minimal acupuncture at LI4 for 5 s (group A, n = 48), semi-standardized individual acupuncture with a maximum of five insertions for up to 30 s (group B, n = 49), or no acupuncture (group C, n = 48). The parents and the ordinary staff were blinded. Data were collected using: (1) diaries at baseline, during the two intervention weeks and 1-week follow-up; and (2) questionnaires with quantitative and qualitative components used at the second and fourth visits and during a follow-up telephone call. Outcomes were the changes in frequency of stooling and in hours of sleep per day.ResultsThere were no differences between groups for stooling, feeding, or sleeping at any time point according to data from the diaries. At the follow-up phone call, more parents in groups A and B (compared to group C) perceived that feeding and sleep had changed and that the symptoms of colic had improved.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-07T01:25:02Z
      DOI: 10.1177/0964528420920308
  • Effects of pain neuroscience education and dry needling for the management
           of patients with chronic myofascial neck pain: a randomized clinical trial
    • Authors: Pedro Valiente-Castrillo, Aitor Martín-Pintado-Zugasti, César Calvo-Lobo, Hector Beltran-Alacreu, Josué Fernández-Carnero
      Abstract: Acupuncture in Medicine, Ahead of Print.
      ObjectivesThe aim of this study was to observe the medium-term effects on pain, disability, and psychological factors of a combination of myofascial trigger point (MTrP) dry needling (DN) with pain neuroscience education (PNE) versus DN alone versus control care as usual (CUC) in patients with chronic neck pain.MethodsA total of 60 patients were randomly selected in a Spanish National Health Service Public Hospital and divided into three groups: 6 sessions of DN with 3 sessions of PNE (TrPDN + PNE group, n = 21), 6 sessions of DN alone (TrPDN group, n = 20), or 10 sessions of usual care (CUC group, n = 19). The primary outcome was neck pain intensity, while neck disability, medication intake, and psychological factors were secondary outcomes. These variables were measured at baseline, post-treatment, and at 1 month and 3 months after treatment.ResultsTrPDN + PNE and DN alone were associated with greater reductions in pain intensity and disability compared to CUC (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-06T01:38:59Z
      DOI: 10.1177/0964528420920300
  • Effects of acupuncture on anthropometric and serum metabolic parameters in
           premenopausal overweight and obese women: a randomized, patient- and
           assessor-blind, sham-controlled clinical trial
    • Authors: Koh-Woon Kim, Woo-Chul Shi, Min Sun Choi, Jae-Heung Cho, Hi-Joon Park, Hye Hyun Yoo, Mi-Yeon Song
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:The aim of this study was to examine the effect of acupuncture on obesity-related parameters with regard to metabolomics.Methods:This two-arm parallel, patient- and assessor-blind, sham-controlled randomized clinical trial included 120 obese participants. Participants were randomized into two groups. The treatment group received a combined intervention of manual acupuncture (MA) plus electroacupuncture (EA), while the control group received a combination of sham acupuncture interventions consisting of sham MA plus sham EA for 6 weeks. The serum lipid levels were measured as the primary outcome measure and anthropometric parameters and serum metabolic profiles including amino acids and carnitines were measured as secondary outcome measures.Results:The serum lipid levels and anthropometric measurements did not significantly differ between groups, while body weight, body mass index (BMI), and waist circumference were improved within each group and the level of high-density lipoprotein cholesterol increased over time in the treatment group. There were no significant differences in amino acid levels between groups, while certain carnitine (C2, C4, C6, and l-carnitine) levels were significantly increased (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-04-17T08:40:56Z
