Mitgliederservice Neue Literatur 4. Quartal 2015

Transcription

Deutsche Ärztegesellschaft
Mitglied in
für Akupunktur e.V.
ICMART International Council of Medical
Wissenschaftszentrum
gegr. 1951
Acupuncture and Related Techniques
Sekretariat: Dr. phil. Eszter Füzéki., Goethe-
ECPM European Council of Doctors for Plurality
Universität, Institut für Sportwissenschaften, Abt.
in Medicine
Sportmedizin Ginnheimer Landstr. 39, D-60487
Frankfurt /Main
Hufeland Gesellschaft e.V.
Dachverband
Leitung: Prof. Dr. med. Winfried Banzer,
Stellvertretende Leitung: Dr.med. Johannes
der
Ärztegesellschaften
für
Naturheilkunde und Komplementärmedizin
Tel.: 069/798 24443
EHK Ärztegesellschft für Erfahrungsheilkunde
Fax: 069/798 24592
e.V.
e-mail: wissenschaftszentrum@daegfa.de
Fleckenstein,
DÄGfA Wissenschaftszentrum Goethe-Universität, Institut für Sportwissenschaften, Abt. Sportmedizin Ginnheimer Landstr. 39, D-60487 Frankfurt /Main
Mitgliederservice Neue Literatur 4. Quartal 2015: Aus dem WissZ
Liebes DÄGfA-Mitglied,
Anbei finden Sie eine Übersicht neuer pubmed-gelisteter Literatur mit dem Stichwort Acupuncture aus dem 4. Quartal
2015, gegliedert in folgende Abschnitte:
o
o
o
Meta-Analysen
Systematische Übersichtsarbeiten (SR)
Randomisiert kontrollierte Studien (RCT)
Es handelt sich um eine Auflistung auf der Grundlage der Artikeltypisierung der Meta-Datenbank pubmed.org der
US National Library of Medicine. Es wurden nur Artikel in englischer Sprache berücksichtigt, die an menschlichen
Probanden durchgeführt wurden. Grundlagenarbeiten wurden nicht systematisch gesucht.
Für das WissZ, 12. Mai 2016
Prof. Dr. Dr. Winfried Banzer
Dr. Johannes Fleckenstein
Leitung
Stellv. Leitung
Deutsche Apotheker- und Ärztebank e.G.,
Vorstand:
Kassenwartin:: Hedi Luxenburger
Ehrenpräsidenten:
München
1. Vorsitzender: Dr. med. Wolfram Stör
Schriftführerin: Gabriela Huemer
Dr. med. Walburg Marić-Oehler
BLZ 700 906 06
2. Vorsitzender und Leiter des Fortbildungszentrums:
Sabine Schierl
Dr. med. Jochen Gleditsch
Kt. Nr. 0301007262
PD Dr. med. Dominik Irnich
Dr. med. Roland Krecht
Wissenschaftszentrum der Deutschen Ärztegesellschaft für Akupunktur DÄGfA e.V.
Reine Meta-Analysen: n = 3
Lee, A., Chan, S. K., & Fan, L. T. (2015). Stimulation of the wrist acupuncture point PC6 for preventing
postoperative nausea and vomiting. Cochrane Database Syst Rev, 11, CD003281.
BACKGROUND: Postoperative nausea and vomiting (PONV) are common complications following
surgery and anaesthesia. Antiemetic drugs are only partially effective in preventing PONV. An alternative
approach is to stimulate the PC6 acupoint on the wrist. This is an update of a Cochrane review first
published in 2004, updated in 2009 and now in 2015. OBJECTIVES: To determine the effectiveness and
safety of PC6 acupoint stimulation with or without antiemetic drug versus sham or antiemetic drug for the
prevention of PONV in people undergoing surgery. SEARCH METHODS: We searched the Cochrane
Central Register of Controlled Trials (CENTRAL) (Cochrane Library, Issue 12, 2014), MEDLINE
(January 2008 to December 2014), EMBASE (January 2008 to December 2014), ISI Web of Science
(January 2008 to December 2014), World Health Organization Clinical Trials Registry, ClinicalTrials.gov,
and reference lists of articles to identify additional studies. We applied no language restrictions.
SELECTION CRITERIA: All randomized trials of techniques that stimulated the PC6 acupoint compared
with sham treatment or drug therapy, or combined PC6 acupoint and drug therapy compared to drug
therapy, for the prevention of PONV. Interventions used in these trials included acupuncture, electroacupuncture, transcutaneous electrical acupoint stimulation, transcutaneous nerve stimulation, laser
stimulation, capsicum plaster, acu-stimulation device, and acupressure in people undergoing surgery.
Primary outcomes were the incidences of nausea and vomiting after surgery. Secondary outcomes were
the need for rescue antiemetic therapy and adverse effects. DATA COLLECTION AND ANALYSIS:
Two review authors independently extracted the data and assessed the risk of bias domains for each trial.
We used a random-effects model and reported risk ratio (RR) with associated 95% confidence interval
(95% CI). We used trial sequential analyses to help provide information on when we had reached firm
evidence in cumulative meta-analyses of the primary outcomes, based on a 30% risk ratio reduction in
PONV. MAIN RESULTS: We included 59 trials involving 7667 participants. We rated two trials at low
risk of bias in all domains (selection, attrition, reporting, blinding and other). We rated 25 trials at high
risk in one or more risk-of-bias domains. Compared with sham treatment, PC6 acupoint stimulation
significantly reduced the incidence of nausea (RR 0.68, 95% CI 0.60 to 0.77; 40 trials, 4742 participants),
vomiting (RR 0.60, 95% CI 0.51 to 0.71; 45 trials, 5147 participants) and the need for rescue antiemetics
(RR 0.64, 95% CI 0.55 to 0.73; 39 trials, 4622 participants). As heterogeneity among trials was substantial
and there were study limitations, we rated the quality of evidence as low. Using trial sequential analysis,
the required information size and boundary for benefit were reached for both primary outcomes.PC6
acupoint stimulation was compared with six different types of antiemetic drugs (metoclopramide,
cyclizine, prochlorperazine, droperidol. ondansetron and dexamethasone). There was no difference
between PC6 acupoint stimulation and antiemetic drugs in the incidence of nausea (RR 0.91, 95% CI 0.75
to 1.10; 14 trials, 1332 participants), vomiting (RR 0.93, 95% CI 0.74 to 1.17; 19 trials, 1708 participants),
or the need for rescue antiemetics (RR 0.87, 95% CI 0.65 to 1.16; 9 trials, 895 participants). We rated the
quality of evidence as moderate, due to the study limitations. Using trial sequential analyses, the futility
boundary was crossed before the required information size was surpassed for both primary
outcomes.Compared to antiemetic drugs, the combination of PC6 acupoint stimulation and antiemetic
therapy reduced the incidence of vomiting (RR 0.56, 95% CI 0.35 to 0.91; 9 trials, 687 participants) but
not nausea (RR 0.79, 95% CI 0.55 to 1.13; 8 trials, 642 participants). We rated the quality of evidence as
very low, due to substantial heterogeneity among trials, study limitations and imprecision. Using trial
sequential analysis, none of the boundaries for benefit, harm or futility were crossed for PONV. The need
for rescue antiemetic was lower in the combination PC6 acupoint stimulation and antiemetic group than
the antiemetic group (RR 0.61, 95% CI 0.44 to 0.86; 5 trials, 419 participants).The side effects associated
with PC6 acupoint stimulation were minor, transient and self-limiting (e.g. skin irritation, blistering,
redness and pain) in 14 trials. Publication bias was not apparent in the contour-enhanced funnel plots.
AUTHORS' CONCLUSIONS: There is low-quality evidence supporting the use of PC6 acupoint
stimulation over sham. Compared to the last update in 2009, no further sham comparison trials are needed.
We found that there is moderate-quality evidence showing no difference between PC6 acupoint
stimulation and antiemetic drugs to prevent PONV. Further PC6 acupoint stimulation versus antiemetic
trials are futile in showing a significant difference, which is a new finding in this update. There is
inconclusive evidence supporting the use of a combined strategy of PC6 acupoint stimulation and
antiemetic drug over drug prophylaxis, and further high-quality trials are needed.
http://dx.doi.org/10.1002/14651858.CD003281.pub4
KEY-PAPER 2016: In der Neuauflage des Cochrane-Reviews wurde die Wirksamkeit der Pe6-Stimulation bei
postoperativer Übelkeit und Erbrechen weiter bestätigt. Die Stimulation ist gleichwertig der Gabe konventioneller
Antiemetika. Dieses Review zeigt eindrucksvoll wie die konstante Erforschung einer Indikation mit qualitativ
hochwertigen Studien (in design und Methodik) die Gültigkeit der Aussagen festigt. Nicht umsonst wurde die Pe6Akupunktur als Behandlungsoption in das PONV Portfolio der Society of Ambulatory Anaesthesia aufgenommen.
