ACUPUNCTURE AND BIOETHICS

Alfio BANGRAZI
Istituto Paracelso. Viale di Trastevere, 281, 00153 Rome, Italy.

We all know the great value of acupuncture-moxibustion as a therapeutic method whose action is deep, gentle, long-lasting, safe and non-invasive. These important features must be brought into light in the training courses because they respect important principles of bioethics. A discipline of great fashion in Western countries today, bioethics took the lead from the necessity of a concrete action into the moral, social and legal problems aroused by the technology-oriented development of medicine and by the growth of medical research.
Which implications can we identify when watching the concept of ethics from the viewpoint of acupuncture? Is it worthwhile going through debating the subject? Yes, in my view. For traditional medicine, man is a microcosm, he has an intrinsic capacity to maintain his own health or to recover it once he has lost it, he is in fact subject to illness since he is exposed to continuous attacks from the outside world, yet he can evolve to perfecting a state of unassailability. These very axioms, which make acupuncture able to explore any aspect of physiology and any pathological modification, contain intrinsically all the moral implications and all the presuppositions of the ethical behavior, to be followed in the art of healing as well as in the development of scientific research.

Symposium B
Saturday, September 21, 1996

EFFECTS OF ACUPUNCTURE ON IL-2, IL-6, IL-10 CYTOKINES
IN CHRONIC ALLERGIC RHINITIS PATIENTS

Flora IPPOLITI1, Alfio BANGRAZI2, Aldo LIGUORI2, Filomena PETTI2
1Cattedra di Immunologia, Universita degli Studi di Roma "La Sapienza", Rome, Italy.
2Istituto Paracelso. Viale di Trastevere, 281, 00153 Rome, Italy.

Aim: The aim of the study was to determine the plasmatic concentration of IL-6, and IL-10 cytokines (respectively pre-inflammatory and regulatory cytokines produced by TH2 lymphocytes) compared to IL-2 cytokine (produced by TH1).
Methods: Basal cytokine levels were taken from a group of 30 healthy volunteers(Group A) and from another group of 90 patients suffering chronic allergic rhinitis (Group B) with a plasmatic increase of cytokine (IL-10); Group B was also divided into three subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham-acupuncture (Group B2); 30 non-treated patients (Group B3). Acupoints: Yintang (Extra), Yinxiang (LI20), Hegu(L14), Zusanli (ST36). In Group A levels were 15¡¾10.
Results: The allergic subjects of Group B1 had a significant regulation of IL-10 after a specific treatment with acupuncture: before acupuncture, it was 130¡¾37; 1/2 hour after acupuncture, it was 80¡¾42; 24 hours after acupuncture, it was 77¡¾21. On the other hand, in Group B2 patients treated with sham-acupuncture, and in Group B3 patients the IL-10 values were: before acupuncture, it was 130¡¾30; there was no change in values 1/2 hour and 24 hour and 24 hours after acupuncture. IL-10 and IL-6 interleukins had no change in basal values after the acupuncture therapy.
Conclusion: We can affirm that the acupuncture treatment can reduce plasmatic levels of IL-10 in chronic allergic rhinitis.

Symposium B
Saturday, September 21, 1996

A STUDY ON THE EFFECTS OF ACUPUNCTURE IN THE TREATMENT OF MIGRAINE WITHOUT AURA (MWA) MEASURED WITH MEDICAL-SOCIAL PARAMETERS

Aldo LIGUORI1, Alfio BANGRAZI1, Filomena PETTI1, Flora IPPOLITI2,
Walter E. NICOLETTE3
1Istituto Paracelso. Viale di Trastevere, 281. 00153 Rome, Italy.
2Cattedra di Immunologia, Universita degli Studi di Roma "La Sapienza".
3Cattedra di Medicina Sociale, Universita degli Studi di Roma "La Sapienza".

This study was carried out on 120 patients affected by "migraine without aura", treated in 4 public health centers and randomly divided into an acupuncture group (AG) and a conventional drug therapy group (CDTG). The evaluation of clinical results was made 6 and 12 months after the beginning of the treatment and was worked out as well according to medical-social parameters. Acupuncture was applied to the following points: Touwei (ST8), Xuanlu (GB5), Fengchi (GB20), Dazhui (GV14), Lieque (LU7), treated with the reducing method. In AG, the figure scoring the entity and frequency of migraine attacks droups from 9,823 before the treatment to 1,990 six months later and 1,590 twelve months later, while in CDTG it drops from 8,405 before the treatment to 3,927 six months later and 3,084 twelve months later. The cost/benefit ratio was therefore clearly in favor of the AG. In AG the total absence from work amounted to 1,120 working days/year, with a total cost (private +social costs) of 186,677,000 Italian liras. In CDTG the absence from work amounted to 1,404 working days/year, with a total cost of 266,614,000 Italian liras.
If we consider that in Italy the patients affected by "migraine without aura" are around 800,000 and that the acupuncture therapy is able to save 1,332,000 Italian liras on the total average cost supported for every single patient, the application of acupuncture in the treatment of "migraine without aura" would allow a saving of the health expenses in Italy for over 1,000 billion liras.

Workshop II
Saturday, September 21, 1996

RESEARCH METHODOLOGY ON ACUPUNCTURE

Filomena PETTI
c/o Istituto Paracelso. Via O. Regnoli 8, 00152 Rome, Italy.

Promoter: Italian Inter-university Commission for Research on Acupuncture
Coordinator: Alfio Bangrazi
Background: In the fifties the research on acupuncture was started in China. In the eighties it appeared in the Western countries. 1987: During its thirty-eight session, the WHO Regional Committee for the Western Pacific adopted a resolution which urged member States to undertake research on traditional medicine. 1989, Geneva: The Scientific Group on Acupuncture recommended that WHO should issue guidelines on research methodology in acupuncture 1989, Rome: The Italian Association of Acupuncture-moxibustion and TCM (AIAM) organized a National Congress for the Foundation of a Research Methodology in Acupuncture-moxibustion. 1991, Rome: AIAM founded in Italy the Inter-university Commission for Research on Acupuncture and promoted its activity. Members of this Commission are professors of six Italian universities and MDs and biologists of Istituto Paracelso in Rome. 1992, Rome: AIAM organized the WFAS Symposium on The Science of Acupuncture, a reality to be emphasized. Which kind of research?, where AIAM presented a work on research financial problems. 1993, Kyoto: The WFAS 3rd Acupuncture World Conference hosted a Workshop on Acupuncture Clinical Research, which was also attended by a WHO representative. 1994: The WHO Regional Office for the Western Pacific organized a working group on clinical research methodology for acupuncture. 1995: The same WHO office published the Guidelines for Clinical Research on Acupuncture.
Objectives: (1)To keep the debate going inside the WFAS on the research methodology for acupuncture. To plan that in the program of all future WFAS World Conference, a section is dedicated to the Workshop on the problems of clinical and basic research on acupuncture. (2)To implement the WHO Guidelines for Clinical Research on Acupuncture. (3)To make the most of the WFAS World Journal of Acupuncture and to rationalize it so that it becomes the official informational channel on the development of research on acupuncture for the international scientific community. (4) To start concrete actions for finding funds to be assigned to research on acupuncture.

Clinical Research & Application
Pain Management & Osteotraumology

ACUPUNCTURE ANALGESIA: CLINICAL EXPERIENCES IN
EXTRACTION OF TEETH AND DEVITALIZATION

Olga WANDERLINGH, Natale NICOTRA
Ospedale "A. Cardarelli". Napoli, Italy.

A description of clinical experience in the extraction of teeth and devitalization conducted in "Cardarelli" hospital of Naples will be persented.
354 cases (235 extraction of teeth and 119 devitalization) were treated during the period 1979¡­1991.
The methods, the evaluation of pain by means of graphic and verbal scale and clinical parameters, and the results of data processing, will be documented.
Moreover, the authors will emphasize the utility of this technique in allergic patients and then they will underline the absolute absence of collateral effects.

Clinical Research & Application
Pain Management & Osteotraumology

THE TREATMENT OF OSTEOARTHRITIC PAIN USING ACUPUNCTURE AND
RELATIONSHIP WITH INTAKE OF NSAID

Camillo SCHIANTARELLI, Lucio PIPPA, Attilio BERNINI, Iole TERZA
Department of Pain Therapy, Medicine Division, General Hospital USL 43: C.so Milano 19, 27029 Vigevano (PV), Italy. University of Chieti.
Gathering of Italian Acupuncture Schools member of the Italian Federation of Acupuncture Associations, Gruppo Studio Societ e Salute. Via Mazzini 148, 40138 Bologna, Italy.