      DOI: 10.1177/0964528420912259
  • Comparison of dry needling and ischaemic compression techniques on pain
           and function in patients with patellofemoral pain syndrome: a randomised
           clinical trial
    • Authors: Shabnam Behrangrad, Maryam Abbaszadeh-Amirdehi, Amin Kordi Yoosefinejad, Seyed Mokhtar Esmaeilnejadganji
      First page: 371
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:To compare the effectiveness of ischaemic compression (IC) applied directly to the knee versus dry needling (DN) with respect to pain, functional status and sensitivity to mechanical stimulation of vastus medialis obliquus (VMO) myofascial trigger points (MTrPs) in patients with patellofemoral pain syndrome (PFPS).Methods:A total of 54 patients with unilateral PFPS aged 20–30 years were selected randomly from patients referred to physical therapy clinics of Babol University of Medical Sciences in Iran. Twenty-seven patients were allocated to either IC or DN groups. Three sessions of treatment were applied over 1 week with follow-up at 1 week, 1 month and 3 months. Primary outcome measures comprised the Kujala questionnaire score for functional status, numerical pain rating scale (NPRS) for pain intensity and pressure pain threshold (PPT) for sensitivity to mechanical stimulation; these were measured and recorded before treatment and 1 week, 1 month and 3 months after the last treatment session.Results:There were no statistically significant differences in the between-group comparisons of any variables at the various follow-up points. Both groups (n = 27 participants each) had significant improvements (p 
      Citation: Acupuncture in Medicine
      PubDate: 2020-04-27T02:58:31Z
      DOI: 10.1177/0964528420912253
  • Effects of dry needling of active trigger points in the scalene muscles in
           individuals with mechanical neck pain: a randomized clinical trial
    • Authors: José L Arias-Buría, Álvaro Monroy-Acevedo, César Fernández-de-las-Peñas, Gracia M Gallego-Sendarrubias, Ricardo Ortega-Santiago, Gustavo Plaza-Manzano
      First page: 380
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:The aim of this study was to compare the effects of dry needling (DN) versus pressure release over scalene muscle trigger points (TrPs) on pain, related disability, and inspiratory vital capacity in individuals with neck pain.Methods:In this randomized, single-blind trial, 30 patients with mechanical neck pain and active TrPs in the scalene musculature were randomly allocated to trigger point dry needling (TrP-DN; n = 15) or pressure release (n = 15) groups. The DN group received a single session of DN of active TrPs in the anterior scalene muscles, and the pressure release group received a single session of TrP pressure release over the same muscle lasting 30 s. The primary outcome was pain intensity as assessed by a numerical pain rate scale (NPRS, 0–10). Secondary outcomes included disability (neck disability index, NDI) and inspiratory vital capacity. Outcomes were assessed at baseline and 1 day (immediately post), 1 week, and 1 month after the treatment session. Data were expressed as mean score difference (Δ) and standardized mean difference (SMD).Results:Patients receiving DN exhibited a greater decrease in pain intensity than those receiving TrP pressure release at 1 month (Δ 1.2 (95% CI–1.8, –0.6), p = 0.01), but not immediately (1 day) or 1 week after. Patients in the DN group exhibited a greater increase in inspiratory vital capacity at all follow-up time points (Δ 281 mm (95% CI 130, 432) immediately after, Δ 358 mm (95% CI 227, 489) 1 week after, and Δ 310 mm (95% CI 180, 440) 1 month after treatment) than those in the pressure release group (p = 0.006). Between-group effect sizes were large at all follow-up time points (1.1 > SMD > 1.3) in favor of DN.Conclusion:This trial suggests that a single session of DN over active TrPs in the scalene muscles could be effective at reducing pain and increasing inspiratory vital capacity in individuals with mechanical neck pain. Future studies are needed to further confirm these results.
