Effect Of Acupuncture Therapy On Plasma Adh (antıdıuretıc hormone), Melatonın And Tac (total Antıoxıdant Capacıty) Levels In patıents Wıth Nocturıa

Noktüri ileri ya&#290;ta uyku bozukluklarının sık görülen sebeplerindendir. Noktüri &#290;ikayeti olan ya&#290;lı hastalar geceleri patolojik olarak azalmı&#290; plazma Antidiüretik Hormon seviyelerine sahiptirler. Bozulmu&#290; melatonin üretimi uykunun normal sirkadiyen ritminin kesintiye uğraması dâhil olmak üzere ya&#290;lı ki&#290;ilerde noktüriye neden olur. Birçok çalı&#290;ma akupunktur noktalarının uyarılmasının nöroendokrinolojik faktörleri düzenleyebileceğini göstermi&#290;tir. Akupunktur tedavisinin noktüri hastalarına ve plazma ADH, melatonin ve TAK seviyelerine etkisini ara&#290;tırmayı amaçladık. 30-70 ya&#290; arası 28 sağlıklı kadın gönüllü (Grup I) ve 27 kadın noktüri hastası (Grup II) çalı&#290;maya katıldı. Haftada 2 seans olmak üzere toplam 10 seans akupunktur tedavisinden sonra noktüri hastalarından kan aldık (Grup III). Plazma ADH, melatonin ve TAK düzeyleri elisa metodu ile çalı&#290;ılmı&#290;tır. Tedavi öncesi ve sonrası hastaların iyile&#290;me durumunu yorumlamak için frekans analiz sonuçlarının verileri hesaplandı. Grup I ile diğer grupların Mann-Whitney U testi ile kar&#290;ıla&#290;tırması yapılırken, tedavi öncesi ve tedavi sonrası gruplar için Wilcoxon testi ile analiz yapıldı. Tedavi öncesi noktüri sıklığı 2-4 olarak kaydedildi. Tüm hastalar bilateral olarak uygulanan HT7, PC6, ST36, ST40, LV3, SP6, CV3 noktalarına olumlu yanıt verdi. 10 seans akupunktur tedavisi sonrası hastaların %52 sinde noktüri &#290;ikâyetlerinin tamamen iyile&#290;tiğini, %48 hastada ise noktüri sayısının azaldığını gözlemledik. Çalı&#290;mamızda noktürnal poliüri hastaları (Grup II) kontrol grubuna (grup I) göre belirgin olarak azalmı&#290; plazma ADH, melatonin hormonu ve TAK seviyeleri göstermekteydi. Plazma melatonin seviyesi tedavi sonrasında grup III&#8223; te grup II&#8223; ye göre artı&#290; göstermesine rağmen plazma ADH seviyelerinde deği&#290;iklik olmadı. Bu nedenle, melatonin santral sinir sistemini etkileyerek noktüri tedavisinde faydalı olabilir. Nokturnal poliüri hastalarında her iki grupta da (grup II ve grup III)plazma TAK seviyesi kontrol grubuna (Grup I) göre dü&#290;ük tespit edildi. Ancak, plazma TAK seviyesi Grup III&#8223; te (tedavi sonrası) Grup II&#8223; ye oranla azaldı. Çalı&#290;manın sonuçlarına göre akupunktur tedavisi noktüri hastalarında plazma melatonin seviyesi üzerine düzenleyici etki göstermektedir ve akupunktur bu hastaların tedavisinde kullanılabilir.Nocturia is a common symptom which causes sleeping disorders in the elderly. Elderly patients with nocturia have been shown to have pathologically reduced plasma antidiuretic hormone levels at night. Impaired melatonin production is involved in disruption of the normal circadian pattern of sleep, which leads to nocturia in older adults. Additionally, aim of this study to measure of plasma total antioxidant capacity level with nocturia patients. A number of studies have demonstrated that acupuncture may modulate a wide range of neuroendocrinological factors following stimulation of acupoints. Methods: We aim to examine the effect of acupuncture treatment on nocturia patients and plasma levels of ADH, melatonin hormone and TAC. 28 healty women subjects (group I) and 27 women nocturia patients (group II) have been joined to our study aged between 30 to 70. After the 10 session of acupuncture treatment every week in two times we took the bloods of the nocturia patients (group III). Plasma antidiuretic hormone, melatonin and TAC levels were studied by Elisa method. The frequency of data analysis to interpret the recovery status of patients before and after treatment is calculated. While comparing Group 1 and other groups with the Mann-Whitney U test, pretreatment and posttreatment groups analyzed using the Wilcoxon test. Nocturia frequency of the patients were recorded 2 to 4 before acupuncture treatment sessions. As a result all of the patients have responded to acupuncture treatment positively which applied bilaterally to Yintang point, Ren 3, Ki 3, Liv 3, Ht 7, St 36, St 40, Sp 6, P 6 points. Results: We have observed that nocturia symptoms recovered completely in 52% of the patients at the end of 10 sessions of the treatment while nocturia frequencies were reduced to one per night in 48% of the patients. In our study, patients with nocturnal polyuria (Group II) showed significantly low plasma antidiuretic hormone and melatonin levels compared with the control group (group I)(p<0.001).Although the plasma melatonin levels were increased in group III compared with group II (after treatment), plasma ADH levels weren&#8223;t changed between the two groups. Thus, melatonin could be beneficial for nocturia via a central nervous system effect. Patient with nocturnal polyuria(Group II) plasma TAC level were decreased compared with the control group (Group I).However, the plasma TAC level were decreased in group III (after treatment) compared with Group II(p=0,044).Conclusion:According to our results we conclude that acupuncture treatment has an regulatory effect on plasma melatonin levels in patients with nocturia and should be used for the treatment of these patients

Comparison of the Effects of Myofascial Meridian Stretching Exercises and Acupuncture in Patients with Low Back Pain

Background : Acupuncture and myofascial meridians show great anatomical and clinical compatibility. Objectives: We aimed to compare the effects of myofascial meridian stretching exercises and acupuncture in patients with low back pain. Methods : We randomized 81 subjects with acute/subacute low back pain into three groups: an acupuncture (A) group, a myofascial meridian stretching (MMS) group, and a control (C) group. We recorded the Numerical Rating Scale (NRS) and Roland- Morris Disability Questionnaire (RMQ) scores at baseline and weeks two and six. We evaluated posterior pelvic tilt and transversus abdominis muscle strenghth with a pressure biofeedback unit, back extensor muscle strength by the Sorenson test, and lumbar range of motion (ROM) with an inclinometer. Group A received acupuncture (BL 57 and BL 62 acupoints) and stretching exercises according to the posterior superficial line were applied to the MMS group. Results : Improvements in the NRS score were more prominent in group A than in group C (p = 0.004). The RMQ score improvement between baseline and weeks two and six was more prominent in groups A and MMS (p < 0.001, p = 0.001, respectively). The Sorenson test showed significant improvement between the baseline and week two in groups A and MMS (p = 0.004, p < 0.001, respectively). The increase in lumbar ROM measurement in the MMS group between baseline and week two was significantly higher than in groups A and C (p = 0.009, p < 0.001, respectively). Conclusion : Stretching exercises according to the myofascial meridian system and acupuncture contributed to improved symptoms in the first two weeks in patients with acute/subacute low-back pain