Transcript Acup has a calming effect and improves well

Acupuncture and the Oncology
Patient
XXX Meeting
Date
03/10/2015
Nicola Kiely, Physiotherapist, Bon Secours Hospital.
Western Acupuncture similar to Chinese acup
to a casual observer.
Needles are inserted into the body incl hands
and feet, agitated by hand and sometimes
electrical impulses, taken out after a period
of time somewhere bt 5 and 30 mins
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However considerable differences…
WA..medical dx made , needles influence
physiology of the body a/c to scientific view and
acup seen as conventional Rx along with drugs or
surgery.
Traditional Acup makes dx in terms of a disturbance
to the bodys ‘balance’ which needs to be corrected
with needles.
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Acup. in the West
• 1970s Felix Mann
• ‘Meridians don’t exist, points don’t exist’
• Gate control theory of (Melzack and
Wall 1965)
• Discovery of Endorphins (Hughes et al
1975)
• Studies show Acup released the
endorphins (Han &Terenius 1982)
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5 mechanisms to understand WA
• Local Effects..stim sensory nerve fibres
in skin and muscle
• CGRP
• Local bl vessels to dilate..local bl flow
increases
• Superficial and deep tissue healing
• Acup promotes local healing
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Segmental Analgesia
• Action potentials travel up nerve to part
segment in spinal cord
• Depress activity of dorsal horn reducing
response to pain
• e.g. pain in the knee joint reduced by
needling muscles around the knee as nerves
from the knee joint enter same segment as
nerves from the muscles around it.
• Acup red. pain in the segment where the
needles are inserted
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Extrasegmental analgesia
• Action potentials then travel on from the
dorsal horn to the brainstem
• Descending nerve pathways..
..neurotransmitters suppress pain
• Extrasegmental as not restricted to a
single segment
• Acup reduces pain throughout the
body
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Central Regulatory effects
• After reaching the mid-brain , the action
potentials go onto influence other
structures..cerebral cortex, hypothalmus and
limbic system
• Calming effects and improves well –being
• Autonomic nervous system and various
female hormones such as those that control
the menstrual cycle
• Acup has a calming effect and improves
well-being
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Myofascial trigger points
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Small ‘knots’ of tight muscle fibres
Tender
Taut bands
Mvt of muscle restricted by pain
Acup inactivates myofascial trigger
points
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Patient Group
Mainly Females
Wide variety of vasomotor
symptoms
Mainly Hot Flushes, Night
Sweats,Fatigue,Pain,CIPN.
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Some studies
Frisk 2008…RCT..45 pts with
flushes due to
Tamoxifen..Electroacup vs
Hormone Replacement…freq of
Hot flushes reduced by 50%
Lee 2009..Cochrane
Review..Post-op nausea and
vomiting..Acup using PC6..PC6
stim prevents PONV
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Acup and Gabapentin
Electro-acup greatest reduction in
hot flushes at end of Rx and 4
months off Rx
Gabapentin similar reduction while
on Rx but not off
EA had less side effects to
Gabapentin
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Some points for Hot Flushes
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LI4
TE5
LR3
SP6
ASAD points Sternum
To note.. no needling to the affected
side..risk of lymphoedema avoided
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Hot Flash Composite Score
• Frequency x Severity
• Severity measured mild, moderate,
severe, very severe..score 1,2,3,4.
• E.g 13 hot flushes in a day x 3
(severe)=39
• Measure before and after rxs at 1/12, 4,
8, 12.
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Acup. Service in the Bons
• Immediate access via GP or Consultant
• Referral letter necessary detailing pt hx and stage
of disease etc..written conset from pt
• Cost same as physio cost
• Treatments weekly for 6 weeks
• Minimal ache felt from needles
• Big plus is it is non pharmacological intervention!
• Time+ with pt promotes physical and emotional
well being
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• Thank you for your attention.
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