      Citation: Acupuncture in Medicine
      PubDate: 2020-03-31T06:28:48Z
      DOI: 10.1177/0964528420912254
  • Low back pain in athletes can be controlled with acupuncture by a
           catecholaminergic pathway: clinical trial
    • Authors: Lourdes Arriaga-Pizano, Daniel Cuauhtémoc Gómez-Jiménez, Luis Angel Flores-Mejía, Yobana Pérez-Cervera, Carlos Josué Solórzano-Mata, Constantino López-Macías, Armando Isibasi, Rafael Torres-Rosas
      First page: 388
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:Activation of the sympathetic nervous system attenuates inflammation via catecholamines. Recent evidence has shown that electroacupuncture (EA) activates neuronal networks involved in the release of dopamine and norepinephrine that control systemic inflammation. In muscle, catecholamines are related to cyclic adenosine monophosphate (cAMP). This signaling molecule has been implicated in recovery from sustained contractile activity, which may induce muscular pain, such as that which occurs during low back pain (LBP).Objective:Our aim was to evaluate the effects of EA used for the control of LBP on the activation of the sympathetic nervous system in a randomized controlled clinical trial in athletes.Methods:Two groups of athletes with acute or chronic low back pain were studied. EA, sham EA and pharmacological treatment (diclofenac sodium) were evaluated. The outcome measures included a pain score represented by a visual analogue scale (VAS) and serum levels of catecholamines quantified by enzyme-linked immunosorbent assay. In addition, blood was collected into chilled heparin tubes, placed in 96-well cell culture plates and incubated with an equal volume of Roswell Park Memorial Institute (RPMI) medium, with lipopolysaccharide (LPS) alone or with catecholamines. Tumor necrosis factor (TNF)-α levels in the supernatants were analyzed.Results:The results indicated that the initial pain ratings did not differ between the groups analyzed. EA induced epinephrine secretion but not norepinephrine or dopamine secretion. Although EA and pharmacological treatment did not differ in terms of pain relief, in vitro epinephrine and norepinephrine reduced TNF-α production in response to LPS stimuli.Conclusion:EA activates the sympathetic nervous system and induces the release of epinephrine, which could ameliorate inflammation and protect muscular tissue in addition to relieving pain.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-20T08:53:36Z
      DOI: 10.1177/0964528420912251
  • Sustained effects of a brief and standardised acupuncture approach on
           menopausal symptoms: post hoc analysis of the ACOM randomised controlled
    • Authors: Kamma Sundgaard Lund, Volkert Siersma, Christine Winther Bang, John Brodersen, Frans Boch Waldorff
      First page: 396
      Abstract: Acupuncture in Medicine, Ahead of Print.
      BackgroundOur objective was to investigate whether the effect of a brief and standardised acupuncture approach persists after the end of the acupuncture treatment (post-treatment effect) and whether the anticipation of future acupuncture treatment affects menopausal symptoms (pre-treatment effect).MethodThis study is a post hoc analysis of data from a randomised controlled trial where women with moderate to severe menopausal symptoms were offered weekly acupuncture treatment over five consecutive weeks and randomised (1:1) to an early intervention group that received treatment immediately and a late intervention group with a 6-week delay. The acupuncture style was Western medical, administered at CV3, CV4 and bilateral LR8, SP6 and SP9. Acupuncturists were general practitioners. The effect was evaluated repeatedly during and after the interventions using scales from the validated MenoScores Questionnaire (MSQ) for hot flushes (HF), day and night sweats (DNS), general sweating (GS) and menopausal-specific sleeping problems (MSSP) with a 26-week follow-up period (corresponding to 21 or 15 weeks post-treatment for the early and late intervention groups, respectively). Multivariable linear mixed models were used to analyse the extent and duration of effects.ResultsSeventy participants were included in the study. Four participants dropped out. Furthermore, one participant was excluded from the short- and long-term follow-up analyses after the insertion of a hormonal intrauterine device, and nine participants were excluded from the long-term follow-up analysis due to the initiation of co-interventions. For each of the four outcomes, the effect was sustained up to 21 weeks post-treatment with an effect size that was only slightly diminished. A small, but significant, pre-treatment effect was observed in the HF scale scores. The same trend, although not significant, was observed in the DNS and MSSP scale scores. No serious harms were reported.ConclusionThis study demonstrated that the overall effect of a brief and standardised acupuncture treatment on menopause-relevant outcomes was sustained up to 21 weeks post-treatment and that there was a small pre-treatment effect.
      Citation: Acupuncture in Medicine
      PubDate: 2020-06-10T04:10:06Z
      DOI: 10.1177/0964528420920280
  • Adverse events related to electroacupuncture: a systematic review of
           single case studies and case series
    • Authors: Jeong Hwan Park, Jun-Hwan Lee, Sanghun Lee, Jae-Young Shin, Tae-Hun Kim
      First page: 407
      Abstract: Acupuncture in Medicine, Ahead of Print.
