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In this Issue

In this Issue Highlights 1,2 David John Carr doi:10.1136/acupmed-2017-011589 Competing interests None declared. The final issue of Acupuncture in Medicine number of heterogeneous trials available for 2017 contains no fewer than four with a relatively high risk of bias, Provenance and peer review Not systematic reviews. The first (this month’s suggested that further evaluation of commissioned; internally peer reviewed. editor’s choice), by Zhang et al tackles the acupressure as a therapeutic modality for © Article author(s) (or their employer(s) topic of chronic knee pain (CKP). In their allergic rhinitis and/or allergic asthma is unless otherwise stated in the text of meta-analysis of 17 studies, the authors warranted. Positive effects of acupuncture the article) 2017. All rights reserved. found evidence of a reduction in CKP on respiratory disorders, including asthma No commercial use is permitted unless after 12 weeks of treatment, measured and chronic obstructive pulmonary otherwise expressly granted. using both the Western Ontario and disease, have also recently been shown by 5 6 McMaster Universities Osteoarthritis preclinical studies in rodent models. RefeRences (WOMAC) score and visual analogue The final systematic review, by Namazi 1 White A, Cummings M. Acupuncture scale. There was no evidence of harm of et al, considered the current evidence for for knee osteoarthritis: study by hinman treatment, reflected by the equivalent laser acupuncture as a potential treatment et al represents missed opportunities. rates of adverse effects in both groups. for obesity (incidentally the inspiration Acupunct Med 2015;33:84–6. Although methodological issues limited for this issue’s cover photo) but, despite 2 Zhang Q, Yue J, Lu Y, et al. the conclusions that could be drawn some positive effects on various biometric underestimates acupuncture efficacy. pending the conduct of further high parameters, was similarly limited by the Acupunct Med 2015;33:170. quality trials, the findings are still encour- relative lack of high quality evidence and 3 Hinman RS, McCrory P, Pirotta M, aging and support the ongoing use of inability to pool the data. Additional find- et al. Acupuncture for chronic knee acupuncture for osteoarthritis of the knee, ings of pilot clinical studies and preclinical 7 8 pain: a randomized clinical trial. JAMA which has been relatively discouraged reports are ulimately encouraging, but 2014;312:1313–22. recently in the face of the widely publi- further research is clearly needed, espe- 1 2 4 National Institute of Health and Care cised, although arguably flawed, nega- cially given the complex nature of adult tive trial by Hinman et al, published in obesity (a growing epidemic worldwide) Excellence. Osteoarthritis: care and JAMA, and the decision of the National and the intuitive need for a multimodal management, 2014 (accessible at https:// Institute of Health and Care Excellence approach to clinical management. www. nice. org. uk/guidance/ cg177) (NICE) not to recommend acupuncture in Elsewhere in this issue, Enblom & 5 Wang WQ, Xu YD, Cui LP, et al. the UK based on its failure to demonstrate Johnson present an analysis of the safety Acupuncture has a positive effect on a minimum clinically important difference of acupuncture at PC6 acupuncture, asthmatic rats in a glucocorticoid- of 0.5 over sham. The second systematic and Wu et al demonstrate nicely, using independent manner. Acupunct Med review of this issue, by Liu et al, found an extracellular signal regulated kinase 2016;34:433–40. encouraging data (pooled from a total of (ERK) inhibitor, that electroacupuncture 6 Li J, Wu S, Tang H, et al. Long-term 11 trials) to support the use of acupunc- can alleviate neurological deficits and effects of acupuncture treatment on ture as an adjunct to Madopar (levodopa reduce cortical apoptosis via upregulation airway smooth muscle in a rat model combined with the dopa decarboxylase of phosphorylated ERK in a rat model of smoke-induced chronic obstructive inhibitor benserazide) to treat Parkinson’s of cerebral ischaemia-reperfusion injury. pulmonary disease. Acupunct Med disease, reflected by improved Unified Next, Liu et al examine the impact of 2016;34:107–13. Parkinson’s Disease Rating Scale (UPDRS) acupuncture at different spinal segmental 7 Belivani M, Lundeberg T, Cummings M, scores. Combined treatment with levels on electromyography/cystome- et al. Immediate effect of three different acupuncture was also associated with trography of the detrusor muscle in a electroacupuncture protocols on fasting lower rates of various adverse effects rat model of urinary retention induced compared with treatment with Madopar by urethral outlet obstruction, in order blood glucose in obese patients: a pilot alone. The third review, by Liang et al, to investigate the mechanisms of action study. Acupunct Med 2015;33:110–4. although greatly limited by the small of acupuncture interventions analogous 8 Gong M, Cao C, Chen F, et al. to posterior tibial nerve stimulation and Electroacupuncture attenuates Department of Obstetrics, Gynecology and sacral neuromodulation: SP6 and BL33 hepatic lipid accumulation via AMP- Reproductive Sciences, The Robert Larner, M.D. stimulation, respectively. Finally, Zhang activated protein kinase (AMPK) College of Medicine, The University of Vermont, et al expand on their previous preclin- activation in obese rats. Acupunct Med Burlington, Vermont, USA 2 ical work examining the properties of 2016;34:209–14. Department of Maternal and Fetal Medicine, myofascial trigger points, using optical UCL EGA Institute for Women’s Health, University 9 Huang QM, Lv JJ, Ruanshi QM, microscopy and transmission electron College London, London, UK et al. Spontaneous electrical activities microscopy to evaluate histopathological Correspondence to Dr David John Carr, at myofascial trigger points at markers of injury including the abundance Department of Obstetrics, Gynecology and different stages of recovery from of mitochondria and contracture knots. Reproductive Sciences, The Robert Larner, M.D. injury in a rat model. Acupunct Med College of Medicine, The University of Vermont, 2015;33:319–24. Burlington, Vermont, 05401, USA; dcarr@ uvm. edu Contributors DJC wrote the manuscript. Carr DJ. Acupunct Med 2017;35:391. doi:10.1136/acupmed-2017-011589 391 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

