Shaftesbury Clinic

11/02/2025

This article from Harvard Medical School examines the science behind and how it triggers an anti-inflammatory response. Here are the key points:

1. ** of Acupuncture**: Researchers identified specific in the hindlimb region (animal model) that are necessary for acupuncture to activate an anti-inflammatory signalling pathway.
2. **Cytokine Storm**: Acupuncture can help manage cytokine storms, a severe response that can be triggered by various factors including COVID-19.
3. **Electroacupuncture**: A modern version of traditional acupuncture using electrical stimulation showed to be effective in reducing cytokine storms in mice by activating the vagal-adrenal axis.
4. **Selective Acupuncture Points**: The study explains why acupuncture in certain body regions (hindlimbs) is effective while other regions (abdomen) are not.
5. **Future Research**: The findings pave the way for future clinical testing of acupuncture in humans and exploring other signalling pathways for treating chronic diseases.

The research aims to advance the scientific understanding of acupuncture and improve its application in treating inflammation-related conditions.

Researchers have discovered neurons needed for acupuncture‘s anti-inflammatory response

11/02/2025

Acupuncture significantly reduces the frequency and severity of migraines compared to sham acupuncture and usual care.

11/02/2025

A small trial enrolled 62 people with RRMS who showed signs of cognitive dysfunction to test the effectiveness of acupuncture on MS symptoms.

18/11/2024

System and

INFO and REFS: https://shaftesburyclinic.com/bladder-issues-condition-resources/

The Research:

Stress and overactive bladder:

A large, multicentre RCT (China: 12 hospitals; n=504) for women with stress incontinence showed that the electroacupuncture group experienced less urine after 6 weeks of treatment, than did the sham control group (Liu et al, 2017). A further systematic review (Zhao 2018; 10 trials; n=794), showed acupuncture (in particular electroacupuncture) as more effective than sham in decreasing nocturia (night-time incontinence), relieving voiding symptoms, decreasing micturition and incontinence , and enhancing quality of life

A small Chinese (n-71) randomised controlled trial for female stress urinary incontinence compared acupuncture plus pelvic floor muscle exercises with the exercises alone. All outcomes improved significantly in both groups, with the total effective rate being higher in the acupuncture group than in the control group, along with improves quality of life scores. A systematic review of treatment of bladder, urge urinary incontinence, and related symptoms (Hartmann et al, 2009; 232 studies) acupuncture was the sole complementary treatment that showed early evidence of benefit.

Forde et al (2016), in a literature review in the International Journal, stated existing studies showed promise for suggesting a role for acupuncture in addressing issues, however there were limitations in the research design, and further well-designed studies should follow to corroborate this.

In other studies, acupuncture treatment significantly reduced the frequency of urinary incontinence compared to a control group (Kim et al, 2008; n=52); a statistically significant difference was found in favour of acupuncture compared to “western” medicine for post-apoplectic urinary issues (Liu et al, 2008); and bladder-specific acupuncture treatments resulted in significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores when compared with placebo acupuncture treatments in a randomised controlled trial (Emmons et al, 2005; n=85).

For Overactive Bladder, Aydoğmuş et al, (2014; RCT; N=82) looked at Urine Nerve Growth Factor (NGF) as a biomarker regarding acupuncture’s effect on bladder function. NGF is a chemical messenger in the body and related to the smooth muscle and urothelium (lining of the urinary tract). Comparing drug treatment solifenacin with acupuncture in two groups, they concluded that “In patients with OAB in whom anticholinergic treatment is contraindicated, acupuncture may be considered another treatment option.” NGF has been shown in a number of studies, to be mediated, normalised by acupuncture.

Acupuncture on the sacral vertebrae (spinal area at the sacrum); the area where nerves suppling the bladder emerge; has been shown to suppress bladder activity, as well as to suppress activity in the areas of the brainstem related to micturition (urination), this in turn could suppress/normalise overactivity of bladder contraction (Wang et al, 2012).

Objective (scientifically measurable) improvements from acupuncture have also been seen in urodynamic studies on females with frequency, urgency and dysuria (Chang, 1988; n=52). Urodynamic studies are medical tests measuring lower urinary tract function. Per Chang in the American Urological Association Journal of Urology : “Our studies indicated that acupuncture could be used as a simple and effective method to treat female patients with frequency, urgency and dysuria”.

