Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

Acupuntura y terapia neural para el tratamiento de la Parálisis de Bell / Acupuncture and Neural Therapy for Treating Bell's Palsy

Introducción: La efectividad de las terapias alternativas para el tratamiento de la parálisis de Bell es aún controvertida. Objetivo: Reportar la experiencia en el tratamiento de la PB mediante la administración conjunta de acupuntura y terapia neural. Métodos: Se recopiló información de 30 pacientes con parálisis de Bell, quienes recibieron una sesión semanal de acupuntura y terapia neural de manera conjunta y fueron evaluados mediante la escala House-Brackmann durante 12 semanas. Resultados: El 80 por ciento (24) de los pacientes continuaron el tratamiento hasta la semana 12 y al término de la misma ninguno alcanzó función motora normal. Apenas 6 (25 por ciento) pacientes mostraron signos de recuperación entre las semanas 6 y 12. Así, el porcentaje de pacientes con grado IV se redujo de 6 (20 por ciento) durante la evaluación inicial a 3 (12 por ciento) durante la semana 9 (p = 0,001) y el de pacientes con grado III de 12 (50 por ciento) durante la semana 9 a 9 (38 por ciento) durante la semana 12 (p = 0,663). Se evidenciaron efectos adversos en 9 (32 por ciento) pacientes, lo que incluyó hematoma en el sito de puntura y síncope, que se resolvieron sin complicaciones. Conclusiones: La administración conjunta de acupuntura y terapia neural durante al menos 6 semanas tuvo efectos modestos sobre la recuperación de pacientes con parálisis de Bell sin producir efectos adversos mayores(AU)

Introduction: The effectiveness of alternative therapies for treating Bell's palsy is still controversial. Objective: To report the experience in the treatment of Bell's palsy through joint administration of acupuncture and neural therapy. Methods: Information was collected from 30 patients with Bell's palsy, who received a weekly session of acupuncture and neural therapy jointly and were assessed using the House-Brackmann scale for 12 weeks. Results: 80 percent (24) of the patients continued treatment until week 12 and, at the end of the week, none reached normal motor function. Only 6 patients (25 percent) showed signs of recovery between weeks 6 and 12. Thus, the percentage of patients with grade IV decreased from 6 (20 percent), during the initial evaluation, to 3 (12 percent), during week 9 (p<0.001); while the percentage of patients with grade III decreased from 12 (50 percent), during week 9, to 9 (38 percent), during week 12 (p=0.663). Adverse effects were evidenced in 9 (32 percent) patients, including hematoma at the puncture site and syncope, which was solved without complications. Conclusions: Joint administration of acupuncture and neural therapy for at least six weeks had modest effects on the recovery of patients with Bell's palsy, without producing major adverse effects(AU)

Efectividad del tratamiento acupuntural en las urgencias hipertensivas durante el preoperatorio de cirugías menores / Effectiveness of Acupuncture against Hypertensive Emergencies during the Preoperative of Minor Surgeries

Introducción: Las urgencias hipertensivas constituyen una de las complicaciones agudas más frecuentes de la hipertensión arterial y es causa de muerte prematura entre adultos. Muchas publicaciones abogan por el uso de la Medicina Tradicional y Natural como método terapéutico eficaz e inocuo en su manejo. Objetivo: Evaluar la efectividad del tratamiento acupuntural en las urgencias hipertensivas durante el preoperatorio en los pacientes que serán sometidos a intervenciones quirúrgicas ambulatorias menores en el Hospital Clínico Quirúrgico Dr. Juan Bruno Zayas Alfonso, de enero a octubre de 2019. Métodos: Se efectuó un estudio de intervención terapéutica. El universo estuvo constituido por 150 pacientes hipertensos que fueron asignados aleatoriamente a un grupo estudio que recibió tratamiento con acupuntura y un grupo control que recibió tratamiento medicamentoso. A todos se les realizó diagnóstico occidental y oriental. Ambos grupos estuvieron conformados por 75 pacientes. Resultados: Predominó el grupo de edades de 45 a 54 años en ambos grupos, un mayor número de mujeres enfermas. El síntoma que más afectó al total de los pacientes fue la cefalea y hubo superioridad del diagnóstico síndrome hiperactividad de fuego de hígado. El 74 por ciento de los pacientes a los que se les aplicó acupuntura mejoraron y un 66 por ciento lo lograron en el grupo control. Conclusiones: El tratamiento acupuntural resultó ser efectivo en los pacientes con urgencias hipertensivas durante el preoperatorio para las intervenciones quirúrgicas ambulatorios menores(AU)

