Clinical Evidence and Scientific Mechanism

 

Symptoms

Acupuncture is used clinically to

  • manage cancer-related symptoms

  • treat side effects induced by anticancer therapies

  • boost blood cell count

  • enhance lymphocyte and natural killer (NK) cell activity.

In cancer treatment, its primary use is symptom management; commonly treated symptoms are

  • cancer pain

  • chemotherapy-induced nausea and vomiting (N/V)

and other symptoms that affect a patient’s quality of life, including

  • weight loss

  • anxiety

  • depression

  • cough

  • coughing up blood

  • speech problems

  • insomnia

  • poor appetite

  • fatigue

  • xerostomia

  • hot flashes

  • chemotherapy-induced peripheral neuropathy

  • gastrointestinal symptoms (constipation and diarrhea

  • postoperative ileus

  • chemotherapy-related cognitive problems

  • hiccups

 

It is noteworthy that almost all reported clinical studies on the effects of acupuncture on cancer or cancer therapy–related symptoms focus on symptom management rather than the disease itself. Investigations into the effects of acupuncture on chemotherapy-induced nausea and vomiting, many of which were randomized and well-controlled, produced the most convincing findings. A number of randomized controlled trials have reported on the effect of acupuncture in alleviating other cancer treatment-associated side effects, with many showing promising evidence supporting the use of acupuncture. Additional phase III clinical trials are ongoing.

 

Tumor size

A team of Chinese scientists adapted the traditional technique to create a form of “electro-chemotherapy” (similar to electrical acupuncture) to treat laboratory mice with brain tumors, shrinking them to less than 1 percent (see the red rectangle below) of their initial size.

Rat Cancer Research.png

Figure 1. (A) Schematic illustration of C6 tumor xenograft establishment, blank and H2-ECT procedures, and therapeutic outcome (n = 3). (B) Typical photographs of the tumor-bearing mice and tumor lumps, and their control groups, before and after 15 days of first treatment in different conditions (10 min twice a day for first 3 days). Red circle indicates the eliminated tumor in this case. Scale bar: 1.5 cm. (C) The body weights of C6 tumor-bearing nude mice with different groups, recorded every day. (D–F) Tumor weight and tumor volume dissected and relative tumor volume after 15 days of first treatment in different conditions (10 min twice a day for first 3 days, n = 3). All the data are represented as mean ± SEM. n denotes the number of mice. n = 3, P<0.05 and P<0.005 representing statistical significance, which is evaluated by Student’s two-sided t-test with GraphPad Prism software compared to the control group.

Another group of investigators found that acupuncture and/or cyclophosphamide (CTX) both reduced the size of the solid tumors of breast cancer. When used in conjunction, the tumor size reduction was even more obvious. The mechanisms are associated with inhibition of angiogenesis.

Acupuncture treatment was also be observed to delay tumor growth and changes of intestinal bacteria in osteosarcoma tumor-burdened mice.

β-endorphin is one of key components related to acupuncture treatment. The cancer-preventive effect of β-endorphin is mediated through the suppression of sympathetic neuronal function, which results in increased peripheral natural killer cell and macrophage activities, elevated levels of anti-inflammatory cytokines, and reduced levels of inflammatory cytokines. β-endorphin inhibition of tumor progression also involves alteration in the tumor microenvironment, possibly because of suppression of catecholamine and inflammatory cytokine production, which are known to alter DNA repair, cell-matrix attachments, angiogenic process, and epithelial-mesenchymal transition. Thus, β-endorphin cell therapy may offer some therapeutic value in cancer prevention.

Figure 2. β-Endorphin neuronal cells in the hypothalamus control the neoplastic growth and progression of tumor cells, likely by modulating one or more of the factors indicated. Effects include the activation of parasympathetic nervous system control of lymphoid organs, causing activation of innate immune cells (macrophages and NK cells) and an increase in anti-inflammatory cytokine levels in the circulation. The hypothalamus-pituitary-adrenal gland (HPA) axis and subsequent stress hormones released from the adrenal gland and sympathetic nerve terminals (glucocorticoids and catecholamines) may also be suppressed. In a tumor microenvironment, these hormonal and cytokine changes downregulate inflammation-mediated epithelial–mesenchymal transition (EMT) and, thereby, suppress cancer progression. Collectively, these effects create an unfavorable environment for tumor initiation, growth, and progression.

Figure 2.jpg

Representative references:

  1. Qi G, et al. A green, efficient and precise hydrogen therapy of cancer based on in vivo electrochemistry. National Science Review, 2020;7(3): 660–670.

  2. National Cancer Institutes. Acupuncture (PDQ®)–Health Professional Version. https://www.cancer.gov/about-cancer/treatment/cam/hp/acupuncture-pdq

  3. Tian Y et al. Acupuncture enhances anticancer effects of cyclophosphamide on 4T1 tumors via suppression of angiogenesis in BALB/c mice. Journal of Traditional Chinese Medical Sciences. 2017;4(2):216-221.

  4. Sarkar DK et al. Regulation of cancer progression by β-endorphin neuron. Cancer Res. 2012;72(4):836-40.

 

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

 

We have good experiences to treat some difficult complications of cancer such as pleural effusion, pericardial effusion, pericardial tamponade and lymphoedema. Some points we use often include LU2 (yunmen), LR14 (qimen), LR 13 (zhangmen), et al. Generally, prolonging life expectancy, improving quality of life are the common benefits. Shrinking tumor size or even complete remission is observed in some cases of late stages of cancer.

We usually use electrical acupuncture to stimulate certain acupoints, and combine with individualized Chinese herbs.

For good long term clinical outcome, we strongly recommend receiving treatment regularly, to have sufficient duration and dosage.