More information on acupuncture and the Urinary System is available on out page here

Diabetic neurogenic bladder:

A randomised controlled trial (n=70) compared acupuncture plus the drug methycobal, with the drug alone. The acupuncture plus methycobal group saw significant improvement in the rate of urgency of urination, frequency of micturition, dribbling urination, urinary incontinence and dysuria, than did the drug alone group. A combined approach was therefore advocated, with acupuncture improving the drug action (Tian et al, 2007)

Post-Stroke:

Acupuncture has been tentatively shown to have positive results for urinary incontinence post-stroke in a systematic review (Thomas, 2008; n=724 from 12 trials, of which 3 were acupuncture trials), although further trials for acupuncture in this field are warranted, due to the low number and quality of the research studies available at the time of the review. A randomised controlled trial (n=58) found the moxibustion group (an acupuncture adjunct treatment) had greater improvement in urinary symptoms than the control group (Yun et al, 2007). In a large study in Taiwan, stroke patients in hospital who received acupuncture treatment experienced a lower incidence of urinary tract infections than did those who didn’t receive acupuncture (Yang et al, 2019)

Bed-wetting in children:

There was some evidence from a systematic review (Bower et al, 2005; 11 studies), that acupuncture could be useful for nocturnal enuresis (bed-wetting) in children when used in conjunction with other treatment, although further trials are warranted due to the low methodological quality of the research studies available at the time.

Post Hysterectomy:

A randomised controlled trial (n=110) examined electroacupuncture on recovery of urinary bladder function after radical hysterectomy. The electroacupuncture group experienced faster improvement of recovery of bladder function, greater improvement of dynamic indexes, fewer days in hospital after surgery and a reduced likelihood of bladder infection than did the control group.

Urinary tract infection (cystitis):

A randomised controlled trial (Qin et al, 2020; n=341) found acupuncture appeared to be beneficial for treatment and prevention of recurrent UTIs, but also noted limitations in the current evidence. The researchers noted the increasing problem of antibiotic resistance, meant such research becomes increasingly important in the overall approach.

From the guidelines The Society of Obstetricians and Gynaecologists of Canada: “Acupuncture may be considered as an alternative in the prevention of recurrent urinary tract infections in women who are unresponsive to or intolerant of antibiotic prophylaxis.” (Epp and Larochelle, 2017).

Alraek et al (2002) concluded from their small RCT (n=100): “our results, as well as previous findings, indicate that acupuncture treatment may be effective in preventing recurrent lower UTIs in healthy adult women.” This echoed the small Norweigan study (N=67) which concluded that acupuncture seems a worthwhile alternative approach in the prevention of recurring lower UTI in women (Aune et al, 1998).

Prostatitis related bladder symptoms:

Pan et al (2023) in the Journal of Pain Research and Management, looked at the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), a complex male dysfunction that affects the quality of life. They compared acupuncture with western medicine and sham acupuncture in high quality randomized controlled trials (RCTs). Outcome measures included pain score, urinary symptom score, NIH-CPSI (prostatitis symptom score), quality of life score, and efficacy rate. Acupuncture was found superior to western medicine and sham acupuncture in improving all outcome measures. This was a relatively small review (10 RCTs; n=798) and the team called for further future research, to supplement the evidence body.

In a review of the literature, acupuncture was found to be beneficial in reducing the symptoms of prostatitis, including urinary symptoms (Franco et al, 2019).

Full References and more information including mechanisms of action, see the above link.

17/11/2024

: “Subsequent Reverses the Aftereffects of Intermittent Theta-Burst Stimulation”

https://www.frontiersin.org/articles/10.3389/fncir.2021.675365/full

16/11/2024

and , research and resources:

https://shaftesburyclinic.com/asthma-condition-resources/

There is some evidence from trials to suggest acupuncture may be a useful adjunct to usual care, be beneficial over placebo and can improve quality of life and be cost effective in asthma (Karlson & Bennicke, 2013; Chu et al 2007; Rheinhold et al, 2014).

Some systematic reviews have been carried out into acupuncture in this area, with the most recent looking at 11 trials, found that many were only small trials and that more research would be needed (Martin et al, 2002) and a Cochrane meta-analysis a year later (McCarney et al, 2003) looked at 12 studies (n=350) drew a similar conclusion. More recently Chen et al, (2020) proposed a protocol for a new systematic review and meta analysis of the research, as they noted that an increasing amount of research trials have been done in this area in recent years, warranting a further, large and structured review.