      ObjectiveElectroacupuncture (EA) is used in the treatment of various diseases through the use of electrical stimulation. Reports of adverse events (AEs) associated with acupuncture are relatively consistent, but the safety of EA has been less well reported. In this systematic review, we provide a summary of the types of AEs related to EA in clinical practice.MethodsTwelve electronic databases, including those in English (PubMed, Ovid-EMBASE, CENTRAL), Korean (KMbase, KISS, NDSL, KISTI, OASIS), Chinese (CNKI, Wanfang, Weipu) and Japanese (J-STAGE), were systematically searched for single case studies and case series through April 2018. There were no language restrictions. We included clinical studies in which EA was used as a key intervention and in which AEs that may have been causally related to EA were reported.ResultsThirty-seven studies, including 27 single case studies and 10 case series, were evaluated. The most frequently reported AEs were pallor (eight cases), skin pigmentation (eight cases), vertigo (seven cases), chest tightness (six cases), vomiting (six cases) and unconsciousness (five cases). Thirty-one cases (62%) achieved full recovery and three cases (6%) achieved partial recovery. There were also three cases of death (6%).ConclusionAEs related to EA included acupuncture-related AEs and serious AEs induced by electrical stimulation. Currently, specific stimulation conditions associated with EA-specific AEs are not identifiable due to inappropriate reporting. However, skin pigmentation, syncope or spasm, implantable cardioverter-defibrillator shock, cardiac emergencies, electrical burns, and potential internal organ injury are potential EA-specific AEs regarding which physicians should be cautious in clinical practice.
      Citation: Acupuncture in Medicine
      PubDate: 2020-05-16T08:30:23Z
      DOI: 10.1177/0964528420920287
  • Acupuncture stimulation attenuates TNF-α production via vagal modulation
           in the concanavalin A model of hepatitis
    • Authors: Hee-Don Lim, Ki-Joong Kim, Byung Gon Jo, Ji-Yeun Park, Uk Namgung
      First page: 417
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Background:A growing body of evidence shows that neuronal activity is involved in modulating the efficacy of acupuncture therapy. However, it has been seldom investigated whether neuronal activity following acupuncture stimulation is effective at regulating hepatic inflammation.Objective:Using the concanavalin A (ConA) model of hepatitis, we investigated the regulation of inflammatory cytokine tumor necrosis factor (TNF)-α in the liver tissue and the blood after acupuncture stimulation at ST36.Methods:Mice were subjected to ConA injection, acupuncture stimulation at ST36 by manual acupuncture (MA) or electroacupuncture (EA) procedures, and vagotomy (VNX). Liver tissue and blood were collected for TNF-α analysis. TNF-α mRNA was analyzed by real-time polymerase chain reaction (PCR), and TNF-α, CD11b, CD68, and Erk1/2 proteins were analyzed by Western blotting, immunofluorescence staining, and enzyme-linked immunosorbent assay.Results:TNF-α mRNA and protein were induced in CD11b-positive hepatic cells and the plasma at 6–24 h after ConA injection. The application of MA or EA was very effective at attenuating the production of TNF-α. Anti-inflammatory effects of acupuncture were greatly suppressed by VNX in ConA-injected animals, suggesting the requirement of vagus nerve activity in acupuncture-mediated anti-inflammatory responses. Electrical stimulation of the sciatic nerve (SNS) resulted in an anti-inflammatory effect similar to acupuncture stimulation. In parallel with TNF-α, production of phospho-Erk1/2, which was induced in the liver tissue, was downregulated by MA and EA in liver cells.Conclusion:The regulatory effects of acupuncture stimulation on inflammatory responses in the liver may be modulated through the activation of the vagus nerve pathway.
