Vasco Senna-Fernandes

Tension neck syndrome treated by acupuncture combined with physiotherapy: A comparative clinical trial (pilot study)

OBJECTIVE To evaluate the effect of acupuncture combined with physiotherapy in comparison with acupuncture and physiotherapy performed alone in different parameters; pain intensity, muscle tension, functional disability and muscle strength in the treatment of tension neck syndrome (TNS). DESIGN A prospective, comparative clinical trial. SETTING Acupuncture and Rehabilitation Department. BACKGROUND TNS can occur in computer users. Acupuncture has been one alternative treatment in physiotherapeutic rehabilitation of musculoskeletal disorders. SUBJECTS Forty-six patients with TNS. INTERVENTIONS Patients were allocated into three groups: Group-1 received physiotherapy (therapeutic exercises) combined with acupuncture; Group-2, acupuncture alone, and Group-3, physiotherapy alone; over a period of 10 weeks, with one or two sessions weekly. OUTCOME ASSESSMENT All patients had completed the protocols and were assessed using a visual analogue scale for pain intensity (VASpain) and muscle tension (VASmt), the Neck Disability Index: Brazilian Portuguese version for functional disability, and the cranio-cervical Flexion Test for isometric neck muscle strength (INMS); in the periods before treatment (baseline), after 10 weeks of treatment, and after 6 months of follow-up. RESULTS All groups showed significant improvement (p < 0.001) in these parameters after 10 weeks of treatment and after 6 months of follow-up. Group-1 was superior to Group-3 in pain and functional disability improvements (p<0.05); and Group-1 was superior to both Group-2 (p < 0.01) and Group-3 (p < 0.05) in INMS. After 6 months of follow-up, the improvements of all groups were maintained (p < 0.05). CONCLUSION The data suggested that acupuncture effect may facilitate and/or enhance physiotherapy performance in musculoskeletal rehabilitation for tension neck syndrome.

Acupuncture at "Zusanli" (St.36) and "Sanyinjiao" (SP.6) Points on the Gastrointestinal Tract: A Study of the Bioavailability of (99m)Tc-Sodium Pertechnetate in Rats.

The objective of this study is to investigate the differences of acupuncture effect between the Zusanli (St.36) and Sanyinjiao (SP.6) points on the gastrointestinal-tract (GIT) segment performed by the bioavailability of 99mTc-sodium-pertechnetate (Na99mTcO4) in rats. Male Wistar rats (n = 21) were allocated into three groups of seven each. Group 1 was treated by acupuncture bilaterally at St.36; Group 2 at SP.6; and Group 3 was untreated (control). After 10 min of needle insertion in anesthetized rats, 0.3 mL of Na99mTcO4 (7.4 MBq) was injected via ocular-plexus. After 20 min, the exitus of animals was induced by cervical-dislocation and GIT organs isolated. However, immediately before the exitus procedure, blood was collected by cardiac-puncture for blood radio-labeling (BRL). The radioactivity uptake of the blood constituents was calculated together with the GIT organs by a well gamma counter. The percentage of injected dose per gram of tissue (%ID/g) of Na99mTcO4 was calculated for each GIT organs, while BRL was calculated in %ID. According to the one-way ANOVA, the stomach, jejunum, ileum from the treated groups (Group 1 and Group 2) had significant differences compared to the controls (Group 3). However, between the treated groups (Group 1 and Group 2), there were significant differences (P < .05) in the stomach, jejunum, ileum, cecum, transverse and rectum. In BRL analysis, Group 2 showed significant increase and decrease of the insoluble and soluble fractions of the blood cells, respectively (P < .0001). The authors suggest that St.36 may have a tendency of up-regulation effect on GIT, whereas SP.6, down-regulation effect. However, further rigorous experimental studies to examine the effectiveness of acupuncture in either acupuncture points need to be carried out.

