Acupuncture In The Real World: Evaluating a 15-Year NADA Auricular Acupuncture Service For Breast Cancer Survivors Experiencing Hot Flushes And Night Sweats As a Consequence of Adjuvant Hormonal Therapies

PurposeWhile clinical trials provide valuable data about efficacy of interventions, findings often do not translate into clinical settings. We report real world clinical outcomes of a 15-year service offering breast cancer survivors auricular acupuncture to manage hot flushes and night sweats (HFNS) associated with adjuvant hormonal treatments. This service evaluation aims to 1) assess whether usual practice alleviates symptoms in a clinically meaningful way and 2) compare these results with scientific evidence. MethodsData were analysed from 415 referrals to a service offering women eight standardised treatments using the National Acupuncture Detoxification Association (NADA) protocol. Outcome measures administered at baseline, end of treatment (EOT), and four- and 18- weeks after EOT included Hot Flush Diaries, Hot Flush Rating Scale (HFRS) and Women’s Health Questionnaire (WHQ).Results2285 treatments were given to 300 women; 275 (92.3%) completed all eight treatments. Median daily frequency of HFNS reduced from 9.6 (IQR 7.3) to 5.7 (IQR 5.8) at EOT and 6.3 (IQR 6.5) 18 weeks after EOT. HFRS problem rating showed a clinically meaningful reduction of ≥2 points at all measurement points. WHQ showed improvements in several symptoms associated with the menopause. Two adverse events were reported, neither were serious. Results are comparable to published research.ConclusionThis first analysis of a long-term auricular acupuncture service compares favourably with outcomes of other studies for reducing HFNS frequency and associated menopausal symptoms. In day-to-day clinical practice, NADA appears to be a safe effective intervention for breast cancer survivors.

Effect of acupuncture on menopausal hot flushes and serum hormone levels: a systematic review and meta-analysis

Objective: To evaluate the efficacy/effectiveness and safety of acupuncture for the treatment of hot flushes and its impact on serum hormone levels in menopausal women. Methods: A total of 10 databases were searched from their inception to August 2018. Reference lists of reviews and included articles were also hand-searched. Randomized controlled trials (RCTs) comparing the effect of acupuncture versus sham acupuncture, or acupuncture versus hormone therapy (HT), as treatment for menopausal hot flushes were included. Outcomes included hot flush frequency, hot flush severity and serum hormone levels of estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Meta-analyses were performed using Review Manager 5.3 software. Results: Thirteen RCTs including 1784 patients were selected, seven of which were available for meta-analysis. Compared with sham acupuncture, acupuncture significantly decreased hot flush frequency (mean difference (MD) −0.84, 95% confidence interval (CI) [−1.64, −0.05], I2 = 54%) from baseline to the end of study, but did not impact end scores of hot flush frequency (MD 0.19, 95% CI [−0.61, 0.99], I2 = 0%) or severity (MD 0.02, 95% CI [−0.13, 0.17], I2 = 0%). No differences were found between acupuncture and HT in serum levels of E2 (MD 6.56, 95% CI [−3.77, 16.89], I2 = 76%), FSH (MD 1.06, 95% CI [−1.44, 3.56], I2 = 0%) or LH (MD −3.36, 95% CI [−13.37, 6.65], I2 = 89%). Conclusion: Acupuncture may not decrease hot flush frequency, but yet appears to have similar effects on serum hormone levels as HT, that is, increased E2 and decreased FSH and LH. Considering that no firm conclusions could be drawn due to the low quality and limited number of included trials included, further high-quality RCTs need to be conducted.

Teaching self-acupuncture survey report

Background: People have been teaching self-acupuncture (SA) in the United Kingdom since 1977. More recently, a small body of research has been conducted on SA. However, detailed guidelines on teaching and delivery of SA have so far, to our knowledge, not been developed. Methods: Acupuncturists were invited to participate in an online survey about their experiences of teaching SA. Data from the survey were extracted, analysed using descriptive statistics and translated into SA teaching guidelines. Results: One hundred thirty-eight acupuncturists completed the survey. Nineteen percent of participants had taught SA. The most common symptoms for which acupuncturists taught SA were pain, nausea, anxiety, hot flushes, headaches/migraines and breathlessness. The six most commonly taught traditional acupuncture point locations were LI4, ST36, SP6, PC6, LR3 and TE5. No participants had received reports of adverse effects from their patients. Conclusion: Acupuncturists who teach SA find it to be an acceptable and safe option for patients. The presented data have important implications for guiding the practice of SA.

