Safe needling depths of upper back acupoints in children: a retrospective study.

BACKGROUND: Acupuncture is applied for treating numerous conditions in children, but few studies have examined the safe needling depth of acupoints in the pediatric population. In this study, we investigated the depths to which acupuncture needles can be inserted safely in the upper back acupoints of children and the variations in safe depth according to sex, age, weight, and body mass index (BMI). METHODS: We retrospectively studied computed tomography (CT) images of patients aged 4 to 18 years who underwent chest CT at China Medical University Hospital between December 2004 and May 2013. The safe depths of 23 upper back acupoints in the Governor Vessel (GV), Bladder Meridian (BL), Small Intestine Meridian (SI), Gallbladder Meridian (GB) and Spleen Meridian (SP) were measured directly from the CT images. The relationships between the safe depths of these acupoints and sex, age, body weight, and BMI were analyzed. RESULTS: The results indicated significant differences in safe needling depth between boys and girls in most upper back acupoints, except at BL42, BL44, BL45, BL46, GB21 and SP21. Safe depths differed significantly depending on age (p < 0.001), weight (p ≤ 0.01), and BMI (p < 0.05). Multiple regression analysis revealed that weight was the most crucial factor in determining the safe depth. CONCLUSIONS: Sex, age, weight, and BMI are relevant factors in determining the safe needling depths of upper back acupoints in children. Physicians should pay attention to wide variations in needle depth when performing acupuncture.

Traditional Chinese medicine therapy improves the survival of systemic lupus erythematosus patients.

OBJECTIVE: No previous studies have evaluated the effect of traditional Chinese medicine (TCM) treatment on the survival of patients with systemic lupus erythematosus (SLE). Hence, in this study, we determined whether TCM treatment affects the survival of SLE patients. METHODS: This nationwide population-based retrospective cohort study assessed 23,084 patients newly diagnosed with SLE between 1999 and 2009, using the database of the Taiwan National Health Insurance program. RESULTS: Among these patients, 9267 (40.15%) used TCM for SLE treatment and exhibited a significantly decreased risk of death [hazard ratio (HR) = 0.73; 95% confidence interval (CI): 0.68-0.78], with multivariate adjustment, compared with those without TCM use. A similar significant protective effect of TCM use was found across various subgroups of comorbidities. TCM use 1 year before diagnosis also reduced the risk of death. Our study findings indicated that Zhi Bo Di Huang Wan (HR = 0.54; 95% CI: 0.32-0.91), Jia Wei Xiao Yao San (HR = 0.35; 95% CI: 0.16-0.73), Liu Wei Di Huang Wan (HR = 0.51; 95% CI: 0.28-0.93), Gan Lu Yin (HR = 0.40; 95% CI: 0.17-0.96), and Yin Qiao San (HR = 0.22; 95% CI: 0.05-0.86) were the most effective TCM agents that improved survival. CONCLUSIONS: This nationwide retrospective cohort study provided information that combined therapy with TCM may improve the survival in SLE patients. This study also suggests that TCM may be used as an integral element of effective therapy for SLE.

Time-trend analysis of prevalence, incidence and traditional Chinese medicine use among children with asthma: a population-based study.

BACKGROUND: This study determined annual prevalence and incidence trends of asthma among children in Taiwan from 2002 to 2008. Risk factors and traditional Chinese medicine (TCM) use were examined. METHODS: A random sample was selected for a population-based study with a selection probability of 0.5 from all 3-18 years insurants. The annual prevalence and incidence of asthma were estimated according to age, sex, insurance premium and degree of urbanization. RESULTS: The prevalence of asthma increased from 12.99% in 2002 to 16.86% in 2008. The increase was greatest in 2008, among boys, 11-15 years, ≥medium insurance premium, and high- and medium-density urban area. TCM use in asthma-prevalent children decreased from 1.16% in 2002 to 0.59% in 2008. The incidence fluctuated, ranging from 1.01% in 2002 to 1.49% in 2005. The highest was in 2005, among boys, 3-5 years, ≥medium insurance premium and high-density urban area. TCM use in asthma-incident children decreased from 3.59% in 2002 to 1.69% in 2008. CONCLUSION: This study demonstrated a substantial increase in annual prevalence of asthma among children in Taiwan from 2002 to 2008. The incidence fluctuated. The TCM use showed a decreasing linear trend and was higher in incident than in prevalent cases.

Time Trend Analysis of the Prevalence and Incidence of Diagnosed Asthma and Traditional Chinese Medicine Use among Adults in Taiwan from 2000 to 2011: A Population-Based Study.

BACKGROUND: The aim of this study was to determine the annual trends of traditional Chinese medicine (TCM) use for prevalent and incident asthmatic adults in Taiwan from 2000 to 2011. The annual prevalence and incidence of asthma in adults among subgroups of sociodemographic factors were also investigated. METHODS: A population-based study was conducted using a random sample with one million beneficiaries of all residents aged ≥18 years enrolled in the National Health Insurance program. Adults diagnosed with asthma were identified from the National Health Insurance Research Database. The annual prevalence and incidence of asthma in the adult population were estimated by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes to identify relevant cases from 2000 to 2011. RESULTS: The number of annual prevalent cases of diagnosed asthma increased from 56,885 in 2000 to 101,535 in 2011. The prevalence increased significantly on annual basis, whereas the incidence rate fluctuated over time. The prevalence of TCM use by adults with asthma decreased significantly (p<0.05), from 38.58% in 2000 to 29.26% in 2011. The number of annual incident cases of diagnosed asthma decreased from 3,896 in 2000 to 2,684 in 2011. TCM use rates in asthma incident adults decreased significantly (p<0.05), from 54.24% in 2000 to 38.19% in 2011. CONCLUSION: The prevalence of TCM utilization is high among adults with asthma in Taiwan. However, our study demonstrated a substantial decrease in the annual prevalence of TCM use by prevalent and incident asthmatic adults in Taiwan from 2000 to 2011. In addition, the prevalence of TCM use was higher among incident cases, compared with those with prevalent cases.

The Depths from Skin to the Major Organs at Chest Acupoints of Pediatric Patients.

Background. Acupuncture is applied to treat numerous diseases in pediatric patients. Few reports have been published on the depth to which it is safe to insert needle acupoints in pediatric patients. We evaluated the depths to which acupuncture needles can be inserted safely in chest acupoints in pediatric patients and the variations in safe depth according to sex, age, body weight, and body mass index (BMI). Methods. We retrospectively studied computed tomography (CT) images of pediatric patients aged 4 to 18 years who had undergone chest CT at China Medical University Hospital from December 2004 to May 2013. The safe depth of chest acupoints was directly measured from the CT images. The relationships between the safe depth of these acupoints and sex, age, body weight, and BMI were analyzed. Results. The results demonstrated significant differences in depth among boys and girls at KI25 (kidney meridian), ST16 (stomach meridian), ST18, SP17 (spleen meridian), SP19, SP20, PC1 (pericardium meridian), LU2 (lung meridian), and GB22 (gallbladder meridian). Safe depth significantly differed among the age groups (P < 0.001), weight groups (P < 0.05), and BMI groups (P < 0.05). Conclusion. Physicians should focus on large variations in needle depth during acupuncture for achieving optimal therapeutic effect and preventing complications.