Electroacupuncture Elicits Dual Effects: Stimulation of Delayed Gastric Emptying
and Inhibition of Accelerated Colonic Transit Induced by Restraint Stress in
Rats
Iwa M, et al. Department of Surgery, Duke University and Durham Veterans Affairs
Medical Center, Durham, North Carolina, 27705, USA.
Acupuncture has been used for treating functional gastrointestinal (GI)
disorders. Animal studies have demonstrated that acupuncture antagonized various
stress-induced responses. We investigated the effects of electroacupuncture (EA)
at ST-36 (Zusanli; lower limb) on stress-induced alteration of GI motor
activities. Solid gastric emptying was significantly delayed by restraint stress
( 29.6+/-2.4%; n=7) compared to that of controls (60.0+/-2.5%; n=8). Delayed
gastric emptying was significantly improved by EA at ST-36 (47.2+/-1.8%).
Intracisternal (IC) injection of corticotropin releasing factor (CRF; 1 mug)
delayed gastric emptying to 25.4+/-3.1%, which was also improved by EA at ST-36,
to 53.0+/-7.1% (n=8). The stimulatory effect of EA on stress-induced delayed
gastric emptying was abolished by atropine (17.6+/-1.9%) but not by guanethidine
(42.2+/-2.3% ). Colonic transit was significantly accelerated by restraint
stress (GC=7.2+/-0.3; n=8) compared to that of controls (GC=5.2+/-0.2; n=8).
Accelerated colonic transit was significantly reduced by EA at ST-36
(GC=4.9+/-0.3 ). IC injection of CRF accelerated colonic transit (GC=6.9+/-0.2),
which was also normalized by EA at ST-36 (GC=4.7+/-0.2). The inhibitory effect
of EA on stress-induced acceleration of colonic transit was not affected by
guanethidine (GC= 4.6+/-0.3). In conclusion, EA at ST-36 showed dual effects:
stimulation of stress-induced delayed gastric emptying and inhibition of
stress-induced acceleration of colonic transit. The stimulatory effect of EA on
stress-induced delayed gastric emptying is mediated via cholinergic pathways.
The inhibitory effect of EA on stress-induced acceleration of colonic transit is
independent of the sympathetic pathway.
Dig Dis Sci. 2006 Jul 26
Source PubMed
[TOP]
Acupuncture
and Knee Osteoarthritis
Scharf HP, et al. University of Heidelberg, Heidelberg, Germany.
BACKGROUND: Despite the popularity of acupuncture, evidence of its efficacy for
reducing pain remains equivocal. OBJECTIVE: To assess the efficacy and safety of
traditional Chinese acupuncture (TCA) compared with sham acupuncture (needling
at defined nonacupuncture points) and conservative therapy in patients with
chronic pain due to osteoarthritis of the knee. DESIGN: Randomized, controlled
trial. SETTING: 315 primary care practices staffed by 320 practitioners with at
least 2 years' experience in acupuncture. PATIENTS: 1007 patients who had had
chronic pain for at least 6 months due to osteoarthritis of the knee (American
College of Rheumatology [ACR] criteria and Kellgren-Lawrence score of 2 or 3).
Interventions: Up to 6 physiotherapy sessions and as-needed anti-inflammatory
drugs plus 10 sessions of TCA, 10 sessions of sham acupuncture, or 10 physician
visits within 6 weeks. Patients could request up to 5 additional sessions or
visits if the initial treatment was viewed as being partially successful.
MEASUREMENTS: Success rate, as defined by at least 36% improvement in Western
Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 26
weeks. Additional end points were WOMAC score and global patient assessment.
RESULTS: Success rates were 53.1% for TCA, 51.0% for sham acupuncture, and 29.1%
for conservative therapy. Acupuncture groups had higher success rates than
conservative therapy groups (relative risk for TCA compared with conservative
therapy, 1.75 [95% CI, 1.43 to 2.13]; relative risk for sham acupuncture
compared with conservative therapy, 1.73 [CI, 1.42 to 2.11]). There was no
difference between TCA and sham acupuncture (relative risk, 1.01 [CI, 0.87 to
1.17]). LIMITATIONS: There was no blinding between acupuncture and traditional
therapy and no monitoring of acupuncture compliance with study protocol. In
general, practitioner-patient contacts were less intense in the conservative
therapy group than in the TCA and sham acupuncture groups. CONCLUSIONS: Compared
with physiotherapy and as-needed anti-inflammatory drugs, addition of either TCA
or sham acupuncture led to greater improvement in WOMAC score at 26 weeks. No
statistically significant difference was observed between TCA and sham
acupuncture, suggesting that the observed differences could be due to placebo
effects, differences in intensity of provider contact, or a physiologic effect
of needling regardless of whether it is done according to TCA principles.
Ann Intern Med. 2006 Jul 4; 145(1):12-20
Source: PubMed
[TOP]
Effectiveness of a Chinese Herbal Medicine Preparation in the Treatment of Cough
in Uncomplicated Upper Respiratory Tract Infection
Wong WC, et al.
ABSTRACT: Background Rigorous scientific and well-designed clinical trials to
evaluate the effect of traditional Chinese medicine (TCM) is lacking. We,
therefore, designed this study to evaluate the effectiveness of a commonly used
TCM preparation in treating acute cough of uncomplicated URTI in adults and to
search for a safe, effective and affordable alternative treatment for this
common condition. Methods A randomised, double-blinded, placebo-control study
comparing this TCM preparation with a placebo was conducted in 82 patients who
attended the Family Medicine Training Centre, Prince of Wales Hospital, Hong
Kong between November and December, 2003. The TCM herbal preparation includes
nine commonly used TCM herbs for cough such as chuanbei, fangfeng, jiegeng,
gancao and baibu (see Table 1). The treatment lasted for 5 days and patients
were followed-up for another 6 days. Patients were asked to fill in a cough
score and validated Leicester cough questionnaire (LCQ). Results 62 patients (
75.6%) had completed the trial and no adverse effects were reported. Both
intervened and control groups had improved in cough score and LCQ in the
follow-up period, despite no overall statistical significance was observed in
the differences of scores between the two groups. Women taking TCM had
significantly fewer problems with sputum production (p= 0.03) and older subjects
(>35 years of age) reported a significant improvement in hoarseness (p=0.05)
when compared to those using placebo. Conclusions TCM was well-tolerated and
received among the Hong Kong Chinese population. This TCM preparation appeared
to have some benefits in the treatment of cough. Future research on TCM should
concentrate more on commonly encountered conditions such as UTRI and cough. Our
experience on the sensitivity of assessment tools used in detecting subtle
differences in an otherwise self-limiting illness and clinical trial methodology
when applying the underlying theory of how TCM works in disease management was
invaluable.
Cough. 2006 Jun 22;2(1):5
Source: PubMed [TOP] |
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