 

Case report

 

  • Chief complaint:
    Initial visit: May, 2019. 78 yo male presents with metastatic lung cancer, chronic kidney disease, stage III, with bilateral pleural and pericardial effusion.

  • History of present illness: In July 2015, he was diagnosed as right lung cancer and metastasis to right occipital condyle, confirmed by chest CT, head MRI and biopsy. Fine needle biopsy showed lepidic growth adenocarcinoma, EGFR mutant. Since then, he received regular chemotherapy and radiation therapy. Since April 2019, he had pericardial and pleural effusion with multiple admits to local hospital.
    He is up with a walker and family assist. Shortness of breath, dyspneic on exertion. Currently on 8L O2, 24 hours a day. He could not walk or sleep, sits in the wheelchair for 24 hours a day. Bilateral foot swelling not improved by Lasix. He was informed poor prognosis and recommended for hospice therapy by local hospital and clinic medical doctors.
    Examination: Diminished breath sound in both lungs. Bilateral pedal edema.
    Lab tests: BUN:39 (H), Creatinine: 2.15 (H), GFR 30(L)
    Image: X-ray bilateral pleural effusion

X-ray.jpg

​Echo: pericardial effusion

  • Medical diagnosis:

    • Lung cancer (non-small cell) metastatic to bone, stage IV

    • Pericardial effusion

    • Pericardial tamponade

    • Bilateral pleural effusion

    • Chronic kidney disease, stage III

    • Gastroesophageal reflux disease

    • Ulcerative colitis

    • Type II diabetes

    • Peripheral neuropathy

  • Treatment details: Acupuncture was conducted at the day of initial visit. Key points were DU20(baihui), LU2 (yunmen), LR14 (qimen), LR13 (zhangmen), CV4 (guanyuan), ST29 (guilai), ST36(zusanli). He was also prescribed with 1.5 grams of Chinese herb, Gansui. Two days later, another session of acupuncture was performed. After that, he received acupuncture and Chinese herbs regularly.

  • Clinical outcome:

      With our active approaches, his conditions improved rapidly, continuously and progressively, which        include symptoms, quality of life, life expectance and renal function.

  • His shortness of breath improved in the night of the initial visit.

  • Aug. 2019. He could walk by himself without assistance, his pleural effusion, pericardial effusion and pericardial tamponade were healed, which was confirmed by ultrasound examination.
    Sep. 2019. His oxygen therapy was stopped. His renal function also showed significant improvement. BUN:23, Creatinine:1.28. GFR:53.
    May. 2020. His renal function was continuously improving. BUN: 19, Creatinine: 1.19, GFR: 57
    May 2021 (two years after the initial visit). The patient passed away because of lung infection and complicated heart failure, but his tumor size stabilized over the past two years.

Your Health is Our Top Priority

Cancer Care

Acupuncture
 

 

Eye Disorders

Our Specialties

Clincal Evidence and Mechanism

Acupuncture has been widely used in treating a various condition of the eye. For some disorders, such as macular degeneration, retinitis pigmentosa, Stargardt’s disease, and other retinal diseases which have no treatment in conventional Western medicine, acupuncture is the treatment of choice. For other diseases, such as cataracts (in the early stage) and chronic (open-angle) glaucoma, acupuncture can be helpful as an adjunct therapy to conventional Western medical treatment.

In addition to severe or chronic eye conditions, acupuncture can boost overall visual acuity, reduce sensitivity to light, reduce or eliminate eye floaters, blurred vision, and dry eyes, decrease excessive tearing, and heal reddened, swollen, and/or painful eyes.

 

One group at Vancouver, Canada, summarized their experiences of treating 108 cases of retinitis pigmentosa, with acupuncture and Chinese Herbs. More than 85% of cases showed significant improvement. Eight cases have reached complete cure.

 

One Chinese herb formula (WO2012079419) has been applied for a patent. This pharmaceutical composition can enhance and stabilize the vision of an age-related macular degeneration patient, promote absorption of hemorrhage, as well as reduce macular area choroidal neovascularization (CNV)  leakage and CNV area. The pharmaceutical composition consists of several traditional Chinese medicine (TCM) components, including Astragalus membranaceus bunge (huang qi), Angelica sinensis (dang gui), Poria cocos wolf (fu ling), Fritillaria thunbergia (zhe bei mu), Panax pseudo-ginseng (san qi), charred Radix et Rhizoma Rhei (da huang tan), Pollen Typhae (puh uang) and Curcuma aromatica Salisb ( e zhu) .

 

Representative References:

  1. Yu, W. Treating 108 cases of retinitis pigmentosa with therapies of traditional Chinese Medicine. World Chinese Medicine. 2008;3(3):162.

  2. Kim BH et al. Optimizing acupuncture treatment for dry eye syndrome: a systematic review. BMC Complement Altern Med. 2018 May 3;18(1):145.

  3. Jiao E. Observation on therapeutic effect of age-related macular degeneration treated with acupuncture (article in Chinese). Zhongguo Zhen Jiu. 2011 Jan;31(1):43-5.

  4. Chen S et al. Effect of Acupuncture on Intraocular Pressure in Glaucoma Patients: A Single-Blinded, Randomized, Controlled Trial. Evid Based Complement Alternat Med. 2020 Apr 28;2020:7208081.

  5. Wang S et al. Traditional Chinese Medicine (TCM) for the treatment of age-related macular degeneration--Evaluation of WO2012079419. Expert Opin Ther Pat. 2013 February; 23(2): 269–272.

