ATTENUATION OF EXERCISE-INDUCED ASTHMA BY ACUPUNCTURE Acute bronchodilating effect of transcutaneous nerve stimulation in asthma. A peripheral reflex or psychogenic response. A controlled trial of real and simulated acupuncture in the management of chronic asthma. No Effect of Chinese Acupuncture on Isocapnic Hyperventilation with Cold Air in Asthmatics, Measured with Impulse Oscillometry Effect of acupuncture on bronchial asthma. Comparison of real and placebo acupuncture in histamine-induced asthma. A double-blind crossover study. Laser acupuncture in children and adolescents with exercise induced asthma Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Comparison of real and simulated acupuncture and isoproterenol in methacholine-induced asthma. Short-term acupuncture therapy is of no benefit in patients with moderate persistent asthma. Effects of acupuncture in bronchial asthma: preliminary communication. The bronchodilating effect of acupuncture in patients with acute asthma. Acupuncture in treatment of stable asthma. CONTROLLED TRIAL OF ACUPUNCTURE FOR DISABLING BREATHLESSNESS Acupuncture and bronchial asthma: a long-term randomized study of the effects of real versus sham acupuncture compared to controls in patients with bronchial asthma. Immunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized controlled study. [Acupuncture - has it a demonstrable bronchospasmolytic effect in bronchial asthma (author's transl)]. Acupuncture and Bronchial Asthma Acupuncture has no immediate treatment effect on the neutrophil respiratory burst: A randomized single-blinded two-period crossover study Acupuncture for bronchial asthma? A double-blind crossover study. Efficacy of laser-acupuncture in the prevention of exercise-induced asthma. Acupuncture in bronchial asthma: bodyplethysmographic measurements of acute bronchospasmolytic effects.
A prospect i ve r and omised single-blind study of the effects of real and sham acupuncture on  exercise-induced asthma  was conducted in nineteen children .  Forced expiratory flow in 1st second ( FEV1 ) , forced vital capacity ( FVC ) , and peak expiratory flow rate ( PEFR ) were measured throughout acupuncture and after treadmill exercise . Neither real nor sham acupuncture affected the basal bronchomotor tone but both , when applied 20 min before exercise , attenuated exercise induced asthma : mean maximum percentage falls in FEV1 , FVC , and PEFR were 44.4 % , 33.3 % , and 49.5 % without acupuncture ; 23.8 % , 15.8 % , and 25.9 % after real acupuncture ; and 32.6 % , 26.1 % , and 34.3 % after sham acupuncture . Real acupuncture provided better protection against exercise-induced asthma than did sham acupuncture ( p less than 0.05 ) The acute effect of electric transcutaneous nerve stimulation ( TNS ) on bronchomotor tone was studied in 20 asthmatics . The stimulation was applied to four classical acupuncture points on the chest and back , and bronchomotor response was determined by measuring peak expiratory flow ( PEF ) . The experiments consisted of an adaptation period , placebo " stimulation " , TNS , and an isoprenaline inhalation test , in that order . In 11 patients PEF increased significantly ( greater than 15 % ) after placebo " stimulation " ; the mean change in all 20 patients after that period was + 12 % ( P less than 0.01 ) . TNS , however , did not change PEF significantly in any patient in spite of the fact that marked residual bronchoconstriction was shown in all patients demonstrated by an increase in PEF after inhalation of two isoprenaline puffs at the end of the experiment . The results suggest that the acute bronchodilatation obtainable with TNS is probably psychogenic ; no cutaneous-bronchial reflex could be demonstrated . The same kind of psychogenic reaction may also be involved in the bronchodilator response to needle acupuncture in asthma In 25 patients with moderate to severe asthma , we compared the therapeutic effectiveness of classic Chinese acupuncture with that of " placebo " acupuncture administered in a r and omly ordered , subject- and evaluator-blind , crossover fashion twice weekly for 4 weeks . Real and placebo acupuncture periods were each preceded and followed by 3- to 4-week periods during which no acupuncture was administered . Outcome variables consisted of the following : daily symptoms and medication use self-scored on patient diaries , spirometry and whole body