How might acupuncture work? A systematic review of physiologic rationales from clinical trials

BACKGROUND: Scientific interest in acupuncture has led numerous investigators to conduct clinical trials to test the efficacy of acupuncture for various conditions, but the mechanisms underlying acupuncture are poorly understood. METHODS: The author conducted a PubMed search to obtain a fair sample of acupuncture clinical trials published in English in 2005. Each article was reviewed for a physiologic rationale, as well as study objectives and outcomes, experimental and control interventions, country of origin, funding sources and journal type. RESULTS: Seventy-nine acupuncture clinical trials were identified. Twenty-six studies (33%) offered no physiologic rationale. Fifty-three studies (67%) posited a physiologic basis for acupuncture: 33 (62% of 53) proposed neurochemical mechanisms, 2 (4%) segmental nervous system effects, 6 (11%) autonomic nervous system regulation, 3 (6%) local effects, 5 (9%) effects on brain function and 5 (9%) other effects. No rationale was proposed for stroke; otherwise having a rationale was not associated with objective, positive or negative findings, means of intervention, country of origin, funding source or journal type. The dominant explanation for how acupuncture might work involves neurochemical responses and is not reported to be dependent on treatment objective, specific points, means or method of stimulation. CONCLUSION: Many acupuncture trials fail to offer a meaningful rationale, but proposing a rationale can help investigators to develop and test a causal hypothesis, choose an appropriate control and rule out placebo effects. Acupuncture may stimulate self-regulatory processes independent of the treatment objective, points, means or methods used; this would account for acupuncture's reported benefits in so many disparate pathologic conditions

The Effect of Patient-selected Music on Early Postoperative Pain, Anxiety, and Hemodynamic Profile in Cesarean Section Surgery

BACKGROUND: After cesarean section surgery, routine pharmacologic methods of analgesia--opioids and benzodiazepines--may impair the immediate close contact of mother and neonate for their sedative and emetic effects. OBJECTIVES: The aim of this study was to explore the effect of patient-selected music on postoperative pain, anxiety, opioid requirement, and hemodynamic profile. METHODS: A total of 80 patients, American Society of Anesthesiologists (ASA) physical status I-II, scheduled to undergo general anesthesia and elective cesarean section surgery were enrolled. Patients were randomly allocated to receive 30 minutes of music or silence via headphones postoperatively. Pain and anxiety were measured with a visual analogue scale. Total postoperative morphine requirement as well as blood pressure and heart rate were recorded after the intervention period. RESULTS: Pain score and postoperative cumulative opioid consumption were significantly lower among patients in the music group (p \u3c 0.05), while there were no group differences in terms of anxiety score, blood pressure, or heart rate (p \u3e 0.05). CONCLUSIONS: Postoperative use of patient-selected music in cesarean section surgery would alleviate the pain and reduce the need for other analgesics, thus improving the recovery and early contact of mothers with their children

Dietary sodium deficiency potentiates the effect of prostaglandin E2 on in vitro renin release in the rat.

Using a renal cortical slice system from sodium loaded (SL) or sodium deficient (SD) rats, this study investigated whether the effect of prostaglandin E2 (PGE2) on renin release (RR) is mediated by tissue cyclic AMP content (TcAMPc) changes, and if it can be modified by dietary sodium manipulation. At 10(-5) M, PGE2 significantly stimulated RR and TcAMPc in both SL and SD groups of slices. PGE2 doses of 10(-9) M and 10(-7) M were ineffective, although RR, but not TcAMPc, was significantly greater in the SD group in response to 10(-7) M PGE2 than RR in the SL group. Addition of the phosphodiesterase inhibitor theophylline (10(-4) M) together with the same three PGE2 doses maintained the stimulatory effect of 10(-5)M PGE2 alone on RR and TcAMPc in both groups of slices, and reversed the effect of 10(-7) M PGE2 alone on RR and TcAMPc in the SD group of slices only. Added by itself, theophylline was ineffective. These data indicate that: PGE2 can stimulate RR by a direct effect on the juxtaglomerular cells; the RR responses to PGE2 and theophylline administration are enhanced in the SD state; and the possibility of cAMP mediation of the effect of PGE2 on RR is discussed

Detection of the acupuncture points in skin by differential path-length spectroscopy

An optical fiber-based diagnostic system was developed to detect the acupuncture points (Bonghan Corpuscle) with small depth in human skin. A split fiber with 600 micrometer diameter was used in contact with the skin to deliver and detect the light to yield backscattered signal, which took information from both small and deep layers. The effect of backscattered signal from deep layer of skin was removed by another single fiber with the same diameter as the split fiber. Both fibers were arranged as close as possible to each other to detect the optical properties of tissue in a very small volume. The optical properties of the acupuncture point and its surrounding tissue in the skin were measured separately in the visible wavelength range (400–700nm), and significant difference was found between them. To control the consistency and reproduction of the experimental conditions of the fiber on the skin, a precise pressure sensor was employed