Determining the effects of NADA acupuncture - The physiologic response to young healthy subjects and the subjective experience in chronic pain patients

Holt, Mette Møller

4. term

Medicine with Industrial Specialisation, Master

2020

2020-05-29

70

Kroniske smerter rammer cirka hver femte voksen på verdensplan og forekommer ofte sammen med depression, angst, søvnproblemer og stress. Medicinsk behandling har ofte begrænset effekt og kan give bivirkninger, så der er behov for nye muligheder. NADA-protokollen (National Acupuncture Detoxification Association) er en standardiseret fem-punkts akupunkturmetode, som bruges til at lindre symptomer som angst, søvnproblemer, kroniske smerter, stofafhængighed og depression. Der mangler dog solid dokumentation for både effekten og virkningsmekanismerne. Denne afhandling omfatter to studier. Studie 1 undersøgte korttidseffekter af to 45-minutters NADA-behandlinger med 24 timers mellemrum sammenlignet med ren hvile hos raske, unge voksne. Vi målte hjertefrekvens og blodtryk og vurderede tryk-smerte-tærskel (PPT)—hvor meget tryk der skal til, før det gør ondt—tre steder på kroppen: skinnebenet (tibia), skuldermusklen (deltoid) og den ydre lårmuskel (vastus lateralis). Deltagerne rapporterede også om livskvalitet og deres umiddelbare oplevelser. Studie 2 undersøgte NADA som supplement til den eksisterende behandling i et 8-ugers forløb for patienter på et center for kompleks kronisk smerte. Før og efter forløbet rapporterede patienterne om smerte, medicinforbrug, livskvalitet og personlighedstræk. Resultater: I studie 1 steg PPT på den ydre lårmuskel i session 2 for NADA-gruppen, og PPT faldt på deltamusklen i session 1 for både NADA- og hvilegruppen. Hjertefrekvensen faldt hurtigt i løbet af det første minut i begge grupper og forblev derefter lavere. I studie 2 sås en sammenhæng mellem søvnkvalitet og personlighedstrækket organiseret samt et fald i personlighedstrækket spontan. Der blev ikke fundet andre klare forskelle eller ændringer i nogen af studierne. Konklusioner og begrænsninger: Vi observerede nogle ændringer hos både raske deltagere og patienter, der modtog NADA-akupunktur. Fortolkningen er dog usikker. Studie 2 havde ingen kontrolgruppe, så ændringer kan ikke med sikkerhed tilskrives NADA. I studie 1 betød randomiseringen, at NADA-gruppen kun bestod af kvinder, hvilket kan pege på en kønseffekt snarere end en behandlingseffekt. En yderligere analyse viste, at begge studier var underdimensionerede, dvs. at de havde for få deltagere til at påvise mindre til moderate effekter. Samlet set kan vi derfor ikke afgøre, om de observerede ændringer skyldtes NADA-akupunktur eller andre forhold.

Chronic pain affects about one in five adults worldwide and often occurs alongside depression, anxiety, sleep problems, and stress. Medications often provide limited benefit and can cause side effects, so new treatment options are needed. The National Acupuncture Detoxification Association (NADA) protocol is a standardized five-point acupuncture method used to ease symptoms such as anxiety, sleep problems, chronic pain, drug addiction, and depression. However, evidence for its benefits and how it works remains limited. This thesis includes two studies. Study 1 tested the short-term effects of two 45-minute NADA acupuncture sessions given 24 hours apart, compared with resting, in healthy young adults. We measured heart rate and blood pressure, and assessed pressure pain threshold (PPT)—how much pressure is needed before a sensation becomes painful—at three sites: the shin bone (tibia), the shoulder muscle (deltoid), and the outer thigh muscle (vastus lateralis). Participants also reported on quality of life and their immediate experiences. Study 2 examined NADA acupuncture as an add-on to usual care in an 8-week program for patients at a center for complex chronic pain. Before and after the program, patients reported on pain, medication use, quality of life, and personality traits. Results: In Study 1, PPT increased at the outer thigh (vastus lateralis) in the second session for the NADA group, and PPT decreased at the deltoid in the first session for both the NADA and Rest groups. Heart rate fell quickly within the first minute in both groups and then remained lower. In Study 2, we found a correlation between sleep quality and the personality trait organized, and a reduction in the trait spontaneous. No other consistent differences or changes were observed in either study. Conclusions and limitations: We observed some changes in both healthy participants and patients receiving NADA acupuncture, but interpretation is uncertain. Study 2 had no control group, so changes cannot be confidently attributed to NADA. In Study 1, randomization resulted in only women in the NADA group, raising the possibility of a gender effect rather than a treatment effect. An additional analysis indicated that both studies were underpowered, meaning they had too few participants to detect small to moderate effects. Overall, we cannot determine whether the observed changes were due to NADA acupuncture or other factors.

[This abstract was generated with the help of AI]

kroniske smerter ; NADA ; akupunktur

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