Acupuncture in Modern Medicine

This book contains four integrated sections: 1) Acupuncture Research; 2) New Developments in Acupuncture; 3) Acupuncture Therapy for Clinical Conditions and 4) Assessment and Accessibility in Acupuncture Therapy. Section 1 provides updates on acupuncture research. From acupuncture effects in modulation of immune system to the role of nitric oxide in acupuncture mechanisms, chapters in this section offer readers the newest trends in acupuncture research. Section 2 summarizes new developments in acupuncture. The included chapters discuss new tools and methods in acupuncture such as laser acupuncture, sham needles, and new technologies. Section 3 discusses acupuncture therapy for clinical conditions. The chapters in this section provide comprehensive and critical views of acupuncture therapy and its application in common clinical practice. Section 4 takes a new look at the issues related to assessment and accessibility in acupuncture therapy. These issues are central to developing new standards for outcome assessment and policies that will increase the accessibility to acupuncture therapy

Low-Intensity Electromagnetic Millimeter Waves for Pain Therapy

Millimeter wave therapy (MWT), a non-invasive complementary therapeutic technique is claimed to possess analgesic properties. We reviewed the clinical studies describing the pain-relief effect of MWT. Medline-based search according to review criteria and evaluation of methodological quality of the retrieved studies was performed. Of 13 studies, 9 of them were randomized controlled trials (RCTs), only three studies yielded more than 3 points on the Oxford scale of methodological quality of RCTs. MWT was reported to be effective in the treatment of headache, arthritic, neuropathic and acute postoperative pain. The rapid onset of pain relief during MWT lasting hours to days after, remote to the site of exposure (acupuncture points), was the most characteristic feature in MWT application for pain relief. The most commonly used parameters of MWT were the MW frequencies between 30 and 70 GHz and power density up to 10 mW cm(−2). The promising results from pilot case series studies and small-size RCTs for analgesic/hypoalgesic effects of MWT should be verified in large-scale RCTs on the effectiveness of this treatment method

Integrative Laser Medicine and High-Tech Acupuncture at the Medical University of Graz, Austria, Europe

At the moment, modernization of acupuncture has a high priority. On the traditional side, acupuncture has only recently been awarded the status of Intangible Cultural Heritage by the UNESCO. On the innovative side, high-tech acupuncture is a registered trademark in Austria. Acupuncture has been used for medical treatment for thousands of years. A large number of empirical data are available but the technical quantification of effects was not possible up to now. Using electroacupuncture, needle, or laser stimulation and modern biomedical techniques, it was possible for the first time to quantify changes in biological activities caused by acupuncture. This paper which serves as introduction for the special issue “High-Tech Acupuncture and Integrative Laser Medicine” of the present journal, focuses on the latest innovative aspects that underline the further enhancement and development of acupuncture. Special emphasis is given to new methodological and technical investigations, for example, results obtained from all kinds of acupuncture innovations (e.g., teleacupuncture) and integrative laser medicine

Integrative, Complementary and Alternative Medicine (CAM) in Healthcare

This compendium describes the multimodal interventions in the field of integrative, complementary, and alternative medicine, which combines biological, behavioral, social, and environmental domains rather than merely treating the disease. Research emphasizing the understanding of connections between organs and body systems is the main focus of this text

