Efeitos e mecanismos da Acupunctura no aparelho reprodutor

Effects and mechanisms of acupuncture in the reproductive system

The use of acupuncture to treat reproductive dysfunction has not been well  investigated. Only a few clinical studies have been reported, most of which are flawed by poor design and a lack of valid outcome measures and diagnostic criteria, making the results difficult to interpret. Experimental studies, however, show that acupuncture has substantial effects on reproductive function. Here we review the possible mechanisms of action of acupuncture on the reproductive system and its effects on reproductive dysfunction, focusing in particular on polycystic ovary syndrome, the most common endocrine and metabolic disorder in women.

Clinical and experimental evidence demonstrates that acupuncture is a suitable alternative or complement to pharmacological induction of ovulation, without adverse side effects. Clearly, acupuncture modulates endogenous regulatory systems, including the sympathetic nervous system, the endocrine system, and the neuroendocrine system. Randomized clinical trials are warranted to further evaluate the clinical effects of acupuncture in reproductive disorders.

Sindrome do Túnel Cárpico: Acupunctura ou Corticoterapia?

Acupuncture better than steroids for carpal tunnel syndrome

A group from Taiwan has demonstrated that short-term acupuncture treatment can result in long-term improvement in carpal tunnel syndrome (CTS) and that acupuncture produces significantly better results than oral steroid treatment. Seventy-seven patients with mild-to-moderate idiopathic CTS were randomised to either four weeks of either oral prednisolone or twice-weekly acupuncture sessions. The patients were followed up at seven and 13 months using global symptom score (GSS) assessments and electrophysiological nerve conduction studies. Compared with baseline levels, the percentages of patients who showed treatment failure, moderate improvement and good improvement were significantly different between the two groups in favour of acupuncture, at both month seven (10.5, 2.6 and 86.8% acupuncture vs 33.3, 7.7, and 59% steroids) and month 13 (15.8, 2.6 and 81.6% acupuncture vs 51.3, 0 and 48.7% steroids). The acupuncture group showed a significantly better improvement in GSS, distal motor latencies and distal sensory latencies compared to the steroid group throughout the one-year follow-up period. Significant correlation was observed between changes of GSS and all but one of the electrophysiological parameters. (A Randomized Clinical Trial of Acupuncture Versus Oral Steroids for Carpal Tunnel Syndrome: A Long-Term Follow-Up. J Pain. 2010 Nov 24. [Epub ahead of print]).

A systematic review and meta-analysis evaluating the effectiveness of acupuncture and acupuncture-like treatments for CTS carried out by Korean authors has concluded that the evidence for acupuncture as a symptomatic therapy for CTS is encouraging, but not convincing. Six RCTs met their inclusion criteria, and a meta-analysis of acupuncture versus steroid injection therapy favored acupuncture in terms of responder rate. The methodological quality of the reviewed studies was assessed as generally being low and the authors called for further rigorous studies to establish the therapeutic value of acupuncture for this condition. (Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials. J Pain. 2010 Nov 17. [Epub ahead of print]).

Acupunctura para a Fibromialgia - evidência científica

Acupuncture for fibromyalgia

A systematic review of TCM therapies for treatment of fibromyalgia has concluded that they appear to be effective. The authors looked at twenty-five RCTs (1516 participants) of which ten were eligible for meta-analysis. Acupuncture reduced pain scores and number of tender points compared with conventional medication, however it showed no significant effect on pain reduction compared with sham acupuncture. A combination of acupuncture and cupping therapy was better than conventional medication for reducing pain and for improving depression scores. Other individual trials demonstrated positive effects of Chinese herbal medicine on pain reduction compared with conventional medication. (Traditional Chinese Medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials. J Altern Complement Med. 2010 Apr;16(4):397-409).

Uma revisão sistemática de terapias da MTC para o tratamento da fibromialgia concluiu que estas parecem ser eficazes. Os autores analisaram 25 RCTs (1516 participantes), dos quais dez eram elegíveis para a meta-análise. A acupunctura reduziu os scores de dor e o número de pontos dolorosos em relação à medicação convencional, porém não apresentou efeito significativo na redução da dor, em comparação com acupunctura sham. Uma combinação de acupunctura e terapia com ventosas foi melhor do que a medicação convencional para reduzir a dor e melhorar os scores de depressão. Outros estudos individuais demonstraram efeitos positivos da fitoterapia chinesa na redução da dor, em comparação com a medicação convencional.

Comentário:

A sham acupuncture é uma suposta acupunctura placebo utilizada em estudos controlados para comparação com a Acupunctura. É efectuada, no grupo controlo, em outras localizações que não os tradicionais pontos de Acupunctura. Ainda assim é uma intervenção e geralmente há punctura (picada) pelo que continua a ser estranho continuar a ser considerada de placebo, pois também a sham acupuncture exerce um efeito na maioria dos estudos. 

