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Abstracts from the Society for Acupuncture Research 2015 THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 22, Number 1, 2016 ª Mary Ann Liebert, Inc. DOI: 10.1089/acm.2015.29000.abstracts Abstracts from the Society for Acupuncture Research 2015 International Conference Reaching Across Disciplines to Broaden the Acupuncture Research Network November 12–14, 2015 Boston, MA The Lung Unit, The Royal Marsden Hospital; Kofi Nimako, The Oral Abstracts Lung Unit, The Royal Marsden Hospital; Ranga Gunapala, The Lung Unit, The Royal Marsden Hospital; Sanjay Popat, O-1 The Lung Unit, The Royal Marsden Hospital; Mary O’Brien, The A QUALITATIVE ANALYSIS OF THE EXPERIENCE Lung Unit, The Royal Marsden Hospital OF ACUPUNCTURE FOR CHRONIC PAIN IN A LOW- INCOME, ETHNICALLY DIVERSE AND MEDICALLY Background: Dyspnea is a common symptom of lung can- UNDERSERVED PATIENT POPULATION cer. Morphine is widely used to control dyspnea. Method: We randomized 173 patients with advanced Benjamin Kligler, Mount Sinai Beth Israel Department of In- NSCLC or mesothelioma with dyspnea score ‡ 4 on visual tegrative Medicine; Michele Buonora, Albert Einstein College of analogue scale (VAS) to one of three arms (acupuncture [A], Medicine; Jonathan Gabison, Albert Einstein College of Medi- morphine [M] or combination [AM]). A was delivered to upper cine; Diane McKee, Albert Einstein College of Medicine sternal, paravertebral, hand and trapezius trigger points. Semi- permanent acupuncture studs were inserted in upper midline Purpose: To examine the experience of patients from a low sternal points and patients instructed to massage them when income, ethnically diverse medically underserved population dyspnoeic. Arm A were given rescue morphine if needed. We receiving acupuncture for chronic pain. recorded VAS dyspnea and relaxation, lung function tests Design: Qualitative analysis using inductive thematic anal- and EORTC QLQ-30/QLQ-LC13 questionnaires at baseline, ysis of interviews with subjects from an acupuncture trial. 30mins, 90mins, 4 hours, day 2, 7 and 14. Primary endpoint was Subjects: 37 adults at four community health centers in the proportion of patients achieving ‡ 1.5 improvement in VAS Bronx, NY, with chronic neck or back pain or osteoarthritis who dyspnea at 4 hours. participated in a previous acupuncture trial. Interventions up to Results: Dyspnea improved by ‡ 1.5 points on VAS in 74% 14 weekly acupuncture treatments. of patients in A, 60% in M and 66% in AM (A versus M Outcome measures: Pain and quality of life were examined p = 0.12, AM versus M p = 0.50). Mean VAS relaxation was in the original trial; this study examines qualitative outcomes. improved in A (-1.06 – 2.60) and AM ( - 1.48 – 2.05) compared Results: The themes grouped into three domains of the to M (0.19 – 2.43;p<0.001). Day 7 median LAR VAS anxiety acupuncture experience: the decision-making process; the score was improved in A (1.50) and AM (1.2) compared to M treatment experience; and the impact of acupuncture on (0; p = 0.003). Day 7 median LAR VAS relaxation score was health. Regarding decision-making, important factors were a improved in A (-1) and AM (-0.94) arm compared to M willingness to try something new even if you do not necessary (0;p = 0.006). 21% of patients in A, 87% in M and 87% in AM ‘‘believe’’ in it or have positive expectations; a sense that took one or more doses of morphine (p < 0.001). 8% of A, 35% medications were not working for their pain, that they caused of M and 39% of AM reported grade 1/2 toxicities in line with significant adverse effects, and that natural strategies might be morphine’s toxicity profile. Two cases of skin irritation were preferable; and a feeling of desperation. Cost and access were attributable to acupuncture site dressings. significant barriers to acupuncture treatment. Regarding the Conclusion: Acupuncture was found to be as effective as process of acupuncture, the open and personal communication morphine in treatment of dyspnea and has additive value for with the acupuncturist was an important factor, as were the anxiety and relaxation. Acupuncture is morphine sparing. sense that the process of acupuncture related to a natural Acupuncture should be a treatment available to lung cancer process of healing or correction within the body and that part patients with dyspnea. of making acupuncture successful required being open to the power of the mind to generate a positive outcome. Regarding the impact of treatment notable aspects were the deep sense of O-3 rest and relaxation subjects reported during treatment and the ACUPUNCTURE AT PC6 PROTECTS MYOCARDIUM benefit they experienced for conditions other than pain. AGAINST ISCHEMIA AND ISCHEMIA-REPERFUSION Conclusions: The themes that emerged in our ethnically INJURY THROUGH EPIGENETIC REGULATION