Acupuncture for the management of low back pain

Background: Low back pain is an extremely common health problem, and is associated with significant economic and social impact. Acupuncture is one of the most frequently sought complementary and alternative medicine modalities for treating low back pain. This thesis investigated the effectiveness of acupuncture in the management of low back pain, with a focus on one aspect of dosage, i.e. number of treatment sessions. Methods: This thesis took a systematic, step-wise, pragmatic approach to address the research question. The United Kingdom Medical Research Council guidelines for developing and evaluating complex interventions provided the framework for the thesis development. Emphasis was placed on the development and feasibility phases of the research process. In the development phase, an overview of systematic reviews was conducted to evaluate evidence for the effectiveness of acupuncture for low back pain; and a review of the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines was performed to explore strategies to improve on the reporting quality of acupuncture research. In the feasibility phase, a randomized controlled feasibility trial was conducted to test the feasibility for conducting a fully powered randomized controlled trial investigating the optimal number of sessions of acupuncture (4, 7 or 10 sessions) used as an adjunct to usual care, for the management of chronic low back pain in adults. Results: Evidence from the overview of systematic reviews suggested that acupuncture is an effective treatment option for patients with chronic low back pain. When compared with no treatment, or used as an adjunct to conventional care, acupuncture provided significant clinical benefits including pain relief and functional improvement at short-term follow-up. In order to improve clinical effectiveness of acupuncture, future research may evaluate the dose response of acupuncture (e.g. number of treatment sessions) in this area. It was demonstrated that STRICTA is a valid reporting guideline based on robust methodology and scientific content. However specific implementation strategies are needed for improvement in the efficacy of the STRICTA, which may serve to promote the reporting quality and reliability of acupuncture research including: updating the STRICTA checklist; improving the STRICTA reporting efficiency; implementing the ‘Instructions to authors’ for journals consistently; establishing STRICTA research centres globally; and expanding the STRICTA website. Results from the feasibility study supported the feasibility of carrying out a definitive randomized controlled trial comparing outcomes from different session numbers of acupuncture for the management of chronic low back pain. 45 participants were recruited within 10 weeks (recruitment rate of 43.7%), and agreed to be randomized. Acupuncture was demonstrated to be acceptable among participants, and high retention rates (86.7%, 86.7%, 100% for the 4, 7, 10 sessions groups, respectively) were recorded. Over 80% of participants indicated that they were ‘very satisfied’ and/or ‘extremely satisfied’ with acupuncture. Participant follow-up rates were 88.9% at discharge (Q1) and at six weeks post randomization (Q2), and 84.4% at 12 weeks post randomization (Q3). Conclusions: The current thesis has provided evidence to add to the scientific basis underpinning the therapeutic value of acupuncture for LBP. From the overview of systematic reviews, acupuncture, either used in isolation or as an adjunct to conventional therapy, has been demonstrated as an effective clinical option for patients with chronic LBP. The need for improvements in the external validity of acupuncture research has been highlighted by the findings of the overview; potential options to improve on such reporting have been discussed surrounding the specific strategies for improving the efficacy of the STRICTA guidelines. There is currently limited evidence available regarding the dose dependence of acupuncture for chronic LBP based on the number of sessions. Collectively, results from the feasibility study supported the decision to proceed to a full-scale randomized controlled trial to definitively test the dose response effects of acupuncture, and investigate the optimal number of sessions of acupuncture for the management of chronic low back pain. Findings may assist with the development of future clinical guidelines regarding the dosage of acupuncture treatment in routine practice, a point of clinical relevance to clinicians, researchers, and policy makers