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

One important acupuncture point we use is Xin ming xue (New point to bright eye):

Earlobe.PNG

Combing Xin Ming 1 and points around the eyes can cover the full eye, from ocular fundus to the top of eye.
We also collaborate with Dr. Weidong Yu at Vancouver, Canada, a world leader in health care of eye disorders.
For more information about Dr. Yu, please visit this website: https://tcmrp.com/
and watch this Youtube video: https://www.youtube.com/channel/UCU1eFGW-UcdUhg3DlTafLOg

 

Chronic Pain

 Depending on the degree of complication of each individual patient, we will use one or several of the following approaches, to reach the optimized recovery and good long term health.

 

  1. Regular acupuncture modalities

  2. Advanced acupuncture technique of motion technique

  3. Advanced acupuncture technique of manipulation/Qi jumping/electrical stimulation.

  4. Classical Chinese herbs pills or formulas.

  5. Up-to-date clinical research evidence of acupuncture and Chinese herbs from literature search, both in English and Chinese

  6. Individualized therapy: combining knowledge of anatomy, physiology, pathology, pathophysiology, pharmacology, psychiatry, psychology and clinical medicines, with Chinese herb medicine, to guide our practice.

  7. Discussion with state, national and international peers and specialists, for a complicated case.

Clinical Evidence and Scientific Mechanisms

Clinical evidence:

A recent meta-analysis conducted by investigators at Memorial Sloan Kettering Cancer Center, New York, NY, whose data received for a total of 20,827 patients from 39 trials. The report showed that acupuncture was superior to both sham and no acupuncture control for each pain condition (all p<0.001) with differences between groups close to 0.5 standard deviations (SD) for comparison with no acupuncture control and close to 0.2 SDs in comparison with sham. They also found clear evidence that the effects of acupuncture persist over time with only a small decrease, approximately 15%, in treatment effect at one year.

Scientific Mechanisms:

The mechanisms of acupuncture on chronic pain are mainly associated with three aspects: dissecting fascia adhesion, anti-inflammation and analgesia effects.​


Dissecting Fascia Adhesion 1.jpg
Dissecting Fascia Adhesion 2.jpg

Dissecting fascia adhesion:

Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up.

 

Although fascia looks like one sheet of tissue, it’s actually made up of multiple layers with liquid in between called hyaluronan. It’s designed to stretch as you move. But there are certain things that cause fascia to thicken and become sticky. When it dries up and tightens around muscles, it can limit mobility and cause pain to develop.

 

By inserting acupuncture needles into layers of fascia, and using some special technique such as motion technique, which has been proved to dissect fascia adhesion, acupuncture can relive associated pain with fascia adhesion.

Anti-inflammation:

After antidromic stimulation of the nociceptor, calcitonin gene-elated peptide (CGRP), substance P and β-endorphin are all released. Initially, substance P will activate mast cells and in a later phase also macrophages to secrete inflammatory mediators. As a consequence, the mast cell will not only secrete serotonin and histamine, but also cytokines such as tumor necrosis factor (TNF)-a. In turn, TNF-a could prime sensory nerve endings. The activation of mast cells and mast cell-mediated inflammation is regulated by nitric oxide (NO). Macrophages will produce a number of cytokines and eicosanoids.

Anti-inflammation.jpg

High levels of CGRP have been shown to be pro-inflammatory but, on the contrary, CGRP in low concentrations exerts potent anti-inflammatory actions. The main attributive effect of substance P could be the feedback regulation of CGRP release from nerve endings. The effects of neuropeptides may vary from one organ or tissue to another. The presence and time dependent contribution of mast cells, macrophages and other inflammatory cells to produce mediators that activate or counteract the inflammatory process may be of crucial importance). Therefore, a well-performed and frequently applied ‘low-dose’ treatment of acupuncture could provoke a sustained release of CGRP with anti-inflammatory activity, without stimulation of pro-inflammatory cells. That could be the explanation why acupuncture only seems to be beneficial in the treatment of some inflammatory conditions.

Analgesia Effects.jpg

Analgesia effects:

This is related to pain inhibitory systems in the central nervous system. Endogenous opioids and their receptors such as β-endorphin, enkephalin, cholecystin cytokinase (CCK) and dynorphin are released selectively by acupuncture needle insertion and electrical stimulation. Common pain inhibitory systems including the arcuate nucleus in the hypothalamus, periaqueductal

grey (PAG), parabrachial nucleus (PBN), rostral ventromedial medulla (RVM), and descending inhibitory systems originating from the nucleus raphe magnus (NRM) and locus coeruleus (LC) as key substrates in the central nervous system  (CNS) are also activated in the process of acupuncture. Meanwhile, both thin (A d and C fibres) and thick (A β fibre) afferents activate the pain inhibitory systems, which inhibits pain via the gate theory.

References:

  1. Vickers AJ et al. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018; 19(5): 455–474. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927830/

  2. Kawakita, K et al. Mechanisms of action of acupuncture for chronic pain relief – polymodal receptors are the key candidates. Acupuncture in medicine.  2006;24(Suppl):S58-66. https://www.researchgate.net/publication/246211362_Mechanisms_of_action_of_acupuncture_for_chronic_pain_relief_-_Polymodal_receptors_are_the_key_candidates

  3. Zijlstra FJ, et al. Anti-inflammatory actions of acupuncture. Mediators of Inflammation. 2003;12(2), 59-69. 
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781596/pdf/12775355.pdf

  4. Scar tissue release using Myofascial techniques. 
    https://www.firstphysio.com/scar-tissue-release-using-myofascial-techniques/

Special acupuncture techniques in our clinic

Besides classical acupuncture techniques, we also use some special techniques such as: Qi jumping, Set Mountain on fire, penetrate heaven coolness, motion technique

  • Qi jumping: insert needles in induce one aspect of “De-qi sensation”, the response is like a finish taking the bait, and then add with/without electrical stimulation. This response usually shorten the duration of recover for 2-4 times.

