Shaftesbury Clinic Star of Conditions

Anxiety – Condition Resources

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Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Roughly 1 in 6 of us experience anxiety, and there has been a modest increase in this during the Covid pandemic – a recent study finding a prevalence of 21.6% at present in a representative sample of the UK population (Shevlin et al, 2020).

The British Acupuncture Council have produced an evidence-based factsheet on Anxiety and acupuncture research, including details of the research studies done (link below) and you can also find and read the original research from this resource.

Any research articles referred to on this page (and on the BAcC helpsheets) are listed in full in the References section at the foot of the relevant page.  Within the text, where studies are quoted as sources of the information being given, the first author’s name and the year of the paper is used (as authors usually have numerous publications), with the full title, journal, etc listed in the References section, in alphabetical order by Author surname to enable identifying and finding the original source paper.

A Large and Growing Body of Research:

A scholarly search of the available research studies on “acupuncture and anxiety” reveals over 20,800 papers from journals, and narrowing this to “RCT” leads to over 1,500 hits, of which 57% have been carried out since 2017.  This demonstrates that acupuncture is being used traditionally and currently in this area; widely scientifically researched, and that the pace at which this research is being carried is increasing – leading us to contend that this is an area worthy of scientific appraisal and consideration.  

Interpreting the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

The Research:

Evidence lies in a positive direction for the use of acupuncture, which is safe, and can be used alongside other modalities. The British Acupuncture Council (BAcC) works with the charity Anxiety UK to provide acupuncture for this condition, and the researchers have generalised anxiety outcomes data from acupuncture patients having a course of six acupuncture treatments, with preliminary results very encouraging (n=30 – see BAcC research digest – link below).

A systematic review and meta-analysis (Au et al, 2015) of the effects of acupressure on anxiety, in 7 RCTs in adults from the anticipation of surgery or treatment, their finding was that treatment was well-tolerated and beneficial.  A systematic review and meta-analysis (Church et al, 2018) examined 6 studies (n=403), found that the tapping of acupuncture points is an active ingredient in emotional freedom technique (EFT).

The BAcC Research Digest discusses several recent trials and reviews, including:

An RCT where a statistical difference in anxiety levels was found for hospital nursing staff receiving an acupuncture protocol after 10 sessions (Kurebayashi et al, 2017; n=180);

A systematic review (13 papers) found encouraging evidence for acupuncture in anxiety disorders, and giving few side effects (Amorim et al, 2018), although they noted trial quality was variable, meaning further well-designed RCTs are warranted. Another review (Goyatá et al, 2016) looked at 67 articles for anxiety and acupuncture, stating that this is a promising area and echoing the call for further research.

Mechanisms of Action:

As per the British Acupuncture Council’s factsheet, there are many physiological studies on animals and humans looking at brain scans (fMRI), as well as levels of hormones and neurotransmitters in blood and other bodily fluids after acupuncture treatment that have shown effects of the treatment on downregulating the response to pain and stress in the body, particularly in the limbic system (for example Hui et al, 2010; fMRI in humans).

Resources:

British Acupuncture Council evidence based factsheet about anxiety including specific research, trials and mechanisms of action for acupuncture in this condition.

British Acupuncture Council Research Digest – Anxiety Section (towards base of document)

BAcC Stress Factsheet

BAcC Depression Factsheet

Our own Blog on Acupuncture, Anxiety and Stress

References:

Amorim, D., Amado, J., Brito, I., Fiuza, S.M., Amorim, N., Costeira, C. and Machado, J., 2018. Acupuncture and electroacupuncture for anxiety disorders: a systematic review of the clinical research. Complementary therapies in clinical practice, 31, pp.31-37.

Au, D.W., Tsang, H.W., Ling, P.P., Leung, C.H., Ip, P.K. and Cheung, W.M., 2015. Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupuncture in Medicine, 33(5), pp.353-359.

Church, D., Stapleton, P., Yang, A. and Gallo, F., 2018. Is tapping on acupuncture points an active ingredient in Emotional Freedom Techniques? A systematic review and meta-analysis of comparative studies. The Journal of nervous and mental disease, 206(10), pp.783-793.

Hui, K.K., Marina, O., Liu, J., Rosen, B.R. and Kwong, K.K., 2010. Acupuncture, the limbic system, and the anticorrelated networks of the brain. Autonomic Neuroscience, 157(1-2), pp.81-90.

