From the Web Pages of Phil Rogers MRCVS
1 Esker Lawns, Lucan, Dublin, Ireland

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1#Ader L, Hansson B, Wallin G (1990) Parturition pain treated by intracutaneous injections of sterile water. Pain May; 41 (2):133-138. Dept of Obs&Gyn, Central Hospital, Molndal, Sweden. Forty-five pregnant women in the first stage of parturition presenting with lower back pain were randomised into 2 groups. One group received intracutaneous injections of sterile water in the lumbosacral region, while the other group was given corresponding subcutaneous injections of isotonic saline, regarded as a placebo treatment. In the group that received intracutaneous sterile water injections the mean VAS score was significantly more reduced compared to the placebo group at 10 min (p<.001), 45 min (p<.02), & at 90 min (p<.05) after the treatment. The midwives' blind estimation of the effectiveness of treatment was consistent with the VAS assessment. However, the requirement of pethidine (meperidine) was similar in the 2 groups. The analgesic method presented was found to be an effective treatment against lower back pain during the first stage of parturition & it is speculated that the mode of action resembles AP. Randomised controlled trial. Comment in: Pain 1991 May; 45 (2):220.

2#Aleksandrina EV; Zharkin AF; Gavrilova AS (1992) [The AP prevention of anomalies in parturition strength in pregnant women of a risk group]. Akush Ginekol (Mosk), 8-12 22-24. AP was carried out for 3-6 d in the course of preparation for parturition of 80 pregnant women at risk of developing abnormalities of parturition. Points on the LU, KI, ST & CV Channels, & Ear- points were used. AP enhanced mainly the cholinergic-type activities of the ANS. Women who had received AP before the birth had a more normal course of spontaneous parturition & significantly less blood loss than those who had not received AP.

3#Alieva EA, Fanchenko ND, Pshenichnikova TIa, Parshutin NP, Gasparov AS, Vetr M (1990) [The PCOS & increased body mass - Article in Russian]. Acta Univ Palacki Olomuc Fac Med 126:233-240. Also: Alieva EA, Fanchenko ND, Parshutin NP, Gasparov AS, Pshenichnikova TIa. (1993) [The effect of a decrease in body weight in patients with the PCOS - Article in Russian]. Akush Ginekol (Mosk) 1993; 3:33-36. 80 patients with PCOS & obesity were investigated. Weight loss was achieved by means of a diet in 60 patients, & AP in 20 patients. Treatment induced pregnancy in 34% patients. Therefore therapeutic diet or AP may be recommended as the first stage of treatment for weight reduction in PCOS patients.

4#Allen DL, Kitching AJ, Nagle C (1994) PC06 acupressure & nausea & vomiting after gynaecological surgery. Anaesth Intensive Care Dec; 22 (6):691-693. Dept of Anaesthesia, Northampton General Hospital, England. We studied the effect of PC06 acupressure on 46 women undergoing laparotomy for major gynaecological surgery who received patient-controlled analgesia. 23 received acupressure at the PC06, the other 23 received acupressure at a "sham" site. There was a reduction in the requests for anti-emetic therapy in the group receiving PC06 acupressure but there was no difference in the incidence of nausea & vomiting. There was no difference in total morphine consumption between the two groups. Randomised controlled trial.

6#al-Sadi M, Newman B, Julious SA (1997) AP in the prevention of postoperative nausea & vomiting. Anaesthesia Jul; 52 (7):658-661. Dept of Anaesthesia, Poole Hospital Trust, UK. The efficacy of intraoperative AP at the PC06 point in the prevention of postoperative nausea or vomiting was studied. A double-blind randomised controlled study of AP versus placebo was performed in 81 patients scheduled for d case gynaecological laparoscopic surgery. Failure of treatment was defined as the occurrence of nausea or vomiting before or within 24 h of discharge. The use of AP reduced the incidence of postoperative nausea or vomiting in hospital from 65% to 35% compared with placebo & after discharge from 69% to 31% compared with placebo. Randomised controlled trial. See also: Allen DL, Kitching AJ, Nagle C (1994) / Belluomini J, Litt RC, Lee KA, Katz M (1994) / de Aloysio D, Penacchioni P (1992) / Dundee JW, Ghaly RG, Bill KM, Chestnutt WN, Fitzpatrick KT, Lynas AG (1989) / Dundee JW; Chestnutt WN; Ghaly RG (1986) / Ghaly RG; Fitzpatrick KT; Dundee JW (1987) / Gieron C, Wieland B, von der Laage D, Tolksdorf W (1993) / Hyde F (1989)

7#An XC; Zhao HS; Li XC (1984) [Clinical observations of 254 cases with AP treatment of vesical & anal functional disorder resulted from occult spina bifida of the sacral region]. 2nd Natl Symp AP-Mox & APA (Beijing):77-78. 254 cases of occult sacral spina bifida were treated. AP points were selected according to the symptoms. For urinary incontinence / dribbling: CV03, KI11 + SP06; for enuresis: X_35-Huatojiaji; for dysuria: GV20, GV11, GV04 + BL54; for faecal incontinence: GV01, CV01 & Perianal Points. Needles were retained for 20-30 min, once every 1-2 d, for 10 times/course, for 3-5 courses. Therapeutic effects were assessed according to the symptoms, volume of residual urine & uroflow rate etc. Excellent in 61 cases (24%), improved in 174 cases (69%), & unchanged in 19 cases (7). 101 cases that had improvement when discharged were followed up for 1-12 yr. The therapeutic effects have persisted in 50 cases (50%), decreased in 30 (30%), vanished in 15 cases (15%), & 6 (5%) died during the period of severe urethral infections & uraemia except one who died from hepatitis.

8#Anon (1988) Therapeutic effect of microwave AP on 53 cases of proliferative mastosis. JTCM Mar; 8(1):23-4.

9#Anon (1995) Electric blankets & birth defects. New Scientist 2 Aug, p11. This reports the first study to show a link between exposure to EMFs (electromagnetic fields) & birth defects. The study looked at 486 women who had been trying to conceive for >12 mo. They found that those who slept with their electric blanket switched on were 7 times more likely to have babies with urinary tract defects than those who turned their blankets off.

10#Arkatov VA; Zverev VV; Volkovinskii KE (1992) [The effect of tramal & APA on parturition pain & the psychoemotional status of the parturient]. Anesteziol Reanimatol Mar-Apr 2:31-33. The changes in psychoemotional status, & the intensity & structure of parturition-pain, were studied in 65 women with reference to the use of concomitant correcting therapy during various types of analgesia. 44 women comprised a control group. APA was optimal during delivery without any correcting therapy, while tramal (at a dose of 1.43+0.06 mg/kg) was optimal during "programmed" delivery.

11#Asakawa K (1988) [Impotence]. Clin JTCM 9 (3):347. A 39-yr old male patient complaining of scrotal pain 1.5 yr ago was diagnosed as varicocele. 1 yr later he had difficulty of urination after eating hot-flavoured noodles & was diagnosed as prostatitis. From then on he had decreased sexual desire, with weak erection & prospermia. The urologist considered the symptoms not to be associated with varicocele nor prostatitis. Symptoms of impotence did not improve even when prostatitis was cured. Examination revealed weak tonus of the abdomen, loss of resistance even pitting on palpation at the lower abdomen near CV04, cold feet & wet sole, superficial weak pulse especially at Chi position, purplish red tongue proper particularly at the tip, with white coating at the base of the tongue. Not only KI Yang Xu but also Stasis of LV Qi with HT abnormality were considered & he was treated mainly by the method of reinforcing KI & soothing LV with regulating HT by means of AP & herbal medicine & was cured after 2 mo of treatment. Varicocele & prostatitis may develop from downward flow of Damp & Heat into Lower Jiao. Their relationship with KI Xu Syndrome causing impotence needs investigation.

12#Asakawa K (1988) [Nocturia]. Clin JTCM 9(4):445. A girl student at the third Year of secondary school complained of nocturia every 1-2 d since she was 3-4 yr-old. Urologic examination revealed no organic changes & she failed to respond to Xiao Jianzhong Decoction. The girl looked thin, pale, with puffy face, light red tongue with thin white coating & cracking striae at the tip. Her pulse was rapid, superficial & firm, weak at Chi position as an evidence of KI-Xu. She also had bad dreams, heaviness, vertigo, lassitude, frozen shoulder, cold feet, dry throat & poor appetite. Acupoints to reinforce KI & strengthen SP were chosen. Treatment was twice/wk. Enuresis disappeared after the first AP & she was cured after 3 sessions without recurrence.

13#Aso T, Motohashi T, Murata M, Nishimura T, Kakizaki K (1976) The influence of AP stimulation on plasma levels of LH, FSH, progesterone & E2 in normally ovulating women. Am J Chin Med 4 (4):391-401. No details.

14#Bahr FR (1994) [AP in Obs&Gyn]. Gynakologe Dec 27(6):369-374. In German. No abstract online.

15#Ban XW (1988) [Medical notes on Zhuang medicine: abdominal diseases treated by AP at point ST36]. Guangxi JTCM Mater Med 11(2):84-85. The paper introduced the functions & clinical application of ST36. 1. Prevention of diseases & health care; 2. Invasion of external pathogenic factors in weak persons; 3. Epigastric pains; 4. Fever due to malaria; 5. Infantile enuresis; 6. Dysmenorrhoea.

16#Bartocci C, Lucentini M (1981) [AP & micro-massage in the treatment of idiopathic nocturnal enuresis- Article in Italian]. Minerva Med Sep 15; 72(33):2237. 1) Goals of the Research. We have treated 15 cases of night enuresis (4-13 yr) 9 of which had already been treated with other therapies without success, in order to compare the two methods. 2) Methods: A) AP in 10 cases at a) HT07, ST36, SP06, CV03; b) BL23, BL28, BL32, alternatively every 2 d, for a mean of 10 times. B) 5 cases were treated by micromassage on the "Nocturia" Points in the creases between the phalanges 1-2 & 2-3 of finger 5 (P. Chang); the first session was in the presence of parents; they then repeated treatments at home every night for 10 min, for a mean of 20 d. With AP: 7/10 cured completely, 2 partially, & 1 failed. With micromassage: 2/5 cured completely, 1 partially, & 2 failed. Both groups were followed-up up to 4 mo after the last treatment. AP produces better results, but because of its simplicity, micromassage is a valid alternative mostly in little children who reject AP & it should be further investigated.

17#Beal MW (1998) Women's use of complementary & alternative therapies in reproductive health care. J Nurse Midwifery May; 43 (3):224-234. Yale Univ School of Nursing, New Haven, CT 06536-0740, USA. Numerous studies have documented that health care consumers all over the world are spending money out of pocket for alternative therapies & that billions of dollars are spent in the United States alone. In this article, the use of complementary & alternative therapies by women health care consumers is discussed, particularly as this phenomenon relates to women's reproductive health in the United States. Women use conventional health care services more frequently than men; thus, it is not surprising that women account for approximately two thirds of health care appointments for complementary & alternative therapies. The traditional conceptual frameworks of herbal medicine, homeopathy, AP, & acupressure are presented, & common clinical applications to women's reproductive care are discussed. Review, tutorial

18#Beal MW2 (1992) AP & related treatment modalities: 2: Applications to antepartal & intrapartal care. J Nurse Midwifery Jul-Aug 37(4):260-268. Yale Univ Sch of Nursing, New Haven, CT 06536-0740. The application of AP, moxa, acupressure, & shiatsu to antepartal & intrapartal care are discussed. Information on therapeutic interventions as described in textbooks is presented & compared with specific treatments evaluated in research studies. Specific clinical indications addressed include nausea during pregnancy, repositioning of the foetus in breech position, stimulation of contractions & true parturition, & pain relief in parturition. Qualifications for practitioners & recommendations for certified nurse-midwives caring for clients seeking referral for these services are discussed.

