Tag Archives: Overactive Bladder Symptoms

What’s real picture about Chinese acupuncture research?

Professor Edzard Ernst’s blog “Problems with Chinese acupuncture trials” mentioned:

Most of the studies were in Chinese, and I therefore have to trust the review-authors’ data extraction. They tell us that most trials were of very poor quality.

Not reporting adverse effects in clinical trials is a serious violation of research ethics, particularly as severe adverse effects and even deaths after acupuncture are well-documented.

Unlike Western medicine that typically treats symptoms through medication or surgery with applied knowledge of science and technology, TCM is not evidence-based, but rooted in traditions of more than 2,000 years. There is also a strong cultural component, including many ideas about the universe and human body that Chinese people take for granted, such as the five elements (water, earth, wood, fire, metal). It is difficult to explain these metaphysical ideas in the wider international community that relies heavily on Western medicine and the scientific method.

Is Chinese acupuncture research really poor quality? What’s real picture about Chinese acupuncture research?

Modern and scientific TCM evaluation system is still imperfect. In the current quality control assurance system established with medicinal materials as the core, the lack of TCM resources, limit of raw material prices and other factors lead to the mismatches between the TCM clinical needs and industrial products.Meanwhile, the lack of information sharing platforms among the central and municipal scientific research institutes has restricted the conversion of scientific and technological achievements. These factors have directly influenced the output value, revenue and profit growth of the TCM industry in Beijing.

Recently, the volume of applied research in Chinese medicine is growing rapidly and the quality is improving.There is good evidence supporting the use of some Chinese patent medicine treatments.Researchers are starting to emphasize the importance of clinical trials. Many experts including clinicians, pharmacologists, statisticians and epidemiologists are discussing and formulating clinical trial protocols for TCM.And quality control is being emphasized for the process of trials more than before.

Chinese medicine is indeed different from western medicine, while TCM is an individual therapeutic method for diseases or conditions. There should be a balance between what is ideal and what is feasible.Sham acupuncture as a control method is still immature, which is not appropriate to be taken as a standard model for acupuncture research. If the research method which takes modern medicine as the control method in Chinese Acupuncture and Moxibustion can be promoted, and the most effective and the most advanced methods and results which are general accepted can be taken as the control, the differences and the advantages of acupuncture-moxibustion can be discovered directly with greater value.

But, the scientist still believe something like this: “In fact there have been several thousand acupuncture studies over decades. After all of this clinical research, acupuncture has not been clearly demonstrated to be effective for any indication. In short, acupuncture does not work. It is too late to talk about acupuncture’s “potential,” as if we just need to study it more. It has been studied. It doesn’t work.Proponents, however, will continue to publish poorly conducted studies where biases and degrees of freedom can generate positive results, and more rigorous studies with negative results that they will promote none-the-less as if they were positive.For acupuncture true believers, acupuncture research is a “heads I win, tales I win” situation.”

latest case report:

Acupuncture and Chinese herbal medicine were used to treat a 65-year-old man who had dry eye disease. He had complained of dryness and stinging sensation in his eyes for five months. His eye discomforts were frequently exacerbated in the afternoon and in air-conditioned spaces. He consulted an ophthalmologist, who made the diagnosis of dry eye disease and prescribed artificial tears. However, the patient’s feeling of tired eyes had hindered his daily activities considerably, even with the use of the artificial tears supplement.

The patient thus consulted the Chinese medicine department in a Taiwan hospital, which diagnosed his case as Kidney Yang Deficiency .

The patient went through a one-month treatment with a daily dose of Chinese herbal medicine and weekly acupuncture sessions. The stinging sensation was reduced by 60 per cent. After four-month treatment, the doctor ordered to stop on the use of artificial tears. The patient reported that he had occasional fatigued eyes in the afternoon, but his life is much better than before.

source: https://is.gd/pZzn6C

Can acupuncture really help with Overactive Bladder Symptoms?

Overactive bladder may also be associated with frequent urination (urinary frequency) and nighttime urination (nocturia). OAB is not the only cause for these symptoms; other possibilities include urinary tract infection, diabetes, medication use such as diuretics (water pills), prostate disease, bladder tumors, or interstitial cystitis (causing pelvic pain, urinary frequency, and urgency).Another type of urinary incontinence is called stress incontinence, which results from weakness of the sphincter and other structures designed to keep urine from leaking out of the bladder. Furthermore, overflow incontinence results from accumulation of excessive amounts of urine in the bladder.

“The overactive bladder syndrome has become an accepted way to simplify a complex array of symptoms and leads people to believe that an overactive bladder is an independent disease in itself. However, the truth is not as simple as this, as there are usually several factors at work explaining the symptoms. This is also one of the reasons why so called overactive bladder medications often do not bring the hoped result,” says Kari Tikkinen, MD, PhD, from the HUCS Department of Urology.