In this Issue

Carr, David John
Acupuncture in Medicine , Volume 35 (6): 1 – Dec 1, 2017
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Publisher
SAGE
Copyright
© 2017 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/acupmed-2017-011589
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Abstract

Highlights 1,2 David John Carr doi:10.1136/acupmed-2017-011589 Competing interests None declared. The final issue of Acupuncture in Medicine number of heterogeneous trials available for 2017 contains no fewer than four with a relatively high risk of bias, Provenance and peer review Not systematic reviews. The first (this month’s suggested that further evaluation of commissioned; internally peer reviewed. editor’s choice), by Zhang et al tackles the acupressure as a therapeutic modality for © Article author(s) (or their employer(s) topic of chronic knee pain (CKP). In their allergic rhinitis and/or allergic asthma is unless otherwise stated in the text of meta-analysis of 17 studies, the authors warranted. Positive effects of acupuncture the article) 2017. All rights reserved. found evidence of a reduction in CKP on respiratory disorders, including asthma No commercial use is permitted unless after 12 weeks of treatment, measured and chronic obstructive pulmonary otherwise expressly granted. using both the Western Ontario and disease, have also recently been shown by 5 6 McMaster Universities Osteoarthritis preclinical studies in rodent models. RefeRences (WOMAC) score and visual analogue The final systematic review, by Namazi 1 White A, Cummings M. Acupuncture scale. There was no evidence of harm of et al, considered the current evidence for for knee osteoarthritis: study by hinman treatment, reflected by the equivalent laser acupuncture as a potential treatment et al represents missed opportunities. rates of adverse effects in both groups. for obesity (incidentally the inspiration Acupunct Med 2015;33:84–6. Although methodological issues limited for this issue’s cover photo) but, despite 2 Zhang Q, Yue J, Lu Y, et al. the conclusions that could be drawn some positive effects on various biometric underestimates acupuncture efficacy. pending the conduct of further high parameters, was similarly limited by the Acupunct Med 2015;33:170. quality trials, the findings are still encour- relative lack of high quality evidence and 3 Hinman RS, McCrory P, Pirotta M, aging and support the ongoing use of inability to pool the data. Additional find- et al. Acupuncture for chronic knee acupuncture for osteoarthritis of the knee, ings of pilot clinical studies and preclinical 7 8 pain: a randomized clinical trial. JAMA which has been relatively discouraged reports are ulimately encouraging, but 2014;312:1313–22. recently in the face of the widely publi- further research is clearly needed, espe- 1 2 4 National Institute of Health and Care cised, although arguably flawed, nega- cially given the complex nature of adult tive trial by Hinman et al, published in obesity (a growing epidemic worldwide) Excellence. Osteoarthritis: care and JAMA, and the decision of the National and the intuitive need for a multimodal management, 2014 (accessible at https:// Institute of Health and Care Excellence approach to clinical management. www. nice. org. uk/guidance/ cg177) (NICE) not to recommend acupuncture in Elsewhere in this issue, Enblom & 5 Wang WQ, Xu