19#Becke H (1982) [Neural therapy & AP in Obs&Gyn - Article in German]. Zentralbl Gynakol 104 (10):602-609. A brief characterisation is made of the working principles underlying neural therapy under local anaesthesia or AP. Common approaches to therapy are offered by disorders of autonomous regulation, including inflammatory processes, & by purely functional disorders. There are many applications in Obs&Gyn. Brief data on lumbosacral pain are quoted as an example. Optimum performance can be expected from them, when used in combination with proven therapeutic methods. They provide a low-cost approach to reducing both the consumption of antibiotics & other pharmaceuticals as well as time of morbidity.

20#Becke H (1988) [EAP in the treatment of pre-menstrual breast pain]. Dtsch Z Akupunkt (DZA) 31(4):96-97. Oedema of the lymphatic vessels & hypertonia of the smooth muscles (milk producing glands & gland tissue) cause pre-menstrual mammary pain as well as the striated thoracic muscles. The aetiology suggests an E2-progesterone-imbalance with hyperprolactinaemia. Hormone therapy involves systemic side effects & means long-term therapy. The same applies to spasmolytic & psychovegetative suppressing substances. EAP takes 1-3 min/treatment. The duration of impulse/application is 0.5 sec., intensity of current 170 uA. Therapy is carried out during the painful phase. Immediate & impressive pain relief achieved. On average, 1-3 sessions/mo are required to obtain a permanent effect (6 mo without symptoms). Defined AP points & TPs are used. In relapses, the aim is to resolve blocking in the cervical-thorax border or in the ribs.

21#Belluomini J, Litt RC, Lee KA, Katz M (1994) Acupressure for nausea & vomiting of pregnancy: a randomised, blinded study. Obstet Gynecol Aug; 84 (2):245-248. Dept of Obs&Gyn, California Pacific Medical Centre, San Francisco. They evaluated acupressure in reducing nausea & vomiting of pregnancy. Symptomatic pregnant women were randomised to one of two acupressure groups: one treatment group used acupressure at PC06; the sham control group used a placebo point. Subjects were blind to the group assignment. Each evening for 10 d, the subjects completed an assessment scale describing the severity & frequency of symptoms that occurred. Data from the first 3 d were used as pre-treatment scores. Beginning on the morning of the d 4, each subject used acupressure at her assigned point for 10 min four times/d. Data from d 4 were discarded to allow 24 h for the treatment to take effect. Data from d 5-7 were used to measure treatment effect. 60 women completed the study. There were no differences between groups in attrition, parity, foetal number, maternal age, gestational age at entry, or pre-treatment nausea & emesis scores. Analysis of variance indicated that both groups improved significantly over time, but that nausea improved significantly more in the treatment group than in the sham control group (F1, 58=10.4, p=.0021). There were no differences in the severity or frequency of emesis between the groups. There was a significant positive correlation (r=0.261, P=.044) between maternal age & severity of nausea. Acupressure at PC06 was effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women. Randomised controlled trial. Comment in: Obstet Gynecol 1995 Jan; 85 (1):159-60.

22#Ben H; Zhu YG; Ye YY (1989) [Primary experimental study on the effects of AP on the function of urinary bladder of rabbits]. Chin AP Moxibust 9(4):37-39. They observed the effects of Ear-AP on bladder function in rabbits. Urine output increased after EAP at BL23 & Earpoint Subcortex, indicating an improved adaptability of the bladder wall. The results provide clues to explain the effectiveness of AP treatment of enuresis in children.

23#Bercovici JP; Mingam M (1985) [Amenorrhoeas & AP]. Meridiens 69-70:147-157. They report AP treatment of 25 secondary amenorrhoeas (18 hypothalamic amenorrhoeas & 7 amenorrhoeas with ovarian dystrophy). Positive results were >50%, which points to a biological & clinical profile (western & eastern) of the patients who are successfully treated. Neuroendocrine hypotheses are formulated in order to explain the AP action on the hypothalamo-hypophyseal level.

25#Berks A (1996) AP in Parturition & Delivery. Adapted from WWW. [After an uncomplicated delivery, Alex & Denise's son Noah Loren was born on 20 Aug 1996. For information on how to order Bob Flaws' books, please see the Blue Poppy Press page at the Acupuncture.com Book Farm: WebMaster]. /The use of TCM in parturition & delivery can be understand in many ways. Like all activities of life, parturition induces a shift in the directionality of the Qi. This may be more important to understand than simple point prescriptions; once one understands the nature of Qi & the points, it is a simple & creative process to choose effective AP points./For the pregnancy, mother has been holding the foetus in & up with her SP-Qi. All the other Zang-Fu Qi has had to spread & regulate & consolidate evenly. During parturition, the Qi must go down & out. Both psychological & physical factors can slow or block this, causing Qi Stasis. Bob Flaws in his book "Path of Pregnancy Vol 1", lists 3 causes of delayed parturition: Qi-Xue-Xu, Qi-Xue-Stasis, & Middle Jiao Qi-Xu. All three cause insufficient Qi and/or Xue to move the foetus down & out the birth canal./The easiest of these to treat is Qi-Xue-Stasis. If the mother-to be can relax & get the uterus to relax, parturition will not be far behind. This can be done with many different therapeutic activities: stimulate the uterus with belly massage, have an orgasm, relax & visualise the uterus contracting. Bob Flaws quotes Wan Mi-Zhai (p169): "If parturition goes on for <1 d, the woman is preoccupied with family & personal affairs & still has an appetite, this is due to astringing of the uterus. But if the woman's parturition goes on for >1 d, all the woman's affairs are settled & her appetite diminished, this is insufficiency of middle Qi not able to transport the & move the foetus"./Yin Channel Qi rises. Yang Channel Qi descends. Therefore, moxa or acupressure down the Yang Channels will assist downward movement of Qi. This principle is also applied in home remedies to bring on parturition such as castor oil, a stimulating purgative & a favourite of Edgar Cayce. See Childbearing Year by Susan Weed (p60)./Specific AP points that descend include: LI04, SP06, GB21. LI04 is LI Yuan point; SP06 is the "3 Yin Crossing" point of the Foot Yin Channels. LI04 & SP06 are important points to circulate Qi-Xue & induce downward movement & parturition. GB21 also descends (see Oriental Med J Spring, 1996 p6). These points can be combined with TH06 & LV03. Bob Flaws recommends not to retain the needles./ST36 (ST He-Sea, Earth, Hour & Uniting point) combines with SP06 invigorates SP & ST, produces Qi-Xue & induces parturition. These points can be needled, pressed, or warmed with moxa./Bob Flaws in "the Path of Pregnancy Vol 1" lists other possible point combinations: LI04, SP06, BL67, Du Yin (Extra point, on the plantar surface of the centre of the proximal phalangeal joint of the second toe). Needle the first 2 points & moxa the second 2. Another combination is: LI04, SP06, BL30 & Y_15-Qimen (Qi Door, also called Cuochanxue-Hastening Birth point, 3" lateral to CV04). Needle 5 fen in depth. In pronounced back parturition pain in the sacrum, needle BL31-34 transversely. Tape the needles in place flush with the skin & use EAP./Potential parturition problems can be greatly aided by the use of herbs & an appropriate activity before parturition to drain (disperse) Shi (Excess) or tonify (nourish) Xu (Weakness). However, AP also can act quickly on Qi-Stasis & Xue Stasis. For further discussion please read Bob Flaws Path of Pregnancy Vol 1./In my limited experience, having recently witnessed the birth of my son Noah, a clear plan of action, focused breathing, a synchronised supportive set of people at the birth & an emotionally clear parturient woman helps parturition. Strong physical fitness also helps. The acupressure that I was able to apply to her back, helped a great deal in preventing her use of medication./The "Bradley Way" is an enjoyable book on Natural childbirth. Though stern in its approach to delivery without Med intervention. It had the best advice to the woman in parturition & how the father should approach the situation as a birth coach.

26#Bian QX (1992) [A 32-case report of hysteromyoma treated by AP]. Shanghai J AP Moxibust 11(1):18. To avoid injury, patients had to empty bladder before AP. Two point groups were alternated: CV03, ST30, BL32 & KI12, SP06. At abdominal points, a 1.5", 30 gauge needle was inserted straight in 25-30 mm deep; Xie Fa by twisting-rotating was used to make Deqi spread to perineum; needle was retained 25 min. At BL32, a 2.5, " 28 gauge needle was inserted straight into posterior sacral foramen 2, with Xie Fa by twisting-rotating & thrusting-lifting to make Deqi spread to lower abdomen. After Deqi, needles were removed immediately. At SP06, by normal Bu Fa-Xie Fa was used to make Deqi spread upwards; needle was retained for 25 min after Deqi. Treatment was every 2 d, 10 times/course. After 3-6 courses, 50% were clearly improved, 31% improved & 19% unchanged; total effective rate, 81%.

27#Bie YF (1992) [A preliminary summary of prostatic hyperplasia treated with fire needle]. J AP Moxibust 8 (5):39-40. Points selected were KI02, BL55 & SP06. Treatments were given with red-hot fire-needles. Of 28 cases treated, 21 were clinically cured, 6 effected & 1 exhibited no change, with an overall efficacy rate of 96%. Several different therapies to hypertrophy of prostate were analysed, of which the fire-needle is considered as applicable.

28#Buchheit H (1986) [Cytoplasmatic AP with foetal spleen in menopause]. Akupunkt Theorie Praxis 14 (1):28-35. In TCM "SP" has a central position to all other organ functions. The organ SP-in the same way like the female endometrium is a residual part of the primary tissue of the mesoblast. According to the author's explanation the function of SP in TCM is identical to the system of basic regulation of Pischinger. That means, SP functions would correspond with endometrial functions. AP with cytoplasmatic substances developed by the author in 1982 showed good efficacy using foetal SP dilution in vaginal acupoints. Thus application of oestrogens could be substituted by therapy with SP extracts without side effects.

29#Cai BX; Zhuang XL; Hua HJ (1984) [APA, epidural block & combined APA for prostatectomy: study of their anaesthetic effects & haemodynamic changes]. 2nd Natl Symp AP-Mox & APA (Beijing):209-210. In this paper, a comparison was made between the analgesic effects & haemodynamic changes of three anaesthetic methods for prostatectomy, i.e. APA, epidural block, & combination of APA with minimal doses of epidural block.

