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1.
Transl Cancer Res ; 13(2): 1166-1187, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38482437

RESUMO

Background and Objective: The cancer-immunity cycle (CIC) is defined as a series of progressive events that cause an anticancer immune response leading to the killing of the cancer cell. The concept of CIC has important guiding significance for the clinical and basic tumor immunotherapy research. As one of the methods of traditional Chinese medicine (TCM), Chinese herbal medicine (CHM) has shown unique advantages in multitarget and multipathway immune regulation. However, the tumor immune circulation targeted by CHM is generally unclear at present. To provide reference for future clinical and basic research, we systematically reviewed the existing literature on CHM (including CHM monomers, CHM compounds, and CHM patent medicines) and the mechanisms related to its efficacy. Methods: We searched the PubMed and China National Knowledge Infrastructure (CNKI) databases for relevant Chinese-language and English-language literature published from January 1988 to October 2022. The literature was screened manually at three levels: title, abstract, and full text, to identify articles related to CHM and their mechanism of regulating tumor immunity. Key Content and Findings: By further classifying the CIC, it was confirmed that CHM can regulate the activation of dendritic cells (DCs) and macrophages and promote the presentation of tumor antigens. Meanwhile, CHM can also reverse tumor-immune escape by enhancing T-cell proliferation and infiltration. In addition, CHM can also enhance the antitumor ability of the body by regulating the killing process of tumor cells. Conclusions: The theory of a CIC is of guiding significance to regulating tumor immunity via CHM.

3.
Med Acupunct ; 35(4): 195-201, 2023 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-37609552

RESUMO

As an inseparable part of Traditional Chinese Medicine (TCM), acupuncture has been used in more than 196 countries or regions and has played an increasingly important role in health care. This article introduces Dr. Lian Zhu, MD, who made great contributions to acupuncture development. Dr. Zhu was a medical doctor, a military physician in her early life, and a high-ranking officer in the health care system of the Chinese government. She became famous as an acupuncturist after learning acupuncture in 1945. She was highly influenced by Zhijun Lu, MD, who learned acupuncture from Zuotian Ren, a TCM doctor in Yan'an, who had cured Chairman Mao Zedong's intractable shoulder pain. Dr. Zhu was one of the 2 earliest acupuncture trainers in the Chinese military health system, helping the Chinese communist military overcome resource shortages during the Chinese Civil War. She was one of China's most-influential acupuncture educators, having taught many acupuncture classes that trained many acupuncturists from 1945 to 1955. She was also an officer and policy maker in the Health Department of the central government, where she established such policy initiatives as training content for TCM doctors' reeducation schools. Dr. Zhu was ones of the earliest acupuncture researchers and administrators with a government-endorsed background. She created the first public acupuncture university in history in 1976 as well as 2 key acupuncture institutes in China and was director of both. She played a crucial role in promoting acupuncture research through TCM and biomedical methods, and was the first scholar in China to publish a thorough book on medical acupuncture using Western-biomedical language, which was highly praised by Chairman Mao. Dr. Zhu's acupuncture theory objectively promoted acceptance of medical acupuncture by the general public, medical doctors, government officials, and international medical societies.

4.
J Integr Med ; 21(4): 320-323, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37331861

RESUMO

In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal Nature by Dr. Qiufu Ma's team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm, the study showed that the distal effect of acupuncture can be achieved by "driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines)." PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of acupoints, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2Cre-markable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma's team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to "driving the vagus-adrenal axis." Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to "driving the vagus-adrenal axis." J Integr Med. 2023; 21(4):320-323.


Assuntos
Terapia por Acupuntura , COVID-19 , Eletroacupuntura , Camundongos , Ratos , Animais , COVID-19/terapia , Anti-Inflamatórios , Inflamação/terapia , Pontos de Acupuntura
5.
Altern Ther Health Med ; 29(7): 242-251, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36302231