Mulla, S. M., Wang, L., Khokhar, R., Izhar, Z., Agarwal, A., Couban, R., . . . Busse, J. W. (2015). Management of
Central Poststroke Pain: Systematic Review of Randomized Controlled Trials. Stroke, 46(10), 28532860.
BACKGROUND AND PURPOSE: Central poststroke pain is a chronic neuropathic disorder that
follows a stroke. Current research on its management is limited, and no review has evaluated all therapies
for central poststroke pain. METHODS: We conducted a systematic review of randomized controlled
trials to evaluate therapies for central poststroke pain. We identified eligible trials, in any language, by
systematic searches of AMED, CENTRAL, CINAHL, DARE, EMBASE, HealthSTAR, MEDLINE, and
PsychINFO. Eligible trials (1) enrolled >/=10 patients with central poststroke pain; (2) randomly assigned
them to an active therapy or a control arm; and (3) collected outcome data>/=14 days after treatment. Pairs
of reviewers, independently and in duplicate, screened titles and abstracts of identified citations, reviewed
full texts of potentially eligible trials, and extracted information from eligible studies. We used a modified
Cochrane tool to evaluate risk of bias of eligible studies, and collected patient-important outcomes
according to recommendations by the Initiative on Methods, Measurement, and Pain Assessment in
Clinical Trials. We conducted, when possible, random effects meta-analyses, and evaluated our certainty
in treatment effects using the Grading of Recommendations Assessment, Development, and Evaluation
System. RESULTS: Eight eligible English language randomized controlled trials (459 patients) tested
anticonvulsants, an antidepressant, an opioid antagonist, repetitive transcranial magnetic stimulation, and
acupuncture. Results suggested that all therapies had little to no effect on pain and other patient-important
outcomes. Our certainty in the treatment estimates ranged from very low to low. CONCLUSIONS: Our
findings are inconsistent with major clinical practice guidelines; the available evidence suggests no
beneficial effects of any therapies that researchers have evaluated in randomized controlled trials.
http://dx.doi.org/10.1161/STROKEAHA.115.010259
Akupunktur findet erstmals Erwähnung in einem übergeordneten Review zur Behandlung des Schlaganfalls.
Jedoch ist die Aussage bisheriger Studien begrenzt und es lässt sich keine Empfehlung für die Akupunktur
aussprechen.
Ren, Y., Zhu, C., Wu, J., Zheng, R., & Cao, H. (2015). Comparison between herbal medicine and fluoxetine for
depression: a systematic review of randomized controlled trials. Complement Ther Med, 23(5), 674684.
OBJECTIVE: To evaluate the effectiveness and safety of Chinese herbal medicine (CHM) versus
fluoxetine on depression. DESIGN: A systematic review of randomized controlled trials (RCTs).
METHODS: RCT with two parallel groups that compared CHM and fluoxetine on treatment of depression
with reported decreased Hamilton Depression Scale (HAMD) and adverse events during treatment were
included after searching through six electric-databases. The methodological quality of RCTs was assessed
according to the Cochrane risk of bias tool. Meta-analysis was conducted using RevMan 5.3 software with
pooled mean difference (MD) or risk ratio (RR) and their 95% confidence interval (CI) if no significant
heterogeneity was detected. A SOF table was generated using GRADEPro software to evaluate the overall
quality of the evidence. RESULTS: Twenty-six trials with 3294 participants were included in the review.
Most of them had high risk of bias during conducting and reporting. The results achieved weak evidence
which showed CHM had similar effect to fluoxetine (20mg/day) on relieving depression according to
HAMD assessment (for primary depression: MD=-0.08, 95%CI -0.98-0.82; for secondary depression:
MD=-0.36, 95%CI -1.55-0.83), but fewer incidences of adverse events than the drug (for primary
depression: RR=0.31, 95%CI 0.17-0.59; for post-stroke depression: RR=0.04, 95%CI 0.00-0.25). No
serious adverse event was found in neither CHM nor fluoxetine group. CONCLUSIONS: Due to the poor
quality of included trials and the potential publication bias of this review, no confirmed conclusion could
be draw to evaluate the effectiveness and safety of CHM for depression compared with fluoxetine.
http://dx.doi.org/10.1016/j.ctim.2015.07.002
Die Meta-Analyse über knapp 3900 Patienten zeigt, dass Chinesische Arzneitherapie ähnliche Wirkeffekte wie die
Einnahme von 20 mg Fluoxetin täglich in der Behandlung von Depressionen erzielt. Die Zahl der Nebenwirkungen
ist reduziert. Die Qualität der gefunden Studien ist verbesserungswürdig.
Systematische Übersichtsarbeiten: n = 27
Abaraogu, U. O., & Tabansi-Ochuogu, C. S. (2015). As Acupressure Decreases Pain, Acupuncture May
Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic
Review with Meta-Analysis. J Acupunct Meridian Stud, 8(5), 220-228.
http://dx.doi.org/10.1016/j.jams.2015.06.010
Systematische Übersichtsarbeit (8 Studien), die zeigt dass Akupunktur das psychische und physische Befinden bei
primärer Dysmenorrhö lindert, und eine Akupunkturpunktmassage den Schmerz reduzieren vermag.
Au, D. W., Tsang, H. W., Ling, P. P., Leung, C. H., Ip, P. K., & Cheung, W. M. (2015). Effects of acupressure on
anxiety: a systematic review and meta-analysis. Acupunct Med, 33(5), 353-359.
http://dx.doi.org/10.1136/acupmed-2014-010720
Systematische Übersichtsarbeit (7 Studien), die zeigt dass eine Akupunkturpunktmassage Nervosität und
Anspannung besser als eine Scheinbehandlung zu lindern vermag (mittlere Effektstärke).
Bae, K., Yoo, H. S., Lamoury, G., Boyle, F., Rosenthal, D. S., & Oh, B. (2015). Acupuncture for Aromatase
Inhibitor-Induced Arthralgia: A Systematic Review. Integr Cancer Ther, 14(6), 496-502.
http://dx.doi.org/10.1177/1534735415596573
Systematische Übersichtsarbeit (4 Studien), die zeigt dass Akupunktur in der Linderung durch
Aromataseinhibitoren verursachten Arthralgien erfolgreich sein kann, weitere Studien aber für ein präziseres Urteil
nötig sind.
Boyles, R., Fowler, R., Ramsey, D., & Burrows, E. (2015). Effectiveness of trigger point dry needling for
multiple body regions: a systematic review. J Man Manip Ther, 23(5), 276-293.
http://dx.doi.org/10.1179/2042618615y.0000000014
Systematische Übersichtsarbeit (19 qualitativ hochwertige Studien), die zeigt dass eine Triggerpunktakupunktur
(dry needling) von myofaszialen Triggerpunkten verschiedener Körperregionen sowohl myofasziale Schmerzen
lindert als auch die Bewegung und Funktionalität verbessert.
Garcia, M. K., Graham-Getty, L., Haddad, R., Li, Y., McQuade, J., Lee, R. T., . . . Cohen, L. (2015). Systematic
review of acupuncture to control hot flashes in cancer patients. Cancer, 121(22), 3948-3958.
http://dx.doi.org/10.1002/cncr.29630
Systematische Übersichtsarbeit (8 Studien), die bei der gegenwärtigen Studienlage nicht klar entscheiden kann, ob
Akupunktur zur Linderung von Hitzewallungen bei onkologischen Patienten im Vergleich zu einer
Scheinakupunktur besser geeignet ist. Alle gefundenen Studien zeigten innerhalb der Verum-Akupunkturgruppen
signifikante Verbesserungen.
Gutke, A., Betten, C., Degerskar, K., Pousette, S., & Olsen, M. F. (2015). Treatments for pregnancy-related
lumbopelvic pain: a systematic review of physiotherapy modalities. Acta Obstet Gynecol Scand,
94(11), 1156-1167.
http://dx.doi.org/10.1111/aogs.12681
Systematische Übersichtsarbeit (vage gehaltene Suchkriterien), die unter anderem zeigt dass Akupunktur neben
Beckenbändern eine geeignete Intervention bei schwangerschafts-assoziiertem lumbopelvinen Schmerzen darstellt..
Hackett, K. L., Deane, K. H., Strassheim, V., Deary, V., Rapley, T., Newton, J. L., & Ng, W. F. (2015). A
systematic review of non-pharmacological interventions for primary Sjogren's syndrome.
Rheumatology (Oxford), 54(11), 2025-2032.
http://dx.doi.org/10.1093/rheumatology/kev227
Systematische Übersichtsarbeit (vage gehaltene Suchkriterien), die unter anderem Akupunktur in der Behandlung
des primären Sjogren Syndrom untersucht. Weitere Studien sind für ein finales Statement nötig...
