Terje Alraek1, Anders Baerheim. 1. Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, Bergen, Norway. terje.alrek@isf.uib.no
Abstract
OBJECTIVE: To evaluate how the effect of acupuncture treatment in recurrent cystitis relates to Traditional Chinese Medicine (TCM) diagnostic categories and physiologic measurements. SETTING/LOCATION: Two private acupuncture clinics in Bergen, Norway. Measurements were carried out in Haukeland University Hospital, Bergen. DESIGN AND SUBJECTS:Ninety-eight (98) cystitis-prone women were randomly assigned to acupuncture treatment or no treatment. Main effect parameter was number of cystitis during 6 months observation time. Residual urine was measured with an automatic Bladder Scan 2500 (Diagnostic Ultrasound Corporation, Bothell, WA) at baseline, 2, 4 and 6 months. RESULTS:Twenty-two (22) patients had Spleen yang/qi xu (Sp), 18 Kidney yang/qi xu (Kid), and 18 Liver qi stagnation (Liv). Of the Kid group, 78% were free of cystitis (irrespective of bacteriuria) during the observation period compared to 45% in the Sp group, 44% in the Liv group (p < or = 0.05, Kid versus Sp and Liv), and 17% in the nontreated group (p < or = 0.01, versus all treated patients). One sixth as many episodes of acute cystitis occurred in the Kid group compared to the nontreated group (incidence rate ratio [IRR] = 0.15, 95% confidence interval [CI] 0.05-0.42, p < or = 0.001). Similarly, we found IRR = 0.49 (0.25-0.83) in the Sp group and IRR = 0.42 (0.21-0.80) in the Liv group. Subanalyzing for cystitis with detected bacteriuria yielded comparable results. Kid patients significantly reduced their residual urine from baseline to 6 months (36.4 mL versus 12.9 mL, p < or = 0.05). The reduction was less and nonsignificant in Sp and Liv groups (31.5 mL versus 22.2 mL, 36.4 mL versus 16.7 mL, respectively). Residual urine remained unchanged among nontreated patients. CONCLUSION: Our findings show a better acupuncture treatment effect on Kidney yang/qi xu than on other TCM syndromes found in women with recurrent cystitis. This has practical implications, and highlights the need for considering different TCM diagnostic categories in acupuncture research.
RCT Entities:
OBJECTIVE: To evaluate how the effect of acupuncture treatment in recurrent cystitis relates to Traditional Chinese Medicine (TCM) diagnostic categories and physiologic measurements. SETTING/LOCATION: Two private acupuncture clinics in Bergen, Norway. Measurements were carried out in Haukeland University Hospital, Bergen. DESIGN AND SUBJECTS: Ninety-eight (98) cystitis-prone women were randomly assigned to acupuncture treatment or no treatment. Main effect parameter was number of cystitis during 6 months observation time. Residual urine was measured with an automatic Bladder Scan 2500 (Diagnostic Ultrasound Corporation, Bothell, WA) at baseline, 2, 4 and 6 months. RESULTS: Twenty-two (22) patients had Spleen yang/qi xu (Sp), 18 Kidney yang/qi xu (Kid), and 18 Liver qi stagnation (Liv). Of the Kid group, 78% were free of cystitis (irrespective of bacteriuria) during the observation period compared to 45% in the Sp group, 44% in the Liv group (p < or = 0.05, Kid versus Sp and Liv), and 17% in the nontreated group (p < or = 0.01, versus all treated patients). One sixth as many episodes of acute cystitis occurred in the Kid group compared to the nontreated group (incidence rate ratio [IRR] = 0.15, 95% confidence interval [CI] 0.05-0.42, p < or = 0.001). Similarly, we found IRR = 0.49 (0.25-0.83) in the Sp group and IRR = 0.42 (0.21-0.80) in the Liv group. Subanalyzing for cystitis with detected bacteriuria yielded comparable results. Kid patients significantly reduced their residual urine from baseline to 6 months (36.4 mL versus 12.9 mL, p < or = 0.05). The reduction was less and nonsignificant in Sp and Liv groups (31.5 mL versus 22.2 mL, 36.4 mL versus 16.7 mL, respectively). Residual urine remained unchanged among nontreated patients. CONCLUSION: Our findings show a better acupuncture treatment effect on Kidney yang/qi xu than on other TCM syndromes found in women with recurrent cystitis. This has practical implications, and highlights the need for considering different TCM diagnostic categories in acupuncture research.
Authors: Claudia M Witt; Mikel Aickin; Daniel Cherkin; Chun Tao Che; Charles Elder; Andrew Flower; Richard Hammerschlag; Jian-Ping Liu; Lixing Lao; Steve Phurrough; Cheryl Ritenbaugh; Lee Hullender Rubin; Rosa Schnyer; Peter M Wayne; Shelly Rafferty Withers; Bian Zhao-Xiang; Jeanette Young; Brian M Berman Journal: Trials Date: 2014-05-13 Impact factor: 2.279