Pang et al (2023) carried out a systematic review and meta-analysis of 16 RCTs to evaluate the effectiveness of acupuncture for treatment of asthma in adults. Acupuncture was well-tolerated and could improve FEV1% (lung function), Cai’s AQLQ (quality of life in Asthma score)), symptom score, ACT score, and exacerbation frequency compared with sham/placebo acupuncture. However, other lung function and medication use parameters were not statistically significant. The researchers also noted that further studies with appropriate controls, more participants, and high-quality evidence are needed.

Allergic Asthma:

Brinkahus et al, (2017) carried out a large randomised pragmatic trial in Germany (n=1445) giving acupunctrure in addition to usual care for allergic asthma, and comparing to a usual care alone group. They found symptomatic improvement, as well as improvement in quality of life (asthma quality of life questionnaire – AQLQ) measures for the acupuncture group.

Mechanisms of action:

In the condition of allergic asthma, inflammatory considerations may play a key part in the process. Acupuncture has been shown to have anti-inflammatory effects, and a review article (Kavoussi & Ross, 2007) suggests this may be due to activation of the vagus nerve, alongside deactivation of inflammatory macrophages and other proinflammatory cytokines which have been seen in studies.

Other studies (Zijlstra et al, 2003) suggest some of the anti-inflammatory effects exhibited in acupuncture may be due to stimulation of vasodilators, neurotransmitters and painkillers (beta-endorphins, CGRP and substance P) within the body when acupuncture is applied, and these further stimulate cytokines and nitric oxide, all of which play roles in inflammatory states.

Zijlstra et al (2003) reviewed the effects and mechanisms of acupuncture in treating various inflammatory diseases and conditions. They proposed the mechanisms of action:

Acupuncture may release neuropeptides from nerve endings that have vasodilative and anti-inflammatory effects through CGRP.
Acupuncture may also interact with substance P, which is involved in pain transmission and inflammation.
Acupuncture may influence the balance between cell-specific pro-inflammatory and anti-inflammatory cytokines such as TNF-α and IL-10.
Wang et al (2023) reviewed evidence from animal and human studies regarding the immunomodulatory mechanism of acupuncture, regarding its effects on different components of the immune system, such as mast cells, macrophages, neutrophils, natural killer cells, astrocytes, microglia, CD4+ and CD8+ T cells, and cytokines. They detailed the neuroanatomical mechanisms of acupuncture in immunomodulation, such as the vagal-adrenal pathway, the cholinergic anti-inflammatory pathway, the spinal sympathetic pathway, the brain-gut axis, and the hypothalamus-pituitary-adrenal axis. They concluded that studies to support the role of acupuncture in regulating inflammation, infection, allergy, pain, and tissue repair.

Per MacDonald et al (2015), acupuncture may: reduce inflammation by downregulating proinflammatory neuropeptides, cytokines, and neurotrophins; modulate immune function by altering the balance of Th1 and Th2 cells and suppressing mast cell degranulation; influence various receptors and signalling pathways that are involved in inflammatory response, such as TRPV1, opioid, chemokine, dopamine, and cannabinoid receptors; activate a novel cholinergic anti-inflammatory pathway that involves vagal and sciatic nerves and is mediated by dopamine.

For full references and more information and studies, as well as mechanisms of action. follow the link above

15/11/2024

“ improves the emotion domain and lipid profiles in women with : a secondary analysis of an ”
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1237260/full

14/11/2024

and

INFO: https://shaftesburyclinic.com/irritable-bowel-syndrome-ibs-condition-resources/

MacPherson et al (2017; n=116) in a follow up two years after their RCT acupuncture for IBS, finding a favourable result 24 months on. Another RCT for diarrhoea type IBS (Zheng et al, 2016; n=448) found the acupuncture group found a level of improvement in line with that of the group assigned pharmacological (Loperamide) intervention in terms of reducing stool frequency.

Zhu et al (2018a) conducted a network meta-analysis of diarrhoea type IBS, with 29 studies (n=9369) entailed in it, finding that acupuncture may improve symptoms, but that further high quality research was needed to corroborate the overall results. A meta analysis of diarrhoea predominant IBS (Deng et al, 2017) looked at 17 trials (n=1333), finding improvement in clinical symptoms in the acupuncture groups. Similar trends have been seen in the trials for acupuncture in constipation predominant IBS, in a network meta-analysis, in which the quality of the trials was predominantly of high quality (40 trials n=11032; Zhu et al, 2018b).