30#Cai ZM (1987) [Relation between markedness of Propagated Channel Sensation in Senegal patients & curative effects of AP in the treatment of enuresis]. Shanghai J AP Moxibust 6(2):1-3. 361 patients with enuresis were treated with AP, Ear-AP or injection of 10% glucose saline. The relationship between the degree of PCS (propagated sensation along the Channel) & the effect of different therapy was observed. (1) The positive rate of PCS in Senegal was rather higher. First degree propagation was found in 142 cases (39%); (2) "Distant points along the Channel" & "Deqi reaching the affected area" methods were used. A marked effect was obtained; total effective rate was 94%; (3) The more marked PCS appeared, the more higher therapeutic effect; (4) In Ear-AP therapy, PCS was found in 31% of cases; there was a close relationship between the effective rate & the degree of PCS. Further study is worthwhile for this phenomenon. Also: Cai ZM (1987) Relation between the extent of distinctness of Propagated Channel Sensation & therapeutic effect of AP on enuresis in Senegal patients. AP Res:65-66. To clarify the relation between the distinct extent of PCS & the therapeutic effect, 361 cases of enuresis were treated with AP, Ear-AP & acuinjection of 0.05% atropine sulphate or scopolamine hydrobromide. Acuinjection was at bilateral SP09 & SP06, once every 1-2 d. Earpoints LU, SP, KI, Shenmen & BL were used for Ear-AP. Treatment was 1-2 times/wk. The distinct extent of PCS was graded into 5 degrees. Cure, marked improvement & effective rates of AP treatment on enuresis were 42, 37 & 15%, respectively; total effective rate was 94%. The therapeutic effect of AP on enuresis in subjects with marked PCS (I-II) was better than that without marked PCS (III-V), suggesting that the distinct extent of PCS was closely related to the therapeutic effect.

32#Caione P; Nappo S; Capozza N; Minni B; Ferro F (1994) Primary enuresis in children: Which treatment today? Minerva-Pediatr Oct 46(10):437-443. Dept di Chirurgia, Ospedale Pediatrico Bambino Gesu-Roma. Enuresis is a problem that paediatric urologists are often called to treat. It affects 15-30% of school children. In 85% of affected children bedwetting is monosymptomatic, not accompanied by other voiding disorders or daytime incontinence. The physiopathology is not yet fully understood & the pathogenesis is multifactorial: genetic & psychological factors, sleep disorders, urinary reservoir abnormalities, urine production disorders can all play a part. Thus, the treatment of choice is still very controversial. Behavioural therapy (psychotherapy, bladder training & biofeedback, electric alarm) & pharmacological therapy (tricyclic antidepressants, anticholinergics, DDAVP) have been used with variable results. In our experience (54 enuretic children) DDAVP effectively reduced the number of wet nights/wk in 79% of cases. AP, which we have been using for many years, also gave good results in 55% of cases. Long term success of DDAVP & AP was respectively 50 & 40%. We discuss the probable pathophysiology & present our own results & those reported in the literature. Accurate diagnostic selection of cases & a better understanding of physiopathology are the basis of effective treatment of enuresis. Also: Capozza N; Creti C; De Gennaro M; Minni B; Caione P (1991) The treatment of nocturnal enuresis: A comparative study between desmopressin & AP used alone or in combination. Minerva Pediatrica Sep 43(9):577-582. In Italian. From Mar to Sep 1989, 40 children, 4-14 yr-old, with primary nocturnal enuresis were included in a study to assess the comparative therapeutic efficacy of DDAVP & AP. Children were assigned to 4 treatment groups (n=10/group): A=DDAVP; B=AP; C=DDAVP + AP and; D=Placebo (untreated control). The trial design included 3 periods: observation (2 wk), treatment (8 wk) & follow-up (4 wk). 19 children completed the study. When used separately, DDAVP & AP were highly effective treatments, as expressed by % of dry nights. However, the combined treatment of DDAVP + AP was best as regards the % of dry nights at the end of treatment & as regards the stability of results after the end of the study. Detailed analysis of correlations between type of treatment & urinary osmolarity is given.

33#Cao GF; Lin HQ; Yu Y (1989) [Urinary calculi treated by electric stimulation at Ear & Body acupoints combined with Chinese herbal drugs: Report of 127 cases]. Liaoning JTCM 13(6):37-38. Earpoints: KI, Ureter, BL & Urethra were selected. Shenmen & Sympathetic were added in cases of severe pain. EAP was used via JJ201 Channel therapy apparatus. Treatment on body points with various frequencies for 2-3 min, 10 times/d for 1 mo. 2. Huashi Tang (decoction to dissolve the urinary stones) Chinese drugs included Prostate, Knotweed, Pyrrosia leaf, Safflower, Dried Vaccaria seed, Achyranthes root, Yunaoshi twice/d. Result: 69% were cured, 20% effective, 11% ineffective. The total effective rate was 89%.

34#Cardini F; Basevi V; Valentini A; Martellato A (1991) Moxibustion & breech presentation: preliminary results. AJCM 19(2):105-114. Div of Obs&Gyn, Zevio Hospital, Verona, Italy. Moxa use at BL67 is an ancient method to correct foetal malpresentation during the last 3 mo of pregnancy. The authors reviewed Chinese references on this subject & stressed the importance of parity & gestational age in testing the efficacy of this therapy. Preliminary results are compared with Chinese reports. Success rates in foetal version by moxibustion versus spontaneous version are also compared. Also: Cardini F; Marcolongo A (1993) Moxibustion to correct breech presentation: a clinical study with retrospective control. AJCM 21(2):133-138. Dept of Obs&Gyn, Policlinico Borgo Roma, Verona, Italy. In this study we treated a group of women during pregnancy by moxa use at point BL67, to obtain foetal inversion in breech presentation. Comparison is made with a control group drawn retrospectively from clinical files at a regional hospital. The aim of the study is to identify the ideal population (in terms of parity & gestational age) to be included in a randomised controlled trial.

35#Ceffa GC, Gandini G (1979) [Telethermographic evaluation of the use of AP in fibrocystic dysplasia in the painful phase - Article in Italian]. Minerva Med May 19; 70(24):1745-54. With this preliminary note the writers propose an objective documentation of AP's effects in fibrocystic mastopathy during the painful phase, using thermography. 5 patients were treated at KI06, SP05, SP06, & LV04 all in the same session. 4/5 cases had remission of symptoms & symptomatic change of the thermography picture. In the treated cases menstruation was always marked in advance. Also: Ceffa GC, Chio C, Gandini G (1981) [AP in breast diseases - How, when & why - Article in Italian]. Minerva Med Sep 15; 72(33):2239-42. We assessed AP in 43 females with breast pain, compared with other similar groups treated with anti-inflammatory drugs & multivitamins. Before & after treatment every patient went through a complete clinical & instrumental examination in which we also assessed with telethermography the condition of mastosic vascular congestion. Positive considerations are made about the therapeutic validity of AP that has reached the highest success (>95%) in comparison with other traditional methods, & patients really appreciated that. We nevertheless emphasise the need to always associate a correct, objective & instrumental study before starting any therapy of mammary pain, to exclude coexistence of a sort of productive or surgical pathology.

36#Cerovsky J, Hudecek V, Rozkot M, Harapat D, Hercik Z (1999) AP to Induce Oestrus in Gilts. Web Journal of AP [http://users.med.auth.gr/~karanik/english/articles/gilts.html] Res Inst of Animal Prod, Praha-Uhrineves, 51741 Kostelec n. Orlici, & ZEVOS Zizelice, SVCH Prevysov, Czech Republic. Using 104 acyclic hybrid (Large White x Landrace) gilts, we studied the efficacy of AP to induce oestrus. We compared the results of aquapuncture (AA, n=20) at acupoints Baihui & Weiken with those of moxa-AP (MA, n=44) at the same points, & with data from untreated control gilts (C, n=40). The interval from the start of the trial to oestrus (and mating) in the control (C) & AP-treated (AA+MA) gilts & was 30.8 v 17.6 d, p<.01). AP treatment shortened the interval to oestrus (and mating) by 13.2 d (p<.01). The percentages of gilts induced into oestrus within the 28 d after the last treatment in groups C, AA, MA, & (AA+MA) were 57.5, 70.0, 70.4, & 70.3%, respectively. These differences were not significant (P >0.05). Further research, with larger numbers of gilts, is needed to re-examine that finding.

37#Chai WJ (1988) [Current status in AP & moxibustion therapy of male infertility & sex disorders]. Chin AP Moxibust 8 (4):51-53. This article presents the treatment of male infertility & sexual dysfunction by means of AP, mild moxibustion, combination of both, Ear-AP & acupoint injection. These treating methods have claimed satisfactory therapeutic effect for impotence, defective ejaculation, spermatorrhoea (involuntary seminal emission), premature ejaculation, dyspermia etc.

38#Chang PL (1988) Urodynamic studies in AP for women with frequency, urgency & dysuria. J Urol Sep; 140(3):563-6. Dept of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China. Urodynamic measurements were performed before & after AP at 2 different points in 52 women who presented with frequency, urgency & dysuria. Measurements included cystometry, anal sphincter electromyography, urethral pressure profilometry & uroflowmetry. The results of this study showed a significant increase in maximum cystometric capacity & a decrease in peak urinary flow rate after AP at SP06, which has traditionally been used for the treatment of urinary problems. During AP at SP06 there were periodic increases in intraurethral pressure at the distal urethra, which were measured with a microtip transducer. AP-induced detrusor inhibition & external sphincteric contractions were demonstrated. Clinically symptomatic improvement was noted in 22/26 patients treated by AP at SP06. AP can be used as a simple & effective method to treat female patients with frequency, urgency & dysuria. PMID: 3411675, UI: 88317081

39#Chang PL; Wu CJ; Huang MH (1993) Long-term outcome of AP in women with frequency, urgency & dysuria. AJCM 21(3-4):231-236. Dept of Surgery, Chang Gung Memorial Hospital, Chang Gung Med Coll, Taipei, Taiwan, ROC. Urodynamic measurements including cystometry, anal sphincter EMG, urethral pressure profilometry & uroflowmetry were carried out on 21 females before AP & at 1 & 3 yr during follow-up. Follow-up ranged from 60-72 (mean 66) mo. Differences in urodynamic measurements before AP & at the 1- or 3- yr follow-up were not significant. During follow-up, AP at SP06 was performed in cases that had recurrence of symptoms of frequency, urgency & dysuria. Mean number of AP treatments was 4.8 (range 2-8). 8 cases decreased their AP treatments after 30 mo, but this was not statistically significant. The long-term outcome of AP at SP06 for women with frequency, urgency & dysuria was positive, but that the effect was temporary & repeated AP was necessary to maintain beneficial effects.

