The following is an inquiry into the phenomenon of “Spirit” and its relation to the practice of locating an acupuncture point. In this context of Traditional Chinese Medicine, which finds its roots in Taoist tradition, the aspect of Spirit shen is understood as being inextricably inter-related, inter-dependent and inter-connected with the Body and Mind aspects of this triune. Eight practitioners agreed to participate in a taped interview describing the experience of locating an acupoint. Although each practitioner described an experience which was unique, four threads emerged which are similar: (1) the practitioner focuses a body mediated awareness inward; (2) this awareness is then extended to the patient; (3) then there is the experience of movement toward the point both with intention and a palpating finger; and (4) when the point has been located there is a pause, followed by the sensation of arrival of the patient’s qi at the acupoint.

Thesis (M.CM)--Hong Kong Baptist University, 2006. / Dissertation submitted to the School of Chinese Medicine. Includes bibliographical references (leaves 20-23).

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Department of Public Health Sciences. Title from pdf file main screen (viewed on April 28, 2010). Includes bibliographical references.

This thesis examines the effectiveness of acupuncture therapy in the treatment of psychological and somatic distress in the context of medically unexplained symptoms (MUS). Also, it explores the role of psychological attachment and experiential avoidance in an effort to explain potential mechanisms of acupuncture’s effect. Existing literature demonstrates some level of effectiveness of acupuncture therapy for the treatment of depression, anxiety and somatic symptoms. However, a lack of experimental rigor in methodology means that existing results cannot be shown to be superior to a placebo and thus current treatment protocols for patients with MUS do not include a recommendation of acupuncture therapy. MUS are defined as any set of symptoms that cannot be explained by organic disease, these clusters of symptoms are theorised to be of psychological aetiology. Sufferers of MUS find themselves stuck in a perpetual loop of secondary care referrals with little or no treatment options being made available. Whilst there is some evidence that talking therapies, such as cognitive behavioural therapy, are effective, their availability, efficacy and stigma mean they are often not desired by patients who suffer with MUS. Previous research has shown that insecure attachment predicts higher instances of, psychological and somatic distress, as well as MUS. Previous work undertaken by the author of this thesis also suggests that there may be a moderating effect of attachment in acupuncture therapy outcomes. In order to investigate acupuncture’s efficacy a double-blind randomised control trial was undertaken; 63 participants were randomised to receive either five treatments of genuine acupuncture or a non-penetrating sham form of acupuncture using the Park sham acupuncture device. A rigorous procedure ensured participant and practitioner blinding to group allocation. Primary measures of psychological (GHQ) and somatic (BSI) distress were taken at pre, post and follow-up time points (8 weeks). Secondary measures included general attachment (RQ), experiential avoidance (MEAQ) and client attachment to therapist (CATS). Results showed a significant effect of acupuncture over placebo in the reduction of both psychological (GHQ) and somatic distress (BSI). This therapeutic effect was maintained at 8-week follow-up. Further results showed moderation effects of secure attachment on somatic symptoms in the treatment group but not placebo group. Experiential avoidance also moderated somatic symptom outcomes in the treatment but not placebo group. A subsequent study utilising a quasi-experimental multi-centre methodology, which used identical measures to the previous experiment, revealed the same significant reduction of both psychological and somatic distress. This study consisted of 184 participants across five clinics, each participant receiving five sessions of acupuncture. Similar results were observed regarding moderation effects of secure attachment on treatment outcomes of somatic symptoms. Results also showed differences in moderation effects between participant with a MUS diagnosis vs. those without. Findings of both studies suggest acupuncture is an effective treatment for psychological and somatic distress, as well as MUS. The differences in attachment moderation effects between treatment and placebo may indicate acupuncture’s ability to elicit endogenous opioid release in the brain. However, further neurological studies are required to confirm this hypothesis.

