Академический Документы
Профессиональный Документы
Культура Документы
with HIV
PETER YOON, Ph.D , L.Ac / KYUNG KYU CHOI, Ph.D OMD, L.Ac., / KARP-SOON
RHEEM, Ph.D.
ABSTRACT
Background: While acupuncture is commonly used in HIV for symptom relief or improving QOL, little is
known about acupuncture trial to improve CD4 counts in patients with HIV. Objectives: To assess whether
constitutionally individualized acupuncture trials increased CD4 counts in patients with HIV. Design: A
quasi-experimental case control design. Subjects: Convenience sample of 10 HIV-positive adults.
Method: Experimental group received individualized acupuncture trials which were tailored to the
individual participant's constitution to promote immune function and health. Controlled- needling group
received treatments with points identified as clinically irrelevant in treating the conditions under
investigation. Subjects were treated twice a week for three weeks to six months. After treatment
peripheral bloods of subjects were analyzed at the authorized institution to find the CD4 variation.
Results: Individualized acupuncture trials showed a statistically significant increase in CD4+ counts
(p=0.05). Conclusions: This preliminary finding suggests that the constitutionally individualized
acupuncture trials may significantly increase CD4 counts in patient with HIV in larger scale, controlled
studies.
Introduction
Acupuncture treatment has been used by many people with HIV and AIDS in the United States as a
complementary treatment to Western medicine. Acupuncture is commonly used in HIV for pain relief.
Most of study articles are related with anecdotal because of its difficulty due to the trouble with creating an
adequate placebo. So, there is scarcity of well-done clinical trials despite popularity of use.
Fig. Schemiatic Drawing of Design for CD4 Changes vs Various Acupuncture Trial
Methods
The present study was conducted with a small convenience sample of HIV patients who were mostly
transferred from western medical institutions. The primary purpose of the study was to access whether
individualized acupuncture trials increased CD4 counts in people with HIV. Written informed consent was
obtained prior to their participation. This study was conducted in compliance with the rules and
regulations stipulated by the institutional review board, South Baylo University.
Trial Protocol
Subjects were grouped by the pulse diagnosis according to the eight constitution medicine which is
known to be one of the most definite and popular constitution acupuncture methods 23"28in Korea: At the
first trial of pulse diagnosis to find sdbject's own constitution, the subject whose pulse was precisely clear
to find its constitution was grouped into the experimental group while the subject whose pulse was too
weak to read its constitution was grouped into the control-needling group. The experimental group
received individualized acupuncture trials which were tailored to individual participant's constitution to
promote immune function and health. The control-needling group received acupuncture treatments with
points identified as clinically irrelevant in treating the conditions under investigation.
Ten participants were treated in this case-control study. Eight patients received experimental treatments
and two participants received the controlled-needling treatment. Participants received acupuncture
treatments twice each week for 3 weeks to six months. The needle is basically inserted superficially at l-
2mm depth and removed quickly. Disposable acupuncture needles (30mm, 160um in diameter, Jesun Co.
Ltd, Seoul, Korea) were inserted into the acupuncture points assigned by the protocol of 8 Constitution
medicine acupuncture. Acupuncture treatment was singly performed with needles, which stayed in place
29-32
for 5s and were stimulated to promote or restrict deki . In order to treat patients with HIV virus, all the
patients with HIV received 3 formulas which were individually tailored to patient's constitution. Every
patient received his own virus formula which was consisted of applications of the fundamental formula at
4 points 5 times, the bactericidal formula at 4 points 5 times and the psycho formula at 2 points once.
Assessments
To evaluate the effect of acupuncture treatment, the CD4 count was since the CD4 count is generally
accepted internationally as an indicator of condition of human immune system. We used the CD4 count
as a surrogate marker. After average 3 month acupuncture trials, the peripheral blood of every patient
was analyzed in the authorized institution to examine CD4 change. To compare the outcome CD4 count
with intake CD4 counts or previous CD4 count data which were obtained when patients were treated with
HAAT therapies without acupuncture trials.
Data analysis
All the statistical analyses were performed using the SPSS 11.0 statistical package. P=0.05 was used.
Results
A great deal of useful information was obtained in this study. Eighty percents of participants showed
increases in CD4 counts in positive rate as a result of individualized acupuncture trials which were
holistically tailored to patient's own constitution physically as well as psychologically. Twenty percents of
participants showed decreases in CD4 counts in negative rate as a result of controlled needling trials with
the points identified as clinically irrelevant in treating the conditions under investigation. After confirming of
drastic decrease in CD4 counts in control group, when new acupuncture trials exactly tailored to
participant's own constitution were applied to subjects in control group in order to make the suppressed
CD4 counts increase, CD4 counts were drastically increased as shown in Fig 3 and Fig 7. When
acupuncture trials exactly tailored to participants were applied, one hundred percents of participants
showed increase in CD4 counts in positive rate.
#1 : Pancreotonia Case
As shown in Fig.1,
-CD4 levels are increasedby 8CMAtrials.
-It is likely to imply that increase in CD4 counts are attributed to the boosting of CD4 activity due to the
8CM acupuncture trials.
-The 1stinvestigation of CD4 counts after13 days trials (3 Acu-trials=Jan 2, 08-Dec 20,07) shows no
difference from intake CD4 counts. After 1st trials for 13 days the 1 stinspection of CD4 shows nearly no
difference from intake data of 343.
-After six monthscontinual trials, his CD4 count increased up to 421 which is 78 points higher than intake
counts. Long term effect was big.
