acupuncture-tcm: November 2009 Archives

Excellent article on diabetes by Clinton J. Choate, L. Ac. published in Acupuncture.com.

November is National Diabetes Month.

Diabetes, Biomedical and TCM Perspectives and Treatments (Part 1)

Part 1 covers the biomedical treatment of diabetes; the nutritional therapy section is helpful.

Diabetes Mellitus From Western and TCM Perspectives - Part 2

Diabetes was discussed in all the earliest ancient TCM tests, including Neijing. According to TCM overconsumption of fatty and greasy food, sweets, emotional disturbances, and a constitution that is too yin is related to developing diabetes. Clinton Choate then analyzes diabetes according to TCM theory, explains treatment according to the Three Burners, giving acupuncture protocol. He explains diabetic complications according to TCM  including cataracts and night blindness, edema, skin infectins, neuropathy and strokes. He describes food remedies for diabetes.

This article is helpful to anyone suffering from diabetes who wants to understand it better, and helpful forTCM practitioners.

Basic TCM Knowledge regarding Osteoarthritis of the Knee In Traditional Chinese Medicine

Osteoarthritis (Degenerative Joint Disease) is mostly related to Fixed Bi and Painful Bi.

Fixed Bi Syndrome: The chief manifestations include pain and heavy sensation in the relatively fixed areas of body limbs or joints, numbness of the muscles, aggravation of the condition in rainy days, white greasy tongue coating, and soft slow pulse.

Painful Bi Syndrome: The chief manifestations include severe pain in the limbs and joints as if being stabbed or pricked. In the worst cases, there is fixed pain that is alleviated by warmth but aggravated by cold, better in the daytime but worse at night, limited movements of the joints, no local redness nor feverish sensation, cold sensation in the affected parts, thin white tongue coating, wiry tense pulse.

Pathogenesis

Wind, cold and dampness invasion causes the blockage of the Qi and blood in the meridian. In modern medicine, it is related to aging, endocrine disorder as well as trauma and improper posture.

Clinical manifestations
 
The onset of osteoarthritis of the knee is insidious. Initially, there is articular stiffness, seldom lasting more than 15 minutes; this develops later into pain on motion of the affected joint(s) and is made worse by activity or weight bearing and relieved by rest. Deformity may be absent or minimal; however, varus deformity of the knee is not unusual.

Imaging

Radiographs may reveal narrowing of the joint space, sharpened articular margin, osteophyte formation and lipping of the marginal bone, and thickened, dense subchondral bone. Bone cysts may also be present.

Major pattern differentiation

Fixed Bi:
Pain fixed in the knee joint accompanied by heaviness, stiffness and numbness, sometimes slight swelling.

Painful Bi:
Severe pain in the knee joint, aggravated by cold and alleviated by heat.

Treatment Principle:
Expel wind, Cold and dampness, improve the meridian circulation and regulate Qi and blood.

Major Acupuncture points and needle techniques

Acupuncture points for knee:
Xiyan (Ex.), Dubi (ST35), Zusanli (ST 36), Yanglingquan (GB 34)

Alternative Therapies:

Auricular therapy
Corresponding area (Knee), Sympathetic, Shenmen


Subcutaneous needling therapy
Select local point or tender points
Seven-star needle tapping and cupping

Read paper on Osteoarthritis of the Knee for Rachel Peterman's Clinical Acupuncture Practice II class at New York College of Traditional Chinese Medicine in Mineola, NY.

She gives an overview of Osteoarthritis of the knee, and Western and TCM treatment approaches.

Rachel H. Peterman, M.S., DHEd(c), J.D.

Osteoarthritis of the Knee.pdf

This author (Rachel Peterman, a student at NYCTCM) believes that the "sham" acupuncture (non-specific needling), would also have the tendency to stimulate Qi (albeit not as effectively as well-placed and executed needling), therefore the acupuncture treatments would appear to provide less clinically significant benefits, as opposed to studies where acupuncture is compared with a "pure" control group.  "Sham" acupuncture is not analogous to placebo.  "Sham" acupuncture is more analogous to giving a half dose of medication.  A drug would not appear to be as efficacious if it was compared to a half-dose, that's why a placebo, with no pharmacologic activity is used as a control in pharmaceutical clinical trials.  A proper control in an acupuncture study would involve no actual needling and consequently no stimulation of Qi. 

It is unclear whether "sham" acupuncture has been implemented in some studies in order to intentionally skew the results of the statistical analysis, or whether it merely reflects an ill-considered and fatally flawed study design.  It is also significant that the study does not provide the exact acupuncture points used in each study, although the authors admit that there was not consistency between the studies.  The usual criterion for meta-analysis is that the studies be identical or extremely close to identical in design.  It is impossible to determine, based upon the information disclosed in this analysis, whether the studies were appropriate for meta-analysis.

For Women With PCOS, Acupuncture And Exercise May Bring Relief, Reduce Risks

By: The American Physiological Society Study finds acupuncture and exercise decrease a key marker for disease

Exercise and electro-acupuncture treatments reduce sympathetic nerve activity in women with polycystic ovarian syndrome (PCOS), according to a new study. The finding is important because women with PCOS often have elevated sympathetic nerve activity, which plays a role in hyperinsulinemia, insulin resistance, obesity and cardiovascular disease. 

The study also found that the electro-acupuncture treatments led to more regular menstrual cycles, reduced testosterone levels and reduced waist circumference.

The full article is reprinted at Acufinder.com

Resource:

Stener-Victorin et al. Low-frequency Electro-Acupuncture and Physical Exercise Decrease High Muscle Sympathetic Nerve Activity in Polycystic Ovary Syndrome. AJP Regulatory Integrative and Comparative Physiology, 2009; DOI: 10.1152/ajpregu.00197.2009

The study has some limitations, including a small sample size, so further research is necessary, the authors wrote. To find the full study, click here