Abstracts des SAR Symposion in Minneapolis – Beginn der Serie für 1.2

Vom 19. – 20. Oktober 2001 fand im Pillsbury Auditorium, Hennepin County Medical Center, Minnesota das 8. jährliche Symposion der Society of Acupuncture Research statt. 
Das Kongressprogramm war wie 2000 bei dem Symposion in Baltimore hervorragend und fokussierte auf den aktuellen Stand der wissenschaftlichen Forschung zur Akupunktur.
Auch der aktuelle Stand der von den National Institutes of Health geförderten, klinischen Studien wurden in Vorträgen vorgestellt und diskutiert. Wie bereits in den letzten Monaten stellen wir an dieser Stelle die Abstracts des Symposiums als Serie hier ins Netz.
Hier den 3. Teil:

PROGRESS REPORT: CROSS-OVER CLINICAL TRIAL EXAMINING ACUPUNCTURE EFFICACY IN CONTROLLING SIDE-EFFECTS OF HIV-COMBINATION THERAPY

Elizabeth Sommers
AIDS Care Project, Boston, MA

Introduction: Although previous studies have demonstrated efficacy in managing digestive side-effects of medications used in cancer chemotherapy and following anesthesia, the role of acupuncture in controlling side-effects of highly-active antiretroviral therapy (HAART) has not yet been addressed. HAART therapy, the current treatment of choice for most individuals diagnosed with HIV/AIDS, results in prevalences of nearly 100% for digestive side-effects such as nausea, vomiting, bowel upsets, weight loss, and indigestion. These symptoms can negatively impact adherence to medication protocols, which may result in serious health consequences.

Methods: A 6-week cross-over clinical trial has been designed to examine whether a set of 4 points (Pericardium 6, Conception Vessel 12, Stomach 37, and Spleen auriculo-point) can be more effective than a set of 4 comparison points (Triple Burner 4, Conception Vessel 19, Liver 5, Shen Men auriculo-point); actual needling is done for each set of points. Treatment in each arm of the study is done for 3 weeks, with the order of treatment determined by randomization. Although the acupuncturists providing treatment are not masked, each participant as well as the principle investigator, data entry personnel, and statistical consultants are masked to treatment assignment.

Demographic information as well as data on medical history, current levels of side-effects and adherence are collected at intake. Participants use daily diaries to record compliance with medication protocols and symptoms experienced throughout the study. A target population of 190 participants was set based on statistical parameters.

Current Results: Although the study will not be completed by fall, 2001 an update on the study will be presented; we estimate that this presentation will include results from the first 25 participants. This discussion will include descriptive statistics on the study population and comparisons of baseline, mid-point, and end of study data on symptom levels and adherence data.

Building upon two previous investigations of Chinese herbs alone for treatment of HIV, the present study examined the combined use of acupuncture and herbs, and used HIV-RNA tests as outcome measures. Other measures were CD4/CD8 counts, and clinical evaluations of symptoms: low-grade fever, night sweats, body weight change, diarrhea, sore throat, fatigue, stress/depression and skin rash. These measures were assessed before treatment and at 4, 8, 12, and 24 weeks into treatment. In addition, chemistry panels were performed for each study participant prior to treatment and once every month of treatment.

Treatment consisted of twice-weekly, 30-minute acupuncture sessions and two herbal formulas. One formula addressed immune system improvement; the other was an antiviral formula. Both formulas remained static throughout the study.

Forty-six patients completed the 24-week treatment. Overall, they experienced considerable improvement in or disappearance of symptoms. Seventy percent of patients gained weight.

Upon completing their participation, 31 patients (67%) had stable or increased CD4 counts (mean increase of 108.2 points), whereas 15 patients (33%) experienced decreased CD4 counts (mean decrease of 114.4 points).

Viral load decreased or was unchanged in 61% of patients (n=28; mean of -1.01 log) and increased in 39% (n=18; mean of + 0.74 log).

Acupuncture and Chinese herbs created no side effects in HIV patients. It is concluded that acupuncture and Chinese herbs may be an effective alternative for HIV patients desiring to delay conventional HAART treatment or for whom the HAART treatment has failed. Further study needs to examine whether acupuncture and Chinese herbs may increase the effectiveness of present HAART treatment when used as adjunctive therapy.