Kurebayashi, L.F.S., Turrini, R.N.T., Souza, T.P.B.D., Marques, C.F., Rodrigues, R.T.F. and Charlesworth, K., 2017. Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial. Revista latino-americana de enfermagem, 25.

Shevlin, M., McBride, O., Murphy, J., Miller, J.G., Hartman, T.K., Levita, L., Mason, L., Martinez, A.P., McKay, R., Stocks, T.V. and Bennett, K.M., 2020. Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open, 6(6).

Takamatsu Goyatá, S.L., Valcanti Avelino, C.C., Marques dos Santos, S.V., Inácio de Souza Junior, D., Lopes Gurgel, M.D.S. and de Souza Terra, F., 2016. Effects from acupuncture in treating anxiety: integrative review. Revista brasileira de enfermagem, 69(3).

Helen
Posted on: May-15-2021 13:31 pm
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Shaftesbury Clinic Star of Conditions

Addictions – Condition Resources

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Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Detoxification must only be done when the client is under direct medical supervision, and the NADA (acupuncture) protocol or other complementary therapies are to be used in complement to a GP or consultant doctor’s care.

Acupuncture is used widely in this field in the United States and the UK (D’Alberto, 2004; Margolin, 2003) as part of a multi-disciplinary approach within a medical team to counter withdrawal effects alongside conventional treatment, and where appropriate. The 5-point NADA (National Acupuncture Detoxification Association) protocol is the most well-known protocol that is used, and is a combination of 5 specific points on the ear.

About the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

Research Studies:

This is a much-researched area: a scholarly search of the available research studies on “acupuncture and addiction” reveals over 30,000 papers from journals, and narrowing this to “RCT” leads to over 2,300 hits, of which 41% since 2017.

From the amount of research that has been done, this we can deduce that acupuncture is both widely applied, and subject to scientific research in these areas, and that the pace at which the research is being carried out is increasing – leading us to understand this is an area worthy of scientific examination and consideration.

Systematic reviews that have been carried out – (all full references are below): Ge et al, 2020: illicit drug withdrawal syndrome – 30 trials and n=2391; Wang et al, 2019 – smoking cessation, 24 trials and n=3984; Chen et al, 2018 – opioid use disorder, 9 studies and n=1063; Dai et al, 2021 – smoking cessation with 6 treatment arms as comparisons – 23 studies, n=2706; Liu et al, 2018 – alcohol withdrawal syndrome, 11 RCTs and n=875. Systematic review outcomes have been mixed, with some tentatively positive, but consideration is to be taken as to the quality of some of the research papers, and additional study is warranted.

More recently this year there have been two Systematic review protocols published to look at RCT’s for acupuncture and withdrawal from opiate addiction (Zhang et al, 2021; Chen et al, 2021 & Chen at al, 2020 in the BMJ). It will be interesting to see the results of the latter three ongoing systematic reviews as these are published, two of which are looking at opiate addiction and one at internet addiction.

There has also been some interesting discussion on the use of alternative analgesia, with particular emphasis on acupuncture as regard the current iatrogenic opioid crisis in the Unites states (Fan et al, 2017 – White Paper), whereby acupuncture has been mooted as playing a potential role in this picture, with Lee et al, (2019)’s protocol for systematic review being another upcoming paper on the matter.

The NADA, or National Acupuncture Detoxification Association protocol is a set of 5 acupuncture points on the ear (also known as auricular acupuncture), which has been used since the 1970’s for many conditions involving addictions.  Whilst the initial development was for substance abuse, it has latterly been used for food addiction and obesity (Chen at el, 2018); nicotine addicion / smoking (Leung, 2012) as well as trauma and PTSD (post traumatic stress, Cronin and Conboy, 2013), and disaster relief efforts (Cole and Yarberry, 2011; Yarberry, 2010).

Studies have shown that in combination with other interventions it can help reduce cravings, and improve the symptoms of depression, and anxiety, mood, headaches and body pains associated with substance withdrawal, as well as improve concentration and energy during the process (Carter et al, 2011; Stiyt et al, 2016)

Mechanisms of action:

Studies in humans and in animals have shown acupuncture to have measurable physiological effects on the brain, nervous system and neurotransmitters, including endogenous (the body’s naturally occurring) opiates (Lin et al, 2012). Studies have also demonstrated the relaxation and de-stressing effects acupuncture can provide from a physiological perspective, beyond placebo.

