Acupuncture and its Complementary Role in the Treatment of Cardiovascular Diseases.

Transcription

1 Acupuncture and its Complementary Role in the Treatment of Cardiovascular Diseases. Roger Wang A.P. Dr. Huimin Wang A.P. Wang Acupuncture Jacksonville, FL

2 How Does Acupuncture Work?

3 How Does Acupuncture Work? 1. Conduction of electromagnetic signals: 1 strategic conductors of electromagnetic signals. electromagnetic signals to be relayed at greater-thannormal rates. Endorphins, immune system. 2. Activation of the body s Natural Opioid System 1: Acupuncture releases opioids. 2-3

4 How Does Acupuncture Work? 3. Stimulation Of The Hypothalamus And The Pituitary Gland: 1, 4 Wide range of effects. 4. Change In The Secretion Of Neurotransmitters And Neurohormones. 1, 5 5. Modulate the activity within specific brain areas to affect perception of pain. 6-9

5 How Does Acupuncture Work? PCC = left posterior cingulate cortex rai = right Anterior Insula 9

6 How Does Acupuncture Work? 6. Eastern perspective: flow of qi in meridians.

7 Who Offers Acupuncture? Mayo Clinic Johns Hopkins Hospital Massachusetts General Hospital Brigham and Women's Hospital Cleveland Clinic University of Texas MD Anderson Cancer Center Memorial Sloan-Kettering Cancer Center And many more...

8 Example from Our Experience: Migraines 86 yo female with severe migraine headaches: Twice a week, each time lasting 2 days. Pain level 10/10 No movement, no food, eye closed lying in bed. After 11 treatments, no pain. Recurred 11 months later with 5/10 intensity. Treated twice and no pain for 12 months. Now only treat as needed.

9 Example from Our Experience: Low Back Pain 70 yo female dragged into clinic by relatives because she s skeptical about acupuncture. She experienced back pain 9-10/10 Poor candidate for back surgery, with high risk of paralysis. 3 Treatments, no pain. Still pain free to this day (5 years so far).

10 Example from Our Experience: Undiagnosed 53 yo female with 34 year history of episodes of hot spells in which she must lie face down on the floor. Retains consciousness. 1-3 time/day on many days, each time for minutes. All tests and exams and imaging studies show no abnormalities. Also evaluated for mental health with no diagnosis. 1 year treatment, now back to normal.

11 Example from Our Experience: Unknown 56 yo male with 8 year history of eyes closing when making right turns. Happens when either walking or driving. Eyes are fine when walking straight or making a left turn. Also fine when turning head right or left while stationary. Eyelids will only open again when manually forced to by hands. No diagnosis and no treatment. Three treatments, each treatment provided relief lasting 2 days. Did not continue treatment due to financial reasons.

12 Our Experience: Other Musculoskeletal Neurological GI Respiratory HEENT Dermatology Genital Urinary system Obstetrics/Gynecology Immune system Endocrine Cardiovascular Etc... Systems

13 Interpretation of Studies Little known fact about acupuncture to outsiders: Diverse field with many approaches. Efficacy is method specific.

14 What are the Indications? According to a VA Literature Review in Pain: 10 Positive Effect: Headache in General and Migraine Specifically. Chronic Pain. Dysmenorrhea

15 What are the Indications? Potentially positive effect: 10 Osteoarthritis General Pain Cancer Pain Labor pain Prostatitis Plantar Heel Tempomandibular Pregnancy pain

16 What are the Indications? Wellness: 10 Potential Positive Effect: Insomnia Smoking cessation Post-Operative Nausea and Vomiting Restless Legs

17 What are the Indications? Mental Health: 10 Potential Positive Effect: Depression Schizophrenia Anxiety PTSD

18 What are the Indications? Cochrane Review: migraine prophylaxis tension-type headache neck disorders low back pain peripheral joint osteoarthritis fibromyalgia chemotherapy-induced nausea or vomiting. Pain management for women in labor postoperative nausea and vomiting

