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Background: Olfactory dysfunction (OD) is a common symptom of Corona Virus Disease 2019 (COVID-19). It is defined as the reduced or distorted ability to smell during sniffing (orthonasal olfaction) and represents one of the early symptoms in the clinical course of COVID-19 infection. A large online questionnaire-based survey has shown that some post-COVID-19 patients had no improvement 1 month after discharge from the hospital. Objective: To explore the efficacy of acupuncture for OD in COVID-19 infected patients and to determine whether acupuncture could have benefits over sham acupuncture for OD in post-COVID-19 patients. Methods: This is a single-blind, randomized controlled, cross-over trial. We plan to recruit 40 post-COVID-19 patients with smell loss or smell distortions lasting for more than 1 month. Qualified patients will be randomly allocated to the intervention group (real acupuncture) or the control group (sham acupuncture) at a 1:1 ratio. Each patient will receive 8 sessions of treatment over 4 weeks (Cycle 1) and a 2-week follow-up. After the follow-up, the control group will be subjected to real acupuncture for another 4 weeks (Cycle 2), and the real acupuncture group will undergo the 4-week sham acupuncture. The primary outcomes will be the score changes on the questionnaire of olfactory functioning and olfaction-related quality of life at week 6, 8, 12, and 14 from the baseline. The secondary outcomes will be the changes in the olfactory test score at week 6 and 12 from the baseline measured by using the Traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC). Discussion: The results of this trial will help to determine the effectiveness of acupuncture for OD in post-COVID-19 patients. This may provide a new treatment option for patients.
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Introduction: Insomnia disorder (ID) and major depressive disorder (MDD) are highly comorbid, above 80% of MDD patients have insomnia disorder. Acupuncture as a major complementary and alternative medicine (CAM) therapy, is utilized extensively in Asia to treat mental health disorders.Transcutaneous electrical cranial-auricular stimulation (TECAS) is a potential new type of acupuncture treatment for MDD and ID which combines the scalp points and auricular points most commonly used by acupuncturists. It has the advantages of portability, quantifiable stimulation parameters and comfort, especially for home treatment under the normal situation of COVID-19, which can avoid the risk of infection due to frequent hospital trips. Materials / Methods: 10 ID-MDD patients were treated by TECAS which was administered at the bilateral auricular acupoints, Bai Hui (GV-20) and Yin Tang (GV-29) (waveform:4/20 Hz, wave width: 0.2ms+/-30%) for twice a day last 8 weeks. Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Rating Scale(HAMD) of ID-MDD patients were evaluated before and after treatment. Result(s): HAMD-17 scores of 10 patients were lower at 4 and 8 weeks than before TECAS treatment, and the reduction was greater at 4 weeks than at 8 weeks. PSQI scores of 8 patients decreased at 4 and 8 weeks compared with before treatment, and the decrease was greater in the fourth week than in the 8th week. Insomnia of 2 patients improved at 4 weeks of treatment, but became worse in the 8th week as before treatment.7 out of 10 patients showed full insomnia response (50% reduction in PSQI) and 8 patients showed full depression response (50% reduction in HAMD-17 scores). Discussion(s): We suggest TECAS is a good therapeutic strategy to modulate the vagus nerve and trigeminal nerve propagate through electrical stimulation projected by neurons from peripheral sites to the central nervous system. Furthermore, we speculate that TECAS can make the trigeminal nerve afferent fibers and vagus nerve auricular branch carry messages from head facial stimulation to NTS, locus coeruleus, raphe nucleus, medullary reticular activating system and structure of the thalamus, and then to feel, edge, cortical and subcortical structures, so the electrical stimulation subcortical can cause direct regulation, namely the change of cortical excitability. Conclusion(s): These preliminary results in this group of CID-MDD patients are encouraging and need to be replicated in prospective sham-controlled studies with larger sample sizes. In addition, for patients with insomnia and depression, it is important to consider combining TECAS with psychotherapy to avoid the interference of acute negative emergency events. Acknowledgements: The support of National Key R&D Program of China (No.2018YFC1705800) and Key Laboratory of Acupuncture and Chronobiology of Sichuan Province(No.2021004) for this project is gratefully acknowledged. Learning Objectives: 1. To provide a new non-drug method for acupuncture treatment of insomnia and depression;2. Provide preliminary experimental results for the large-sample experimental design of TECAS for the treatment of insomnia and depression;3. Compared with previous studies on insomnia and depression, the regularity and characteristics of TECAS in treating insomnia and depression were found. Keywords: Transcutaneous Electrical Cranial-Auricular Stimulation (TECAS), insomnia disorder, a case series, acupuncture, Major Depressive Disorder Copyright © 2022