Aim: Rheumatic diseases (RD) represent some 20% of all outpatient pathology in public structures in Italy. Degenerative RD, usually known as arthrosis, represent more than half of all rheumatologic pathology. The aim of this study is to evaluate the efficacy of acupuncture in the control of pain and in the reduction of NSAID intake in patients affected by RD without significant comorbidities.
Methods: 90 patients have been randomized in three groups: (A) 30 patientstreated only with NSAID without restrictions; (B) 30 patients treated only with acupuncture (2 sessions a week for 6 weeks); (C) 30 patients underwent both treatments. NSAID for pain control were given according to the standard posology prescribed by the general practitioner; acupuncture points were chosen according to the disease localization and to the individual energetic imbalance. Pain was estimated according to: Simple Descriptive Scale, Weekly chart for self-compilation and Visual Analogue Scale by Scott-Huskisson. Data were collected a week before the treatment, weekly under the treatment, 2 and 6 weeks after the end of the treatment. All patients were requested to specify in a weekly form all the analgesic drugs taken, will brand names, intake modalities and daily posology.
Results: In group A, pain control was significantly achieved (p<0.005) at the end of the 2nd week of the treatment. In group B, pain control was rather significant(p<0.05)at the 3rd week and significant (p<0.01) at the 8th week. In group C, pain control was achieved after the 2nd week of the treatment. NSAID intake, in all observed patients formerly higher than the average consumption registered in the area, decreased well below the average in group C.
Conclusions: Our study shows a pain control in all observed groups; combined acupuncture and NSAID therapy (group C) allowed a quicker reduction of pain, with a maximum of statistical difference (p<0.06) compared with the other two groups at the 4th week of the treatment. Noteworthy is the fact that reduction in NSAID intake entailed a significant reduction in pharmaceutical expenses.

Clinical Research & Application
Pain Management & Osteotraumology

CURRENT NEWS IN THE TREATMENT OF JAW ARTHROSIS

Alberto FERRARA, Roberto CARELLI
Istituto Paracelso. Viale Trastevere, 281, 00153 Rome, Italy.

Aim: Pain, noise and functional abnormality are the main complaints of Temporo-Mandibular Joint's (TMJ) syndrome. Alterations or malformations of the maxillo-facial region and a number of systemic disease are considered etiological factors of the syndrome. For the most part of the cases it is very difficult to identify any simple noxious pathogen; on the contrary, it is very common to observe two or more factors acting jointly. The authors, after a careful examination of international literature, draw the TMJ syndrome diagnosis and therapy guidelines with particular reference to acupuncture's utility to gain recovery in acute cases.
Material and Methods: The review of the literature permitted the authors to create a clinical schedule to collect anamnestic data and that will contribute to facilitate the evaluation of etiological factors found to determine TMJ syndrome. In this respect the authors underline that very rarely TMJ syndrome is sustained by severe inflammatory or degenerative joint tissues modifications. It is very common to observe, on the contrary, a TMJ syndrome linked to a postural disorder that often remained not recognized or not treated for several years. The diagnosis in the first contingency can be easily done by performing a TMJ tomography. On the contrary, a postural disorder, asymptomatic at beginning, can constitute the prime factor of a TMJ syndrome that will give a sign of it with muscular contraction, localized or neuralgic pain, mandibular functional limitation, articular locking. The authors, with the aid of two clinical cases, discuss the clinical schedule features and necessary instrumental examinations to define clinics and efficacy of the therapy in acute cases.
Discussion and Conclusion: An analysis of data collected before and after combining the treatment with bite plane and acupuncture permits the authors to provide such data for dysfunctional patient's statistical analysis. Moreover, they will aspirate the creation of an international schedule form to standardize research on TMJ syndrome.

Clinical Research & Application
Pain Management & Osteotraumology

A COMPARISON OF ZHONGTIAO, HUANZHONG AND HUANTIAO;
A CLINICAL EXPERIENCE ON 150 CASES OF LUMBOSCIATALGIA

Francesco MARINO, Roberto PULCRI, Nicol VISALLI, Luigia ALESSANDRINO
Italian Academy of Traditional Medicine Omoios. 47 G. Mameli, Rome 00153, Italy.

Aim: Zhongtiao is a recently acknowledged extra point. Its effect was evaluated on 150 patients suffering from lumbosciatalgia, which was variously classified according to the TCM criteria.
Methods: 150 patients (80 males and 70 females ranging from 30 to 65 years old)suffering from lumbosciatalgia were treated by acupuncture and/or moxibustion, on the basis of the criteria concerning the differentiation of Bi-syndromes. The effectiveness of Zhongtiao, Huanzhong and Huantiao was compared. Zhongtiao is just the middle point located between the other two acupoints. The needle must be inserted perpendicularly at 2 to 3 cun depth with the even method.
Results: The clinical experience of the AA pointed out that Zhongtiao is more effective than Huantiao and Huanzhong, as resulted from the following efficacy rates: Zhongtiao 92%, Huantiao 72%, Huanzhong 60%.
Conclusion: On the basis of the AA's clinical experience Zhongtiao was revealed as a precious extra point for the best restoration of lumbosciatalgia.

Clinical Research & Application
Pain Management & Osteotraumology

245 CASES OF LUMBAR INTERVERTEBRAL DISK HERNIATION
TREATED BY ACUPUNCTURE COMBINED WITH
CHINESE MASSAGE AND GRAVITATIONAL TRACTION

Rinaldo RINALDI, Aldo LIGUORO, Alfio BANGRAZI
Istituto Paracelso. Viale di Trastevere, 281, 00153 Rome, Italy.

Aim: Lower back pain with sciatica is a common clinical syndrome among working people, most frequently caused by protrusion or herniation of the intervertebral disc. The authors applied Chinese massage and gravitational traction in treating acute and chronic sciatica and studied results.
Methods: 245 patients(160 males and 85 females between 32 and 64 years old) suffering from sciatica caused by lumbar intervertebral disk herniation, were treated from January 1991 to December 1995.
Treatment: (1) Acupuncture: Shenshu (BL23), Chengfu (BL36) and Weizhong (BL40) were selected as main acupoints, combined with a series of auxiliary points, selected according to the differentiation of syndromes. (2)Preliminary Tuina: Palm rubbing, pushing technique and rolling method were applied on both sides of the lumbar region and on lower limbs. (3) Gravitational traction: This method was carried out by means of vertical suspension in order to widen the intervertebral spaces and to promote the reduction of herniation. The patient is suspended in a particular apparatus and he is encouraged to perform a series of active exercises. (4)Closing Tuina: A series of passive movements of the lumbar region of the patient was applied in hyperextension and rotation.
Results: 131 patients (53.4%) were cured, 79 patients (32.2%) were basically cured; 28 patients (11.4%) obtained satisfactory results. The total effective rate was 97%.
Conclusion: This therapeutic method is simple, safe and effective. Moreover, its combination with other TCM techniques could achieve even better results.

Clinical Research & Application
Pain Management & Osteotraumology

THE EFFICACY OF ACUPUNCTURE IN THE TREATMENT OF
THE CERVICAL VERTEBRATE SPONDILOSYS

Loredana M. AVANTAGGIATO, D. CORLIAN , G. DE PAOLIS
Italian Association Acupuncture and Moxibustion Section of Puglia. Via Lazio N.2 Corigliano Dotranto 73022, Italy.

Aim: Acupuncture treatment of 30 patients affected from cervical vertebrae spondilosys by utilizing Jilin Zhonghy Zazhi protocol was compared to a control group treated only with pharmacological therapy.
Methods: Dazhui (GV14), Tianzong (SI11), Zhiaheng (SI7), Pianli (LI6), Waiguan (TE5), and Neiguan (PC6) were selected with dispersion. The control group was given 100 mg of sodium Diclofenac, muscular relaxation drugs and antinevritic drugs for 20 days in case of light troubles and for 20 days a month for two months in case of middle troubles.
Conclusion: Acupuncture efficacy in the treatment of vertebrae spondilosys at short and middle time; no contra-indications, side effects or risks in comparison with the pharmacological treatment.

Clinical Research & Application
Paralysis & Nervous System Diseases

THE TREATMENT OF VERTEBRAL FRACTURES IN 67 CASES BY SPECIFIC
TRADITIONAL CHINESE EXERCISES COMBINED WITH ACUPUNCTURE

Giorgio D'ACUNZO1, Alessandro DE FABRITHS2, Gianni MARTELLI2, Antonio ALFIERO2, Alfio BANGRAZI1
1Istituto Paracelso. Viale Trastevere 281, 00153 Rome, Italy.
2Anzio Hospital, USL RM35-ANZIO (RM) Italy.