      Citation: Acupuncture in Medicine
      PubDate: 2020-04-01T09:23:46Z
      DOI: 10.1177/0964528420907338
  • Manual acupuncture relieves microglia-mediated neuroinflammation in a rat
           model of traumatic brain injury by inhibiting the RhoA/ROCK2 pathway
    • Authors: Ming-min Zhu, Ji-huan Lin, Peng Qing, Liu Pu, Shu-lian Chen, Shu-jun Lin, Cheng-lu Li, Lu-xi Cao, Yi-min Zhang
      First page: 426
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To investigate the regulatory mechanism of manual acupuncture (MA) on microglial polarization–mediated neuroinflammation after traumatic brain injury (TBI), focusing on the RhoA/Rho-associated coiled coil-forming protein kinase (ROCK2) pathway.Methods:Sprague Dawley (SD) rats were used to generate a TBI model using Feeney’s freefall epidural impact method. MA was performed on half of the TBI model rats, while the others remained untreated. Acupuncture was administered at GV15, GV16, GV20, GV26, and LI4. At the end of the intervention, rat brain tissue samples were collected, and the microglial M1 polarization status was observed by immunofluorescence labeling of CD86, an M1 microglia-specific protein. RhoA/ROCK2 signaling components were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. An enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of inflammatory factors.Results:Compared with normal rats, the CD86 expression density in the untreated TBI model rats was high and showed an aggregated expression pattern. The genes and proteins of the RhoA/ROCK2 signaling pathway were highly expressed, and inflammatory factors were significantly increased. The CD86 expression density in TBI rats after MA was reduced compared to that in untreated TBI rats and showed a scattered distribution. The expression of RhoA/ROCK2 signaling pathway genes and proteins was also significantly reduced, and inflammatory factors were decreased.Conclusion:These results show that MA may inhibit M1 polarization of microglia by regulating the RhoA/ROCK2 signaling pathway, thereby reducing neuroinflammation in TBI.
      Citation: Acupuncture in Medicine
      PubDate: 2020-04-20T01:07:11Z
      DOI: 10.1177/0964528420912248
  • Dry needling for scar treatment
    • Authors: Evgeni Rozenfeld, Eleanora Sapoznikov Sebakhutu, Yuval Krieger, Leonid Kalichman
      First page: 435
      Abstract: Acupuncture in Medicine, Ahead of Print.
      Objective:To review current scientific knowledge as to the efficacy of dry needling of scars on pain and other related symptoms and explore the possible physiological mechanisms of action.Methods:A narrative review of scientific literature published in English.Results:Two randomized controlled trials found that dry needling of scars (using the classic “surrounding the dragon” technique in one study and intradermal needling in a second study) was more effective than sham or control interventions with respect to scar appearance and pain. Two case reports have suggested that scar needling generates a rapid decrease in pain and improvement of mobility in scarred tissues. Another two case reports have reported positive effects of scar needling on the wound healing process. These findings are supported by an animal study examining the effect of needling on the wound healing process and the physiological mechanisms of action underlying the technique.Conclusion:There is preliminary evidence that the “surrounding the dragon” needling technique is a beneficial treatment for patients suffering from scar pain and other scar-related symptoms and can facilitate wound healing and make this process less painful. Further high-quality studies should be conducted to verify/quantify the efficacy of this method, to better understand the underlying mechanisms of action underlying the effects of scar needling and to establish an effective intervention protocol.
      Citation: Acupuncture in Medicine
      PubDate: 2020-03-31T06:49:08Z
      DOI: 10.1177/0964528420912255
  • Acupuncture for pain management in pediatric psoriatic arthritis: a case
    • Authors: Giuliano Marchetti, Alessandro Vittori, Ilaria Mascilini, Elisa Francia, Sergio Giuseppe Picardo
      First page: 440
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-05-06T07:31:28Z
      DOI: 10.1177/0964528420920281
  • Awake craniotomy for patients with difficult airway: a case of anesthetic
           management using a combination of wrist–ankle acupuncture analgesia and
           scalp block
    • Authors: Lu Zhixia, Zhou Na, Zhang Chunlei, Hao Wei
      First page: 443
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-05-14T03:27:42Z
      DOI: 10.1177/0964528420920284
  • Acupuncture for post-stroke shoulder pain: a case report
    • Authors: Hiroyoshi Yajima, Miho Takayama, Ruka Nobe, Judith M Schlaeger, Nobuari Takakura
      First page: 446
      Abstract: Acupuncture in Medicine, Ahead of Print.

      Citation: Acupuncture in Medicine
      PubDate: 2020-06-16T02:12:55Z
      DOI: 10.1177/0964528420920292
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762

Your IP address:
Home (Search)
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-