  • Set Mountain on fire: this technique can increase the temperature of local tissue by 0.5-4 Celsius degree. It is good for long time disorders, especially those feeling weak and cold from time to time.

  • Penetrate heaven coolness: this technique can decrease the temperature of local tissue by 0.5-2 Celsius degree. It is usually good for sharp pain.

  • Motion technique: After needles are inserted to certain acupuncture points, people are asked to do some movement with needles inside the body. This technique is good for pain caused by soft tissue.

​FAQ:

What is chronic pain?

Chronic pain is pain that is ongoing and usually lasts longer than six months. It has seven categories:

  • Chronic primary pain: defined by 3 months of persistent pain in one or more regions of the body that is unexplainable by another pain condition.

  • Chronic cancer pain: defined as cancer or treatment related visceral (within the internal organs), musculoskeletal, or bony pain.

  • Chronic post-traumatic pain: pain lasting 3 months after an injury or surgery, excluding infectious or pre-existing conditions.

  • Chronic neuropathic pain: pain caused by damage to the somatosensory nervous system.

  • Chronic headache and orofacial pain: pain that originates in the head or face, and occurs for 50% or more days over a 3 months period.

  • Chronic visceral pain: pain originating in an internal organ.

  • Chronic musculoskeletal pain: pain originating in the bones, muscles, joints or connective tissue.

 

What benefits are noticed from treatment?

According our experience, with our acupuncture techniques, more than 85% of people can feel improvement right after the initial treatment.

How many treatments are required?

This varies from people to people. Some only need 1-2 visits and some need longer. If the stress causing the pain still exists, we recommend a tune up treatment once every 1-2 month, to maintain normal function and prevent pain recurrence after the first whole course of treatment, even it is pain free.

Case report

  • Chief complaint: Dec. 3rd, 2020. 60yr male presents with right meniscus tear for more than one month.

  • History of present illness: When he was playing hockey, he felt down with the right knee on the still position. The twist caused him pain immediately, He then went to see a medical doctor, did MRI, which showed a 4mmx7mm tear, in the right meniscus. The doctor prescribed him cortisone injection at the lateral side of right knee, which had no major improvement. He is also taking ibuprofen which was not significantly helpful as well.
    Examination: Antalgic gait, local swelling and tenderness, with limited range of motion.

  • Medical diagnosis: Right meniscus tear.

  • Treatment details: At the initial visit, Qi jumping and electrical stimulation cross the knee was conducted. At the second visit, Qi jumping and motion techniques were performed.

  • Clinical outcome: After two visits, his right knee pain is 75% better.

  • Note:

    • Response of treatment varies from person to person. Pre-existing surgery caused some damage in the anatomy and physiology function of normal joints and soft tissues, left some scare tissue and tissue adhesion, thus, it usually takes longer time to reach the same improvement as a non-surgery person.

    • The Qi jumping technique usually comes with a “Deqi” sensation, which is good for accelerating recovery of pain disorders by 2-4 times than a regular acupuncture technique. After receiving this technique, some people will feel some sequelae discomfort such as soreness, heaviness, or other feelings. If you don’t like the sequelae, please let us know. We can make the “Deqi” sensation from zero, mild, moderate to strong level.

 

Infertility and Female Health
 

Clinical Evidence and Scientific Mechanism

The research published to date does not show a definitive positive impact of acupuncture on IVF success rates. However, researchers seem to lack traditional scientific practices when interpreting the data. More and more data support the positive role of acupuncture. For example, some investigators analyzed four published randomized clinical trials (RCTs), and found that three revealed significantly higher pregnancy rates in the acupuncture groups compared with the control groups.

Scientific Mechanism:

Needle insertion into the skin and muscle excite ergo receptors and cause afferent activity in A-, and C-fibers. Needles placed and stimulated in the same somatic innervation area as the ovary decrease sympathetic nerve activity, which leads to decreased secretion and release of ovarian androgens. In parallel, the activity of higher control systems is modulated either directly or by the release of opioids, in particular -endorphin, that induce functional changes in different organ systems. In women with PCOS, sympathetic nerve activity and -endorphin production/release are increased. Low-frequency electrical acupuncture decreases the central -endorphin release, leading to decreases in sympathetic tone and LH pulse frequency and amplitude, which in turn decrease ovarian androgen production. DHEA, dihydroepiandrosterone; DHEA-S, sulfate ester of DHEA.

Hypothetical Model of Acupuncture on Infertility.jpg

Representative References:

  1. Stener-Victorin E et al. Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006 Dec;24(4):157-63.

  2. Stener-Victorin E, et al. Effects and mechanisms of acupuncture in the reproductive system. Auton Neurosci. 2010 Oct 28;157(1-2):46-51.

 

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

Basic acupuncture formula

  • Regulate Chong and Ren meridian: CV12, (Zhongwan), CV4 (Guanyuan), ST25 (Tianshu), KI 12 (Dahe), Zigong, UB 32 (Ciliao)

  • Calm shen: DU 20 (Baihui), DU24 (shenting), GB13 (benshen)

  • Tonify kidney and liver: LI 3 (Taixi), UB23 (Shenshu), LR3 (Taichong), SP6

We may add some Chinese herb medicine when it is necessary. The formula of Chinese herb is adjusted according to phases of the menstrual cycle.

 

Mental Disorders

Clinical Evidence and Mechanism 

Anxiety and depression are the top 2 and top 3 disease for Americans seeking help from acupuncture.