Electroacupuncture for the treatment of perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trials

Objective: To assess the efficacy, comparative effectiveness and safety of electroacupuncture (EA) in the treatment of perimenopausal syndrome (PMS). Methods: Nine databases were searched until June 2019. Only relevant randomized controlled trials (RCTs) of EA for PMS were included. Results: Twelve trials involving 746 women were included. EA and hormone therapy (HT) did not significantly differ in terms of effective rate (risk ratio (RR) = 0.98, 95% confidence interval (CI) = 0.93 to 1.04), Kupperman index (KI) (mean difference (MD) = −0.25, 95% CI = −0.76 to 0.26) and serum levels of follicle-stimulating hormone (FSH) (MD = −3.80, 95% CI = −11.59 to 3.98) or luteinizing hormone (LH) (MD = −2.51, 95% CI = −10.72 to 5.70). Serum estradiol (E2) levels were significantly lower in EA versus HT groups (MD = −60.58, 95% CI = −71.93 to −49.23). Compared with sham EA, EA had a significantly greater effect on reductions in KI (MD = −4.71, 95% CI = −6.57 to −2.86) and hot flushes score/24 h (MD = −2.43, 95% CI = −2.93 to −1.93). There were no significant differences between EA and manual acupuncture (MA) in terms of effective rate (RR = 1.14, 95% CI = 0.98 to 1.33) or serum FSH (MD = −2.87, 95% CI = −29.65 to 23.91), LH (MD = 2.73, 95% CI = −9.65 to 15.11) or E2 (MD = 26.80, 95% CI = −12.06 to 65.65). However, it seemed that EA had a better effect than MA on KI (MD = −2.44, 95% CI = −4.80 to −0.08). Subgroup analyses indicated that EA may have more of a benefit in the pre-menopausal state (hot flushes score/24 h: MD = −1.66, 95% CI = −3.49 to 0.17) compared to post-menopause (p > 0.05). Conclusion: The effect of EA appeared broadly similar to HT and MA in the treatment of PMS, although EA-associated reductions in KI were superior to MA and sham EA, suggesting effects beyond placebo. The evidence base is limited by a small number of eligible studies, risk of bias and clinical/statistical heterogeneity, limiting our ability to draw firm conclusions. As such, additional larger scale, high-quality RCTs are needed.

A Case Report on 14 Patients with Palpitations Treated with Gami-ondam-tang

Objectives: This study examined cases of patients with palpitations treated with Gami-ondam-tang.Methods: The patients were treated with Gami-ondam-tang and changes in their symptoms were assessed using a self-reported numeral rating scale (NRS) score.Results: Following treatment, the patients’ palpitations and accompanying symptoms (e.g., insomnia, hot flushes, dyspepsia, and depression) improved. The study investigated 14 first occurrences and 10 subsequent recurrences. In the subsequent recurrent cases, compared to the first occurrence cases, the symptoms according to the NRS score were not severe, and the treatment period was shorter.Conclusions: The results showed that Gami-ondam-tang is effective for treating palpitations and accompanying symptoms.

A REVIEW ON AYURVEDIC MANAGEMENT OF POSTMENOPAUSAL SYNDROME (RAJONIVRITTI LAKSHANAS)

Rajonivruttijanya Lakshana is a group of symptoms produced by degenerative changes. It requires a major healthcare initiative to improve the quality of life of women after Menopause. Post-Menopausal Symptoms are Hot flushes, Fatigue, Disturbed Sleep, Dyspareunia, Vaginal dryness, Leucorrhoea, Decrease Sexual desire, De- pression, Skin wrinkling, Anxiety, Mood swing, dementia, inability to concentrate, Osteoporosis etc. Ayurvedic treatment of Menopause focuses on strengthening and rejuvenating the reproductive system and whole body. Management of Rajonivruttijanya Lakshana through Rasayan Chikitsa, Abhangya, Basti, Shirodhara supplement of Phytoestogens, Bruhaniya, Balya and Vayasthapan drugs along with maintenance of mental health with the help of Yoga, Asanas, meditation and with Ahara and Vihara helps menopausal females to change annoying men-opause to healthy and happy menopause. Avoid the provocative causes of Vata dosha as there is natural vitiation of vata dosha with advancing age. Keywords: Rajonivritti Lakshanas, Postmenopausal Syndrome, Panchakarma, Ayurvedic medicinal plants.

FACTORS AFFECTING SEXUAL LIFE OF MENOPAUSAL WOMEN: SCOPING REVIEW

Background: WHO predicts that there will be a menopause explosion in 2030 with around 1.2 billion women aged over 50 years. Most of them (about 80%) live in developing countries. The population of postmenopausal women is increasing by about three percent every year. Although menopause is a normal condition, it turns out that not all women can accept this well, one of which is related to sexual problems. Objective: To determine the factors that influence the sexual life of menopausal women in various countries based on the results of past studies. Method: Scoping Review which adapts the Arskey and O'Malley framework. This study took databases from PubMed, EbscoHost, and ProQuest. Results: There were 20 articles out of 2,415 selected based on inclusion and exclusion criteria. This research has 2 main themes, consisting of physical aspects and psycho-social aspects. Physical aspects that affect the sexual life of menopausal women are hot flushes, vaginal dryness, changes in body shape, insomnia, fatigue, and body image. Meanwhile, psycho-social aspects, in this case, include stress, depression, socio-culture, intimacy with partners, lack of social support, and lack of information and health services for menopausal women. Conclusion: The factors that affect the sexual life of menopausal women are a description of physical and psychological discomfort. The most dominant factors affecting the sexual life of menopausal women are hot flushes, vaginal dryness, body image, depression, lack of social support, and lack of information and health services for women during menopause. There is a need for further research on the factors that influence the sexual life of menopausal women in Indonesia to be more relevant to describe conditions in Indonesia. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0888/a.php" alt="Hit counter" /></p>