19 What are the Indications? According to Johns Hopkins Integrative Medicine & Digestive Center: 20 Acute and chronic pain, including repetitive motion injuries (e.g. carpal tunnel syndrome, trigger finger, and tendonitis), TMJ and teeth grinding, traumatic and post-surgical pain Autoimmune disorders, including rheumatoid arthritis, fibromyalgia and chronic fatigue, Sjogren s syndrome, Hashimoto s thyroiditis, Graves disease, Raynaud s phenomenon, scleroderma, Crohn s disease, Systemic lupus erythematosus, autoimmune hepatitis, and multiple sclerosis

20 What are the Indications? According to Johns Hopkins Integrative Medicine & Digestive Center: 20 Cognitive issues, such as lack of concentration, poor memory, ADD, and inability to focus Dermatological conditions, such as eczema, psoriasis, and cystic acne Energy problems, such as fatigue, lack of motivation, and chronic fatigue syndrome Gastrointestinal conditions, including heartburn; abdominal pain; irritable colon; diarrhea; constipation

21 What are the Indications? According to Johns Hopkins Integrative Medicine & Digestive Center: 20 Gynecological and obstetric issues, including PMS; painful periods; morning sickness, fetal breech presentation, support for delivery in late pregnancy, support for lactation difficulties Infertility and reproductive problems of women and men Insomnia and sleep disorders Musculoskeletal issues, such as low back pain; muscle, tendon, or joint pain; sports injuries Neurological conditions including chronic headaches; sciatica; nerve injuries Respiratory problems, such as asthma; sinusitis; allergic rhinitis

22 What are the Indications? According to Johns Hopkins Integrative Medicine & Digestive Center: 20 This list is not exhaustive. If you have a health concern not listed above, give us a call and we will be happy to discuss your case. 20

23 What are the Indications? According to the World Health Organization: 21 Adverse reactions to radiotherapy and/or chemotherapy Allergic rhinitis (including hay fever) Biliary colic Depression (including depressive neurosis and depression following stroke) Dysentery, acute bacillary Dysmenorrhoea, primary Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)

24 What are the Indications? According to the World Health Organization: 21 Facial pain (including craniomandibular disorders) Headache Hypertension, essential Hypotension, primary Induction of labour Knee pain Leukopenia Low back pain Malposition of fetus, correction of Morning sickness

25 What are the Indications? According to the World Health Organization: 21 Nausea and vomiting Neck pain Pain in dentistry (including dental pain and temporomandibular dysfunction) Periarthritis of shoulder Postoperative pain Renal colic Rheumatoid arthritis Sciatica Sprain Stroke Tennis elbow

26 Cardiovascular Indications. According to the above sources: Raynaud s phenomenon 20 Hypertension, essential 21 Hypotension, primary 21 Stroke 21

27 Cardiovascular Indications. According to Our Clinical Experience: Stroke Recovery Peripheral Neuropathy (due to PAD or other causes) Hypertension Hypotension Certain types of arrhythmia (possible parasympathetic and sympathetic regulation) 22, 23 Raynaud s phenomenon Chest Pain (CAD already ruled out by physician)

28 Cardiovascular: Case 1 Urologist from Chicago sort treatment for arrhythmia. Before treatment, skipped beats 12-15/min 3 treatments, down to 3-5/min

29 Cardiovascular: Case 2 64 yo female with peripheral arterial disease and peripheral neuropathy. Numbness, burning, tingling and pain 8-9/10 on both feet After 12 treatments, 1/10 on both feet.