plethysmography performed once weekly during the entire course of the study and repeated serially during 3 hours after real and placebo acupuncture treatment , patients ' self- assessment of acute efficacy of acupuncture therapy , and physician 's physical findings before and after  acupuncture treatment . Two-way analysis of variance failed to reveal a significant effect of either form of acupuncture  on symptoms , medication use , or lung function measurements . Similarly , no significant acute effect of  acupuncture on lung function , self-ratings of efficacy , or physician 's physical findings was found by covariance analysis or the Wilcoxon signed-rank test . When data during the entire course of the study were examined on an individual basis by analysis of variance with repeated measures , only two subjects demonstrated significantly favorable responses to real versus placebo acupuncture , but one subject demonstrated the reverse , suggesting that these responses were not specifically related to acupuncture therapy . Thus , our findings failed to demonstrate any short- or long-term benefit of acupuncture therapy in the management of moderate to severe asthma The cost to society and the individual of treating asthma has been increasing in developed countries . This has given rise to studies of the efficacy of complementary treatments . The aim of this study was to evaluate the efficacy of traditional Chinese Acupuncture in patients with mild asthma . The method used for evaluation of efficacy was total airway resistance at 5Hz ( R5 ) as measured by impulse oscillometry ( IOS ) – a forced oscillation technique , at baseline and after a bronchial challenge with voluntary isocapnic hyperventilation of cold air ( IHCA ) . The study was a parallel group r and omised placebo controlled trial with evaluator blinding . Twenty-seven asthmatics were recruited and 24 completed the study , 10 of them received acupuncture and 14 received a placebo treatment ( mock-TENS ) . Treatment continued for 15 weeks , and efficacy was tested two weeks following the last treatment . R and omisation result ed in female over representation in the acupuncture group , but lung-function and bronchial responsiveness to IHCA were comparable in the two population s before the start of treatment ( p>0.05 vs. p>0.05 ) . There were no statistically significant effects of the treatment before ( p>0.05 ) or after IHCA ( p>0.05 ) in either of the groups . The statistical power of the study to show a clinical ly relevant difference in bronchial responsiveness to IHCA after treatment was near 80 % . We conclude that there were no significant effects of traditional Chinese Acupuncture on airway status in our patients with asthma 1 . Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma . 2 . In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated , and in five patients wheezing was abolished . 3 . Stimulation at the correct site produced a significant increase in the mean FEV1 - 0 ( 58 % ) and FVC ( 29 % ) but not in maximal mid-expiratory flow rate ( MMFR ; 76 % ) , when compared with the findings before acupuncture , along with a significant fall in the Pa , CO2 and an insignificant fall in Pa , O2 . A mild tachycardia was also observed . 4 . After acupuncture a greater improvement in FEV1 - 0 , FVC and MMFR was produced by inhalation of isoprenaline . 5 . No significant changes in FEV1 - 0 , FVC , MMFR , pulse rate or arterial blood gas tensions occurred after acupuncture at control sites . 6 . In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge , but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction . 7 . It is concluded that acupunture probably reduced the reflex component of the bronchoconstriction , but failed to influence direct smooth muscle constriction caused by histamine A double-blind crossover study of the effects of real and placebo acupuncture on bronchial reactivity to histamine was carried out on 16 patients with moderately severe asthma . Treatment with real or placebo acupuncture  failed to modulate the bronchial hyperreactivity to histamine . These results suggest that a single treatment with acupuncture is unlikely to provide improvement in the management of acute bronchial asthma Background : Laser acupuncture , a painless technique , is a widely used alternative treatment method for childhood asthma , although its efficacy has not been proved in controlled clinical studies . Methods : A double blind , placebo controlled , crossover study was performed to investigate the possible protective effect of a single laser acupuncture treatment on cold dry air hyperventilation induced bronchoconstriction in 44 children and adolescents of mean age 11.9 years ( range 7.5–16.7 ) with exercise induced asthma .  