Kim, K. I., Shin, S., Lee, N., Lee, B. J., Lee, J., & Lee, H. (2016). A traditional herbal medication,
Maekmoondong-tang, for cough: A systematic review and meta-analysis. J Ethnopharmacol, 178,
144-154.
http://dx.doi.org/10.1016/j.jep.2015.12.005
Systematische Übersichtsarbeit (9 Studien), die zeigt dass die traditionelle Kräutermixtur Maekmoondong-tang den
Schweregrad von Husten im Vergleich zu konventionellen Antitussiva um 75% reduziert und die Zahl von
Nebenwirkungen sehr gering ist. Dies lässt sich jedoch nicht auf alle Hustenformen übertragen und weitere Studien
sind nötig.
Kim, K. N., Chung, S. Y., & Cho, S. H. (2015). Efficacy of acupuncture treatment for functional dyspepsia: A
systematic review and meta-analysis. Complement Ther Med, 23(6), 759-766.
Systematische Übersichtsarbeit (20 Studien), welche die Wirksamkeit von Akupunktur in der Behandlung der
funktionellen Dyspepsie bestätigt.
Kim, T. H., Kang, J. W., & Park, W. S. (2015). The Reporting Quality of Acupuncture-Related Infections in
Korean Literature: A Systematic Review of Case Studies. Evid Based Complement Alternat Med,
2015, 273409.
http://dx.doi.org/10.1155/2015/273409
Wichtige Systematische Übersichtsarbeit (9 Studien), die zeigt dass die Berichterstattung von angeblich
Akupunktur-assoziierten Infektionen in Korea häufig auf Datensätzen und klinischen Berichten resultieren, die
keine klare Zuordnung ermöglichen. Die beschriebenen Fälle sind daher relativ zu werten.
Li, X. Q., Tao, K. M., Yang, G. L., Zhou, Q. H., & Ling, C. Q. (2016). How do systematic reviews of
acupuncture for pain relief incorporate risk of bias assessments into the synthesis? A
methodological study. Acupunct Med, 34(2), 84-89.
Systematische Übersichtsarbeit (über 85 Systematische Übersichtsarbeiten), die zeigt dass meisten der Reviews
zwar die Risk of Bias (also die potentielle Fehlerqualität) untersuchen, die Ergebnisse jedoch nicht in eine
Gesamtanalyse mit übertragen.
Liu, T., Peng, Y., Zhu, S., Chen, H., Li, F., Hong, P., . . . Zhang, L. (2015). Effect of miniscalpel-needle on
relieving the pain of myofascial pain syndrome: a systematic review. J Tradit Chin Med, 35(6), 613619.
Systematische Übersichtsarbeit (8 Studien), die zeigt dass auch die Anwendung der Mini-Skalpell-Nadel be9i
myofaszialen Schmerzen hilfreich sein kann, größere systematische Studien fehlen jedoch..
Liu, X. L., Tan, J. Y., Molassiotis, A., Suen, L. K., & Shi, Y. (2015). Acupuncture-Point Stimulation for
Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled
Trials. Evid Based Complement Alternat Med, 2015, 657809.
http://dx.doi.org/10.1155/2015/657809
Systematische Übersichtsarbeit sie zeigt dass weiterhin Unklarheit wegen der Anwendung von
Akupunkturtechniken zur postoperativen Schmerztherapie herrschen, generell ordnen die Autoren die Therapien
wie folgt ein:
No serious APS-related adverse effects (AEs) were reported.
Level I evidence for the effectiveness of body points plaster therapy
Level II evidence for body points electroacupuncture (EA), body points acupressure, body points acupoint stimulation (APS) for
abdominal surgery patients, auricular points seed embedding, manual auricular acupuncture, and auricular EA.
Level III evidence for body points APS in patients who underwent cardiac surgery and cesarean section and for auricular-point
stimulation in patients who underwent abdominal surgery. Wissenschaftszentrum der Deutschen Ärztegesellschaft für Akupunktur DÄGfA e.V.
Ma, R., Liu, X., Clark, J., Williams, G. M., & Doi, S. A. (2015). The Impact of Acupuncture on Neurological
Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis. J Neurotrauma, 32(24),
1943-1957.
http://dx.doi.org/10.1089/neu.2014.3866
Systematische Übersichtsarbeit (12 Studien), welche der Akupunktur eine generelle Wirksamkeit in der
neurologischen Rehabilitation nach Rückenmarksverletzung zuschreibt (beinhaltet motorische und funktionelle
Rekonstitution), die Qualität der Studien jedoch teilweise sehr schwach ist.
Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A
Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2015, 425108.
http://dx.doi.org/10.1155/2015/425108
Systematische Übersichtsarbeit (11 Studien), welche die Akupunktur in der Behandlung von Ischias als wirksam
beschreibt, die Effekte über den von Medikamenten einordnet, sowie beschreibt dass Akupunktur
Medikamentenwirkungen zu verstärken vermag. Weiter Studien sind nötig
Tan, H. Y., Lenon, G. B., Zhang, A. L., & Xue, C. C. (2015). Efficacy of acupuncture in the management of
atopic dermatitis: a systematic review. Clin Exp Dermatol, 40(7), 711-715; quiz 715-716.
http://dx.doi.org/10.1111/ced.12732
Systematische Übersichtsarbeit (0 Studien), die keine Untersuchung hinsichtlich Akupunktur und atopischer
Dermatitis fand, die den Einschlusskriterien genügte. Es gibt jedoch eine Vielzahl an Studien die die potentiell
antiinflammatorischen und juckreizlindernden Wirkungen der Akupunktur beschreiben.
Tang, H., Fan, H., Chen, J., Yang, M., Yi, X., Dai, G., . . . Liang, F. (2015). Acupuncture for Lateral
Epicondylitis: A Systematic Review. Evid Based Complement Alternat Med, 2015, 861849.
http://dx.doi.org/10.1155/2015/861849
Systematische Übersichtsarbeit (4 Studien), die Wirkeffekte der Akupunktur auf den lateralen Ellenbogenschmerz
zeigen kann, jedoch aufgrund der geringen Zahl aussagekräftiger Studien nur bedingt beweiskräftig ist..
Tao, W., Luo, X., Cui, B., Liang, D., Wang, C., Duan, Y., . . . Liu, Q. (2015). Practice of traditional Chinese
medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic
review and meta-analysis. Oncotarget, 6(37), 39725-39739.
http://dx.doi.org/10.18632/oncotarget.5388
Systematische Übersichtsarbeit die den potentiellen Nutzen von psychologischen Verhaltensinterventionen auf der
Basis Chinesischer Medizin bei onkologischen Patienten diskutiert.
van der Velde, G., Yu, H., Paulden, M., Cote, P., Varatharajan, S., Shearer, H. M., . . . Taylor-Vaisey, A. (2015).
Which interventions are cost-effective for the management of whiplash-associated and neck painassociated disorders? A systematic review of the health economic literature by the Ontario Protocol
for Traffic Injury Management (OPTIMa) Collaboration. Spine J.
http://dx.doi.org/10.1016/j.spinee.2015.08.025
Systematische Übersichtsarbeit (6 Studien), wdie zeigt das multimodale Therapiekonzepte (auch Akupunktur
beinhaltende) in der Therapie des von Schleudertrauma-assoziierten Problemen kosteneffektiv sind. .
Verghese, T. S., Riordain, R. N., Champaneria, R., & Latthe, P. M. (2015). Complementary therapies for
bladder pain syndrome: a systematic review. Int Urogynecol J.
http://dx.doi.org/10.1007/s00192-015-2886-3
Systematische Übersichtsarbeit (11 Studien), neben der Akupunktur sind eine diätetische Ernährung und
Physiotherapie wirksame Maßnahmen in der Therapie von chronischen Blasenschmerzen, auf der Grundlage
kleinerer und schwächerer Studien.
Woitzik, E., Jacobs, C., Wong, J. J., Cote, P., Shearer, H. M., Randhawa, K., . . . Carroll, L. J. (2015). The
effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle,
and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa)
Collaboration. Man Ther, 20(5), 633-645.
http://dx.doi.org/10.1016/j.math.2015.03.012
Systematische Übersichtsarbeit (10 Studien), welche eigentlich die Wirksamkeit von Training bei Verletzungen
von Fuß und Sprunggelenk untersucht. In der Aussage kommt die Auswertung darauf, dass exzentrische Übungen
zwar wirksam, aber weniger wirksam als Akupunktur bei der Achillessehnen Tendinopathie sind.
Wong Lit Wan, D., Wang, Y., Xue, C. C., Wang, L. P., Liang, F. R., & Zheng, Z. (2015). Local and distant
acupuncture points stimulation for chronic musculoskeletal pain: A systematic review on the
comparative effects. Eur J Pain, 19(9), 1232-1247.
http://dx.doi.org/10.1002/ejp.671
Systematische Übersichtsarbeit (19 Studien), welche zeigt, dass die Behandlung lokaler Ah Shi Punkte der
Behandlung lokaler Akupunkturpunkte bei chronischen muskuloskelettalen Scvhmerzen überlegen ist. Klassische
Nah- und Fernpunkte erreichen ein gleiches Maß an Analgesie. eine Kombination aus beiden unter Verwendnung
von Ah-Shi Punkten ist daher zu empfehlen.
