Another version of Alternative Therapy Seminar about Acupuncture Clinical Pharmacy Mansoura University

1. Acupuncture
ALTERNATIVE THERAPY SEMINAR

2. Acupuncture
 is a form of alternative medicine and a key component
of traditional Chinese medicine (TCM) involving thin
needles inserted into the body at certain points.
 that has been practiced for centuries. It's based on the
theory that energy, called chi (say "chee"), flows
through and around your body along pathways called
meridians.
 it's believed that illness occurs when something blocks
or unbalances your chi. Acupuncture is a way to unblock
or influence chi and help it flow back into balance.

3. Acupuncture
 it is generally safe when done by an appropriately
trained practitioner using clean needle technique and
single-use needles.
 When properly delivered, it has a low rate of mostly
minor adverse effects. Accidents and infections are
associated with infractions of sterile technique or
neglect of the practitioner

4. Needles
 - The most common mechanism
of stimulation of acupuncture
points employs penetration of
the skin by thin metal needles,
which are manipulated
manually or the needle may be
further stimulated by electrical
stimulation
(electroacupuncture).
 - Acupuncture needles are
typically made of stainless
steel, making them flexible and
preventing them from breaking.

5. Needles
 - Needles are usually disposed of after each use to
prevent contamination, Reusable needles when used
should be sterilized between applications.
 - Needles vary in length between 13 to 130 millimetres
(0.51 to 5.12 in), with shorter needles used near the
face and eyes, and longer needles in areas with thicker
tissues; needle diameters vary from 0.16 mm (0.006 in)
to 0.46 mm (0.018 in),[49] with thicker needles used on
more robust patients.

6. Mechanism of Action
 How acupuncture is said to work?
 Acupuncture dates back to at least 100 B.C., which is
when an organized system of diagnosis and treatment
using needles was first described in writing in China.
 However, the practice likely precedes this written
history, according to Dr. Edzard Ernst.
 But the modern practice of acupuncture has changed
considerably since it was first introduced in China,
according to David W. Ramey and Bernard E. Rollin, who
describe the evolution of acupuncture in their book
"Complementary and Alternative Veterinary Medicine
Considered"

7. Mechanism of Action
 By the 18th century, acupuncture looked much different
than the practices described in ancient Chinese texts.
And by the early 20th century, aspiring doctors at the
Chinese Imperial Medical Academy no longer studied
acupuncture, according to the authors.
 In traditional Chinese medicine, acupuncture is linked
to the belief that disease is caused by disruptions to the
flow of energy, or qi, in the body.

8. Mechanism of Action
 Acupuncture stimulates points on or under the skin
called acupuncture points or acupressure points,
releasing this qi.
 The qi then travels through channels called meridians,
according to the Center for Spirituality & Healing at the
University of Minnesota.
 But the acupuncture treatments carried out in hospitals
and other health care facilities in the West today are
not based on the same principles that were established
in ancient Eastern texts, according to Bao.

9. Mechanism of Action
 Western scientists have been trying to study the
mechanism of acupuncture for years and have come up
with several hypotheses, she said.
 "One major hypothesis is that acupuncture works
through neurohormonal pathways. Basically, you put the
needle through specific points in the body and stimulate
the nerve.
 The nerve actually sends signals to the brain, and the
brain releases neural hormones such as beta-
Endorphins.

10. Mechanism of Action
 By doing that, the patient may feel euphoric, or happy,
and this increases the pain threshold and they feel less
pain," Bao said.
 Another hypothesis is that acupuncture works by
reducing pro-inflammatory markers, or proteins, in the
body.
 Some animal and human studies suggest that by doing
acupuncture, you can significantly decrease these pro-
inflammatory markers — including TNF and IL-1β —
which decreases inflammation and reduces pain, Bao
said.

11. Mechanism of Action
 Yet another hypothesis applies
specifically to how acupuncture
can be used to treat nerve
damage, such as chemo-induced
peripheral neuropathy, a
condition that often causes
numbness or weakness in the
feet and hands.
 "The idea is that by putting the
needle in, you stimulate the
brain to secrete some nerve
growth factor, and then that
helps the nerve to regenerate,"
Bao said.

