Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial Effects of Auricular Acupressure Combined with Low-Calorie Diet on the Leptin Hormone in Obese and Overweight Iranian Individuals Effect of Electroacupuncture on Visceral and Hepatic Fat in Women with Abdominal Obesity: A Randomized Controlled Study Based on Magnetic Resonance Imaging. Acupuncture for Chronic Severe Functional Constipation The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Reduction in postpartum weight with laser acupuncture Comparison of the placebo effect between different non-penetrating acupuncture devices and real acupuncture in healthy subjects: a randomized clinical trial Influence of Acupuncture on Leptin, Ghrelin, Insulin and Cholecystokinin in Obese Women: A Randomised, Sham-Controlled Preliminary Trial Randomised Clinical Trial of Five Ear Acupuncture Points for the Treatment of Overweight People The effect of auricular acupuncture in obese women: a randomized controlled trial. Effects of auricular acupressure using Sinapsis alba seeds on obesity and self-efficacy in female college students. Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women Acupuncture for reducing pruritus induced by intrathecal morphine at elective cesarean delivery: a placebo-controlled, randomized, double-blind trial. Efficacy and safety of acupuncture for hypertension: An overview of systematic reviews. Urtica dioica in comparison with placebo and acupuncture: A new possibility for menopausal hot flashes: A randomized clinical trial.
Importance Acupuncture is used to induce ovulation in some women with polycystic ovary syndrome , without supporting clinical evidence . Objective To assess whether active acupuncture , either alone or combined with clomiphene , increases the likelihood of live births among women with polycystic ovary syndrome . Design , Setting , and Participants A double-blind ( clomiphene vs placebo ) , single-blind ( active vs control acupuncture ) factorial trial was conducted at 21 sites ( 27 hospitals ) in mainl and China between July 6 , 2012 , and November 18 , 2014 , with 10 months of pregnancy follow-up until October 7 , 2015 . Chinese women with polycystic ovary syndrome were r and omized in a 1:1:1:1 ratio to 4 groups . Interventions Active or control acupuncture administered twice a week for 30 minutes per treatment and clomiphene or placebo administered for 5 days per cycle , for up to 4 cycles . The active acupuncture group received deep needle insertion with combined manual and low-frequency electrical stimulation ; the control acupuncture group received superficial needle insertion , no manual stimulation , and mock electricity . Main Outcomes and Measures The primary outcome was live birth . Secondary outcomes included adverse events . Results Among the 1000 r and omized women ( mean [ SD ] age , 27.9 [ 3.3 ] years ; mean [ SD ] body mass index , 24.2 [ 4.3 ] ) , 250 were r and omized to each group ; a total of 926 women ( 92.6 % ) completed the trial .  Live births occurred in 69 of 235 women ( 29.4 % ) in the active acupuncture plus clomiphene group , 66 of 236 ( 28.0 % ) in the control acupuncture plus clomiphene group , 31 of 223 ( 13.9 % ) in the active acupuncture plus placebo group , and 39 of 232 ( 16.8 % ) in the control acupuncture plus placebo group . There was no significant interaction between active acupuncture and clomiphene ( P = .39 ) , so main effects were evaluated . The live birth rate was significantly higher in the women treated with clomiphene than with placebo ( 135 of 471 [ 28.7 % ] vs 70 of 455 [ 15.4 % ] , respectively ; difference , 13.3 % ; 95 % CI , 8.0 % to 18.5 % ) and not significantly different between women treated with active vs control acupuncture ( 100 of 458 [ 21.8 % ] vs 105 of 468 [ 22.4 % ] , respectively ; difference , −0.6 % ; 95 % CI , −5.9 % to 4.7 % ) . Diarrhea and bruising were more common in patients receiving active acupuncture than control acupuncture ( diarrhea : 25 of 500 [ 5.0 % ] vs 8 of 500 [ 1.6 % ] , respectively ; difference , 3.4 % ; 95 % CI , 1.2 % to 5.6 % ; bruising : 37 of 500 [ 7.4 % ] vs 9 of 500 [ 1.8 % ] , respectively ; difference , 5.6 % ; 95 % CI , 3.0 % to 8.2 % ) . Conclusions and Relevance Among Chinese women with polycystic ovary syndrome , the use of acupuncture with or without clomiphene , compared with control acupuncture and placebo , did not increase live births . This