Acupuncture and the opioid system: Implications in management of migraine

Pintov, Shay; Lahat, Eli; Alstein, Miriam; Vogel, Zvi; Barg, Jacob

doi:10.1016/s0887-8994(97)00086-6

Cited by 116 publications

(56 citation statements)

References 17 publications

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“…The dose may be affected by the state of the patient (eg nervous, immune and endocrine systems); different doses may be required for different conditions. 60 Pintov et al 61 Responses elicited Lundeberg et al, 59 Hui et al 62 Needle stimulation -method Ceccherelli et al, 63 Marcus, 44 Harris et al, 39 and strength Deluze et al, 64 Barlas et al 65 Needle retention time Lundeberg et al, 59 Hansen, 66 Leung et al 2008 67 Needle type Marcus 44 Treatment schedule Number of treatment sessions None identified…”

Section: The Dose Of Acupuncture Needlingmentioning

confidence: 99%

Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature

et al. 2008

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Many different styles of acupuncture practice exist, and lack of agreement on the optimal acupuncture treatment for any particular condition may mean that some patients do not receive the best treatment. This uncertainty also makes the negative results of sham controlled trials difficult to interpret. Unless we can be sure that both adequate acupuncture and an inactive sham were used in a particular trial, then that trial should not be interpreted as dismissing acupuncture for that condition. Acupuncture practice clearly involves much more than needling procedures, but there is a strong argument for elucidating the role of those needling procedure first. The components of acupuncture needling procedures have been described in the STRICTA document, but it is also clear that the patient's perception of needling is relevant for the outcome of treatment. We therefore recommend the concept of ‘dose’ of acupuncture needling, which should include both the stimulus given to the patient, and certain aspects of the patient's perceptions and response that are known to be linked to the subsequent therapeutic response. We propose the following definition of dose: the physical procedures applied in each session, using one or more needles, taking account of the patient's resulting perception (sensory, affective and cognitive) and other responses (including motor). The dose may be affected by the state of the patient (eg nervous, immune and endocrine systems); different doses may be required for different conditions. The constituents of an adequate dose can be established initially by clinical opinion and subsequently by empirical evidence from experimental studies, which may be either clinical or basic research studies. Systematic reviews which do not consider the adequacy of the acupuncture treatment may have unreliable conclusions. Out of 47 recent systematic reviews, only six have applied some criteria for adequacy. Five used a rating system or conducted a subgroup analysis, and one excluded studies from the analysis altogether if they did not meet criteria for adequacy. Research into what constitutes an adequate dose of acupuncture has long been neglected and is now urgent. Clinical studies that compare the effects of different treatment protocols are probably the most reliable source of evidence, and may also demonstrate a dose-response relationship.

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Section: The Dose Of Acupuncture Needlingmentioning

confidence: 99%

Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature

et al. 2008

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“…34;35 Stimulation of acupuncture points can raise the endorphin level in the brain, 22 and can lead to an increase in activity of the opioidergic system, including panopioid activity and beta-endorphin levels in plasma. 4 However, some authors believe that the quality and amount of evidence is not fully convincing, 3;36 and there is evidence that beta-endorphin is not involved in the pathogenesis of chronic tension-type headache, or that such a role is not reflected in CSF or plasma concentrations of the neuropeptide. 35 This study has limitations that could have affected the results.…”

Section: This Trial Compares Three Key Variables Of Headache (Headachmentioning

confidence: 99%

“…2 The effects of acupuncture on various types of headache have been studied widely. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In a Cochrane review, Melchart et al compared the effectiveness of acupuncture with 'sham' (placebo) acupuncture and other interventions used to treat idiopathic (primary) headaches including tensiontype headache. 3 They concluded that the evidence supports the role of acupuncture for the treatment of idiopathic headaches but is not conclusive.…”