Functional MRI has shown the location in the brain for acupuncture points work on. Acupuncture can work on the neurons, to make chemicals such as cortisol levels balanced.

Acupuncture points fMRI.png
MRI 2.jpg

For example, the two vision-related points GB37 (gall bladder) and UB60 (urinary bladder) showed deactivation in visual brain areas like the Cuneus. Thus, acupuncture seems to affect the brain’s processing of both physical Sensations and Emotions.

Mechanism.jpg

Mechanisms of anxiolytic action of acupuncture.
Preventive effect of acupuncture at specific acupoint HT7 on the expression of anxiety-like behavior and the over-secretion of corticosterone (CORT) during ethanol withdrawal was observed in rats. Additionally, acupuncture at HT7 also inhibited the increase in the levels of norepinephrine (NE) and 3-methoxy-4-hydroxy-phenylglycol (MHPG) and the decrease in the levels of dopamine (DA) and 3, 4-dihydroxyphenylacetic acid (DOPAC) in central nucleus of the Amygdala (CEA) induced by ethanol withdrawal.  

BIOCHEMICAL MECHANISMS OF ACUPUNCTURE

The autonomic nervous system (ANS), which is comprised of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), regulates the internal conditions necessary for existence (homeostasis). Information is received from the body and external environment and a response is delivered by either the SNS, which releases excitatory signals, or the PNS which releases signals for relaxation. These signals direct the body to react in very different ways, such as increasing the heart rate and contraction force, or by reducing blood pressure and slowing the heart rate. It is exciting to know that studies show acupuncture has an effect on both the SNS and the PNS, as some further examples presented below reveal.

One of the most sensitive measures of the body’s ability to cope with stress is something called Heart Rate Variability (HRV). Rather than beating consistently at the same rate like a metronome, the heart actually changes its rate based on its fine-tuned response to the environment. A higher HRV has been

Central Nervous System.jpg

associated with better health in all domains, including mental health and low levels of anxiety. Acupuncture has been shown to improve the body’s ability to cope with stress through improving HRV. When the body is under stress, an area of the brain called the hypothalamus releases neurochemicals, and research shows that acupuncture can calm this response. Acupuncture has also been shown to increase the release of endorphins, the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function. All of these acupuncture mechanisms have a direct effect on reducing anxiety.
 

Representative references:

Zheng L, et al. Acupuncture Attenuates Anxiety-Like Behavior by Normalizing Amygdaloid Catecholamines during Ethanol Withdrawal in Rats. Evidence-based Complementary and Alternative Medicine 2011(2):429843.

 

Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

We use gentle technique to stimulate some points such as DU20, SSC to calm the brain and make the chemical levels released be balanced. Some formulas such as Xiaoyaowan may be combined to maximize the medical benefits of acupuncture.

We will also identify your origin of stress and provide a comprehensive solution for this.

 

Digestive Disorders

Clinical Evidence and Scientific Mechanism

Accumulating evidence showed that acupuncture is helpful but not limited to the following digestive disorders:

  • Irritable bowel syndrome

  • Crohn’s disease

  • Ulcerative colitis

  • Gastroesophageal reflux disease

  • Biliary syndrome

  • Cirrhosis

Acupoint
Location
GI Symptoms Reported to Treat
LI4 (Hegu)
Webbing between the index finger and the thumb
Diarrhea, constipation, and abdominal pain
LI11 (Quchi)
Lateral end of the transverse cubital crease midway between LU5 and the lateral epicondyle of the humerus
Diarrhea, constipation, and abdominal pain
ST36 (Zusnali)
1 finger lateral of the tibia, 3 cm below the lower patella
Enteritis, abdominal pain, nausea, gas, and bloating
ST37 (Shangjuxu)
6 cm below lower board patella, 1 finger-width lateral from the anterior border of the tibia
Diarrhea, dysentery, borborygmus, abdominal pain, bloating, distention, constipation
ST39 (Xiajuxu)
3 cm inferior to Shangjuxu ST-37, 1 finger-breadth lateral to the anterior crest of the tibia
Lower abdominal pain, diarrhea
ST21 (liangmen)
4 cm above the belly button, 2 cm lateral to the median line
Diarrhea, pain, and burning in the stomach
ST25 (Tianshu)
2 cm lateral to the belly button
Gas, distention and abdominal pain, constipation
BL20 (Pishu)
1.5 cm lateral to GV6, level with T11
Poor appetite, tiredness
BL21 (Weishu)
1.5 cm lateral to GV line, level with T12
Reflux, dampness, phlegm, heartburn, stomach pain, fullness
BL25 (Dachangshu)
1.5 cm lateral to GV3, level with L4
Borborygmus, gas, diarrhea, blood in feces, constipation
BL27 (Xiaochangshu)
1.5 cm lateral to GV line, level with 1st PSF
Diarrhea, blood in stool, constipation, gas
BL18 (Ganshu)
1.5 cm lateral GV8, level with T9
Abdominal distension and pain
BL23 (Shenshu)
1.5 cm lateral GV4, level with L2
Diarrhea
BL60 (Kunlun)
In a depression between the tip of the external malleolus and the Achilles tendon
Abdominal pain, constipation
PC6 (Neiguan)
2 cm above the wrist crease between the tendons of palmaris longus and flexor carpi radialis
Stomach ache, reflux, nausea, hiccup, vomiting, anxiety
CV12 (Zhongwan)
4 cm above the belly button, at the midline of the body
Nausea, heartburn, abdominal pain
CV4 (Guanyuan)
2 cm above pubic symphysis
Fullness, diarrhea
GV4 (Mingmen)
Below L2
Hemorrhoids, blood in the stool
GV20 (Baihui)
Meeting point of the midline and the top of the ears
Hemorrhoids
GV26 (Renzhong)
In the first third of the distance between the nose and the upper lip
Loss of smell
SP6 (Sanyingjiao)
3 cm directly above the tip of the medial malleolus on the posterior border of the tibia
Colitis, abdominal distension, and flatulence
SP4 (Gongsun)
In a depression distal and inferior to the base of the 1st metatarsal bone at the junction of the red and white skin
Fullness, epigastric distension, abdominal or chest pain
SP9 (Yinlingquan)
Lower border of the medial condyle of the tibia in the depression posterior and inferior to the medial condyle of the tibia
Abdominal distension and pain, poor appetite
SP14 (Fujie)
4 cm lateral to the midline, 1.3 cm below the navel
Abdominal pain
SP15 (Daheng)
4 cm lateral to the navel
Chronic diarrhea, mucus in the stool, constipation
LV3 (Tai chong)
Dorsum of the foot in a depression distal to the junction of the 1st and 2nd metatarsal bones
Nausea, vomiting, and abdominal pain
TB5 (Waiguan)
3-cm width above the wrist crease, on the outer side of the hand
Nausea and vomiting
Mechanism for Action of Acupuncture.jpg

