Artiklar

Forskning om akupunktur

In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. 

Anderson, B. J., Haimovici, F., Ginsburg, E. S., Schust, D. J., & Wayne, P. M. (2007).

Alternative therapies in health and medicine, 13(3), 38–48.

Abstract

To provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. Literature review using PubMed, the Science Citation Index, The Cochrane Library (Database of Systematic Reviews and Central Register of Controlled Trials), the New England School of Acupuncture library databases, and a cross-referencing of published data, personal libraries, and Chinese medicine textbooks. Limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interventions employed often were not consistent with traditional Chinese medical principles. The reviewed literature suggests 4 possible mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression. More high-quality randomized, controlled trials incorporating placebo acupuncture controls, authentic acupuncture interventions, and a range of outcome measures representative of both clinical outcomes and putative mechanistic processes are required to better assess the efficacy of acupuncture as an adjunct for IVF.

Länk: https://www.researchgate.net/publication/6317601_In_vitro_fertilization_and_acupuncture_Clinical_efficacy_and_mechanistic_basis

 

Artificial Intelligence and Acupuncture: A Data-Driven Synergy

Authors: Claudia M. Witt Sandro Graca

Journal of Integrative and Complementary MedicineVol. 30, No. 4. Published Online: 4 April 2024

Länk: https://www.liebertpub.com/doi/10.1089/jicm.2024.0109

In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. 

Anderson, B. J., Haimovici, F., Ginsburg, E. S., Schust, D. J., & Wayne, P. M. (2007).
Alternative therapies in health and medicine, 13(3), 38–48.

Abstract

To provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. Literature review using PubMed, the Science Citation Index, The Cochrane Library (Database of Systematic Reviews and Central Register of Controlled Trials), the New England School of Acupuncture library databases, and a cross-referencing of published data, personal libraries, and Chinese medicine textbooks. Limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interventions employed often were not consistent with traditional Chinese medical principles. The reviewed literature suggests 4 possible mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression. More high-quality randomized, controlled trials incorporating placebo acupuncture controls, authentic acupuncture interventions, and a range of outcome measures representative of both clinical outcomes and putative mechanistic processes are required to better assess the efficacy of acupuncture as an adjunct for IVF.
Länk: https://www.researchgate.net/publication/6317601_In_vitro_fertilization_and_acupuncture_Clinical_efficacy_and_mechanistic_basis

 

Acupuncture for Female Infertility: Discussion on Action Mechanism and Application.

Xu, J. Y., Zhao, A. L., Xin, P., Geng, J. Z., Wang, B. J., & Xia, T. (2022).
Evidence-based complementary and alternative medicine : eCAM, 2022, 3854117.

Abstract

A higher incidence of female infertility has been reported with an unexpectedly early appearance in recent years. The female infertility treatment and application of assisted reproductive technology have recently gained immense interest from scientists. Many studies have discussed the beneficial effects of acupuncture on female infertility. With advancements in science and medical technology, acupuncture-related research has increased in investigating its effectiveness in treating female infertility. This review focuses on a compilation of research in recent years on acupuncture for female infertility treatment and the exploration of the underlying mechanism. For this purpose, literature was searched using various search engines like PubMed, Web of Science, and Google Scholar. The search was refined by only focusing on recent studies on acupuncture effectiveness and mechanism in female infertility and evaluating pregnancy outcomes.
https://doi.org/10.1155/2022/3854117
Länk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273356/

 

Acupuncture combined with gonadotropin‑releasing hormone agonists improves endometrial receptivity and pregnancy outcome in patients with recurrent implantation failure of in vitro fertilization‑embryo transfer

Jingya Yang, Yan Lu, Yuan Zhang, Cuijuan Zhou, Qin Liang, Ting Liang
Received: 11 March 2024 / Accepted: 7 May 2024
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024