40#Chen B, Gao H, Ji S (1994) [The effects of naloxone & EAP on the release of GnRH from female rat's preoptic area - Article in Chinese]. Chen Tzu Yen Chiu (AP Res) 19 (2):31-34. Dept of Neurobiology, Shanghai Medical Univ. By means of push-pull perfusion technique & RIA we determined the GnRH concentration of the perfusates from preoptic area (POA) in ovariectomised (OVX) & intact (INT) female rats, to observe the influence of naloxone & EAP on the release of GnRH & beta-endorphin from POA. The basic GnRH level of POA perfusate in OVX was 271.8+77.5pg/ml & in INT was 52.4+11.1pg/ml. There was a significant difference between the basic levels of two groups (p<.02, n=12). No difference of beta-endorphin basic level in OVX & INT was found. The GnRH level of POA perfusate in OVX was increased by 146.6+46.5pg/ml (p<.01, n=12) 30 min after i/p administration of naloxone, but no obvious change was found in INT after naloxone administration. EAP had no effect on the release of GnRH & beta-endorphin in both OVX & INT. Negative feedback of oestrogen may be a major regulative factor of GnRH under normal conditions; central opioid peptides may be the main regulative mechanism for GnRH after abolition of oestrogen feedback induced by ovariectomy.

41#Chen B, Ji S, Gao H, He L (1994) [The effects of EAP treatment on nucleolar organiser regions of adrenal cortex in ovariectomised rats - Article in Chinese]. Chen Tzu Yen Chiu (AP Res) 19 (1):46-50. Inst of AP Research, Shanghai Medical Univ, PRC. They report the morphometric analysis of nucleolar organiser regions (NORs) of the adrenal cortex in ovariectomised rats after EAP using argyrephil (Ag-NOR) method for NORs. Animals were divided into four groups, the control group (CT group, n=4), the EAP group (n=3), the ovariectomised group (OV group, n=4) & the ovariectomised EAP group, (OV+EAP group, n=7). The number of AgNORs of 100 cells from zona fasciculata of the adrenal cortex in each case of all groups was counted at random & the mean+SE (number/cell) in each group was calculated as follows: OV+EAP group 2.71+0.26, OV group 1.62+0.15, EAP group 1.21+0.04 & CT group 1.48+0.03. The mean of AgNORs in OV+EAP group differed highly significantly from the other three groups (p<.01) tested by ANOVA & LSD method, No significant distinction was found among the OV group, EAP group & CT group. Gross specimen examination showed that adrenal glands in OV+EAP were significantly heavier than those in the other three groups (p<.01). Vaginal smears showed that a response like that of oestrogen-induced with exfoliative cells appeared in the OV+EAP group rats after EAP. EAP had no influence on the change of exfoliative cells in EAP group. EAP may promote the synthesis & secretion of the adrenal steroids, the androgen of which will then be transformed into oestrogen in other tissues, thus compensating the deficiency of E2 induced by ovariectomy.

42#Chen BY (1997) AP normalises dysfunction of HPOA. AP Electrother Res 22 (2):97-108. Inst of AP, Shanghai Medical Univ, PRC. This article summarises the studies of the mechanism of EAP in the regulation of the abnormal function of hypothalamic-pituitary-ovarian axis (HPOA) in our laboratory. EAP at effective acupoints could cure some anovulatory patients in a highly effective rate. EAP may regulate the dysfunction of HPOA in several ways, which means EAP could influence some gene expression of brain, thereby, normalising secretion of some hormones, such as GnRH, LH & E2. The effects of EAP at different acupoints may be relatively specific.

43#Chen BY, He L (1992) EAP enhances activity of adrenal nucleolar organiser regions in ovariectomised rats. AP Electrother Res 17 (1):15-20. Inst to AP Research, Shanghai Medical Univ, PRC. Nucleolar organiser regions (NORs) may reflect the activity of cell Differentiation & transcription of nucleolar rDNA; the present paper studied nucleolar organiser regions of the adrenal cortex to explore the regulatory effect of EAP. Animals were divided into four groups: (1) ovariectomised EAP group (OV+EAP group, n=7); (2) ovariectomised group (OV group, n=4); (3) EAP group (n=3); (4) control group (CT group, n=4). Number of AgNORs of 100 cells from zona fasciculata of the adrenal cortex in each case of the four groups was counted at random & the mean+SE (number/cell) in each group was calculated as follows: OV+EAP group, 2.71+0.26, OV group, 1.26+0.15, EAP group, 1.21+0.04 & CT group, 1.48+0.03. The mean of AgNORs in OV+EAP group differed highly significantly from the other three groups (p<.01) as tested with ANOVA & LSD method. No significant difference was found among the other three groups. Gross specimen examination showed that adrenals in the OV+EAP group were significantly heavier than those in the other three groups (p<.01). Vaginal smears showed that a response like oestrogen-induced one with exfoliative cells appeared in the OV+EAP group. EAP had no significant effect on normal rats. EAP may promote the synthesis & secretion of adrenal steroid hormones, the androgen of which will then be transformed into oestrogen in other tissues, thus compensating the deficiency of E2 induced by ovariectomy.

44#Chen BY; Yu J (1991) Relationship between blood radioimmunoreactive beta-End & hand skin temperature during the EAP induction of ovulation. AETRIJ 16(1-2):1-5. Inst of AP Research, Shanghai Med Univ, PRC. 13 cycles of anovulation menstruation in 11 cases were treated with EAP to induce ovulation. In 6 of these cycles that showed ovulation, the hand skin temperature (HST) of these patients was increased after EAP. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-End (r beta-E) fluctuated, & returned to the pre-AP level by 30 min after withdrawal of needles in normal subjects. After EAP, the level of blood r beta-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood r beta-E in cycles in which the induction failed to cause ovulation was kept higher than normal (p<.05). There was a negative correlation in the decrease of blood r beta-E & increase of HST after EAP (r=.677, p<.01). EAP can regulate the function of the hypothalamic-pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method to predict the curative effect of EAP. The role of r beta-E in the mechanism of ovulation induction by EAP was discussed.

45#Chen C; Gao ZW; Lin JF (1989) [Laser-AP in the treatment of chronic prostatitis]. Chin AP Moxibust 9 (5):5-7. Laser-AP & simple AP were used to treat 104 cases with chronic prostatitis. The laser group: effective rate: 84.9; AP group: effective rate: 52.6. Laser stimulation: He-Ne laser-AP apparatus developed by Pingyang Factory in Zhejiang. Power, 3mW; wavelength, 6328 Angstrom; needle-tip output power 0.5mW. Needle: 1.5" or no.28, 3". Main points selected were BL32 & BL30. Helper points were selected according to Differentiation of Syndromes. It was shown that laser had a stronger effect than AP needles. Results of experimental study were also reported.

46#Chen C; Gao ZW; Liu YL (1991) [Clinical observations & experimental researches on laser-AP in the treatment of 122 cases of chronic prostatitis]. Pap Inter Cong Tradit Med (Beijing '91):121. This article discusses the treatment of 122 cases of chronic prostatitis by laser-AP versus needle AP with a total cure rate of 71%, among which, the cure rate of the group treated by laser-AP was 83% while that in the group treated by AP was 52%. He-Ne Laser-AP was superior to simple AP. Needling the Prostate Point and/or BL32 & BL30 showed no marked difference in curative effect; all these points were effective. Selection of the normal points is easy, safe & causes less suffering to the patients. But the Prostate point has its specific effect when prostatitis is marked by perineal pain. The follow-up study of 32 cases indicated a total relapse rate of only 16% in 2 yr; the effect of the short-term laser-AP was confirmed, & the mid-term effect was stabilised.

47#Chen C; Xu XP (1991) Summary of AP-treatment of chronic prostatitis. J Zhejiang TCM Coll 15 (4):48-49. The treatment of chronic prostatitis with somatic AP, Ear-AP, hydro-AP, EAP & laser-AP was reviewed & the direction of future development was discussed.

48#Chen DB (1993) [Progress of clinical practice on Ear-plaster therapy in Dept of Paediatrics]. J Yunnan Coll TCM 16(4):39-41. The use of Earpoint-plaster therapy in paediatrics was reviewed from the aspects of the manipulations needed, materials used, such as drug pills, adhesive plaster & probe needle. Diseases treated included bronchitis, bronchial asthma, fever, epidemic parotitis, albinism, obesity, restless leg syndrome, weak intelligence, cerebral paralysis, abdominal pain, enuresis, anorexia, acute optic neuritis & nearsightedness.

49#Chen H (1993) Recent studies on Ear-AP & its mechanism. JTCM Jun; 13 (2):129-143. Shanghai Inst of AP & Moxibustion. This article is based on the review of more than eighty references involving AP therapy, APA, Earpoint for diagnosis & its mechanism. Part 1 deals with point selection, methods of manipulation, therapeutic effects & related experience in 56 kinds of disease. These include respiratory, circulatory, digestive, urological, gynaecological, obstetrical, paediatric, otolaryngologic & ophthalmologic, dermatologic diseases & diseases of the nervous systems, as well as treatment of acute abdominal diseases, reduction of body weight, abstinence from smoking & drinking, etc. Many stimulation methods, such as Ear-AP, needle embedding therapy, point injection, bloodletting, laser-AP, Ear-plaster & pressing therapy, etc. are introduced. Part 2 describes experiences of surgical operation & endoscopy under Ear-APA. Part 3 deals with Earpoint-diagnosis, & the clinical application of Earpoints in the diagnosis of cancers, coronary diseases, cholelithiasis, hepatitis, tertian malaria, etc. Part 4 discusses the correlation between the morphology & function of Earpoints. It discusses the relationship between Earpoints & visceral function, & main development in clinical therapy, diagnosis & mechanism of Ear-AP, including the results of studies on reactions of Earpoints during disorders of the body & viscera, reactions of viscera during stimulation of Earpoints & their transmission routes. Based on the analysis of the history & current status of research on Ear-AP, the author emphasises the necessity of attaching importance at the same time to prophylaxis & treatment of serious diseases & standardisation of nomenclature. Suggestions in this regard are made.

50#Chen JL; Chen DZ; Guo DX (1987) [Repair of inguinal hernia under AP anaesthesia]. WFAS 1st Conf (Eng):125. 34 cases of inguinal hernia were operated under APA with good results; there were no relapses during 1-3 yr follow-up. Points used for EAPA were SP06 bilateral + peri-incisional points. Needles were connected to a G6805 EAP stimulator with continuous wave. Excellent 56%, good 32%, poor 12%. After surgery, the patients were ready to walk around. That is beneficial to their early recovery. The wound healed very well in 100% of cases.

51#Chen JY (1988) [Acute mastitis treated by cutaneous AP: Report of 134 cases]. Xinjiang TCM (2):45, 34. Invasion of the exterior pathogens, which are retained & turned into masses, Stasis of LV Qi, Heat in the ST Channel, or Obstruction of Channels, cause acute mastitis. The writer applied the cutaneous needle to stimulate the sacral area, nape area & painful area on the breasts. A medium tapping technique & a frequency of 3 time/second were given. Curative effects: 100 of the cases were cured.

52#Chen WC (1984) [Brief remarks on AP therapy based on the principle of the same disease with different treatments]. Shanghai J AP Moxibust (3):19-20. This is a report of 2 cases of the same disease treated with different methods of AP. Case 1: male, 15 yr-old, with enuresis of the Syndrome of KI-Yang Xu & dysfunction of BL. Points: CV04, SP06, PC06, GB34. Twirling Bu Fa-Xie Fa was used & needle was retained 15 min. The patient was cured after 3 sessions. After 4 more sessions, the therapeutic effect was enhanced. Case 2: male, 14 yr-old, with enuresis of the Syndrome of SP-Xu & disturbance of Qi in the Middle-Jiao. Points: BL20, ST36, GV20, CV03, BL28. Twirling Bu Fa-Xie Fa was used & the needle was retained for 15 min. The patient was cured after 12 sessions.

