Acupuncture and Eczema

I've been meaning to write about this interesting study that was presented at the Society for Acupuncture Research Meeting in North Carolina in March. I had met the author at previous meetings and had the opportunity to speak with him at length at the poster session. Apparently he's on his way to Harvard to do some work there. There is a center of gravity of acupuncture research starting to develop at Harvard and it's all for the good. At the epicenter is Vitaly Napadow who has done incredible work in staggering amounts on fMRI and acupuncture and other topics. He presented at the SAR also and cited my paper (had to mention that...) Turns out there is a U.C. Berkeley alum (like me),Andrew Ahn, who is headed to Harvard also who presented an interesting paper on "wavelet analysis" which is something I tried to do for awhile with my own data. Still haven't cracked that.
So I've digressed.
This study shows that acupuncture helps prevent flares of acupuncture and also the actual wheal and flare after provoked eczema. They compared verum acupuncture (VA) puncture at points Large Intestine 11, and Spleen 10 to "no acupuncture" (NA) and placebo acupuncture (PA.) Verum acupuncture significantly lowered the itching and wheal and flare associated with eczema. Details in the abstract.

Influence of acupuncture on type I hypersensitivity itch and the wheal and flare response in adults with atopic eczema - a blinded, randomized, placebo-controlled, crossover trial.

Pfab F, Huss-Marp J, Gatti A, Fuqin J, Athanasiadis GI, Irnich D, Raap U, Schober W, Behrendt H, Ring J, Darsow U.

Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.
Abstract

Background: Itch is a major symptom of allergic skin disease. Acupuncture has been shown to exhibit a significant effect on histamine-induced itch in healthy volunteers. We investigated the effect of acupuncture on type I hypersensitivity itch and skin reaction in a double-blind, randomized, placebo-controlled, crossover trial. Methods: An allergen stimulus (house dust mite or grass pollen skin prick) was applied to 30 patients with atopic eczema before (direct effect) and after (preventive effect) two experimental approaches or control observation: acupuncture at points Quchi and Xuehai [verum acupuncture (VA), dominant side], 'placebo-point' acupuncture (PA, dominant side), no acupuncture (NA). Itch intensity was recorded on a visual analogue scale. After 10 min, wheal and flare size and skin perfusion (via LASER-Doppler) were measured at the stimulus site, and the validated Eppendorf Itch Questionnaire (EIQ) was answered. Results: Mean itch intensity was significantly lower in VA (35.7 +/- 6.4) compared to NA (45.9 +/- 7.8) and PA (40.4 +/- 5.8) regarding the direct effect; and significantly lower in VA (34.3 +/- 7.1) and PA (37.8 +/- 5.6) compared to NA (44.6 +/- 6.2) regarding the preventive effect. In the preventive approach, mean wheal and flare size were significantly smaller in VA (0.38 +/- 0.12 cm(2)/8.1 +/- 2.0 cm(2)) compared to PA (0.54 +/- 0.13 cm(2)/13.5 +/- 2.8 cm(2)) and NA (0.73 +/- 0.28 cm(2)/15.1 +/- 4.1 cm(2)), and mean perfusion in VA (72.4 +/- 10.7) compared to NA (84.1 +/- 10.7). Mean EIQ ratings were significantly lower in VA compared to NA and PA in the treatment approach; and significantly lower in VA and PA compared to NA in the preventive approach. Conclusions: Acupuncture at the correct points showed a significant reduction in type I hypersensitivity itch in patients with atopic eczema. With time the preventive point-specific effect diminished with regard to subjective itch sensation, whereas it increased in suppressing skin-prick reactions.