Aim: The vertebral fractures represent 3 to 4% of all the possible fractures. The authors applied a very particular self-reduction method currently used in China for the treatment of acute and subacute stage of vertebral fractures, and studied its effects.
Methods: 67 patients (38 males, 29 females), aged from 19 to 74 years, affected by somatic dorsal and lumbar vertebral fractures, were treated in the Anzio Hospital (Rome province, Italy) combining traditional Chinese exercises with acupuncture. Acupuncture was given in order to improve the post-traumatic painful condition and to help the patients to start the practice of traditional Chinese exercises as early as possible, generally within the first week after the injury. Such physical practice consists of a series of exercises aimed to extend the spinal column, which enable the patient to obtain the following results: (1) Improvement of the local circulation of blood and better nutrition of soft tissues and bones; (2) Self-reduction of the fracture; (3) Increases tone of the paravertebral muscles, in order to achieve a rapid and stable recovery.
Results: Excellent in 35% of cases; good in 44%; fairly good in 19% and poor in 2%.
Conclusion: In most cases this method proved to be very effective, especially in the lumbar fractures; it also allows to avoid the worst disadvantages of a prolonged immobilization both bed and in the plaster device.

Clinical Research & Application
Paralysis & Nervous System Diseases

THE EFFICACY OF ACUPUNCTURE IN THE TREATMENT OF BALANCE DISORDERS AFTER WHIPLASH INJURY

Carlo BORSARI, Bruno FATTORI, Luciano BONUCELLI, Augusto CASANI, Giovanni
VANNUCCI, Pierluigi GHILARDI
III Servizio di Anestesia, Clinica Ortopedica. Via Risorgimento, 37, 56126 Pisa, Italy.

The introduction of Computerized Static Posturography to postural function studies permits an objective and repetitive analysis of balance disorders arising after whiplash injury (WI).
Methods: With the aid of static stabilometry, we studied the modifications in posture and balance of patients with whiplash injury during and after acupuncture treatment. Fifteen patients of both sexes and with a mean age of 35.5 years old, suffering from balance disorders following cervical whiplash injury, were submitted to a once-weekly session of acupuncture for a total of four weeks. The points which were stimulated manually were B10 and B20. The control group, made up of 17 patients with vertigo symptoms following whiplash injury, was treated with medical treatment and physiotherapy.
Results: The following features resulted from the study: (1) acupuncture showed greater efficacy than the traditional methods (control group); (2) the stabilometric values returned to normal after the first acupuncture session; (3) the maximum response was achieved in the days following the acupuncture session.

Clinical Research & Application
Drug, Alcohol & Smoking Abuse

A PRELIMINARY ANALYSIS OF THE ABSTINENCE SYNDROME
FOR OPIATES DRUG ADDICTION TREATED WITH ACUPUNCTURE

Domenico L. CAMPANELLA1, Claudio LEONARDI1, Serena MINCIARELLI2,
Maurizio CIPRIANI1
1Servizio Tossicodipendenti, Ambulatorio Appia Antica, USL RM C. Rome, Italy.
2Istituto Parcelso. Viale di trastevere, 281, 00153 Rome, Italy.

Aim: This preliminary analysis is the first step of a large-scale research to verify the effectiveness of acupuncture treatments for the abstinence syndrome of opiates addiction. The obtained results were compared to the ones surveyed from a testing group treated with medicines.
Methods: 60 patients were divided into two groups, with each one composed of 30 patients who manifested the abstinence syndrome of opiates. The first group (group A) was treated with the pharmacological treatment while the second group (group B) was subjected to the auricular-therapy treatment. There were three daily applications on the patients of group B for three days. The auricular points were: Lung, Asthma, Shenmen while the pharmacological treatment adopted the administering of benzodiazepines, clonidine, doxepin, analgesics, antidepressants and symptomatics.
Results: The data show that the auricular-therapy has an interesting effect on abstinence syndrome. The effect is comparable to the one obtained adopting the pharmacological medicine. The auricular-therapy is an easy method but it requires qualified workers; sometimes the auricular-therapy treatment is more difficult than the prescriptions of medicine but it seems to make it possible for the therapeutic treatments tailor to each patient's needs. Moreover, the auricular-therapy does not produce side effects.
Conclusion: This research has shown that the auricular-therapy would be a suitable therapeutic method for the abstinence syndrome. It is possible to adopt the auricular-therapy as the only method or combined with pharmacological treatments.

Clinical Research & Application
Stress, Chronic Fatigue Syndrome & Psychological Problems

A CLINICAL STRATEGY AND METHOD TO TREAT CHRONIC FATIGUE SYNDROME BY ACUPUNCTURE

Jia-lang HE, Yong-chun ZENG
Saint George Studi Medici Specialistici, Viale Delle Accademie n.81/B10, 00147 Rome, Italy.
Clinica Neurologica, Dipto. Sanit Pubblica e Biologia Cellulare, Universit Tor Vergata. Via Tor Vergata 135, 00133 Rome, Italy.

Chronic fatigue syndrome (CFS), known as a disease of the 90's, is attracting a considerable attention in the world of medicine. The characteristic clinical features are chronic fatigue over 6 months with general debility or with low fever, muscle and/or joint pain and other physiological signs or with depression, irritability anxiety and other psychological signs. The diagnostic test and disease history have to rule out other possible diseases.
Traditional Chinese medicine describes CFS as one kind of clinical syndromes with unbalance of yin-yang, disorder of circulation of qi-blood and dysfunction of zhang-fu caused by physical intolerance or over-exhaustion under the stress in modern society.
The therapeutic approaches are to correct deficiency and strengthen healthy qi, as well as reinforcing qi-blood and balancing yin-yang. Over a period of 3 years, 155 patients were classified to be definite cases of CFS. For patients with a deficiency in spleen qi, the acupoint in meridians and collaterals of Taiyin (LU, SP) and Yangming (LI, ST) should be chosen. It is mainly to take the tonifying method, and improving the function of spleen and stomach. For patients with a deficiency in qi-blood, the acupoint should be chosen from meridians and collaterals of Shaoyin (HT, KI) and Shaoyang (TE, GB) with a method of soft invigoration and soft relief. Dysfunction of zhang-fu and qi-blood should be restored by nourishing the heart so as to calm the mind and by regulating the physical and psychological function. One hundred and forty one patients (90.9%) have not complained of any chronic fatigue for over an approximate period of 6 months after the aforementioned treatments. Acupuncture, together with four diagnostics and eight gang and with the analysis and synthesis of the data collected, play a key role in the proper treatment of CFS.

Clinical Research & Application
Stress, Chronic Fatigue Syndrome & Psychological Problems

THE TREATMENT OF HUMOR DISORDERS BY ACUPUNCTURE

Mauro CUCCI, Anna CORTESE
A.N.I.A. Via Tagliamento 9, 00198 Roma, Italy.

Aim: In 1993, during the WFAS Symposium in Rome, our Institution suggested a treatment of Humor Disorders by acupuncture. During the past 3 years a lot of patients were treated with the method suggested on that occasion. The aim of this paper is to show the results of the work mentioned above.
Methods: An energetic diagnosis according to the standards of the Traditional Chinese Medicine was made for 50 patients. They were 20 to 59 years old and diagnosed of "Major Depression". The patients were selected from a larger sample among those who were not taking psychopharmaceuticals. All the patients presented signs of energetic imbalance (lack) in the Metal Element, placed West according to the Law of the 5 Movements and where the traditional data place "sadness". Although each treatment had to be personalized, which is imposed by acupuncture, the main goal for each patient was to tonify the Metal Element in its Operator group (101 Yang Ming) and to enable the well-balanced energetic circulation in the Fire Element (010 Chao Yin) in order to prevent the onset of Maniacal fits. The patients were submitted to an acupuncture session once a week until the symptoms disappeared. Eight to twelve sessions seemed to be necessary.
Results: All treatments resulted in the resolution of the symptoms and the patients did not present any recidivation during the following year.
Conclusion: Taking the result into consideration, acupuncture appears to be a valid instrument for the treatment of Humor Disorders.

Clinical Research & Application
Internal Organ Disorders

A CLINICAL STUDY OF ACUPUNCTURE TREATMENT IN 25 CASES OF PALPITATION

Yonggang JIN
Natural Medical Center, Via C. Cantli 25 Dogana 47031 Ref. of San Marino, Italy.

