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akupunktur Behandling

MEDICAL ACUPUNCTURE

Volume 25, Number 6, 2013

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview

Background: Acupuncture is being used increasingly to treat gynecologic and obstetric disorders.

Objective: The aim of this review was to determine the efficacy and safety of acupuncture for treating

pelvic and low-back pain during pregnancy, pain during labor, primary dysmenorrhea, and menopausal

symptoms.

Design: This is an overview of systematic reviews (SRs) and randomized controlled trials (RCTs).

Search strategy: A literature search was conducted, in July 2010, in MEDLINE, the Cochrane

Database of Systematic Reviews, CENTRAL, the Database of Abstracts of Reviews of Effects, and

Tripdatabase.

Selection criteria: Published SRs and RCTs found during the literature search were included as well as RCTs

that were published after completion of the literature search.

Analysis: Data from SRs and RCTs that provided quantitative information were pooled.

Results: Eight SRs and nine RCTs were included. One SR and 4 RCTs showed that acupuncture reduced

pelvic and low-back pain, compared to physiotherapy or usual prenatal care. Results were contradictory when

interventions were compared with sham acupuncture. With respect to reduction of pain during labor, two SRs

showed no differences between acupuncture and sham acupuncture. None of the three SRs included on

primary dysmenorrhea produced conclusive results. Two SRs of studies on menopausal symptoms showed no

differences between acupuncture and sham acupuncture. A meta-analysis of three additional RCTs identified

a favorable effect of acupuncture for reducing frequency and intensity of hot flashes. Adverse effects were

mild and infrequent.

Conclusions: Evidence for the efficacy of needle acupuncture for treating the disorders evaluated remains

inconclusive. The intervention showed promising results for reducing pelvic and back pain during pregnancy

and climacteric vasomotor symptoms, although well-designed studies are needed to make the results more

precise and reliable.​

Anna Selva Olid et al.

Sjukgymnastik
Läkare undersöker gravid kvinna

BMC Complement Altern Med. 2014 Jun 9;14:187

Acupuncture with manual and electrical stimulation for labour pain: a longitudinal randomised controlled trial.

BACKGROUND: 

Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.

METHODS: 

A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals . 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC).

PRIMARY OUTCOME: 

labour pain, assessed by Visual Analogue Scale (VAS).

SECONDARY OUTCOMES: 

relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.

RESULTS: 

Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).

CONCLUSIONS: 

Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.

Vixner L et al.

benskada
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Semin Reprod Med 2017; 35(04): 353-358

Acupuncture for Infertility in Women with Polycystic Ovary Syndrome: What Does It Add?

Acupuncture is a nonpharmacological therapy to induce ovulation in women with polycystic ovary syndrome (PCOS), but not until recently there has been a study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant to pharmacological ovulation induction. Clomiphene citrate, the first-line treatment for ovulation induction in women with PCOS, was twice as effective at achieving live birth, with no effect of acupuncture alone or in combination with clomiphene. Thus, the findings from the recent randomized control trial do not support acupuncture as an infertility treatment, alone or in combination, in women with PCOS. The recent trial has important clinical implications not only for women with PCOS with an active wish for pregnancy but also for those with no active wish of pregnancy, as acupuncture induces ovulation to a higher degree than no treatment and also relieves other PCOS-related symptoms. This narrative review dissects possible mechanism of action of acupuncture on reproductive function, it discusses stimulation parameters, it discusses the recent findings on live birth, and it also discusses the control situation in potential future acupuncture trials.

Elisabet Stener-Victorin

Se fler artiklar av professor Elisabeth Stener-Victorin vid Karolinska Institutet.

Gå in på https://ki.se/en/people/eliste

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September 2017

Acupuncture and Connective Tissue - Learn more about connective tissue.

Gå in och lyssna på Youtube till       Dr Helena Langevin MD             Director for Osher Centre for Integrative Medicine. 

Lyssna till hennes och kollegors forskning om Akupunktur.

February  2019

Default Mode Network as a Neural Substrate of Acupuncture: Evidence, Challenges and Strategy.

Acupuncture is widely applied all over the world. Although the neurobiological underpinnings of acupuncture still remain unclear, accumulating evidence indicates significant alteration of brain activities in response to acupuncture. In particular, activities of brain regions in the default mode network (DMN) are modulated by acupuncture. DMN is crucial for maintaining physiological homeostasis and its functional architecture becomes disrupted in various disorders. But how acupuncture modulates brain functions and whether such modulation constitutes core mechanisms of acupuncture treatment are far from clear. This Perspective integrates recent literature on interactions between acupuncture and functional networks including the DMN, and proposes a back-translational research strategy to elucidate brain mechanisms of acupuncture treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378290/pdf/fnins-13-00100.pdf

Yuqi Zhang et al. 2019

Frontiers in Neuroscience 

April 2020

Activation of LXRβ Signaling in the Amygdala Confers Anxiolytic Effects Through Rebalancing Excitatory and Inhibitory Neurotransmission upon Acute Stress.

The balance of major excitatory (glutamate, Glu) and inhibitory (γ-aminobutyric acid, GABA), named as E/I neurotransmission, is critical for proper information processing. Anxiety-like responses upon stress are accompanied by abnormal alterations in the formation and function of synapses, resulting in the imbalance of E/I neurotransmission in the amygdala. Liver X receptors (LXRs), including LXRα and LXRβ isoforms, are nuclear receptors responsible for regulating central nervous system (CNS) functions besides maintaining metabolic homeostasis. However, little is known about the contribution of LXRs in E/I balance in regulating anxiety-related behaviors induced by stress. In this study, we found stress-induced anxiety led to the expression reduction of LXRβ not LXRα in mice amygdala. GW3965, a dual agonist for both LXRα and LXRβ, alleviated anxiety-like behaviors of stressed mice through activation of LXRβ, confirmed by the knockdown of LXRβ mediated by lentiviral shRNAs in the basolateral amygdala (BLA). This was paralleled by correcting the disequilibrium of E/I neurotransmission in the stressed BLA. Importantly, GW3965 exerted anxiolytic effects by correcting the promoted amplitude and frequency of miniature excitatory postsynaptic current (mEPSC), and augmenting the decreased that of miniature inhibitory postsynaptic current (mIPSC) in the stressed BLA. This suggests that stress-induced anxiety-like behaviors can largely be ascribed to the deficit of LXRβ signaling in E/I neurotransmission in BLA. These findings highlight the deficiency of LXRβ signaling in the amygdala linked to anxiety disorder, and LXRβ activation may represent a potential novel target for anxiety treatment with an alteration in synaptic transmission in the amygdala.

Yu W et al. 

Neurotherapeutics (2020)