Introduction: Hypertensive emergencies are one of the most frequent acute complications of arterial hypertension and the cause of premature death among adults. Many publications advocate the use of traditional and natural medicine as an effective and safe therapeutic method for its management. Objective: To assess the effectiveness of acupuncture against hypertensive emergencies during the preoperative period in patients who will undergo minor outpatient surgical interventions at Dr. Juan Bruno Zayas Alfonso Clinical-Surgical Hospital, from January to October 2019. Methods: A therapeutic intervention study was carried out. The population consisted of 150 hypertensive patients who were randomly assigned to either a study group that received acupuncture or a control group that received drug treatment, all of whom underwent Western and Eastern diagnoses. Both groups consisted of 75 patients. Results: The age set 45-54 years predominated in both groups, together with a greater number of sick women. The symptom that most affected all the patients was headache and there was superiority of the diagnosis of Liver-fire hyperactivity syndrome. 74 percent of the patients who received acupuncture improved, while 66 percent achieved it as part of the control group. Conclusions: Acupuncture turned out to be effective in patients with hypertensive emergencies during the preoperative period for minor outpatient surgeries(AU)

Acupuntura e farmacopuntura no tratamento da asma em adultos e idosos: qual é a eficácia e a segurança da acupuntura, da auriculoterapia e da farmacopuntura para o tratamento da asma em adultos e/ou idosos? / Acupuncture and pharmacopuncture in the treatment of asthma in adults and the elderly: what is the effectiveness and safety of acupuncture, auriculotherapy and pharmacopuncture for the treatment of asthma in adults and/or the elderly?

A acupuntura se caracteriza pela estimulação de pontos cutâneos específicos por meio do uso de agulhas. A auriculoterapia consiste na estimulação mecânica de pontos específicos do pavilhão auricular com esferas de aço, ouro, prata, plástico, agulhas ou sementes de mostarda. A acupuntura é recomendada para promoção, manutenção e recuperação da saúde, bem como prevenção de agravos e doenças. Além disso, parece propiciar a liberação de neurotransmissores e outras substâncias responsáveis pela promoção da analgesia. A auriculoterapia promove a regulação psíquico orgânica do indivíduo. Ambas as prá ticas foram incorporadas no SUS mediante Portaria nº 971, de 03 de maio de 2006. Qual é a eficácia e a segurança da acupuntura e da auriculoterapia para o tratamento de asma em adultos e/ou idosos? As buscas foram realizadas em sete bases de dados sem restrição de ano de publicação. Os critérios de inclusão foram: revisões sistemáticas em inglês, português e espanhol que avaliaram os efeitos da acupuntura e auriculoterapia no tratamento de asma na população adulta e idosa. A avaliação da qualidade metodológica foi realizada por meio da ferramenta AMSTAR 2, feita por uma pesquisadora e revisada por outra. Nesta revisão rápida, produzida em cinco dias, foram utilizados atalhos metodológicos, de maneira que apenas o processo de seleção foi realizado em duplicidade e de forma independente. De 142 relatos recuperados nas bases de dados, foram incluídas cinco revisões sistemáticas que atenderam aos critérios de elegibilidade. A pergunta de pesquisa incluiu acupuntura e auriculoterapia, o que orientou as buscas de evidências. No entanto, não foram identificados estudos sobre auriculoterapia e a maioria das revisões analisou um tipo específico de acupuntura, denominada farmacopuntura, uma técnica que combina acupuntura com injeção de ervas medicinais. De maneira geral, a farmacopuntura combinada ou não a outros tratamentos, mostrou melhores resultados, em relação a seus comparadores, nos seguin tes desfechos: taxa de resposta e melhora dos sintomas de adultos com asma, melhora da Capacidade Vital Forçada (CVF), do Volume Expiratório Forçado em 1 segundo (VEF1), da relação VEF1/CVF e no Pico de Fluxo Expiratório (PFE). Os resultados sobre acupuntura foram melhores com relação a taxa de melhora dos sintomas de asma e do VEF1. Duas revisões avaliaram a segurança das intervenções, com relatos sobre ocorrência de eventos adversosleves com o uso da farmacopuntura. Esta revisão identificou alguns benefícios da acupuntura e farmacopuntura como tratamento adjuvante em pessoas com asma. No entanto, é necessário interpretar estes resultados com cautela, devido à diversidade de terapias utilizadas nos estudos primários e à qualidade metodológica das revisões sistemáticas, avaliadas como de confiança baixa ou criticamente baixa.

Acupuncture induces adenosine in fibroblasts through energy metabolism and promotes proliferation by activating MAPK signaling pathway via adenosine3 receptor.

Acupuncture has many advantages in the treatment of certain diseases as opposed to drug therapy. Besides, adenosine has been revealed to affect cellular progression including proliferation. Therefore, this study aimed at exploring the mechanism involving acupuncture stress and adenosine in fibroblast proliferation. The fibroblasts from fascia tissues of the acupoint area (Zusanli) were stimulated by different levels of stress, different concentrations of adenosine, and agonist or antagonist of A3 receptor (A3 R) to investigate the effect of stress stimulation, adenosine, and adenosine-A3 R inhibition on fibroblasts. Then, the fibroblasts were treated with stress stimulation of 200 kPa or/and mitogen-activated protein kinase (MAPK) blocker. We revealed that stress stimulation and the binding of adenosine and A3 R promoted fibroblast proliferation in the fascial tissue, increased the expression of immune-related factors, adenosine and A3 R, and activated the MAPK signaling pathway. MAPK signaling pathway also directly affected the expression of adenosine, A3 R, and immune-related factors. Stress stimulation and adenosine treatment upregulated A3 R expression, and then activated the MAPK signaling pathway, which could in turn upregulate expression of adenosine, A3 R and immune-related factors, and promote cell proliferation. Adenosine is shown to form a positive feedback loop with the MAPK signaling pathway. Collectively, stress stimulation in vitro induces the increase of adenosine in fibroblasts through the energy metabolism and activation of the MAPK signaling pathway through A3 R, ultimately promoting fibroblast proliferation.