53#Chen Y (1993) AP treatment of functional defective ejaculation: a report of 70 cases. JTCM Mar 13(1):10-12. Dept of AP, Moxibustion & Massage, Fujian TCM College, Fuzhou, PRC. No abstract online.

54#Chen YD (1984) [A preliminary study on catgut embedding at point SP06 to induce ovulation]. Chin J Integ Tradit West Med 4 (9):521-522, 514. This paper presents 24 cases treated since 1974, among which 18 are classified as functional sterility, the other 6 as secondary amenorrhoea. Through regular measurement of BBT & endometrial biopsy, all 24 patients were diagnosed as anovulatory. Catgut embedding at SP06 had good therapeutic effect. 18/22 cases that were followed up ovulated, & 16 became pregnant. The treatment of another 4 cases with amenorrhoea had no effect. Catgut embedding at point SP06 not only induced ovulation, but also showed therapeutic effect on PCOS. It has an action similar of Clomiphene in inducing ovulation, but no side effects to that of the latter. Owing to the limited number of cases the rates of ovulation & pregnancy cannot be worked out at present, but clinical observation shows that catgut embedding at point SP06 is an ideal therapy to induce ovulation. It is simple & handy, with no side effect or danger of over-stimulation. Catgut embedding can regulate the function of ovary for a long period of time, but the mechanism awaits further study.

54a#Chen Z; Chen L (1991) The treatment of enuresis with scalp AP. JTCM Mar 11(1):29-30. Linhai City Hospital of TCM, Zhejiang Province, PRC.

55#Chen ZH (1989) [AP in the treatment of traumatic paraplegia: Report of 150 cases]. Tianjin TCM 1989; (5):5-6 . Before AP, ask patient to urinate. Main Points: 1-2 GV points above & below the traumatic level; or 1-2 X_35 (Huatojiaji) Points above below the traumatic level between spinous processes. Puncture perpendicularly to a depth of 1.5-2.5" & lift & thrust the needles slowly & evenly. If a sensation of break-through is perceived suddenly, or a lightening sensation occurs in the external urethral orifice, the anus, & lower extremities, stop needling immediately to avoid damage to the spinal cord. Helper Points: CV04 (or CV03), ST25, BL54, BL37, BL40, BL60, ST31, ST32, ST42, ST36, GB34, GB39. Needle perpendicularly; lift & thrust coordinated with twisting-rotating. CV03, CV04 may be selected alternately. Depth of AP, 1.5-2". Results: Basically cured, 31 cases; notably effective, 36 cases; improved, 79 cases; ineffective, 4 cases. Total effective rate, 97%.

56#Chen ZW (1988) [Scalp AP therapy: Report of 4 cases]. J Zhejiang TCM Coll 12(2):54. 1. Hemiplegia after apoplexy. Main points: Take middle line of vertex, anterior oblique line of vertex-temporal, middle line of forehead with acupoints 3-5 in number on the limbs. After 2 courses of treatment, free movements resumed. 2. Enuresis in children. Take middle line of vertex, needle retained intermittently for 2 h. Treatment was stopped after 2 courses of therapy (15 sessions/course). Follow-up studies over 3 mo showed no longer enuresis. 3. Acute sprain of the back. Take upper middle line of occiput & upper-lateral line of occiput. After 2 trials of treatment free movement resumed. 4. Perarthritis of the shoulder joint. Puncture the point 2/5 of the way along the anterior oblique line of vertex-temporal, in addition another puncture at the Ashi / tender point of the shoulder. After 2 trials of treatment, free movement resumed.

57#Cheng PT, Wong MK, Chang PL (1998) A therapeutic trial of AP in neurogenic bladder of spinal cord injured patients - a preliminary report. Spinal Cord Jul 36(7):476-480. 80 cases with spinal cord injury (SCI) & neurogenic bladder were studied. 28 (70%) cases in the control group & 32 (80%) cases in the EAP group achieved ultimately balanced voiding & were selected for further analysis. The AP group received EAP at 4 points: CV03, CV04, & bilateral BL32 + conventional intermittent catheterisation program (ICP). The control group underwent conventional bladder training program with ICP only. The time of achieving balanced voiding was significantly shorter with EAP than in the control group: 57.1+22.5 vs 85.2+27.4 d (p<.005) for upper motor neurone lesions, & 55.4+22.6 vs 83.4+26.1 d (p<.01) for lower motor neurone lesions. However, there was almost no difference between upper motor neurone lesions & lower motor neurone lesions. When AP commenced was also a factor to influence the results. Those who received AP <3 wk after injury had a significantly shorter interval to achieve a balanced bladder, as compared to those who received AP 3 wk after injury (46.6+13.2 vs 65.8+15.4 d, p<.005). AP may be beneficial in the management of neurogenic bladder of SCI; the earlier the patient received EAP therapy, the sooner the bladder balanced. However, AP was not useful in complete spinal cord injury, either with pronounced detrusor-sphincter dyssynergia in upper motor neurone lesion or with persistent areflexic bladder in lower motor neurone lesion.

58#Chi ZR (1987) [Prostatitis treated by He-Ne laser-AP: Report of 30 cases]. Shandong JTCM (4):13. 30 cases among the group were treated with the He-Ne Laser made in the Weihai Medical Instrument Factory. The fibre diameter of the He-Ne Laser was 50/125 microns, & the efferent power of ending was 1.8 mW. A special needle with an optic fibre inside was inserted from CV01 into the prostate under the index finger, which was inserted into the anus. The treatment was given once/d, & each treatment lasted 20 min. Four treatments were as a course. 19 cases recovered, 10 improved. The total effective rate was 96%.

59#Chien CH, Li SH, Shen CL (1991) The ovarian innervation in the dog: a preliminary study for the base for EAP. J Auton Nerv Syst Sep; 35 (3):185-192. Dept of Anatomy, College of Medicine, National Cheng-Kung Univ, Tainan, Taiwan, ROC. The origin of the canine ovarian sensory & sympathetic nerves was studied by applying horseradish peroxidase (HRP) or wheat germ agglutinin conjugated to HRP (WGA-HRP) to the ovarian stroma & into the ovarian bursa. HRP/WGA-HRP positive neurones were found bilaterally in the dorsal root ganglia of T10 to L4 segment with the majority located in T13 to L2. In sympathetic paravertebral ganglia, labelled neurones were distributed bilaterally in ganglia from T11 to L4 with the majorities located in segments T13 to L2. Both distributions show ipsilateral predominance. Labelled prevertebral neurones were mainly located in the aorticorenal ganglion, ovarian ganglia & caudal mesenteric ganglion. No labelled neurones were found in the dorsal motor nucleus of vagus, nodose ganglia or sacral segment from S1 to S3. This study provides the possible morphological basis of EAP concerning the somatovisceral reflex of the ovary.

60#Chu CY (1985) [Selection of medical records from Dr. Yang Jiebing's patients]. Sichuan TCM 3(5):37-38. This paper contains 5 case records by Yang Jiebin concerning acroparaesthesia, prolonged penile erection with spontaneous emission, deviation of the eye & mouth, pain in the hypochondrium & pain in the waist & the lower extremities by cold-wetness evil.

61#Collet D, Chameaud J, Baudet JH, Bossy J (1985) [AP in obstetrics - Article in French]. Rev Fr Gynecol Obstet Jan; 80 (1):25-31. AP has been used in China as a treatment modality for 1000 yr & is becoming increasingly important in the western world. Through a special effect on the reticular formation, AP is becoming a first choice among the various methods available to relieve pain, especially in the pregnant woman. It can be useful, in fact, during the three periods of a pregnancy: before delivery: it can effect all the functional & psychiatric problems a pregnant woman may develop; during delivery: there is a definite analgesic & oxytocic effect; after delivery: it can be beneficial in all difficulties with breast feeding. Acupoints used in obstetrics are not very numerous. There are approximately 30 that are located along the body Channels or on the ear.

62#Crocetti E, Crotti N, Feltrin A, Ponton P, Geddes M, Buiatti E (1998) The use of complementary therapies by breast cancer patients attending conventional treatment. Eur J Cancer Feb; 34(3):324-8. U.O. di Epidemiologia, CSPO, Azienda Ospedaliera Careggi, Firenze, Italy. The aim of this study was to measure the proportion & characteristics of complementary therapy (CT) users among female breast cancer patients receiving conventional treatment. 473 women who had received surgical intervention for breast cancer in the year of diagnosis were sent a questionnaire for completion, & 242 responded. CT had been used by 16.5% after cancer diagnosis, only 8.7% before. The most commonly used CTs were homeopathy, manual healing method, herbalism & AP. The main reason for using CTs was physical distress. Only a minority was searching for psychological support. 24 users were satisfied with these treatments, & 66.7% would suggest them. Users were significantly younger, more educated, & previous users of CTs than non-users. Adjusting each variable for the effect of the others, only previous use had an independent effect on increasing the probability of being users after cancer diagnosis.

63#Cui SY (1986) [Treatment of epididymal stasis after vasoligation with audio-freqency therapy applied on the points]. Chin J Integ Tradit West Med 6(2):89 An Audio-frequency Instrument, Model NY-2, with adjustable frequencies 50-500 Hz. & 50x15x1 mm lead-plate electrodes, with a 60x20 mm lining, were used. Two electrode protocols were used once/d, 10 d/course: (a) In Course 1, two electrodes placed symmetrically at bilateral ST30-LV12-LV11 along both sides of the genitals (200 Hz, 20 mA); (b) In Course 2, two electrodes were placed along the courses of CV, Chongmai & KI Channels at CV01 + CV03-K112 (200 Hz, 20-30 mA). Protocols (a) & (b) were alternated between courses, using the principle of combination of related points. The intensity used in the 3rd course depended upon the patients' conditions, but the maximal intensity was kept <40 mA. 10/11 cases were cured.

64#Dai XJ (1990) Postoperative pain treated by Ear-AP: Analysis of 94 cases. J Nanjing Coll TCM 6(2):42-43. 47 patients operated on abdomen, breast, neck & perineum were included in this group. AP was used at Earpoints Shenmen, LV; helper points were: in appedectomy add Appendix; hernia repair add External genitalia; cholecystectomy add GB; hiccup add Diaphragm; hypertension add Adrenal. Sterilise Earpoints; tape on dried Vaccaria Seeds & press for 5-10 min, once every 30 min, 2-3 times, & when pain occurred. Control group: 47 cases got Dolantin, i/m. Of 38/47 cases treated by Ear-AP were markedly better, 4/47 effective, & 5/47 not effective. Recovery of intestinal peristalsis by pressing Earpoints increased more markedly than in the Dolantin group.

