Research and Projects

Our faculty and student researchers are engaged in the ethical conduct of research in the fields of the study of both Traditional Chinese Medicine and integrative medicine and in the development of institutional research partnerships. Students in the master’s program may assist in the conduct of institutional research projects. Students in the doctoral program conduct an original research study or a quality improvement project focused on clinical, educational or ethnographic in the fields of the study of both Traditional Chinese Medicine and integrative medicine.

AOMA-CARE: AOMA CAse REports (Faculty and Students, on-going)

Study Area:

traditional Chinese medicine, case reports, academic health clinic

Project Description:

AOMA students and faculty conduct Case Reports or Case Series for patients seen at AOMA and affiliated clinical settings. Case Reports are typically used to share new unique information experienced by one (or more) patient(s) during his/her clinical care that may be useful for other physicians and members of a health care team.  A case report may be published for others to read, and/or presented at a conference. 

The AOMA CAse REports Project, known as AOMA-CARE, provides a structured approach to the collection and dissemination of Case Report information for AOMA students and faculty. AOMA follows the CARE Guidelines for all case reports.

Status:

Active

Principal Investigator:

Program Directors, with Students

Research team:

Jing Fan PhD, MD (China), LAc

Master Regulator Systems of Metabolism as Seen Through Biomedicine and Chinese Medicine Lenses: Comparison of Spleen Qi, Biomedical and FGF21 Metabolic Functions (DAOM, Schwartz)

ABSTRACT

Introduction: FGF21 is a regulator of glucose uptake and lipolysis in adipocytes and exhibits therapeutic characteristics to effectively treat obesity, diabetes mellitus (DM), high plasma glucose and high triglycerides. In Chinese Medicine (CM), the Spleen network, which includes the anatomical spleen, pancreas, stomach and adipose tissue, is responsible for digestion and metabolism. This CM Spleen network will be referred to as the Spleen Pancreas Stomach Axis (SPSA). According to CM theory, dysfunction of the SPSA results in the development of metabolic disorders. Obesity originates from the SPSA being deficient, leading to states of chronic inflammation, described by CM as damp and phlegm accumulation in the body.1 The FGF21/FGFR1c/β-Klotho axis (FGF21/BKL) may be an innovative model for understanding SPSA theory of disease.

Objective: The objective of this paper is to describe a model that shows the similarities between SPSA function, biomedical (BM) metabolism and regulation of the FGF21/BKL in creating metabolic homeostasis. This paper proposes novel correlations between CM master regulator of metabolism using the SPSA and BM master regulator of metabolism using the FGF21/BKL and showing novel insights as to how BM and CM are looking thru different physiology lenses, but are both describing the same phenomena that is human metabolism.

Significance: This research is significant in that 1) it will describe a model of SPSA function described in BM terminology, 2) we will describe how the FGF21/BKL and SPSA processes are the very similar and 3) describe the commonalities between CM and BM using a common language.

Conclusions: Medicine has evolved over thousands of years and whether that medicine originated from the East or West we should continue to study the old in order gain insight into new medical innovations. The FGF21/BKL model gives us novel insights and understanding into the processes of how the body stores excess nutrients and the release of those nutrients as energy.

Keywords

FGF21, FGFR1c, beta-Klotho, Chinese Medicine, Spleen, Pancreas, Stomach, Obesity.

Student Researcher:

Sandra Schwartz, DAOM, LAc

From The Outside In: An Investigation of Hot and Cold Diagnostics in Traditional Oriental Medicine and Correspondences in Thermal Findings Using Thermography (DAOM, Cline)

Abstract:

This study is a comparative diagnostic investigation into hot and cold phenomena of the body. Traditional Chinese medicine has within its traditions various concepts of how Heat and Cold affect the body, the way they interact in normal and abnormal physiology. Our suggest a correlation between the traditional Chinese medical patterns of Heat and Cold to thermal findings of heat and cold in the body by comparing thermography, vital signs and traditional pulse and tongue diagnosis. It is common to use thermography imaging cameras to diagnose thermal imbalances associated to inflammation and circulatory disturbances and to gauge the effect of acupuncture on tissue. However drawing associations between traditional diagnostics of tongue, pulse and symptom complex with thermal images have as of yet not been done. Our study found that correlations do exist between thermal readings and the tongue color as well as between pulse rates and oral temperatures. These may show the complex relationships of core temperature, topical temperatures and their relation to channel distribution in the body. We also found correlations of the tongue as a diagnostic measure of heat and cold. Environmental sensitization is increasingly considered a contributing factor in pain and disease. The significance of this study lies in enhancing understanding of the much under researched areas of environment, weather and temperature on pain and disease by exploring relationships of traditional medicine to biomedical phenomena.