Aim: The new points and the theory of acupuncture were used by the author to try to cure palpitation.
Methods: Two groups of patients were divided in this study. In the control group the Meridian points Neiguan, Sanyinjiao, Zusanli, and Guanyun were used. In the treated group, needles of 0.25¡¿25 mm were inserted into C4-T3 positions 1 cm away from the middle line in every vertebra. Eight to twelve points might be chosen and the depth should be about 1 Cun. The electrostimulator was used in all of the cases for about 20 minutes.
Results: The effective rate was about 90% after five to ten times of treatment within two or three weeks in the treated group (recovery of palpitation, fatigue and numbness of upper limbs). It was less than 60% in the control group.
Conclusion: The new theory states that palpitation (maybe also other cardiac diseases) is caused from blocks that involves the nervous radices in the vertebral column. The evidence of grave pains on the positions of C4-T3 in all of the patients on the treated group was found in this study. The frequency and intensity of the nervous electronic conduct in the nervous fibers are the main controls for biophysical and biochemical functions of every organ. Any blocks that involve the nervous radices with scoliosis, arthritis or incident as well as other chronic inflammations of the conduct channel will cause the change in the bioelectronic frequency and intensity. Consequently, the diseases occur in the relative nervous distributing position and in the organs. The needles should be taken near these blocked nervous radices to obtain a satisfactory clinical result.

Clinical Research & Application
Internal Organ Disorders

FUNCTIONAL HYPERTHYROIDISM

Francesco MASTROCINQUE
Via Prato N*53 Foglianise (BN) Italy.

Methods: Cases of Functional Hyperthyroidism have been selected according to clinical simptomatology (symptoms of hyperthyrroidism) of chemical-instrumental exams, of hormones: T3, T4, TST, FT3, FT4, to scintigraphy, to FNAB. THERAPEUTIC TREATMENT Acupuncture as taugth by the Superior Institute of Acupuncture. Therapy is conducted in two stages. Two 30/45 minutes session, on a weekly basis. First stage: Thiroid direct extraction; Puncture of points delimiting thyroid: 9E, 10E, 22VC, with other four needles in a very superficial positioning in thyriod zone. Then, we had a lower polarization on the stomach meridian with: 43E, 44E ensuring return on the "contrary" of the stomach 6R. Second stage: we acted on TchongMo in points 4RT, 30E, 6MC, 5VC, we defined thyroid zone as in the first sessions, we did lower polarization as well. After four 30 minutes sessions, on a weekly basis, we expected about two weeks and hence we did a thyroid hormonal check-up and a thyroid scintigraphy with results.
Results: Beginning from the third stage (first stage Tchong-Mo thyroid) clinical symptoms connected with the hyperthyroidism: irritability, asthenia, intolerance of heat, rise of perspiration, tachicardia, anxiety, insomnia, have gradually improved till disappearing at the end of the treatment. Thyroid hormones, that at the beginning had values within the maximum limits of the rule, have fallen thowards values next the median range of normality and TSH increased with a significant progress.
Conclusion: Acupuncture results are surprising in the endocrinological field.

Clinical Research & Application
Internal Organ Disorders

BYLER DISEASES: DESCRIPTION OF A CASE TREATED
WITH ACUPUNCTURE AND CHINESE HERBS

Carlo M. GIOVANARDI, Carlo DI STANISLAO, Franco DE GASPARRE,
Dante DE BERARDINIS, Maurizio CORRADIN
Scuola Italo-Cinese di Agopuntura. Bologna-Roma, Italy.
Associazione Medici Agopuntori Golognesi. Gologan, Italy.

Byler disease (a rare autosomal recessive affection) causes (because of enzyme defect) a progressive intrahepatic cholestasis to secondary biliary cirrhosis. About fifty cases have been discovered in the world. Hepatic transplantation is resolute. Drug therapy (cortisone, rifamycin, bile salt) leads to partial remissions and various idiosyncratic responses.
All the icteric diseases (in TCM) are described (the first references are in "Qianjin fang") ad "huang dan" and divided in "yang huang", "yin huang" and "ji huang". We may distinguish patterns in which Damp (shi) or Heat (re) or Poison (du) predominate, according to the onset of the disease, the color, the general signs and symptoms, the tongue (she) and the pulse (mai). It is essential to investigate the condition of the Liver and Middle Burner for prognosis and therapy.
A boy of 13 years old suffered from Byler diseases. He was treated with acupuncture for a year (first weekly, then every fifteen days, finally monthly) and Chinese herbs (basic formula Huang Lian Je Du Tang + Yin Chen Hao). This patient made a very good progress (bilirubin decreased, transaminase halved, bile salts, leucine aminopeptidase, gamma-glutamil transpeptidase). The symptoms (malabsorption, anorexia, asthenia, and poor attention at school) disappeared very quickly. After the end of the treatment, the patient's weight increased 6 kg and he was 5 cm taller. The main acupuncture points used were: Youmen(KI21), Hunmen (BL47), Yinjiao (CV7) (they affected Jing, Yuan Qi and the Lower Burner). These points were needled together with some others.

Clinical Research & Application
Internal Organ Disorders

THE EFFICACY OF ACUPUNCTURE IN TREATING ITCH AND BONE PAIN
OF PATIENTS WITH CHRONIC RENAL INSUFFICIENCY
UNDERGOING HEMODIALYSIS

Sebastiano RIZZO
University of Pavia, Irccs Policlinico S. Matteo, I-27100 Pavia, Italy.

Aim: Itch and pain are frequent and fastidious symptoms in patients with chronic renal insufficiency undergoing hemodialysis. Pain and itch-relieving synthetic drugs are generally futile and their long-term effects are not apparent. The author reports his successful experience using acupuncture to relieve the symptoms.
Methods: 4 patients (2 males and 2 females with a mean age of 59 years old) currently undergoing hemodialysis requested an acupuncture treatment for chronic diffuse itch (3 cases) and spine or shoulder pain (3 cases) which resisted to common drug therapy. The acupuncture treatment, according to TCM, was aimed at the main symptom and the whole aspect of the disease. Each patient received one course of therapy. Itch and pain were reported on a 0-to-10 analogic scale. One oliguric patient and one anuric patient were also treated for their residual renal function.
Results: Itch and pain rapidly disappeared and were present anymore at the end of the treatment as well as after 3, 6, 12 months of following up in 3 of 3 patients (100%). In one case the survey was taken after 10 years. Moreover, the urine amount rose rapidly during the treatment, from 400 to 700 ml/day in the oliguric patient and from 0 to 500 ml/day in the anuric patient; so maintaining for 4 and 8 months, respectively (average 6 months). It allowed a half hour reduction of the dialysis time in both cases.
Conclusion: Acupuncture is effective to treat oliguric-anuric patient's symptoms. Although long-standing results may be obtained, it is also good for the residual renal function.

Clinical Research & Application
Dermatology, Surgery & Oncology

A CLINICAL STUDY ON UREMIC ITCHING OF DIALYZED PATIENTS
TREATED BY ACUPUNCTURE

Gianmaria CANTONI, Maria Grazia CAPORALI
C.S.S.A. ¡ª SO WEN. Via Soperga 36, 20127 Milano, Italy.

Aim: Skin itching is a common secondary symptom in dialyzed patients, worsening in a very important way the quality of life of these patients. The authors applied the traditional acupuncture in treating this symptom and studied its effects.
Methods: 28 patients were studied and divided into a treatment group of 16 and a control group of 12, homogeneous for age, sex and severity of illness. For the treatment group we used the following standard points: Sanyinjao (SP6), Xudhai (SP10), Quchi (LI11), Zusanli(ST36). In addition, a personalized point chosen on the specific energetic perturbation of the single patient. For the control group we used random needling on non-acupuncture points. All patients were treated twice a week for four weeks, and the final evaluation was based on a self-evaluation test.
Results: In the treatment group 8 patients were cured (50%), 6 had a very good result (37.5%), 2 had a sufficient result (12.5%), 1 had an insufficient control of itching (6.25%) and 1 had no result (6.25%). In the control group no patient had a good result, and for this reason after the four-week treatment we started the real acupuncture, obtaining the same results as the former treatment group.
Conclusion: The comparison between the two groups revealed a statistically significant difference (p<0.05), , indicating the real efficacy of acupuncture in treating the itching in dialyzed patients. The results also showed that acupuncture is more effective than the usual treatment of this problem which was demonstrated ad ineffective in the early stage of this study and therefore, we started the needling method.

Clinical Research & Application
Dermatology, Surgery & Oncology

INCREASED DENSITY OF LYMPHOCYTIC BENZODIAZEPINE RECEPTORS ASSOCIATED TO ACUPUNCTURE ANXIOLTIC TREATMENT PRE-CHEMOTHERAPY

Anna CORTESE1, Mauro CUCCI1, Rachele TORTORELLA1, Tiziana COGLIATI2,
Graziella BIANCHI2, Davide PASSONI2, Vincenzo NOCITI3, Carlo FERRARESE2
1A.N.I.A. Via Tagliamento 9, Roma, Italy.
2Dept. of Neurology and 3Dept. of Surgery, Univ. of Milano, Osp. S. Gerardo, Monza, Italy.

