By Sayer Ji
An amazing study has found that acupuncture, the ancient practice of using needles to stimulate self-healing in the body, is more effective than intravenous morphine for acute pain relief.
A truly groundbreaking study published in the American Journal of Emergency Medicine, titled “Acupuncture vs intravenous morphine in the management of acute pain in the ED”, reveals that acupuncture — one of the oldest techniques to treat pain — is more effective, faster in relieving pain, and with less adverse effects, than intravenous morphine.
The study was conducted over the course of a 1-year period at the Fattouma Bourguiba University Hospital in Tunisia, a tertiary care facility with over 100,000 Emergency Department (ED) visits per year.
300 ED patients with acute pain were included in the study: 150 in the morphine group (administered up to 15 mg a day) and 150 in the acupuncture group. The two groups were comparable in terms of age, sex, and co-morbidities, with the only significant difference being that there were more abdominal pain patients in the morphine group and more low back pain cases in the acupuncture group.
The striking results were reported as follows:
“Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P b .01). Resolution time was 16 ± 8 minutes in the acupuncture group vs 28 ± 14 minutes in the morphine group. The difference was statistically significant (P b .01). The mean absolute difference in pain score between the 2 groups was 7.7. This difference is not clinically significant because the minimal clinically significant absolute difference reported by Todd et al is 13. In morphine group, the mean total dose of morphine administered was 0.17 ± 0.08 mg/Kg.
In short, the acupuncture group saw a great pain-relieving effect, which occurred faster, with significantly less side effects.
Since 1996, the World Health Organization has recognized acupuncture as a safe and effective therapy for the treatment of a wide range of conditions, including pain and discomfort.Despite this, the use of acupuncture within the conventional standard of care is still exceedingly rare. A deep skepticism exists for therapeutic modalities that do yet have a clearly characterized mechanism of action, as defined through conventional biomedical understanding and terminology. Often, in lieu of this, its therapeutic effects are written off as merely “placebo”.
Placebo, however, is not as diminutive term as it may first seem. The placebo effect actually reflects the deep power and regenerative capability of the body-mind to heal itself. And since its power translates directly into real, measurable improvements in terms of clinical outcomes, it does not matter if we fully understand “how” it works. Also, consider that “evidence-based” (EB) medicine not only depends entirely on clinical outcomes as final proof of an intervention’s efficacy, but also, the entire EB medicine model depends on “controlling” for the placebo effect, as it is already tacitly recognized as having immense power in influencing the outcomes in most interventions. And so, whether or not a fully known or plausible “mechanism of action” has been identified is secondary in importance to whether it works or not in clinical practice.
Acupuncture happens to be one of the most extensively supported alternative modalities, with clinical trial data supporting its value in over 100 different conditions. If you do a pubmed.gov search you’ll find over 6,700 published studies related to the keywords “pain” and “acupuncture.” You can view the primary literature we have gathered on the topic at the Acupuncture page on GreenMedInfo.com.
Clearly the new study reveals that acupuncture has a powerful role to play in pain management. With addiction to pain relieving drugs affecting millions around the world, acupuncture is perfectly poised to provide patients a time-tested, drug-free alternative. As you can see from the study’s graph (table 3), the adverse effects comparison is staggeringly in favor of acupuncture as the safer modality.
Finally, here are the study’s powerful conclusions:
“Our study demonstrated that in patients with acute pain syndromes presenting to the ED, acupuncture is at least as efficacious and has a better safety profile than IV morphine. The results of this study suggest that acupuncture has a potential role in controlling acute pain conditions presenting to EDs and appears to be safe and effective. Future studies should be performed in international populations.”
About the author:
Sayer Ji is the founder of Greenmedinfo.com, a reviewer at the International Journal of Human Nutrition and Functional Medicine, Co-founder and CEO of Systome Biomed, Vice Chairman of the Board of the National Health Federation, and Steering Committee Member of the Global Non-GMO Foundation.
By Stephanie Megal, Wellness Ambassador Director | Dao Labs
Limoncello is the Italian word referring to an intensely lemon flavored liqueur most famously associated with southern Italy that is made from lemon zest (strictly non-treated), alcohol, lemon juice, water and sugar. It is a beverage usually consumed after meals but is perfect for any special occasion as an aperitif or digestive.
In Traditional Chinese Medicine there is a long history of the use of wine and liquor as a medicinal in decoctions or tinctures.
Ginseng is a very popular ingredient used in medicinal wines or liqueurs and can be one of the more expensive and prized medicinal herbs available. Ginger and goji berries are also often used as medicinal infusions. More easily accessible and much more familiar is licorice infused spirit such as the Italian Sambuca or the Greek Ouzo. It is indeed currently quite fashionable at many popular bars to see the mixologists combining art and science by adding medicinal value to the world of cocktails.
In Chinese medicine theory, alcohol will leave your body damp and hot. Damp, in the inability to metabolize food and fluids well so your body gets bogged down and retains water. Hot, in that it’s post digestive temperature will leave you warm or hot which can make you restless or irritable. Too much alcohol will overwhelm your spleen, kidney and liver and hurt your overall digestion but in moderation a small amount of alcohol can warm your middle burner and aid your digestion. Spirits such as vodka are very good at moving and dispersing stagnation.
