Acupuncture 101 Acupuncture 101 NEOCMN Conference and Exhibit April 25, 2013 Lina Sbrocco ND, LAc Naturopathic Doctor Licensed Acupuncturist Lina Sbrocco, ND, LAc Naturopathic Doctor, Licensed Acupuncturist Topics Overview History History Theory- Eastern Mechanism of Action-Western Scientific Evidence Indications Referrals Contraindications Q & A with Possible Demonstration Originated 3,000-5,000 years old in Ancient China Practiced in most countries today CA-1975 legislation allowing Acupuncturists PCP s US schools early 80 s Why Acupuncture? Safe/effective Non-pharmacological alternative symptom control Autonomy- Participation in their own care Decreased long term cost- improved health NIH- 38%(2008) using CAM greater among women and those with higher levels of education and incomes Concept of qi Theory-Eastern What is qi? Chinese translation: life force Western translation: organ function related to biochemistry and physiology Flows in meridians Obtained from: Body- genetics, body fluids (hormones,enzymes, etc) Energy- preneatal, postnatal (food,air,water) Spirit- mind, awareness,cognition 1
Meridians Meridians Theory- 5 Element Theoretical Foundation Element 5 Elements Associations Wood- Liver/gallblader Water- kidney/urinary bladder Fire- heart/small intestine Earth- stomach/spleen Metal- lung/large intestine Disease Theory Yin/Yang imbalance Yin- female, nourishing, cool, lower/outer organs Yang- male, hot, inner/upper organs, dominant Flow organs and meridians imbalanced Needles FDA regulated hair-like (typically 32-36 gauge) Solid, Stainless steel, unmedicated Single-use, disposable Inserted into muscle tissue Do NOT puncture nerves/arteries/veins Sensations: light pressure, tingling Retention time: approx 30 minutes 2
Needles Thickness.12-.30mm Various Mechanism of Actions Points near neurovascular structures Points near or between muscle groups Radioactive tracer true vs. sham point Rapid progression of tracer vs random diffusion Endorphin hypothesis Needle as electrode activating ionic changes in interstitial fluid Neurogate theory nocioceptive stimulation blocking pain perception Various Mechanisms of Actions Foreign body (needle) concept Stimulate vascular and immune factors Increase adrenocorticotropic hormone (ACTH)/endogenous corticosteroids Harvard Medical School Stimulates neurotransmitters in CSF Endorphins/enkephalins Stimulate new cell growth Stimulate immune system (WBC) Suppress early development cancer cells Scientific Evidence Clinical Application National Institutes of Health (NIH)- National Center for Complementary and Alternative Medicine (NCCAM) World Health Organization (WHO) American Academy of Medical Acupuncture Consensus panel Current standards of practice Common cinical applications Research Pubmed 19,000 entries Harvard Medical School Stimulates neurotransmitters Endorphins Stimulate new cell growth Stimulate immune system (WBC) Challenges- similar to other modalities Sample size, improper statistical analysis, follow-up, inapprpriate evaluation of results Unique- different styles, blinding 3
Common Clinical Indications Dental pain Digestive Emotional ENT GYN Musculoskeletal Neurological Respiratory Addiction Chronic fatigue Immune disorders Blood pressure regulation Nausea (pregnancy induced and chemotherapy induced Contraindications Sepsis or infection (cellulitis) unexplained, unstable syncope Inability to remain seated Relative CI Allergy to metal bleeding disorders Implants (no electro) Local infections Appropriate Referrals Learn most common indications Recognize role early in treatment of potentially disabling/chronic illness Acute/chronic pain unresponsive to std therapy is most common Std care not effective Std care not acceptable to patient Std care has intolerable side effects Typical Treatment Practitioner-patient engagement Tongue/pulse- chinese dx method Patient position supine or prone 5-25 needles inserted Retention time approx 30 min 1-2 times/week Average 10 sessions 22 Contact Information Lina Sbrocco, ND, LAc for appointments call: 216-285-4070 E-mail: UHhospitals.org/integrativemedicine 4
Thank You! 25 January 2013 26 5