Abstract
Objective Gonadotropin-releasing hormone agonists (GnRHa), combined with other auxiliary treatments, can improve
pregnancy outcomes in in vitro fertilization-embryo transfer (IVF-ET). This research investigated the effect of acupuncture
combined with GnRHa in patients with recurrent implantation failure (RIF) of IVF-ET.
Methods A total of 164 patients who intended to undergo frozen-thawed embryo transfer after RIF of IVF-ET were selected
for experiments and then divided into the control (received conventional hormone replacement therapy (HRT) for endometrial preparation) and study groups (received a combination of acupuncture, GnRHa, and HRT for endometrial preparation)
(n = 82). Endometrial thickness (EMT), endometrial morphological classification, submucosal uterine blood flow classification, clinical pregnancy rate, embryo implantation rate, and early abortion rate for each transfer cycle were compared
between the two groups.
Results EMT of the study group was higher than that of the control group 1 day before transfer. There were more patients
with linear endometrium (A + B type) in the study group on the day of endometrial transformation than in the control group.
The number of patients with type I submucosal uterine blood flow in the study group was decreased and the number of
patients with type III was increased compared with the control group on the day of endometrial transformation. The clinical
pregnancy rate and embryo implantation rate of the study group were higher than those of the control group.
Conclusion Acupuncture combined with GnRHa improves the endometrial receptivity of patients with RIF of IVF-ET,
thereby increasing clinical pregnancy rates and improving pregnancy outcomes.
Länk: https://usercontent.one/wp/akupunkturforbundet.se/wp-content/uploads/2024/08/2024_Acup_IVF_Study.pdf?media=1683488878

 

Point of Influence: What is the Role of Acupuncture in In Vitro Fertilization Outcomes?

Lee E. Hullender Rubin, DAOM, MS, LAc, FABORM1
Med Acupunct. December 2019; 31(6): 329–333.
Published online 2019 Dec 13. doi: 10.1089/acu.2019.1392 PMCID: PMC6918533 PMID: 31871519
Abstract
Augmenting in vitro fertilization (IVF) with acupuncture is a popular adjuvant therapy in the United States, but its influence on IVF birth outcomes remains controversial. Recent meta-analyses found acupuncture is effective to increase the risk of live births by 30% when acupuncture was compared with no treatment in nine trials of 1,980 women. The efficacy of acupuncture is unclear, however, and confounded by the need for an adequate, inert control. Acupuncture does not increase the risk of miscarriage. Additionally, acupuncture was 42% more effective to increase live births when women had previously failed a cycle, and baseline pregnancy rate continues to mediate acupuncture's effects. The characteristics of treatment more favorable to improving birth outcomes included more treatments, timing treatments in the period before and on the day of embryo transfer (ET), and using a modified Paulus protocol on the day of ET. These findings should inform the dosage, timing, and components of acupuncture therapy and type of comparator in future trials investigating the effects of acupuncture on IVF outcomes.

Acupuncture and in vitro fertilisation research: current and future directions

Lee E Hullender Rubin, Belinda J Anderson, LaTasha B Craig
2018 Apr;36(2):117-122. doi: 10.1136/acupmed-2016-011352. Epub 2018 Feb 10.
Abstract

Background: Acupuncture is a common adjuvant treatment to support patients undergoing in vitro fertilisation (IVF). However, the impact of acupuncture and the different roles it can play in IVF remain unclear.

Objective: In this paper, we present an overview and critique of the current evidence on acupuncture's impact on IVF-related stress, describe harms, and propose future directions for investigation.

Conclusion: Two to three acupuncture sessions performed on or around the day of embryo transfer are insufficient interventions to improve IVF birth outcomes but provide significant IVF-related stress reduction. Research investigating acupuncture to support IVF is heterogeneous and confounded by the lack of an appropriate comparator. However, evidence suggests several acupuncture sessions improve endometrial thickness, reduce stress, and improve patient satisfaction. Observational studies suggest more sessions are associated with increases in clinical pregnancy and live birth rates. An optimised acupuncture intervention with a reasonable comparator is necessary for future studies, with evidence-based guidance on technique and number of sessions. Acupuncture should not be rejected as an adjuvant therapy for IVF, but more studies are needed to clarify acupuncture's role in supporting IVF cycles.

Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis

Caroline A Smith, Mike Armour, Zewdneh Shewamene, Hsiewe Ying Tan, Robert J Norman, Neil P Johnson
PMID: 30658892 DOI: 10.1016/j.rbmo.2018.12.038
Abstract
This was a systematic review and meta-analysis to examine the efficacy, effectiveness and safety of acupuncture as an adjunct to embryo transfer compared with controls to improve reproductive outcomes. The primary outcome was clinical pregnancy. Twenty trials and 5130 women were included in the review. The meta-analysis found increased pregnancies (risk ratio [RR] 1.32, 95% confidence interval [CI] 1.07-1.62, 12 trials, 2230 women), live births (RR 1.30, 95% CI 1.00-1.68, 9 trials, 1980 women) and reduced miscarriage (RR 1.43, 95% CI 1.03-1.98, 10 trials, 2042 women) when acupuncture was compared with no adjunctive control. There was significant heterogeneity, but no significant differences between acupuncture and sham controls. Acupuncture may have a significant effect on clinical pregnancy rates, independent of comparator group, when used in women who have had multiple previous IVF cycles, or where there was a low baseline pregnancy rate. The findings suggest acupuncture may be effective when compared with no adjunctive treatment with increased clinical pregnancies, but is not an efficacious treatment when compared with sham controls, although non-specific effects may be active in both acupuncture and sham controls. Future research examining the effects of acupuncture for women with poorer IVF outcomes is warranted.
Länk: https://pubmed.ncbi.nlm.nih.gov/30658892/
Acupuncture for Menopausal symptoms

BY SAUNDERS, N. Lic.Ac. BA(Hons) Traditional Acupuncture & BERRY, K. BHSc TCM Acupuncture, MSc Research
Länk: Evidence Based Acupuncture

Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies

Lina M. Chavez, Shiang-Suo Huang, Iona MacDonald, Jaung-Geng Lin, Yu-Chen Lee, and Yi-Hung Chen
Abstract
Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care. Clinical trial and meta-analysis findings have demonstrated the efficacy of acupuncture in improving balance function, reducing spasticity, and increasing muscle strength and general well-being post-stroke. The mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation remain unclear. The aim of this study was to conduct a literature review, summarize the current known mechanisms in ischemic stroke rehabilitation through acupuncture and electroacupuncture (EA) therapy, and to detail the frequently used acupoints implicated in these effects. The evidence in this review indicates that five major different mechanisms are involved in the beneficial effects of acupuncture/EA on ischemic stroke rehabilitation: (1) Promotion of neurogenesis and cell proliferation in the central nervous system (CNS); (2) Regulation of cerebral blood flow in the ischemic area; (3) Anti-apoptosis in the ischemic area; (4) Regulation of neurochemicals; and, (5) Improvement of impaired long-term potentiation (LTP) and memory after stroke. The most frequently used acupoints in basic studies include Baihui (GV20), Zusanli (ST36), Quchi (LI11), Shuigou (GV26), Dazhui (GV14), and Hegu (LI4). Our findings show that acupuncture exerts a beneficial effect on ischemic stroke through modulation of different mechanisms originating in the CNS.

Neuroimaging.BAsed Scalp Acupuncture Locations för Dementia.

Jin Cao , Yiting Huang , Nathaniel Meshberg, Sierra A. Hodges and Jian Kong

Abstract

Scalp acupuncture is a modality of acupuncture in which acupuncture needles are inserted
into a certain layer of the scalp in order to affect the function of corresponding areas of the cerebral cortex
and relieve symptoms. Clinical studies have demonstrated the potential of scalp acupuncture as a
non-pharmacological treatment for dementia. Unfortunately, recent findings from brain neuroimaging
studies on dementia have not been incorporated into scalp acupuncture. This study aims to integrate
meta-analysis, resting-state functional connectivity, and diffusion tensor imaging (DTI) to identify
potential locations of scalp acupuncture for treatment of dementia. We found that the prefrontal
cortex, the medial prefrontal cortex, the middle and superior temporal gyrus, the temporal pole,
the supplementary motor area, the inferior occipital gyrus, and the precuneus are involved in the
pathophysiology of dementia and, therefore, may be the target areas of scalp acupuncture for dementia
treatment. The neuroimaging-based scalp acupuncture protocol developed in this study may help to
refine the locations for the treatment of dementia. Integrating multidisciplinary methods to identify
key surface cortical areas associated with a certain disorder may shed light on the development
of scalp acupuncture and other neuromodulation methods such as transcranial electrical current
stimulation, particularly in the domain of identifying stimulation locations
Länk: Neuroimaging-Based Scalp Acupuncture Locations for Dementia

 