Aim: Since acupuncture has been successfully adopted as a useful anxiolytic treatment, it has been employed in the present study to ameliorate acute stress in post-surgical breast cancer patients before chemotherapy. Peripheral benzodiazepine receptor (PBR) density was used as a biological indicator of changes in patient's emotional status, based on its known modulatory role in neuro-endocrine-immunological interactions. Previous studies indicated that lymphocytic peripheral benzodiazepine receptors (PBR) density decreased in anxious patients and reverted to normal values after diazepam treatment, therefore PBR level may be considered a biological maker of anxiety.
Methods: 10 post-menopausal breast cancer women were treated two times with acupuncture (one week after surgery and one week later) before chemotherapy or radiotherapy. In all patients anxiety was evaluated before and after the cycle of two acupuncture treatments by Zung's and Hamilton's self rating scales and at the same time blood samples were taken for the evaluation of PBR density on lymphocytes, determined by binding assay with the specific radioligand 3H-PK11195.
Results: (1) The acupuncture treatment induced a remarkable increase of variable entity of PBR density in 7 out of 10 patients. (2) The clinical aspect of anxiety have improved in 8 out of 10 patients after acupuncture. (3) Changes in the biochemical and behavioral parameters after acupuncture are correlated.
Conclusion: The presented data indicate a positive effect of acupuncture on anxiety symptoms and on the modulation of a putative biological marker such as PBR. This effect may suggest the use of acupuncture as an anxiolytic treatment to ameliorate cancer patients compliance with and response to conventional chemotherapy or radiotherapy.

Clinical Research & Application
Gynecology, Obstetrics & Pediatries

ACUPUNCTURE TREATMENT OF UTERINE FIBROMYOMAS TRIAL OF 18 CASES

Raimondo SPITALI, Aldo LIGUORI
Cattedra di Clinica Ostetrica e Ginecologica, Universit degli Studi di Roma "La Sapienza".
Rome, Italy.
Istituto Paracelso. Viale di Trastevere, 281, 00153 Rome, Italy.

The effects of acupuncture on 18 patients with uterine fibromyomas were evaluated.
The treatment of acupuncture was made according to the TCM differentiation of syndromes. Different groups of acupoints were selected for each syndrome.
1. Heat stagnation with stasis of liver qi (7 cases): Gongsun (SP4), Lieque (L7), Tianzong (SI11), Qihai (CV6), Guanyuan (CV4), Zigong(Extra22), Fenglong (ST40), Zhigou(TE6), Dadun.
2. Heat in the blood (4 cases): Gongsun(SP4), Lieque(L7), Yingu(KI10), Shuiquan (KI5), Liangqiu (ST34), Tianzong(SI11), Qihai(CV6), Guanyuan(CV4), Fenglong(ST40), Zigong(Extra22).
3. Dampness-heat (3 cases): Qihai (CV6), Sanyinjiao (SP6), Yinbai(SP1), Zhongji(CV3), Yinlingquan(SP36).
4. Qi deficiency (2 cases): Pishu (B20), Qihai(CV6), Shenshu(B23), Zusanli(ST36), Sanyinjiao(SP6), Baihui(GV20), Guanyuan(CV4), Geshu(B17), Jiaoxin(KI8).
5. Yang deficiency (2 cases); Shenshu (B23), Guanyuan(CV4), Fuliu(KI7), Sanyinjiao(SP6), Qihai (CV6), Mingmen(GV4).
The acupuncture treatment of uterine fibromyomas has produced good results. After the treatment the fibromyomas were getting smaller in 12 cases (66%). Pelvic pain, edema, urinary and intestinal symptoms were significantly reduced in all cases. The results show that acupuncture is an effective therapy for uterine fibromyomas without any side effects.

Clinical Research & Application
ENT & Ophthalmology

A CLINICAL OBSERVATION OF 50 PEDIATRIC CASES OF RECURRENT
ALLERGIC RHINITIS WITH VACCARIA SEEDS PRESSING ON EAR POINTS

Maria Rosa SPERONELLO, Carlo CARMIGNOLA
Istituto Prosa. Via Rossignago, 32, 30038 Spinea-VE, Italy.

The pediatric patients with allergic respiratory diseases tend to increase in Italy. Usually children don't want to receive acupuncture treatment, for this reason the authors have suggested to treat with Auricular Point Pressing Method (APPM).
50 pedicaric patients between the age of 4 to 14 years old, suffering from allergic rinithis have been treated from February 1993 to June 1996 with APPM. The authors divided the children into two groups according to the symptoms: Group 1 patients with allergic rhinitis and ocular problems and Group 2 patients with allergic rhinitis and lower respiratory tract problems. Main points selected were: Fengxi, Pingchuan, Neibi, Fei. Auxiliary points selected were: Erjian, Shenshangxian, Waibi, Yan, Ershenmen, Gan, E. The selected points were treated with Vaccaria seeds covered by plaster. It was suggested to massage the points at least 3 times a day for 2 minutes on every point. Each time 4 to 5 points were selected.
The authors treated the patients in two different periods of the year: during spring time for pollen rhinitis, while in winter time for mite dust rhinitis.
The APPM has been well accepted by children and parents, and it is easy to work with and immediately effective.

Clinical Research & Application
ENT & Ophthalmology

A THERAPY OF GLAUCOMA BY ACUPUNCTURE AND
CHINESE HERBAL MEDICINE ¡ªCLINICAL ANALYSIS OF 68 CASES

Lucio PIPPA1,2,3,4, Camillo SCHIANTARELLI1,2,3
1University of Medicine. Via P.A. Valignani, 66100, Italy.
2Gathering of Italian Acupuncture Schools Member of the Italian Federation of Acupuncture Associations.
3Italian School of Chinese Medicine, Gruppo di Studio "Societa e Salute".
4Italian Society of Chinese Herbal Therapy.

Aim: According to the standard Western medicine definition, glaucoma is a disease characterized by arisen intra-ocular pressure (IOP, higher than 21 mmHg); according to TCM, glaucoma is referred to as "Liu Feng Nei Zheng". Among the variants classified on different etiopathogeneses, we chose to analyze the one caused by kidney and liver Yin deficiency with liver Yang rising. We used a therapy by means of acupuncture as well as Chinese herbal medicine, and observed its effects.
Methods: We studied 68 patients between the age of 60 and 75 years old. Forty of them were female and 28 were male. All of them had the bilateral glaucoma caused by kidney and liver Yin deficiency, and an intra-ocular pressure in the range of 26 to 50 mmHg. All patients were on a Western medicine regimen consisting of miotic (pilocarpine) or ¥â-blocker (timoptol) eye drops. All patients were treated with a course of 10 twice-weekly, 20-lasting acupuncture sessions, and with 8 Qi Ju Di Huang Wan (Lycium-Chrysanthemum-Rehmannia Pill) t.i.d., given early before meals, for as long as patients were treated by acupuncture.
Results: Improvements were observed in 56 patients (82.4%). Excellent outcome was recorded in 51 patients (75%), who showed IOP normalization and became symptom-free without the help of Western remedies. Good results were observed in 5 more patients (7.4%), whereas no appreciable result could be seen in the remaining 12 patients (17.6%). Unmodified figures were scored in 6 months of following up.
Conclusion: Our results support the view that combining acupuncture with Chinese herbal medicine turns out to be quite effective in diseases caused by kidney and liver Yin deficiency with liver Yang rising. We observed our best results in patients aged 60 to 70, with an IOP 30 mmHg.

Clinical Research & Application
ENT & Ophthalmology

A CLINICAL STUDY ON GLAUCOMA TREATED BY A COMBINED THERAPY (DRUGS AND PLUM BLOSSOM NEEDLE) VERSUS A SIMPLE DRUG THERAPY

Stefania CONTI1, Filippo CRUCIANI2, Alfio BANGRAZI1, Corrado BALACCO GABRIELI2
1Istituto Paracelso. Viale di Trastevere, 281, 00153 Rome, Italy.
2Cattedra di Ottica Fisiopatologica, II Div. di Clinica Oculistica, Policlinico Umberto I. Rome, Italy.

