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Taoist Musings

When virtue is lost, benevolence appears, when benevolence is lost right conduct appears, when right conduct is lost, expedience appears. Expediency is the mere shadow of right and truth; it is the beginning of disorder.
Lao Tzu

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Research

LATEST RESEARCH:
MOXIBUSTION EFFECTIVE FOR BREECH PRESENTATION
UK researchers exploring the effects of moxibustion on breech presentation have concluded that it creates a better chance of achieving vaginal delivery. In a prospective multicentre study, 76 pregnant women were taught how to apply moxibustion and instructed to continue it at home, twice a day, for seven days. If breech presentation persisted after treatment, external cephalic version (ECV) was carried out. After moxibustion 40.8% of breech presentations spontaneously turned and a further 43.4% of breech presentations were turned by ECV. Women who involved other people in the administration of moxibustion were found to be twice as likely to successfully achieve breech version. Multiparous women were also 16% more likely than primiparous women to achieve spontaneous version with moxibustion. Of the women who were successful in turning their babies using moxibustion, 88% went on to have a normal birth and 12% had a caesarean section. The authors conclude that moxibustion treatment should be offered to all women with a breech presentation. (Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment to external cephalic version. Midwifery. 2009 Dec;25(6):774-80).
Spanish authors have carried out a systematic review of the evidence for moxibustion to correct nonvertex presentation of the foetus. Six studies with 1087 subjects and a high degree of heterogeneity compared moxibustion with observation or postural methods. Meta-analysis showed a rate of cephalic version for moxibustion of 72.5% versus 53.2% in the control group; the number of women who would have to be treated with moxibustion to achieve one breech version was calculated to be five. No significant safety differences were found between moxibustion and other techniques. The authors conclude that moxibustion at Zhiyin BL-67, whether used alone or in combination with acupuncture or postural measures, produces a positive effect on the correction of nonvertex presentation compared with observation or postural methods alone. (Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis. Am J Obstet Gynecol. 2009 Sep;201(3):241-59).
ACUPRESSURE DECREASES PAIN AND DURATION OF LABOUR
Iranian clinicians have found that acupressure at Sanyinjiao SP-6 can decrease the duration and severity of pain in the active phase of labour, lower the requirement for oxytocin and reduce the need for caesarean section. One hundred and twenty nulliparous women at the beginning of the active phase of labour were randomised to receive either acupressure at Sanyinjiao SP-6 for 30 minutes during contractions, or light touch at this point. In the absence of forceful contractions two hours later, oxytocin infusion was initiated. The mean duration of the active phase was significantly shorter in the treatment group (252.37 minutes versus 441.38 minutes). 10% of patients in the acupressure group and 41.7% of the control group delivered via cesarean section. Pain severity in the acupressure group was less than the control group (5.87 versus 6.79). 41.7% of the acupressure group and 63.3% in the control group required oxytocin. The amount of oxytocin used in the acupressure group was also less than the control group (73.33 ml vs. 126.6 ml). (J Matern Fetal Neonatal Med. 2009 Sep 15:1-4. [Epub ahead of print]).
ACUPUNCTURE DECREASES POST-CAESARIAN PAIN
A Chinese study has shown that acupuncture at Sanyinjiao SP-6 can decrease the amount of analgesia required in the first 24 hours after caesarian section. Sixty women who had spinal anesthesia during caesarian section were randomly assigned to receive either acupuncture or electro-acupuncture at bilateral Sanyinjiao SP-6, or to a control group. Women in the acupuncture and electro-acupuncture groups delayed the time of requesting morphine up to 11 minutes later than the control group. The total dose of patient-controlled analgesia (PCA) used within the first 24 hours was 30%-35% less in the acupuncture groups compared with the control group, which was statistically significant. There was no significant difference between acupuncture and electro-acupuncture. Both acupuncture groups’ pain scores were significantly lower than the control group’s within the first two hours. Two hours later, however, there were no significant differences in pain scores between groups. The incidence of opioid-related side effects, such as dizziness, was also less in the acupuncture groups. (Effects of acupuncture on post-cesarean section pain. Chin Med J (Engl). 2009 Aug 5;122(15):1743-8).
Zhongguo Zhen Jiu. 2009 Oct;29(10):775-9.
[Effects of electroacupuncture on in vitro fertilization-embryo transfer (IVF-ET) of patients with poor ovarian response]
[Article translated from Chinese]
Chen J, Liu LL, Cui W, Sun W.
Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan 250001, China. fusantai@126.com
