KIDNEY & URINARY DISORDERS RESEARCH © JCM Ltd
ACUPUNCTURE BENEFICIAL FOR INCONTINENCE
A pilot study carried out in the USA has found preliminary evidence of the benefits of acupuncture in the treatment of incontinence in women. Nine women (aged 44 to 66) with urge, mixed urge and stress urinary incontinence were randomised to receive true acupuncture or a sham needle control. Subjects who received true acupuncture had a mean 63.30% reduction in daytime accidents per day at one week post-acupuncture and a 67.47% reduction at four weeks post-acupuncture. In contrast, the sham group’s mean reduction in daytime accidents was 18.88% at 1 week and 16.67% at four weeks post treatment. (J Wound Ostomy Continence Nurs. 2009 Nov-Dec;36(6):661-70).
ACUPUNCTURE HELPS OVERACTIVE BLADDER
A study of 74 women who suffered from an overactive bladder (frequent urination, urinary incontinence, and reduced bladder capacity and urinary volume) randomly assigned the women to either an acupuncture protocol directed at the urinary symptoms, or an acupuncture protocol designed simply to promote urination (in this study referred to as a placebo group). Women in both groups had a significant decrease in the number of incontinent episodes (59% for the treatment group and 40% for the placebo, a non-significant difference). The treatment group however showed a significantly greater reduction in urinary frequency and urgency and a significantly greater increase in maximum voided volume and maximum cystometric capacity. Both groups had an improvement in a urinary stress inventory and incontinence impact questionnaire scores, with a significantly greater benefit in the treatment group. (Obstetrics & Gynecology 2005;106:138-143).
ACUPUNCTURE EFFECTIVE FOR DIALYSIS PRURITIS
In a Taiwanese study, 40 patients with refractory uraemic pruritus were randomised into two groups. In one group Quchi L.I.-11 was needled three times a week for one month (true acupuncture group), and in the second group a non-point (2cm lateral to Quchi L.I.-11) was needled with the same frequency (sham acupuncture group). Pruritis scores were recorded before and after treatment and at a 3-month follow-up. Pruritus scores were significantly lower after true acupuncture and at the 3 month follow-up compared to the sham acupuncture. (Nephrol. Dial. Transplant., Sep 2005; 20: 1912-1915).
ACUPRESSURE FOR DIALYSIS PATIENTS
A Taiwanese study set out to determine whether acupressure was effective in treating fatigue and depression in patients with end-stage renal disease (ESRD) receiving haemodialysis treatment. The study applied an experimental pre-test and post-test design. Sixty-two patients were randomly assigned to an acupressure group or a control group. Patients in the acupressure group received point massage for 12 minutes daily, three days a week, for four weeks. Patients in the control group received only routine unit care. The study found that fatigue and depression among patients in the acupressure group showed significantly greater improvement than in patients in the control group. (J Nurs Res. 2004 Mar;12(1):51-9). A previous Taiwanese study randomly assigned 98 end-stage renal disease patients with sleep disturbances into an acupressure group, a sham acupressure group and a control group. Acupressure and sham acupressure group patients received point or non point massage three times a week during haemodialysis treatment for a total of 4 weeks, whilst the control group received only routine care. The results indicated significant differences between the acupressure group and the control group in a whole range of sleep markers as well as significantly improved quality of life. (J Adv Nurs. 2003 Apr;42(2):134-42).
ACUPUNCTURE & URINARY TRACT INFECTIONS
Researchers from the University of Bergen in Norway have investigated the benefits of acupuncture in a group of 94 women, all of whom had experienced at least 3 urinary tract infections during the previous 12 months. Sixty-seven of the women received acupuncture 2 times per week for 4 weeks. 73% of the women who received acupuncture remained infection-free during the 6 months after treatment, relative to only 52% of those who did not receive acupuncture. They also measured the amount of residual urine left in bladders after urination, which is thought to be a risk factor in recurrent urinary problems, and found this was halved in those receiving acupuncture. (American Journal of Public Health 2002;92:1609-1611).