Uso de la medicina natural en el tratamiento de la artritis reumatoide / Use of natural medicine in the treatment of rheumatoid arthritis

Introducción: la artritis reumatoide es una enfermedad inflamatoria, sistémica y crónica que afecta fundamentalmente el sistema osteomioarticular. Clinicamente se caracterizan por la presencia de dolor, inflamación, rigidez y deformidad. Estos elementos inciden en la aparición de la discapacidad funcional y en la disminución de la percepción de la calidad de vida relacionada con la salud. Objetivo: dar a conocer las ventajas del uso de la medicina natural en el tratamiento de la artritis reumatoide. Método: se realizó un estudio no experimental, descriptivo y retrospectivo en 115 pacientes a los cuales se les adicionó medicamentos naturales para el control de su enfermedad. Resultados: promedio de edad de 56,58 años con predominio de pacientes femeninas (69.60 por ciento), de color de la piel blanca (55.20 por ciento) y entre 50 y 59 años de edad (29.60 por ciento). La combinación de esteroides y methotrexate fue la más utilizad (55.20por ciento). La MNT se utilizó en el 62.4 por ciento de los pacientes con destaque para el servicio de hospitalización con una utilización del 79.19 por ciento. Los fitofármacos y la acupuntura fueron las modalidades más representadas. Conclusiones: existe un elevado por ciento de aplicación de la MNT en los esquemas terapéuticos de los pacientes con AR. Los fitofármacos y la acupuntura son las modalidades de mayor indicación. Los usuarios y prestadores mostraron elevados porcientos de aceptación al uso de la MNT en pacientes con enfermedades crónicas(AU)

Introduction: rheumatoid arthritis is an inflammatory, systemic and chronic disease that mainly affects the osteomyoarticular system. Clinically they are characterized by the presence of pain, inflammation, stiffness and deformity. These elements affect the appearance of functional disability and the reduction of the perception of the quality of life related to health. Objective: to present the advantages of the use of natural medicine in the treatment of rheumatoid arthritis. Method: a not experimental, descriptive, retrospective study was conducted in 115 patients to whom natural medicines were added to control their disease. Results: average age of 56.58 years with predominance of female patients (69.60 percent), white skin color (55.20 percent) and between 50 and 59 years of age (29.60 percent). The combination of steroids and methotrexate was the most used (55.20 percent). The NTM was used in 62.4 percent of the patients with a highlight for the hospitalization service with a utilization of 79.19 percent. The phytopharmaceuticals and acupuncture were the most represented modalities. Conclusions: there is a high percentage of application of NTM in the therapeutic schemes of patients with RA. The phytopharmaceuticals and acupuncture are the most indicated modalities. The users and providers showed high percentages of acceptance to the use of MNT in patients with chronic diseases(AU)

The Effect of Acupuncture in Breast Cancer-Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis.

Background: Breast cancer-related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (-1.90; 95% confidence interval = -5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.

La Medicina Natural y Tradicional como tratamiento alternativo de múltiples enfermedades / Natural and Traditional Medicine as an Alternative Treatment for Several Diseases

Introducción: El origen de la Medicina Natural y Tradicional está íntimamente unido con la historia del hombre en su lucha por la supervivencia. Las diferentes modalidades de la misma ofrecen grandes potencialidades a la medicina actual. Objetivo: Describir el uso terapéutico de algunas modalidades de la medicina natural y tradicional en la actualidad. Métodos: Se realizó un estudio cualitativo descriptivo mediante la técnica de revisión bibliográfica, a través del análisis, desde una visión integradora, de 40 artículos con calidad científica, publicados en los últimos 5 años, referentes a las modalidades de la Medicina Natural y Tradicional como tratamiento alternativo de múltiples enfermedades. Conclusiones: La Medicina Natural y Tradicional constituye una alternativa más de tratamiento para diferentes enfermedades. Dentro de las principales modalidades utilizadas en Cuba se encuentran: Acupuntura, fitoterapia, apiterapia, moxibuxtión, homeoterapia y ozonoterapia. Algunos de sus usos terapéuticos son: expectorantes, antihipertensivos, antifúngicos, antinflamatorios, analgésicas, estimulantes inmunológicos, sedantes, entre otros. En Cuba se aprobó un programa para su aplicación y una guía para la prescripción de productos naturales, que se convirtió en una herramienta de trabajo para el médico(AU)