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Methods: The study is a retrospective analysis of a virtual acupressure service administered from May to December 2020 at a National Cancer Institute-designated Comprehensive Cancer Center. A semi-standardized virtual acupressure protocol was developed, consisting of 50 min, one-on-one session between the acupuncturist and patient. At the start of each session, the acupuncturist assessed the patient's symptom burden using the Edmonton Symptom Assessment Scale (0-90), for which higher scores represent greater symptom severity. Changes in ESAS scores from baseline to follow-up were evaluated using paired t-test for patients with follow-up within 14 days of baseline. Acupuncturists held weekly group meetings to discuss challenges and ways to improve the delivery of tele-acupressure. Results: A total of 102 virtual acupressure sessions were administered to 32 unique patients. Most patients were females (90.6%) and white (84.4%), the mean age was 55.7 (range=26-82;SD=15.73), and the most common cancer diagnosis was breast (53.1%). Of 32 patients, 13 had follow up in 14 days or less. For these 13 patients, there was a statistically significant reduction in total symptom burden (-4.85±7.6;p=0.04) from baseline to follow-up. Based on the acupuncturists' experiences, various factors were discussed and considered important in implementing virtual acupressure, including effective communications (e.g., both verbal and nonverbal cues), potential technological barriers (e.g., technology literacy), and healing environment (e.g., physical space and/or virtual background appearing on the screen). Background: Oncology acupuncture service was disrupted by COVID-19, and a virtual acupuncturist-guided, patient self-acupressure intervention was implemented. We explore the potential impact of tele-acupressure on patient-reported symptoms and summarize acupuncturists' experiences on the challenges and opportunities of implementing a virtual acupressure service for cancer patients. Conclusion: Virtual acupressure may be a promising therapy for symptom management, especially when in-person acupuncture service may not be feasible, but further research is needed to rigorously evaluate its safety and efficacy among cancer patients.
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Methods: Following IRB approval LAcs who had been prescribing CHM for COVID-related patients were recruited to complete an anonymous survey consisting of 28 questions soliciting information about demographics, modes of practice, sources of information, and treatment success. The survey was undertaken between 4/1/21 and 7/20/21. Results: Our survey was undertaken by 125 LAcs from all regions of the US. Average years in practice was 17 and 68% had received formal research training. The majority did not get infected, and of those that did most took CHM. Over 2/3 reported they had received or intended to receive the vaccine. Most treated less than 30 patients and mainly in the acute initial infectious stage. Appointments were predominantly undertaken remotely with 18% being in-person. 14% of respondents never closed their office, and 18% closed and reopened. The predominant form of CHM was granules and the duration of treatment was usually less than 20 days. A variety of information sources informed their practice. These were mainly from East Asian medical sources, but 61% reported also using biomedical sources. LAcs reported few patient deaths and little development of long-COVID. Background: Licensed acupuncturists (LAcs) in the US started using Chinese herbal medicine (CHM) to treat patients with COVID-19 related symptoms soon after the pandemic began despite little information about the use of CHM to treat COVID-19. Throughout 2020 information about the use of CHM in China was disseminated in the US, and scientific studies were published. Our study examined the critical thinking process and information sources that US LAcs used to prescribe CHM for COVID-related patients. Conclusion: LAcs in the US used CHM to treat COVID-related patients throughout the pandemic. They predominantly interacted remotely with patients, used granulated herbs, accessed information disseminated from China through collegial networks, and reported effective treatment outcomes.