65#Darenkov AF; Balchii-ool AA; Shemetov VD; Troitskii OA; Kuznetsov VM (1993) AP in the combined treatment of pyelonephritis. Urologiia i Nefrofogiia Mar-Apr(2):10-12. Pyelonephritis causes problems in practical uronephrology; the main clinical treatments aim to enhance the patient's resistance, KI blood flow & urodynamics. As AP was said to meet the above requirements, it was used in a combination treatment of 102 pyelonephritis cases (51 acute & 51 chronic) with intact KI function. Radionuclide renography showed a positive trend in the secretion & urodynamics of the upper urinary tract in 50% of the cases. Dynamic nephroscintigraphy gave a positive response in 60% of cases versus 25% in those treated without AP. AP promoted earlier recovery or remission, reduced the scope of chemotherapy & gave good short- & long-term response. AP is recommended for application in urological & nephrological practice.

66#de Aloysio D, Penacchioni P (1992) Control of morning sickness in early pregnancy by acupressure at PC06. Obstet Gynecol Nov; 80 (5):852-854. Dept of Obs&Gyn, Bologna Univ, Italy. They evaluated the antiemetic effect of acupressure at PC06. 60 women in early pregnancy were entered into a randomised, double-blind, cross-over, placebo-controlled trial. During a 12-d period, organised in four steps of 3 d each, the women were divided into two homogeneous groups to test the effectiveness of unilateral & bilateral acupressure. Acupressure gave in a significantly lower frequency of morning sickness compared with placebo treatment. >60% positive effect was found with unilateral & bilateral acupressure, compared with an approximately 30% positive effect of placebo acupressure. Changing from unilateral to bilateral pressure on PC06 caused no significant improvement. No noteworthy side effects occurred. Acupressure on PC06 relieves morning sickness. Randomised controlled trial.

67#Deng CL (1988) [Clinical achievements of treating bladder diseases by AP & moxibustion]. Chin AP Moxibust 8(2):48-50. Current experience in treating bladder disease by AP & moxibustion was summarised. They are the best way to cure enuresis, retention of urine due to varied causes, inflammation of the urinary system, & bladder & urethral stones. Prostatectomy, i/v pyelography, & pyelolithotomy performed under APA discussed.

68#Donchenko VS; Kiverov SV; Lants GI; Uramaev FR; Samoilov VA (1991) [Pharmacological stimulation of AP points for analgesia in patients with gynaecologic diseases in the postoperative period]. Akush Ginekol Mosk May 5:69-70. No abstract online.

69#Dong XQ (1985) [Current status of AP & moxibustion therapy of gynaecological & obstetric diseases]. Zhejiang JTCM 20(6):286-288. This is a summary of recent developments of acupuncture & moxibustion in the treatment of various gynaecological & obstetrical diseases from 1980 to 1984. The diseases include dysmenorrhoea, acute mastitis, leukoplakia vulvae, lactation deficiency & lactifuge, threatened abortion, artificial abortion, induced parturition & oxytocic parturition, postpartum urinary retention, parturition pain, etc.

70#Dundee JW, Ghaly RG, Bill KM, Chestnutt WN, Fitzpatrick KT, Lynas AG (1989) Effect of stimulation of the PC06 antiemetic point on postoperative nausea & vomiting. Br J Anaesth Nov; 63 (5):612-618. Dept of Anaesthetics, Queen's Univ of Belfast, Ireland. The antiemetic action of stimulation of PC06 has been studied in women, premedicated with nalbuphine 10 mg, undergoing minor gynaecological operations under methohexitone-nitrous oxide-oxygen anaesthesia. Invasive AP, manual or electrical at 10 Hz, for 5 min at the time of administration of the premedication markedly reduced the incidence of vomiting & nausea in the first 6 h after operation, compared with untreated controls. This did not occur with stimulation of a "dummy" AP point outside the recognised AP Channels. Non-invasive methods (stimulation via a conducting stud or by pressure) were equally as effective as invasive AP during the early postoperative period. However, both these non-invasive approaches were less effective than invasive AP in the 1-6 h postoperative period, although each was as effective as two standard antiemetics (cyclizine 50 mg, metoclopramide 10 mg). In view of the total absence of any side effects in more than 500 AP procedures, the clinical applications of this finding are worthy of further study. Randomised controlled trial.

71#Dundee JW; Chestnutt WN; Ghaly RG (1986) Traditional Chinese AP: a potentially useful antiemetic?. Br Med J [Clin Res] 293 (6547):583-584. Two consecutive studies were done to evaluate the effectiveness of AP as an antiemetic when used with opioid premedication in patients undergoing minor gynaecological operations. In the first study 25 of the 50 patients underwent AP immediately after premedication with 100 mg meptazinol, the rest receiving the drug alone, & in the second 75 patients were allocated randomly to one of three groups: a group receiving 10 mg nalbuphine & AP, a group receiving premedication & dummy AP, & a group receiving premedication alone. Manual needling for 5 min at PC06 significantly reduced perioperative nausea & vomiting in the 50 patients who underwent AP compared with the 75 patients who received no AP. These findings cannot be explained, but it is recommended that the use of AP as an antiemetic should be explored further.

72#Engel K; Gerke-Engel G; Gerhard I; Bastert G (1992) [Foetomaternal macrotransfusion after successful internal version from breech presentation by moxibustion]. Geburtshilfe Frauenheilkd Apr 52(4):241-243. Univ-Frauenklinik Heidelberg, Germany. In a primigravida with a fundal/anterior wall placenta, a successful cephalic version was noted at 39 wk after repeated moxa use at BL67. Since routine foetal heart rate monitoring showed a sinusoidal pattern with severe decelerations, immediate Caesarean section was performed. Foetomaternal macrotransfusion of circa 300 ml of blood was found. In view of this complication, possible risks of the method are discussed. Moxibustion is not suitable as self-therapy without close medical follow-up.

73#Fan MF; Deng CL (1994) [Enuresis treated with irradiation of He-Ne laser on acupoints in 212 cases]. Chin AP Moxibust 14(5):245-246. They treated 212 cases of enuresis using He-Ne laser-AP at CV04, SP06 & Yeniaodian (EX) as Main Points & CV03 as a Helper point. 204/212 cases were effective (96%). Statistical analysis showed that the effect was not markedly different with variation of ages & the course of disease (P>.05).

74#Fang SH (1985) [EAP therapy of enuresis: Report of 150 cases]. Hubei JTCM (6):37. EAP was used at CV06, CV04 as the main points for enuresis, & ST36 & SP06 as Helper points. The needle was punctured from CV06 through CV04 to CV03 until Deqi spread to the external genitalia. A Helper point was used also. The needles were connected to a 6805 apparatus with high-frequency & continuous wave current, & retained for 30 min. Treatment was once/d for 10-15 d/course, with an interval of 3-5 d between courses, if needed. 79/150 cases were cured, 58 improved & 13 failed.

75#Fang YA (1986) [Acupuncture in the treatment of menoxenia, menalgia & leucorrhoea]. Shanghai J AP Moxibust 5(2):20-22. To treat menstrual disturbance & menorrhalgia: For Shi or Heat syndrome, CV06, SP10 & SP06; For Xu & Cold syndrome, CV04, KI03 & SP06. In both cases, helper points are BL15, BL18, BL20, B23, LV05, LU10, ST36, PC06 & LV03. During menstruation, the main points were applied with Xie Fa for Shi syndrome, or reinforcing method (Bu Fa) for Xu syndrome. After menstruation, the helper points may be applied. For leukorrhagia: in Shi & Heat syndrome, BL24, BL28 & SP05 as Group A, & GB26, SP09 + SP06 as Group B points. Alternate group A & B. For Xu & Cold syndrome, BL20, BL23 & SP06 as group A, & CV04, CV03 & KI03 as group B. Alternate group A & B.

76#Fava A, Bongiovanni A, Frassoldati P (1980) [AP therapy of hypogalactia - Article in Italian]. Minerva Med Dec 22; 71(51):3747-52. Reference is made to the current tendency to reappraise breast feeding in the light of both medical & social-cultural considerations, & attention is called to the current lack of sound treatments for hypogalactia. The physiopathological mechanisms underlying this condition are examined, & an account is given of results obtained with AP reflexotherapy in this field. The technique is effective, innocuous & well accepted.

77#Fei TF; Song XC; Wang SY (1988) [Effects of AP on levels of plasma oestradiol, progesterone & testosterone in early follicular phase in healthy women of childbearing age women]. Chin AP Moxibust 8 (3):39-42, 38. With RIA, the authors observed experimentally the influence of AP at point Baihui (GV20) on the contents of E2, progesterone & T in early plasma of follicle in 36 cases of healthy women of childbearing age. Progesterone & T were markedly raised but E2 was slightly increased. The authors think that the action of AP is based on regulating Yin & Yang; to enhance the adaptability of internal milieu through endocrine system is the main mechanism of AP in preventing & treating irregular menstruation caused by intrauterine device.

79#Feng SH (1993) [Ear-plaster treatment for 120 cases of dysmenorrhoea]. Shanghai J AP Moxibust 12 (3):117. Earpoints used were Uterus, Endocrine, Jiaogan (MA-AH 7), Ovary, Subcortex & Shenmen, combined with LV for Xue Stasis due to Qi Xu; with SP for Stasis of Cold-Damp; with KI for Qi-Xue Xu. Sterilise Earpoints; tape on dried Vaccaria Seeds & have patient press 4-6 times/d, 5-7 min/time. 2 d later, the contralateral ear was used in the same way as mentioned above. One cycle of menstruation constituted a therapeutic course. 44 cases were cured, 52 had marked improvement, 19 improvement & 5 no effect.

80#Fischl F; Riegler R; Biegelmayer Ch (1984) [AP therapy of subfertility]. Dtsch Z Akupunkt 27 (3):53-56. Also: Fischl F, Riegler R, Bieglmayer C, Nasr F, Neumark J. (1984) Geburtshilfe Frauenheilkd Aug; 44 (8):510-512. [Modification of semen quality by AP in subfertile males - Article in German]. Our first attempt in treating subfertility by AP was carried out on 28 males. The results from experiences in veterinary medicine encouraged us to try AP. Each patient received a total of 10 treatments for a period of 3 wk. Several spermiograms were made after diagnosing subfertility. We checked spermiograms & hormone levels before & after AP. Total count, concentration & motility were evaluated. In all cases we observed a statistically significant improvement of sperm quality. We intend to continue AP therapy in subfertile males for insemination or intercourse on time of the ovulation of their female partners.

81#Flaws B (1986) Leucorrhoea & vaginitis: Their differential diagnosis & treatment. Am J AP 14 (4):306-316. The views of several different authors are compared with the schema of the Chinese patterns of disharmony covering leucorrhoea & vaginitis. Also, AP therapy & herbal protocols for each of the patterns are discussed. Also described are the Syndromes that most commonly cause leucorrhoea & vaginitis, & comprehensive treatment plans for western patients including diet & lifestyle modification.

82#Flaws B (1989) Grasping the essence: a short discussion of spermatorrhoea & the logic of TCM. Am J AP 17 (2):153-158. In this paper the author discusses Damp Heat in the Lower Jiao as the most common cause of spermatorrhoea in young American men & the fact that this Pattern of Disharmony is largely overlooked in the current English-language literature. The author further discusses the necessity of understanding disease mechanisms in order to avoid misinterpreting the significance of individual signs & symptoms.

