A Acupuntura é um dos procedimentos na Medicina Tradicional Chinesa, cujos registros indicam seu surgimento há cerca de 4.500 anos. Esta técnica, mediante finas agulhas metálicas, inseridas em pontos específicos do corpo, pode compartilhar na recuperação da homeostasia. A teletermografia neste trabalho foi a técnica escolhida para demonstrar os eventuais efeitos térmicos da aplicação da acupuntura no ponto Taixi (R3), situado entre maléolo medial e o tendão do calcâneo, porque é uma técnica de alta sensibilidade que demonstra as alterações na circulação periférica da perna. Nove indivíduos saudáveis de ambos os sexos, escolhidos aleatoriamente, participaram deste estudo. A temperatura da sala onde o experimento foi conduzido não ultrapassou 21ºC. Inicialmente, estes indivíduos permaneceram por 10 minutos na sala para climatização quando foram captadas as primeiras imagens termográficas para padronização. Em seguida, foi introduzida uma agulha de acupuntura no ponto Taixi (R3) da perna direita até a obtenção do De Qi, com estimulação manual, a qual ali permaneceu por 15 minutos. Em seguida, foram captadas novas imagens teletermográficas. Foi observada redução significativa na temperatura da perna direita, em torno de 1,1ºC nos voluntários que receberam agulha de acupuntura no ponto Taixi (R3), com coeficiente de variação de p<0,0001, enquanto que na outra perna não estimulada a variação ocorreu em torno de 0,7ºC, com um coeficiente de variação não significativo de p>0,05. Este trabalho demonstrou que a acupuntura no ponto R3 promoveu alteração significativa na circulação periférica da perna, caracterizada por vasoconstrição, conseqüente do aumento do tônus simpático, demonstrada pela diminuição da temperatura em torno de 1,1ºC da área correspondente ao ponto estimulado. A teletermografia mostrou ser um método eficaz para avaliar os efeitos da acupuntura sobre a circulação periférica, confirmando resultados de estudos anteriores, embora em outras regiões do corpo do que aquela escolhida para este experimento. / Acupuncture is a procedure in Traditional Chinese Medicine, with registers that indicate it\'s appearance around 4.500 years ago. This technique, by means of fine metallic needles, inserted into specific points of the body, can help in the recuperation of homeostasis. The telethermography was chosen for this study as the means to demonstrate the eventual thermic effects of stimulating the acupuncture point Tai Xi (Kl 3) situated near to the medial malleolus on the posterior border of the tibia, because it is a highly sensitive technique that shows alterations in the peripheral circulation of the leg. Nine individuals of both sexes, chosen randomly, participated in this study. The temperature of the room where the experiment was carried out did not rise above 21ºC. At the start of the experiment the volunteer stayed exactly ten minutes in the room for acclimatization, then the first thermographic image was recorded for standardization purposes. Following this, an acupuncture needle was inserted into Tai Xi (KI 3) point only in the right leg, whose depth was limited to obtaining De Qi, only manual stimulation with fifteen minutes permanence in the site. After this period, new images were recorded. Significant reduction of all the right leg temperatures, by about 1.1ºC in all the volunteers that received the acupuncture needles in the Tai Xi (Kl 3) was noted, with a coefficient variation of p< 0.0001 that was statistically highly significant, while on the other non stimulated leg the variation that occurred was around 0.7ºC, with a non significant coefficient variation of p>0.05. The results of this study demonstrate that manual stimulation of the Tai Xi (Kl 3) acupuncture point, influences significantly peripheral vascular circulation, by means of sympathetic stimulation causing vasoconstriction. These results were visualized through telethermography and the thermic differences calculated were statistically significant characterized by vasoconstriction, as shown by the lowering of the temperature by 1.1ºC around the area correspondent to the stimulated point. The telethermography showed itself to be an efficient method for evaluation of the effects of acupuncture, confirming results of previous studies carried out with the same technology, albeit in other regions of the body than those chosen for this experiment.

Thesis (M.Ph.)--Chinese University of Hongkong. / Bibliography: leaves 53-58.