Investigation into the acupuncture and meridian system

The Meridian system conceived by the ancient Chinese has been described and referenced for more than a thousand years. The Meridians meaning paths are the main trunks that run longitudinally within the body. The Meridian system consists of about 400 acupuncture nodes and 20 Meridian channels connecting most of these points. It deals with the routing and distribution of certain signals that may affect physiological functions. It integrates meridians, tissues and organs into a complex system. Initially, modeling of the acupuncture system is investigated. The physical effect of injecting an acupuncture needle at a node is suggested by an equivalent model of a current (voltage) source based on a simple Faraday disk generator concept. The motion of the needle due to hand manipulation in the presence of Earth\u27s magnetic fields acts as a Faraday\u27s dynamo and causes accumulation of positive (negative) charges at the tip of the needle. Due to clockwise (counter clockwise) rotation, further increase of accumulated charges at the tip results in their release in the form of an equivalent current (voltage) source. This effect has been enhanced by connecting a variable frequency source on a needle inserted into one of the nodes of the meridian system. Voltage variations at the adjacent nodes along the same meridian are measured and the relative connectivity has been observed to verify the concept of a network. It is observed that the induced voltages are proportional to the corresponding path lengths, and further more, the existence paths are found to be frequency dependent. An equivalent transmission line model is suggested. The presence of minute electrical currents also suggests that there is magnetic field along the meridian and therefore the inclusion of series inductance is appropriate. This has already been confirmed by SQUID measurements carried out and reported by [Lo 2003]. The presence of the inductive (resistive) path suggests that capacitive effects due to accompanying electric fields have to be included as shunt capacitance in the equivalent model. It shows that distributed resistance and inductance plus the shunt capacitance perfectly simulate the equivalent transmission line that is essential for signal propagation along the meridians of the acupuncture system. Measurements carried out indicate the presence of lossy resistive paths along the meridian consisting of three nodes. This has been carried out in an acupuncture clinic and two human subjects are subjected to testing on three different occasions. Sinusoidal signals in the frequency range between 20 to 80 Hz are used with different amplitudes, and strengths of propagated signals are measured to verify the existence of the electrical transmission path along that meridian. Additional hypothesis is made suggesting that the cluster water wire can be used to model the pathways of the acupuncture system. One of the reasons for this approach is that cluster water wires are ideal to model tiny nano-size capillaries. They may be present but their presences have not been verified yet physically, even through the SQUID measurements confirm the flow of minute currents along the acupuncture meridians. Petri net formulation has been developed as an attractive alternative to model bionetwork consisting of acupuncture nodes and meridians. However, validating this assumption requires an extensive measurement to be carried out, which is beyond the currently available capabilities and resources. Future work includes much more accurate modeling of pathways and nodes on each meridian, their coupling with each other. Further frequency dependent system identification in terms of equivalent parameters and their coupling behavior in the complex network, i.e., Petri net formation is required to solve the unexplained acupuncture meridian system. The presence of 20 meridians involving more than 400 nodes suggests that the acupuncture system is ideal to model a biological network

Exosomes Derived From Pericytes Improve Microcirculation and Protect Blood–Spinal Cord Barrier After Spinal Cord Injury in Mice

Spinal cord injury (SCI) often leads to severe and permanent paralysis and places a heavy burden on individuals, families, and society. Until now, the therapy of SCI is still a big challenge for the researchers. Transplantation of mesenchymal stem cells (MSCs) is a hot spot for the treatment of SCI, but many problems and risks have not been resolved. Some studies have reported that the therapeutic effect of MSCs on SCI is related to the paracrine secretion of cells. The exosomes secreted by MSCs have therapeutic potential for many diseases. There are abundant pericytes which possess the characteristics of stem cells in the neurovascular unit. Due to the close relationship between pericytes and endothelial cells, the exosomes of pericytes can be taken up by endothelial cells more easily. There are fewer studies about the therapeutic potential of the exosomes derived from pericytes on SCI now. In this study, exosomes of pericytes were transplanted into the mice with SCI to study the restoration of motor function and explore the underlying mechanism. We found that the exosomes derived from pericytes could reduce pathological changes, improve the motor function, the blood flow and oxygen deficiency after SCI. In addition, the exosomes could improve the endothelial ability to regulate blood flow, protect the blood-spinal cord barrier, reduce edema, decrease the expression of HIF-1α, Bax, Aquaporin-4, and MMP2, increase the expression of Claudin-5, bcl-2 and inhibit apoptosis. The experiments in vitro proved that exosomes derived from pericytes could protect the barrier of spinal cord microvascular endothelial cells under hypoxia condition, which was related to PTEN/AKT pathway. In summary, our study showed that exosomes of pericytes had therapeutic prospects for SCI

Osteoarthritis

Osteoarthritis is one of the most debilitating diseases affecting millions of people worldwide. However, there is no FDA approved disease modifying drug specifically for OA. Surgery remains an effective last resort to restore the function of the joints. As the aging populations increase worldwide, the number of OA patients increases dramatically in recent years and is expected to increase in many years to come. This is a book that summarizes recent advance in OA diagnosis, treatment, and surgery. It includes wide ranging topics from the cutting edge gene therapy to alternative medicine. Such multifaceted approaches are necessary to develop novel and effective therapy to cure OA in the future. In this book, different surgical methods are described to restore the function of the joints. In addition, various treatment options are presented, mainly to reduce the pain and enhance the life quality of the OA patients