RESUMO

Context: Shunfa Jiao, the founder of the major school of scalp acupuncture (SA), and several other authors, have speculated that SA can effectively treat diseases or disorders through needling of the external scalp zones projected from the cerebral cortex's internal function zones that are directly underneath. Objective: The review intended to analyze and discuss the historical development of Jiao's SA system, the composition of Jiao's SA stimulation zones, and the projection of the cerebral cortex's function zones on the scalp, to correct the shortcomings and inaccuracies of Jiao's hypothesis and accelerate the development of SA and its clinical application based on solid evidence. Design: The research team performed a narrative review based on the literature currently available. The research team searched PubMed, Cochrane, Webscience, CNKI (China National Knowledge Infrastructure), Wangfang, Google Scholar and Baidu Scholar databases. The search used the keywords: "Scalp acupuncture, head acupuncture, Jiao Shunfa, functional zone of cerebral cortex, history" in both English and Chinese. Setting: The study was conducted in Shanghai Bailing Tianshou Clinic of Chinese Medicine, Shanghai, People's Republic of China, and McLean Center for Complementary and Alternative Medicine, Vienna, VA, USA. Results: The nineteen stimulation zones in Jiao's SA system are actually a mixture of Jiao's speculation on SA and other authors' clinical experiences, and are confusing. The five zones on the forehead and the nasopharyngeal-mouth-tongue, madness control, spirit-emotional zones as well as the balance zone, chore-tremor control zone, and vascular movement center-more than 57% of the zones-aren't related to the projection on the scalp of the cerebral cortex's function zones directly underneath. Jiao didn't discover the five zones on the forehead through his findings of acupuncture-sensation transmission to organs, but rather Yunpeng Fang identified them in his study of SA. The nasopharyngeal-mouth-tongue, madness control, spirit-emotional zones are also others' finding. Jiao's projection of the cerebral cortex's function zones on the scalp was merely an adoption of a series of brain-surgery marks that surgeons draw before neurosurgery, which correlate external skull locations with underlying cortical areas. That Jiao believed that needling those lines could treat cerebrovascular diseases or disorders was an unfounded guess on his part. In fact, the effects of stimulating such functional zones to treat such diseases that Jiao found weren't ideal. Furthermore, Jiao's SA system has nothing to do with the integration of Chinese and Western medicine. Conclusion: Scientific evidence hasn't confirmed Jiao's hypothesis nor has that hypothesis followed from the development of neuroscience. Jiao insistence on his hypothesis seriously hindered the research and development of SA therapy. Clinical trials and experimental studies on acupuncture, especially using an fMRI, are warranted to evaluate SA's therapeutic value and to identify the functional changes of various parts of the brain that acupuncture on the scalp can cause.


Assuntos
Terapia por Acupuntura , Couro Cabeludo , Humanos , China , Atividades Cotidianas , Córtex Cerebral
6.
BMC Med Inform Decis Mak ; 21(Suppl 6): 381, 2022 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-35773641

RESUMO

Traditional medicine (TM) is practiced in various forms in over 180 countries. Despite this, health information systems on TM are limited. Consistent with this, the World Health Organization's (WHO) international classification for diseases (ICD) has not to date included TM concepts. This is now changing, as the WHO has endorsed the reflection of TM paradigms in the new 11th Revision of ICD (ICD-11). Although some countries have had national Traditional Medicine classification systems for many years, information from such systems has not been standardized nor been made available globally. By including TM within the ICD, international standardization will be possible allowing for measuring, counting, comparing, formulating questions and monitoring over time. ICD-11 is a classification system for the twenty-first century, and it now provides an opportunity for interested users to integrate the coding of diagnostic concepts from both TM and Western Medicine. This paper describes the new TM classification in ICD and demonstrates through coding examples how to code TM concepts alongside Western Medicine concepts.


Assuntos
Classificação Internacional de Doenças , Medicina Tradicional , Humanos , Organização Mundial da Saúde
7.
J Integr Med ; 19(5): 460-466, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34154967

RESUMO

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO2), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient's breath rate, SpO2, heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient's breathing function, increased SpO2, and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.


Assuntos
Terapia por Acupuntura , COVID-19 , Medicamentos de Ervas Chinesas , COVID-19/terapia , Feminino , Humanos , Resultado do Tratamento
8.
Zhongguo Zhen Jiu ; 41(4): 359-64, 2021 Apr 12.
Artigo em Chinês | MEDLINE | ID: mdl-33909353

RESUMO

Professor LIANG Fan-rong's team from Chengdu University of TCM published Acupuncture as adjunctive therapy for chronic stable angina: a randomized clinical trial in JAMA Internal Medicine on July 29, 2019, which demonstrates that acupuncture as an adjunctive therapy is safety and effective for mild and moderate chronic stable angina. Sixteen experts at home and abroad conducted serious discussions on the research design, evaluation methods, principles and mechanisms, clinical significance and enlightenment of future acupuncture research, and provided practical suggestions for acupuncture and moxibustion to go global and gain international recognition.


