Pediatric Acupuncture: A Spiritual Perspective.

Background: Approaching pediatric acupuncture from a spiritual perspective is the most effective means for providing a valuable holistic relatively noninvasive approach to pediatric acupuncture, as well as preventive treatments for the repulsion of disease and the correction of Qi (i.e., vital energy) imbalances. Objectives: Parents may be taught to apply acupressure to their children with an excellent response, especially when given with loving kindness. Materials and Methods: Methods include the use of acupressure, laser techniques, and acupuncture for children who do not display fear toward the shallow insertion of needles. Results: Owing to the young age of the patients, children will display fast and effective positive responses to therapy, just as they are susceptible to negative effects in similar timeframes. Children will respond faster than adults to such treatments, which can also increase immune system functionality and bolster resistance to invasive forms of Qi imbalances and disease. Such treatments will also relieve pain and distress and improve concentration and mental attitudes in children. Difficult conditions such as attention-deficit/hyperactivity disorder (ADHD) and attention deficit disorder (ADD) can also be effectively treated through a spiritual approach to pediatric acupuncture. Conclusions: Pediatric acupuncture from a spiritual perspective provides a specific, safe, and effective therapy for a wide variety of painful and nonpainful conditions through Qi balancing in children. Moreover, parents may be taught to apply acupressure to their children with an excellent response, especially when given with loving kindness. Such techniques not only resolve acute symptoms but also provide preventive measures and enable parent-child relationships to thrive. Overall, medical acupuncture from a spiritual perspective is one of the best complementary therapies in pediatrics.

Efficacy of a Peruvian Botanical Remedy (Sabell A4+) for Treating Liver Disease and Protecting Gastric Mucosal Integrity.

The purpose of this study was to determine the efficacy of a Peruvian botanical formulation for treating disorders of hepatic function and gastric mucosal integrity. The formulation A4+ (Sabell Corporation) contains extracts of Curcuma longa rhizome, Cordia lutea flower, and Annona muricata leaf. Individually these plants have been used as traditional remedies for liver disease. We report the efficacy of A4+ and its components using a variety of in vitro and in vivo disease models. The methods used included tests for antioxidant, anti-inflammatory, and antiviral activity as well as mouse models of liver disease, including Concanavalin A-induced immune-mediated hepatitis and a bile duct ligation model for evaluating sickness behaviour associated with liver disease. Rat models were used to evaluate the gastric mucosal protective property of A4+ following indomethacin challenge and to evaluate its anti-inflammatory action in an "air pouch" model. In all tests, A4+ proved to be more effective than placebo. A4+ was antioxidant and anti-inflammatory and diminished Hepatitis C virus replication in vitro. In animal models, A4+ was shown to protect the liver from immune-mediated hepatitis, improve behavioural function in animals with late stage liver disease, and protect the rat gastric mucosa from ulceration following NSAID exposure. We conclude that A4+ ameliorated many aspects of liver injury, inhibited hepatitis C virus replication, and protected the gastric mucosa from NSAIDs. These varied beneficial properties appear to result from positive interactions between the three constituent herbs.

Toxicology of a Peruvian botanical remedy to support healthy liver function.

BACKGROUND: The purpose of these studies was to determine the safety of a botanical treatment for supporting healthy liver function developed in Peru. The formulation, A4+, contains extracts of Curcuma longa L. rhizome (A4R), Cordia lutea Lam. flower (A4F) and Annona muricata L. leaf (A4L). The tests were used to support an application for a non-traditional Natural Health Product Licence from the Natural Health Product Directorate of Health Canada and future clinical trials. METHODS: Besides reviewing the scientific and clinical information from Peru on the ingredients and conducting an initial Ames test for mutagenicity, we analysed A4+ for its chemical profile and tested genotoxicity (micronucleus test) and general toxicity (28-day repeated dose). RESULTS: A4+ and extracts from the three plants provided distinctive chemical fingerprints. A4L contained acetogenins, requiring a second chromatographic method to produce a specific fingerprint. The Ames test proved positive at the highest concentration (5,000 µg/mL) but A4+ showed no evidence of genotoxicity in the more specific mouse micronucleus test. The 28-day repeated dose (general toxicity) study in rats showed no toxicity at 2,000 mg/kg. CONCLUSIONS: We conclude that under the conditions of these studies, A4+ shows no evidence of toxicity at the levels indicated. A no observed adverse effect level (NOAEL) of 2,000 mg/kg was assigned.

Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases.