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A Acupuntura é um dos procedimentos na Medicina Tradicional Chinesa, cujos registros indicam seu surgimento há cerca de 4.500 anos. Esta técnica, mediante finas agulhas metálicas, inseridas em pontos específicos do corpo, pode compartilhar na recuperação da homeostasia. A teletermografia neste trabalho foi a técnica escolhida para demonstrar os eventuais efeitos térmicos da aplicação da acupuntura no ponto Taixi (R3), situado entre maléolo medial e o tendão do calcâneo, porque é uma técnica de alta sensibilidade que demonstra as alterações na circulação periférica da perna. Nove indivíduos saudáveis de ambos os sexos, escolhidos aleatoriamente, participaram deste estudo. A temperatura da sala onde o experimento foi conduzido não ultrapassou 21ºC. Inicialmente, estes indivíduos permaneceram por 10 minutos na sala para climatização quando foram captadas as primeiras imagens termográficas para padronização. Em seguida, foi introduzida uma agulha de acupuntura no ponto Taixi (R3) da perna direita até a obtenção do De Qi, com estimulação manual, a qual ali permaneceu por 15 minutos. Em seguida, foram captadas novas imagens teletermográficas. Foi observada redução significativa na temperatura da perna direita, em torno de 1,1ºC nos voluntários que receberam agulha de acupuntura no ponto Taixi (R3), com coeficiente de variação de p<0,0001, enquanto que na outra perna não estimulada a variação ocorreu em torno de 0,7ºC, com um coeficiente de variação não significativo de p>0,05. Este trabalho demonstrou que a acupuntura no ponto R3 promoveu alteração significativa na circulação periférica da perna, caracterizada por vasoconstrição, conseqüente do aumento do tônus simpático, demonstrada pela diminuição da temperatura em torno de 1,1ºC da área correspondente ao ponto estimulado. A teletermografia mostrou ser um método eficaz para avaliar os efeitos da acupuntura sobre a circulação periférica, confirmando resultados de estudos anteriores, embora em outras regiões do corpo do que aquela escolhida para este experimento. / Acupuncture is a procedure in Traditional Chinese Medicine, with registers that indicate it\'s appearance around 4.500 years ago. This technique, by means of fine metallic needles, inserted into specific points of the body, can help in the recuperation of homeostasis. The telethermography was chosen for this study as the means to demonstrate the eventual thermic effects of stimulating the acupuncture point Tai Xi (Kl 3) situated near to the medial malleolus on the posterior border of the tibia, because it is a highly sensitive technique that shows alterations in the peripheral circulation of the leg. Nine individuals of both sexes, chosen randomly, participated in this study. The temperature of the room where the experiment was carried out did not rise above 21ºC. At the start of the experiment the volunteer stayed exactly ten minutes in the room for acclimatization, then the first thermographic image was recorded for standardization purposes. Following this, an acupuncture needle was inserted into Tai Xi (KI 3) point only in the right leg, whose depth was limited to obtaining De Qi, only manual stimulation with fifteen minutes permanence in the site. After this period, new images were recorded. Significant reduction of all the right leg temperatures, by about 1.1ºC in all the volunteers that received the acupuncture needles in the Tai Xi (Kl 3) was noted, with a coefficient variation of p< 0.0001 that was statistically highly significant, while on the other non stimulated leg the variation that occurred was around 0.7ºC, with a non significant coefficient variation of p>0.05. The results of this study demonstrate that manual stimulation of the Tai Xi (Kl 3) acupuncture point, influences significantly peripheral vascular circulation, by means of sympathetic stimulation causing vasoconstriction. These results were visualized through telethermography and the thermic differences calculated were statistically significant characterized by vasoconstriction, as shown by the lowering of the temperature by 1.1ºC around the area correspondent to the stimulated point. The telethermography showed itself to be an efficient method for evaluation of the effects of acupuncture, confirming results of previous studies carried out with the same technology, albeit in other regions of the body than those chosen for this experiment.

Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Charles University, Czech Republic Student: Zuzana Maršálková Tutor: PharmDr. Jitka Pokladníková, Ph.D. Title of Diploma Thesis: PATIENTS' EXPERIENCES WITH ACUPUNCTURE TREATMENT III Background: Acupuncture becomes more popular in Czech Republic where study concerning patients' experiences and opinions with this treating method hasn't been carried out yet. Aim: To assess patients' experiences with acupuncture focusing on the patients' expected effect before, during and after treatment, on the potential change in expectations during treatment and on its potential effect on treatment outcomes, and on the evaluation of the truly perceived therapeutic effect. Methods: Using semistructured questionnaires, we led interviews with selected patients in the period from 19. 9. 2015 to 18. 5. 2016. Rewritten dialogues were afterwards coded in MAXQDA 12 and evaluated using the content analysis method. Results: Content analysis identified topics related to the expected and actual effect of acupuncture. It involved symptoms of migraine before and after treatment, treatment beliefs and expectations before, after and during treatment, recognition of therapeutic effect, adverse effects and benefit in patients' life. Patients had...