A xerostomia é um efeito adverso comum e frequentemente irreversível decorrente da radioterapia de neoplasias malignas da região de cabeça e pescoço, afetando, sobremaneira, a qualidade de vida dos pacientes. Diferentes métodos para solucionar tal problema são propostos, de resultados, todavia questionáveis. Este estudo avaliou a eficácia clínica da acupuntura como método de tratamento preventivo e curativo de tais condições. Os pacientes foram distribuídos, aleatoriamente, em três grupos: grupo preventivo, constituído de 12 indivíduos, sem queixa de secura bucal, tratados com 12 a 16 sessões de acupuntura, antes e durante a radioterapia; grupo curativo, constituído de 12 indivíduos, diagnosticados, clinicamente, com xerostomia severa, tratados com 12 aplicações de acupuntura após concluído o tratamento oncológico, e grupo controle, formado pelos mesmos indivíduos do grupo curativo no momento da primeira consulta, precedente à terapêutica com acupuntura. O tratamento foi conduzido de acordo com os princípios da medicina tradicional chinesa e medicina ocidental ortodoxa, realizado de forma padronizada para todos os pacientes, duas vezes por semana, por um período de 20 minutos cada sessão. A avaliação da eficácia terapêutica fundamentou-se na mensuração da xerostomia, conduzida sob duas formas: objetiva, através da sialometria, com o registro quantitativo dos índices de fluxo salivar em repouso e estimulado (IFSR e IFSE), e subjetiva, por intermédio dos questionários Xerostomia Inventory (XI) modificado, Escala Visual Analógica (EVA) e Treatment Emergent Symptom Scale (TESS), mensurando o grau de severidade dos sintomas. Os resultados obtidos no grupo preventivo foram estatisticamente significativos quanto as avaliações objetivas e subjetivas, evidenciados por índices de fluxo salivar mais elevados tanto para o IFSR (P<0.001) como para o IFSE (P<0.001) e pela menor intensidade dos sintomas (P<0.001), quando comparadas ao controle. Para o grupo curativo, resultados também significativos foram constatados em ambas as avaliações, demonstrados pelo aumento dos IFSR (P<0.05) e IFSE (P<0.05) e redução da sintomatologia (P<0.05), comparados aos valores iniciais. Constatamos também que houve efeito de grupo e os pacientes que se beneficiaram do método preventivo, obtiveram médias estatisticamente mais significativas (P<0.001), para ambas as respostas clínicas, objetivas e subjetivas. É lícito concluir que a acupuntura mostrou-se um importante método de tratamento de xerostomia decorrente da radioterapia, visto ter alcançado uma confiabilidade significativa de eficácia, que nos faz indicá-la e sugerir a disponibilização do método preventivo nos centros de tratamento. / Xerostomia is a common and usually irreversible radiotherapy side effect in patients with head and neck cancer, affecting the patients’ quality of life. Many attempts have been suggested to manage this condition nevertheless of questionable results. This study evaluated the acupuncture treatment efficacy as a preventive and curative method for radiation-induced xerostomia. The patients were randomly assigned in three groups: preventive, composed of 12 individuals, without complaints of dry mouth, treated with 12-16 acupuncture sessions, before and concomitant radiotherapy; curative, composed by 12 individuals, diagnosed with severe xerostomia, treated with 12 acupuncture sessions after radiation therapy, and control, comprised of the curative’s group patients at the moment of the first visit, preceding this therapy. Acupuncture treatment, according to traditional Chinese medicine and occidental orthodox medicine concepts was performed twice a week, lasting 20 minutes each session, following standardize techniques for all patients. Acupuncture efficacy was evaluated, based upon objective and subjective methods of xerostomia measurements, performed by sialometry, measuring the resting and stimulated salivary flow rates (RSFR and SSFR), and by means of questionnaires such as Xerostomia Inventory (XI) modified, Visual Analog Scale (VAS) and Treatment Emergent Symptom Scale (TESS), which evaluated referred symptoms. Results obtained in preventive group, evidenced RSFR (P<0.001) and SSFR (P<0.001) significantly increased, and improvement of symptoms (P<0.001), compared with control. Within curative group, after acupuncture treatment, the results showed statistically significant improved for both resting and stimulated salivary flow rates (P<0.05) and reduces of referred symptoms (P<0.05). There were statistically differences between groups, being the patients in preventive group those who evidenced the most significant improved of values (P<0.001) for objective and subjective evaluations. We concluded that acupuncture plays an important role in xerostomia’s treatment, as shown by the results, reaching a significant confiability of efficacy, indicating and suggesting the preventive method at oncology centers.