Assuntos
Terapia por Acupuntura , Acupuntura , Angina Estável , Moxibustão , Terapia Combinada , Humanos
9.
Auton Neurosci ; 232: 102793, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33684727

RESUMO

Sepsis is a serious medical condition in which immune dysfunction plays a key role. Previous treatments focused on chemotherapy to control immune function; however, a recognized effective compound or treatment has yet to be developed. Recent advances indicate that a neuromodulation approach with nerve stimulation allows developing a therapeutic strategy to control inflammation and improve organ functions in sepsis. As a quick, non-invasive technique of peripheral nerve stimulation, acupuncture has emerged as a promising therapy to provide significant advantages for immunomodulation in acute inflammation. Acupuncture obtains its regulatory effect by activating the somatic-autonomic-immune reflexes, including the somatic-sympathetic-splenic reflex, the somatic-sympathetic-adrenal reflex, the somatic-vagal-splenic reflex and the somatic-vagal-adrenal reflex, which produces a systemic effect. The peripheral nerve stimulation also induces local reflexes such as the somatic-sympathetic-lung-reflex, which then produces local effects. These mechanisms offer scientific guidance to design acupuncture protocols for immunomodulation and inflammation control, leading to an evidence-based comprehensive therapy recommendation.


Assuntos
Terapia por Acupuntura , Sepse , Sistema Nervoso Autônomo , Humanos , Reflexo , Sepse/terapia , Sistema Nervoso Simpático
10.
Med Acupunct ; 32(5): 310-319, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33101576

RESUMO

Background and Objective: Acupuncture and Oriental medicine are widespread, practiced in >183 countries and regions. As such, it has played an important role in the world health care system. However, there are no official statistics available on the number of acupuncture practitioners in China. The aim of this study is to calculate the number ranges of acupuncture practitioners in China in 2018. Materials and Methods: In total, 33.708 million was used as the total number of patient visits for acupuncture in 2018 in China. This number was calculated using the data released by the National Administration of Traditional Chinese Medicine (China), in which the average daily workload of all acupuncture practitioners in China was 134,832 patient visits. Acupuncture practitioners in China are part of Chinese Medicine doctors (CMDs) at the physician level, called "acupuncture doctors." This number 134,832 was divided by the workload of a single doctor of acupuncture, which was 19.4 or 7.0 patient visits per day. These numbers were from a survey by the authors. There are also the numbers 16.0 or 9.4 patient visits per day; these numbers were calculated from the salary level of acupuncture practitioners at 10,000 Yuan per month (providing the doctor's net income was 30% or 50% in his/her gross income). From these 2 sources, the authors then obtained 2 sets of ranges of acupuncture practitioners in China in 2018. There were 9,927 CMDs in 49 big hospitals, of which 619 were acupuncture practitioners; the ratio of acupuncture practitioners to the whole of all CMDs was 6.23%. Using this ratio multiplied by the whole number of CMDs in 2018, then the number of acupuncture practitioners in China in 2018 could be obtained as well. Results: Calculating based on the workload, the range of acupuncture practitioners in China in 2018 was from 6,950 to 19,262. Calculating based on the salary level, the range was 10,618 to 17,697. Calculating based on the ratio of the number of acupuncture practitioners to the whole population of CMDs, the number was 28,360. Conclusions: The reasonable range of acupuncture practitioners in China in 2018 was 10,618 to 17,697, with a median of 14,157. Considering that some acupuncture practitioners are also engaged in teaching, research, and management, the mentioned number is enlarged by 30% to produce 18,404, which would be reasonable. It was also concluded that the density of acupuncture practitioners was 1.31 per 100,000 residents.

11.
J Integr Med ; 18(5): 385-394, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32792254

RESUMO

BACKGROUND: There is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease. OBJECTIVE: This systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19. SEARCH STRATEGY: Six electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial. INCLUSION CRITERIA: Randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM. DATA EXTRACTION AND ANALYSIS: Two evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled. RESULTS: Seven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (-1.30 by SMD, 95% CI [-2.43, -0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; -11.82 by MD, 95% CI [-17.95, -5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs. CONCLUSION: Current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.