Introduction: The origin of natural and traditional medicine is closely associated with the history of mankind in the struggle for survival. Its different modalities offer great potentialities to present-day medicine. Objective: To describe the therapeutic use of some modalities of natural and traditional medicine at present. Methods: A qualitative, descriptive study was carried out using the bibliographic review technique, through the analysis, from an integrating view, of 40 articles with scientific quality, published in the last five years, referring to the modalities of natural and traditional medicine as alternative treatment for multiple diseases. Conclusions: Natural and traditional medicine is another treatment alternative for different diseases. Among the main modalities used in Cuba are acupuncture, herbal medicine, apitherapy, moxibustion, homeotherapy, and ozone therapy. Some of its therapeutic uses are as expectorants, antihypertensive, antifungal, anti-inflammatory, analgesic, immune stimulants, and sedatives. In Cuba, a program was approved for its application, as well as it was a guide for prescribing natural products, which became a working tool for the physician(AU)

The efficacy of Tung's acupuncture for sex hormones in polycystic ovary syndrome: A randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common and heterogeneous endocrine disorder in reproductive-age women. Tung's acupuncture, a Traditional Chinese Medicine (TCM) treatment, is widely used for PCOS in East Asia, but evidence on its efficacy is rare. The aim of this RCT study was to examine whether the Tung's acupuncture could be a complementary treatment method for PCOS. METHODS: A total of 60 PCOS patients were randomly assigned to a Tung's acupuncture group (n = 30) or a cyproterone acetate/ethinylestradiol (CPA/EE) group (n = 30). Each participant received treatments for 12 weeks to assess the short-term treatment efficacy and then followed up for another 12 weeks to assess the long-term treatment efficacy. The primary outcome examined was change in the ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH); the secondary outcomes examined were changes in body mass index (BMI), LH, FSH, total testosterone (TT), ovarian volume, polycystic ovary number and menstrual frequency. RESULTS: Both groups showed significant reductions in the LH/FSH ratio, LH and TT after 12-week treatment (p < 0.001) and 12-week follow-up (p < 0.05). No significant differences existed between the two groups (p > 0.05). Both groups showed significant improvement in BMI, menstrual frequency and polycystic ovary number after 12-week treatment (p < 0.05). CONCLUSION: Compared with CPA/EE, Tung's acupuncture showed no better improvement on LH/FSH ratio for PCOS although it could reduce the ratio. Tung's acupuncture might have some effect on long-term weight control and menstruation frequency. Further studies addressing this study's limitations are recommended.

Acupuncture for Hot Flashes in Cancer Patients: Clinical Characteristics and Traditional Chinese Medicine Diagnosis as Predictors of Treatment Response.

BACKGROUND: Acupuncture is a recognized integrative modality for managing hot flashes. However, data regarding predictors for response to acupuncture in cancer patients experiencing hot flashes are limited. We explored associations between patient characteristics, including traditional Chinese medicine (TCM) diagnosis, and treatment response among cancer patients who received acupuncture for management of hot flashes. METHODS: We reviewed acupuncture records of cancer outpatients with the primary reason for referral listed as hot flashes who were treated from March 2016 to April 2018. Treatment response was assessed using the hot flashes score within a modified Edmonton Symptom Assessment Scale (0-10 scale) administered immediately before and after each acupuncture treatment. Correlations between TCM diagnosis, individual patient characteristics, and treatment response were analyzed. RESULTS: The final analysis included 558 acupuncture records (151 patients). The majority of patients were female (90%), and 66% had breast cancer. The median treatment response was a 25% reduction in the hot flashes score. The most frequent TCM diagnosis was qi stagnation (80%) followed by blood stagnation (57%). Older age ( P = .018), patient self-reported anxiety level ( P = .056), and presence of damp accumulation in TCM diagnosis ( P = .047) were correlated with greater hot flashes score reduction. CONCLUSIONS: TCM diagnosis and other patient characteristics were predictors of treatment response to acupuncture for hot flashes in cancer patients. Future research is needed to further explore predictors that could help tailor acupuncture treatments for these patients.

A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy.

PURPOSE: Chemotherapy-induced peripheral neuropathy is a complex side effect with few available treatment options. The aim of the study was to test the effectiveness of an 8-week course of acupuncture in the management of chemotherapy-induced peripheral neuropathy in cancer patients who were receiving or had received neurotoxic chemotherapy. METHODS: Randomized assessor-blinded controlled trial with 2 arms; one arm received acupuncture twice weekly for 8 weeks, while the other arm was a wait-list control group receiving only standard care. Primary outcome was pain intensity and interference over the past week using the Brief Pain Inventory at the end of the intervention. Secondary outcomes included clinical assessment (CTCAE [Common Toxicity Criteria for Adverse Events] grading and Total Neuropathy Score-Clinical Version) and nerve conduction studies; and patient-reported outcome measures (Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity Quality of Life scale and Symptom Distress Scale) assessed at baseline, end of treatment (8 weeks), week 14, and week 20 from the beginning of treatment. RESULTS: Eighty-seven patients were randomized to the experimental arm (n = 44) and to the standard care wait-list control arm (n = 43). Significant changes at 8 weeks were detected in relation to primary outcome (pain), the clinical neurological assessment, quality of life domains, and symptom distress (all P < .05). Improvements in pain interference, neurotoxicity-related symptoms, and functional aspects of quality of life were sustained in the 14-week assessment ( P < .05), as were physical and functional well-being at the 20-week assessment ( P < .05). CONCLUSIONS: Acupuncture is an effective intervention for treating chemotherapy-induced peripheral neuropathy and improving patients' quality of life and experience with neurotoxicity-related symptoms with longer term effects evident.