OBJECTIVE: To observe the effect of electroacupuncture therapy on oocyte quality and pregnancy outcome of patients with poor ovarian response or decreased reserve in the course of in vitro fertilization (IVF). METHODS: Sixty cases accepting IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The two groups were both treated with antagonist scheme for ovulation induction, and the electroacupuncture intervention was also added in the observation group, Guanyuan (CV 4), Taixi (KI 3), Sanyinjiao (SP 6) etc. were selected. The therapeutic effects in the two groups were compared after treatment. RESULTS: There was no significant difference between the two groups before treatment. The symptoms of kidney difficiency in the observation group were significantly improved after treatment, and the levels of serum estradiol (E2), fertilization rate, oocyte maturation rate, good quality embryos rate, and implantation rate in the observation group were superior to those in the control group on human Chorionic Gonadotropin (hCG) injection day (all P<0.05); the levels of stem cell factor (SCF) in follicular fluid and serum in the observation group were significantly higher than those in the control group (both P<0.05). The pregnancy rate in the observation group was higher than that in the control group, and the abortion rate in the observation group was lower than that in the control group, but there was no significant difference between the two groups (both P>0.05). CONCLUSION: Electroacupuncture therapy has a good clinical effect for IVF patients with poor ovarian reserve, and can improve oocyte quality and pregnancy outcome.
ACUPUNCTURE FOR MENOPAUSAL HOT FLUSHES
A multicentre randomised clinical study of menopausal women has concluded that acupuncture carried out in addition to usual care is associated with marked clinical improvement in hot flushes and other menopause-related symptoms. One hundred and seventy five Korean women were randomised to receive 12 sessions of acupuncture over four weeks in addition to usual care, or to usual care alone. The mean change in the average 24 hour hot flush score was -16.57 in the treatment group compared with -6.93 in the control group, a significant difference. Scores for psychological, somatic and urogenital symptoms of menopause also showed significant improvement in the acupuncture group compared with the control group. (Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women – a multicenter randomised clinical trial. Menopause. 2009 Nov 10. [Epub ahead of print]).
ACUPUNCTURE HELPS WITH LABOUR PAIN
Danish clinicians carrying out the largest randomised controlled trial of acupuncture for relief of labour pain have found it to be a good supplement to existing pain relief methods, reducing the need for pharmacological and invasive methods during delivery. A randomised controlled trial was conducted with 607 healthy women in labour at term who received acupuncture, TENS, or traditional analgesics. Acupuncture was individualised, based on women’s mobility and localisation of pain, with points chosen from a list of 34 specified points. Although pain scores were comparable across the three groups, the use of pharmacological and invasive methods was significantly lower in the acupuncture group. Acupuncture did not influence the duration of labour or the use of oxytocin. In addition, indications of neonatal wellbeing (Apgar score and umbilical cord pH value) were significantly better among infants in the acupuncture group compared with infants in the other groups. (Acupuncture as pain relief during delivery: a randomized controlled trial. Birth. 2009 Mar;36(1):5‑12).
ACUPUNCTURE FOR PREGNANT WOMEN WITH PELVIC GIRDLE PAIN
Elden H, Ladfors L, et al. Perinatal Center, Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska Academy, East Hospital, 41685 Gothenburg, Sweden.
A recent randomized, single blind and controlled study was conducted in order to compare the effects of standard treatment, standard treatment with acupuncture, and standard treatment with stabilizing exercises for pelvic girdle pain during pregnancy. 386 pregnant women with pelvic girdle pain were randomly assigned to three groups: for six weeks with standard treatment (n=130), standard treatment plus acupuncture (n= 125), or standard treatment plus stabilizing exercises (n= 131). A visual analogue scale was used to measure the pain and an independent examiner did an assessment of the severity of the pain before and after treatment.
After treatment, the stabilizing exercise group had less pain than the standard group in the morning and in the evening. The acupuncture group also had less pain than the standard treatment group in the morning and in the evening. However, the acupuncture group had less pain in the evening than the stabilizing exercise group. Attenuation of pelvic girdle pain as assessed by the independent examiner was greatest in the acupuncture group.
The study concluded that acupuncture and stabilizing exercises were effective complements to standard treatment for the management of pelvic girdle pain during pregnancy. Also, acupuncture was superior to stabilizing exercises in this study.
ACUPUNCTURE SHOWN TO EASE INDIGESTION IN PREGNANT WOMEN
June 2009, Acupuncture in Medicine Journal
Joining a range of wellness treatments helpful to mothers-to-be, a new study shows acupuncture to be useful to those suffering heartburn and indigestion while pregnant.
Acupuncture relieves the indigestion and heartburn that bother many women as their pregnancy progresses, a new Brazilian study shows. Indigestion is common during pregnancy, with up to 80% of moms-to-be suffering heartburn, stomach pain or discomfort, reflux, belching and bloating. Symptoms tend to worsen over time, and women who avoid taking medicine for fear of harming the developing fetus might welcome an alternative treatment.
“Although small, this study suggests that acupuncture can relieve symptoms of indigestion that are pretty common in pregnancy and may provoke loss of quality of life in the final days, disturbing not only eating but also sleeping,” said lead researcher Dr. Joao Bosco Guerreiro da Silva, from the department of internal medicine at Rio Preto Medical College.
For the study, the researchers randomly assigned 42 pregnant women with indigestion to dietary counseling plus antacids or to dietary counseling and antacids plus acupuncture once or twice a week. The researchers assessed the women’s symptoms at the beginning of the study and every two weeks after that for eight weeks.
Heartburn, the main symptom, was reduced by half in 75% of the women treated with acupuncture. Women receiving acupuncture also ate and slept better.