Background: Integrative medicine is becoming increasingly accepted in the global scheme of health care. Traditional Chinese Medicine (TCM) is often included among integrative medicine modalities. Objective: This article provides a background for integration of acupuncture and other TCM-derived approaches to managing psychiatric conditions. Methods: Classical theories of TCM that pertain to psychiatric conditions are reviewed, focusing on concepts of energetic imbalance, the implications of mind-body-spirit connections, and treatment strategies that involve TCM modalities. An example of correlation between TCM patterns of disharmony and the Western diagnosis of generalized anxiety disorder (GAD) is given, along with an illustrative case in which counseling, medications, and acupuncture were combined in treatment. TCM principles are incorporated in certain energy psychology modalities, such as Emotional Freedom Technique (EFT). A case is presented demonstrating the integration of energy psychology with acupuncture, Qigong and hypnosis as an avenue for releasing pathogenic emotions. In classical TCM theory, assessing and treating spiritual disharmonies is fundamental for dealing with emotional disorders. Practical application in a clinical case is described. Conclusions: TCM offers a cogent theoretical basis for assessing and clinically managing patients presenting with mental health issues. TCM principles integrate well with other systems, including Western medicine.

Systematic reviews of TCM trials: how does inclusion of Chinese trials affect outcome?

AIM: Systematic reviews (SRs) are an important tool for the synthesis of research and are used to guide both research and clinical practice. Previous research suggests that changes to standard SR methodology may be warranted. The objectives of this study were to determine the value of adding Chinese-language databases to conventional systematic review (SR) search strategies, and ii) to determine the importance of methodological validation of TCM RCTs in the conduct of SRs of two health conditions, chronic fatigue syndrome (CFS) and EBV-infectious mononucleosis (mono). METHODS: Ten English-language and two Chinese-language databases were searched from inception to 2008. After initial screening potentially relevant publications were retrieved and assessed based on predetermined inclusion criteria. Method of randomization was verified using author interviews. RESULTS: Mono Search - While English-language database searches did not yield any potentially relevant references, Chinese-language database searches identified 14 studies labelled as RCTs. Author interview determined that 10 were clinical summaries and one a controlled clinical trial. Authors for three publications were unavailable. CFS Search - English-language and Chinese-language database searches identified 8 and 28 potentially relevant references, respectively, for a total of 36, however, none met all inclusion criteria. CONCLUSIONS: Utilization of Chinese-language databases greatly increased the number of potentially relevant references for each search. Unfortunately, due to methodological flaws, this additional information did not generate any usable information. Medical research in China continues to be active, including the conduct of RCTs, however, improvements in trial design and conduct in medical research in China are essential in order for this material to be useful in guiding research and practice.

Considering complementary and alternative medicine alternatives in cases of life-threatening illness: applying the best-interests test.

In this article we explore decision-making about treatment when a child faces a life-threatening illness but conventional treatment presents substantial risk and uncertain benefit. When is it acceptable for parents to decide to use complementary and alternative medicine as an alternative, rather than a complement, to conventional care? We use the example of a young child suffering from progressive glycogen storage disease, for whom liver transplant offers the only prospect of a cure. Without a liver transplant, the disease usually results in death within a few years. However, experience using transplant to treat this illness has been limited, success is far from ensured, and the risks (including death and continued progression of the disease) are substantial. The child's parents, who are first-generation immigrants, consider the risks of the transplant unjustified because it still does not offer good prospects for a healthy future. They believe that traditional Chinese medicine could help remediate their daughter's disease. In the article we (1) review parents' obligation to make treatment decisions in the best interests of their child, (2) explain limits on parents' decision-making authority, (3) explore how "best interests" are determined, focusing on cases of serious illness for which conventional treatment is risky and benefit is possible but uncertain, (4) explain the standard of care that physicians must meet in advising about treatment, and (5) outline factors that clinicians and parents should take into account when making decisions.

The safety of pediatric acupuncture: a systematic review.

CONTEXT: Acupuncture is increasingly used in children; however, the safety of pediatric acupuncture has yet to be reported from systematic review. OBJECTIVE: To identify adverse events (AEs) associated with needle acupuncture in children. METHODS: Eighteen databases were searched, from inception to September 2010, irrespective of language. Inclusion criteria were that the study (1) was original peer-reviewed research, (2) included children from birth to 17 years, inclusively, (3) involved needle acupuncture, and (4) included assessment of AEs in a child. Safety data were extracted from all included studies. RESULTS: Of 9537 references identified, 450 were assessed for inclusion. Twenty-eight reports were included, and searches of reference lists identified 9 additional reports (total: 37). A total of 279 AEs were identified, 146 from randomized controlled trials, 95 from cohort studies, and 38 from case reports/series. Of the AEs, 25 were serious (12 cases of thumb deformity, 5 infections, and 1 case each of cardiac rupture, pneumothorax, nerve impairment, subarachnoid hemorrhage, intestinal obstruction, hemoptysis, reversible coma, and overnight hospitalization), 1 was moderate (infection), and 253 were mild. The mild AEs included pain, bruising, bleeding, and worsening of symptoms. We calculated a mild AE incidence per patient of 168 in 1422 patients (11.8% [95% confidence interval: 10.1-13.5]). CONCLUSIONS: Of the AEs associated with pediatric needle acupuncture, a majority of them were mild in severity. Many of the serious AEs might have been caused by substandard practice. Our results support those from adult studies, which have found that acupuncture is safe when performed by appropriately trained practitioners.