ACUPUNCTURE & ENURESIS
A small Japanese study has added to the research showing nocturnal enuresis can be effectively treated with acupuncture. 15 patients with nocturnal enuresis were treated by acupuncture using a disposable stainless steel needle (0.3 mm in diameter, 60 mm in length) inserted into bilateral Zhongliao BL-33 and rotated manually for 10 minutes. Bladder capacities and number of wet nights per week were compared before and after treatment. Treatment was deemed effective where wet nights decreased by 50% or more compared with the baseline. The researchers from Kyoto University of Medicine found that 6 out of the 15 (40%) improved immediately after treatment, and 7/15 (47%) 2 months after. In 6 patients where wet nights were cut in half, just after treatment the nocturnal bladder capacity (NBC) increased significantly, from 201 mL to 334 mL. No side-effects were recognised throughout the treatment period. (Int J Urol 2002 Dec;9(12):672-676).
ACUPUNCTURE & VULVAR VESTIBULITIS
Vulvar vestibulitis is a disease of unknown aetiology involving inflammation of the skin and the mucous secreting glands found in the skin of the vulvar vestibule. It can occur in women of all ages, whether sexually active or not, can persist for years, and gives rise to symptoms such as severe pain on pressure (for example cycling, exercise or tight fitting clothes), intercourse or insertion of tampons, burning, stinging and irritation, redness and the urge to urinate frequently or suddenly. Possible implicating factors include human papilloma virus, chronic yeast infections, chronic bacterial infections, chronic changes of the acid-base balance in the vagina and chronic use of chemicals or irritants such as detergents, soaps, spermicides or lubricants. Various conventional treatments are used including steroid ointments, interferon injections, and surgery or laser treatment with varying effectiveness and risks. In a new Swedish study, 14 young (aged 19-26) patients received acupuncture 10 times, once or twice a week. Points Guanyuan REN-4, Qihai REN-6, Yaoyangguan DU-3, Shangliao BL-31, Yinlingquan SP-9 and Ququan LIV-8 were needled each time, with further points Shimen REN-5, Zhongji REN-3, Zusanli ST-36, Zhongliao BL-33 and Taixi KID-3 used occasionally. After arrival of deqi, needles were left in situ for 30-45 minutes with occasional stimulation. The treatment was assessed by both positive and negative quality of life (QOL) assessments. Results showed that the patients tolerated the treatment well, and that acupuncture had a significant impact on the subjects’ quality of life for several months after being treated, with12 women having lower negative QOL scores than before receiving acupuncture, and nine having higher positive QOL scores. The benefit continued at least until 3 months after treatment. The authors conclude “that acupuncture may be added to our arsenal of treatment methods for vulvar vestibulitis.” (Acta Obstet Gynecol Scand 2001;80:437-41).
ACUPUNCTURE AND URINARY INCONTINENCE
A study carried out at the Department of Urology of Kyoto University, Japan, has demonestarted the effiacy of acupuncture in treating urinary incontinence in patients with spinal cord injuries. 13 patients suffering incontinence due to detrusor hyperreflexia were needled at Zhongliao BL-33. Urodynamic studies were performed before acupuncture, immediately after the first treatment and 1 week after the fourth treatment. In 6 patients, these urodynamic studies were performed again 1 month after the fourth acupuncture. No side effects were observed throughout the treatment period. Of the 13 patients, incontinence disappeared in 2 (15%) and decreased to 50% or less compared to baseline in a further 6 (46%). Maximum cystometric bladder capacity increased significantly one week after the fourth treatment. (Urol Int, 2000;65(4):190-5).
ACUPUNCTURE & CHILDHOOD ENURESIS
A study carried out in a Romanian hospital for severely handicapped children aged between 3 and 18 years showed significant benefit in treating nocturnal enuresis in 29% of patients. The most responsive group was the 10-14 year olds (50%). Children with the most severe mental retardation and those with daytime fecal and urinary incontinence responded least. Points selected were Guanyuan REN-4, Sanyinjiao SP-6, Zusanli ST-36, Shenshu BL-23, Pangguangshu BL-28 and Ciliao BL-32. Additional points were needled in difficult cases. Treatment was given 3 or 4 times a week for a total of approximately 20 treatments (Acupuncture in Medicine, December 1999, Vol 17 (2), 82-85).