30 Cardiovascular: Case 3 Extent of stroke recovery vs. start of treatment following event. Patient # Treatment Started Recovery 1 11 days 100% 2 6 months 50-60% 3 2 years 30% 4 5 years 5% The earlier you start acupuncture, the better the prognosis. Note: all are thrombotic strokes

31 Recap: Acupuncture s indications according our experience and methods. Pain relief: Migraines. Neck Pain Back Pain Musculoskeletal/Sports Injuries Neurological Conditions GI conditions Much more... For a more complete list, visit our website:

32 Recap: Acupuncture s indications according our experience and methods. Cardiovascular indications: Stroke Recovery Peripheral Neuropathy (due to PAD or other causes) Hypertension Hypotension Certain types of arrhythmia (possible parasympathetic and sympathetic regulation) 22, 23 Raynaud s phenomenon Chest Pain

33 Chinese Medicine vs. Western Medicine Chinese Medicine Western Medicine Natural Ancient Technologically Advanced Based on Science These two approaches complement each other.

34 References 1. How Does Acupuncture Affect the Body. New York Presbyterian Hospital Website. Published Accessed March 17th, Han JS. Acupuncture and endorphins. Neurosci Lett May 6;361(1-3): Wang SM1, Kain ZN, White P. Acupuncture analgesia: I. The scientific basis. Anesth Analg Feb;106(2):602-10

35 References 4. Cho ZH1, Hwang SC, Wong EK, et al. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurol Scand Jun; 113(6): Yu LL1, Liu RP, Gao XY, et al. Development of studies on neurochemical mechanism of acupuncture underlying improvement of depression. Zhen Ci Yan Jiu Oct;36(5):

36 References 6. Huang W, Pach D, Napadow V, et al. Characterizing acupuncture stimuli using brain imaging with FMRI--a systematic review and meta-analysis of the literature. PLoS One. 2012;7(4):e doi: /journal.pone Epub 2012 Apr Liu H1, Xu J, Shan B, et al. Determining the precise cerebral response to acupuncture: an improved FMRI study. PLoS One. 2012;7(11):e doi: / journal.pone Epub 2012 Nov 9.

37 References 8. You Y1, Bai L, Dai R, et al. Altered hub configurations within default mode network following acupuncture at ST36: a multimodal investigation combining fmri and MEG. PLoS One May 17;8(5):e doi: / journal.pone Print Zyloney CE1, Jensen K, Polich G, et al. Imaging the functional connectivity of the Periaqueductal Gray during genuine and sham electroacupuncture treatment. Mol Pain Nov 16;6:80.

38 References 10. Hempel S, Taylor SL, Solloway MR, et al. Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs; 2014 Jan. Accessed March 17th Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD DOI: / CD pub2

39 References 12. Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for migraine prophylaxis. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD DOI: / CD pub Trinh K, Graham N, Gross A, Goldsmith CH, Wang E, Cameron ID, Kay TM, Cervical Overview Group. Acupuncture for neck disorders. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD DOI: / CD pub3

40 References 14. Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, van der Windt DAWM, Berman BM, Bouter LM. Acupuncture for peripheral joint osteoarthritis. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD DOI: / CD pub2 15. Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD DOI: / CD

41 References 16. Deare JC, Zheng Z, Xue CCL, Liu JP, Shang J, Scott SW, Littlejohn G. Acupuncture for treating fibromyalgia. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD DOI: / CD pub Ezzo J, Richardson MA, Vickers A, Allen C, Dibble S, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe JA, Shen J, Shivnan JC, Streitberger K, Treish I, Zhang G. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD DOI: / CD pub2.

42 References 18. Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP. Pain management for women in labour: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD DOI: / CD pub Lee A, Fan LTY. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD DOI: / CD pub3.

43 References 20. Acupuncture. Johns Hopkins Integrative Medicine & Digestive Center Website ne_digestive_center/services/acupuncture.html. Accessed March 17th, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. World Health Organization. ml. Published Accessed March 17 th, 2014.

44 References 22. Lombardi F1, Belletti S, Battezzati PM, Lomuscio A. Acupuncture for paroxysmal and persistent atrial fibrillation: An effective non- pharmacological tool? World J Cardiol Mar 26;4(3): Li J1, Li J, Chen Z, et al. The influence of PC6 on cardiovascular disorders: a review of central neural mechanisms. Acupunct Med Mar; 30(1):47-50.