12. Applications of Acupuncture
 Low back
 Headaches and migraines
 Nausea and vomiting and post-operative pain

13. Low Back
 A 2013 systematic review found that acupuncture may
be effective for nonspecific lower back pain, but the
authors noted there were limitations in the studies
examined, such as heterogeneity in study
characteristics and low methodological quality in many
studies.
 A 2012 systematic review found some supporting
evidence that acupuncture was more effective than no
treatment for chronic non-specific low back pain.

14. Low Back
 The evidence was conflicting comparing the
effectiveness over other treatment approaches,
individualized acupuncture is not better in reducing
symptoms than formula acupuncture or sham
acupuncture with a toothpick that does not penetrate
the skin.
 The specific therapeutic effects of acupuncture were
small, whereas its clinically relevant benefits were
mostly due to contextual and psychosocial
circumstances.
 Brain imaging studies have shown that traditional
acupuncture and sham acupuncture differ in their effect
on limbic structures, while at the same time showed
equivalent analgesic effects.

15. Headaches and migraines
 A 2012 review found that acupuncture has
demonstrated benefit for the treatment of headaches,
but that safety needed to be more fully documented in
order to make any strong recommendations in support
of its use.

16. Headaches and migraines
 A 2009 Cochrane review of the use of acupuncture for
migraine prophylaxis treatment concluded that "true"
acupuncture was no more efficient than sham
acupuncture, but "true" acupuncture appeared to be as
effective as, or possibly more effective than routine
care in the treatment of migraines, with fewer adverse
effects than prophylactic drug treatment prophylaxis of
tension-type headaches.

17. Nausea and vomiting and
post-operative pain
 A 2014 overview of systematic reviews found
insufficient evidence to suggest that acupuncture is an
effective treatment for postoperative nausea and
vomiting (PONV) in a clinical setting.
 A 2013 systematic review concluded that acupuncture
might be beneficial in prevention and treatment of
PONV, A 2009 Cochrane review found that stimulation of
the P6 acupoint on the wrist was as effective (or
ineffective) as antiemetic drugs and was associated
with minimal side effects.
 A 2014 overview of systematic reviews found
insufficient evidence to suggest that acupuncture is
effective for surgical or post-operative pain.

18. Nausea and vomiting and
post-operative pain
 For the use of acupuncture for post-operative pain,
there was contradictory evidence.
 A 2014 systematic review found supportive but limited
evidence for use of acupuncture for acute post-
operative pain after back surgery.
 A 2014 systematic review found that while the evidence
suggested acupuncture could be an effective treatment
for postoperative gastroparesis.

19. Limitations and
misconceptions
 Increasingly, mainstream doctors and medical
institutions are accepting the practice of acupuncture,
particularly for treatment of pain and nausea.
 For example, found that acupuncture could reduce
vomiting and nausea among patients receiving
chemotherapy, according to Cancer Research UK.
 The World Health Organization maintains an extensive
list of diseases and conditions (mostly pain related)
possibly treatable by acupuncture.

20. Limitations and
misconceptions
 Many doctors now do not discourage their patients from
receiving acupuncture when conventional medicine fails
them or when convention treatment entails too many
adverse side effects.
 There is a growing body of research exploring whether
acupuncture also can be used to treat depression, sleep
disturbances and drug addiction.
 In general, however, acupuncture is considered
complementary to conventional treatments, and it is
likely most effective when implemented along with
certain healthy lifestyle habits, according to Bao.

21. Limitations and
misconceptions
 "Usually, when people are more health conscious, they
pay attention to diet, they exercise more, they think
about a mind-body approach to decrease stress, and
they might also use acupuncture.
 Ideally, I think these things should all come together,
rather than having the goal be to use acupuncture to
treat everything. That doesn't necessarily work," Bao
said.

22. Thank You