YD, Cui LP, et al. the UK based on its failure to demonstrate Johnson present an analysis of the safety Acupuncture has a positive effect on a minimum clinically important difference of acupuncture at PC6 acupuncture, asthmatic rats in a glucocorticoid- of 0.5 over sham. The second systematic and Wu et al demonstrate nicely, using independent manner. Acupunct Med review of this issue, by Liu et al, found an extracellular signal regulated kinase 2016;34:433–40. encouraging data (pooled from a total of (ERK) inhibitor, that electroacupuncture 6 Li J, Wu S, Tang H, et al. Long-term 11 trials) to support the use of acupunc- can alleviate neurological deficits and effects of acupuncture treatment on ture as an adjunct to Madopar (levodopa reduce cortical apoptosis via upregulation airway smooth muscle in a rat model combined with the dopa decarboxylase of phosphorylated ERK in a rat model of smoke-induced chronic obstructive inhibitor benserazide) to treat Parkinson’s of cerebral ischaemia-reperfusion injury. pulmonary disease. Acupunct Med disease, reflected by improved Unified Next, Liu et al examine the impact of 2016;34:107–13. Parkinson’s Disease Rating Scale (UPDRS) acupuncture at different spinal segmental 7 Belivani M, Lundeberg T, Cummings M, scores. Combined treatment with levels on electromyography/cystome- et al. Immediate effect of three different acupuncture was also associated with trography of the detrusor muscle in a electroacupuncture protocols on fasting lower rates of various adverse effects rat model of urinary retention induced compared with treatment with Madopar by urethral outlet obstruction, in order blood glucose in obese patients: a pilot alone. The third review, by Liang et al, to investigate the mechanisms of action study. Acupunct Med 2015;33:110–4. although greatly limited by the small of acupuncture interventions analogous 8 Gong M, Cao C, Chen F, et al. to posterior tibial nerve stimulation and Electroacupuncture attenuates Department of Obstetrics, Gynecology and sacral neuromodulation: SP6 and BL33 hepatic lipid accumulation via AMP- Reproductive Sciences, The Robert Larner, M.D. stimulation, respectively. Finally, Zhang activated protein kinase (AMPK) College of Medicine, The University of Vermont, et al expand on their previous preclin- activation in obese rats. Acupunct Med Burlington, Vermont, USA 2 ical work examining the properties of 2016;34:209–14. Department of Maternal and Fetal Medicine, myofascial trigger points, using optical UCL EGA Institute for Women’s Health, University 9 Huang QM, Lv JJ, Ruanshi QM, microscopy and transmission electron College London, London, UK et al. Spontaneous electrical activities microscopy to evaluate histopathological Correspondence to Dr David John Carr, at myofascial trigger points at markers of injury including the abundance Department of Obstetrics, Gynecology and different stages of recovery from of mitochondria and contracture knots. Reproductive Sciences, The Robert Larner, M.D. injury in a rat model. Acupunct Med College of Medicine, The University of Vermont, 2015;33:319–24. Burlington, Vermont, 05401, USA; dcarr@ uvm. edu Contributors DJC wrote the manuscript. Carr DJ. Acupunct Med 2017;35:391. doi:10.1136/acupmed-2017-011589 391

Journal

Acupuncture in Medicine – SAGE

Published: Dec 1, 2017

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