Abstracts des SAR Symposion in Minneapolis

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 6. Teil:

THE STUDY OF ACUPUNCTURE ANALGESIA IN OPERATIVE DENTISTRY: METHODOLOGICAL FACTORS FOR SUCCESS

Eric Goldlust, Ellen Beck, Melanie Parker, Ana de Vedia
Department of Family & Preventive Medicine, School of Medicine, University of California San Diego, La Jolla, CA

Preliminary work for a modified triple-blind, randomized, controlled clinical trial of an electro-acupuncture protocol as a substitute or adjunct to local anesthesia has provided much needed but rarely published suggestions for the proper conduct of such a study.

A pilot study (n = 23) of the electro-acupuncture protocol as sole means of analgesia suggests the following guidelines:

1. Acupuncturists should adhere to a specified decision tree for such a protocol, even if such treatment is individualized by tooth or by patient’s health status;
2. Study protocols should exclude the anxious patient, or may incorporate differential treatment of the anxious patient, as long as such treatment is applied effectively prior to randomization;
3. To better ascertain differences between individuals, treatment "success" should be based on a continuous scale, such as reported pain on a scale of 0-10, rather than dichotomous outcomes such as "success" of treatment; and
4. Homeless and low-income clients are sufficiently amenable to acupuncture analgesia, for reasons not formally analyzed.

A validation study (n = 24; in progress) of blinding methods in patients randomly allocated to two groups (placebo electro-acupuncture + lidocaine 2% with epinephrine 1:100,000 vs. real electro-acupuncture + lidocaine 2% without epinephrine) suggests these additional guidelines:

1. The role of the acupuncturist may be divided effectively into the roles of "practitioner" (unblinded, and responsible for needling only) and "communicator" (blinded, responsible for modification of electrical stimulation ("E-stim") during time-variable portion of study) in a manner which facilitates blinding;
2. Use of sterile callus cushions for placement of Streitberger needles (Streitberger et al ‘98) is superior to the ring and plaster method;
3. Novel placebo leads are an effective means of blinding the E-stim;
4. Use of active placebo assists treatment confusion by combining positive soft tissue signs with ostensibly minor effects on dental pulp;
5. Blinding is assisted by concurrent induction periods for acupuncture and anesthetic; and
6. Assessments of blinding effectiveness preceding and following post-treatment evaluations of tooth and gum sensation suggest blinding is dependent on results of evaluations.

Methods are still under development regarding blinding of E-stim in the 0-10 Hz frequency range, which is often visible to even untrained observers.

CLINICAL STUDY OF HERPES ZOSTER TREATMENT USING ACUPUNCTURE OF THUMB-JOINT ACUPOINT AND FIRE-TWINKLING METHOD

Shilan Zhou
Research Laboratory for Lung Cancer, Shanghai Pneumology Hospital, Shanghai, PR China

This paper is the summary of clinical results of using Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling for 27 cases of Herpes Zoster, a virulent skin disease called "Yao Chan Huo Dan" and "She Du Cang" in traditional Chinese medicine. The condition usually results from decreased immune function, emotional depression, dietary disorder, malfunctional spleen and liver, or virus infection. The course of the illness lasts from two to fifteen days. The purpose of using Acupuncture of Thumb-joint Acupoint locally is to stimulate the infected region, improve the overall body immune system, and thus kill the virus using the body’s own immune functionality. Additionally, the Fire-Twinkling method utilizes the flame’s radiating and heating effect to enlarge local blood vessels, accelerate blood circulation and energize body cells. Treatment involved sterilization of Herpes Zoster with 75% alcohol, and insertion of 1-cun long #30 needles into the Herpes Zoster concentrated area at 25-degree angle, at a depth of 0.7 – 0.8 cun, with 1.5 cun apart between needles. The needles were rotated and twisted during insertion, retained for 30 to 40 minutes, and removed with the same rotating and twisting method. If blisters were clustered together they were pricked with three 3-cun needles and cleansed with medical cotton ball. For the Fire-Twinkling method, 98% alcohol was applied to a medical cotton ball and ignited. The ignited cotton ball was moved swiftly up and down toward the infected area so the flame heated the infected skin but the patient remained comfortable. Under the heat of the flame, the blisters gradually shrank in size until the skin turned dark red. In most cases, the Herpes Zoster became darker, smaller, flatter, and the patient felt less pain the next morning. One treatment was performed per day, with ten such treatments equaling one course of therapy. In most cases, two to three courses of therapy were performed. The outcome of the treatment and observation study showed that Acupuncture of Thumb-Joint Acupoint and Fire-Twinkling was a very effective treatment method for Herpes Zoster: among the 27 cases studied, 24 (88.8%) were completely cured, 2 cases (7.4%) showed evident improvement, and only one case (3.8%) showed no sign of improvement. The overall efficiency of the treatment was 96.8%. Cure was defined as full recovery from the disease with complete disappearance of Herpes Zosters and Herpes-related pain. Evident improvement meant that clinical and generalized symptoms were markedly decreased: most of the Herpes Zosters dried and formed scabs, and pain was greatly reduced. No effect meant that there was no obvious change in the clinical and generalized symptoms.