Wu, X., Chung, V. C., Hui, E. P., Ziea, E. T., Ng, B. F., Ho, R. S., . . . Wu, J. C. (2015). Effectiveness of
acupuncture and related therapies for palliative care of cancer: overview of systematic reviews. Sci
Rep, 5, 16776.
http://dx.doi.org/10.1038/srep16776
Systematische Übersichtsarbeit (über 23 systematische Übersichtsarbeiten), die zeigt dass gegenwärtig keine klare
Aussage (Pro oder Contra) zum Potential der Akupunktur in der Behandlung tumor-assoziierter Symptome wie
Xerostomie, Dyspnoe, Lymphödem oder der Verbesserung der psychologischen Gesundheit zu machen sind.
Akupunktur ist eine nebenwirkungsarme Therapie, daher ist Akupunktur stets als Ergänzung von Symptomen
geeignet.
Xin, Z., Xue-Ting, L., & De-Ying, K. (2015). GRADE in Systematic Reviews of Acupuncture for Stroke
Rehabilitation: Recommendations based on High-Quality Evidence. Sci Rep, 5, 16582.
http://dx.doi.org/10.1038/srep16582
Systematische Übersichtsarbeit (19 Studien), welche zeigt, dass die Behandlung lokaler Ah Shi Punkte der
Behandlung lokaler Akupunkturpunkte bei chronischen muskuloskelettalen Scvhmerzen überlegen ist. Klassische
Nah- und Fernpunkte erreichen ein gleiches Maß an Analgesie. eine Kombination aus beiden unter Verwendnung
von Ah-Shi Punkten ist daher zu empfehlen.
Yang, Y., Que, Q., Ye, X., & Zheng, G. H. (2016). Verum versus sham manual acupuncture for migraine: a
systematic review of randomised controlled trials. Acupunct Med, 34(2), 76-83.
Systematische Übersichtsarbeit die die Wikrsamkeit von Akupunktur auf die Verbesserung der neurologischen
Funktion, des Schluckvermögens und der Beeinträchtigung körperlicher Funktionen in der Rehabilitation des
Schlaganfalls untersucht. Jedoch lässt die Qualität der Studien nach den GRADE-Richtlinien nur eine
eingeschränkte Beurteilung zu.
Zhang, C. S., Tan, H. Y., Zhang, G. S., Zhang, A. L., Xue, C. C., & Xie, Y. M. (2015). Placebo Devices as
Effective Control Methods in Acupuncture Clinical Trials: A Systematic Review. PLoS One, 10(11),
e0140825.
http://dx.doi.org/10.1371/journal.pone.0140825
Systematische Übersichtsarbeit (36 Studien),die sich mit den gegenwärtig erwerbbaren Placebo-NAdeln
(Streitberger, Park und Takakura) beschäftigt. Keine dieser Nadeln stellt ein inertes Placebo dar. Die Takakura
Randomisiert kontrollierte Studien: n = 16
Bosch, P., van den Noort, M., Yeo, S., Lim, S., Coenen, A., & van Luijtelaar, G. (2015). The effect of
acupuncture on mood and working memory in patients with depression and schizophrenia. J Integr
Med, 13(6), 380-390.
BACKGROUND: In patients with depression, as well as in patients with schizophrenia, both mood and
working memory performance are often impaired. Both issues can only be addressed and improved with
medication to some extent. OBJECTIVE: This study investigates the mood and the working memory
performance in patients with depression or schizophrenia and whether acupuncture can improve these.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A pragmatic clinical trial design was
used. The study was conducted in a psychiatric clinic. Fifty patients with depression and 50 with
schizophrenia were randomly divided into an experimental and a waiting-list group. Additionally, 25
healthy control participants were included. Twelve weeks of individualized acupuncture treatment was
used as the clinical intervention. MAIN OUTCOME MEASURES: All patients were tested before (T1)
and after (T2) acupuncture treatment on a mood scale (Beck Depression Inventory-II, BDI-II), a simple
working memory task (digit span), and a complex working memory task (letter-number sequencing); the
healthy controls were tested at T1 only. RESULTS: Patients with depression scored worse than the others
on the BDI-II, and patients with schizophrenia scored worse than the healthy controls. On the digit span,
patients with schizophrenia did not differ from healthy controls whereas they scored worse of all on the
letter-number sequencing. With respect to the acupuncture findings, first, the present study showed that
the use of acupuncture to treat patients with schizophrenia was both practical and safe. Moreover,
acupuncture had a positive effect on the BDI-II for the depression group, but acupuncture had no effect on
the digit span and on the letter-number sequencing performance for the two clinical groups.
CONCLUSION: The clinical improvement in patients with depression after acupuncture treatment was
not accompanied by any significant change in a simple working memory task or in a more complex
working memory task; the same was true for the patients with schizophrenia. TRIAL REGISTRATION:
Dutch Trial Register NTR3132.
http://dx.doi.org/10.1016/S2095-4964(15)60204-7
Pragmatische Studie an 100 Patienten die Effekte der Akupunktur auf die Befindlichkeit depressiver und
schizophrener Patienten Untersucht. Unter einer Akupunkturbehandlung traten keine relevanten Nebenwirkungen
auf, jedoch konnten nur depressive Patienten bezüglich des Symptoms „Empfindlichkeit“ profitieren.
Fan, Y., & Wu, Y. (2015). Effect of electroacupuncture on muscle state and infrared thermogram changes in
patients with acute lumbar muscle sprain. J Tradit Chin Med, 35(5), 499-506.
OBJECTIVE: To observe the effect of electroacupuncture (EA) on force-displacement value (FDV) of
muscle state and the temperature index of infrared thermogram in patients with acute lumbar muscle
sprain. METHODS: Patients with acute lumbar muscle sprain were randomly divided into a medication
group and an EA group. The medication group (n = 60) were treated with diclofenac sodium dual release
enteric-coated capsules, 75 mg per day for 7 days. The EA group (n = 60) received EA at bilateral Houxi
(SI 3), Jiaji (EX-B2), and Ashi points, at 20-30 mm depth and 10-25 Hz frequency for 20 min daily for 7
days. Muscle states were determined by measuring FDVs of the bilateral lumbar muscle with a
Myotonometer fast muscle state detector. The temperature index of the lumbar skin was measured before
and after treatment with a Fluke Ti30 non-refrigerated focal plane infrared thermal imaging detector.
RESULTS: There were no significant pre-treatment differences between the medication group and the EA
group in mean FDV (P = 0.052) or temperature index of the lumbar skin (P = 0.25). The cure rate was
63.3% in the EA group and 53.3% in the medication group. The total efficacy in the EA group (93.3 %)
was not significantly different from that in the medication group (86.6 %, P = 0.204). After treatment, the
mean FDV of the lumbar muscle significantly increased in both groups (P < 0.05 for both groups); the
FDV increase in the EA group was significantly higher than in the medication group (P = 0.015). The
temperature index was also significantly increased in both groups (P < 0.05 for both groups); the infrared
thermogram in the EA group indicated significantly greater recovery compared to the medication group (P
= 0.026). CONCLUSION: Both EA and diclofenac sodium markedly improved acute lumbar sprain, but
EA better improved the rehabilitation and regeneration of FDVs and temperature index of infrared
thermogram of the muscle.
Elektroakupunktur wirkte ebensogut in der Behandlung von lumbalen Muskelzerrungen (120 Patienten) wie
Diclofenac (75 mg täglich für 7 Tage). Deskriptiv scheint das Ansprechen unter Akupunktur leicht verbessert. Die
Elektroakupunktur wurde an den Punkten Dü3, Ex-B2 und diversen Ahshi-Punkten durchgeführt.
Fang, L., Fang, M., Jiang, S., & Chen, H. (2015). Optimization of parameters of Yi Zhi Chan Tuina
manipulation promotes peripheral circulation. J Tradit Chin Med, 35(5), 558-563.
OBJECTIVE: To explore the most effective parameters of Yi Zhi Chan Tuina manipulation for
improving peripheral blood circulation. METHODS: A total of 45 volunteers were recruited from Pudong
district in Shanghai, China, from October to December 2010, and randomly divided into nine groups using
computer-generated random numbers. Participants received Yi Zhi Chan Tuina manipulation on Chengjin
(BL 56) acupoint; each group received a particular combination of manipulation force and treatment time.
We used a two-factor, three-level factorial design to examine the effects of force and treatment time on
changes in popliteal artery average volume flow, pulsatility index, and vessel diameter to determine the
optimal parameter group. Outcomes were assessed at baseline and after Tuina manipulation by
interviewers blind to treatment group status. RESULTS: After manipulation, two of the nine groups
showed an increase in popliteal artery volume flow. An inter-participants effect test showed that for main
effect of time, F = 0.331, P = 0.720; for main effect of force, F = 2.934, P = 0.066; and for the force-time
interaction effect, F = 1.072, P = 0.385, indicating no interaction between force and time. However, a
pairwise comparison of the three levels of time showed that a treatment time of 10 min was significantly
more effective than that of 2 min (P = 0.024). A pairwise comparison of light force, medium force, and
heavy force showed a statistically significant effect for medium force (P = 0.035). CONCLUSION: Yi Zhi
Chan Tuina manipulation with vertical force of 9.31 N for 10 min is most effective in improving
peripheral circulation.