What about the sugar?
Sugar, we must remember, passes quickly into the bloodstream, shocking and weakening the digestive system, to result in a blood sugar imbalance that causes a craving for more sugar. This is clearly a recipe to use sparingly and save as a treat for certain occasions.
Every year my parents receive a large box of freshly picked organic meyer lemons from a friends back yard trees in California so it has become tradition to make limoncello during the holidays. Use only organic lemons as commercial fruits are dyed, waxed and have fungicide and pesticide residues. No other liqueur made from a simple infusion can gratify the taste buds quite like limoncello. Although a highly alcoholic liqueur, the perfume and flavor of this variety of lemons allows this drink to be lemony, sweet and very pleasing to the palate.
Ingredients From a Chinese Medicine Perspective
Sugar – Sweet and neutral, white sugar can supplement and harmonize the center, boost Qi and moisten the lungs.
Lemon – Sour, astringent and slightly cool. Transforms and resolves dampness and phlegm, resolves stagnation, engenders fluids in the body and supplements the spleen. Aids digestion by stimulating the flow of saliva. Relieves heat and helps with thirst, sore throat, fevers and cough. Can act as a laxative and diuretic with important antiseptic and antimicrobial properties. Lemons can benefit the liver by encouraging the formation of bile,
Alcohol – Bitter, sweet, acrid, warm and can be toxic; frees the flow of the blood vessels and disperses cold Qi, arouses the spleen and warms the stomach.
About 60, 1 ½ ounce servings
Prep Time / Cook Time / Inactive
1 hour / - / 1 week
Directions: Using a vegetable peeler, remove the peel from the lemons in long strips. Using a small sharp paring knife, trim away the white pith from the lemon peels as pith is bitter; discard the pith. A micro plane will work here as well. Place the lemon zest in a glass pitcher and pour the vodka over the zest and cover with plastic film. Steep the zest in the vodka for one week at room temperature. Juice the lemons and add the sugar and water as needed to make four cups simple syrup. Strain the zest from the vodka, add the simple syrup, bottle and store in freezer.
By Stephanie Megal, Wellness Ambassador Director | Dao Labs
Depression--with symptoms such as low-self worth, lack of concentration, fatigue, loss of appetite, insomnia and others--is a common mental disorder around the world. In fact, an estimated 300 million people suffer from mental illnesses globally.
Described as an “unseen burden” by the World Health Organization (WHO), depression can become chronic and lead to significant impairments in an individual’s ability to carry out everyday activities and can lead to suicide. The United States is one of the most depressed countries in the world after China and India. In a given year 43.8 million adults, or 1 in 5, in the U.S. experience mental illness in a given year.
Antidepressants—known by brand names such as Zoloft, Celexa, Prozac—are commonly prescribed to treat depression and are some of the most popular drugs in the United States. Nearly 13% of people 12 years of age and older said they took an antidepressant in the last month according to a 2017 report from the National Center for Health Statistics. As you can see from the graph below, women are twice as likely as men to say they took antidepressants.
Figure 1. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by age and sex: United States, 2011–2014
Many antidepressants come from a class of medications known as Selective Serotonin Reuptake Inhibitors or SSRIs. Unfortunately, there are many common side effects to using SSRIs including drowsiness, fatigue, sleep difficulties, weight gain, nervousness, dry mouth, blurred vision and more. Doctors recommend a slow weaning off of SSRIs because abruptly stopping can cause Antidepressant Discontinuation Syndrome which comes with its own set of side effects including spells, extreme restlessness, dizziness, fatigue, and aches and pains.
In China, where approximately 100 million people suffer from depression, doctors have been using the Chinese herbal formula Xiao Yao San (“Free and Easy Wanderer”) as a treatment for centuries. This formula contains eight commonly used herbs: Bupleurum root, Chinese angelica root, white peony root, poria, bighead atractylodes rhizome, roasted ginger, prepared licorice root, menthol and peppermint.
In a research article entitled Chinese Herbal Formula Xiao Yao San for Treatment of Depression: A Systematic Review of Randomized Controlled Trials (Evidence-Based Complementary and Alternative Medicine, Volume 2012, Article ID 931636), researchers set out to evaluate the beneficial and harmful effects of Xiao Yao San. What they found was that using prescriptions based on Xiao Yao San in the form of pills, powder and boiling the herbs may be beneficial to patients with depression.
In Chinese Medicine theory terms, Xiao Yao San may be soothing the liver, invigorating the spleen, nourishing the blood and clearing away the liver fire due to blood deficiency. Biochemically, this formula also reversed CIS-induced decreases in brain-derived neurotrophic factoroche and increases in tyroxine hydroxylase, and neurotrophin 3 in the frontal cortex, and the hippocampal CA subregion.