Aim: A typical case-control clinical study was performed, in order to check the effectiveness of the Plum Blossom Needle therapy in treating glaucoma.
Methods: 30 patients affected by simple chronic glaucoma (tonometric values ranging between 25 and 20 mmHg) already receiving medical treatment, were randomized in to 2 groups: 15 patients continued the therapy in progress (control group); 15 patients, besides the drug therapy, received the Plum Blossom Needle treatment as follows: 3 therapeutic courses, 10 times each one, twice a week, with 1 week rest between one course and another.
Results: At the follow-up 2 months later, the tonometric values checked in the 2 groups have been compared.

Clinical Research & Application
Diagnosis Methods in Acupuncture

A SOFTWARE TOOL FOR DIAGNOSTIC AND THERAPEUTICAL SUGGESTIONS IN ACUPUNCTURE

Maurizio CHIAROLINI, Macro ANZOVINO
So-WEN sri, via Soperga 36, 20100 Milano, Italy.
SKYLINE sri, via Manzoni 1, 24121 Bergamo, Italy.

Aim: The proposed system is a program for personal computer conceived of providing the acupuncture treatment with the necessary support to the activities of collecting, consulting and managing the patients' clinical data. The software is also able to suggest the set of the acupoints that are potentially useful for the therapy, allowing the user to save them in a specific database for further elaborations.
Methods: The underlying conceptual data model is based on the idea of transforming the information obtained during the phases of anamnesis and clinical examination to a set of structured observations or assertions. The predefined values of such assertions are located in 3 maps that refer to the symbols of sky (time), earth (space), and man (individual). Each map consists of 4 headings in an analogy to the 4 cosmic elements (air, fire, water, and earth), each of which is widened horizontally by 12 voices that correspond to a numerological scan of the essential energy in progressive rhythms from 1 to 12. The diagnostic hypothesis consists in matching the principal 12 meridians with 12 voices.
Results: The elaboration of the assertions shows the most scored meridians; besides, the user can choose the therapy according to 4 needling suggestions that are mainly based on Shu acupoints.
Conclusion: The proceeding traditional approach consisting in the iteration of the 4 phases (in terms of anamnesis, clinical examination, diagnosis and therapy) is integrated by an "analogical" or "associative" approach. In this approach, the process of formalization of an assertion represents anamnesis and clinical examination, and the process of extraction of the meridians and of the acupoints represents respectively the diagnosis and the therapy.

Clinical Research & Application
Therapeutic Methods & Acupoints

HEAVENLY STEMS AND EARTHLY BRANCHES:
ACTIVITY OF THE SHU POINTS AND THEIR USE IN THERAPY

Macro MAIOLA, Lara LAUER
C.S.S.A. ¡ª SO WEN. Via Soperga N.36, Milano 20127, Italy.

Aim: The aim of this work is to evaluate the energetic activity of the Shu points(related to the energetic cyclicity of the heavenly stems and earthy branches) in order to see whether their use is possible in therapy through kinesthetic trials and by means of electromedical equipment.
Methods: Approximately 400 patients were tested using the two Shu points that, depending on the day and on the hour, should have had a greater energetic activity in that particular spatial-temporal situation. Of these 400, about 100 were selected and subsequently treated with acupuncture on the day most energetically suitable for each of them, employing the two Shu points chosen using the spatial-temporal criterion mentioned above.
Results: The results, mainly positive even from a prognostic point of view, are being studied further and are to be completed. However, it can already be concluded that there is definitely a relationship between the heavenly stems, earthly branches, and through the Shu points of Man. It is also usable in thearpy.

Experimental Research
Meridians & Acupoints

OBSERVATIONS ON THE EFFECTS OF ACUPUNCTURE AT NEIGUAN (PC6)
ON THE LEFT VENTRICLE FUNCTIONS OF NORMAL SUBJECTS

Maria Rosaria STORNAIUOLO1, Aldo LIGUORI2, Maria Rosa SPEROnELLO3,
Gianluigi DI MURO4, Lucio MOS4
1AIAM - Associazione Italiana di Agopuntura-moxibustione e Medicina tradizionale cinese.
Via O. Regnoli 8, 00152 Rome, Italy.
2Istituto Parracelso. Viale di Trastevere, 281, 00153 Rome, Italy.
3Istituto Prosa. Via Rossignago 32, 30038 Spinea (VE), Italy.
4Servizio di Cardiologia, Stabilimento Ospedaliero di S. Daniele del Friuli. S. Daniele Del Friuli, Italy.

Aim: The acupuncture stimulation at points has a regulatory action of bi-directional nature on the function of internal organs. Some report have shown that acupuncture at Neiguan (PC6) can reduce the degree of tissue lesion, caused by myocardial ischemia, can induce a protective action on ischemic myocardium and promote its recovery processes. The purpose of this experimental work was to analyze the cardiovascular response of healthy persons after acupuncture stimulation of Neiguan (PC6). By means of non-invasive methods, the mechanical and the electrical aspects of the left ventricular functions have been studied, by echocardiogram and by long-lasting dynamic Holter electrocardiogram, respectively.
Methods: 38 subjects were divided into two groups, 15 males and 23 females between the age of 24 and 64 years old. The first group (20 subjects) was treated by acupuncture by acupuncture stimulation, the second group was used as control without any treatment. The neiguan point was punctured slowly to a depth of a cun by reducing manipulation. The needle was tretained for 20 minutes. It was only twirled once or twice to maintain a proper needling sensation. Cardiac frequency values were measured immediately after treatment (t=0) and then at 1, 3, 5 and 10 hours respectively. The same measures were taken in the control group. All the measures were done at 8:30 a.m. ¡­ 9:00 a.m. and 7:00 p.m. ¡­ 7:30 p.m.
Results: The results from the control group showed no significant variation of mean values of the cardiac frequency in the time span but the treated group showed a significant variation (p<0.05) in the first 3 to 5 hours after acupuncture, with evident bradycardia while the trend was to recovery the initial values in the next hours. The echocardiogram parameters before and after acupuncture did not show significant variations (that means the acupuncture only regulated the function but not the structure of the heart.
Conclusion: We suggest that the acupuncture stimulation of Neiguan (PC6) to be used for care of the functional disorders of cardiac activity such as tachycardy with a high emotional component.

Experimental Research
Immunity & Neuroendocrine Effect

THE STATE OF THE ART ON THE EFFECTS OF ACUPUNCTURE-MOXIBUSTION
ON THE IMMUNE SYSTEM: A LITERATURE REVIEW

Laura GUARDIA, Pina SECRETI, Filomena PETTI
AIAM. Via O. Regnoli 8, 00152 Rome, Italy.

Aim: Authors carried out a review of both Chinese and Western scientific literature of the last ten years and reported the state of the art about the effects of acupuncture-moxibustion on the immune system.
Results: Positive modulation of immune response is achieved by means of chain activations of neuro-endocrine-immune network. Stimulation of specific acupoints lets central nervous system (CNS) release endogenous opiate OLP (bEK, ENK, LEK, MEK) and neurotransmitter (VIP, SP, etc.) linked to receptors situated on T-lymphocytes. T-lymphocytes are the very privileged target of neuromodulation action of acupuncture. An increase of cell-mediate immunity is reported after the treatment. Peculiar is the increase of EaFRC which represents the morpho-functional aspects of activated T-lymphocytes. Other effects induced are: (a) increase of blastogenesis and lymphocytes subpopulations; (b) development of humoral immunity; (c) unspecific stimulation of cytotoxicity antibody-dependent with an increase of phagocytosis. Studies on this matter report that acupuncture and moxibustion have a different role of regulation and re-balancing depending on starting conditions: in healthy bodies they stimulate immunity functions in a physiologic range, while in ill bodies they stimulate immune response and optimize altered values by correction of functional excess or deficiency.
Conclusion: Acupuncture and moxibustion can be used in prevention and therapy of immunity disorders and in viral infections without side effects to restore physiological homeostasis.

Literature Review & Acupuncture Theory
International Survey

ACUPUNCTURE: A NEW INTERNATIONAL LANGUAGE IN MEDICINE
A BIBLIOGRAPHIC STUDY FROM MEDLINE ON SILVERPLATTER OF PUBLICATION YEAR 1994

Xiaosong ZHUO
Dept. of Respiratory Diseases, University of Parma. Via Rasori 10, 43100 Parma, Italy.

Aim: The study is to investigate the world-wide extension of acupuncture by means of an literature analysis.
Methods: Using the term "acupunct*", the author searched all 87 references from MEDLINE on SilverPlatter of Publication year 1994. MEDLINE of U.S. National Library of Medicine is bibliographic database from more than 3200 journals, approximately 75% of the articles are in English. Its language spectrum is 28 languages.
Results: The countries and languages of these 87 publication are shown as below:

Table 1: Acupuncture references and country of publication

Table 2: Acupuncture references and language of article

The references of acupuncture on MEDLINE 1994 are published in 16 countries with 11 languages, only 63.2% in English, comparing with 75% of all references in English.
Conclusion: The bibliographic analysis result indicated that acupuncture becomes a widespread phenomenon over the world.