Um die peripherer Zirkulation zu verbessern sollte die spezielle Form des Xi Zhi Chuan Tuina an Bl56
durchgeführt werden. Kleine Explorative Studie an 45 frewilligen Probanden.
Go, H. Y., Lee, J. A., Park, S., Park, S., Park, J. S., Cheon, C., . . . Lee, S. H. (2015). Comparative effects of
artemisia vulgaris and charcoal moxa stimulating Zhongwan (CV 12) on body temperature in
healthy participants: a cross-over single-blind randomized study. J Tradit Chin Med, 35(5), 551-557.
OBJECTIVE: To evaluate the efficacy, safety, satisfaction, discomfort and patient preference of moxa
cones of artemisia vulgaris and charcoal moxa. METHODS: This comparative study of moxibustion
treatment with Artemisia vulgaris and charcoal moxa cone stimulating Zhongwan (CV 12) is a cross-over
single-blinded, randomized clinical trial. A total of 40 healthy subjects (24 males and 16 females)
participated in this study. Two subjects dropped out of the trial. Thirty-eight subjects were treated with
Artemisia vulgaris and charcoal moxa cones for 30 min in a cross-over design. After treatment, the
patients underwent a 30 minute waiting period, and then the temperatures at Tanzhong (CV 17),
Zhongwan (CV 12) and Guanyuan (CV 4) were measured using digital infrared thermal imaging.
RESULTS: After the use of Artemisia vulgaris moxa, the patients' body temperatures were slightly
lowered at Tanzhong (CV 17), Zhongwan (CV 12) and Guanyuan (CV 4), but the changes were not
statistically significant. After the use of charcoal moxa, the patients' body temperatures were somewhat
increased at Zhongwan (CV 12) and Guanyuan (CV 4), but the changes were not statistically significant.
After Artemisia vulgaris moxa use, the body temperature difference between Zhongwan (CV 12) and
Guanyuan (CV 4) was significantly increased. After charcoal moxa use, the body temperature difference
between Tanzhong (CV 17) and Zhongwan (CV 12) was significantly decreased in males and in the whole
group. This change was caused by the difference in the moxibustion type and by gender differences.
CONCLUSION: This pilot study found that moxibustion did not raise the body temperature, but
temperature differences between acupoints were affected. Further large-scale randomized controlled trials
are needed for the effect of moxibustion on body temperature.
Kleine explorative Studie an 40 Probanden. Moxibustion mit verschiedenen Wärmequellen an KG12 führt zu
keiner nennenswerten Veränderung der Körpertemperatur, jedoch zu unterschiedlichen Temperaturänderungen an
anderen Akupunkturpunkten (KG4, KG17).
Liu, Y., Feng, H., Mo, Y., Gao, J., Mao, H., Song, M., . . . Liu, W. (2015). Effect of soothing-liver and
nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset for
depressive disorder and related indicators of neuroimmunology: a randomized controlled clinical
trial. J Tradit Chin Med, 35(5), 507-513.
OBJECTIVE: To observe the effect of soothing-liver and nourishing-heart acupuncture on selective
serotonin reuptake inhibitor (SSRIs) treatment effect onset in patients with depressive disorder and related
indicators of neuroimmunology. METHODS: Overall, 126 patients with depressive disorder were
randomly divided into a medicine and acupuncture-medicine group using a random number table. Patients
were treated for 6 consecutive weeks. The two groups were evaluated by the Montgomery-Asberg
Depression Rating Scale (MADRS) and Side Effects Rating Scale (SERS) to assess the effect of the
soothing-liver and nourishing-heart acupuncture method on early onset of SSRI treatment effect. Changes
in serum 5-hydroxytryptamine (5-HT) and inflammatory cytokines before and after treatment were
recorded and compared between the medicine group and the acupuncture-medicine group. RESULTS: The
acupuncture-medicine group had significantly lower MADRS scores at weeks 1, 2, 4, and 6 after treatment
compared with the medicine group (P < 0.01). The acupuncture group had significantly lower SERS
scores at weeks 1, 2, 4, and 6 after treatment compared with the medicine group (P < 0.01). At 6 weeks
after treatment, serum 5-HT in the acupuncture-medicine group was significantly higher compared with
the medicine group (P < 0.01). Interleukin-6 (IL-6) in the acupuncture-medicine group was significantly
lower than that in the medicine group (P < 0.01), whereas there was no significant difference in IL-1beta
between the groups (P > 0.05). Anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in
the acupuncture-medicine group compared with the medicine group (P < 0.01, P < 0.05, respectively).
CONCLUSION: The soothing-liver and nourishing-heart acupuncture method can effectively accelerate
the onset of SSRI effects when treating depressive disorder and can significantly reduce the adverse
reactions of SSRIs. Moreover, acupuncture can enhance serum 5-HT and regulate the balance of proinflammatory cytokines and anti-inflammatory cytokines.
Die Kombination aus Leber besänftigender und Herz nährender Akupunktur an 126 depressiven Patienten zeigte
sich gegenüber einer konventionellen Behandlungsgruppen überlegen in der Reduktion der Symptomatik und dem
Auftreten von Nebenwirkungen. Eindrucksvoll ist ein signifikanter Anstieg von 5-HAT (Serotonin) im Serum nach
6 Wochen sowie von anti-inflammatorischen Zytokinen.
Liu, Y., Park, J. E., Shin, K. M., Lee, M., Jung, H. J., Kim, A. R., . . . Choi, S. M. (2015). Acupuncture lowers
blood pressure in mild hypertension patients: a randomized, controlled, assessor-blinded pilot trial.
Complement Ther Med, 23(5), 658-665.
OBJECTIVES: To preliminarily assess the effects of acupuncture on prehypertension and stage I
hypertension, and to provide data for further research. DESIGN: A randomized, controlled, assessorblinded study with an 8-week intervention period and a 4-week follow-up. INTERVENTIONS:
Participants were patients with systolic blood pressure (SBP) of 120-159mmHg or diastolic blood pressure
(DBP) of 80-99mmHg.Thirty participants were allocated to acupuncture group or untreated control group
at a 1:1 ratio. The acupuncture group received standard acupuncture twice weekly for 8 weeks, and was
followed-up for 4 weeks after treatment; the control group did not receive any type of anti-hypertensive
treatment for 12 weeks. MAIN OUTCOME MEASURES: Primary outcome measure was SBP and DBP
at post-treatment. The secondary outcomes were SBP and DBP at follow-up; Euro Quality of life (EQ5D), heart rate variability (HRV), body mass index (BMI), and blood lipid profile. RESULTS: DBP (5.7mmHg; P=0.025), but not SBP (-6.0mmHg; P=0.123), was significantly different between groups at
post-treatment. Both DBP (-7.8mmHg; P=0.004) and SBP (-8.6mmHg; P=0.031) were significantly
different at follow-up. Among the HRV indices, only high frequency power was significantly different
between groups at weeks 4 and 8 (P=0.047 and P=0.030, respectively). There were no differences between
groups in EQ-5D, BMI or lipid profile. CONCLUSION: The results of this study show that acupuncture
might lower blood pressure in prehypertension and stage I hypertension, and further RCT need 97
participants in each group. The effect of acupuncture on prehypertension and mild hypertension should be
confirmed in larger studies. TRIAL REGISTRATION: KCT0000496.
Pilotstudie mit 30 hypertensiven Patienten (milde Hypertonie), die zeigt dass Akupunktur im Verlauf den
disatoischen und den systolischen Blutdruck zu senken vermag (je ca. 8 mmHg). Die Autoren sind weitsichtig und
geben bereits eine Studienplanung für konfirmatorische Untersuchungen vor, die besagt dass pro Gruppe ca. 96
Patienten eingeschlossen werden müssten um die Ergebnisse auf einem hohen Signifikanzniveau zu reproduzieren.
Liu, Y., Xu, M., Che, X., He, J., Guo, D., Zhao, G., . . . Zhang, N. (2015). Effect of direct current pulse
stimulating acupoints of JiaJi (T10-13) and Ciliao (BL 32) with Han's Acupoint Nerve Stimulator on
labour pain in women: a randomized controlled clinical study. J Tradit Chin Med, 35(6), 620-625.