ACUPUNCTURE & NEUROGENIC BLADDER
One group of patients with spinal cord injury (SCI) and neurogenic bladder received electro-acupuncture at points Zhongji REN-3, Guanyuan REN-4 and Ciliao BL-32 in addition to conventional intermittent catheterisation program (ICP). Compared to a control group who underwent conventional bladder training program with ICP only, the acupuncture patients achieved balanced bladder voiding in a significantly shorter time. It was also found that those who received acupuncture within 3 weeks after injury responded significantly better than those who received acupuncture 3 weeks after injury. The study also found that complete spinal cord injury, either with pronounced detrusor-sphincter dyssynergia in upper motor neuron lesion or with persistent areflexic bladder in lower motor neuron lesion, was not affected by acupuncture (Spinal Cord 1998 Jul;36(7):476-80).
URINARY INCONTINENCE AND ACUPUNCTURE
A study carried out at the Department of Physiology at Meiji University of Oriental Medicine in Japan has confirmed the value of acupuncture in treating urinary incontinence in patients with chronic spinal cord injuries. Eight male patients, four with cervical lesions and four with thoracic lesions, were treated with acupuncture at Zhongliao BL-33. Four once-weekly treatments were given with needles inserted into bilateral Zhongliao and manually rotated for ten minutes. Incontinence was controlled completely in three patients and partially in three more. (Nippon Hinyokika Gakkai Zasshi Jul;89(7):665-669).
ACUPUNCTURE AND URINARY TRACT INFECTIONS
A study carried out in Bergen, Norway has demonstrated the value of acupuncture in preventing urinary tract infections in women who are especially prone to repeated recurrences. 67 such women (3 or more attacks in the past 12 months) were randomly divided into an acupuncture group, a sham acupuncture group and a control (no treatment). Acupuncture was given twice a week for 4 weeks mainly at Zhongji REN-3, Shenshu BL-23, Pangguangshu BL-28, Taixi KID-3, Sanyinjiao SP-6, Yinlingquan SP-9 and Xingjian LIV-2 or Taichong LIV-3 according to differentiation. Sham acupuncture was given superficially in the thighs, calves or abdomen outside known points or channels and the needles were not manipulated. Over a 6-month observation period, 86% of the acupuncture group were free of lower urinary tract infections, compared to 58% in the sham group and 36% in the control. (Acupuncture in the prophylaxis of recurrent lower urinary tract infection in adult women, Audun Aune, Terje Alraek, Huo LiHua and Anders Baerheim, Scand J Prim Health Care 1998; 16).
CHINESE MEDICINE REDUCES DIALYSIS FREQUENCY
A Chinese study has demonstrated that when Chinese medicine is combined with peritoneal dialysis, it is possible to reduce the frequency of the dialysis whilst maintaining renal function (Chung-Kuo Chung Hsi i Chieh Ho Tsa Chih. 1996 ;16(2):67-9).
ACUPUNCTURE AND THE OVERACTIVE BLADDER
Eleven patients (9 males and 2 females) with overactive bladders were treated by acupuncture. The age range was from 51 to 82 years (mean 71 years). Nine patients complained of urge incontinence and 2 patients of urgency. Uninhibited contraction was observed in all patients before the acupuncture. Acupuncture was given at bilateral Zhongliao BL-33 and the needles rotated for 10 minutes manually. After an average of 7 treatments, urge incontinence was controlled completely in 5 and partially in 2 of the 9 patients. In 2 patients who complained of urgency, complete response was obtained after the treatment. Uninhibited contraction disappeared in 6 patients after the treatment. Acupuncture also significantly induced an increase of maximum bladder capacity and bladder compliance. (Japanese Journal of Urology. 1995; 86(10):1514-9).
CHINESE HERBS AND STEROID-DEPENDENT NEPHROTIC SYNDROME
37 children with steroid-dependent nephrotic syndrome (SDNS) were treated with Chai-Ling-Tang (Sairei-to). After treatment, relapse was markedly improved, time for negative conversion of proteinuria shortened, prednisone dosage significantly reduced, and side effects eased. It is considered that Chai-Ling-Tang may be a useful substitute for patients with SDNS who fail to respond to or manifest severe toxic effect from cytotoxic agents. (Am J Chin Med 1995;23(3-4):255-60).