Physiotherapists in New Zealand are increasingly learning and practicing Western acupuncture. Western acupuncture as a new and different tool is enhancing and yet challenging physiotherapists practice. This study explores the meaning behind Western acupuncture practice to further understand the implications of its development and possible future direction.Hermeneutic methodology was used because it facilitates the exploration between that which is familiar and that which is unfamiliar. Seven New Zealand physiotherapists qualified to practise Western acupuncture were interviewed about their practice experiences. The data in relation to the phenomenon of inquiry was analysed thematically.The findings revealed a complex array of tensions within physiotherapy because of the differences Western acupuncture brings to physiotherapists' practice. Western acupuncture is a new and useful tool in the physiotherapists 'toolbox'. It is congruent with other physiotherapy practices in that it shares the same scientific neurophysiological foundation. However, the association of Western acupuncture with traditional Chinese acupuncture causes it to be viewed as a complementary medical practice and thus, not completely legitimate as a part of physiotherapy. These tensions are further confounded because the technical rationalist paradigm, upon which physiotherapy is based, values evidence-based practices. The best evidence is perceived to be that gained from the randomised controlled trial. I argue that the randomised controlled trial is poorly suited to the evaluation of complex practices such as Western acupuncture. Such insights also challenge physiotherapy, as a whole, because the available 'evidence' does not acknowledge the complexities of practice involving individual practitioners, their colleagues, the profession, other healthcare professions, patients and the public.The tensions encountered in physiotherapy and Western acupuncture practice have led to a number of recommendations in education, practice, research and legislation. Overall, they suggest a need to develop a more inclusive model of practice development. Western acupuncture is a potentially valuable tool. In order to maximise use of this tool physiotherapy practice understandings need to be extended. This in turn, will assist development of the profession as a whole.

The process of pulse diagnosis was examined in a sample of 100 patients randomly selected from the author's acupuncture clinic. Patient symptoms, pulses (as utilised in traditional Chinese medicine), diagnostic criteria (as described in traditional Chinese medicine), acupuncture points selected and patient comments after each treatment were coded into a numerical format suitable for stepwise multiple regression and crosstabulation analysis. The analysis indicated that the interpretation of pulse qualities predicted the diagnostic criteria when used in accordance with the theories of acupuncture. The selection of acupuncture points could not be predicted from the diagnostic criteria when using pulse diagnosis. Additionally the analysis indicated that the patient comments after acupuncture were independent of the initial patient symptoms. More research is needed to more fully understand the process of pulse diagnosis. However the analysis does suggest that pulse diagnosis should be incorporated into acupuncture curricula in both traditional acupuncture courses and medical acupuncture courses.