finding does not support acupuncture as an infertility treatment in such women . Trial Registration clinical trials.gov Identifier : Background Human leptin is a peptide hormone that is released from white adipocytes . The absence of leptin or its receptor leads to uncontrolled food intake , leading to obesity . In the present work , the effects of auricular acupressure combined with low-calorie diet on the leptin hormone level were investigated . Methods Volunteers ( n=86 ) with body mass indices ( BMI ) between 25 and 45 kg/m2 were r and omised into a case ( n=43 ) or a control ( n=43 ) group . Participants in each group received a low-calorie diet for 6 weeks . The case group was treated with auricular acupressure and the control group received a sham procedure .  Plasma leptin levels , body fat mass , body weight and BMI were measured before and after treatment . Results Participants who received auricular acupressure showed significant reductions in their plasma leptin levels ( 18.57 % , p<0.01 ) as well as in their body fat mass ( 4 % , p<0.05 ) . These changes were not observed in the control group . The reduction in leptin was significantly greater in the acupressure group than the controls . Conclusions Auricular acupressure combined with a low-calorie diet significantly reduced plasma levels of leptin . However , the mechanism of this reduction is not clear OBJECTIVE Visceral adipose tissue ( VAT ) and hepatic fat deposition are the most important risk factors for women 's health . Acupuncture , including electroacupuncture ( EA ) , is used to treat obesity throughout the world . The effect of EA is evaluated mainly by body mass index ( BMI ) and waist circumference ( WC ) . Few studies have assessed its effect in reducing VAT volume and hepatic fat fraction ( HFF ) based on an exact measurement method such as magnetic resonance imaging ( MRI ) . This study aim ed to resolve this issue . METHODS Thirty subjects were r and omly divided into two groups . The control group ( n = 15 ) did not receive any  intervention  and maintained a normal diet and their usual exercise habits . The treatment group ( n = 15 ) received EA three times a week for 3 months . BMI and WC were measured using different devices . VAT and HFF were measured by MRI and calculated by related software before and after the intervention . RESULTS A marked difference was evident in group that received EA treatment in the following tests . The differences in BMI ( U = 21.00 , p < 0.001 ) , WC ( U = 40.50 , p = 0.002 ) , VAT volume ( U = 13.00 , p < 0.001 ) , and mean HFF ( U = 0.00 , p < 0.001 ) before and after the intervention in the treatment group were distinct and significant compared with those of the control group . Three months later , the treatment group showed a lower BMI ( W = 91.00 , p = 0.001 ) , WC ( t = 4.755 , p < 0.001 ) , VAT volume ( t = 5.164 , p < 0.001 ) , and mean HFF ( W = 120.00 , p = 0.001 ) compared with pretreatment levels . Compared with the control group , the treatment group showed a lower VAT volume ( t = 60.00 , p = 0.029 ) after 3 months of treatment . After 3 months , the control group showed higher mean HFF ( t = -2.900 , p = 0.012 ) and VAT volume ( W = 11.50 , p = 0.006 ) compared with their initial levels . CONCLUSION Based on MRI evaluation , this r and omized controlled study proved that EA treatment reduces BMI and WC as well as VAT volume and HFF in women with abdominal obesity Chronic constipation affects approximately 16 % of the world 's population ( 1 ) , 17.1 % of persons in Europe ( 2 ) , 12 % to 19 % of those in North America ( 3 ) , and 10.8 % of those in Asia ( 1 ) . Patients with severe chronic constipation have complete spontaneous bowel movements ( CSBMs ) no more than twice per week , with hard stools , frequent straining , and the sensation of incomplete evacuation ( 4 ) . Most chronic constipation is functional and is associated with decreased quality of life ( 5 ) . Laxatives produce only temporary relief , and constipation tends to reoccur after discontinuing medication ( 6 , 7 ) . Nearly half of patients are dissatisfied with their traditional therapies , such as laxatives ( 8) . Other treatment options may include prokinetic agents . In a trial , 1 to 2 mg of prucalopride ( an agonist for 5-hydroxytryptamine receptor 4 ) per day was reported to normalize BMs in 37.9 % of patients with severe chronic constipation ( 9 ) . However , the adverse cardiac effects induced by some prokinetic agents can not be ignored ( 10 ) , and their long-term effects remain unknown . A systematic review supports the use of acupuncture for chronic constipation ( 11 ) , and our previous study indicates that electroacupuncture ( EA ) might have some sustained effects ( 12 ) . However , the evidence for the therapeutic effects of acupuncture is limited because many r and omized , controlled trials have had small sample sizes or other method ological limitations ( 11 ) . Our goal was to determine the efficacy of EA for the treatment of chronic severe functional constipation ( CSFC ) over an 8-week treatment period and evaluate the maintenance of effects throughout the 12-week follow-up . We hypothesized that EA would be superior to sham EA ( SA ) at both end points . Methods Design Overview We conducted a multicenter , r and omized , parallel , sham-controlled trial at 15 sites in China . The study duration per patient was 22 weeks : 2 weeks before r and omization ( baseline assessment ) ; 8 weeks of treatment ; and 12 weeks of follow-up without treatment . Research ers screened c and i date s for study participation , and experienced physicians at digestive or anorectal departments made diagnoses . Participants Participants were included if they met the diagnosis of functional constipation based on the Rome III diagnostic criteria for functional gastrointestinal disorders ( 13 ) , had CSFC with 2 or fewer mean weekly CSBMs for more than 3 months , were aged between 18 and 75 years , had not taken constipation medication for a minimum of 2 weeks before enrollment except for rescue medicine ( glycerol or sorbitol anal enema ) , had not received acupuncture for constipation , and had not participated in any other trial in the previous 3 months . The exclusion criteria were constipation caused by irritable bowel syndrome or drugs or that was secondary to endocrine , metabolic , neurologic , or postoperative diseases ; severe cardiovascular , hepatic , or renal diseases ; cognitive dysfunction , aphasia , mental disorders , or illness that could affect patient cooperation ; pregnant or lactating women ; abdominal aortic aneurysm or hepatosplenomegaly ; blood coagulation disorders or regular anticoagulant use , including warfarin or heparin ( an exception was antiplatelet treatment using aspirin or clopidogrel ) ; and cardiac pacemaker implantation . C and i date s signed informed consent . After the 2-week baseline assessment , eligible participants were r and omly assigned and received their first treatment on the same day . The study was performed according to common guidelines for clinical trials ( Declaration of Helsinki and International Conference on Harmonisation Good Clinical Practice E6 guidance ) . The study protocol ( 14 ) adhered to the St and ards for Reporting Interventions in Clinical Trials of Acupuncture guidelines and was approved by the ethics committees of each responsible site . R and omization and Blinding Participants were allocated to the EA or SA group using stratified block r and omization . The r and omization sequences were generated by using PROC PLAN in SAS , version 9.4 ( SAS Institute ) , with the study site as the stratification factor and the block length as 4 . Acupuncturists obtained each patient 's r and om number and assignment through the central r and omization system ( Institute of Basic Research in Clinical Medicine , China Academy of Chinese Medical Sciences ) . All participants were treated separately to prevent communication . Except for acupuncturists , all relevant parties were blinded to the intervention ( EA vs. SA ) groups . Participants were informed that they had an equal chance of allocation to the EA or SA group before study participation . To test the success of blinding , we r and omly selected 140 participants ( 70 from each group , with 9 to 10 participants at each site ) for the blinding assessment ; the acupuncturists asked them to guess whether they received EA or SA after treatments in weeks 4 and 8 . Intervention Study interventions were developed by the consensus of acupuncture experts and per the results of our pilot study ( Cai Y , Wu J , Liu Z. Electroacupuncture versus sham electroacupuncture for chronic  severe functional constipation : a r and omized controlled pilot study . 