Is there a role for acupuncture in the symptom management of patients receiving palliative care for cancer? A pilot study of 20 patients comparing acupuncture with nurse-led supportive care.

PURPOSE: A pilot study to document changes in symptoms after acupuncture or nurse-led supportive care in patients with incurable cancer. METHODS: Patients receiving palliative care with estimated survival of at least 3 months were screened with the Edmonton Symptom Assessment System (ESAS). Patients (n=20) with significant symptoms were randomised to receive weekly acupuncture or nurse-led supportive care for 4 weeks. ESAS scores were obtained before and after each treatment, and weekly for 6 weeks after treatment by telephone. RESULTS: 42 of 170 patients screened were eligible. 20 gave consent for recruitment. The compliance rate was 90% for acupuncture and 80% for nurse-led supportive care. Total symptom scores were reduced by an average of 22% after each acupuncture visit and by 14% after each supportive care visit. Compared with baseline, ESAS scores at the end of the follow-up period were reduced by 19% for the acupuncture arm and 26% for nurse-led supportive care. CONCLUSION: Patients appear to benefit from incorporating acupuncture in the treatment of advanced incurable cancer. Acupuncture was well tolerated with no significant or unexpected side effects. Acupuncture had an immediate effect on all symptoms, whereas nurse-led supportive care had a larger impact 6 weeks after the final session. Both interventions appear helpful to this population and warrant further study.

Promotion of blood fluidity by inhibition of platelet adhesion using electroacupuncture stimulation.

Stress applied to rats is known to result in a quick decrease in blood fluidity. Although electrical acupuncture stimulation (ACU) attenuates stress responses, the influence of ACU on blood fluidity has not been well examined. In the present study, the effect of ACU on blood fluidity and platelet adhesion was examined using a Micro Channel Array Flow Analyzer and a laser scattering platelet aggregometer (PA-20), respectively. Male Wistar rats (7-8 weeks old) were used. ACU (1 Hz, 3-5 V), which causes slight muscle twitching, was applied to acupoints for 60 minutes/day once or on 2 consecutive days. Stimulated acupoints were as follows: ZuSanli (ST-36), Sanyinjiao (SP-6), Hegu (L-I4), Neiguan (P-6), and Shenshu (BL-23). ACU applied to ST-36, SP-6, and L-14 revealed significant increases in blood fluidity while platelet adhesion activity decreased. No significant changes were observed when ACU was applied to P-6 and BL-23. Results indicate that ACU affects blood fluidity depending on the acupoints. Blood fluidity changed with ACU within 1 day. In other words, the effect of acupuncture has an immediate effect. In addition, platelet aggregation decreased with ACU, suggesting that an increase in blood fluidity is associated with platelet aggregation ability.

Scaling of sensorimotor control in terrestrial mammals.

Sensorimotor control is greatly affected by two factors--the time it takes for an animal to sense and respond to stimuli (responsiveness), and the ability of an animal to distinguish between sensory stimuli and generate graded muscle forces (resolution). Here, we demonstrate that anatomical limitations force a necessary trade-off between responsiveness and resolution with increases in animal size. To determine whether responsiveness is prioritized over resolution, or resolution over responsiveness, we studied how size influences the physiological mechanisms underlying sensorimotor control. Using both new electrophysiological experiments and existing data, we determined the maximum axonal conduction velocity (CV) in animals ranging in size from shrews to elephants. Over the 100-fold increase in leg length, CV was nearly constant, increasing proportionally with mass to the 0.04 power. As a consequence, larger animals are burdened with relatively long physiological delays, which may have broad implications for their behaviour, ecology and evolution, including constraining agility and requiring prediction to help control movements.

Effectiveness of acupuncture for the initiation of labour at term: a pilot randomized controlled trial.

OBJECTIVE: This study was designed to determine the effectiveness of acupuncture for the initiation of labour in women at term. METHODS: A prospective pilot randomized control trial was undertaken, in which 16 pregnant women at term were randomly assigned to receive acupuncture either at sites reported to cause onset of labour or at nearby sham sites. The primary outcome assessed was the interval from initial acupuncture treatment to delivery. RESULTS: There was a difference in intervention to delivery interval of 62 hours in favour of the treatment group. Furthermore, women in this group had shorter labours by a mean of 2 hours and 20 minutes. CONCLUSION: The interesting results of this pilot trial warrant further investigation into the use of acupuncture for the initiation of labour in women at term.