A recent, interesting paper (Lee et al, 2021): A review of neurobiological mechanisms of acupuncture for drug addiction. The authors examine the context from reward pursuit models, motivation, and the role of the mesolimbic dopamine pathway in drug sensitisation. They connect this to the way in which acupuncture can make neurochemical changes and influence dopamine levels via inhibition of neuronal and behavioural sensitization of the mesolimbic dopamine pathway. The neurotransmitter GABA is implicated along with endogenous opioids. A detailed paper, of interest to those who like a bit of research and technical explanation.

Case Study and Video for Trauma/PTSD

Acupuncturists (MBAcC) Rachel Peckham and Samina Haider set up an acupuncture NADA group in a Mosque in London in the aftermath of the Grenfell Tower tragedy, using the NADA protocol for trauma application, there is a video about this from the British Acupuncture Council here that may be of interest, and which shows the NADA protocol in action, and patients talking about it and their experiences of it: BAcC auricular (NADA) video Rachel talks about the general uses of this, background and the idea which came from the use of this in the aftermath of 9/11 in America.

Regarding Your Individual Condition and Symptoms:

Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response, we are able to tell you in the decades of experience we personally have at the clinic of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, which is why the research data do not tell the whole story and if you want to find out more specific information in how this could relate to your own individual situation, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.

Resources:

British Acupuncture Council evidence based factsheet about addictions and substance use including specific research, trials and mechanisms of action for acupuncture in this condition.

British Acupuncture Council Review Paper Substance abuse and acupuncture: the evidence for effectiveness

References:

Carter, K.O., Olshan-Perlmutter, M., Norton, H.J. and Smith, M.O., 2011. NADA acupuncture prospective trial in patients with substance use disorders and seven common health symptoms. Medical Acupuncture, 23(3), pp.131-135.

Chen, J.A., Chen, J.A., Lee, S. and Mullin, G., 2018. Potential role for acupuncture in the treatment of food addiction and obesity. Acupuncture in Medicine, 36(1), pp.52-55.

Cole, B. and Yarberry, M., 2011. NADA training provides PTSD relief in Haiti. Deutsche Zeitschrift für Akupunktur, 54(1), pp.21-24.

Cronin, C. and Conboy, L., 2013. Using the NADA Protocol to Treat Combat Stress-Induced Insomnia: A Pilot Study. Journal of Chinese Medicine, (103).

Chen, Z., Wang, Y., Wang, R., Xie, J. and Ren, Y., 2018. Efficacy of acupuncture for treating opioid use disorder in adults: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2018.

Chen, Z., Wang, R., Zhang, M., Wang, Y. and Ren, Y., 2020. Acupuncture combined with medication for opioid use disorder in adults: a protocol for systematic review and meta-analysis. BMJ open, 10(6), p.e034554.

Chen, Y., Zhang, L., Liu, Y., Yang, Y., Qiu, M., Wang, Y., Peng, W., Li, H. and Zhu, T., 2021. Acupuncture for Internet addiction: A protocol for systematic review. Medicine, 100(12), p.e24872.

D’alberto, A., 2004. Auricular acupuncture in the treatment of cocaine/crack abuse: a review of the efficacy, the use of the National Acupuncture Detoxification Association protocol, and the selection of sham points. Journal of Alternative & Complementary Medicine, 10(6), pp.985-1000.

Dai, R., Cao, Y., Zhang, H., Zhao, N., Ren, D., Jiang, X., Zheng, G., Bao, S., Yan, X. and Fan, J., 2021. Comparison between Acupuncture and Nicotine Replacement Therapies for Smoking Cessation Based on Randomized Controlled Trials: A Systematic Review and Bayesian Network Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2021.

Fan, Arthur Yin, David W. Miller, Bonnie Bolash, Matthew Bauer, John McDonald, Sarah Faggert, Hongjian He et al. “Acupuncture’s role in solving the opioid epidemic: evidence, cost-effectiveness, and care availability for acupuncture as a primary, non-pharmacologic method for pain relief and management–white paper 2017.” Journal of integrative medicine 15, no. 6 (2017): 411-425.

Ge, S., Lan, J., Yi, Q., Wen, H., Lu, L. and Tang, C., 2020. Acupuncture for illicit drug withdrawal syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine, 35, p.101096.

Lee, S. and Jo, D.H., 2019. Acupuncture for reduction of opioid consumption in chronic pain: A systematic review and meta-analysis protocol. Medicine, 98(51).