2012 . Unpublished data . ) . Fifteen acupuncturists with 2 to 3 years of experience at the 15 sites administered the EA and SA treatments . All acupuncturists had at least a 5-year undergraduate education and were registered practitioners of traditional Chinese medicine . All research assistants and acupuncturists received a 2-day training session before study initiation . Both treatments consisted of 28 sessions , each for 30 minutes , and were administered over 8 weeks ( 5 sessions in each of the first 2 weeks , and 3 sessions in each of the remaining 6 weeks ) . Disposable needles ( Huatuo ) and the SDZ-V EA apparatus ( Suzhou Medical Appliance ) were used . Participants in the EA group received EA at the bilateral acupoints of Tianshu ( ST25 ) , Fujie ( SP14 ) , and Shangjuxu ( ST37 ) ( 15 ) . When participants were supine , 0.3050 mm or 0.3575 mm needles were inserted approximately 30 to 70 mm into ST25 and SP14 slowly and vertically , without manipulation , until they pierced the muscle layer of the abdominal wall . Paired alligator clips from the EA apparatus were attached transversely to the needle holders at bilateral ST25 and SP14 . The EA stimulation lasted for 30 minutes with a dilatational wave of 10/50 Hz and a current intensity of 0.1 to 1 mA depending on the participant 's comfort level ( preferably with skin around the acupoints shivering mildly without pain ) . In addition , 0.3040 mm needles were inserted vertically about 30 mm into ST37 and 3 small , equal manipulations of twirling , lifting , and thrusting ( once every 10 minutes ) were performed to reach acupuncture de qia soreness , heaviness , and distension sensation when needling ( 16 ) . Participants in the SA group received shallow needling at bilateral sham ST25 , sham SP14 , and sham ST37 ( nonacupoints that were located at different physical locations than ST25 , SP14 , and ST37 for EA ) ( Supplement ) . Specifically , 0.3025 mm needles were inserted vertically about 3 to 5 mm into nonacupoints without manipulation . Similar to EA , paired alligator clips from the specially constructed EA apparatus were attached to the needle holders of sham ST25 and sham SP14 . When switched on , the EA apparatus in the SA group had the same working power indicator and sound without actual current output . Supplement . Data Supplement In both groups , participants without BMs for 3 or more consecutive days were allowed to use 110-mL glycerol or 40- to 60-mL sorbitol anal enema as rescue medicine with documentation in the stool diary . Outcomes and Follow-up Participants completed a stool diary during the 22-week study period and the Patient Assessment of Constipation Quality of Life question naire ( PAC-QOL ) ( 17 ) at baseline and weeks 4 and 8 . The main components of the stool diary included BMs , SBMs , CSBMs , stool consistency , straining , and medication use . Participants documented their stool consistency according to the Bristol Stool Form Scale ( 18 ) ( scored from 1 to 7 for stool types 1 to 7 , respectively ) . Straining was rated with scores of 0 , 1 , 2 , and 3 indicating not difficult ; a little difficult , need some straining to defecate ; difficult , need straining to defecate ; and very difficult , need hard straining to defecate , respectively . An SBM was defined as a BM that occurred without use of any medication or other methods to assist defecation in the previous 24 hours ( 4 ) . A BM was not considered as an SBM when it occurred within 24 hours after the use of any assisted method for defecation . The PAC-QOL allowed participants to score the effects of constipation on physical discomfort , psychosocial discomfort , worriedness and concerns , and satisfaction in their daily lives . Higher scores indicate greater impairment or dissatisfaction . The primary outcome was the change from baseline in mean CSBMs per week , calculated as the total number of CSBMs divided by the number of weeks in the assessment period , during weeks 1 to 8 . Secondary outcomes included the changes from baseline in mean CSBMs per week during weeks 9 to 20 , mean SBMs per week during weeks 1 to 8 , mean scores for stool consistency and straining of SBMs during weeks 1 to 8 , and health-related quality of life via PAC-QOL score at weeks 4 and 8 ; the proportion of participants with 3 or more mean CSBMs per week ( 4 ) ; the proportion of participants using rescue medicine and other defecation measures ; and the mean weekly frequency of using