Acupuncture, electroacupuncture, and moxibustion have been shown to have several beneficial effects in rats with TNBS-induced colitis, including (1) improving weight loss and diarrhea; (2) ameliorating inflammatory profiles with reduction of neutrophil myeloperoxidase activity (MPO), decrease of inducible nitric oxide synthase expression, increase of serum IL-10, and downregulation of serum TNF-α and IL1-β and colonic TNF-α mRNA expression; and (3) attenuating adhesion and macroscopic damage scores.

Potential mechanism of action of acupuncture.

Multiple regulating channels of acupuncture-moxibustion in treating irritable bowel syndrome.

Irritable Bowels Acupunture.jpg

IBS: Irritable bowel syndrome; AQP: Aquaporins.
Action mechanisms of acupuncture-moxibustion for IBS include the regulation of gastrointestinal motility, visceral hypersensitivity, brain-gut axis, neuroendocrine, and immunity.

 

Representative References:

  1. Ma XP, et al. Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work? World J Gastroenterol 2014; 20(20): 6044-6054

  2. Song G, et al. Acupuncture in Inflammatory Bowel Disease. Inflammatory Bowel Diseases 2019; 25(7): 1129–1139.

 

Cardiovascular Disorders

 
Clinical Evidence and Scientific Mechanisms

Current clinical evidence showed that acupuncture is helpful for at least the following cardiovascular disorders:

  • Arrythmia

  • Angina

  • Heart failure

 

According to the eight studies reviewed, 87% to 100% of participants arrythmia converted to normal sinus rhythm after acupuncture. A randomized clinical trial that included 404 patients with chronic stable angina found that acupuncture on the acupoints in the disease-affected meridian significantly reduced the frequency of angina attacks compared with acupuncture on the acupoints on the nonaffected meridian, sham acupuncture, and no acupuncture. This indicates that adjunctive therapy with acupuncture had a significant effect in alleviating angina within 16 weeks.

Another report suggested that acupuncture provides a useful adjunct to the treatment of congestive heart failure. It has the potential to improve cardiac and renal function, while enhancing patients’ tolerance for exercise. The acupuncture points they used are: 

  • Neiguan (PC6)

  • Gongsun (SP4)

  • Shenmen (HT7)

  • Zusanli (ST36)

  • Sanyinjiao (SP6)

  • Auricular: Heart, Sympathetic, Shenmen

  • For patients with a diagnosis of phlegm obstruction: Fenglong (ST40)

  • For patients with blood stasis: Xuehai (SP10)

  • For patients with qi stagnation: Taichong (LV3)

 

References:

  1. VanWorme AM et al. The effects of acupuncture on cardiac arrhythmias: a literature review.  Heart Lung. Nov-Dec 2008;37(6):425-31.

  2. Zhao L, et al. Acupuncture as Adjunctive Therapy for Chronic Stable Angina:A Randomized Clinical Trial. JAMA Intern Med. 2019;179(10):1388-1397.

  3. Lei Y et al. “Effect of medicine in combination with acupuncture on 30 chronic congestive heart failure patients” China Tropical Medicine, 2010,Vol. 10 (3) pp.349, 351.
     

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

We select acupuncture points and techniques based on classical textbooks, research publications and personal experience.

We may add some Chinese herb formula or individual herb such as Zhen wu tang and/or dong chong xia cao

Case report

 

  • Chief complaint: May 1999, initial visit. 58yr male presents with obvious shortness of breath after walking for more than three years.

  • History of present illness: Three years ago, he started to have foot swelling and mild shortness of breath after long walking. Local hospital prescribed with diuretics and the foot swelling was better, but the shortness of breath was progressively deteriorating. Three months ago, he slept on the bed almost 20 hours a day, only got up to have meal. Even several steps of walking could cause severe shortness of breath.
    Examination: Severe lethargy, jugular vein distention, diminished heart and breath sound. X ray showed cardiomegaly. EKG was normal.

  • Medical Diagnosis: Right congestive heart failure, stage D

  • Treatment details: Chinese herbs of tonifying lung and kidney were added to the regular treatment plan.

  • Clinical outcome: After three months, the patient could walk by himself, without external support. After six months, he could walk freely, with feeling shortness of breath. After 20 years of the initial visit, his quality of life is still high, with only occasional shortness of breath, which is under well control with help of Chinese medicine and regular medical plan.