research

MOXIBUSTION EFFECTIVE FOR BREECH PRESENTATION

UK researchers exploring the effects of moxibustion on breech presentation have concluded that it creates a better chance of achieving vaginal delivery. In a prospective multicentre study, 76 pregnant women were taught how to apply moxibustion and instructed to continue it at home, twice a day, for seven days. If breech presentation persisted after treatment, external cephalic version (ECV) was carried out. After moxibustion 40.8% of breech presentations spontaneously turned and a further 43.4% of breech presentations were turned by ECV. Women who involved other people in the administration of moxibustion were found to be twice as likely to successfully achieve breech version. Multiparous women were also 16% more likely than primiparous women to achieve spontaneous version with moxibustion. Of the women who were successful in turning their babies using moxibustion, 88% went on to have a normal birth and 12% had a caesarean section. The authors conclude that moxibustion treatment should be offered to all women with a breech presentation. (Factors affecting the success of moxibustion in the management of a breech presentation as a preliminary treatment to external cephalic version. Midwifery. 2009 Dec;25(6):774-80).

Spanish authors have carried out a systematic review of the evidence for moxibustion to correct nonvertex presentation of the foetus. Six studies with 1087 subjects and a high degree of heterogeneity compared moxibustion with observation or postural methods. Meta-analysis showed a rate of cephalic version for moxibustion of 72.5% versus 53.2% in the control group; the number of women who would have to be treated with moxibustion to achieve one breech version was calculated to be five. No significant safety differences were found between moxibustion and other techniques. The authors conclude that moxibustion at Zhiyin BL-67, whether used alone or in combination with acupuncture or postural measures, produces a positive effect on the correction of nonvertex presentation compared with observation or postural methods alone. (Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis. Am J Obstet Gynecol. 2009 Sep;201(3):241-59).