Section: Introductionmentioning

confidence: 99%

“…3 They concluded that the evidence supports the role of acupuncture for the treatment of idiopathic headaches but is not conclusive. While some researchers recommended that acupuncture is valuable for various types of headache, including tension type and migraine, [4][5][6][7][8][9][10] others failed to demonstrate clinically significant differences. [11][12][13][14][15][16][17] Factors which make the practice of acupuncture unlikely to be acceptable to certain medical communities include the possibility of transmitting infection, the risk of visceral trauma, particularly pneumothorax, and the invasive nature of the practice in general.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Laser Acupuncture on Chronic Tension Headache – a Randomised Controlled Trial

Ebneshahidi¹,

Heshmatipour²,

Moghaddami

et al. 2005

Acupunct Med

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Objective Headache affects the quality of life for many people throughout the world. Tension headache is among the commonest forms. Acupuncture is the most widely practised non-medicinal treatment for headaches. The purpose of this study was to explore the effects of laser acupuncture in this type of headache. Methods Fifty patients with chronic tension-type headache were randomly allocated to treatment or placebo groups. Patients in the treatment group received low energy laser acupuncture to LU7, LI4, GB14, and GB20 bilaterally. Points were irradiated for 43 seconds, and the intensity was 1.3J (~13J/cm2). Ten sessions were given, three per week. The placebo group was treated in a similar way except that the output power of the equipment was set to zero. The outcome variables were headache intensity (VAS), duration of attacks, and number of days with a headache per month, by daily diary, assessed monthly to three months after treatment. Results There were significant differences between groups (P<0.001) in changes from baseline in months one, two and three, in median score for headache intensity (treatment group -5, -3 and -2, placebo group -1, 0 and 0), median duration of attacks (treatment group -6, -4 and -4, placebo group -1, 0 and 0 hours), and median number of days with headache per month (treatment group -15, -10 and -8, placebo group -2, 0 and 0). Conclusion This study suggests that laser acupuncture may be an effective treatment for chronic tension-type headache, but the results should be confirmed in larger and more rigorous trials.

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“…The activity of hypothalamic β-EP and its levels in the cerebrospinal fluid of perimenopausal women were both lower than those in fertile women [10][11]. β-EP production and activity can also be increased by acupuncture stimulation [12][13][14]. Can acupuncture also regulate the HPOA in women after oophorectomy?…”

mentioning

confidence: 99%

Acupuncture for Perimenopausal Symptoms in Women who Underwent Oophorectomy – a Comparative Study

Zhou²,

Nan³

2007

Complement Med Res

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Objective: To explore the effects of acupuncture on perimenopausal symptoms in women who underwent oophorectomy. Methods: 67 women who had undergone oophorectomy were divided into an acupuncture group (n = 36) and a comparison group (n = 31) according to their wishes. The first group was treated by acupuncture and the latter group by Livial®. Clinical symptoms were assessed by the modified Kupperman index. The levels of venous blood serum ß-endorphin (ß-EP), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and the maturation index (MI) of vaginal epithelial cells were assessed. Results: There were no significant group differences for the MI of vaginal exfoliative cells nor for the levels of FSH, LH and E2 after treatment (p > 0.05), but Kupperman scoring and the levels of ß-EP differed significantly between the acupuncture and the Livial group (p < 0.05). No side-effects were reported in either group. Conclusion: Acupuncture results in a significant improvement in perimenopausal symptoms in women who have had an oophorectomy. Acupuncture performs as well or better than Livial. Yet, this result may have been influenced by a potential bias and the small sample size.

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Acupuncture and the opioid system: Implications in management of migraine

Cited by 116 publications

References 17 publications

Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature

Defining an Adequate Dose of Acupuncture Using a Neurophysiological Approach – a Narrative Review of the Literature

The Effects of Laser Acupuncture on Chronic Tension Headache – a Randomised Controlled Trial

Acupuncture for Perimenopausal Symptoms in Women who Underwent Oophorectomy – a Comparative Study

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