Efeitos da acupuntura sobre diagnósticos de Enfermagem dor e ansiedade em adolescentes com fibrose cística / Effects of acupuncture on nursing diagnoses of pain and anxiety in adolescents with cystic fibrosis

Dentre as doenças raras, a Fibrose Cística (FC) é a mais frequente no Brasil e é reconhecida como a mais importante doença hereditária. Diferentes estudos apontam para a presença de dor e ansiedade neste grupo de pacientes e correlacionam com pior adesão, menor função pulmonar e menor qualidade de vida. A assistência do enfermeiro ao paciente e suas famílias deve ser estabelecida na perspectiva do cuidado integral, e primar pela busca de resultados favoráveis dos aspectos físicos e biopsicossociais. O uso da Acupuntura associado ao tratamento convencional, pode agir neste intento. Entende-se a acupuntura realizada pelo enfermeiro como uma tecnologia aplicada ao cuidado de enfermagem que se opera em atos e que pode ter seu processo de avaliação norteado através das respostas aos diagnósticos de enfermagem, defendida como possibilidade terapêutica. Objetivo geral: avaliar as respostas dos Diagnósticos de Enfermagem Dor e Ansiedade à intervenção com acupuntura associada ao tratamento convencional de adolescentes com Fibrose Cística. Objetivos específicos: analisar a evolução dos Diagnósticos de Enfermagem, Dor e Ansiedade, identificados em adolescentes com Fibrose Cística durante tratamento com acupuntura; avaliar a evolução dos parâmetros de acompanhamento clínico de padrão respiratório observados em adolescentes com Fibrose Cística durante o tratamento; e relacionar o diagnóstico energético à luz da Medicina Tradicional Chinesa com os Diagnósticos de Enfermagem sob análise nesses adolescentes. Método. Estudo quase-experimental, comparativo, do tipo antes-depois, com abordagem quantitativa, realizado em ambulatório especializado de Pediatria, com 13 adolescentes com diagnóstico de FC, após aplicação de cálculo de amostra aleatória simples, poder do teste (1-ß) de 80% e nível de significância (α) de 5%. Foram utilizados instrumentos já validados para a captação dos dados: consulta de enfermagem; escala visual analógica da dor; escala hospitalar de ansiedade e depressão; padrão respiratório e prontuário dos participantes. As medições foram registradas em uma planilha de Excel®. Para o estímulo dos pontos após estabelecido o diagnóstico, foi utilizada a técnica de laser-acupuntura com equipamento infravermelho, duração de aproximadamente 30 (trinta) minutos cada entre o preparo do participante e o procedimento. O tratamento foi individualizado, de intervenção única. Para realização das análises foi utilizado pacote estatístico Action, disposto sob a plataforma do R. A descrição dos dados foi apresentada na forma de frequência observada, porcentagem, valor mínimo e máximo, medidas de tendência central e de variabilidade. Resultados. Dos participantes, 38,5 % possuem baixo peso e 23% na faixa considerada pré-obesidade; 30,8% possuem 1o ano do ensino médio; 46,1% são evangélicos, com renda familiar inferior a dois salários mínimos. No referente às doenças associadas, um participante (7,7%) relatou diabetes e um (7,7%) doença celíaca e epilepsia. O tempo de diagnóstico variou de menos de um ano a doze anos de idade. O DE 'falta de adesão' foi identificado em 100% dos participantes em algum momento da avaliação, seguido da ansiedade (84,6%), campo energético perturbado (69,3%), dor (69,3%), atividade de recreação deficiente (61,5%) e insônia (53,8%). Os resultados pré e pós intervenção revelaram que, para a escala de ansiedade, o escore após a realização da LA foi menor em média (4.5; DP ± 2.8) do que antes da realização da mesma (6.8; DP ± 3.5); a frequência respiratória foi menor em mediana (20 irpm) após a realização da LA do que antes de sua realização da mesma (22 irpm); a média da frequência cardíaca reduziu (75.69 bpm; DP ± 10.20 irpm) após a aplicação da LA. Já a saturação do O 2 aumentou em média (97.77; DP ± 1.42) após a aplicação e a dor se manteve constante antes da aplicação e nos 3 momentos posteriores; apenas 15,4% participantes referiram dor no momento da avaliação que, apesar de sua relevância clínica, foi um n inexpressivo para avalição estatística.