ACUPRESSURE DECREASES PAIN AND DURATION OF LABOUR

Iranian clinicians have found that acupressure at Sanyinjiao SP-6 can decrease the duration and severity of pain in the active phase of labour, lower the requirement for oxytocin and reduce the need for caesarean section. One hundred and twenty nulliparous women at the beginning of the active phase of labour were randomised to receive either acupressure at Sanyinjiao SP-6 for 30 minutes during contractions, or light touch at this point. In the absence of forceful contractions two hours later, oxytocin infusion was initiated. The mean duration of the active phase was significantly shorter in the treatment group (252.37 minutes versus 441.38 minutes). 10% of patients in the acupressure group and 41.7% of the control group delivered via cesarean section. Pain severity in the acupressure group was less than the control group (5.87 versus 6.79). 41.7% of the acupressure group and 63.3% in the control group required oxytocin. The amount of oxytocin used in the acupressure group was also less than the control group (73.33 ml vs. 126.6 ml). (J Matern Fetal Neonatal Med. 2009 Sep 15:1-4. [Epub ahead of print]).

ACUPUNCTURE DECREASES POST-CAESARIAN PAIN

A Chinese study has shown that acupuncture at Sanyinjiao SP-6 can decrease the amount of analgesia required in the first 24 hours after caesarian section. Sixty women who had spinal anesthesia during caesarian section were randomly assigned to receive either acupuncture or electro-acupuncture at bilateral Sanyinjiao SP-6, or to a control group. Women in the acupuncture and electro-acupuncture groups delayed the time of requesting morphine up to 11 minutes later than the control group. The total dose of patient-controlled analgesia (PCA) used within the first 24 hours was 30%-35% less in the acupuncture groups compared with the control group, which was statistically significant. There was no significant difference between acupuncture and electro-acupuncture. Both acupuncture groups’ pain scores were significantly lower than the control group’s within the first two hours. Two hours later, however, there were no significant differences in pain scores between groups. The incidence of opioid-related side effects, such as dizziness, was also less in the acupuncture groups. (Effects of acupuncture on post-cesarean section pain. Chin Med J (Engl). 2009 Aug 5;122(15):1743-8).

Zhongguo Zhen Jiu. 2009 Oct;29(10):775-9.

[Effects of electroacupuncture on in vitro fertilization-embryo transfer (IVF-ET) of patients with poor ovarian response]

[Article translated from Chinese]

Chen J, Liu LL, Cui W, Sun W.

Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan 250001, China. fusantai@126.com

OBJECTIVE: To observe the effect of electroacupuncture therapy on oocyte quality and pregnancy outcome of patients with poor ovarian response or decreased reserve in the course of in vitro fertilization (IVF). METHODS: Sixty cases accepting IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The two groups were both treated with antagonist scheme for ovulation induction, and the electroacupuncture intervention was also added in the observation group, Guanyuan (CV 4), Taixi (KI 3), Sanyinjiao (SP 6) etc. were selected. The therapeutic effects in the two groups were compared after treatment. RESULTS: There was no significant difference between the two groups before treatment. The symptoms of kidney difficiency in the observation group were significantly improved after treatment, and the levels of serum estradiol (E2), fertilization rate, oocyte maturation rate, good quality embryos rate, and implantation rate in the observation group were superior to those in the control group on human Chorionic Gonadotropin (hCG) injection day (all P<0.05); the levels of stem cell factor (SCF) in follicular fluid and serum in the observation group were significantly higher than those in the control group (both P<0.05). The pregnancy rate in the observation group was higher than that in the control group, and the abortion rate in the observation group was lower than that in the control group, but there was no significant difference between the two groups (both P>0.05). CONCLUSION: Electroacupuncture therapy has a good clinical effect for IVF patients with poor ovarian reserve, and can improve oocyte quality and pregnancy outcome.