rescue medicine and other defecation aids during weeks 1 to 4 , 1 to 8 , and 9 to 20 . We also assessed the CSBMs per week and their change from baseline during treatment and follow-up ( not prespecified ) . Adverse events ( AEs ) were appropriately assessed , managed , and categorized by the acupuncturists and related clinical specialists within 24 hours . Severe AEs had to be reported to the principal investigator and the independent data and safety Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background : Gestational weight gain and weight retention at 1 year after delivery are associated with long-term obesity . We aim ed to investigate the effect of laser acupuncture therapy on postpartum weight control . Methods : We r and omly assigned 66 subjects with postpartum weight retention to a laser acupuncture group and control group . The subjects were treated at acupoints including the stomach and hunger points of the ear , ST25 , ST28 , ST40 , SP15 , CV9 , and SP6 by using verum or sham laser acupuncture over 5 sessions per week . After 12 treatment sessions , the differences in the body mass index ( BMI ) , body fat percentage ( BFP ) , and waist-to-buttocks ratio ( WBR ) of the patients were analyzed and compared between the laser acupuncture and control groups via analysis of variance , chi-square tests , and stepwise regression tests . Results : The characteristics of the patients did not significantly differ between the laser acupuncture and control groups . Analysis of repeated measures data between the laser acupuncture and control groups indicated the presence of significant differences in postpartum BMI ( P < 0.001 ) and BFP ( P < 0.001 ) ; however , no significant difference was observed for WBR ( P = 0.09 ) . Conclusion : Laser acupuncture reduces postpartum weight retention by improving BMI and BFP , but does not impact the WBR following short-term treatment Background Several studies have used placebo acupuncture methods in recent years as a way for blinding therapeutic effect of acupuncture , however placebo method selection has not followed enough method ological criteria to the point of stabilishing a consensus of what should be the best method to be used . This study aim ed to evaluate the effectiveness of three different placebo acupuncture methods for blinding applied in healthy subjects . Methods This study was approved by the Ethics Committee of the Federal University of Sergipe with the number 47193015.5.0000.5546 and all individuals participating in the study signed a free and informed consent . For this study , 321 healthy volunteers were r and omly divided into seven groups using the abdominal point stomach ( ST ) 25 and seven groups using the lumbar point bladder ( Bl ) 52 for stimulation . For real acupuncture procedure , three different methods of placebo acupuncture plus a mix between real acupuncture and placebo applied in the same individual , totaling fourteen groups in this study . Outcome assessment s were performed before and immediately after applying the technique . Investigator who assessed variables had no knowledgement about the method was applied . Identification , weight and height were measured before puncture by using . At the end , subjects were asked if they believed they were receiving real or placebo acupuncture . Results There was no significant difference between groups for the perception about the type o stimulation ( wheter real or placebo puncture ) . Percentage of subjects who reported to have received  real acupuncture  in the abdominal point was 69.56 % in real group , 86.95 % in group Park Sham , 82.60 % in needle + foam , 91.30 % in insertion and removal , 78.26 % in real + Park Sham , 86.36 % in real + needle and foam , 86.95 % in real + insertion and removal , and for the lumbar point was 86.36 % in real group , 86.95 % in group Park Sham , 69.56 % in needle + foam , 72 % in insertion and removal , 86.95 % in real + Park Sham , 81.81 % in real + needle and foam and 78.26 % in real + insertion and removal . Conclusion All placebo acupuncture methods proposed in this study were equally effective for bliding the study participants using either abdominal or lumbar acupoints , and none of the placebo methods presented benefit compared to the other to be used in future clinical trials . Ethics CommitteeFederal University of Sergipe ( UFS ) , number of approval : 47193015.5.0000.5546Trial