Acupuncture Traditional Chinese herbal medicine

Renal Disorders

 
Acupuncture
Clinical Evidence and Scientific Mechanism

 

In patients with chronic kidney disease (CKD), acupuncture improves renal function, reduces proteinuria, controls hypertension, corrects anemia, relieves pain, and controls many hemodialysis related complications such as uremic pruritus, insomnia and fatigue. The mechanisms are related to the regulation of sympathetic nerve and the activation of bioactive chemicals.

A nationwide retrospective cohort study in Taiwan showed that Chinese Herb Medicine (CHM) improves long-term survival in patients with chronic kidney disease, suggesting that CHM is an effective adjuvant therapy for CKD.

Fig. 1. The potential mechanisms of acupuncture techniques in CKD patients.
Acupuncture improves many clinical symptoms or complications of CKD, including improving renal function, reducing proteinuria, controlling hypertension, correcting of anemia, relieving of pain, controlling of hemodialysis-related complications, through different mechanisms. SNS, sympathetic nervous system; RAAS, renin-angiotensin-aldosterone system; NO, nitric oxide; ET-1, endothelin-1; rHuEpo, recombinant human erythropoietin; IGF-1, insulin-like growth factor 1.

Figure 1.jpg

References:

  1. Xiong W et al. Acupuncture application in chronic kidney disease and its potential mechanisms. Am J Chin Med.. 2018;46(6):1169-1185

  2. Huang K et al. Chinese Herbal Medicine improves the long-Term survival rate of patients with chronic kidney disease in Taiwan: a nationwide retrospective population-based cohort study. Front Pharmacol. 2018 Oct 1;9:1117.

 

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

We help people based on their body constitution and symptoms. Some key acupuncture points for chronic kidney disease include UB 23 (Shenshu) and KI3 (taixi).

Some Chinese herbs such as Radix et Rhizoma Rhei (da huang), Radix Astragali (huang qi), Fructus Arctii (niu bang zi) have been proved be beneficial for renal function.

Autoimmune Disorders

Clinical Evidence and Scientific Mechanism

Accumulating evidence showed that acupuncture is helpful but not limited to the following autoimmune disorders:

  • Sjogren syndrome

  • Rheumatoid arthritis

  • Multiple sclerosis

  • Myasthenia gravis

The primary acupoints selected for Sjögren syndrome are the following:

  • LI4 (Hegu)

  • BL20 (Pishu)

  • BL23 (Shenshu)

  • ST36 (Zusanli)

  • SP6 (Sanyinjiao)

  • KI3 (Taixi)

Acupuncture

One report used the following basic Chinese herb formula:

  • Bai Hua She She Cao 15 g

  • E Zhu 15 g

  • Sheng Huang Qi 30 g

  • Dang Gui 9 g

  • Bai Shao 12 g

  • Sheng Gan Cao 6 g

They found that the total effective rate of the TCM treatment group was 83.33% with the following break down of improvement tiers: 30.00% significant improvements, 53.33% moderate improvements, 16.67% no improvements.

 

The total effective rate of the control group was 60.00% with the following breakdown of improvement tiers: 20.00% significant improvements, 40.00% moderate improvements, 40.00% no improvements. The results demonstrate that acupuncture and herbal medicine treatments yield significant positive patient outcomes for patients with Sjögren syndrome.

Woman Receiving Acupuncture

For myasthenia gravis, a meta-analysis showed a significant difference in the absolute clinical score in the acupuncture group than the control group. The treatment duration was 12 weeks. No severe adverse events corresponding to acupuncture were reported. 

Representative references:

 

  1. Li B et al. Clinical observation on the effects of disease index linked to Sjögren syndrome by acupuncture combined with traditional Chinese medicine.Tianjin Journal of Traditional Chinese Medicine, 2017,34(01):26-31.

  2. Zhang X, et al. The effectiveness and safety of acupuncture for the treatment of myasthenia gravis: a systematic review and meta-analysis of randomized controlled trials. Ann Palliat Med. 2019 Nov;8(5):576-585.

Reiki Treatment
 
Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

As a lifetime disorder, we usually recommend the combination of acupuncture and Chinese herb medicine for autoimmune disease.

Skin Disorders

Special acupoints and Chinese herbs

 

For skin disorders, acupuncture is usually used to relieve some symptoms such as itching and anxiety. The commonly used points we use are “five points of skin disorders”: hegu, quchi, sanyinjiao, zhubin, xuehai.

Chinse herbs are widely used in skin disorders. The key formula we use is “ke yin fang”, which has herbs of da qing ye, bai xian pi, she gan, sheng di et al. This formula helps many skin disorders such as eczema, psoriasis and neurodermatitis. Please see the case report for details.

Case report

 

  • Chief complaint:

    • Initial visit: Nov. 2020. 36 yr female presents with eczema for more than 20 years.

  • History of present illness: She has skin lesion in her face, neck, wrist and back leg. The manifestation is red patches, crackle and peeling. The medical diagnosis is eczema. She has this for more than 20 years. Her skin lesion is worse in the summer, presented as dry, scaly skin, skin flushing, itching, and open, crusted, or weeping sores. She tried multiple therapies and only had mild improvement.
    Below are images of neck and hand lesions at the initial visit.

Neck Skin Lesion.png
Hand Skin Lesion.png
  • Medical diagnosis: Ectopic dermatitis

  • Treatment details: She received acupuncture 1-2 times a week, with the focus on itching and hot sensation. She also took the formulation of “No. 2 Ke yin fang”, once a week.

  • Clinical outcome:
    Below are images of the neck and hand lesions 2 months after the initial visit.

Ectopic Dermatitis.jpg
Hand Skin Lesion (Two Months).jpg
  • Note: Response to treatment may vary people to people. She only took Chinese herbs one bag a week. The regular dose is one bag a day.

