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Acupuncture and the Oncology PatientXXX MeetingDate
Nicola Kiely, Physiotherapist, Bon Secours Hospital.
03/10/2015
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Western Acupuncture similar to Chinese acup to a casual
observer.Needles are inserted into the body incl hands and feet,
agitated by hand and sometimes electrical impulses, taken out after
a period of time somewhere bt 5 and 30 mins
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However considerable differencesWA..medical dx made , needles
influence physiology of the body a/c to scientific view and acup
seen as conventional Rx along with drugs or surgery.Traditional
Acup makes dx in terms of a disturbance to the bodys balance which
needs to be corrected with needles.
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Acup. in the West1970s Felix MannMeridians dont exist, points
dont existGate control theory of (Melzack and Wall 1965)Discovery
of Endorphins (Hughes et al 1975)Studies show Acup released the
endorphins (Han &Terenius 1982)
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5 mechanisms to understand WALocal Effects..stim sensory nerve
fibres in skin and muscleCGRPLocal bl vessels to dilate..local bl
flow increasesSuperficial and deep tissue healingAcup promotes
local healing
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Segmental AnalgesiaAction potentials travel up nerve to part
segment in spinal cordDepress activity of dorsal horn reducing
response to paine.g. pain in the knee joint reduced by needling
muscles around the knee as nerves from the knee joint enter same
segment as nerves from the muscles around it.Acup red. pain in the
segment where the needles are inserted
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Extrasegmental analgesiaAction potentials then travel on from
the dorsal horn to the brainstemDescending nerve pathways..
..neurotransmitters suppress painExtrasegmental as not restricted
to a single segmentAcup reduces pain throughout the body
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Central Regulatory effectsAfter reaching the mid-brain , the
action potentials go onto influence other structures..cerebral
cortex, hypothalmus and limbic systemCalming effects and improves
well beingAutonomic nervous system and various female hormones such
as those that control the menstrual cycleAcup has a calming effect
and improves well-being
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Myofascial trigger pointsSmall knots of tight muscle
fibresTenderTaut bandsMvt of muscle restricted by painAcup
inactivates myofascial trigger points
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Patient GroupMainly FemalesWide variety of vasomotor
symptomsMainly Hot Flushes, Night Sweats,Fatigue,Pain,CIPN.
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Some studiesFrisk 2008RCT..45 pts with flushes due to
Tamoxifen..Electroacup vs Hormone Replacementfreq of Hot flushes
reduced by 50%Lee 2009..Cochrane Review..Post-op nausea and
vomiting..Acup using PC6..PC6 stim prevents PONV
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Acup and GabapentinElectro-acup greatest reduction in hot
flushes at end of Rx and 4 months off RxGabapentin similar
reduction while on Rx but not offEA had less side effects to
Gabapentin
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Some points for Hot FlushesLI4TE5LR3SP6ASAD points SternumTo
note.. no needling to the affected side..risk of lymphoedema
avoided
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Hot Flash Composite ScoreFrequency x SeveritySeverity measured
mild, moderate, severe, very severe..score 1,2,3,4.E.g 13 hot
flushes in a day x 3 (severe)=39Measure before and after rxs at
1/12, 4, 8, 12.
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Acup. Service in the BonsImmediate access via GP or
ConsultantReferral letter necessary detailing pt hx and stage of
disease etc..written conset from ptCost same as physio
costTreatments weekly for 6 weeks Minimal ache felt from needlesBig
plus is it is non pharmacological intervention!Time+ with pt
promotes physical and emotional well being
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Thank you for your attention.
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