Acupuncture Stimulation at Sanyinjiao: Effect on the Sodium Pertechnetate Bioavailability in Rats

In clinical acupuncture, when acupuncture points are stimulated, several types of reflex responses can be evoked. Consequently, different categories of physiological responses are induced, which include changes in the activities of internal organs and tissues. The acupuncture point Sanyinjiao (SP6) has been used successfully to treat different human gastrointestinal conditions. The aim of this work was to investigate the effects of end-organ response induced by acupuncture point SP6 on the bioavailability of the radiopharmaceutical sodium pertechnetate (Na99mTcO4) in Wistar rats. Healthy rats were allocated into 2 groups, control-CG and treated-TG. TG was bilaterally stimulated at acupuncture point SP6 with stainless steel needles. Ocular plexus administration of Na99mTcO4 (3.7MBq) was carried out 10 min after every needle insertion in all animals. Ten minutes later, the animals were killed, the organs were isolated, the radioactivity was determined in a well gamma counter, and the percentage of injected dose per gram of tissue (%ID/g) was determined for each organ. The %ID/g was significantly altered (p < 0.05) in the small intestine of TG (0.56 +/- 0.09) when compared to CG (0.82 +/- 0.18). These results may suggest that this stimulation might induce physiological responses capable of altering the bioavailability of the radiopharmaceutical sodium pertechnetate. These findings aid in providing a better understanding of acupuncture and its effects on various organs and tissues.

Effect of Zusanli (ST.36) Electroacupuncture at Two Frequencies on the Bioavailability of 99mTc-Sodium Pertechnetate and on Labeling of Blood Constituents in Rats

OBJECTIVES A study was performed on the effects of stimulation at Zusanli-point (ST.36) by electroacupuncture (EA) at two frequencies on the bioavailability of (99m)Tc-sodium pertechnetate (Na(99m)TcO(4)) in rats. METHODS Forty Wistar rats were divided into four groups: untreated control, treated by manual acupuncture at ST.36 bilaterally, treated by EA at 2 Hz at ST.36 bilaterally, and the same site at 100 Hz bilaterally. Na(99m)TcO(4) (7.4 MBq) was administrated via the ocular-plexus and, 20 minutes before sacrifice, blood was withdrawn for radiolabeling assay (BRL). In the bioavailability analysis, organs and tissues were isolated, their radioactivity determined, and the percentage of injected dose per gram of organ or tissue (%ID/g) and the %ID were calculated for each organ or tissue (%ID/ot). For BRL, the plasma and blood cells isolated, and the fractions also precipitated with 5% trichloroacetic acid to separate the soluble and insoluble fractions; these were assessed as percentage of injected dose (%ID) in blood (%ID/b). RESULTS The results showed significant differences in the %ID/g in some organs and tissues in comparison with controls; lung (p = 0.0013), spleen (p = 0.0085), pancreas (p = 0.0167), liver (p = 0.0003), stomach (p < 0.0001), small-intestine (p = 0.0181), large-intestine (p = 0.04099), urinary-bladder (p = 0.0271), thyroid (p < 0.0001), muscle (p = 0.0187); %ID/ot in spleen (p = 0.0349); and %ID/b in blood sample (p = 0.0235). In the blood labeling analyses, EA in either frequency significantly increased insoluble fraction/blood cells (p < 0.0001). CONCLUSIONS These findings suggested that acupuncture procedures at ST.36 could modulate responses in some organs, tissues, and blood in rats. Further rigorous experimental studies to examine the effectiveness in either acupuncture therapy need to be pursued.

On the Interconnectedness of Meridian System and Zang-Fu: A Comparative Review and Its Implications

In recent decades, the interest in complementary and alternative medicine has stimulated research in various methodologies and approaches worldwide. Among them, acupuncture in Traditional Chinese Medicine (TCM) has been studied by many researchers as a very efficacious and economic treatment procedure. According to the fundamental theory of TCM, acupuncture efficacy depends heavily on the premise that diseases of visceral organs can be cured via puncturing their corresponding meridians. It is believed that the normal flow of Qi and Xue to Zang- Fu (visceral organs) can be thus restored. Hence, validating the interconnectedness of Zang-Fu and meridian system is of paramount importance in clinical practice. In this review article, radiopharmaceuticals that have been used in nuclear medicine to evaluate the functions of organs are examined at first. Then, variations on the uptake of radiopharmaceuticals in different visceral organs of Wistar rats after acupuncture stimulation of different meridians are compared. Trying to decipher their interconnectedness, bioavailability results of radiopharmaceuticals in combination with the modern conceptualizations of meridian system and Five-Phase theory are invoked. Finally, implications in acupuncture therapeutics and the physiology of internal organs based on the aforementioned results are conjectured. This review, hopefully, will spark more research on using acupuncture as an integrative approach in studying physiology, pathophysiology and treatment of visceral organs.