Laser acupuncture was performed on real and placebo points in r and om order on two consecutive days . Lung function was measured before laser acupuncture , immediately after laser acupuncture ( just before cold dry air challenge ( CACh ) ) , and 3 and 15 minutes after CACh . CACh consisted of a 4 minute isocapnic hyperventilation of –10 ° C absolute dry air . Results : Comparison of real acupuncture with placebo acupuncture showed no significant differences in the mean maximum CACh induced decrease in forced expiratory volume in 1 second ( 27.2 (18.2)% v 23.8 (16.2)% ) and maximal expiratory flow at 25 % remaining vital capacity ( 51.6 (20.8)% v 44.4 (22.3)% ) . Conclusions : A single laser acupuncture treatment offers no protection against exercise induced bronchoconstriction in paediatric and adolescent patients Acupuncture treatment and control group interventions in parallel-group r and omised trials of acupuncture are not always precisely reported . In an attempt to improve st and ards , an international group of experienced acupuncturists and research ers devised a set of recommendations , design ating them STRICTA : ST and ards for Reporting Interventions in Controlled Trials of Acupuncture . In a further consensus-building round , the editors of several journals helped redraft the recommendations . These follow the Consoli date d St and ards for Reporting Trials ( CONSORT ) format , acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies . Participating journals are publishing the STRICTA recommendations and requesting prospect i ve authors to adhere to them when preparing reports for publication . Other journals are invited to adopt these recommendations . The intended outcome is that interventions in controlled trials of acupuncture  will be more adequately reported , thereby facilitating an improvement in critical appraisal , analysis and replication of trials In a double-blind ( patient and evaluator ) , crossover study effects of real acupuncture , simulated acupuncture , nebulized isoproterenol , nebulized saline and no treatment in reversing methacholine-induced bronchospasm were compared in 12 asthmatics ( ages 16 to 64 ) . Saline and simulated acupuncture did not result in any significant improvement in specific airway conductance ( SGaw ) , thoracic gas volume ( Vtg ) or forced expiratory flow rates compared with no treatment following methacholine-induced bronchospasm . Isoproterenol and real acupuncture were both followed by increases in SGaw and flow rates and decreases in Vtg which were significantly different from the changes observed following no treatment , saline or simulated acupuncture , although isoproterenol produced greater improvement than real acupuncture , although isoproterenol produced greater improvement than real acupuncture . These findings suggest that stimulation of specific acupuncture loci reduces methacholine-induced bronchospasm and hyperinflation to an extent greater than can be attributed to placebo phenomena STUDY OBJECTIVES Acupuncture traditionally has been used to treat asthma . Nevertheless , only a few controlled studies have been performed to determine the efficacy of this treatment . Our study aim ed to determine the efficacy of acupuncture in patients with moderate persistent asthma . METHODS Twenty-three patients with moderate persistent asthma who had been treated only with inhaled beta(2)-agonists were r and omly assigned to receive four sessions of real acupuncture ( RA ) or sham acupuncture ( SA ) in a blinded manner . After a washout period of 3 weeks , the patients were crossed over . Monitoring included FEV(1 ) , methacholine challenge , daily peak flow ( PF ) variability , and the keeping of an asthma diary . RESULTS Twenty of 23 patients completed the study . There was no significant change in FEV(1 ) following treatment . The mean ( + /- SE ) FEV(1 ) values before and after the RA were 73 + /- 4 % and 73 + /- 3 % , respectively ( not significant [ NS ] ) . FEV(1 ) values before and after SA were 70 + /- 3 % and 70 + /- 3 % , respectively ( NS ) . There was also no change in provocative methacholine concentration causing a 20 % fall in FEV(1 ) ( PC(20 ) ) before and after treatment . The mean PC(20 ) values before and after RA were 0.92 + /- 0.42 mg/mL and 1.16 + /- 0.51 mg/mL , respectively ( p = 0.71 ) , while the PC(20 ) values before and after SA were 1.47 + /- 0.83 mg/mL and 1.11 + /- 0.79 mg/mL , respectively ( p = 0.59 ) . There was no change in the mean PF variability before and after the RA ( 1.6 + /- 3.1 % and 1.8 + /- 2.3 % , respectively [ NS ] ) . The PF variability before and after SA were 3.6 + /- 2.8 % and 2.8 + /- 3.4 % , respectively ( NS ) . No significant difference was demonstrated for symptom scores or for the use of beta(2)-agonist inhalers ( RA , 6.7 + /- 3.4 ; SA , 8.1 + /- 3.6 ; p = 0.58 ) . CONCLUSION In patients with moderate persistent asthma , a short course of acupuncture treatment result ed in no change in lung functions , bronchial hyperreactivity , or patient symptoms Twenty patients r and omly assigned to an experimental and a control group participated in a double blind study to assess the effectiveness of  acupuncture  in bronchial asthma , using the peak expiratory flow rate ( PEFR ) as an index of bronchial patency . All patients in the control group showed a significant improvement in their PEFR while only 3 patients in the treated group showed an improvement . A subjective improvement and a reduction in drug dosages were observed in both groups . It is concluded that acupuncture has a placebo effect in bronchial asthma The effectiveness of acupuncture therapy for asthmatic patients was studied by continuous monitoring of the respiratory function . Using the forced 5 Hz oscillating technique , the investigators could estimate the change of total respiratory resistance ( Rrs ) of asthmatic patients throughout their reception of acupuncture therapy . They performed a single-blind study consisting of a placebo acupuncture , a placebo stimulation and real acupuncture therapy For further control of this study , they selected an easily locatable point for needle placement among the many traditional meridian points . In 10 out of 26 acupuncture therapies . Rrs significantly decreased while in only one of 17 placebo treatments did Rrs decrease Previous studies of acupuncture in asthma have reported conflicting results , some cl aim ing benefit for some patients . We conducted a r and omized , double-blind ( patient and evaluator ) study in 23 non-smoking asthmatics ( 10 M ; 13 F ) aged 43 + /- 15 years with forced expiratory volume in 1 s ( FEV1 ) 59 + /- 16 % pred . After initial assessment ( respiratory function tests and Asthma Quality Life Question naire ) patients were r and omized to receive either ' real ' or ' sham ' acupuncture . The measurements were repeated within 1 h and after 2 weeks . Patients were recording peak expiratory flow rate ( PEFR ) throughout the period of the study . After 2 weeks patients who received ' real ' treatment on the first visit received ' sham ' treatment and vice versa . The measurements were again repeated within 1 h and after 2 weeks . There was no improvement in any aspects of respiratory function measured after either form of acupuncture . Despite this there was a significant improvement in AQLQ and parallel reduction in the usage of bronchodilators . We concluded that in some patients acupuncture could be useful in improving quality of life and reducing the need for using bronchodilators either by having a placebo effect or that the exact site of needle puncture on the chest is unimportant In a r and omised controlled trial , twelve matched pairs of patients with chronic obstructive pulmonary disease received traditional Chinese acupuncture or placebo acupuncture . After three weeks ' treatment the traditional-acupuncture group showed significantly greater benefit in terms of subjective scores of breathlessness and six-minute walking distance . Objective measures of lung function were unchanged in either group . Whether these differences are mediated by endogenous opiate and /or peptide release remains speculative BACKGROUND Acupuncture has traditionally been used in China in the treatment of bronchial asthma and is being increasingly applied in Western countries . Although there are many published studies on acupuncture and asthma , few meet the scientific criteria necessary to prove the effectiveness