Depression in Pregnancy, Acupuncture Treatment

This is an important study in that it focuses on a patient population that could benefit greatly from a non-pharmaceutical option for treatment. It is unusual in the study design in that it uses practitioners who were "junior," meaning that they were merely administering the acupuncture so not biased by whether the point selection was appropriate or not. The depression specific acupuncture patients achieved much better results than the acupuncture non-specific patients or the massage treatment patients. This is a positive development in the acupuncture research world since many of the recent studies out of Europe have had a hard time clearly delineating the benefits of condition specific treatment versus non-specific treatment. Of note is that they consider 12 sessions a "short" trial. In day to day practice a short practice would be more around 4 visits...

Obstet Gynecol. 2010 Mar;115(3):511-20.
Acupuncture for depression during pregnancy: a randomized controlled trial.

Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, Carlyle E, Celio C, Gress JL, Huang MI, Kalista T, Martin-Okada R, Allen JJ.

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA. rmanber@stanford.edu
Abstract

OBJECTIVE: To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial. METHODS: A total of 150 pregnant women who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). Junior acupuncturists, who were not told about treatment assignment, needled participants at points prescribed by senior acupuncturists. All treatments were standardized. The primary outcome was the Hamilton Rating Scale for Depression, administered by masked raters at baseline and after 4 and 8 weeks of treatment. Continuous data were analyzed using mixed effects models and by intent to treat. RESULTS: Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (P<.05) compared with the combined controls (Cohen's d=0.39, 95% confidence interval [CI] 0.01-0.77) or control acupuncture alone (P<.05; Cohen's d=0.46, 95% CI 0.01-0.92).They also had significantly greater response rate (63.0%) than the combined controls (44.3%; P<.05; number needed to treat, 5.3; 95% CI 2.8-75.0) and control acupuncture alone (37.5%; P <.05: number needed to treat, 3.9; 95% CI 2.2-19.8). Symptom reduction and response rates did not differ significantly between controls (control acupuncture, 37.5%; massage, 50.0%). CONCLUSION: The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, www.clinicaltrials.gov, NCT00186654.

Heart Rate Variability and Acupuncture, a review

I started looking at acupuncture and HRV in 2000. I am somewhat heartened that there have been enough studies to warrant a review. I would rather that they had found some good correlations between acupuncture treatment and heartrate variability. But given the difficulties with acupuncture studies in general and the relative newness of HRV monitoring, I guess I should not be surprised nor disappointed.

Auton Neurosci. 2010 Mar 19

Acupuncture and heart rate variability: A systematic review.

Lee S, Lee MS, Choi JY, Lee SW, Jeong SY, Ernst E.

Department of Acupuncture and Moxibustion, College of Oriental Medicine, Kyung Hee University, Seoul, South Korea.

Acupuncture has been reported to affect the autonomic system. Currently, there are no systematic reviews examining the effect of acupuncture on HRV available in the literature. Therefore, the aim of this systematic review was to summarize and critically assess the effects of acupuncture on heart rate variability. We searched the literature using 14 databases for articles published from the earliest available publications until October 2009 without language restrictions. We included randomized clinical trials (RCTs) comparing acupuncture and sham acupuncture. The risk of bias in each study was assessed using the Cochrane criteria. Twelve RCTs met all of the inclusion criteria. One RCT evaluated the effects of acupuncture in patients with minor depression or anxiety disorders and another RCT examined the effect of acupuncture on migraine patients. Another four RCTs tested the effects of acupuncture in healthy subjects who were exposed to several conditions, including mental stress, fatigue from driving, and caffeine intake. The remaining six RCTs assessed the effects of acupuncture on healthy subjects in a normal state without any stressors. Five RCTs found significant differences in HRV between patients treated with acupuncture versus those treated with sham acupuncture (controls). However, the majority of the other RCTs showed inconsistent results or did not identify significant differences in HRV spectral parameters among individuals treated with acupuncture as compared to those treated with sham acupuncture. In conclusion, sham-controlled RCTs showed variable results and no clear evidence that acupuncture has any specific effects on HRV. Therefore, more rigorous research appears to be warranted. Copyright © 2010 Elsevier B.V. All rights reserved.