OBJECTIVE: To assess the clinical effect and safety of direct current (DC) pulse produced by Han's
Acupoint Nerve Stimulator in reduction (HANS) of labor pain. METHODS: Totally 120 participants were
enrolled in this clinical trial, and were randomly divided into 4 groups including: HANS group, patient
controlled intravenous analgesia (PCIA) group, patient-controlled epidural analgesia (PCEA) group and
control group. The HANS group was treated by stimulating the acupoints of JiaJi (T10-L3) and Ciliao (BL
32) with DC pulse of 100 Hz and 15-30 mA produced by a portable battery-powered Han's Acupoint
Nerve Stimulator for 30 min. The PCIA group was intravenously infused Ondansetron (8 mg) for 5 min,
then tramadol injection (1.5 mg/kg) was slowly dripped by using BaxterAP II electronic pump with 50 mL
tramadol (0.70%) + ondansetron (8 mg), background infusion 2 mL/h, PCA dose of 2 mL, lockout interval
of 10 min. In PCEA group, women received intrathecal injection ropivacaine (3 mg) in L2-3, and epidural
catheter was connected to BaxterAP II electronic pump, with 100 mL Ropivacaine (0.1%) and Sufentanil
(50 ug), background infusion 5 mL, Patient controlled analgesia (PCA) dose of 5 mL, lockout interval of
10 min. The control group was not received analgesia. The visual analogue scale (VAS), stage and manner
of labor, Apgar score of newborn, neonatal weights, oxytocin dosage, postpartum hemorrhage and side
effects were monitored in all groups. RESULTS: The vital signs were all stable in the four analgesic
groups. After analgesia, there was statistical difference in VAS score between HANS group and control
group, between PCEA group and the control group, between PCIA group and control group. The analgesic
effect in the PCEA group was significantly better than that of other two groups. The second stage of labor
in the PCEA group was longer than the other three groups, showing significant difference between them.
The Apgar score of newborn 1 min after birth in the PCIA group was slightly lower than that of the other
two groups, showing significant difference between them. The neonatal weights between four groups were
not significantly different. The rate of cesarean section in the control group was significantly higher than
that of the labor analgesia group, there was statistically difference in four groups. The number of PCIA
group that used oxytocin was lower than that of other three groups. There was no significant difference in
postpartum hemorrhage between four groups. The side effects of the PCEA group were itching, uroschesis
and neonatal asphyxia and PCIA group were nausea and vomiting and neonatal asphyxia. However, fewer
side-effects were observed in the HANS group. CONCLUSION: The DC pulse produced by HANS may
be a non-pharmacological alternative to labor pain with fewer side effects.
In dieser Studie zu Geburtsschmerzen wurden 120 Patientinnen untersucht. Der Goldstandard der Wehenhemmung
ist die patietinnen-kontrollierte peridurale Analgesie, wobei auch intravenöse Anästhesie und Elektroakupunktur an
den Punkten Ex-R2 (von Th10-13) sowie Bl32 Schmerzen suffizient lindern konnten. Unter Akupunktur ist die
Zahl der Nebenwirkungen (peroidrual: Juckreiz, neonatale Asphyxie; intravenös: Übelkeit und erbrechen,
Asphyxie), reduziert.
MacPherson, H., Tilbrook, H., Richmond, S., Woodman, J., Ballard, K., Atkin, K., . . . Watt, I. (2015). Alexander
Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized
Trial. Ann Intern Med, 163(9), 653-662.
BACKGROUND: Management of chronic neck pain may benefit from additional active self-careoriented approaches. OBJECTIVE: To evaluate clinical effectiveness of Alexander Technique lessons or
acupuncture versus usual care for persons with chronic, nonspecific neck pain. DESIGN: Three-group
randomized, controlled trial. (Current Controlled Trials: ISRCTN15186354). SETTING: U.K. primary
care. PARTICIPANTS: Persons with neck pain lasting at least 3 months, a score of at least 28% on the
Northwick Park Questionnaire (NPQ) for neck pain and associated disability, and no serious underlying
pathology. INTERVENTION: 12 acupuncture sessions or 20 one-to-one Alexander lessons (both 600
minutes total) plus usual care versus usual care alone. MEASUREMENTS: NPQ score (primary outcome)
at 0, 3, 6, and 12 months (primary end point) and Chronic Pain Self-Efficacy Scale score, quality of life,
and adverse events (secondary outcomes). RESULTS: 517 patients were recruited, and the median
duration of neck pain was 6 years. Mean attendance was 10 acupuncture sessions and 14 Alexander
lessons. Between-group reductions in NPQ score at 12 months versus usual care were 3.92 percentage
points for acupuncture (95% CI, 0.97 to 6.87 percentage points) (P = 0.009) and 3.79 percentage points for
Alexander lessons (CI, 0.91 to 6.66 percentage points) (P = 0.010). The 12-month reductions in NPQ
score from baseline were 32% for acupuncture and 31% for Alexander lessons. Participant self-efficacy
improved for both interventions versus usual care at 6 months (P < 0.001) and was significantly associated
(P < 0.001) with 12-month NPQ score reductions (acupuncture, 3.34 percentage points [CI, 2.31 to 4.38
percentage points]; Alexander lessons, 3.33 percentage points [CI, 2.22 to 4.44 percentage points]). No
reported serious adverse events were considered probably or definitely related to either intervention.
LIMITATION: Practitioners belonged to the 2 main U.K.-based professional associations, which may
limit generalizability of the findings. CONCLUSION: Acupuncture sessions and Alexander Technique
lessons both led to significant reductions in neck pain and associated disability compared with usual care
at 12 months. Enhanced self-efficacy may partially explain why longer-term benefits were sustained.
PRIMARY FUNDING SOURCE: Arthritis Research UK.
http://dx.doi.org/10.7326/M15-0667
Große offene Untersuchung an 517 Nackenschmerzpatienten aus englischen Arztpraxen. Sowohl Akupounktur als
auch Alexandertechnik reduzieren den Gesamtsymptomscore nach 12 Monaten um ca. 30%. Beide Therapien
steigerten signifikant das Selbstvertrauen der Teilnehmer.
Mao, J. J., Bowman, M. A., Xie, S. X., Bruner, D., DeMichele, A., & Farrar, J. T. (2015). Electroacupuncture
Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized PlaceboControlled Trial. J Clin Oncol, 33(31), 3615-3620.
PURPOSE: Hot flashes are a common and debilitating symptom among survivors of breast cancer. This
study aimed at evaluating the effects of electroacupuncture (EA) versus gabapentin (GP) for hot flashes
among survivors of breast cancer, with a specific focus on the placebo and nocebo effects. PATIENTS
AND METHODS: We conducted a randomized controlled trial involving 120 survivors of breast cancer
experiencing bothersome hot flashes twice per day or greater. Participants were randomly assigned to
receive 8 weeks of EA or GP once per day with validated placebo controls (sham acupuncture [SA] or
placebo pills [PPs]). The primary end point was change in the hot flash composite score (HFCS) between
SA and PP at week 8, with secondary end points including group comparisons and additional evaluation at
week 24 for durability of treatment effects. RESULTS: By week 8, SA produced significantly greater
reduction in HFCS than did PP (-2.39; 95% CI, -4.60 to -0.17). Among all treatment groups, the mean
reduction in HFCS was greatest in the EA group, followed by SA, GP, and PP (-7.4 v -5.9 v -5.2 v -3.4; P
= < .001). The pill groups had more treatment-related adverse events than did the acupuncture groups: GP
(39.3%), PP (20.0%), EA (16.7%), and SA (3.1%), with P = .005. By week 24, HFCS reduction was
greatest in the EA group, followed by SA, PP, and GP (-8.5 v -6.1 v -4.6 v -2.8; P = .002).
CONCLUSION: Acupuncture produced larger placebo and smaller nocebo effects than did pills for the
treatment of hot flashes. EA may be more effective than GP, with fewer adverse effects for managing hot
flashes among breast cancer survivors; however, these preliminary findings need to be confirmed in larger
randomized controlled trials with long-term follow-up.
http://dx.doi.org/10.1200/JCO.2015.60.9412
Diese Studie mit 120 Brustkrebs Patientinnen zeigte eine signifikant reduzierte Rate an Hitzewallungen durch
Elktroakupunktur im Vergelich zu Scheinakupunktur, Gabapentin und Placebo. Beide Akupunkturvarianten zeigen
sich deskriptiv dem medikamentösen Ansatz sowie dem Placebo überlegen. Leider sind nur die
Gruppenunterschiede nicht jedoch die Einzelunterschiede signifikant unterschiedlich.
Pai, H. J., Azevedo, R. S., Braga, A. L., Martins, L. C., Saraiva-Romanholo, B. M., Martins Mde, A., & Lin, C. A.
(2015). A randomized, controlled, crossover study in patients with mild and moderate asthma
undergoing treatment with traditional Chinese acupuncture. Clinics (Sao Paulo), 70(10), 663-669.
