The Practice of Korean Medicine: An Overview of Clinical Trials in Acupuncture Acupuncture for Chronic Pain in Japan: A Review The different immunomodulation of indirect moxibustion on normal subjects and patients with systemic lupus erythematosus. Insomnia due to deficiency of both the heart and spleen treated by acupuncture-moxibustion and Chinese tuina. [Chronic neck pain of cervical spondylosis treated with acupuncture and moxibustion in terms of the heart and kidney theory: a randomized controlled trial]. [Post-stroke depression treated with acupuncture and moxibustion: an evaluation of therapeutic effect and safety]. Treatment of ankylosing spondylitis with medicated moxibustion plus salicylazosulfapyridine and methotrexate--a report of 30 cases.
Acupuncture , one of the Oriental medical therapeutic techniques that can be traced back at least 2500 years , is growing in popularity all over the world . Korea has continued to develop its own unique tradition of medicine throughout its long history , and has formed different types of acupuncture methods . The purpose of this review is to summarize clinical case studies in acupuncture and related therapies , such as acupressure , electric acupuncture , auricular acupuncture and moxibustion in Korea . A survey of Korean journals revealed that a total of 124 studies were published from 1983 to 2001 . Results obtained from the survey showed that most clinical studies using acupuncture , electric acupuncture , moxibustion and other traditional therapies could alleviate a relatively broad range of medical problems . However , it should be emphasized that almost all clinical case studies published in various local journals did not follow the ‘ good clinical practice ’ with respect to regulatory aspects . Since they were not conducted using the r and omized double-blinded controls with a large sample size , all the results should be considered as therapeutic indications . This review is an attempt to show the scope of acupuncture in our country and the kind of diseases , after many years of clinical experience , that were deemed valid targets for clinical trials Many Japanese reports of acupuncture and moxibustion for chronic pain are not listed in medical data bases such as Medline . Therefore , they are not easily accessible to research ers outside of Japan . To complement existing review s of acupuncture and moxibustion for chronic pain and to provide more detailed discussion and analysis , we did a literature search using ‘ Igaku Chuo Zasshi We d ’ ( Japana Centra Revuo Medicina ) and ‘ Citation Information by National Institute of Information ’ covering the period 1978–2006 . Original articles and case reports of acupuncture and moxibustion treatment of chronic pain were included . Animal studies , surveys , and news articles were excluded . Two independent review ers extracted data from located articles in a pre-defined structured way , and assessed the likelihood of causality in each case . We located 57 papers written in Japanese ( 20 full papers , 37 case reports ) . Conditions examined were headache ( 12 trials ) , chronic low back pain ( 9 trials ) , rheumatoid arthritis ( 8 trials ) , temporom and ibular dysfunction ( 8 trials ) , katakori ( 8 trials ) and others ( 12 trials ) . While 23 were described as clinical control trials ( CCTs ) , 11 employed a quasi-r and om method . Applying the 5-point Jadad quality assessment scoring system , the mean score was 1.5 ± 1.3 ( SD ) . Eleven ( 52 % ) of the CCTs were conducted to determine a more effective procedure for acupuncture ; these compared a certain type of acupuncture with another type of acupuncture or specific additional points . In particular , the trigger point acupuncture was widely used to treat chronic low back pain in Japan . Many reports of chronic pain treatment by acupuncture and moxibustion are listed in Japanese data bases . From the data , we conclude that there is limited evidence that acupuncture is more effective than no treatment , and inconclusive evidence that trigger point acupuncture is more effective than placebo , sham acupuncture or st and ard care Moxibustion has been thought to enhance immunity in healthy condition , but suppress abnormal immune response in disease status . We collected 12 patients with systemic lupus erythematosus ( SLE ) and 12 healthy women who received indirect moxibustion on acupuncture points ST-36 ( Zusanli ) and SP-6 ( Sanyinjiao ) 20 minutes per day for 1 week . During the course , there were no changes of their regular medications or intercurrent infections in normal subjects and SLE patients . We found that indirect moxibustion for 1 week could elevate CD3 + and CD4 + T-lymphocytes in normal subjects , whereas decrease relative proportions of CD8 + T-lymphocytes in patients with SLE . This result confirms that indirect moxibustion has different immunomodulation in normal condition and autoimmune status . However , whether immunomodulatory effects of indirect moxibustion are beneficial for normal subjects and patients with SLE require further confirmation OBJECTIVE To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen . METHODS 92 cases were divided r and omly into the treatment group ( treated by acupuncture-moxibustion and Chinese Tuina ) and the control group ( treated by acupuncture-moxibustion ) . RESULTS The therapeutic effect of the treatment group was obviously superior to that of the control group ( the CHI2 test showed P < 0.01 ) . CONCLUSIONS The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen OBJECTIVE To evaluate the clinical efficacy of acupuncture and moxibustion on chronic neck pain of cervical spondylosis in terms of the heart and kidney theory . METHODS One hundred and eleven cases were r and omized into a heart-kidney acupuncture group ( 55 cases ) and a conventional acupuncture