Acupuncture as a multifunctional neuroprotective therapy ameliorates cognitive impairment in a rat model of vascular dementia: A quantitative iTRAQ proteomics study.

AIMS: Acupuncture has been reported to affect vascular dementia through a variety of molecular mechanisms. An isobaric tag for relative and absolute quantification (iTRAQ) with high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses makes it possible to attain a global profile of proteins. Hence, we used an iTRAQ-LC-MS/MS strategy to unravel the underlying mechanism of acupuncture. METHODS: Wistar rats were subjected to vascular dementia with bilateral common carotid occlusion. Acupuncture was intervened for 2 weeks at 3 days after surgery. The Morris water maze was used to assess the cognitive function. Proteins were screened by quantitative proteomics and analyzed by bioinformatic analysis. Four differentially expressed proteins (DEPs) were validated by western blot. The reactive oxygen species (ROS) production, neuron cell loss, and long-term potentiation (LTP) were determined after western blot. RESULTS: Acupuncture at proper acupoints significantly improved cognitive function. A total of 31 proteins were considered DEPs. Gene ontology (GO) analysis showed that most of the DEPs were related to oxidative stress, apoptosis, and synaptic function, which were regarded as the major cellular processes related to acupuncture effect. Western blot results confirm the credibility of iTRAQ results. Acupuncture could decrease ROS production, increase neural cell survival, and improve LTP, which verified the three major cellular processes. CONCLUSION: Acupuncture may serve as a promising clinical candidate for the treatment of vascular dementia via regulating oxidative stress, apoptosis, or synaptic functions.

Acupuncture for the relief of hot flashes in breast cancer patients: A systematic review and meta-analysis of randomized controlled trials and observational studies.

OBJECTIVE: To critically assess the effectiveness and safety of acupuncture for treating hot flashes (HFs) among breast cancer (BC) patients, and to get much more highly compelling evidence then to guide clinical practice. METHODS: Comprehensive systematic literature searches were carried out for identifying randomized controlled trials and observational studies (OSs) published before January 2015. The meta-analysis (MA) was performed by Review Manager 5 software if data could be merged routinely, if not descriptions would be given. RESULTS: A total of 18 studies were eligible ultimately. With respect to HFs frequency, the MA during treatment showed a significant difference (MD = -1.78, 95% confidence intervals [95% CIs]: -3.42--0.14), but no statistical differences were observed when posttreatment or follow-up period. While electroacupuncture versus applied relaxation, they both helped to promote HFs markedly but did not reveal statistically significance between them. Referring to Kupperman's index, all the treatment brought out great assistance when compared with baseline conditions, and there was significant difference between real acupuncture sham acupuncture (posttreatment: MD = -4.40, 95% CI: -6.77--2.03; follow-up: MD = -4.30, 95% CI: -6.52--2.08). In terms of OS, 7 prospective single arm studies focused on exploring the efficacy of traditional acupuncture, and all revealed moderate or great benefit for BC patients suffering from HFs. CONCLUSIONS: Acupuncture still appeared to be an efficacious therapeutic strategy, especially for the less/no side effects. Because of its widespread acceptance and encouraging effectiveness for improving HFs, much more high-quality studies are in need urgently.

Clinical Benefits of Acupuncture for the Reduction of Hormone Therapy-Related Side Effects in Breast Cancer Patients: A Systematic Review.

IMPORTANCE: Acupuncture can help reduce unpleasant side effects associated with endocrine therapy for breast cancer. Nevertheless, comprehensive evaluation of current evidence from randomized controlled trials(RCTs) is lacking. OBJECTIVE: To estimate the efficacy of acupuncture for the reduction of hormone therapy-related side effects in breast cancer patients. EVIDENCE REVIEW: RCTs of acupuncture in breast cancer patients that examined reductions in hormone therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, Ovid MEDLINE, and Cochrane Library databases through April 2016. The quality of the included studies was evaluated according to the 5.2 Cochrane Handbook standards, and CONSORT and STRICTA (Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture) statements. INTERVENTION: Interventions included conventional acupuncture treatment compared with no treatment, placebo, or conventional pharmaceutical medication. Major outcome measures were the alleviation of frequency and symptoms and the presence of hormone therapy-related side effects. Findings/Results. A total of 17 RCTs, including a total of 810 breast cancer patients were examined. The methodological quality of the trials was relatively rigorous in terms of randomization, blinding, and sources of bias. Compared with control therapies, the pooled results suggested that acupuncture had moderate effects in improving stiffness. No significant differences were observed in hot flashes, fatigue, pain, gastrointestinal symptoms, Kupperman index, general well-being, physical well-being, tumor necrosis factor (TNF), and interleukin (IL). CONCLUSIONS: Acupuncture therapy appears to be potentially useful in relieving functional stiffness. However, further large-sample trials with evidence-based design are still needed to confirm these findings.

Acupuncture for reducing pruritus induced by intrathecal morphine at elective cesarean delivery: a placebo-controlled, randomized, double-blind trial.