 
 

Neurological disorders

Figure 3.jpeg

The acupuncture points for Bell’s palsy are usually the following: Yangbai (BL 14), Sibai (ST2), Jingming (BL1), Quanliao (SI 18), Taiyang (EX-HN5), Zanzhu (BL 2), Tongziliao(GB 1), Yifeng (SJ 17), Dicang (ST4), Yingxiang (LI 20), Fengchi (GB 20), and Hegu (LI 4). Frequency is usually 3-6 times a week. Most studies use electric acupuncture after the acute phase. After 1-2 course of acupuncture treatment, the cure rate varies from 23.3% to 74%, and the total effective rate varies from 83% to 100%.

 

For trigeminal neuralgia, a review analyzed six literatures, with 392 cases in total. The number of cured or significantly improved case is 341, which accounts for 86.5% of success rate.

For multiple sclerosis, one group used acupuncture to treat relapsing-remitting multiple sclerosis (RRMS) at remission stage in a randomized controlled trial. Acupuncture was applied according to Leiting Wang’s empirical prescriptions as “the empirical ten needles”, ‘thirteen needles of the governor vessel”, ‘twelve needles of hand and foot” as well as the symptomatic points. Acupuncture was given twice a day for 5 days a week, continuously for 2 weeks. At the intervals of 2 weeks, totally treatment of 3 months was required. The follow—up visit was conducted for 2 years. Separately, the scores of the expanded disability status scale (EDSS) were observed. They found that in the observation group, EDSS scores in 3-mionth and 6-month follow-up were reduced as compared with those before treatment and those in the 12-month and 24-month follow-up were increased, and better than the control group.

References:

  1. Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531040/

  2. Acupuncture in the management of trigeminal neuralgia. https://journals.sagepub.com/doi/10.1177/0964528420924042?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

  3. Complementary therapy use by persons with multiple sclerosis: Benefits and research priorities. https://www.sciencedirect.com/science/article/abs/pii/S1744388108000364?via%3Dihub

 

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

 

We focus on using multiple approaches and inducing strong “De-qi” sensation to reach the optimized recovery.

Clinical Evidence and Scientific Mechanisms

Acupuncture has been commonly used in the treatment of the following neurological disorders:

 

Bell’s Palsy

Trigeminal Neuralgia

Multiple sclerosis

Carpal Tunnel Syndrome

Guillain-Barré syndrome

Stroke

Peripheral neuropathy

Headaches

Alzheimer’s disease

Parkinson disease

 

For Bell’s palsy, a meta-analysis included 11 randomized controlled trials with an overall sample of 1258 individuals. Acupuncture treatment was associated with an increased cure rate [relative risk (RR)=1.77, 95% confidence interval (CI): 1.41–2.21], and a significant difference in total effective rate in acupuncture and drug treatment for Bell’s palsy (RR=1.18,95% CI: 1.07–1.31.

Endocrinological disorders

 

Acupuncture has been commonly used to help the following endocrinological disorders:

 

Diabetes (Type II)

Hyperthyroidism

Hypothyroidism

Polycystic ovary syndrome (PCOS)

Evidence:

In one review published in 2019 at Complementary Therapies in Clinical Practice, acupuncture has been shown to reduce fast blood glucose, HBA1C level. This study includes a total of 21 studies, which comprised a total of 1,943 participants, so the results are very convincing, Acupuncture can also help for complications of diabetes such as diabetes nephropathy, diabetes retinopathy and diabetes peripheral neuropathy.

Mechanism:

The mechanism study has shown that acupuncture and Chinese herb medicine can help diabetes in multiple levels. They can increase the activity of SOD, GSH-px, and inhibiting the level of MDA, NO, and NOS; reducing the expression of TGF-β1 and TβRI in renal cortex and upregulating the expression of Smad7 and IκBα; up-regulating the expression of IRS-1/−2, p85 in liver, skeletal muscle and adipose tissue; downregulation of MMP-9, CD36 and PPARγ in macrophages.

Reference:

  1. Chen C, Liu J, Sun M, Liu W, Han J, Wang H, Acupuncture for type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled. Complement Ther Clin Pract. 2019 ;36:100-112.

  2. Tang XM, Guan J. Effect of acupuncture combined with conventional drug on type 2 diabetes mellitus. Renming Junyi (People's Military Surgeon). 2013(09):1039-1040.

  3. Yang QY, Liu CH, Wu YQ, Li B. Acupuncture combined with Liuwei Dihuang Pill for the treatment of 80 cases of type 2 diabetes with renal Yin deficiency. Henan Zhongyi (Henan Traditional Chinese Medicine). 2015;35(3):573-575.

  4. Chen X, Huang J, Li P, et al. Effects of alcohol alkaloids on hypoglycemic and oxidative stress in diabetic mice. Asia-Pacific Trad Med. 2012; 8:24-25.

Special Acupuncture Technique and Formula of Chinese Medicine in Our Clinic

 It often takes several complementary treatment methods to effectively reduce symptoms and increase quality of life. Depending on the unique situation of each patient, a multi-pronged approach utilizing alternative medicine, lifestyle adjustments, and prescription medications may be needed.

Those living with diabetes should make efforts to maintain a healthy weight, get plenty of daily exercise, eat a balanced diet high in fruits, vegetables, and whole grains, and monitor their blood sugar levels. Taking part in activities that help them manage stress such as yoga, meditation, massage, and participating in enjoyable hobbies.

While diabetes cannot be cured, the risk factors and symptoms can be reduced and it’s possible to live a full and active life free of prescription medication, less complications.