(Sciencedaily)

Can acupuncture help? Yes!
Oregon Health and Science University has done a research to compare acupuncture treatment for overactive bladder with urge incontinence with a placebo acupuncture treatment.Eighty-five women enrolled in this randomized, placebo-controlled trial. Women were randomly assigned to either receive an acupuncture treatment expected to improve their bladder symptoms, or a placebo acupuncture treatment designed to promote relaxation.
Researchers found Women who received 4 weekly bladder-specific acupuncture treatments had significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores as compared with women who received placebo acupuncture treatments.
Actually, Chinese acupuncturist treat urinary incontinence by very similar acupoints and electro acupuncture as well. And we even have more treatment style than just nerves stimulation.
To explore the effectiveness and significance of whether electrical acupuncture stimulation combining with pelvic floor muscle therapy (PFMT) can improve the recovery of urinary continence,Chinese Shanghai Medical College has done a new research about urinary incontinence acupuncture treatment.A total of 109 patients took part in the study of novel combination treatment for urinary continence from September 2008 to September 2009.
Chinese researchers found Electrical acupuncture stimulation therapy combining with PFMT can improve the recovery of patients’ urinary continence after radical prostatectomy.
So, For almost same treatment, if patient see acupuncturists,£50 per session. If patient see private doctors,they charge you £240 per session. And £150 in NHS.
That’s all.
______________________________________________________________________________________________
Reference:Yang BS, Ye DW, Yao XD, Peng JY, Zhang SL, Dai B, Zhang HL, Shen YJ, Zhu Y, Zhu YP, Shi GH.Zhonghua Wai Ke Za Zhi. 2010 Sep;48(17):1325-1327
:Emmons SL, Otto L.Obstet Gynecol. 2005 Jul;106(1):138-43.
Latest research:Initial animal studies suggest several biochemical mechanisms of action underlying the effect of acupuncture on OAB suppression. The experience in humans includes two case series and six comparative trials. All studies demonstrated subjective improvement in OAB symptoms, and some reported objective improvement in urodynamic studies. Notably, some comparative trials showed the benefit of acupuncture to be comparable with antimuscarinic treatment.
CONCLUSION: Despite their limitations, existing studies serve as a promising foundation for suggesting a role for acupuncture as an alternative therapy for OAB. Further well-designed studies are required to investigate optimal technique and their outcomes.
Reference:Int Urogynecol J. 2016 Jan 6
new research from Front Med. 2017 Feb 14

Electroacupuncture (EA) at Zhongliao (BL33) can improve the symptoms of overactive bladder (OAB), such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups: no intervention group, D-BL33 group (deep needling at BL33), S-BL33 group (shallow needling at BL33), non-acupoint group (needling at the non-acupoint next to BL33), Weizhong (BL40) group, Sanyinjiao (SP6) group, Tongtian (BL7) group, and Hegu (LI4) group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval (ICI) of rats with OAB (P = 0.001, P = 0.005, P = 0.046, respectively, post-treatment vs. post-modeling). Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups (all P < 0.01). Significantly shortened vesical micturition time (VMT) and elevated maximum detrusor pressure (MDP) were also observed in the D-BL33 group (P = 0.017 and P = 0.024, respectively, post-treatment vs. post-modeling). However, no statistically significant differences in the changes of VMT and MDP from post-modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.
Ten randomized controlled trials (RCTs) with 794 patients were included in this systematic review. The combined results showed that electroacupuncture (EA) may be more effective than sham electroacupuncture (sham EA) in improving the 24-hour nocturia episodes and EA may enhance tolterodine for relieving voiding symptoms and enhancing patients’ quality of life. However, more trials with high quality and larger sample sizes will be needed in the future to provide sufficient evidence. Only 15 of 794 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, acupuncture is safe for treating OAB.
CONCLUSION: Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.

Another case study:

PATIENT CONCERNS:

The patient was 73 years old and had frequent urination and urge urinary incontinence for 3 years; she had 24 to 30 counts of urination per day and 7 to 9 counts of urge incontinence. The patient was treated with multiple TCM and Western medicines and therapies. The TCM treatment consisted of several patented Chinese medicines and TCM decoctions. The Western medication comprised mainly antibiotics, alpha receptor antagonists, and muscarinic receptor antagonists. The treatment effect was unsatisfactory, and there was no apparent alleviation of symptoms; therefore, she underwent electroacupuncture.
DIAGNOSIS:

Refractory OAB.
INTERVENTIONS:

The patient received 30 days of TCM-based electroacupuncture with optimized acupoint positioning, which comprised a total of 10 sessions (1 electroacupuncture session every 2 days) targeting the bilateral Zhongliao and Sanyinjiao acupoints. After treatment, the patient experienced a good therapeutic outcome.
OUTCOMES:

After 30 days of electroacupuncture treatment, the average daily count of urination in 5 days decreased from 29.3 per day before treatment to 19.8 after treatment, and the average count of urge incontinence decreased from 9.3 before treatment to 5.8 after treatment. However, good prognosis was not stable. After careful consideration, the patient accepted SNM treatment, which greatly alleviated the symptoms of frequent urination and urge incontinence. The patient received follow-up visits for 2 years, during which she manifested stable curative effects.
LESSONS:

The optimized positioning at the Zhongliao acupoint improves the accuracy of acupuncture. Accurate electroacupuncture alleviates the symptoms of refractory OAB by stimulating the Zhongliao and Sanyinjiao acupoints, as the underlying mechanisms are similar to those of SNM. Therefore, it is possible to use electroacupuncture to estimate the therapeutic effect of SNM, thereby providing a reference for patients and clinicians to determine whether SNM treatment will be effective.