Qi et al (2022; n=90; pilot, multicentre RCT) examined a potential biological mechanism of action on IBS by reducing “visceral hypersensitivity” and modulating the gut-brain axis. They compared 3 groups: Specific acupuncture (real points); non-specific points; and sham acupuncture, and compared measurements of abdominal pain scores and types of stool. Both the specific and non-specific groups showed meaningful improvement in the IBS-D symptoms from baseline. It’s of note that non-specific real points do nonetheless have an impact, although the verum acupuncture effect is longer lived.

Research is ongoing, and recently, a protocol for a systematic review for anxiety and depression in IBS is awaited with interest (Li et al, 2021a), as is a systematic review of a comparison of acupuncture and pinaverium bromide in IBS (Li et al, 2021b), and a systematic review of acupuncture for adults with IBS-D (Guo et al, 2020). Search terms “acupuncture” + “IBS” + “RCT” + “protocol” since 2021 yield over 80 results, showing there is more to come in this area of growing interest in the very near future.



for full references and more studies and info, see link above

13/11/2024

: " Modulates the Cerebello-Thalamo-Cortical Circuit and Regions in Patients of 's Disease With Tremor"

https://www.frontiersin.org/articles/10.3389/fnagi.2018.00206/full

12/11/2024

for , references and research: https://shaftesburyclinic.com/insomnia-condition-resources/

A randomised controlled trial (n=224) found acupuncture intervention superior to waiting list control for , and the effect continued over 13 weeks, and the treatment was safe with a very low side effect profile (Chung et al, 2018). Another RCT (n=72) using sleep monitors as well as patient questionnaires found varying degrees of sleep improvement and a significant improvement in the Insomnia Severity Index (Yin et al, 2017).

A recent systematic review (Shergis et al, 2016), looked at 30 studies (n=2363 in total), some trials used a medicine for the control group, whereas others used a sham or placebo in comparison to acupuncture. was found superior in both cases, although many of the studies had some risk of bias, meaning that further better designed studies would be needed to corroborate these trends.

There is also promising research for acupuncture in insomnia where this is linked to another condition such as and quality (D**g et al, 2017 – systematic review and meta-analysis for depression-related insomnia); or stroke (Lee et al, 2016 – systematic review and meta-analysis of 13 RCTs for insomnia after stroke).

Mechanisms of action:

Acupuncture is believed to stimulate the nervous system and has been shown to affect the levels of neurotransmitters in the body. Studies have shown effects which may be linked to a an influence on sleep, in particular acupuncture can increase the levels of a number of neurotransmitters and their modulators including a significant increase in melatonin secretion at night-time (Spence et al, 2004; n=18 with a related decrease in anxiety scores).

Acupuncture has also been shown to influence levels of serotonin, noradrenaline, dopamine, GABA and endorphins in mechanism of action studies (e.g. Samuels et al, 2008 – literature review; Zhou et al, 2008 in an animal model); and to increase nitric oxide activity in the brain in an animal model (Gao et al, 2007, n=48 mice). Acupuncture has been shown in mechanism of action studies to downregulate pain and stress reactions in the brain and nervous system and calm the sympathetic nervous system.

For full references and more information, follow the link above.

11/11/2024

🟧 : "Comparative efficacy of -related techniques for mild impairment: A Bayesian network analysis"

https://www.frontiersin.org/articles/10.3389/fmed.2022.904864

10/11/2024

and
Resources and research: https://shaftesburyclinic.com/sciatica-condition-resources/

Sciatica is also known by its medical name , and is where nerves become impinged in the , causing referred
pain and ( -related) symptoms into the areas that nerve supplies, usually buttock and lower limb.

Evidence suggests acupuncture may provide pain relief in sciatica; RCTs such as Wang (2009; n=139) comparing acupuncture and TENS and finding in favour of acupuncture; another finding for acupuncture’s effectiveness along with an increase in pain threshold in the true acupuncture group (Chen et al, 2009; n=90).

Other studies have looked at how the above may come about, for example Inoue et al (2008), in a clinical trial where patients had improvement in pain and nerve symptoms from lower back impingement, and put forward the theory that as seen in animal studies the blood flow in the region of the sciatic nerve was modulated by acupuncture, as well as the well known mechanisms of action of acupuncture in pain relief and inflammation reduction.

A network meta-analysis comparing 21 different therapies for sciatica (Lewis et al, 2015), finding acupuncture the second-best therapy in terms of addressing pain intensity and in terms of overall effect and having a statistically significant effect, leading them to suggest it should be considered as a treatment option.

More info and the References, see the link above.