Lee, M.Y., Lee, B.H., Kim, H.Y. and Yang, C.H., 2021. Bidirectional role of acupuncture in the treatment of drug addiction. Neuroscience & Biobehavioral Reviews, 126, pp.382-397.

Leung, L., Neufeld, T. and Marin, S., 2012. Effect of self-administered auricular acupressure on smoking cessation–a pilot study. BMC complementary and alternative medicine, 12(1), p.11.

Lin, J.G., Chan, Y.Y. and Chen, Y.H., 2012. Acupuncture for the treatment of opiate addiction. Evidence-Based Complementary and Alternative Medicine, 2012.

Liu, X., Qin, Z., Zhu, X., Yao, Q. and Liu, Z., 2018. Systematic review of acupuncture for the treatment of alcohol withdrawal syndrome. Acupuncture in Medicine, 36(5), pp.275-283.

Margolin, A., 2003. Acupuncture for substance abuse. Current psychiatry reports, 5(5), pp.333-339.

Stuyt, E.B. and Voyles, C.A., 2016. The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Substance abuse and rehabilitation, 7, p.169.

Wang, J.H., van Haselen, R., Wang, M., Yang, G.L., Zhang, Z., Friedrich, M.E., Wang, L.Q., Zhou, Y.Q., Yin, M., Xiao, C.Y. and Duan, A.L., 2019. Acupuncture for smoking cessation: A systematic review and meta-analysis of 24 randomized controlled trials. Tobacco induced diseases, 17.

Yarberry, M., 2010. The Use of the NADA Protocol for PTSD in Kenya. Deutsche Zeitschrift für Akupunktur, 53(4), pp.6-11.

Zhang, T., He, X., Wu, L., Feng, X., Yang, Y. and Deng, L., 2021. Electro Acupuncture Combined Methadone for Withdrawal Symptoms of Opioid Addiction: A Protocol for Systematic Review and Meta Analysis. Acupuncture & Electro-Therapeutics Research.

Helen
Posted on: May-15-2021 10:44 am
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Shaftesbury Clinic Star of Conditions

Acupuncture Research Resources

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Over 4 million acupuncture treatments are carried out annually in the UK. Musculoskeletal pain is the most common presenting symptom, although people seek acupuncture for a wide variety of conditions and issues.

Acupuncture has a very high satisfaction rate amongst users, according to research.

References: British Acupuncture Council Research Digest, evidence based factsheet about acupuncture research including specific research, trials and mechanisms of action for acupuncture in various conditions.

Helen
Posted on: May-15-2021 10:35 am
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Shaftesbury Clinic Star of Conditions

Pelvic Pain – Condition Resources

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Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

Chronic Pain in General

“Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain”. (Vickers et al, 2018: large chronic pain review of high quality RCTs updating a previous meta-analysis; 39 trials, n=20827; conditions addressed chronic headache, back/neck pain and osteoarthritis)

Another recent overview (Yin et al, 2017) confirms that there is increasing evidence for acupuncture  as an effective, safe, and cost-effective intervention in chronic low back, neck, shoulder, and knee pain, as well as headaches.

The NHS body in charge of which treatments should be used in particular conditions recommends acupuncture for chronic pain:  The NICE Scenario Management guidelines (2021) for chronic pain state: “consider a course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system”

Overall, a large systematic review has found acupuncture a cost effective intervention for several painful conditions (Ambrósio et al, 2012).

Pelvic Pain and Conditions

Prostatitis related bladder symptoms and pain: Acupuncture has been found to be beneficial in reducing the symptoms of prostatitis, including urinary symptoms (Franco et al, 2019). 

Chronic prostatitis/chronic pelvic pain syndrome: A systematic review and meta-analysis found that acupuncture showed promise from the RCTs that they reviewed (Chang et al, 2017).

Mechanisms of action:

Acupuncture studies have shown it can: provide pain relief by stimulating nerves in body tissues and leading to endorphin release (natural painkilling substances), as well as downregulating the brain and nervous system’s reaction to stress and pain (Zhao 2008; Zijlstra et al, 2003; Pomeranz, 1987).

Acupuncture stimulates the body to create its own natural painkilling substances, such as Beta Endorphins (β-Endorphin). In studies acupuncture has been shown to stimulate the production of natural painkillers called opioid-like peptides (OLPs), including β-Endorphin: For example, this was shown in an RCT in 90 patients with a range of painful disorders (Petti et al, 1998). The same study showed acupuncture also and enhanced the activity of immune cells (lymphocytes, natural killer cells and monocytes) that help fight infections and diseases (Petti et al, 1998).