of acupuncture . OBJECTIVE To examine the short- and long-term effects of real versus sham or no acupuncture in patients with bronchial asthma . DESIGN R and omized partially blinded study with three parallel groups . SUBJECTS Sixty-six ( 66 ) patients of both genders ( mean age , 39 years ) with mild-to-moderate persistent bronchial asthma . INTERVENTIONS After 2 weeks of run-in , the patients with asthma were r and omized to receive either real ( 23 patients ) or sham acupuncture ( 23 patients ) or no acupuncture ( 20 patients ) . Two acupuncture periods ( each 4 weeks ) within the first 4 months were followed by a 6-month observation . MEASUREMENTS Primary outcome was the change of peak expiratory flow ( PEF ) variability at the end of the two treatment periods . Secondary outcomes were changes in forced expiratory volume in 1 second ( FEV1 ) , airway responsiveness , symptoms of asthma , the use of asthma drugs , and patients ' well-being . Moreover , the effect of the intervention on eosinophils and eosinophil cationic protein ( ECP ) in blood and sputum was assessed . RESULTS PEF variability decreased in all groups . In a subgroup of patients whose asthma medication remained fairly unchanged , PEF variability decreased significantly after needling of real as well as sham points at month 4 and 5 compared to controls ( p < or = 0.005 ) . However , there was no difference in the decrease of PEF variability between patients who had the blinded treatment with real or sham acupuncture . Most of the other functional and clinical variables did not differ from those obtained in controls . Eosinophils and ECP in blood and sputum decreased in all groups , but the only significant differences were found in blood eosinophil count at 4 months between sham acupuncture and the control group ( p < 0.05 ) and at 10 months between real and sham acupuncture ( p < 0.05 ) suggesting a possible effect on eosinophilic inflammation . CONCLUSIONS In view of the fact that the effects after real and sham acupuncture compared to controls who had no needling at all were small , in all likelihood clinical ly irrelevant , our data do not seem to support the use of acupuncture in the management of pharmacologically well-treated patients with mild-to-moderate persistent asthma OBJECTIVE According to Traditional Chinese Medicine ( TCM ) acupuncture is a suitable treatment for complex chronic diseases such as bronchial asthma . In a r and omized , controlled study we investigated immunologic effects of Chinese acupuncture on patients with allergic asthma . PATIENTS AND METHODS The effects of acupuncture treatment given according to the principles of TCM  ( TCM group , n = 20 ) were compared with those of acupuncture treatment using points not specific for  asthma ( control group , n = 18 ) . All patients were treated 12 times for 30 minutes over a time period of 4 weeks . Patients ' general well-being and several peripheral blood parameters ( eosinophils , lymphocyte sub population s , cytokines , in vitro lymphocyte proliferation ) were determined before and after acupuncture treatment . RESULTS In the TCM group , significantly more patients indicated an improvement in general well-being ( 79 % in the TCM group versus 47 % in the control group ; p = 0.049 ) after acupuncture treatment . The following changes were found in the TCM group : within the lymphocyte sub population s the CD3 + cells ( p = 0.005 ) and CD4 + cells ( p = 0.014 ) increased significantly . There were also significant changes in cytokine concentrations : interleukin (IL)-6 ( p = 0.026 ) and IL-10 ( p = 0.001 ) decreased whereas IL-8 ( p = 0.050 ) rose significantly . Additionally , the in vitro lymphocyte proliferation rate increased significantly ( p = 0.035 ) while the number of eosinophils decreased from 4.4 % to 3.3 % after acupuncture ( p > 0.05 ) . The control group , however , showed no significant changes apart from an increase in the CD4 + cells ( p = 0.012 ) . CONCLUSION The results imply that asthma patients benefit from acupuncture treatment given in addition to conventional therapy . Furthermore , acupuncture performed in accordance with the principles of TCM showed significant immune-modulating effects In 12 patients with bronchial asthma the effects of acupuncture ( 45 tests altogether ) on airway resistance have been investigated . In 9 patients there was a significant decrease of airway resistance 10 minutes , 1 hour and 2 hours after the end of acupuncture . The lowest level for airway resistance ( 70,1 % of control value ) was reached during the first hour after acupuncture . The possibility of a merely suggestive effect could be excluded , because " placebo-acupunctures " did not change airway resistance significantly . The comparison with a parasympatholytic acting drug as a metered aerosol ( Atrovent ) demonstrated that acupuncture had a some-what weaker bronchospasmolytic effect . 