Assuntos
Betacoronavirus/efeitos dos fármacos , Medicamentos de Ervas Chinesas/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Humanos , SARS-CoV-2 , Tratamento Farmacológico da COVID-19
12.
Med Acupunct ; 32(3): 136-142, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32595820

RESUMO

Objective: Chinese Medicine (known as acupuncture and Oriental Medicine (AOM) in the United States), has spread far and been utilized in more than 183 countries or regions. It has played an important role in the health care systems of many countries. Licensed acupuncturists' contribution to the U.S. market alone is more than 3.5 billion dollars. The aim of the current study was to determine the ranking status of Chinese Medicine schools on the global or international level in 2020. Materials and Methods: Databases of PubMed.gov, wanfangdata.com.cn, cnki.net, and google.com were searched, using the keywords: university or college or school, Chinese Medicine or acupuncture and Oriental Medicine, global ranking or international ranking, 2020 both in English and Chinese. If the ranking did not show up in the results directly, the authors moved on to find global or international higher education (universities or colleges) ranking agencies or institutions. Then the authors used the websites of ranking agencies or institutions to conduct more research, using the keywords: 2020, Chinese Medicine, or acupuncture and Oriental Medicine. Results: U.S. News & World Report is the only recognized authority that reported the ranking status of universities of Chinese Medicine in its 2020 edition, in which the best global universities were ranked. A total of 1500 universities in 81 countries and regions were included. Based on the overall academic strength of each university, Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as numbers 1376, 1390 and 1440, respectively. In clinical medicine, 750 universities were ranked among the strongest in the world; Nanjing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as 688th, 734th, and 738th, respectively. In pharmacology and toxicology, 250 universities were among the strongest in the world; Shanghai University of Traditional Chinese Medicine and Nanjing University of Chinese Medicine were ranked as 153rd and 209th, respectively. In oncology, 250 universities were ranked as strongest in the world; Nanjing University of Chinese Medicine was ranked as 243rd in the world. Conclusions: Chinese Medicine schools are more accepted and more highly ranked than they had been in the past.

13.
J Integr Med ; 18(2): 89-91, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32001200

RESUMO

Two reports of trials investigating the potential effect of acupuncture in increasing live birth rate (LBR) in women with polycystic ovary syndrome (PCOS) or those undergoing in vitro fertilization (IVF) were published by Journal of American Medical Association in 2017 and 2018 respectively. The trial investigators did not recommend acupuncture for the women with PCOS or IVF based on their findings. This paper raises the concern that the findings that acupuncture did not increase LBR for women with PCOS or undergoing IVF may be the result of methodological flaws in the studies and unintended bias such as use of an invalid control intervention and underestimation of the true acupuncture effect. Therefore, their findings may not be a valid reflection of acupuncture's effect in improving LBR in women with these clinical conditions.


Assuntos
Terapia por Acupuntura , Síndrome do Ovário Policístico , Clomifeno , Feminino , Fertilização In Vitro , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Altern Ther Health Med ; 26(3): 40-46, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31719212

RESUMO

CONTEXT: In the United States. and other Western countries, dry needling (DN) has been a disputed topic in both the academic and legal fields. OBJECTIVE: The research team intended to examine whether DN is a technique independent from acupuncture and also how nonacupuncturists, such as physical therapists (PTs), started practicing DN. DESIGN: The research team completed research, examined critical issues related to DN, and published a white paper in 2017 that discussed evidence and expert opinions from academic scholars, for health care professionals, administrators, policy makers, and the general public that demonstrate that DN is acupuncture. This article continues that endeavor. RESULTS: DN is not merely a technique but a medical therapy that is a simplified form of acupuncture practice. To promote DN theory and business, some commercial DN educators have recruited a large number of nonacupuncturists, including PTs, athletic trainers, and nurse practitioners, in recent years. PTs did not initiate the practice of DN and DN does not fit into the practice scope for PTs because it is an invasive practice. The national organizations of the PT profession, such as the American Physical Therapy Association and the Federation of State Boards of Physical Therapy, began to support the practice of DN by PTs in approximately 2010. Currently, more PTs are involved in DN practice and are teaching than any other specialty. CONCLUSIONS: Acupuncturists and physicians must complete extensive acupuncture training in accredited programs and pass national examinations to become licensed or certified to practice acupuncture. However, a typical DN course runs only 20-30 h, often in the course of 1 weekend, and the participants may receive a DN certificate without any national examination being required. For the safety of patients and professional integrity, the research team strongly suggests that all DN practitioners and educators should have to meet the same basic standards as those required for licensed acupuncturists or physicians.


Assuntos
Terapia por Acupuntura , Agulhamento Seco/métodos , Pessoal de Saúde , Humanos , Modalidades de Fisioterapia , Médicos , Estados Unidos
15.
J Integr Med ; 17(5): 315-320, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31281066

RESUMO

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.