No description available.

No description available.

L’objectif de cette thèse est d’appréhender la complexité des mécanismes biologiques de l’acupuncture afin de construire un modèle mathématique multi-échelle. Ce modèle est étudié théoriquement et numériquement. L’acupuncture est une des plus vielles pratiques de l’histoire de la médecine et une partie intégrante de la médecine traditionnelle chinoise. Dans sa pratique la plus classique, une ou plusieurs aiguilles sont placées à des endroits spécifiques, nommés points d’acupuncture. L’aiguille est ensuite manipulée en utilisant des mouvements de rotation et de translation de façon à stimuler le point d’acupuncture. Les effets cliniques de l’acupuncture pourraient être le résultat d’effet de cascades de réactions produites par les interactions entre l’hypoderme et les systèmes nerveux, endocrinien et immunitaire. Le travail présenté s’articule sur la modélisation de l’insertion d’une aiguille dans le tissu conjonctif de l’hypoderme. Un modèle d’écoulement en milieu poreux du liquide interstitiel de l’hypoderme a permis d’étudier numériquement les composantes de contrainte qui agissent sur les récepteurs à la surface des cellules du tissu et notamment des mastocytes.Un modèle mathématique de la réponse chimiotactique des mastocytes à une contrainte physique créée par le traitement d’acupuncture est développé. Ce modèle prend en compte les mécanismes de signalisation cellulaire. La contrainte physique induit la libération rapide et continue, grâce au recrutement chimotactique de mastocytes, d’attractants et de médiateurs chimiques. Le modèle est basé sur le modèle de chimiotaxie de type Keller-Segel. / The objective of this thesis is to comprehend the complexity of the underlying basis of acupuncture. Acupuncture needling is investigated in order to establish a multiscale model that takes into account the complexity of biology but is mathematically simple enough to run simulations.Acupuncture is one of the oldest practices in the history of medicine and is the core of Traditional Chinese Medicine. Once needles are inserted in the right locations, called acupoints, they are manipulated via manual needling to stimulate the acupoint. The physiological reactions of acupuncture needling lead to therapeutic effects which can be explained by a series of interactions between the skin and the nervous, the endocrine, and the immune systems.In the present work, the thrusting and lifting of an acupuncture needle inserted in subcutaneous connective tissue is modeled. A porous media model is used to run simulations and compute the pressure and shear stress affecting the organization of fibers and of isolated cells in their matrix. A mathematical model was conceived to take into account cell signaling. There is ample evidence that needle manipulation in acupuncture can cause degranulation of mastocytes directly through a physical stress to occur. Activated mastocytes rapidly release granules containing chemical mediators. These chemical mediators play a key role recruiting mastocytes in their environment and are known to affect the excitability of nerve endings as well as local microcirculation permeability and size for the appropriate transfer of long-term acting endocrine signals. The process is sustained by the recruitment of mastocytes through chemotaxis.

Introduction: Acupuncture is an ancient Chinese treatment. It is difficult to know what role the nurse performs during acupuncture in Sweden since no guidelines exist. Indications that patients appreciate receiving acupuncture justifies investigating nurses’ work in China. Good practice may be uncovered that could provide the basis for understanding, defining and promoting the nurses’ role in acupuncture in other countries. Aim: The aim of this study was to describe the nurses’ conception of their role in acupuncture therapy in an acupuncture clinic in Chengdu, China. Method: A descriptive qualitative study. Data collection by methodological triangulation from observations and interviews. Result: Results show that the role of the nurse is to perform practical procedures, support patients and have responsibility for hygiene. Conclusion: Nurses have an important role in acupuncture therapy to carry out treatment as well as caring for the patients and treating them as individuals.

published_or_final_version / Chinese Medicine / Master / Master of Philosophy