ACUPUNCTURE FOR MENOPAUSAL HOT FLUSHES

A multicentre randomised clinical study of menopausal women has concluded that acupuncture carried out in addition to usual care is associated with marked clinical improvement in hot flushes and other menopause-related symptoms. One hundred and seventy five Korean women were randomised to receive 12 sessions of acupuncture over four weeks in addition to usual care, or to usual care alone. The mean change in the average 24 hour hot flush score was -16.57 in the treatment group compared with -6.93 in the control group, a significant difference. Scores for psychological, somatic and urogenital symptoms of menopause also showed significant improvement in the acupuncture group compared with the control group. (Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women – a multicenter randomised clinical trial. Menopause. 2009 Nov 10. [Epub ahead of print]).

ACUPUNCTURE HELPS WITH LABOUR PAIN

Danish clinicians carrying out the largest randomised controlled trial of acupuncture for relief of labour pain have found it to be a good supplement to existing pain relief methods, reducing the need for pharmacological and invasive methods during delivery. A randomised controlled trial was conducted with 607 healthy women in labour at term who received acupuncture, TENS, or traditional analgesics. Acupuncture was individualised, based on women’s mobility and localisation of pain, with points chosen from a list of 34 specified points. Although pain scores were comparable across the three groups, the use of pharmacological and invasive methods was significantly lower in the acupuncture group. Acupuncture did not influence the duration of labour or the use of oxytocin. In addition, indications of neonatal wellbeing (Apgar score and umbilical cord pH value) were significantly better among infants in the acupuncture group compared with infants in the other groups. (Acupuncture as pain relief during delivery: a randomized controlled trial. Birth. 2009 Mar;36(1):5‑12).

ACUPUNCTURE FOR PREGNANT WOMEN WITH PELVIC GIRDLE PAIN

Elden H, Ladfors L, et al. Perinatal Center, Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska Academy, East Hospital, 41685 Gothenburg, Sweden.

A recent randomized, single blind and controlled study was conducted in order to compare the effects of standard treatment, standard treatment with acupuncture, and standard treatment with stabilizing exercises for pelvic girdle pain during pregnancy. 386 pregnant women with pelvic girdle pain were randomly assigned to three groups: for six weeks with standard treatment (n=130), standard treatment plus acupuncture (n= 125), or standard treatment plus stabilizing exercises (n= 131). A visual analogue scale was used to measure the pain and an independent examiner did an assessment of the severity of the pain before and after treatment.

After treatment, the stabilizing exercise group had less pain than the standard group in the morning and in the evening. The acupuncture group also had less pain than the standard treatment group in the morning and in the evening. However, the acupuncture group had less pain in the evening than the stabilizing exercise group. Attenuation of pelvic girdle pain as assessed by the independent examiner was greatest in the acupuncture group.

The study concluded that acupuncture and stabilizing exercises were effective complements to standard treatment for the management of pelvic girdle pain during pregnancy. Also, acupuncture was superior to stabilizing exercises in this study.

ACUPUNCTURE SHOWN TO EASE INDIGESTION IN PREGNANT WOMEN

June 2009, Acupuncture in Medicine Journal

Joining a range of wellness treatments helpful to mothers-to-be, a new study shows acupuncture to be useful to those suffering heartburn and indigestion while pregnant.

Acupuncture relieves the indigestion and heartburn that bother many women as their pregnancy progresses, a new Brazilian study shows. Indigestion is common during pregnancy, with up to 80% of moms-to-be suffering heartburn, stomach pain or discomfort, reflux, belching and bloating. Symptoms tend to worsen over time, and women who avoid taking medicine for fear of harming the developing fetus might welcome an alternative treatment.

“Although small, this study suggests that acupuncture can relieve symptoms of indigestion that are pretty common in pregnancy and may provoke loss of quality of life in the final days, disturbing not only eating but also sleeping,” said lead researcher Dr. Joao Bosco Guerreiro da Silva, from the department of internal medicine at Rio Preto Medical College.

For the study, the researchers randomly assigned 42 pregnant women with indigestion to dietary counseling plus antacids or to dietary counseling and antacids plus acupuncture once or twice a week. The researchers assessed the women’s symptoms at the beginning of the study and every two weeks after that for eight weeks.

Heartburn, the main symptom, was reduced by half in 75% of the women treated with acupuncture. Women receiving acupuncture also ate and slept better.