Morning exercise makes up for unhealthy diet

Exercising first thing in the morning before breakfast can significantly lessen the detrimental effects of an unhealthy diet.  Belgian researchers fed healthy active young men a high-fat, high-calorie diet for six weeks. Those who exercised before breakfast gained almost no weight and showed no signs of insulin resistance at the end of the study. In addition, men in this group were found to have burned the fat they were taking in more efficiently. (Training in the fasted state improves glucose tolerance during fat-rich diet. J Physiol. 2010 Nov 1;588(Pt 21):4289-302).

A few hours of meditation is enough to change brain structure

A collaborative study by scientists from China and the USA has found that 11 hours of meditation can induce positive structural changes in an area of the brain that helps regulate behaviour. The meditation technique used, integrative body-mind training (IBMT), was developed from Daoist and Confucian meditation practices commonly used in traditional Chinese medicine. Previous studies of IBMT have found that it improves attention and self-regulation by changing the interaction between the central (brain) and autonomic (body) systems, as measured by theta wave activity in the anterior cingulate cortex and high frequency heart-rate variability correlation. It has also been shown to improve immune parameters in healthy adults, both at a basal level and following a stress challenge. The most recent work involved 45 healthy volunteers who were randomised to either IBMT (consisting of body relaxation, mental imagery and mindfulness training) or a control group that received the same amount of relaxation training (guided muscle relaxation). Neuroimaging using a type of magnetic resonance allowed researchers to examine fibres connecting brain regions before and after training. The most marked changes were seen in connections involving the anterior cingulate cortex, a brain area involved in the regulation of emotions and behaviorbehaviour. The changes were observed only in those who practiced meditation and not in the control group, were observable after six hours of meditation and became clear by 11 hours of practice. The authors suggest that the changes were due to re-organisation of white-matter tracts or an increase in neuronal myelination. (Short-term meditation induces white matter changes in the anterior cingulate. Proc Natl Acad Sci U S A. 2010 Aug 31;107(35):15649-52).

Quais os fundamentos para a realização dos tratamentos de Acupunctura ?

 Neste consultório é efectuada Acupunctura Médica ou Contemporânea, que é o nome que se dá à prática da acupuntura realizada com base em conhecimentos científicos, utilizando a punctura de áreas de intervenção neurológica, vascular e muscular para obter o efeito pretendido. 

 Este tipo de Acupunctura não utiliza o modelo de diagnóstico da Medicina Tradicional Chinesa, que se fundamenta numa estrutura teórica sistemática e abrangente, de natureza filosófica e que inclui entre os seus princípios o estudo da relação yin/yang, da teoria dos cinco elementos e do sistema de circulação da energia pelos meridianos do corpo humano.

Acupuncture improves exercise tolerance in heart patients, German study finds

ScienceDaily (July 1, 2010) — Acupuncture can improve exercise tolerance in patients suffering from chronic heart failure, according to new research from Germany.The finding comes from a clinical pilot study by the team headed by Dr. Johannes Backs, physician and study director at the Department of Internal Medicine III (Cardiology, Angiology, and Pneumology -- Medical Director: Professor Dr. Hugo Katus) of Heidelberg University Hospital. The needles do not increase the heart's pump function, but they seem to have an influence on skeletal muscle strength and thus can increase the walk distance that heart patients can cover. The results of the clinical study, which was conducted with a comparison group treated with placebo acupuncture using dull needles, have been published in the medical journal Heart..

Acupunctura para a cervicalgia

Neck pain: does the number of needles matter?

Italian researchers have investigated the ‘dose’ of acupuncture that is necessary to achieve an adequate analgesic effect in patients with cervical myofascial pain syndrome (MPS). Thirty-six patients were divided into two groups: the first group was treated with five needles while the second group was treated with 11 needles. The duration of needle stimulation was the same in both groups (100 seconds) and each group received six acupuncture sessions. Pain intensity was evaluated before, immediately after and one and three months after treatment. In both groups the needles were inserted superficially, apart from the two most painful trigger points where they were deeply inserted. The results showed that both groups - independently of the number of needles used - obtained a good therapeutic effect, without clinically relevant differences. The authors conclude that, for this pathology, the number of needles does not seem not to be important in determining the therapeutic effect. (Neck Pain Treatment With Acupuncture: Does the Number of Needles Matter? Clin J Pain. 2010 Nov-Dec;26(9):807-12).

http://www.jcm.co.uk/research-archive/article/neck-pain-does-the-number-of-needles-matter-1584/