Acupuncture can activate mast cells at acupoints, which release histamine, serotonin, adenosine, and other mediators that modulate nerve transmission and inflammation (Li et al, 2022)

Zijlstra et al (2003) reviewed the effects and mechanisms of acupuncture in treating various inflammatory diseases and conditions. They proposed the mechanisms of action:

  • Acupuncture may release neuropeptides from nerve endings that have vasodilative and anti-inflammatory effects through CGRP.
  • Acupuncture may also interact with substance P, which is involved in pain transmission and inflammation.
  • Acupuncture may contribute to analgesia by stimulating the release of β-endorphin, which binds to opioid receptors and inhibits pain signals.
  • Acupuncture may influence the balance between cell-specific pro-inflammatory and anti-inflammatory cytokines such as TNF-α and IL-10.

Acupuncture has been shown in animal models to promote the release of factors that involved in the reduction of inflammation (vascular and immunomodulatory factors – (Kim et al, 2008; Kavoussi and Ross, 2007 [review article]; Zijlstra et al, 2003), and also to affect levels of serotonin (in an animal model), and other peptides in the brain and nervous system and modulate blood flow in the brain and elsewhere in the body, in humans (Zhong and Li, 2007; Shi et al, 2010).

Resources:

Evidence Based Acupuncture Factsheet on Pain

References:

General Chronic Pain References:

Vickers, A.J., Vertosick, E.A., Lewith, G., MacPherson, H., Foster, N.E., Sherman, K.J., Irnich, D., Witt, C.M., Linde, K. and Acupuncture Trialists’ Collaboration, 2018. Acupuncture for chronic pain: update of an individual patient data meta-analysis. The Journal of Pain, 19(5), pp.455-474.

Birch, S., Lee, M.S., Alraek, T. and Kim, T.H., 2018. Overview of treatment guidelines and clinical practical guidelines that recommend the use of acupuncture: a bibliometric analysis. The Journal of Alternative and Complementary Medicine, 24(8), pp.752-769.

NICE 2021 Chronic pain: Scenario: Management Last revised in April 2021

Yin, C., Buchheit, T.E. and Park, J.J., 2017. Acupuncture for chronic pain: an update and critical overview. Current opinion in anaesthesiology, 30(5), pp.583-592.

Mechanism Of Action in Pain References:

Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther. 2007 Sep;6(3):251-7.

Kim HW, Uh DK, Yoon SY et al. Low-frequency electroacupuncture suppresses carrageenan-induced paw inflammation in mice via sympathetic post-ganglionic neurons, while high-frequency EA suppression is mediated by the sympathoadrenal medullary axis. Brain Res Bull. 2008 Mar 28;75(5):698-705.

Li, Y., Yu, Y., Liu, Y. and Yao, W., 2022. Mast cells and acupuncture analgesia. Cells, 11(5), p.860.

Petti, F.., Bangrazi, A., Liguori, A., Reale, G. and Ippoliti, F., 1998. Effects of acupuncture on immune response related to opioid-like peptides. Journal of Traditional Chinese Medicine 18(1), pp.55-63.

Pomeranz B. Scientific basis of acupuncture. In: Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987:1-18.

Shi H, Li JH, Ji CF, Shang HY, Qiu EC et al.[Effect of electroacupuncture on cortical spreading depression and plasma CGRP and substance P contents in migraine rats]. Zhen Ci Yan Jiu. 2010 Feb;35(1):17-21.

Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008 Aug;85(4):355-75.

Zhong G.-W. Li W. Effects of acupuncture on 5-hydroxytryptamine1F and inducible nitricoxide synthase gene expression in the brain of migraine rats. Journal of Clinical Rehabilitative Tissue Engineering Research. 2007;11(29)(pp 5761-5764)

Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J. Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003 Apr;12(2):59-69.

Prostatitis References:

Chang, S.C., Hsu, C.H., Hsu, C.K., Yang, S.S.D. and Chang, S.J., 2017. The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: a systemic review and meta‐analysis. Neurourology and urodynamics, 36(2), pp.474-481.

Franco, J.V., Turk, T., Jung, J.H., Xiao, Y.T., Iakhno, S., Garrote, V. and Vietto, V., 2019. Non‐pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome: a Cochrane systematic review. BJU international, 124(2), pp.197-208.

Helen
Posted on: May-1-2021 13:58 pm
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