3 patients showed after repeated acupunctures no reaction whatever Seventeen patients with stable bronchial asthma were r and omly assigned to receive either correct acupuncture or placebo acupuncture . The study lasted 11 weeks and consisted of a pre‐therapy , therapy , and post‐therapy period . The patients received 10 treatments during a 5‐week period . The effect of therapy on pulmonary function was assessed daily by the patients at home . Morning and evening peak expiratory flow rate , number of puffs beta2‐agonist aerosol needed , as well as subjective symptoms of asthma were recorded in a diary . The correctly treated group improved significantly throughout the study . Also , compared with the placebo group , a significant improvement was found in all assessed parameters 2 weeks after beginning therapy . Hereafter , no differences could be shown Little is known about the influence of acupuncture treatment on the immune system . The respiratory burst ( RB ) of polymorphonuclear leukocytes ( PMN ) is a recognized measure of their cytotoxicity , an important component of the immune system . The present trial was therefore performed to examine whether a single-acupuncture treatment has an immediate effect on the RB of neutrophil PMNs . Sixteen volunteers were enrolled in the study . After r and omization , eight volunteers were treated bilaterally with st and ard needles at acupoint LI11 and eight volunteers with placebo needles at the same acupoint , each for 30 min . The RB was determined before and 30 min after treatment . After two weeks , each group received the alternative treatment . There was a drop-out of two volunteers . No period or carryover effects were found in the remaining fourteen volunteers . No effect of acupuncture on the neutrophil RB was observed The therapeutic effectiveness of classic Chinese acupuncture was compared with " placebo " acupuncture in 15 patients with stable bronchial asthma . The patients received treatments with real and placebo acupuncture in a r and omly ordered , subject and evaluator-blind crossover fashion twice weekly for five weeks . Both real and placebo treatment periods were preceded by three week periods when no acupuncture was administered . Five patients felt better on real treatment , five patients preferred placebo and five did not feel any improvement on either of the two treatments . Treatment with real acupuncture when compared with no treatment and placebo treatment failed to provide any improvement in daily peak flow rates , asthma symptom scores , number of puffs of beta 2-agonist aerosol use , and pulmonary function results Many asthmatic patients are reluctant to follow the medication schedule prescribed for them and turn to alternative treatment methods . The results of this study indicate that one such method , laser acupuncture , does not prevent exercise-induced asthma In 12 patients with bronchial asthma the effects of acupuncture ( 45 tests altogether ) on airway resistance have been investigated . In 9 patients there was a significant decrease of airway resistance 10 minutes , 1 hour and 2 hours after the end of acupuncture . The lowest level for airway resistance ( 70.1 % of control value ) was reached during the first hour after acupuncture . The possibility of a merely suggestive effect could be excluded , because " placebo-acupunctures " did not change airway resistance significantly . The comparison with a parasympatholytic acting drug as a metered aerosol ( Atrovent ) demonstrated that acupuncture had a somewhat weaker bronchospasmolytic effect . Three patients did not show any reaction after repeated acupunctures
BACKGROUND Acupuncture has traditionally been used to treat asthma in China and is used increasingly for this purpose internationally .
OBJECTIVES The objective of this review was to assess the effects of acupuncture for the treatment of asthma or asthma-like symptoms .