Acupuncture To Treat Alzheimer

Acupuncture to treat Alzheimer’s: Results of a pilot feasibility study NB Emerson Lombardo, L Vehvilainen, WL Ooi, L Volicer, G Xu, C McManus, M Dresser, S Lewis, C Laughlin, Wellesley College Center for Research on Women, Wellesley, MA Acupuncture, a core component of Traditional Chinese Medicine (TCM), is becoming recognized as an effective mode of treatment for many chronic ailments including depression, pain, addiction and stroke, with virtually no side effects in competent hands. One recent Chinese matched controlled study of Vascular Dementia (VD) using Western diagnoses and outcome measures showed substantial and statistically significant improvements in cognition. As yet, no published report exists of a randomized clinical trial (RCT) of the effects of acupuncture on Alzheimer’s Disease (AD), vascular or other dementias. Analysis of data from the Wellesley small feasibility study (no controls) demonstrated that acupuncture is feasible for American AD and VD subjects. All 11 subjects, 10 with AD and 1 with VD, completed at least 22 treatments during a three month, twice a week, acupuncture intervention. We found statistically significant ( p < .05) improvements in mean depressive and anxious mood symptoms, confirmed with multiple measures, including the Cornell Scale for Depression in Dementia, Spielberger State Anxiety Scale, the tension subscale of the Profile of Mood States and the Anxiety subscale for the SF-36. These subjects also experienced insignificant cognitive decline, from an average Mini-mental Status Exam (MMSE) score of 21.9 to 21.3. Two of four subjects who experienced substantial improvement in mood symptoms also improved in MMSE scores (from 15 to 20 and 17 to 21) and in some of the other cognitive measures. A third improved in tests of fluency and naming ability, while MMSE scores remained stable. In addition, we found statistically significant improvements in subjects’ energy or vitality, listening ability, and sociability, based on caregiver report. There was also a trend towards fewer mood-related behavioral symptoms. In the realm of ADL and IADL functioning, while there was no statistically significant decline, there was a suggestion that the trend was toward decline rather than improvement. Table 1: Result of Paired T-Tests of Anxiety,Depression and Cognition Measures N=11 Anxiety

Depression

POMS Spielberger Cornell Baseline Mean (S.D.)

8.8 (6.3)

Cognition

GDS

MMSE

BNT

FAS

49.5 (8.4)

6.4 (5.0)

7.4 (3.9)

21.9 (5.2)

50.8 (19.8)

25.4 (17.1)

Post Test Mean (S.D.)

4.6 (3.4)

40.1 (8.0)

3.1 (3.0)

6.7 (7.0)

21.3 (4.9)

48.0 (19.1)

25.5 (17.9)

p value Paired T test*

0.050

0.005

0.011

0.358

.646

.588

.968

*One-tailed test for mood (predicted improvement) Two-tailed in cognition (no prediction)

Efficacy Study of Acupuncture and Chinese Herbs for HIV Treatment Neal Miller, L. Ac., Studio City Oriental Medical Center Jin Lin Wang, L. Ac., M.D. (China), Oriental Medical Center Abstract. This study investigates the efficacy of Acupuncture and Chinese Herbs in the treatment of HIV. Building upon two previous investigations, we wanted to add acupuncture with herbs in the study and to use HIV-RNA tests as a measure. Other measures consisted of CD4/CD8 counts, clinical evaluations of symptoms (low-grade fever, night sweats, body weight change, diarrhea, sore throat, fatigue, stress/depression and skin rash). These measures were assessed before treatment and at 4, 8, 12 and 24 weeks into treatment. Also, before treatment and then once every month of treatment, we had a chemistry panel assessed for each study participant. Treatment consisted of twice weekly, 30 minute acupuncture sessions and two herbal formulas. One formula addressed immune system improvement and the other was an antiviral formula. Both formulas remained static throughout the study. Forty-six patients completed the 24-week treatment. Overall, they experienced considerable improvement in or disappearance of symptoms. Seventy percent of patients gained weight. Upon completing their participation, 67 percent of the patients (No. = 31) had stable or increased (Mean of 108.16 points) CD4 counts. Thirty-three percent (No. = 15) experienced decreased CD4 counts (Mean of -114.4 points). Sixty-one percent of the patients (No. = 28) decreased (Mean of -1.01 log) or remained the same in viral load. Thirty-nine percent (No. = 18) experienced increased viral load (Mean of +0.74 log). Acupuncture and Chinese herbs created no side effects in HIV patients. It was concluded that acupuncture and Chinese herbs may be an effective alternative for HIV patients desiring to delay conventional HAART treatment or for whom the HAART treatment has failed. Further study may demonstrate that acupuncture and Chinese herbs increase the effectiveness of present HAART treatment when used complimentarily.

A Chinese Herbal Compound for the Treatment of Hepatitis C U. Beyendorff, Hennepin County Medical Center, Department of Medicine, Division of Alternative Medicine, Minneapolis, MN Approximately 3.9 million Americans are infected with Hepatitis C and there are 28,000 new cases reported each year, and 8,000 – 10,000 deaths occur annually. Studies suggest HCV will be the major cause of cirrhosis and liver cancer in the next century, and the number of deaths could triple in the next 10 to 20 years. One quarter of sufferers of HCV are symptomatic with fatigue, joint pains, brain fog, mild GI distress and report significant reduction of quality of life. In Asia, sufferers of viral

hepatitis and other chronic liver diseases commonly seek symptom-relief from herbal medicine. Ulrich Beyendorff, licensed acupuncturist has been treating individuals with HCV and HBV since 1989. This work was the basis for an NIH/NCCAM grant through the Center for Addiction and Alternative Medicine Research and an FDA IND application in 1999. The IND for the herbal compound 3AR was received in July of 1999 and recruitment for the randomized, placebo-controlled study began soon after that. In the study, subjects are being randomized to one of two groups and will consume 10 g per day of the herbal compound or the placebo (both will be taken orally in the form of two tablets) over a 12-week period. There will be a two-month follow-up and standardized quality of life measures will be used as well as laboratory tests. The specific aims of this study are to assess the relative effectiveness of 3AR compared to a placebo; measure changes in health status, including levels of fatigue; assess changes in quality of life and mood states; measure ALT and Viral RNA load levels; and, assess any adverse effects of 3AR. Several of the difficulties in assessing a Chinese herbal approach in a double blind, placebo controlled trial setting will be discussed as will future directions for the study.