Literature Review & Acupuncture Theory
International Survey

A SURVEY ON THE STATE OF RESEARCHIN ACUPUNCTURE AND TCM
WORKED OUT FROM THE WFAS CONGRESSES

Diamantine G. RACCAH, Alfio BANGRAZI
Istituto Paracelso. Viale di Trastevere,281, 00153 Rome, Italy.

The survey aims to outline a comprehensive picture of Traditional Chinese Medicine (TCM) research throughout the world, using the WFAS conferences as a most significant source for number of papers, scientific level and advanced achievements. We plan to classify the abstracts and work out the data relative to the following areas:
Effects of TCM on single pathological ambits Studies on acupuncture-anesthesia
Areas of application of the different methods New methods and emergent techniques
Studies on acupoints and meridians Study on TCM history, theory and literature
By integrating available data wherever possible and by identifying deficient areas that need further study, we shall try to lay the foundation of a work that, from a wide variety of many single works, starts focusing some coherent ideas and evaluations on the state of research in acupuncture and TCM.
This survey might continue in the future years integrating new information as it will emerge from future congresses, assuming it is important not only to start new studies, but also to have wide statistics and comprehensive results, since only in this way we can assert the value of acupuncture.
We also hope that this survey can become an instrument we can use to have clearer ideas in selecting our research areas, enriching poor data, integrating results. Obviously research must meet domestic requirements of each country, yet it would be useful to gave one eye directed to evaluate in which way our single activity can increase and improve TCM research worldwide, with the objective to offer a valuable contribution to strengthen acupuncture as a weapon to win the battle against disease.

Literature Review & Acupuncture Theory
Advance of Acupuncture & Meridian Research

POSSIBLE CORRELATIONS BETWEEN ACUPUNCTURE EFFECT
ON IMMUNE RESPONSE REGULATION AND PERIODONTAL DISEASE:
A DOCUMENTARY RESEARCH

Roberto CARELLI, Alberto FERRAR
Istituto Paracelso. Viale Trastevere, 281, 00153 Rome, Italy.

Introduction: Foetus antibody ability versus maternal oral plaque antigens constitutes an acquired datum in international literature, less clear results foetal lymphocytes sensibilization modality. The newborn and infant will observe a gradual immunity system maturation up to the age of twelve years; adult potentiality is gained in different ages of life in relation to different immunue responses (B lymphocytes, T lymphocytes, compement). It seems anyway that there exists a close time relation between physiologic ipogammaglobulinemy, that results on maternal IgG clearance, infant antibody production, sensibilized lymphocytes presence and bacterial colonization on erupting primary teeth. Antibody and sensibilized lymphocytes role in oral bacterial colonization will have pound on microbic population balance. The weak balance oral plaque-immune defence can undergo, during life, a number of alterations linked to many variables: an example is constituted pregnant women gingivitis, that will develop in progesterone-relating epulides.
Materials and Methods: AA conducted a documentary research on two topics, i.e. the acupuncture immunoregulating effect on one side and the role of the immune system on periodontal disease pathogenesis. The research moves on by the intuition that acupuncture can stop periodontal disease pathogenesis modulating and balancing those immune system functions that, although useful and adequate in early and starting phases, can sustain or grow worse illness. AA's purpose is to inspire research in the suggestive hypothesis of revolutionalizing the therapeutical approach in periodontal disease.
Results and Conclusions: Review of the international literature permits to state that more studies are necessary to find a therapeutical correlation between acupuncture immune response regulation and periodontal disease pathogenesis.

Literature Review & Acupuncture Theory
Advance of Acupuncture & Meridian Research

REVIEW ON PRESENT SITUATION OF B AND C HEPATITIS
TREATED BY ACUPUNCTURE

Linda MILLE1, Alessandro CAIOLA2, Filomena PETTI1
1Istituto Paracelso. Viale di Trastevere, 280, 00153 Rome, Italy.
2AIAM-Associazione Italiana di Agopuntura e Medicina tradizonal cinese. Via Oreste
Regnoli, 8, 00152 Rome, Italy.

The authors' aim is to evaluate the situation of acupuncture effects in the treatment of B and C viral hepatitis, summarizing all data produced in the last 15 years (although the amount of papers is small, the case-report under examination is rather high, more than 1000 cases).
In the 30% of papers examined, hepatitis is considered according to Traditional Chinese Medicine as "heat-dampness in the Liver and Gallbladder"; in 20% it is subdivided in various syndromes, so the acupuncture points are accordingly selected.
Laboratory tests were carried out in order to evaluate the hepatic function (GPT, icteric index, etc.), or to identify the responsible virus (HbsAg) and, in the 20% papers, to evaluate the cell immunity.
The control groups were formed by: patients treated with Chinese herbs (20%); patients treated with B and C vitamins (40%); not treated patients.
The effectiveness of the treatment is evaluated on the basis of the improvement of symptoms and of laboratory data.
In 90% of the papers, results are more satisfactory in acupuncture groups, compared with the control groups; the negative HbsAg response and the functional recovery of the liver occur more often and in a shorter time.
The conclusions of papers about the acupuncture mechanism in the treatment of hepatitis are mainly based on the regulation of immunologic system, particularly of the cell immunity.
The authors consider the data reported by Chinese authors self-explanatory and very interesting, but research methodology in Western countries should require a controlled research versus patients treated with interferon, broadly used out of China for the treatment of hepatitis.

Literature Review & Acupuncture Theory
Acupuncture Theory

PHYSICO-MATHEMATICAL FORMULATION AND CLINIMETRY
OF CHINESE ACUPUNCTURE

Mauro Angelo CODIFAVA, Elisa COCCHI
China Acadmy of Science. Italy.

Aim: In accordance with relativistic physics, quantum mechanics, set theory, mathematical logic and clinimetry, the authors decode acupuncture after a universal physico-mathematical model.
Methods: A clinimetric chart, applied to large number of cases for more than a decade, sums up the individual energy level (IEL), the percentage of energy in the patient and the correlation among the patient's IEL, percentage of energy, biological and lifetime.
Results: Starting from the intensity of pain at the moment of examination (IP1) and after a course of 5 acupuncture treatment sessions (IP2), the authors have elaborated the quotient of therapeutic efficacy of acupuncture (QTEA).
Conclusion: The universally valid and rigorously scientific language of physics and mathematics expresses acupuncture in an extremely precise way, clearing the ground from vague terminologies so widespread both in China and in the West, and restoring acupuncture in the domain of real science.

Literature Review & Acupuncture Theory
Acupuncture Theory

REVIEW ON THE MEDICAL LITERATURE CONCERNING ACUPUNCTURE EFFECTS IN THE TREATMENT OF FROZEN SHOULDER, CARPAL TUNNEL SYNDROME, TENOSYNOVITIS, STIFF NECK AND TENNIS ELBOW

Michael HELD, Antonio MAIELLO, Aldo LIGUORI
AIAM-Italian Association of Acupuncture-Moxibustion and TMC. Via Oreste Regnoli, 8, 00152 Rome, Italy.

The authors have studied the medical literature of the last ten years concerning the following diseases: frozen shoulder, carpal tunnel syndrome, tenosynovitis, stiff neck, tennis elbow. The case-report includes 3318 cases. In 34.8% of the works the diseases are subdivided in syndromes according to the patterns of the Traditional Chinese Medicine. The main acupoints and the techniques of manipulation of the needles were selected according to the differentiation of the syndromes. In the remained 65.2% of the works the different diseases are described only in patterns of the Western medicine and the typical symptomatology; these diseases were treated with the same main acupoints and with auxiliary points selected according to the symptoms. In 82.6% of the works the patients were treated with acupuncture; in 17.4% of the works other treatments were adopted (Chinese herbs, techniques of Chinese massage, magnetotherapy, Western medicines), or alone or in combination with acupuncture. The therapeutic efficacy is estimated on the basis of the disappearing of the symptomatology. The total effective rate was 92.1%, only in 7.9% of the cases the treatment showed no positive effects. These results reveal the high therapeutic efficacy of acupuncture in these diseases. To achieve more significant outcomes according to the Western research methodology, it would be useful to repeat the above named studies versus groups of patients treated with conventional medicines and techniques usually adopted in the Western countries.

Literature Review & Acupuncture Theory
Acupuncture Theory

A REVIEW OF THE RESEARCH IN CHINESE AURICULAR THERAPY

Fabio ZAMPIERI, Maria Rosa SPERONELLO
Instituto Prosa. Via Rossignago, 32 Spinea Venice, Italy.