Objectives: Electro-acupuncture (EA) has been demonstrated to be effective in reducing post-operative acute consumption of opioid-like medications (OLM) by previous studies. This effect has not been examined in patients with chronic pain. In this thesis, a randomised, double-blind, sham acupuncture-controlled study was reported. The trial aimed to evaluate the effect of EA in reducing OLM consumption in patients with chronic non-malignant pain. Methods: Thirty-five patients were recruited from a multidisciplinary pain management clinic in Melbourne. After a two-week baseline assessment, participants were randomly assigned to one of the two groups by a computer generated randomisation sequence: real EA (REA, n = 17) or sham EA (SEA, n = 18). The REA group received 2/100 Hz EA stimulation on two pairs of acupoints (Zusanli ST36 and Fenglong ST40 on one leg and Hegu LI4 and Quchi LI11 on one arm) and manual acupuncture on an additional five chosen acupoints for 30 minutes. The SEA group received superficial needling on non-acupoints without Deqi sensation or electrical stimulation. Both groups received treatment twice a week for six weeks. Participants were followed up for 12 weeks at intervals of four weeks. During the trial, participants were given clear instructions on how to reduce their OLM usage. A researcher telephoned the participants three times during the trial to encourage them to reduce OLM intake. The assessor, researcher and participants were blinded to treatment allocation. Outcome measures: The primary outcome measures included OLM consumption, related side effects, dosage of non-opioid analgesics and the intensity and unpleasantness of pain. These measures were recorded daily for two weeks before the intervention, six weeks during the treatment period and three times during the follow up period. Secondary outcome measures were depression and quality of life as assessed by the Beck Depression Inventory-II (BDI-II) and the Medical Outcome Study 36-Item Short Form (SF-36), respectively. Data were analysed with independent t-tests or analysis of variance (ANOVA) where appropriate and per protocol analysis was employed. Results: Nine participants withdrew from the study. At baseline, the two groups were comparable on all demographic characteristics and major outcome variables except for the average intensity of pain. During the treatment period, the reduction of OLM consumption was more rapid in the REA group (64%) than in the SEA (46%) (ANOVA, p less than 0.05). The effect was maintained for four weeks in the REA group. There were no differences in the improvement of all other measures between the two groups. The incidence of EA-related adverse events (AEs) per treatment was 21% and 10% in the REA and SEA groups, respectively. All AEs were minor. Over 90% of the participants were satisfied with the treatments given and would recommend EA to others. The blinding was successful. Conclusions: EA could be an effective and safe treatment for reducing OLM consumption for patients with chronic pain, and may be used as an adjunct therapy in chronic pain management. Further studies with larger sample sizes are warranted.

There was few human study evaluated the analgesic effect of acupuncture on central nervous system (CNS). The electrical temporal summation (TS) pain model has been validated and provides the opportunity to study the central inhibition effect of acupuncture in healthy humans. The present study aimed to: 1. systematically review available randomised, controlled trials (RCTs) of acupuncture on experimentally induced pain in healthy humans; 2. conduct a RCT to assess the effect of manual acupuncture (MA) and electro-acupuncture (EA) on TS of pain and the spatial (i.e. the local and remote sites to acupuncture stimulation) and the temporal (i.e. immediately after and 24-hours after the intervention) characteristics of this effect. The systematic review was carried out in accordance with the requirements of a Cochrane Systematic Review. The methodological quality and credibility of the acupuncture intervention of the included RCTs were assessed. The Review Management software (RevMan version 4.2, The Cochrane Library) was used for data extraction and data analysis. 605 papers were identified from four databases (Pubmed, Cochrane Library, CINAHL and EMBASE). Only nine papers met the inclusion criteria. The methodological quality and credibility of the acupuncture invention were satisfactory. The pain models and interventions applied varied substantially from study to study. Consequently, meta-analyses were not conducted. Comparing acupuncture with non-invasive control, significant acupuncture analgesia was reported. These studies also demonstrated that invasive controls produced analgesia. For the RCT of acupuncture on TS, 27 healthy volunteers were recruited and randomly assigned to either EA, MA or sham-acupuncture (SA) group, with nine volunteers in each group. To test pain thresholds, transcutaneous electrical stimulation was delivered to two sites on the anterior aspects of both legs and one site on the dorsum of the non-dominant forearm. Pain thresholds to single electrical stimulation (SPT) and to TS stimulation (TST) were assessed before, 30-minutes after and 24-hours after the intervention. Acupuncture was given to Zusanli (ST36) and Fenglong (ST 40) on the dominant leg. The level of anxiety was assessed before and after acupuncture with Spielberg State and Anxiety Inventory. The three groups were comparable at baseline. The level of anxiety did not change significantly after acupuncture. EA significantly increased SPT and TST on the treatment leg 24-hour after the treatment when compared with SA (p less than 0.05), but did not increase those measured on the non-treatment leg or the forearm. The fact that such an effect increased within 24 hours after acupuncture might indicate the potential role of neurohumoral mechanisms in acupuncture analgesia. The analgesia effect of EA on TS tended to be localised at the needling site. This observation is different from the understanding of the wide-spread effect of acupuncture. The discrepancy could be due to the small sample size of the current study. In conclusion, this is the first study that demonstrates EA elicits a strong inhibition on the CNS in health humans. Such a central effect lasts more than 24 hours, and limits to the site where acupuncture is applied. These findings need to be confirmed in other TS models.