AcupunctureAcupunctureBy Katie HicksBy Katie Hicks

IntroductionIntroduction Acupuncture has been Acupuncture has been

practiced in China and practiced in China and other Asian countries for other Asian countries for thousands of years.thousands of years.

Acupuncture is one of Acupuncture is one of several forms for several forms for Traditional Chinese Traditional Chinese MedicineMedicine

Became better known in Became better known in the U.S. in the early 1970’s the U.S. in the early 1970’s after a reported wrote after a reported wrote about doctors in China about doctors in China using needles to ease his using needles to ease his post-operative pain.post-operative pain.

Qi (pronounced “chee”)Qi (pronounced “chee”) In English, Qi means In English, Qi means

“energy”“energy” An invisible, flowing An invisible, flowing

force responsible for force responsible for lifelife

Qi is the force in Qi is the force in nature that operates nature that operates as air and weatheras air and weather

Responsible for the Responsible for the functioning of the functioning of the Organ-energy systemsOrgan-energy systems

MeridiansMeridians Meridians (also called Meridians (also called

channels and vessels) channels and vessels) are networks of are networks of pathways providing pathways providing routes along which Qi routes along which Qi energy flowsenergy flows

14-20 main channels 14-20 main channels connecting the body in connecting the body in a weblike a weblike interconnecting matrix interconnecting matrix of at least 2,000 of at least 2,000 acupuncture pointsacupuncture points

MeridiansMeridians Disease occurs when Disease occurs when

an internal an internal imbalance of Qi flow imbalance of Qi flow occurs due to occurs due to blocked meridiansblocked meridians

TCM acupuncturist TCM acupuncturist identifies the nature identifies the nature of the imbalance and of the imbalance and then selects then selects acupuncture points acupuncture points along the meridiansalong the meridians

AcupunctureAcupuncture Typically 5 to 15 Typically 5 to 15

needles are inserted needles are inserted by the acupuncturist by the acupuncturist at depths varying at depths varying from superficial to 5 from superficial to 5 cm cm

Needles remain in Needles remain in place anywhere place anywhere from five minutes to from five minutes to over an hour over an hour

““Petupuncture”Petupuncture”

Additional Forms of Additional Forms of AcupunctureAcupuncture

ElectroacupunctureElectroacupuncture Moxibustion (heat)Moxibustion (heat) Pressure Pressure Laser-generated light Laser-generated light

Adverse Events Associated Adverse Events Associated with Acupuncturewith Acupuncture

InfectionInfection PneumothoraxPneumothorax Organ punctureOrgan puncture Cardiac tamponadeCardiac tamponade Broken or forgotten Broken or forgotten

needlesneedles FatigueFatigue NauseaNausea HeadacheHeadache

Review of LiteratureReview of Literature Effects of acupuncture to treat Effects of acupuncture to treat

fibromyalgia: A preliminary fibromyalgia: A preliminary randomized controlled trialrandomized controlled trial– 16 participants16 participants– Group A received a total of 5 Group A received a total of 5

electroacupuncture treatments (one per week) electroacupuncture treatments (one per week) followed by weekly clinical exams for 5 weeks.followed by weekly clinical exams for 5 weeks.

– Group B received 10 electroacupuncture Group B received 10 electroacupuncture treatments (one per week)treatments (one per week)

– Study demonstrated a statistically significant Study demonstrated a statistically significant difference between the two groupsdifference between the two groups

– Limitations: small sample sizeLimitations: small sample size

Review of LiteratureReview of Literature Effects of Acupuncture During Labor and Effects of Acupuncture During Labor and

Delivery in a U.S. Hospital Setting: A Case-Delivery in a U.S. Hospital Setting: A Case-Control Pilot StudyControl Pilot Study

– 45 participants received acupuncture during labor 45 participants received acupuncture during labor compared with 127 matched historical controlscompared with 127 matched historical controls

– Incidence of C-section, amount of parenteral opioids Incidence of C-section, amount of parenteral opioids used, use of epidural analgesia, and duration of labor used, use of epidural analgesia, and duration of labor were evaluated. were evaluated.

– Patient and nursing staff satisfaction and acceptance Patient and nursing staff satisfaction and acceptance were assessed by post-partum questionnaires. were assessed by post-partum questionnaires.