Assuntos
Terapia por Acupuntura/economia , Custos e Análise de Custo/métodos , Gastos em Saúde , Cidades , Humanos , Estados Unidos
16.
J Integr Med ; 17(2): 71-76, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30738771

RESUMO

Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity; therefore, it should be effective for CLBP in older adults.


Assuntos
Terapia por Acupuntura , Dor Crônica/terapia , Dor Lombar/terapia , Pontos de Acupuntura , Terapia por Acupuntura/economia , Terapia por Acupuntura/instrumentação , Idoso , Idoso de 80 Anos ou mais , Feminino , Guias como Assunto , Humanos , Masculino , Agulhas , Padrões de Prática Médica , Ensaios Clínicos Pragmáticos como Assunto
18.
Complement Ther Med ; 41: 295-301, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477857

RESUMO

This study was conducted to identify the approximate number and density of actively licensed acupuncturists, as well as the number of schools in acupuncture and oriental medicine (AOM) by January 1, 2018 in the United States (U.S.). We contacted the appropriate department governing acupuncturists, such as the Board of Acupuncture or Board of Medicine, etc. in each state and U.S. territories, to collect the data. We also conducted online license information searches in order to collect the most accurate numbers of licensed acupuncturists, especially for those states in which a board could not be reached. We found that the number of actively licensed acupuncturists as of January 1, 2018 in the U.S. was 37,886. The ten states with the largest number of acupuncturists (28,452 or 75.09% of the U.S. total), in order by total, included California, New York, Florida, Colorado, Washington, Oregon, Texas, New Jersey, Maryland and Massachusetts. The number of practitioners was greater than 1000 for each of these states. Among them, the largest three were California (12,135; 32.03%), New York (4438; 11.71%) and Florida (2705; 7.13%). These three states accounted for more than half of the overall total. The number of total licensed acupuncturists has increased 257% since 1998. The overall acupuncturist density in the U.S. - measured as number of acupuncturists per 100,000 - was 11.63 (total number of licensed acupuncturists: 37,886, divided by the total population: 325,719,178 at the start of 2018). There were 20 states with an acupuncturist density of more than 10 per 100,000 population. Hawaii (52.82) was the highest, followed by Oregon (34.88), Vermont (30.79), California (30.69) and then New Mexico (30.27). There were 62 active, accredited AOM schools which altogether offered 100 programs: 32 master degrees in Acupuncture, 53 master degrees in Oriental medicine, 13 postgraduate doctorate degrees and 2 entry-level doctorate degrees. Among these active accredited schools, institutions in the West and East Coast states comprised 77.42% of the national total. California, Florida, and New York represented 41.94%. There were 48 jurisdictions (47 States and the District of Columbia) with acupuncture practice laws in place. States without acupuncture laws included Alabama, Oklahoma and South Dakota. The data suggests that acupuncture profession has steadily grown in the United States.


Assuntos
Terapia por Acupuntura/estatística & dados numéricos , Terapias Complementares/educação , Pessoal de Saúde/estatística & dados numéricos , Humanos , Estados Unidos/epidemiologia
19.
J Integr Med ; 16(6): 384-389, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30341023

RESUMO

BACKGROUND: Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse. The study also examines how long the effect of acupuncture lasts in women with vulvodynia. METHODS/DESIGN: The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups 1a and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group (Group 2). Patients in Group 1a will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group 1b will receive acupuncture focused on traditional (distal) meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tenderness and trigger points (Ashi points) are also recorded. All measurements will be recorded at baseline (before the treatment), at the end of each week during treatment and at the end of the 6 weeks. Follow-up will be done 6 weeks following the last treatment. DISCUSSION: Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupuncture focused on distal meridian points for vulvodynia. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03481621. Register: March 29, 2018.


Assuntos
Terapia por Acupuntura , Vulvodinia/terapia , Analgesia por Acupuntura , Adolescente , Adulto , Protocolos Clínicos , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Projetos de Pesquisa , Adulto Jovem
20.
J Integr Med ; 16(1): 1-5, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29397086

RESUMO

In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34,481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27,965) and 2004 (n = 22,671), respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.


Assuntos
Acupuntura/educação , Pessoal de Saúde/legislação & jurisprudência , Licenciamento/legislação & jurisprudência , Escolas para Profissionais de Saúde , Acupuntura/legislação & jurisprudência , Acupuntura/organização & administração , Pessoal de Saúde/educação , Humanos , Escolas para Profissionais de Saúde/legislação & jurisprudência , Estados Unidos , Recursos Humanos
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