-The mean value of CD4 counts before 8CMA trials was 295 while after trials mean value was 379
# 2 : Pancreotonia Case
At the first trial of pulse diagnosis to find subjects own right constitution, the subject whose pulse was too
weak to read constitution was grouped into the control-needling group. In Fig.3, this subject received the
controlled needling at the acupuncture points of which constitution were assumed to be Pancreotonia until
second inspection of CD4 counts finished.
The 1st investigation of CD4 counts after two months trials shows a very slight change in CD4 counts.
After confirming of drastic reduction in CD4 counts at the 2 nd blood analysis, the new acupuncture trials
matched with the right constitution of Pulmotonia were applied to the patient, resulting in remarkable
increase in CD4 counts.
It is noteworthy that during the first trials, the patient said I feel so good whenever I receive 8CMA trials.
After 2 month trials, the 1st inspections CD4 count of 519 was not so different from the previous number
of 520.
So, same therapy was continued to find any more changes in CD4 until
2nd inspection. After finding a drastic reduction in CD4 counts, new trials corresponding to the right
constitution of Pulmotonia were applied to make the decreased CD4 counts get recovered. As the result,
the CD4 counts was remarkable increased as shown in Fig.3.
From the control needling, it was found that there is a better or the best acupoint to lead to the result of
the best treatment.
There are many references which show the importance of right acupoint to increase more the CD4
counts.
# 4 : Hepatonia Case
The 1st inspection of CD4 counts after first trials for 22 days (from Feb 7 to Feb 29, 08) shows sharp
increase in CD4 counts by 68 points from 252 to 320.
# 5 : Hepatonia Case
Fig.5. Hepatonia Constitution Case
1st Visit: April 29,2008, M, Age:60, Ht:58
# 7 : Pancreotonia
Fig.7.Pancreotonia Constitution Case
1st Visit: Nov.20, 07, M, Age:46, Ht:62, Wt:230
At the first trial of pulse diagnosis to find subjects own right constitution, the subject whose pulse was too
weak to determine
its right constitution was grouped into the control-needling group 33-34. In Fig.7, this subject received the
controlled needling at acupuncture points that are clinically irrelevant in treating the
conditions under investigation. The controlled needling was applied at the acupuncture points of which
constitution were assumed to be of Hepatonia until second inspection of CD4 counts finished. After 2nd
inspection, the right acupuncture treatment matching with right constitution of Pancreotonia was carried
out, resulting in sharply increase in CD4 counts up to the highest value
of 312.
# 8 : Hepatonia Case
After receiving 8CMA treatment for over two months, the 1 stblood analysis showed drastic increase in
CD4 by nearly 100 points. The 2ndblood analysis also showed great increase by 82 points after getting
one months 8CMA trials.
After having 2ndblood analysis, he stopped taking medication without any consultation with doctor.
With a relation to stopping medication, the CD4 count decreased at the 3 rdblood analysis. At the same
time, he broke important rules to maintain quality of life. As the result, the 4 thblood analysis showed that
he became a patient with AIDS of poor CD4 counts under 200.
On Oct 1, 2008, he restarted taking medication in healthy circumstance. After receiving three weeks
acupuncture trials, the CD4 counts at the 5thblood analysis were remarkably increased from 187 to 594 by
407 points.
This case shows that if any patient receives the right acupuncture trials matched with his own constitution,
dramatic increase in CD4 count is possible by 8CMA trials even though CD4 counts are temporarily
suppressed by stopping taking medicine in unhealthy circumstance.
This case also shows that
# 9 : Hepatonia Case
Discussion
Needling of Superficial Pricking:
According to the functional magnetic resonance imaging of whole brain, when superficial pricking is
applied, it has been demonstrated that superficial pricking revealed more signal intensity than minimal
applied acupuncture.91 the present study, superficial pricking was applied to all the subjects without any
exception.
CD4 Counts Decline by Control Needling and Trials to increase CD4 Counts: At the first trial of pulse
diagnosis to find subject's own constitution, the subject whose pulse is too weak to read its constitution
was grouped into the control-needling group. In Fig.3 & 7, control needling was administrated at
acupuncture points that were clinically irrelevant in treating the conditions under investigation. The
controlled needling trials were given to subjects until 2nd inspection of CD4 changes. After confirming the
reduction in CD4 counts by controlled needling, the right needling at the acupuncture points precisely
tailored to patient's own constitutions was applied to subjects in order to make up the reduced CD4
counts to be recovered. New applications of the right constitution acupuncture trials resulted in drastic
increases in CD4 counts as shown in Fig. 3 and 7.
The naive CD4 cell subset and the Memory CD4 cell Subset
Antoni,M.H et al109reviewed that with progression of HIV infection, there is a preferential decline among
subsets of CD4 T cells; the Naive CD4 T-helper- inducer cell subset(CD4 +CD45 RA+) declines more than
the memory subset (CD4++), resulting in disruptions in the cellular immune repertoire for novel antigens
110
that underline susceptibility to opportunistic pathogens and rising CD4+T cell counts following
antiretroviral therapy are due primarily to the redistribution of memory CD +T cell, with "reconstitution" of
Naive CD4+ T cell being delayed for several months.111In the present study, the reason why the
temporally suppressed CD4 cells can be restored by the application of right constitution acupuncture trials
may be analyzed in the light of viewing the above suggestion.
Conclusions
This paper uses an innovative methodology to evaluate clinical outcomes. Using a quasi-experimental
retrospective case control design treatment,
Using nonparametric statistical analysis, it was found that the means of the treatment groups' differences
in pre-and post-CD4 counts showed improvement when compared with the non-treatment control group's
pre- and post-CD4 counts. Treatment subjects were then interviewed and asked to rate their experiences
of the therapies; the subjective experience was very positive.
Acknowledgement:
We appreciate the financial support of the Korean 8 constitution medicine association.
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