Traditional Chinese medicine diagnoses in persons with ketamine abuse.

OBJECTIVES: To explore the distribution of TCM patterns in ketamine users and the inter-rater reliability of TCM diagnosis among TCM practitioners. METHODS: Eighty-four subjects recruited from substance abuse clinics and non-governmental counseling services catering for ketamine abusers were examined by one or two TCM practitioners. The distribution and inter-rater reliability of the TCM diagnoses between the two TCM practitioners were described and measured. RESULTS: Seven TCM patterns were differentiated. The four most common patterns were the Heart Yin deficiency (29.8%), Kidney Yang deficiency (26.2% Kidney Yin deficiency (19.0%), and Spleen Yang deficiency (14.3%). The agreement between the two TCM practitioners was 59%; the kappa for the three most common patterns was 0.472 (P = 0.003). The proportion of men was lower in the Kidney Yin deficiency group (18.8%), in comparison to the Heart Yin deficiency (60.0%, P = 0.009) and Kidney Yang deficiency group (59.1%, P = 0.013). CONCLUSION: The differences between the TCM groups in terms of the source of referral and number of drug uses other than ketamine were of borderline significance. Further research should focus on validating diagnostic tools and improving inter-rater reliability in TCM to enhance the quality of clinical trials of TCM treatments for ketamine abuse.

Therapeutic effects of acupuncture for neurogenic dysphagia--a randomized controlled trial.

OBJECTIVE: To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia. METHODS: Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture (experimental group) or sham acupuncture (control group 1) for approximately one and a half months. A third group (control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards. The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), as well as by the consistencies of ingested food and fluid. RESULTS: A total of 87 subjects (experimental group, n = 20; control group 1, n = 19; control group 2, n = 48) were recruited into the trial. The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2. The average levels of food and fluid consistencies displayed greater improvement in the experimental group than in the two control groups. CONCLUSIONS: This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia. However, due to an insufficient sample size and the lack of follow-up for control group 2, multi-centre trials employing a larger sample size may be required to draw concrete conclusions.

[Study on safe depth of needling at acupoints of kidney regions based on MRI imaging].

OBJECTIVE: To measure the dangerous depth and the effective safe depth of needling at acupoints of kidney regions based on MRI imaging, and to provide the imaging support for clinical practice. METHODS: The abdominal enhanced T1 MRI imaging of horizontal plane of 61 healthy subjects was included, the anatomical structure of bilateral Weishu (BL 21), Sanjiaoshu (BL 22), Shenshu (BL 23), Weicang (BL 50), Huangmen (BL 51) and Zhishi (BL 52) was analyzed, and the dangerous depth and effective safe depth of perpendicular and oblique needling were measured between the left and right sides and subjects with different body sizes. RESULTS: There were no significant differences between dangerous depth and effective safe depth of perpendicular and oblique needling at bilateral acupoints of kidney region (P>0.05). The dangerous depth and effective safe depth of perpendicular and oblique needling at bilateral acupoints of kidney region in the moderate group were larger than the underweight group (P<0.05), while those in the overweight group were larger than the moderate group and the underweight group (P<0.05). CONCLUSION: The safe depth of needling at acupoints of kidney region is related to body size, for moderate weight and overweight patients, the needling depth could be increased for better efficacy, while for underweight patients, the recommend direction and depth of needling should be restricted to avoid acupuncture accident.