OBJECTIVES: This study sought to verify the effects of acupuncture as an adjuvant treatment for the
control of asthma. METHODS: This was a randomized, controlled, crossover trial conducted at the
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. A total of 74 patients with
mild/moderate, persistent asthma were randomized into two therapeutic groups: Group A - 31 patients
underwent 10 real weekly acupuncture sessions, followed by a 3-week washout period and 10 sham
weekly acupuncture sessions; and Group B - 43 patients underwent 10 sham weekly acupuncture sessions,
followed by a 3-week washout period and 10 real weekly acupuncture sessions. Patients used short- and
long-acting beta-2 agonists and inhaled corticosteroids when necessary. Prior to treatment and after each
period of 10 treatment sessions, the patients were evaluated for spirometry, induced sputum cell count,
exhaled nitric oxide (NO) and with the Short Form 36 (SF-36) and Questionnaire on Quality of LifeAsthma (QQLA) questionnaires. Daily peak flow and symptom diaries were registered. The level of
significance adopted was 5% (alpha=0.05). RESULTS: In Group B, after real acupuncture, there was a
decrease in eosinophils (p=0.035) and neutrophils (p=0.047), an increase in macrophages (p=0.001) and
an improvement in peak flow (p=0.01). After sham acupuncture treatment, patients experienced less
coughing (p=0.037), wheezing (p=0.013) and dyspnea (p=0.014); similarly, after real acupuncture,
patients reported less coughing (p=0.040), wheezing (p=0.012), dyspnea (p<0.001) and nocturnal
awakening episodes (p=0.009). In Group A, there was less use of rescue medication (p=0.043). After the
sham procedure, patients in Group A experienced less coughing (p=0.007), wheezing (p=0.037), dyspnea
(p<0.001) and use of rescue medication (p<0.001) and after real acupuncture, these patients showed
improvements in functional capacity (p=0.004), physical aspects (p=0.002), general health status
(p<0.001) and vitality (p=0.019). Sham acupuncture also led to significant differences in symptoms, but
these were not different from those seen with real acupuncture. Spirometry and exhaled NO levels did not
show a difference between sham and real acupuncture treatment. In addition, no significant difference was
demonstrated between treatments regarding the quality of life evaluation. CONCLUSION: Real and sham
acupuncture have different effects and outcomes on asthma control. The crossover approach was not
effective in this study because both interventions led to improvement of asthma symptoms, quality of life
and inflammatory cell counts. Thus, sham acupuncture cannot serve as a placebo in trials with
acupuncture as the main intervention for asthma.
http://dx.doi.org/10.6061/clinics/2015(10)01
Die Studie mit 74 Asthampatienten (mild-moderat) zeigt eine deutliche Symptomreduktion durch Akupunktur und
Verbesserung pulmonaler Funktionsparameter. Scheinakupunktur konnte inbesondere auf subjektiver Ebene zu
Symptomverbesserungen beitragen, funktionelle Effekte sind gering ausgeprägt. Bemerkenswert sind die
Veränderungen inflmmatorischer Zellen im Blutbild nach Akupunktur.
Raith, W., Schmolzer, G. M., Resch, B., Reiterer, F., Avian, A., Koestenberger, M., & Urlesberger, B. (2015).
Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial. Pediatrics,
136(5), 876-884.
BACKGROUND: Neonatal abstinence syndrome (NAS) is usually treated with opiate derivatives and
supported with nonpharmacological treatment. METHODS: This prospective, randomized, controlled,
blinded, single-center study was carried out between March 2009 and November 2014. Newborn infants
diagnosed with NAS after maternal opioid substitution therapy were eligible for inclusion. Infants were
randomly allocated to the acupuncture group (combining laser acupuncture and pharmacological therapy
of morphine and phenobarbital) or control group (pharmacological therapy alone). Laser acupuncture was
performed with a LABpen MED 10 (675 nm/10 mW) at 5 ear and 4 body acupuncture points, bilaterally,
and sessions were repeated every day. The primary outcome measure was duration of oral morphine
therapy for NAS. Secondary outcomes included highest single Finnegan score, time to highest single
Finnegan score, maximum amount of oral morphine solution (in milliliters per kilogram and milligrams
per kilogram), time to maximum amount of oral morphine solution, and length of hospital stay.
RESULTS: Twenty-eight newborns (14 in each group) were eligible for analysis. Duration of oral
morphine therapy was significantly reduced in the acupuncture group compared with the control group (28
vs 39 days, respectively, P = .019). In addition, we observed a significantly reduced length of hospital stay
in the acupuncture group compared with the control group (35 days [interquartile range 25 to 47] vs 50
days [36 to 66], P = .048). CONCLUSIONS: Adjunctive laser acupuncture significantly reduced the
duration of morphine therapy in newborns with NAS.
http://dx.doi.org/10.1542/peds.2015-0676
Eindrucksvolle Studie an 20 Neugeborenen die zeigt, dass durch Akupunktur die Dauer einer oralen
Morphintherapie bei neonatalem Abstinenzproblem um 9 Tage reduziert werden konnte.
Wei, H., Xu, J., Jiang, Z., Ye, S., Song, H., Ning, X., . . . Du, H. (2015). Effect of a Traditional Chinese
Medicine combined therapy on adolescent idiopathic scoliosis: a randomized controlled trial. J
Tradit Chin Med, 35(5), 514-519.
OBJECTIVE: To evaluate the effectiveness of a combined Traditional Chinese Medicine (TCM)
therapy versus conventional treatment on adolescent idiopathic scoliosis. METHODS: One hundred
twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a
TCM group (TCMG) and a brace group (CG). TCMG patients underwent Daoyin, Tuina, and
acupotomology therapies. CG patients were treated with a Milwaukee brace. Each patient's Cobb angle
was measured after 12 and 24 months of treatment, and pulmonary function was determined after 12
months of treatment. Average electromyogram (AEMG) ratio of the surface electromyogram was
measured after 6 and 12 months of treatment and followed-up after 18 and 24 months. RESULTS: The
Cobb angle significantly decreased in both groups after 12 months of treatment compared with before
treatment (P< 0.05). The percentages of original Cobb angle in TCMG and CG were 51.4% and 47.8% (P
> 0.05) after 12 months and 62.5% and 34.7% (P < 0.05) after 24 months, respectively. Pulmonary
function significantly improved after 12 months in TCMG (P < 0.05) but significantly decreased in CG (P
< 0.05). The AEMG ratio was significantly lower (P < 0.01) and tended to remain at 1 after stopping
treatment in TCMG, but increased in CG (P < 0.05). CONCLUSION: TCM combined therapy can prevent
the progression of scoliosis. The AEMG ratio is a promising index that could replace radiography in the
evaluation of treatment effect and progression in scoliosis.
Interessante Techniken: Studie an 120 Adoleszenten mit idopathischer Skoliose. Im Vergleich zu einer
Behandlung mit einem Skoliosekorsett wurde ein Programm aus DaoYin (einer Art QiGong), Tuina und
Akupunktomologie (einer Art schneidender Nadeln) verglichen. Beide Maßnahmen konnten den Skoliosewinkel im
ersten Jahr verringern, nach 24 Monaten zeigte sich eine signifikante Überlegeheit der chinesischen Intervention.
Ein Sekundärergbnis war darüberhinaus die signifikante Verbesserung der Lungenfunktion der Patienten.
Xue, C. C., Zhang, A. L., Zhang, C. S., DaCosta, C., Story, D. F., & Thien, F. C. (2015). Acupuncture for
seasonal allergic rhinitis: a randomized controlled trial. Ann Allergy Asthma Immunol, 115(4), 317324 e311.
BACKGROUND: Seasonal allergic rhinitis (SAR) is a common condition with relatively high
prevalence in Australia. It causes a significant impact on sufferers' quality of life (QoL). Meta-analysis has
shown that the efficacy of acupuncture for SAR is uncertain. OBJECTIVE: To evaluate the efficacy and
safety of 12 sessions of acupuncture treatment during 4 weeks for SAR in a randomized, subject- and
assessor-blinded, sham-controlled trial conducted during the pollen seasons in 2009 through 2011 in
Melbourne. METHODS: Patients diagnosed with SAR and confirmed allergic to rye grass pollen were
randomly allocated to receive real acupuncture (RA) or sham acupuncture (SA) treatment. RA was
delivered manually, whereas SA involved superficial needling at non-acupoints without additional
stimulation. Severity of SAR symptoms was the primary outcome measurement. Secondary outcomes
were QoL, global change, SAR-related medication usage, and adverse events. Analysis of covariance
using pollen count as a covariate was used to analyze outcome data. RESULTS: A total of 175 participants
were included in this trial. RA was significantly better than SA for decreasing SAR symptom severity
(sneezing, mean difference -0.28, 95% confidence interval -0.51 to -0.05; itchiness of ears and palate,
mean difference -0.40, 95% confidence interval -0.69 to -0.11) at the end of treatment and improving
participants' QoL at the end of the treatment and follow-up phases. Furthermore, the acupuncture
treatment was safe and well tolerated. CONCLUSION: Four weeks of acupuncture treatment is a safe and
effective option for clinical management of SAR in the Melbourne area for patients' symptom relief and
QoL improvement.
http://dx.doi.org/10.1016/j.anai.2015.05.017
Große methodologisch saubere Studie mit 175 Heunschnupfen-Patienten. Verum Akupunktur verringert die
Symptomschwere signifikant im Verleich zu einer Scheinbehandlung. Die Lebesnqualität der Teilneherm war
verbessert.