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Objective: The purpose of an Employee Acupuncture Clinic is to provide additional support to our fellow Cook County Health (CCH) colleagues and coworkers on the frontline of the COVID-19 pandemic. Healthcare professionals impacted by high levels of risk, trauma, fatigue, mental and emotional stress, and possibly quarantined social isolation, could benefit from additional services offered to promote wellness, which may conceivably influence performance, stamina, and resilience. Description: Announcements for the clinic will be posted on the intranet Welcome page, as email blasts, and through Employee Health Services. The clinic will be staffed with CCH Attending Acupuncturists, and appointments will be at the Pain Management Center, Clinic B, from 3 PM - 7 PM. Healthcare insurance reimbursement for acupuncture is the CCH Blue Cross Blue Shield PPO plan. Discussion: Acupuncture is one of the safest interventions in medicine with a low occurrence of serious adverse events, 11 per 4,441,103 procedures, when performed by qualified acupuncturists. Research into acupuncture as a medical treatment has grown over the past 20 years, with over 13,000 studies conducted in 60 countries. Acupuncture treats a wide variety of conditions and has been recommended by both the Joint Commission and the ACGME as a non-pharmaceutical approach to pain management. The implementation of employee acupuncture clinics has previously been researched by the Mayo Clinic, and at Brigham and Women's Hospital. The Veterans Health Administration has incorporated the use of acupuncture for treating veterans with chronic pain and PTSD. Conclusion: An Employee Acupuncture Clinic would be supportive of our colleagues at CCH, during the COVID-19 pandemic, and thereafter. There is evidence-based support documenting the safety and efficacy of acupuncture. The employee BCBS PPO health plan covers acupuncture. And finally, healthcare providers could receive the additional care and support they require and deserve.
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Objective: To provide acupuncture support to front-line staff in an inpatient oncology setting during the COVID-19 pandemic. Methods: When COVID-19 struck New York, all in-person integrative medicine therapies at Memorial Sloan Kettering were suspended. In order to support front-line colleagues, the acupuncture service developed a plan to provide auricular acupuncture for stress reduction to hospital employees. We developed a simple protocol that aims to reduce stress and consisted of three bilateral points with calming effects: Shen Men, Point 0 and Sympathetic. Needles were retained for 20 minutes while staff were comfortably seated in a quiet setting. Acupuncturists could accommodate up to 3 staff at one time. Infection control was consulted to ensure safety. The plan was approved through the Hospital Incident Command Structure (HICS). Sessions were promoted through email and flyers posted throughout the hospital. Results: Between May 7th, and July 30th, 294 visits were conducted during 42 sessions: 28 sessions were held in a patient lounge that was converted for staff relaxation during the pandemic. The remaining 14 sessions were in conference rooms and visitor lounges to cater to staff whose roles made it difficult to leave their unit, including the ICU, and a COVID-19 dedicated floor. Each session ranged from 2 to 3 hours and were staffed by MSKCC acupuncturists. There were no adverse events reported, and no known cases of COVID-19 transmission linked to the sessions. Response from staff and administration was very positive: I needed that!, can I come every day?, and we continue to receive requests to provide these support services. Conclusion: Our experience shows that auricular acupuncture is a feasible tool that can be quickly deployed to provide emotional support to front-line hospital staff during a public health emergency. Further research should explore auricular acupuncture's effects on morale, burnout levels, and patient care outcomes.