83#Fouques Duparc V, Herlicoviez M, Levy G (1979) [The induction of parturition by EAP: A new technique & one that is thirty centuries old; a preliminary study - Article in French]. J Gynecol Obstet Biol Reprod (Paris) 8 (8):755-760. Ten patients had their parturitions induced by EAP. This method was successful in starting parturition each time. Eight women delivered normally vaginally. One had a caesarean & had uterine contractions without dilatation of the cervix. EAP has also allowed us to accelerate parturition.

84#Frygner K (1994) [AP during childbirth]. Jordmorbladet 5:20-21. In Norwegian. No abstract online.

85#Fu XS (1994) [Clinical application & general research situation of AP-induced painless parturition]. Chen Tzu Yen Chiu (AP Res) 19 (3/4):178-179. In this article, the author reviewed clinical application of AP therapy & its general situations of experimental research in painless parturition in the past 10 yr. It has got fairly good effects & satisfied progress in clinical application & is thought to be safe, effective & painless. There is no harmful effects to parturients & their babies.

86#Gao DK; Su JM; Liu CA (1986) Efficacy of AP at GB21 in 393 cases of acute mastitis. JTCM 6(1):19-20. 393 cases of acute mastitis were successfully treated by AP at ipsilateral GB21, using a 28-30 gauge, 2" needle, inserted with the Xie Fa to a depth of 0.5-0.8". Fast twisting & twirling of the needle (no lifting & thrusting) until Deqi was felt at the shoulder, breast or arm gives strong stimulation. The manipulation was continued for 3-5 min. All 393 cases were in the inflammatory stage. 82% were cured in 1-3 d & total effective rate was 99%. Early cases are particularly suitable for AP therapy.

87#Gao H, Ji S, Chen B (1995) [EAP promotes enlargement of adrenals & enhances level of blood cortisol in ovariectomised rats - Article in Chinese]. Chen Tzu Yen Chiu (AP Res) 20 (2):55-58. Dept of Neurobiology, Shanghai Medical Univ. The present article reports EAP with special acupoints may promote the enlargement of bilateral adrenals & enhance the level of blood cortisol in ovariectomised (OV) rats. The mean of adrenal weights (X+SE, mg) were: OV+EAP group 71+2.1, OV group 57.4+4.7, EAP group 57.6+1.1 & control group 54+2.8 respectively. As a self control, the detection of blood cortisol contents was performed in the same animals before & after ovariectomy. Before ovariectomy the contents of blood cortisol in the rats were 3.27+0.7 micrograms/100ml before EAP & 3.63+0.9 micrograms/100ml after EAP. No significant difference of blood cortisol level was found before & after EAP. After ovariectomy, the level of blood cortisol increased from 4.38+0.62 to 6.02+0.77 micrograms/100ml after EAP (p<.01). No similar effect of EAP at control acupoints in OV rats was seen. EAP may regulate abnormal endocrine function; the effect of EAP has relative specificity of acupoint.

88#Gao HR (1985) [Functional uterine haemorrhage treated by Earpoint pressure with vegetable seeds]. Chin AP Moxibust 5 (5):45. Points: Uterus, Ovary, Fallopian tube, Pelvis, Helper points: Subcortex, Endocrine, Adrenal, Shenmen, Brainstem, Brain point, LV, SP, KI. Disinfect the relevant points of the ear, & then fix the Rapeseeds against the points with adhesive tape. For severe cases, treat every 2 d. After 3-5 treatments, the treatment was changed to 2 times/wk. The ears were treated alternately. The therapy should last 1-4 wk, then you could get the effect.

89#Gao XG (1984) [Observation on the treatment of enuresis by AP on CV04 & SP06]. 2nd Natl Symp AP-Mox & APA (Beijing):93-94. In TCM theory, enuresis is related to abnormal function of the three Foot-Yin Channels (LV, SP, KI), the CV, TH, SI & BL Channels. So CV04 (Mu point of SI Channel & the intersection of three Foot-Yins & CV Channel) & SP06 (intersection of three Foot-Yins) were selected. 230 cases, 4-20 yr-old, 144 male, 89 female, were treated. AP needles, 32 gauge, were used. After point-sterilisation 74% alcohol, needles were inserted rapidly, with moderate stimulation until Deqi; needles were retained for 20-30 min. Treatment was twice/wk for 10 times/course. 92/230 cases recovered completely, 29 improved markedly (enuresis decreased by 80-90%), 78 improved (enuresis decreased by 50%) & 31 failed. Total effective rate was 86%.

90#Ge SH; Meng FY; Xu BR (1988) AP treatment in 102 cases of chronic prostatitis. JTCM (ENG) 8 (2):99-100. AP at BL35 & BL23 was used to treat 102 cases of chronic prostatitis. Strong Xie Fa was used with no needle retention. Treat every 1-2 d, 10 times/course. After treatment, 46% were cured, 20% greatly improved, 18% improved & 16% were ineffective.

91#Geirsson G; Wang YH; Lindström S; Fall M (1993) Traditional AP & electrostimulation of the posterior tibial nerve: A trial in chronic interstitial cystitis. Scand J Urol Nephrol 27(1):67-70. Dept of Surgery, Sahlgrenska sjukhuset, Univ of Göteborg, Sweden. A prospective study on the symptomatic effect of traditional Chinese AP treatment & TENS of the tibial nerve in cases with interstitial cystitis is presented. There was no difference in voiding frequency, mean voided volume, maximal voided volume or visual analogue scale symptom scores before or after treatment with either TENS or AP. Only one patient improved subjectively & objectively after AP for a short period of time. Even though the present material involves a small group of patients, it seems that the 2 methods, as applied in this study, have very limited effect in cases with interstitial cystitis.

92#Gerhard I, Postneek F (1988) [Possibilities of therapy by Ear-AP in female sterility - Article in German]. Geburtshilfe Frauenheilkd Mar; 48 (3):165-171. Abteilung fur gynakologische Endokrinologie der Univ.-Frauenklinik Heidelberg. After a differentiated endocrine & gynaecologic diagnosis Ear-AP was used in 15 women with oligoamenorrhoea & 12 women with corpus luteal insufficiency who had come for hormone consultation because of sterility. In both groups the subsequent incidence of pregnancy was comparable to that achieved by drug therapy. The greatest successes were in cases of amenorrhoea with positive progesterone test & normal basal hormones or hyperandrogenaemia, while there was less improvement in cases with negative progesterone test, anorexia & luteal insufficiency. Even though it is time-consuming, AP deserves to be more widely used, considering the lack of side effects, the low abortion rate & its positive influence on the patient's general condition.

93#Gerhard I; Postneek F (1992) Ear-AP in the treatment of female infertility. Gynaecol Endocrinol 6(3):171-181. Dept for Gynaecological Endocrinology & Reproduction, Women's Hospital, Univ of Heidelberg, Germany. In a German study, after a full gynaecologic-endocrine work-up, 45 infertile women (oligoamenorrhoea (n=27); luteal insufficiency (n=18)) were treated with Ear-AP. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle & tubal patency. There was a fractionally higher birth rate in the group treated with AP (22/45) than in the group treated with hormones (20/45). The researchers noted that the AP group experienced additional health benefits & no adverse side effects. Ear-AP seems to be a valuable alternative therapy for female infertility due to hormonal disorders, being more effective & with no side effects.

94#Ghaly RG; Fitzpatrick KT; Dundee JW (1987) Antiemetic studies with traditional Chinese AP: A comparison of manual needling with ES & commonly used antiemetics. Anaesthesia 42 (10):1108-1110. EAP (low frequency, 10 Hz) for 5 min to an AP needle at PC06 is as effective as manual needling in the reduction of emetic sequels in women premedicated with nalbuphine 10 mg for a minor gynaecological under a standard anaesthetic. Both were slightly, but not significantly, better than the antiemetic properties of cyclizine 50 mg.

95#Gieron C, Wieland B, von der Laage D, Tolksdorf W (1993) [Acupressure in the prevention of postoperative nausea & vomiting - Article in German]. Anaesthesist Apr; 42 (4):221-226. Klinik fur Anasthesiologie, Med Fak, RWTH Aachen. Despite modern anaesthetic procedures, postoperative nausea & vomiting are still the side-effects most often mentioned: acupressure is reported to be an additional method of preventing these effects in minor gynaecological surgery. We investigated the effectiveness of acupressure in patients undergoing gynaecological operations of longer duration (6-8 h) in a real acupressure group compared to a placebo group. Before beginning the study we investigated a control group to find out the frequency of emesis. In the worst case of nausea that we encountered, 80% in the 0-6 h postoperative period, the number of random samples for the acupressure & placebo groups was calculated (30 patients in each group). The error for alpha was established at 5% & the reduction of nausea was 50%. METHODS. The female patients were 18 to 65 yr old (ASA group I & II). Acupressure was carried out by fastening small metal bullets at the point PC06 to each forearm by means of an elastic bandage. The bullets were left there for 24 h. The premedication anaesthesia, postoperative analgesia, & antiemetic treatment were standardised. During a 24-h period we investigated the incidence of nausea & vomiting. The anthropometric data, the duration of surgery & the amount of postoperative analgesia were comparable between the three groups. Real acupressure obtained a statistically significant & relevant reduction in nausea up to the 6th postoperative hour in comparison with the placebo group (p=.03). Nausea was reduced from 53% in the placebo group to 23% in the acupressure group. Acupressure effectively prevented nausea & vomiting without any side-effects in patients under longer gynaecological surgery, & in chemotherapy-induced nausea & vomiting. It is a valuable addition to the prevention of postoperative nausea & vomiting. Further studies should be conducted to investigate this possibility further.

96#Ginzburg LI, Zharkin NA (1985) [Status of the breasts after reflexotherapy of chronic recurrent salpingo-oophoritis - Article in Russian]. Akush Ginekol (Mosk) Jul; (7):32-4.

97#Gong D; Liang C; Lai X; Lai X (1993) [Effects of different AP manipulation on plasma oestradiol (E2), testosterone (T) & cortisol (C) in patients with KI Xu]. Chen Tzu Yen Chiu 18(4):253-256. Dept of AP & Moxibustion, Guangzhou Coll of TCM. Observation was made on the effect of different AP manipulation on plasma E2, T, E2/T & C in 78 patients with KI Xu (Deficiency). Both reinforcing manipulation (Bu Fa) & reducing manipulation (Xie Fa) lowered the level of E2 & T in women. Xie Fa, but not Bu Fa, lowered E2/T index, & there was a significant difference (p<.05) between the Xie Fa & Bu Fa groups in E2/T, but no significance between the men's groups. The level of C was decreased by Xie Fa but not by Bu Fa. The different manipulation effects are different on the level of sex hormones in women & the C level in patients with KI Xu.