registration ensaiosclinicos.gov.br RBR-3w2p32 Registered in 28th January 2016 Background Obesity is an energy balance problem caused by overeating . Obesity treatment includes diet , exercise , behaviour treatment , pharmacotherapy and surgery ; in addition , acupuncture is also an option . Objective To investigate the effect of acupuncture on weight loss and whether a brief acupuncture treatment of 5 weeks can change circulating levels of leptin , ghrelin , insulin and cholecystokinin ( CCK ) in obese women . Methods 40 women with a body mass index ( BMI ) > 30 kg/m2 were equally r and omised to either an  acupuncture group or a sham ( non-penetrating ) acupuncture group  and received treatment at LI4 , HT7 , ST36 , ST44 and SP6 bilaterally . Both groups had two sessions of 20 min/week for a total of 10 sessions . Serum insulin , leptin , plasma ghrelin and CCK levels were measured by ELISA . Results Acupuncture treatment decreased insulin and leptin levels and induced weight loss , together with a decrease in BMI compared with sham acupuncture . Furthermore , between-group analyses demonstrated increases in plasma ghrelin and CCK levels in subjects who received acupuncture treatment . Conclusion These findings suggest that acupuncture may help to regulate weight owing to its beneficial effects on hormones such as insulin , leptin , ghrelin and CCK in obese subjects even after a few weeks of treatment Objective To evaluate the efficacy of the five ear acupuncture points ( Shen-men , Spleen , Stomach , Hunger , Endocrine ) , generally used in Korean clinics for treating obesity , and compare them with the Hunger acupuncture point . Methods A r and omised controlled clinical trial was conducted in 91 Koreans ( 16 male and 75 female , body mass index ( BMI ) ≥23 ) , who had not received any other weight control treatment within the past 6 months . Subjects were divided r and omly into treatment I , treatment II or sham control groups and received unilateral auricular acupuncture with indwelling needles replaced weekly for 8 weeks . Treatment I group received acupuncture at the five ear acupuncture points , treatment II group at the Hunger acupuncture point only and the sham control group received acupuncture at the five ear acupuncture points used in treatment I , but the needles were removed immediately after insertion . BMI , waist circumference , weight , body fat mass ( BFM ) , percentage body fat and blood pressure were measured at baseline and at 4 and 8 weeks after treatment . Results For the 58 participants who provided data at 8 weeks , significant differences in BMI , weight and BFM were found between the treatment and control groups . Treatment groups I and II showed 6.1 % and 5.7 % reduction in BMI , respectively ( p<0.004 ) . There were no significant differences between the two treatment groups . Conclusions This finding suggests that the five ear acupuncture points , generally used in Korean clinics , and the Hunger point alone treatment are both effective for treating overweight people BACKGROUND The aims of this r and omized study are to examine the effect of auricular acupuncture on obese women and to explore the relationship between the effect of auricular acupuncture and obesity-related hormone peptides . METHODS Forty-five of 60 obese women aged between 16 and 65 years with body mass index ( BMI ) > 27 kg/m2 and who had not received any other weight control maneuvers within the last 3 months completed this study . The subjects were blinded and r and omly divided into groups A and B. Group A ( n = 23 ) received auricular acupuncture , and group B ( n = 22 ) received sham auricular acupuncture using placebo needles , twice each week for 6 weeks . The subjects ' body weight ( BW ) , BMI , waist circumference ( WC ) , and obesity-related hormone peptides were measured at the beginning of the study and after 6 weeks of treatment . The data were compared and expressed as percent reductions . RESULTS This study found no statistical difference in percent reduction in BW , BMI , and WC between the group receiving 6 weeks of auricular acupuncture treatment and the control group . After treatment , group A revealed a significant increase in ghrelin level and decrease in leptin level . On the other h and , group B , who received sham auricular acupuncture , showed no significant difference in ghrelin and leptin levels . CONCLUSIONS This study