BACKGROUND: Intrathecal morphine is a standard postoperative analgesic administered after cesarean delivery, but frequently causes pruritus. Acupuncture reportedly resolves refractory pruritus in certain patients. The aim of the study was to investigate the effectiveness of acupuncture in preventing pruritus induced by intrathecal morphine. METHODS: Thirty parturients received intrathecal hyperbaric bupivacaine (12 mg), fentanyl (10 µg), and morphine (150 µg) for spinal anesthesia at elective cesarean delivery at term. Patients were randomly divided into the acupuncture group (n=15) and the control group (n=15). In the acupuncture and control groups, certified acupuncturists inserted either indwelling press needles or sham needles, into Hegu (LI4), Neiguan (PC6), Quchi (LI11), and Zhigou (SJ6) on both arms the day before surgery. Needles were removed 48 hours postoperatively. The primary outcome was the incidence of postoperative pruritus. Adverse effects including nausea and vomiting were also investigated. RESULTS: There were no significant differences between the acupuncture group and the control group in the incidence of pruritus (67% vs. 67%, P=1.000, RR 1.0 [95% CI 0.60 to 1.66]) or the requirement for antipruritic therapy (6.7% vs. 20.0%, P=0.283, RR 0.33 [95% CI 0.04 to 2.85]). The incidence of postoperative nausea in the acupuncture group versus control group was 40.0% vs. 13.3%, P=0.099, RR 3.0 [95% CI 0.72 to 12.6]). The postoperative analgesic effect was comparable. CONCLUSION: Preoperatively administered acupuncture using press needles did not decrease intrathecal morphine-induced pruritus or the requirement for treatment.

Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain.

BACKGROUND: Bortezomib-induced peripheral neuropathy (BIPN) is a common and debilitating side effect. Our pilot study demonstrated that acupuncture is safe and can decrease total neuropathic symptoms. However, there is lack of knowledge in which individual BIPN symptoms benefited from acupuncture. PURPOSE: To characterize individual symptoms reduced by acupuncture in patients with BIPN. METHODS: Patients with multiple myeloma treated with bortezomib who developed BIPN grade 2 or above, based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), were enrolled and received 10 acupuncture treatments over 10 weeks. Self-reported BIPN-associated symptoms assessments were collected weekly at baseline, during, and after acupuncture treatment using the Neuropathy Pain Scale (NPS) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) questionnaires. Changes in individual symptoms were analyzed based on FACT/GOG-Ntx and NPS scores. RESULTS: There were statistically significant reductions in individual symptoms in both NPS and FACT/GOG-Ntx. The FACT/GOG-Ntx reductions were most pronounced in hand/feet numbness/tingling, discomfort, and trouble walking. The sensory symptoms, such as tingling and numbness, especially in the feet, reduced the most ( P < .0001), and motor dysfunction also reduced significantly ( P = .0001). Both hearing and dysfunction scores were also statistically significantly increased, indicating improved symptoms. The NPS scores showed significant symptom relief in all 10 items from the NPS assessment, particularly in cold sensitivity and an unpleasant feeling. CONCLUSIONS: Acupuncture can improve multiple symptoms associated with BIPN, particularly numbness and tingling in hands and feet, cold sensitivity, and an unpleasant feeling. Further randomized control trials are warranted to confirm our findings.

SoftPuntura, software educativo sobre Acupuntura y Digitopuntura / Soft-Puncture, educational software on acupuncture and digital acupuncture

Introducción: la Medicina Natural y Tradicional actualmente se aplica como estrategia curricular en las carreras de las ciencias médicas, responde al lineamiento 138 de la política del partido. Objetivo: diseñar un software educativo sobre los principales puntos de acupuntura y digitopuntura para desarrollar habilidades teóricas y prácticas en los estudiantes de la carrera de medicina. Método: se realizó un estudio de desarrollo tecnológico en la Universidad de Ciencias Médicas de Pinar del Río, de octubre de 2014 a febrero de 2015. Como universo se tuvo en cuenta a todos los estudiantes de la carrera de medicina y profesores que imparten contenidos relacionados con el tema; la muestra de 60 estudiantes y 30 profesores se seleccionó de forma aleatoria simple, se utilizaron métodos teóricos y empíricos, se realizó un análisis estadístico porcentual, se diseñó y aplicó el software teniendo en cuenta las necesidades de aprendizaje. Resultados: se determinó un alto porciento de estudiantes que dominaron los principales contenidos sobre las técnicas de acupuntura y digitopuntura, los cuales eran deficientes antes de su aplicación, además se obtuvo aceptación por el estudiantado y los profesores, por lo que fue considerado como una útil herramienta para el estudio de la Medicina Natural y Tradicional en la carrera de Medicina. Conclusiones: se diseñó un recurso del aprendizaje que permite interactuar con la acupuntura y la digitopuntura, de fácil acceso y transportación, útil a estudiantes y profesores, lo que permitió el perfeccionamiento del proceso docente educativo en las asignaturas de la carrera de medicina(AU)