group ( 56 cases ) . In the heart-kidney acupuncture group , acupuncture was applied to Bailao ( EX-HN 15 ) , Shenmen ( HT 7 ) and Wangu ( SI 4 ) . Afterwards , the direct moxibustion was applied to Dazhui ( GV 14 ) , Xinshu ( BL 15 ) and Shenshu ( BL 23 ) . After moxibustion , the intradermal needling therapy was provided at Bailao ( EX-HN 15 ) , Xinshu ( BL 15 ) and Shenshu ( BL 23 ) . In the conventional acupuncture group , acupuncture was applied to Bailao ( EX-HN 15 ) and Zhongzhu ( TE 3 ) at first . Afterwards , the direct moxibustion was done at Dazhui ( GV 14 ) , Bailao ( EX-HN 15 ) and Jianzhongshu ( SI 15 ) . After moxibustion , the interdermal needling therapy was provided at Bailao ( EX-HN 15 ) and Jianzhongshu ( SI 15 ) . The northwick park pain question naire ( NPQ ) was adopted as the main efficacy index for the evaluation . RESULTS After the intervention and during the follow-up visit period , NPQ scores were all reduced remarkably as compared with those before the intervention for the patients in two groups ( all P < 0.001 ) , but the differences were not statistically significant in groups ( all P > 0.05 ) . By the age stratification analysis for the patients in two groups , the program in terms of the heart and kidney theory achieved the superior efficacy for the patients over 45 years old as compared with those in the conventional acupuncture group ( P < 0.05 , P < 0.01 ) . By the stratification analysis of the sick duration , the program in terms of the heart and kidney theory achieved the superior efficacy for the patients with over 7 years sick duration as compared with those in the conventional acupuncture group ( P < 0.05 , P < 0.01 ) . CONCLUSION The acupuncture and moxibustion therapeutic program in terms of the heart and kidney theory achieves the superior efficacy on chronic pain of cervical spondylosis for the patients over 45 years old and with over 7 years sick duration . It is one of the optimized programs for the treatment of this disease OBJECTIVE To evaluate the efficacy and safety of acupuncture and moxibustion in the treatment of post-stroke depression ( PSD ) by regulating the liver and strengthening the root prescription . METHODS In light of the r and om controlled trial principle , 123 cases were r and omized into an acupuncture-moxibustion group ( 42 cases ) , a medication group ( 40 cases ) and an acupuncture + medication group ( 41 cases ) . In the acupuncture-moxibustion group , the therapy of regulating the liver and strengthening the root was applied . Acupuncture was given at Hegu ( LI 4 ) , Taichong ( LR 3 ) , Baihui ( GV 20 , Yintang ( GV 29 ) , etc . The granule moxibustion was applied at Zhongwan ( CV 12 ) , Xiawan ( CV 10 ) , Guanyuan ( CV 4 ) and Qihai ( CV 6 ) . The treatment was given once a day and stopped in weekend . In the medication group , paroxetine hydrochloride tablets were prescribed for oral administration , 20 mg each day after breakfast . In the acupuncture + medication group , the therapies were adopted as the acupuncture-moxibustion group and the medication group . In the 2nd and 4th week of treatment , HAMD was used as the primary index and Barthel index as the secondary one for the efficacy assessment in the three groups respectively . The spleen and stomach syndrome scale of TCM was used for the assessment of TCM syndrome efficacy . Treatment emergent symptom scale ( TESS ) was applied for the safety assessment . RESULTS In the 4th week of treatment , the markedly effective rates were 69.0 % ( 29/42 ) , 65.0 % ( 26/40 ) and 70.7 % ( 29/41 ) in the acupuncture-moxibustion group , the medication group and the acupuncture + medication group respectively . The efficacies of anti-depression were similar in comparison among groups ( P > 0.05 ) . In the 2nd week of treatment , the improvement of HAMD score was significant in the acupuncture + medication group as compared with that before treatment and in comparison with the medication group ( P < 0.05 , P < 0.01 ) . As for improving Barthel index , reducing the spleen and stomach symptom score of TCM and decreasing the score of TESS , the results in the acupuncture-moxibustion group and the acupuncture + medication group were superior to those in the medication group ( P < 0.05 , P < 0.01 ) . CONCLUSION The therapy of acupuncture and moxibustion with regulating the liver and strengthening the root achieves the definite efficacy of anti-depression and presents the quite high safety in treatment OBJECTIVE To evaluate the therapeutic effect of medicated moxibustion plus administration of salicylazosulfapyridine ( SASP ) and methotrexate ( MTX ) for treatment of active ankylosing spondylitis ( AS ) . METHOD Ninety cases of active AS were r and omly assigned to Group A , B and C ( N = 30 in each group ) , and treated respectively with SASP and MTX , acupuncture plus SASP and MTX , and composite sulfur ( tablet ) moxibustion plus SASP and MTX for 3 successive courses ( 2 months each course with an interval of 5 days ) . RESULTS Improvement in sacroiliitis index , Schober test , occipital wall test , finger-ground distance , as well as the erythrocyte sedimentation rate ( ESR ) and the content of C-reactive protein ( CRP ) in Group B and C was far superior to that of Group A ( P < 0.01 ) . CONCLUSION Combined use of western medicine with acupuncture or with medicated moxibustion produces a better therapeutic effect than western medicine given alone
This systematic review fails to provide conclusive evidence for the effectiveness of moxibustion compared with drug therapy in rheumatic conditions .
Moxibustion , an acupuncture-like intervention , is increasingly used in the management of rheumatic conditions .
The aim of this review is to summarize and critically evaluate the trials testing effectiveness of moxibustion for major rheumatic conditions .