diverse, low income population were very similar to those that have emerged over the past decade of qualitative re- Bing-Mei Zhu, Nanjing University of Chinese Medicine search on the acupuncture experience in more homogeneous, middle class patient populations. Background: Acupuncture exerts cardioprotective effects on several types of cardiac injuries, including myocardial O-2 ischemia (MI)and ischemia-reperfusion(I/R), but the mech- A RANDOMIZED STUDY COMPARING THE anisms have not yet been well elucidated. By employing high EFFECTIVENESS OF ACUPUNCTURE OR MORPHINE throughput sequencing technology, we aim to explore the VERSUS THE COMBINATION FOR THE RELIEF possible cardioprotective mechanisms of acupuncture in OF DYSPNEA IN PATIENTS WITH ADVANCED coronary arterial disease patients, MI and I/R rats. NSCLC AND MESOTHELIOMA Methods & Results: Based on the TCM theory, Nei- guan(PC6)was selected to be needled using Han’s stimulator for Jacqueline Filshie, Department of Anaesthetics and Pain Man- 4 weeks (3 times/wk) in the patients, 1 week(once a day)in the agement, The Royal Marsden Hospital; Anna Minchom, The MI rats, and 2 weeks(once a day) in the I/R rats prior to I/R Lung Unit, The Royal Marsden Hospital; Ravi Punwani, The operation. For RNA-seq analysis,peripheral blood was collected Lung Unit, The Royal Marsden Hospital; Jaishree Bhosle, and neutrophils were selected in the patients,and heart tissues A2 were harvested in the rats. The results showed that electro- and patients’ groups to observe BP effect, and between post and acupuncture treatment at PC6 in human patients and rats can pre-acupuncture to identify acupuncture effect. effectively protect myocardium. RNA-seq study revealed the Results: For BP effect, SMN of early group had increased gene expression signatures of angina patients, MI rats and connectivity over healthy group at sensorimotor processing acute myocardial I/R rats.Pathway analyses showed that acu- areas including bilateral SI and supramarginal gyrus, ipsilateral puncture can modify multiple functional genes, including (left) middle cingulate cortex as well as cognitive and emotional genes involved in ECM, MAPK signaling, apoptosis, cytokine processing area including ipsilateral DLPFC and contralater- and leukocyte pathways. In addition, some pathways were al(right) anterior cingulate gyrus. Interestingly for acupuncture uniquely regulated by EA at PC6, but not non-acupoint. Fur- effect, early group, SMN connectivity to sensorimotor proces- thermore, we investigated epigenetic modifications in the pa- sing areas including bilateral SI, MI and SII; ipsilateral insula tients and animals.Our study has determined that increased was decreased after acupuncture, while there was increase in H3K9 acetylation was according with the upregulated VEGF contralateral SI, MI, Insula and SII in late group. expression in the EA-treated MI rats.ChIP-seq is being used to Conclusion: BP increased SMN connectivity with different uncover genome-wide profiles for histone modifications in the brain regions due to neuroplasticity even within short duration target tissues. at early stage and at both hemispheres which may be a com- Conclusions: Our study demonstrates for the first time that pensatory way to solve the impairment of facial movement. It acupuncture can effectively regulate gene expressions through can be speculated that acupuncture controlled SMN connec- H3K9 acetylation modification directly at the gene promoter in tivity changes due to BP in order to recover SMN connectivity rat MI models. We employed high throughput sequencing and, pattern towards normal. for the first time, generated genome-wide gene expression profiles both in the rat MI and I/R model and in human patients O-5 with/without acupuncture treatment. We also are continuing to ACUPUNCTURE FOR INFLAMMATORY PAIN explore the epigenetic modifying patterns in the patients and AND CENTRAL SENSITIZATION – A PILOT STUDY animals using ChIP-seq analysis. Nicholas Phillips, University of Vermont Medical Center; Jonah O-4 Hershowitz, San Francisco Acupuncture Group; Lauren Bottoms, ACUPUNCTURE EFFECT ON FUNCTIONAL Kent State University; Brenda Golianu, Stanford University; Martin CONNECTIVITY OF SENSORIMOTOR NETWORK Angst, Stanford University; Helene Langevin, University of Ver- IN BELL’S PALSY; FMRI STUDY mont College of Medicine Abdalla Z. Mohamed, Department of Biomedical Engineering, Aim of Investigation: Clinical trials of acupuncture have Kyung Hee University, Yongin, Republic of Korea; Chuanfu Li, demonstrated analgesic effects, though the mechanisms and var- Laboratory of Digital Medical Imaging, First Affiliated Hospital iables contributing to specific and non-specific effects have yet to of Anhui TCM University, Hefei, Anhui 230031, China; Seulgi be elucidated. Validation
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