Introduction: Natural and Traditional Medicine is currently applied as a curricular strategy in medical science studies, it responds to the 138th guideline of the policies of the Cuban Communist Party. Objective: to design educational software on the main points of acupuncture and digital acupuncture to develop theoretical and practical skills in medical students. Method: a study of technological development was carried out at Pinar del Rio University of Medical Sciences, from October 2014 to February 2015. As a target group, all the students of the medical professions and professors who taught contents related to the subject were taken included; the sample of 60 students and 30 professors was chosen in a simple randomized approach, theoretical and empirical methods were used, a percentage statistical analysis was done, the software was designed and applied considering the needs of learning. Results: a high percentage of students who mastered the main contents on the acupuncture and digital acupuncture techniques were determined, which were deficient before their application, besides of having acceptance by the student body and the professors, because it was considered as a useful tool for the study of Natural and Traditional Medicine in medical studies. Conclusions: a learning resource was designed to interact with acupuncture and digital acupuncture, with easy access and transportation, useful to students and professors, which allowed the improvement of the educational process in the subjects of the medical studies(AU)

Effects of Acupuncture on Cancer-Related Cognitive Impairment in Chinese Gynecological Cancer Patients: A Pilot Cohort Study.

BACKGROUND: Among women in China, gynecological cancers are the second most common cancers after breast cancer. Cancer-related cognitive impairment (CRCI) has emerged as a significant problem affecting gynecological cancer survivors. While acupuncture has been used in different aspects of cancer care, the possible positive effects of acupuncture on cognitive impairment have received little attention. This study hypothesized that patients would demonstrate lower neurocognitive performance and lower structural connectivity compared to healthy controls. This pilot study also hypothesized that acupuncture may potentially be effective in treating CRCI of cancer patients by increasing brain structural connectivity and integrity. METHODS: This prospective cohort study consisted of 3 stages: the first stage included a group of gynecological cancer patients and a group of age-matched healthy controls. This baseline stage used a core set of neurocognitive tests to screen patients with cognitive impairment and used a multimodal approach of brain magnetic resonance imaging (MRI) to explore the possible neurobiological mechanism of cognitive impairment in cancer patients, comparing the results with a group of noncancer controls. The second stage involved assigning CRCI patients into the acupuncture intervention group, while patients without CRCI were assigned into the cancer control group. The third stage was a postintervention assessment of neurocognitive function by the same set of neurocognitive tests at baseline. To explore the possible neurobiological basis of acupuncture for treating CRCI, this study also used a multimodal MRI approach to assess changes in brain structural connectivity, and neurochemical properties in patients at pre- and postacupuncture intervention. RESULTS: This study found that the prevalence of cognitive impairment in Chinese gynecological cancer patients at diagnosis was 26.67%. When investigating the microstructural white matter in the brain, diffusion tensor imaging data in this study indicated that premorbid cognitive functioning (before clinical manifestations become evident) has already existed, as the global and local connectome properties in the entire patient group were lower than in the healthy control group. Using magnetic resonance spectroscopy, this study indicated there was a significant reduction of relative concentration of NAA ( N-acetyl aspartate) in the left hippocampus, comparing these results with healthy controls. Regarding the effects of acupuncture on reducing CRCI, patients in the acupuncture group reported better neurocognitive test performance after matching for age, menopausal status, cancer stage, and chemotherapy regimen dosage. On a microstructural level, acupuncture's ability to reduce CRCI may be attributed to a reduction in demyelination and an enhancement of the neuronal viability of white matter in the hippocampus. CONCLUSION: This pilot study indicates that acupuncture is a promising intervention in treating CRCI in gynecological cancer patients undergoing chemotherapy; however, it requires evaluation in larger randomized controlled studies to definitively assess its benefit. By using a multimodal imaging approach, this pilot study also provides novel insights into the neurobiological basis of cognitive impairment on the human brain that has been induced by cancer and/or its treatment.

Critical roles of TRPV2 channels, histamine H1 and adenosine A1 receptors in the initiation of acupoint signals for acupuncture analgesia.

Acupuncture is one of the most promising modalities in complimentary medicine. However, the underlying mechanisms are not well understood yet. We found that in TRPV2 knockout male mice, acupuncture-induced analgesia was suppressed with a decreased activation of mast cells in the acupoints stimulated. The mast cell stabilizer sodium cromolyn could suppress the release of adenosine in the acupoints on male rats. A direct injection of adenosine A1 receptor agonist or histamine H1 receptor agonist increased ß-endorphin in the cerebral-spinal fluid in the acute adjuvant arthritis male rats and thus replicated the analgesic effect of acupuncture. These observations suggest that the mast cell is the central structure of acupoints and is activated by acupuncture through TRPV2 channels. The mast cell transduces the mechanical stimuli to acupuncture signal by activating either H1 or A1 receptors, therefore triggering the acupuncture effect in the subject. These findings might open new frontiers for acupuncture research.