and Raynaud's Disease
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recent study indicates that acupuncture surpasses drug treatment for Raynaud's
disease, a vascular disorder that causes the small arteries of the hands
and, less commonly, the feet to spasm during exposure to cold or stress.
The appendages go white and sometimes hurt due to insufficient blood flow.
Raynaud's affects twice as many women as men, and its cause is unknown. Conventional treatment is limited to avoiding the cold and taking nifedipine, a drug that dilates small arteries and is more commonly used to treat angina. Although nifedipine reduces the severity of attacks by up to 90 percent, many patients discontinue therapy because of undesirable side effects.
The study, conducted by R. Appiah and colleagues at the Medizinische Hochschule Hannover department of angiology in Hannover, Germany, randomized 33 people with Raynaud's disease into treatment and control groups. During the course of 23 winter weeks, the treatment subjects received seven acupuncture sessions. Control subjects received no sessions. All patients kept a diary chronicling the daily frequency, duration and severity of attacks. At weeks one, 12 and 23, subjects underwent a "cooling test" that exposed their appendages to cold.
Eleven of the 17 treated patients reported a subjective improvement in symptoms. After acupuncture, the frequency of Raynaud's attacks fell significantly from 1.4 per day to 0.6 per day. When attacks did occur, however, duration and severity did not change significantly. Changes among control subjects were not significant.
Overall, acupuncture reduced attacks by 63 percent. When patients' hands were exposed to cold, the mean time of no blood flow through the nail-bed capillaries decreased from 71 to 24 seconds. Follow-up questionnaires showed that the benefits lasted beyond 10 months, and there were no adverse effects.
These results suggest that traditional Chinese acupuncture can induce long-lasting reduction of Raynaud's attacks.
Treatment of Primary Raynaud's Syndrome with Traditional Chinese Acupuncture
Appiah R, Hiller S, Caspary L, Alexander K, Creutzig A
Medizinische Hochschule Hannover, Department of Angiology, Germany
OBJECTIVE: Evaluation of the effects of a standardized acupuncture treatment in primary Raynaud's syndrome. DESIGN: A controlled randomized prospective study.
SETTING: A winter period of 23 weeks, angiological clinic of Hannover Medical School. SUBJECTS: Thirty-three patients with primary Raynaud's syndrome (16 control, 17 treatment).
INTERVENTIONS: The patients of the treatment group were given seven acupuncture treatments during the weeks 10 and 11 of the observation period.
MAIN OUTCOME MEASURES: All patients kept a diary throughout the entire observation period noting daily frequency, duration and severity of their vasospastic attacks. A local cooling test combined with nailfold capillaroscopy was performed for all patients at baseline (week 1) and in weeks 12 and 23, recording flowstop reactions of the nailfold capillaries.
RESULTS: The treated patients showed a significant decrease in the frequency of attacks from 1.4 day-1 to 0.6 day-1, P < 0.01 (control 1.6 to 1.2, P = 0.08). The overall reduction of attacks was 63% (control 27%, P = 0.03). The mean duration of the capillary flowstop reaction decreased from 71 to 24 s (week 1 vs. week 12, P = 0.001) and 38 s (week 1 vs. week 23, P = 0.02) respectively. In the control group the changes were not significant.
These findings suggest that traditional Chinese acupuncture is a reasonable
alternative in treating patients with primary Raynaud's syndrome.