98#Gourion A (1987) [3 case reports with discussion]. Rev Fr Med Tradit Chin (121):75-81. Case 1, female, 21 yr, eczema since youth. Main points: SP10 & GV14; with lesion at the elbow, add TH10, TH03, TH05; lesion in the neck, add TH15, GB21, GB20, ST25; frequent prolonged & irregular menstruation with dysmenorrhoea, use CV17; alternation of constipation & diarrhoea, add CV12 & SP06. Case 2, male, 57 yr, pain in neck, elbow, shoulder, hip, knee, fingers & toes, diagnosed as Fengpi (Arthralgia due to Wind). AP BL17 & SP10 with Bu Fa, & GV16, GB20 & BL12 with Xie Fa. Case 3, male, 76 yr, constipation & mild vision disorder for many years, ameliorated if fasting & less food. Points: ST25, CV04, CV12, PC06, LI04, LI02, TH06, ST36, ST40, SP06, LV01; Pricking & pulsating headache Z_09, GV23, LI04 with Xie Fa; hypertrophy of the prostate since 66 yr of age, Moxibustion at BL23, CV04, or add KI06, ST36, & SP06.

99#Grochmal SA, Ostrzenski A, Connant C, Garratt D (1996) Seven-Year Experience with Office Microlaparoscopy & Hysteroscopy. J Am Assoc Gynecol Laparosc Aug; 3 (4, Supplement):S16-S17. Dept of Obs&Gyn, Howard Univ College of Medicine, 2041 Georgia Avenue, NW, Washington, DC 20060.[Record supplied by publisher]. Since 1989 more than 1200 office-based endoscopies have been performed at our facility. Visualisation was initially achieved with 1.6-mm optical catheters, but recently, we have used larger-diameter fibre & glass rod endoscopes. Ancillary instruments progressed from 5- to 2-mm diameters, although we punctured occasionally with cannulas up to 20-mm. Anaesthesia remained consistent, with local infiltration followed by conscious sedation given by an on-site anaesthesiologist. Lately, alternative methods of anaesthesia including hypnosis & AP have had some initial success. To date, we have performed 156 tubal ligations, 293 diagnostic laparoscopies, 151 treatments of endometriosis, 43 ovarian cyst aspirations, 29 adhesiolyses, 263 second-look procedures, 21 ectopic pregnancy removals, 198 diagnostic hysteroscopies, 64 endometrial biopsies, 20 fibroid resections, & 39 endometrial ablations. Patient response has been rewarding, thanks to decreased time off work, decreased cost of procedures to health insurance carriers, & immediate satisfaction from the diagnosis & treatment of their conditions.

100#Gu XD (1994) Clinical report on treatment of postoperative urinary retention with AP at 4-Liao (BL32 & BL33) & SP06 acupoints. Am J AP 22(4):349-351. The Baliao (Four Liao) points are BL31-BL34, over the 4 sacral foramina. This reports on 12 cases with postoperative urinary retention treated with AP at 2 of the 4 Liao, BL32 & BL33, bilaterally + SP06. Treatment was successful in 100% of cases. The treatment methods are safe, easily mastered, effective & without side effects.

101#Guan ZH (1988) [Effects of AP on lactation]. Chin J Integ Tradit West Med 8(7):441. Promotion of lactation: LI11, CV17 & ST18. Helper points were SI01, ST36 & LV03. 3-4 points were used each time, once/d with Bu Fa, retaining the needle for 10 min. Moxa was added at CV17 & ST18. 11/42 cases were very effective, 23 effective, & 8 failed. To dry off lactation (Huinai): three Huinai points (at midpoint of spinal process of T4, T5 & T6 respectively), GB37 & GB41 were chosen. One of the 3 Huinai points was used/d; after needle insertion, rotate in a small amplitude 1 min & retain 5 min. Normal Bu Fa-Xie Fa & 5 min needle retaining were used at GB37 & GB41; moxa was added after AP. After moxa, moderate circular flicking 2 times with plum blossom needle was applied from the areola to the periphery. 5/12 cases dried off within 5 d; 3/12 were non-effective.

102#Guillaume G (1992) Postmenopausal osteoporosis & Chinese medicine. Am J AP 20:105-111. Postmenopausal osteoporosis, a major health threat to woman, is described in terms of its energetics according to TCM. Included are prescriptions for treatment of its symptoms with AP & herbal therapy. Research into the prevention & treatment of osteoporosis through the application of these modalities is warranted.

103#Guo CJ; Zhang HY; Gao ZY (1987) [Antagonism of AP with mammary hyperplasia caused by E3]. Shaanxi J Chin Tradit Med 8(11):517. The effect of AP treatment of mammary hyperplasia in our hospital was satisfied. Its mechanism of treatment in the experiment was studied, & the animal model of mammary hyperplasia in rabbit was first established domestically. AP decreased the occurrence of E3-induced mammary hyperplasia in rabbit. The promotion of the sensibility of the E3 receptor may be its mechanism. Also: Guo CJ (1988) Observations on the therapeutic effect of mammary hyperplasia of 500 cases treated by AP. J Chin AP Moxibust [Eng] 1(3-4):87-89. 500 cases of mammary hyperplasia were treated since 1978 (150 outpatients & 350 inpatients). Major points: ST15 bilateral, CV17, LI04 bilateral; in chest group. SI11, GB21, BL18 bilateral, in back group. In LV Fire, LV03 & GB43 were added & LI04 subtracted; in Yin-Xu of LV & KI, KI03 was added & BL18 subtracted; in Xu of Qi-Xue, BL20, ST36 were added & BL18, LI04 subtracted; irregular menstruation, SP06 was added & LI04 subtracted; fullness of chest, TH05 was added & LI04 subtracted. The two groups of points were alternated. AP was once/d with reinforcing method (Bu Fa) in case of Xu & reducing method (Xie Fa) in case of Shi. Needles were retained 30 min, & manipulated 4 times in that time for 10 times/course, with a 3-4 d between courses. Recovery usually came after 3-4 courses. Also: Guo CJ; Zhang WH (1988) JTCM (ENG) 8(3):157-160. Effect of AP treatment in 500 patients of mammary gland hyperplasia. In TCM, mammary hyperplasia is related to functional disorders of the SP & LV induced by anxiety & anger. Since 1978, 500 patients were treated with AP & the curative effects compared with other treatments, including Western medicine, herbal medicine, bean extract or control. The long-term effects of AP were followed-up for 1-5 yr. AP gave good immediate & long-term curative results with little side effects compared with other therapies. The mechanism may relate to improved cellular immunological function & correction of hormonal disturbances. Also: Guo CJ; Zhang WH; Zheng SX (1991) [Clinical observations on mammary hyperplasia treated with EAP & its influence on immune function]. Pap Inter Cong Tradit Med (Beijing '91):135. In recent years we treated 158 in-patients with mammary hyperplasia by EAP & obtained a satisfactory therapeutic effect (The short-term cure rate was 54% & the total effective rate 95%), with no side-effects. On assay of the sex hormones, the E2 level before treatment was apparently higher than in normal subjects, but it was restored to normal after treatment. Experiments on animal models of HMG (rabbits & white rats) induced by hypodermic injection of E2 have proven that AP stimulation was effective in counteracting the model formation. Also AP treatment had a better effect than drug administration in normalising the affected mammary tissues. Elevated concentration of E2 is one of the main causes of HMG & EAP has definite effect in normalising the imbalanced female hormones. The mechanism of EAP treatment for HMG lies in the fact that it lowers the raised E2 in the body, so as to reduce its inhibition on the immune organs & immunocytes, thus strengthen the function of the lymphocytes & accelerate the clearance of the diseased tissues. This study was significant to make further investigation into the AP mechanism & the reduction of the mastocarcinoma morbidity. Also: Guo YM; Guo CJ (1992) [Observation on the therapeutic effect of EAP for 260 cases of mammary hyperplasia]. Chin AP Moxibust 1992; 12(6):293-294. Of 260 cases of mammary hyperplasia treated by EAP, 64% were cured, 18% well improved, 16% improved, & 2% unchanged. The effective rate was 98%. Points: Group 1 ST15, CV17, & LI04; Group 2 SI11, GB21, & BL18, alternating between sessions. AP was once/d, 10 times/course. Most patients were cured or were well improved after 1-3 courses of treatment. Also: Guo CJ, Zhang WH, Zheng SX, Ju D, Zhao C (19??) Clinical observation on efficacy of EAP therapy in mammary hyperplasia & its effect on immunological function. JTCM Dec; 16(4):281-287. Shaanxi College of TCM, Xianyang. We determined the change in immunological function before & after EAP in 44 in-patients with mammary hyperplasia & having the same menstruation date. We also assessed EAP to treat mammary hyperplasia on a rat model. There was decrease of immunological function in mammary hyperplasia; this function was remarkably enhanced by EAP both in human mammary hyperplasia & in the rat model. We presume an inhibitory effect on immunological function exerted by high concentration of E2, & that EAP reversed that. Hence EAP reinforced immunological function. The results of this study are important in exploration of both the pathogenesis of this disease & the mechanism of EAP, & in reducing the incidence of breast carcinoma.

104#Guo CJ; Zhang WH (1987) JTCM 28(1):47-49. [Short-and long-term effect of AP treatment in mammary proliferative diseases: An approach to its mechanism]. Mammary hyperplasia is thought to be a disorder resulting from Stasis of LV-Qi, Xue & Phlegm & Obstruction of Collaterals in the mammary gland. Treatment principle is to soothe LV-Qi & regulate ST-Qi. Points selection: Group 1: ST15 bilateral, CV17 & LI04 bilateral; Group 2: SI11, GB21 & BL18, bilateral. Needle CV17 obliquely outward in 25 degree to 1.5"; needle SI11 horizontally forward to 1.5". Bu Fa is applied for those with Xu-Syndrome, & Xie Fa for Shi-Syndrome. Retain needles for 30 min. Alternate the 2 groups. Treat once/d, 30 times/course. Short-term result in 150 in-patients: 67% were cured, 33% markedly effective, 5% effective & 5% ineffective, the total effective rate was 95%. In 350 out-patients, 37% were cured, 30% markedly effective, 28% effective & 5% ineffective, the total effective rate being 95%. The long-term effect was stable & increased as the period of follow-up lengthened.

105#Hammar M, Frisk J, Grimas O, Hook M, Spetz AC, Wyon Y (1999) AP treatment of vasomotor symptoms in men with prostatic carcinoma: a pilot study. J Urol Mar; 161(3):853-6. Dept Health & Environment, Fac of Health Sciences, Univ of Linkoping, Sweden. Most men who undergo castration for prostatic carcinoma have vasomotor symptoms that usually persist for years. Vasomotor symptoms are elicited from the thermoregulatory centre, possibly due to a decrease in hypothalamic opioid activity induced by low sex steroid concentrations. AP treatment in women, which stimulates hypothalamic opioid activity, alleviates vasomotor symptoms. We report on men treated with AP for relief of vasomotor symptoms after castration therapy. We asked 7 men with vasomotor symptoms due to castration therapy to receive AP treatment for 30 min twice/wk for 2 weeks & once/wk for 10 wk. 6/7 men completed at least 10 weeks of AP therapy & all had a substantial decrease in the number of hot flushes (average 70% after 10 weeks). At 3 months after the last treatment the number of flushes was 50% lower than before therapy. Therapy was discontinued after 10 wk due to a femoral neck fracture in 1 man & after 3 wk due to severe back pain in 1. AP may be a therapeutic alternative in men with hot flushes after castration therapy & merits further evaluation.

106#Hammar M, Neds