In comparing Xiao Yao San prescriptions alone, antidepressants along, and the combination of Xiao Yao San prescriptions and antidepressants, the researchers found that Xiao Yao San prescriptions may have the same effectiveness as antidepressants at the end point of treatment with fewer side effects. Combining Xiao Yao San with antidepressants actually showed significant beneficial effects—shorter onset time, symptom improvement with less adverse events—as compared to the results of those taking just antidepressants or just Xiao Yao San prescriptions.
By Kylee Junghans
Research suggests that between 1-30% of the global population suffers from some form of anxiety.1 There are 13 different sub-classifications of anxiety disorders listed in the latest Diagnostic and Statistical Manual (used by medical professionals to diagnose and treat psychological conditions),2 with symptoms and physical manifestations varying considerably. From shortness of breath and variations in heart rate, to full blown and debilitating panic attacks, headaches, pain and insomnia,3 anxiety is a complex, pervasive condition that is generally treated using medication.
ACUPUNCTURE FOR ANXIETY: THE CLINICAL EVIDENCE
According to the most up to date evidence, acupuncture is an effective treatment for anxiety. In 2017, The Acupuncture Evidence Project, co-authored by Dr John McDonald, PhD and Dr Stephen Janz,4 was published, providing an up-to-date comparative review of the clinical and scientific evidence for acupuncture. This comprehensive document, updating two previous reviews, determined that acupuncture is moderately effective in treating anxiety according to high level evidence.5 Their evidence included a 2016 systematic review with over 400 randomised patients that concluded that ‘the effects from acupuncture for treating anxiety have been shown to be significant as compared to conventional treatments.’6 The largest of these studies, which included 120 randomized patients, found that acupuncture had a large effect on reducing anxiety and depression compared to conventional treatment involving pharmalogical approaches and psychotherapy, with over twice the reduction in symptoms.7
A more recent systematic review published in 2018 found that all 13 included studies “reported an anxiety decrease for their treatment group relative to the control groups.” Three of these studies used pharmaceuticals as controls.8
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BIOCHEMICAL MECHANISMS OF ACUPUNCTURE FOR ANXIETY
The autonomic nervous system (ANS), which is comprised of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), regulates the internal conditions necessary for existence (homeostasis).(8) Information is received from the body and external environment and a response is delivered by either the SNS, which releases excitatory signals, or the PNS which releases signals for relaxation. These signals direct the body to react in very different ways, such as increasing the heart rate and contraction force, or by reducing blood pressure and slowing the heart rate.(9) It is exciting to know that studies show acupuncture has an effect on both the SNS and the PNS, as some further examples presented below reveal.
One of the most sensitive measures of the body’s ability to cope with stress is something called Heart Rate Variability (HRV). Rather than beating consistently at the same rate like a metronome, the heart actually changes its rate based on its fine-tuned response to the environment. A higher HRV has been associated with better health in all domains, including mental health and low levels of anxiety. Acupuncture has been shown to improve the body’s ability to cope with stress through improving HRV.(10)
When the body is under stress, an area of the brain called the hypothalamus releases neurochemicals,9 and research shows that acupuncture can calm this response.10
Acupuncture has also been shown to increase the release of endorphins,11 the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function.12131415 All of these acupuncture mechanisms have a direct effect on reducing anxiety.
CONVENTIONAL TREATMENT OF ANXIETY
The conventional treatment of anxiety primarily involves some combination pharmacological and psychological interventions.
There are several medications that are prescribed for anxiety, including benzodiazepines (alprazolam), selective-serotonin re-uptake inhibitors (SSRIs) such as paroxetine, and tricyclic antidepressants (imipramine), either singularly or in combination.16 According to recent research, around 50% of patients treated pharmacologically for anxiety have an ‘inadequate response,’17meaning that their symptoms are not alleviated to clinically significant levels or that the patient experiences adverse side effects. Some researchers go so far as to say that pharmacological treatments are ‘not ideal’ in terms of efficacy when employed for either short- and long-term treatment.18
Systematic reviews demonstrate that benzodiazepines can result in ‘sedation and drowsiness, mental slowing and anterograde amnesia’ (difficulty in forming new memories).19
Cognitive behavioral therapy (CBT) and mindfulness-based CBT are two other popular and effective forms of conventional treatment for anxiety and may be prescribed as standalone therapies, or in combination with medications.20 CBT is a ‘talking therapy’ that aims to overcome inaccurate or negative thought patterns,21 and has the advantage of flexibility, where therapy is tailored to each individual and their relevant anxiety disorder. A meta-analysis found that compared to a placebo therapy, CBT had a moderate to large effect on reducing anxiety from a variety of causes.22
While there are ethical and methodological challenges to designing studies that compare the effectiveness of acupuncture to the conventional treatment of anxiety,2324 the best available evidence demonstrates that acupuncture has moderate benefits in the treatment of anxiety. Studies show that acupuncture is more effective than pharmacotherapy and comparable to talking therapy, making it a helpful referral choice. Moreover, research has revealed several known biochemical and biophysical mechanisms that may offer an explanation of how this ancient modality works.
M.Om., Dipl. Acu (NCCAOM) L.Ac.
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