– Study show statistically significant decrease in C-section Study show statistically significant decrease in C-section rate in the acupuncture group, no acupuncture-related rate in the acupuncture group, no acupuncture-related adverse events, and a high subjective perception of adverse events, and a high subjective perception of improvement by patients and nurses improvement by patients and nurses

– Limitations include no control for a possible placebo Limitations include no control for a possible placebo effect, relatively small sample size, and participants effect, relatively small sample size, and participants allowed any choice of pain medication allowed any choice of pain medication

Review of LiteratureReview of Literature Electroacupuncture for Primary Insomnia: Electroacupuncture for Primary Insomnia:

A Randomized Controlled TrialA Randomized Controlled Trial– Purposed that electroacupuncture would be Purposed that electroacupuncture would be

superior to placebo acupuncture in the short-term superior to placebo acupuncture in the short-term treatment of primary insomniatreatment of primary insomnia

– randomized, single-blind parallel-group study randomized, single-blind parallel-group study design to compare the effects of design to compare the effects of electroacupuncture and placebo acupunctureelectroacupuncture and placebo acupuncture

– group were treated 3 times per week for 3 group were treated 3 times per week for 3 consecutive weeks consecutive weeks

– Both groups were connected to the same electric Both groups were connected to the same electric stimulator, however the placebo group received no stimulator, however the placebo group received no current current

– study showed statistically significant improvements study showed statistically significant improvements in subjective and objective measures of sleep in subjective and objective measures of sleep efficiency in the electroacupuncture group efficiency in the electroacupuncture group

Review of LiteratureReview of Literature Acupuncture for Essential HypertensionAcupuncture for Essential Hypertension

– Meta-analysis that looked at the efficacy of Meta-analysis that looked at the efficacy of acupuncture in treatment of essential hypertension acupuncture in treatment of essential hypertension

– Data from 20 articles met the inclusion criteriaData from 20 articles met the inclusion criteria– Total of 1528 patients from the 20 trials were Total of 1528 patients from the 20 trials were

included in this review included in this review – Blood pressure was significantly lower with Blood pressure was significantly lower with

acupuncture plus antihypertensive drugs than with acupuncture plus antihypertensive drugs than with sham acupuncture plus hypertensive drugssham acupuncture plus hypertensive drugs

– Limitations included failure to the trials to specify many factors, such as allocation, randomization, and follow-up

– The frequency of acupuncture sessions varied from study to study

ROL ConclusionROL Conclusion PROsPROs

– Generally safeGenerally safe– Well tolerated by most Well tolerated by most

clientsclients– Appears to improve Appears to improve

well-being in many well-being in many people who have tried itpeople who have tried it

CONsCONs– very few sound studies very few sound studies

out there on which to out there on which to build evidence-based build evidence-based practicepractice

– Most studies had relatively Most studies had relatively small sample sizessmall sample sizes

– Randomized controlled Randomized controlled studies difficult to perform studies difficult to perform due to many variables due to many variables (ineffective blinding, (ineffective blinding, inadequate treatment inadequate treatment “dose”, incomplete “dose”, incomplete understanding of how understanding of how acupuncture really worksacupuncture really works

Incorporation Into Advanced Incorporation Into Advanced Nursing PracticeNursing Practice

Attendance at an acupuncture course Attendance at an acupuncture course of approximately two years in length is of approximately two years in length is recommended recommended

Kansas State Board of Nursing (KSBN) Kansas State Board of Nursing (KSBN) requires that as long as an ARNP has requires that as long as an ARNP has “protocols” regarding acupuncture, “protocols” regarding acupuncture, he/she may practice under ARNP he/she may practice under ARNP license license

Kansas does not currently require Kansas does not currently require acupuncturists to be certified acupuncturists to be certified

Incorporating Acupuncture into Incorporating Acupuncture into Advance Nursing PracticeAdvance Nursing Practice

Acupuncture can be recommended Acupuncture can be recommended to patients with a variety of common to patients with a variety of common syndromes as an adjunctive or even syndromes as an adjunctive or even primary treatment option primary treatment option

Further research is needed on the efficacy and cost-effectiveness of acupuncture

QuestionsQuestions