found no statistical difference in percent reduction in BW , BMI , and WC between the two groups . No adverse effects of short-term auricular acupuncture treatment were seen in the study . Auricular acupuncture may have potential benefit on obesity-related hormone peptides OBJECTIVES To examine the effects of auricular acupressure with Sinapsis alba seeds on obesity and self-efficacy . DESIGN R and omized controlled trial . SETTING S College setting s located in metropolitan areas of Korea . PARTICIPANTS A total of 49 female college students who were overweight or obese ( body-mass index [ BMI ] ≥25.0 kg/m(2 ) ) were recruited and r and omly assigned to the experimental group ( n=25 ) or the control group ( n=24 ) . INTERVENTIONS The experimental group applied three S. alba seeds to each of five auricular points ( Shenmen , mouth , stomach , endocrine , and small intestine points ) . These participants were asked to stimulate those points 10 times at a rate of two times per second 30 minutes before mealtime , three times daily , for 1 month . They performed the procedure for each earlobe for alternating weeks ( a total of 2 weeks ' treatment for each ear ) . OUTCOME MEASURES The obesity index included weight ( kg ) , BMI ( kg/m(2 ) ) , percentage body fat , and waist-to-hip ratio . Self-efficacy was measured by using a self-efficacy scale . RESULTS Female students in the experimental group showed significant decreases in weight ( t=10.76 ; p<0.001 ) and BMI ( t=9.60 ; p<0.001 ) and significant improvement in self-efficacy ( t=1.85 ; p<0.05 ) compared with those in the control group . However , percentage body fat ( t=1.27 ; p>0.05 ) and waist-to-hip ratio ( t=0.60 ; p>0.05 ) changes did not significantly differ between the two groups . CONCLUSIONS These findings suggest that auricular acupressure using S. alba seeds may be an effective intervention for decreasing weight and BMI and increasing self-efficacy of overweight and obese individuals Obesity , defined by body mass index ( BMI ) , is a well-established risk factor of type 2 diabetes , but BMI has been criticized for its inability to discriminate fat mass and lean body mass . We examined the association between predicted fat mass and type 2 diabetes risk  in two large US prospect i ve cohorts , and compared the magnitude of the association with BMI and other obesity indicators . Vali date d anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey were used to estimate predicted fat mass and percent fat for 97,111 participants from the Health Professionals Follow-up Study ( 1987–2012 ) and the Nurses ’ Health Study ( 1986–2012 ) who were followed up for type 2 diabetes .  Multivariable-adjusted hazard ratios for type 2 diabetes across quintiles of predicted fat mass were 1.00 , 1.96 , 2.96 , 3.90 , and 8.38 for men and 1.00 , 2.20 , 3.50 , 5.73 , and 12.1 for women ; of BMI were 1.00 , 1.69 , 2.45 , 3.54 , and 6.94 for men and 1.00 , 1.76 , 2.86 , 4.88 , and 9.88 for women . Predicted FM showed the strongest association with  type 2 diabetes  in men followed by waist circumference ( WC ) , waist-to-height ratio ( WHtR ) , predicted percent fat , BMI , Waist-to-hip ratio ( WHR ) , and a body shape index ( ABSI ) . For women , the strongest association was shown for WHtR , followed by WC , predicted percent fat , predicted fat mass , BMI , ABSI , and WHR . Compared to BMI , predicted fat mass demonstrated consistently stronger association with type 2 diabetes risk . However , there was inconclusive evidence to suggest that predicted fat mass is substantially superior to other obesity indicators BACKGROUND Intrathecal morphine is a st and ard postoperative analgesic administered after cesarean delivery , but frequently causes pruritus . Acupuncture reportedly resolves refractory pruritus in certain patients . The aim of the study was to investigate the effectiveness of acupuncture in preventing pruritus induced by intrathecal morphine . METHODS Thirty parturients received  intrathecal hyperbaric bupivacaine ( 12 mg ) , fentanyl ( 10 µg ) , and morphine ( 150 µg ) for spinal anesthesia  at elective cesarean delivery at term . Patients were r and omly divided into the acupuncture group ( n=15 ) and the control group ( n=15 ) . In the acupuncture and control groups , certified acupuncturists inserted either indwelling press needles or sham needles , into Hegu ( LI4 ) , Neiguan ( PC6 ) , Quchi ( LI11 ) , and Zhigou ( SJ6 ) on both arms the day before surgery . Needles were removed 48 hours postoperatively . The primary outcome was the incidence of postoperative pruritus . Adverse effects including nausea and vomiting were also investigated . RESULTS There were no significant differences between the acupuncture group and the control group in the incidence of pruritus ( 67 % vs. 67 % , P=1.000 , RR 1.0 [ 95 % CI 0.60 to 1.66 ] ) or the requirement for antipruritic therapy ( 6.7 % vs. 20.0 % , P=0.283 , RR 0.33 [ 95 % CI 0.04 to 2.85 ] ) . The incidence of postoperative nausea in the acupuncture group versus control group was 40.0 % vs. 13.3 % , P=0.099 , RR 3.0 [ 95 % CI 0.72 to 12.6 ] ) . The postoperative analgesic effect was comparable . CONCLUSION Preoperatively administered acupuncture using press needles did not decrease intrathecal morphine-induced pruritus or the requirement for treatment BACKGROUND AND PURPOSE Acupuncture is widely used in the treatment of hypertension , yet its efficacy and safety for hypertension remain controversial . This overview aim ed to summarize the evidence on acupuncture for hypertension . METHODS Eight data bases were search ed . The Assessment of Multiple Systematic Review s ( AMSTAR ) tool and the Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach were performed . RESULTS Fifteen systematic review s ( SRs ) were identified . Method ological quality and quality of evidence were unsatisfactory . Acupuncture combined with Western medicine ( WM ) was superior to WM in systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) , efficacy rate , and traditional Chinese medicine ( TCM ) syndrome .  Acupuncture was more effective in treating SBP and DBP than sham acupuncture plus WM . Evidence regarding the benefit of acupuncture alone for SBP and DBP , efficacy rate and TCM syndrome was inconsistent . No serious adverse effects were identified . CONCLUSION High- quality SRs and r and omized controlled trials ( RCTs ) are required OBJECTIVES The purpose of this research was to investigate the effect of Urtica dioica in comparison with placebo , acupuncture and combined therapy on hot flashes and quality of life in postmenopausal women . METHODS In a double-blinded r and omized controlled trial , patients were treated for 7 weeks then followed up 4 weeks . Seventy-two postmenopausal women who reported at least 20 hot flashes attacks per week were r and omly allocated into one of the 4 groups of Urtica dioica 450 mg/day and acupuncture 11 sessions ( A ) , acupuncture and placebo ( B ) , sham acupuncture and Urtica dioica ( C ) , and sham acupuncture and placebo ( D ) . The primary outcomes were the change in hot flashes score from baseline to the end of treatment and follow up ; and the change in the quality of life ( MENQOL ) from baseline to the end of treatment . Secondary outcomes included changes in FSH , LH , and ESTRADIOL levels from baseline to the end of treatment . The trial was conducted from October 2017 to July 2018 in Acupuncture clinic of a teaching hospital in Iran . RESULTS A total of 72 women 45 - 60 years old were enrolled , and 68 were included in the analyses . The median ( IQR ) hot flashes score decreased in the A group by 20.2 ( 31.7 ) and 21.1 ( 25.1 ) , B group by 19 ( 18 ) and 17.3 ( 27 ) , C group by 14.6 ( 25.4 ) and 20.8 ( 13 ) , and D group by 1.6 ( 11.6 ) and 1 ( 13.3 ) at the end of treatment and follow up ( P < 0.0001 , P < 0.0001 ) ; no significant difference between A , B and C groups . The mean ( SD ) of MENQOL score decreased in the A group by 42.6 ( 21.1 ) , B group by 40.7 ( 29.8 ) , C group by 37.8 ( 26.8 ) and D group by 9.8 ( 14.3 ) at the end of treatment ( P = 0.001 ) ; no significant difference between A , B and C groups . CONCLUSIONS Urtica dioica can decrease menopausal hot flashes and increase the quality of life of postmenopausal women better than placebo-sham control but same as acupuncture . The combination of Urtica dioica and acupuncture did not add to the effects of those therapies
Obesity is a growing chronic health problem worldwide .
Studies about acupuncture for obesity treatment are many .
But there are some doubts about the effectiveness of acupuncture versus sham acupuncture in treating obesity due to its lack of medical evidence .
Therefore , the aim of this study is to assess the efficacy of acupuncture for obesity treatment and provide clinic evidence .