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Effectiveness of two different acupuncture strategies in patients with vulvodynia Study protocol for a pilot pragmatic controlled trial

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Journal of Integrative Medicine 2018年第6期16卷 384-389页

作者： Arthur Yin Fan Sarah F.Alemi Yingping H.Zhu sudaba rahimi Hui Wei Haihe Tian Deguang He Changzhen Gong Guanhu Yang Chong He Hui Ouyang American Traditional Chinese Medicine Association ViennaVA 22182USA McLean Center for Complementary and Alternative Medicine PLC.ViennaVA 22182USA

Background： Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evalu- ate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with inter- course. The study also examines how long the effect of acupuncture lasts in women with vulvodynia. Methods/design： The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups la and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group （Group 2）. Patients in Group la will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group lb will receive acupuncture focused on traditional （distal） meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tender- ness and trigger points （Ashi points） are also recorded. All measurements will be recorded at baseline （before the treatment）, at the end of each week during treatment and at the end of the 6weeks. Follow-up will be done 6 w

关键词： Acupuncture Vulvodynia Meridian points Pudendal nerve Study protocol

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Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on Ok ***

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Journal of Integrative Medicine 2019年第5期17卷 315-320页

作者： Arthur Yin Fan David Dehui Wang Hui Ouyang Haihe Tian Hui Wei Deguang He Changzhen Gong Jipu Wen Ming Jin Chong He Sarah Faggert Alemi sudaba rahimi Acupuncture Profession Survey Project American Traditional Chinese Medicine AssociationViennaVA 22182USA Tongrentang Ming Qi Clinic New YorkNY 10016USA Oriental Asclepius LLCPlantationFL 33317USA Eastern Roots Wellness PLCMcLeanVA 22101USA McLean Center for Complementary and Alternative Medicine PIC.ViennaVA 22182USA Ohio State Integrative Medicine Wexner Medical CenterOhio State UniversityColumbusOH 43221USA YIN & YANG Healthcare FriendswoodTX 77546USA Chinese Acupuncture and Herbs Center LargoFI 33778USA Wei's Chinese Medical Center Lake WorthFL 33467USA New England School of Acupuncture NewtonMA 02458USA American Academy of Acupuncture Oriental Medicine RosevilleMN 55113USA TCMzone TempeAZ 85281USA

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States(U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, Ok ***. We examined descriptive statistics(range, median and 20% intervals) for the cost of acupuncture "first-time visits"and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15–400;the highest median was $150 in Charleston, South Carolina,while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were:Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits,the cost range was $15–300;the highest median was $108 in Charleston, South Carolina, and the lowest$40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

关键词： Acupuncture Price Out-of-pocket cost Annual cost City, United States

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