Yang, X. Y., Xiao, J., Chen, Y. H., Wang, Z. T., Wang, H. L., He, D. H., & Zhang, J. (2015). Dexamethasone
alone vs in combination with transcutaneous electrical acupoint stimulation or tropisetron for
prevention of postoperative nausea and vomiting in gynaecological patients undergoing laparoscopic
surgery. Br J Anaesth, 115(6), 883-889.
BACKGROUND: Postoperative nausea and vomiting (PONV) is commonly reported after surgery and
anaesthesia. We compared the effects of combinations of electrical acupoint stimulation or tropisetron
with dexamethasone with the effects of dexamethasone alone, for inhibition of PONV in gynaecological
patients undergoing laparoscopic surgery. METHODS: We randomized 157 patients undergoing elective
gynaecological laparoscopic surgery under general anaesthesia into the following three groups: acupoint
stimulation+dexamethasone (Group Acu, n=53), tropisetron+dexamethasone (Group Trp, n=53), and
dexamethasone alone (Group Dxm, n=51). The incidence of nausea, vomiting, and need for rescue
antiemetics was recorded 2, 6, 24, and 48 h after surgery. RESULTS: We found significant differences in
the incidence of PONV during 24 h after surgery between the combination therapy groups and the
dexamethasone-alone group (P=0.021). In the first 24 h, 28% of patients in Group Acu, 26% of patients in
Group Trp, and 50% of patients in Group Dxm experienced nausea, vomiting, or both. The incidence of
24 h PONV in Group Acu was significantly lower than that in Group Dxm (P=0.048; odds ratio 0.389;
95% CI 0.170-0.891). The incidence of 24 h PONV in Group Trp was also significantly lower than that in
Group Dxm (P=0.042; odds ratio 0.359; 95% CI 0.157-0.819). There was no significant difference
between Group Acu and Group Trp (P=0.857). The need for antiemetic rescue medication was similar in
the three groups. All groups expressed similar patient satisfaction. CONCLUSIONS: Combined with
dexamethasone, electrical acupoint stimulation or tropisetron is more effective in PONV prophylaxis than
dexamethasone alone in gynaecological patients undergoing laparoscopic surgery. CLINICAL TRIAL
REGISTRATION: NCT 02096835.
http://dx.doi.org/10.1093/bja/aev352
Studie zu postoperativer Überlkeit und Erbrechen an 157 laproskopisch operierten gynäkologischen Patientinnen.
Die Kombination von Dexamethason mit elektrischer Punktstimulation oder Tropisetron senkt gegenüber der
einfachen Dexamethasongabe die Inzidenz von PONV um 50% in den ersten 24 Stunden.
You, X. M., Mo, X. S., Ma, L., Zhong, J. H., Qin, H. G., Lu, Z., . . . Li, L. Q. (2015). Randomized Clinical Trial
Comparing Efficacy of Simo Decoction and Acupuncture or Chewing Gum Alone on Postoperative
Ileus in Patients With Hepatocellular Carcinoma After Hepatectomy. Medicine (Baltimore), 94(45),
e1968.
To compare the efficacy of simo decoction (SMD) combined with acupuncture at the tsusanli acupoint
or chewing gum alone for treating postoperative ileus in patients with hepatocellular carcinoma (HCC)
after hepatectomy.In postoperative ileus, a frequent complication following hepatectomy, bowel function
recovery is delayed, which increases length of hospital stay. Studies suggest that chewing gum may reduce
postoperative ileus; SMD and acupuncture at the tsusanli acupoint have long been used in China to
promote bowel movement.Patients with primary HCC undergoing hepatectomy between January 2015 and
August 2015 were randomized to receive SMD and acupuncture (n = 55) or chewing gum (n = 53) or no
intervention (n = 54) starting on postoperative day 1 and continuing for 6 consecutive days or until flatus.
Primary endpoints were occurrence of postoperative ileus and length of hospital stay; secondary endpoints
were surgical complications.Groups treated with SMD and acupuncture or with chewing gum experienced
significantly shorter time to first peristalsis, flatus, and defecation than the no-intervention group (all P <
0.05). Hospital stay was significantly shorter in the combined SMD and acupuncture group (mean 14.0 d,
SD 4.9) than in the no-intervention group (mean 16.5 d, SD 6.8; P = 0.014), while length of stay was
similar between the chewing gum group (mean 14.7, SD 6.2) and the no-intervention group (P = 0.147).
Incidence of grades I and II complications was slightly lower in both intervention groups than in the nointervention group.The combination of SMD and acupuncture may reduce incidence of postoperative ileus
and shorten hospital stay in HCC patients after hepatectomy. Chewing gum may also reduce incidence of
ileus but does not appear to affect hospital stay. (Clinicaltrials.gov registration number: NCT02438436.).
http://dx.doi.org/10.1097/MD.0000000000001968
Studie mit 162 Patienten die aufgrund eines hepatozellulären Karzinoms hepatektomiert wurden. Verglichen
wurdendie Kombination eines Dekoktes (Simo: Fructus aurantii, Radix aucklandiae, Semen arecae und Radix
linderae) mit Akupunktur an Ma36 versus Kaugummikauen in der Prevention eines postoperativen Ileus. Beide
Gruppen hatten eine verkürzte Zeit bis zur ersten Peristaltik und Defäkation im Vergleich zu einer Kontrollgruppe.
In der Dekokt/Akupunkturgruppe war die Krankenhausaufenthaltsdauer deutlich verringert. Die Hypothese hinter
dem Simo-dekokt ist ein Anregen muskarinerger Rezeptoren des gastrointestinaltrakts bei gleichzeitiger Hemmung
adrenerger Einflüsse
Zhu, B., Wang, Y., Zhang, G., Ouyang, H., Zhang, J., Zheng, Y., . . . Tang, C. (2015). Acupuncture at KI3 in
healthy volunteers induces specific cortical functional activity: an fMRI study. BMC Complement
Altern Med, 15, 361.
BACKGROUND: Using functional magnetic resonance imaging (fMRI), we determined brain regions
that were activated/deactivated more by acupuncture at Taixi (KI3) than by non-acupoint or sham
acupuncture. METHODS: A total of 30 healthy volunteers were randomly divided into a KI3 group (15
subjects) and non-acupoint group (15 subjects). Subjects in KI3 group received a sham acupuncture and
then a real acupuncture, fMRI was performed before and after sham acupuncture as well as after ture
acupuncture. Subjects in non-acupoint group received a ture acupuncture and the fMRI was performed
before and after ture acupuncture. The fMRI data obtained were successively analyzed using DPARSF2.3
and REST1.8 software, yielding regional homogeneity (ReHo) and amplitude of low frequency
fluctuations (ALFF) values. RESULTS: Compared with sham acupuncture, ALFF values were higher in
Brodmann area (BA) 10 and lower in BA7 and BA18. ReHo values after real acupuncture at KI3 were
higher in the right sub-lobar region and BA10 and were lower in BA31. Compared with the changes
before and after real acupuncture at non-acupoint, the changes at KI3 showed higher ALFF valued in the
left cerebellum posterior lobe, BA10, BA39, BA31 and decreased ALFF was observed in the BA18, BA19
and BA40; and higher ReHo values were shown in left cerebellum posterior lobe pyramis, left cerebellum
anterior lobe. BA37, BA10, BA39, BA31 and lower ReHo values were shown in BA18 and BA31.
CONCLUSION: Acupuncture at KI3 has a specific effect on certain brain regions associated with
perception, body movement, spirit, and association. Additionally, visual and auditory cortices were
affected, which may be related to the clinical applications of KI3 acupuncture in auditory and cognitive
disorders, hypomnesis, loss of concentration, and the loss of ability to work and learn. TRIAL
REGISTRATION: The research ethics committee was achieved at 01/08/2012, the NO. was ChiECRCT2012011. Website for Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=7123 .
This study was registered at www.chictr.org, the Clinical Trial Registration Number was ChiCTR-TRC12002427, and the registration number was achieved at 18/08/2012. The name of IRB that provided
approval for the study and clearly state is Chinese Clinical Trail Registry.
http://dx.doi.org/10.1186/s12906-015-0881-3
Funktionelle Kernspin Studie an 30 gesunden Probanden, die zeigt, dass eine Nadelung von Ni3 (wenn mit einer
NAdelung an einem Nicht-Akupunkturpunkt verglichen) zu einer Aktivierung von Arealen des Gehirns führt die
mit Wahrnehmung, Körperbewegung, Stimmung und Assoziationen in Verbindung gebarcht werden. Zudem findet
man vermherte Signale im auditiven und visuellen Kortex. Die Autoren stellen die Vermutung auf, dass eine
Nadelung von Ni3 demzufolge bei Merkfähigkeits- oder Konzentrationsstörungen denkbar wäre.

Mitgliederservice Neue Literatur 4. Quartal 2015

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