Barriers to Acupuncture Use Among Breast Cancer Survivors: A Cross-Sectional Analysis

Ting Bao 1, Qing Li 1, Janice L DeRito 1, Christina Seluzicki 1, Eun-Ok Im 2, Jun Mao 1

DOI: 10.1177/1534735418754309

Abstract

Introduction: Increasing evidence suggests that acupuncture may be helpful to manage common symptoms and treatment side effects among breast cancer (BC) survivors. Acupuncture usage among BC survivors remains low with little known about the barriers to its utilization. We evaluated perceived barriers to acupuncture use among BC survivors and explored the sociodemographic variations of such barriers. Methods: We conducted a cross-sectional analysis at an urban academic cancer center on 593 postmenopausal women with a history of stage I-III hormone receptor-positive BC who were taking or had taken an aromatase inhibitor. We used the modified Attitudes and Beliefs about Complementary and Alternative Medicine instrument to evaluate patients’ perceived barriers to acupuncture. Multiple linear regression analysis was performed to determine sociodemographic factors associated with perceived barrier scores. Results: The most common barriers were lack of knowledge about acupuncture (41.6%), concern for lack of insurance coverage (25.0%), cost (22.3%), and difficulty finding qualified acupuncturists (18.6%). Compared with whites, minority patients had higher perceived barriers to use acupuncture (β coefficient = 1.63, 95% confidence interval = 0.3-2.9, P = .013). Patients with lower education had higher barriers to use acupuncture (β coefficient = 4.23, 95% confidence interval = 3.0-5.4, P < .001) compared with patients with college education or above. Conclusion: Lack of knowledge and concerns for insurance coverage and cost are the common barriers to acupuncture use among BC survivors, especially among minority patients with lower education. Addressing these barriers may lead to more equitable access to acupuncture treatment for BC survivors from diverse backgrounds.

Länk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142082/

 

Reducing Hot Flashes in Patients with Breast Cancer Using Acupuncture

Lu W et al. Acupuncture for hot flashes in hormone receptor-positive breast cancer: A pooled analysis of individual patient data from parallel randomized trials. Cancer. 2024;DOI:10.1002/cncr.35374.  

Länk: European Medical Journal

Acupuncture for chronic pain: update of an individual patient data meta-analysis

Andrew J. Vickers, PhD, Emily A. Vertosick, MPH, George Lewith, MD, Hugh MacPherson, PhD, Nadine E. Foster, DPhil, Karen J. Sherman, PhD, Dominik Irnich, MD, Claudia M. Witt, MD, and Klaus Linde, MD, on behalf of the Acupuncture Trialists’Collaboration
Abstract
Despite wide use in clinical practice, acupuncture remains a controversial treatment for chronic pain. Our objective was to update an individual patient data meta-analysis to determine the effect size of acupuncture for four chronic pain conditions. We searched MEDLINE and the Cochrane Central Registry of Controlled Trials randomized trials published up until December 31, 2015. We included randomized trials of acupuncture needling versus either sham acupuncture or no acupuncture control for non-specific musculoskeletal pain, osteoarthritis, chronic headache, or shoulder pain. Trials were only included if allocation concealment was unambiguously determined to be adequate. Raw data were obtained from study authors and entered into an individual patient data meta-analysis. The main outcome measures were pain and function. An additional 13 trials were identified, with data received for a total of 20,827 patients from 39 trials. Acupuncture was superior to both sham and no acupuncture control for each pain condition (all p<0.001) with differences between groups close to 0.5 standard deviations (SD) for comparison with no acupuncture control and close to 0.2 SDs in comparison with sham. We also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at one year. In secondary analyses, we found no obvious association between trial outcome and characteristics of acupuncture treatment, but effect sizes of acupuncture were associated with the type of control group, with smaller effects sizes for sham controlled trials that used a penetrating needle for sham, and for trials that had high intensity of intervention in the control arm. We conclude that acupuncture is effective for the treatment of chronic pain, with treatment effects persisting over time. While factors in addition to the specific effects of needling at correct acupuncture point locations are important contributors to the treatment effect, decreases in pain following acupuncture cannot be explained solely in terms of placebo effects. Variations in the effect size of acupuncture in different trials are driven predominately by differences in treatments received by the control group rather than by differences in the characteristics of acupuncture treatment.