Aims of present study are: (1) To take an overall picture of research in Chinese auricular therapy at an international level, mainly through an analysis of the scientific reports presented in the WFAS World Conferences. (2)To analyze therapeutic and diagnosis relevance of auricular therapy. (3) To examine main problems related to the locations of points. (4) To evaluate a possible wider use of auricular therapy.
It takes into examination the results of basic and clinical research, going through data relative to different pathologies, overall efficacy rates; it analyzed the contribution given by diagnosis, main sign, related problems, etc.
Also it makes into examination the main problems related to the objective locations of ear points, finally it shows the most common methods used in diagnosis and treatments, needling, vaccaria seeds, moxibustion, massage etc.
Chinese auricular therapy is an important diagnostic and therapeutic instrument, it is easy, inexpensive, less painful and with a good therapeutic efficacy rate.

Qi, Qigong, Daoyin & Massage

THE TREATMENT OF WHIPLASH OUTCOMES
WITH TCM COMPLEMENTARY TECHNIQUES
(TUINA-ANMO, AI ZHU JIU, MEI HUA ZHEN, BA HUO GUAN, ER YA LIAO FA)

Carlo CARMIGNOLA
Instituto Prosa. Via Rossignago, 32 Spinea, Venice, Italy.

The whiplash is a kind of trauma rather frequent; in most cases there is a lesion of the muscle-tendinous and ligamental structures of the tract between the cranial basement and the first dorsal vertebare; there are seldom bone lesions. The usual treatment, when there are no bone lesions, is a period more or less long (from 10 to 30 days)of cervical tract immobilization with Schanz's necklace (or similar) and subsequent physiotherapy.
The work shows as in cases where there are no fracture, it is possible, using TCM complementary techniques, to intervene immediately after the trauma in order to:
promote a more rapid functional recovery of the traumatized area reducing the time of use of the necklace
eliminate in a short time the painful symptomatology and other symptoms as dizziness, vertigo, nausea that often appear after trauma and that cause a general bodily discomfort condition.

Qi, Qigong, Daoyin & Massage

AN ANTI-HYPERTENSIVE EFFECT OF QIGONG: A STUDY OF 8 CASES

Lorena TASSI, Aldo LIGUORI
Istituto Paracelso. Viable die Trastevere, 281, 00153 Rome, Italy.

A 2-year study (1993¡­1994) was carried out to observe the anti-hypertensive effect of Qigong in 5 patients (4 males and 1 female) affected by essential hypertension. The achievements of this study were reported at the WFAS '95 Symposium on Acupuncture and Qi in Istanbul, Turkey. The research work went on throughout 1995 and 3 new patients (2 males and 1 female) joined the group later. Patients' age ranged between 45 and 68 years old, the average course of disease was 9 years. The patients were all taking Ca-antagonizers(medium dosage) with unsatisfactory results and refused other anti-hypertensive drugs. They regularly practiced a series of specific Qigong exercises developed by the Qigong Research Institute of Shanghai, twice a day for 12 to 14 months while continuing the drug therapy. The results obtained demonstrate that the daily practice of Qigong exercises for a minimum of 12 months is effective in controlling the blood pressure. Moreover, 3 patients gradually improved and finally stopped the intake of anti-hypertensive drugs.

Basic Theory of Traditional Chinese Medicine

EPISTEMOLOGICAL MEANING OF TRADITIONAL CHINESE MEDICINE

Ciro D'ARPA1, Pierluigi GIORDANO2, Daniele LA BARBERA1,2, Evelinda PRETI1,2,
Antonella COMPAGNO1, Angela LENTINI1
1A.I.A.M. - Italian Association of Acupuncture-moxibustion and Traditional Chinese Medicine.
Via Libert , 103, 90143 Palermo, Italy.
2Institute of Psichiatry, Palermo University. Italy.

TCM theories stick to a happy medium between inclusiveness and delimitation, that is the reason for their persistence over thousand of years, contrary to more inclusive and not delimited theories(peculiar to the European Middle Ages tradition as an example) that lost their power of application, or contrary to more delimited and not much inclusive theories (peculiar to the present Conventional Medicine for instance) that quickly become obsolete.
The scientific system of TCM probably is the most tested and documented scientific system in all human history.
It can act as a pattern for the evolution of every Modern Science, provided that it is presented in its whole reality, consisting of postulates, prototheories, theories and models, and clinical data.
Authors make a proposal to increase the state of "epistemological maturity" in which we find the modern TCM.

Basic Theory of Traditional Chinese Medicine

HUN AND PO: FUNCTIONS AND DIAGNOSIS

Elisa M. ROSSI, Laura CARETTO, Gianfranco MORELLI
MediCina, Associazione di Studio e Ricerca in MTC. Viale Bligny 29, 20136 Milano, Italy.

Aim: This study is developed from a work on the diagnosis of Shen. It investigates Hun and Po (concepts developed in medical history), links with different traditions(Taoist, Buddhist and Confucian thoughts), signs and symptoms to differentiate a diagnosis, the significance as an etiological factor, the interaction in pathogenesis, and approaches in treatment.
Methods: A direct textual research on original medical literature was conducted in an attempt to outline the concepts of Hun and Po in Chinese medical tradition. The semantical spectrum covered by the words Hun and Po as they occur in classical medical texts has been analyzed, especially with a focus on the Huangdi Neijing tradition (different compilations and commentaries). Modern Chinese and Western literature on the subject has been consulted. When deemed necessary for a better understanding we have taken into account a broader philosophical and cultural background, by enlarging the view to other coexistent cultural traditions.
Results: The pair Hun-Po relates to other pairs such as Yi-Zhi, Jing-Shen, Qi-Xue, Hun-Po represents two opposite poles: Hun moves in a field closer to mind, to the activity of images and dreams, while Po is more involved in the organization of body life, in the functions of movement and sensitivity.
Conclusion: From traditional medical models and from different philosophical lineages we see the importance of Hun and Po in human psychic and somatic life. Concepts of this pair offer a theoretical basis and practical references to read emotions and somatic expressions, trace their connections, and work on the possibility of change in pathological conditions.

Clinical Research & Application
Pain Management & Osteotraumology

ACUPUNCTURE TREATMENT OF ALGIC LOIN SYNDROME BASED UPON
DIFFERENTIATION OF SYNDROMES VS. TREATMENT ON HUATUO JIAJI POINTS

Maria Concetta DE FRANCISCI1, Marina LO GIUDICE2, Antonino RENDA2,
Domenica TRAPANI1, Rita Anglea VIVOLI1, Ernesta BACARELLA1, Letizia MARRAFFA1, Calogero AGRO1, Ivana VOCASKOVA1
1AIAM - SECT. SICILY.
2AZIENDA OSPEDALIERA VILLA SOFIA-C.T.O. PALERMO.

Sixty patients with algic loin syndrome were divided into two groups: (a) thirty patients were treated with pervious differentiation of syndromes as follows: Kidney-yin deficiency, Kidney-yang deficiency, Invasion of cold/dampness, and Trauma; (b)thirty patients were treated with acupuncture on Huatuo Jiaji points.
Each patient has been evaluated by 4 standards: pain, parestesis, reflexes, functional limitation as distance of the finger-tips to the floor less or equal 5 cm.
The differentiation of syndromes group obtained improvements of symptomatology especially for functional limitation, whereas in the Huatuo Jiaji points group obtained less positive results.

Basic Theory of Traditional Chinese Medicine

THE RELATIONSHIP BETWEEN FIBERGASTROSCOPIC PICTURE
AND TONGUE INSPECTION

Pellegrino BUSTERNA, Massimo CAMMARATA, Giovanni VETRO, Maria BILLERI,
Antonino PARUTA, Maria CHINNICI, Larta PIRICO
AIAM SEC. Sicily.

The relationship between fibergastroscopic picture and tongue inspection is discussed in 250 subjects. Among the 250 cases, 150 were males and 100 females, a ratio of 3 to 2. Their ages ranged from 18 to 85 years old; 48 cases were under 30, 178 were between 31 and 60, and 24 were over 60.
Fibergastroscope of type Olympus GIF-Q 20 was used. Red tongue and dark red tongue were found in most of the cases (155, or 62%); the coatings of the tongues were mostly yellow (135, or 54%). Yellow tongue coating is found to be related to edema, congestion, erosion, ulcer and bleeding of the gastric or duodenal mucosa, the pale tongue to pallor of gastric mucosa, the dark red tongue to congestion and erosion or ulcer of the gastric or duodenal mucosa.