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Purpose: An ethnographic and qualitative research study was conducted with licensed acupuncturists to elicit treatment and public health philosophies for COVID-19 related issues as well as it was created to see if integration of the theory of Wu Yun Liu Qi was a foundational consideration for their viewpoints methods using a quasi experimental design in remote natural settings 12 acupuncturists gave irb approved recorded interviews to answer questions on their views of covid-29 and related public health issues to a licensed acupuncturist interviewer on a cloud based software platform (zoom) summary although not consciously included, answers were found to have a strongly associative role to the philosophical premise of Wu Yun Liu Qi from those acupuncturists who live in weather regions affected by Wildfires in 2020. Conclusions: Formal training of most acupuncturists does not include the tenants of Wu Yun Liu Qi the acupuncturists in this study did show a philosophical correlation with extreme climate and weather conditions due to their geographic region locations.
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Purpose: The COVID-19 pandemic has caused widespread acute and chronic stress for healthcare workers not seen before in modern medicine. Acupuncture could help manage this stress. The U.S. military has a history of successfully training lay personnel to perform auricular therapy for acute pain management. Based on this model, a treatment protocol was developed and evaluated for non-acupuncturist clinicians to treat colleagues, staff, and family struggling with pandemic stress. Methods: A team of acupuncturists developed a YouTube to introduce and teach the COVID Rapid De-Stress Protocol (CRDP). In November of 2020, two family physicians and one emergency medicine physician from an academic medical center volunteered. They viewed the video and then participated in three 1-hour Zoom sessions to learn the theory behind point selection, the anatomy, and how to insert the needles. The learners practiced on each other and family members over 3 weeks. In the final Zoom, each learner demonstrate proficiency, shared their experience, and asked questions. Surveys were completed post training. Questions were posed using 5-point Likert scale (# below). The treatment protocol points were GV- 20, Yin Tang, LI-4, LR-3, and auricular points, Shen Men, Point Zero, Hypothalamus, Hippocampus, Amygdala, and Master Cerebral. Needles were left in place for 20 to 40 minutes. Results: All three physicians completed their training. Twenty-two treatments were provided to nine individuals. All treatments minus one resulted in reduction of stress for days to one week. There were no complications. ''Confidence in my ability to effectively perform the CRDP technique'' (two #2;one #3);''Instructors' effectiveness in teaching the subject matter'' (two #1;one #2);''Content was organized and easy to follow'' (one #1;two #2). Conclusion: CRDP may be able to be taught virtually to nonacupuncture trained clinicians and performed safely. Despite treatment provided by novices, stress reduction was almost uniformly achieved.
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Purpose: In the summer of 2020, the US professional acupuncture association, The American Society of Acupuncturists (ASA), surveyed their members concerning members' experiences of the effects of COVID-19 on themselves and their business practices. Our goal is to learn more about members' experiences and gather helpful suggestions that can be shared with other members. Methods: We used the SurveyMonkey platform to survey ASA members. Duplicate entries were removed by the ASA administrator before analysis by Dr. Conboy. With IRB oversight from Massachusetts College of Pharmacy and Health Sciences, we are analyzing responses to consider how the pandemic has influenced the profession. Simple tabulations are used for categorical responses, and grounded theory coding is being used for the free response. We plan to produce a manuscript for the profession and its members. A sociological manuscript will be designed to share experiences of how the pandemic influenced business practices. Results: We received over 5500 responses from ASA members across the United States. Qualitative analyses are finding that while many practitioners had concerns for their business, health of their patients, and their own health, approximately 30% reported hope that they would continue to practice and help patients during the pandemic. Still others saw the lockdown in a positive manner allowing time to help their colleagues, further their own education, and focus on their own self-care. Quantitative analyses suggest that practitioners apply responded to state and local practice guidelines. Conclusions: COVID-19 had unprecedented effects on the East Asian Medicine and Acupuncture Profession. Many practitioners were able to pivot to new methods of practicing, while for some it was devastating. The majority of acupuncturists demonstrated their ability to turn an uncertain period into one of opportunity and learning. Specific examples will be given.