Student Researcher:

Allen Cline, DAOM, LAc

Evaluating the effects of acupuncture in the treatment of Chemo Induced Peripheral Neuropathy (CIPN): A case series (DAOM, Hendry)

Abstract

Chemotherapy Induced Peripheral Neuropathy (CIPN) continues to be a limiting and painful side effect of chemotherapeutic treatment. Chemotherapy remains a mainstream treatment for patients with advanced malignant tumors that are incurable by either local surgery or radiotherapy.  Although chemotherapy is very effective in killing cancer cells, its toxicity can also produce distressing side effects, one of which is CIPN.  This case series looks at three case studies of cancer patients who experienced CIPN following chemotherapy and were treated with an electro-acupuncture protocol.  The use of acupuncture for peripheral neuropathy has been studied in both diabetic and AIDS related neuropathy but little attention has been focused on its benefit for CIPN.

In all three cases the patients complained of neuropathic symptomatic in their feet and lower leg.  In addition to signs of hypoesthesia, all three noted painful sensations that included either aching, burning, stinging or electrical sensations.  Similarly, they all complained of balance issues due to the reduced ability to feel sensations in their feet, impairing their sense of proprioception.

Although each patient received a different number of electro-acupuncture treatments, each expressed decreased symptoms, resulting in a higher Quality of Life (QOL) than they otherwise would have had.  The results of this case series suggest that electro-acupuncture may provide a positive benefit to those suffering from painful peripheral neuropathy due to chemotherapeutic treatment.

Key Words

Acupuncture, electro-acupuncture, chemotherapy, peripheral neuropathy, CIPN

Student Researcher(s):

William Hendry, DAOM, LAc

AOMA Cold and Flu Survey (DAOM, Bienz)

Abstract:

Influenza is a highly contagious viral infection that attacks the respiratory system and has devastated numerous populations throughout history.  AOMA Graduate School of Integrative Medicine (AOMA) surveyed consenting participants during the influenza season between the months of December 2013 and February 2014.  The survey’s main purpose was to estimate the prevalence of influenza at AOMA and the behaviors used to prevent the spread of the disease.  This cross-sectional study analyzed 110 online surveys completed by AOMA community members.  The participant status included faculty, staff, and post-graduate students.  Participant’s status, age range, hygiene practices, symptoms, influenza history, risk assessments, vaccine history, including absence of vaccine were all used as measures for outcomes.

Key Words

Influenza, behaviors, cross-sectional, hygiene, survey

Student Researcher:

Michelle Bienz, DAOM, LAc

Qi Quotient Survey – A Validation Study Quality of Life Survey (DAOM, Captain)

Abstract:

Background:  Survey forms and inventories have been proven useful in determining individual perception in quality of life domains as seen with the development of the National Institutes of Health, PROMIS database.  Additional information is necessary to generate public awareness of lifestyle behaviors, how they affect general health and the development and progression of disease.  This validation and measurement study is being conducted to provide alternative, complementary, and conventional practitioners with a validated, integrated and unique tool to increase health awareness/consciousness in the general population. 

Objectives: This study was designed to determine the internal reliability and construct validity of the QiQuotient ™© survey as compared to a validated PROMIS tool survey.

Method: Both the QiQuotient™© survey and the validated PROMIS v.1.1-global tool were sent via email to participants gathered from the AOMA-Graduate School of Integrative Medicine’s clinic patient population database.  All responses were anonymous and collected with direct data entry into the REDCap application.  A total of 133 participants responded to the survey request. Of those, 131 respondents or 98.5% consented to participate in the survey. After scoring, a total of 114 surveys were included for analysis. Demographic information had varying sample sizes and all responses were reported since there was no relative effect upon Qi Quotient score.      

Results: Of the 114 survey responses that qualified for inclusion, factor analysis revealed low correlations as compared to the PROMIS v.1.1-global tool and low internal consistency (Cronbach’s α =0.38). Construct validity was measured by Kruskal -Wallis one-way analysis of variance to test whether QiQuotient™© scores differed significantly amongst the groups.

Conclusions:  In conclusion, the QiQuotient™© survey is not able to be validated as it is written currently. The possibility that more than one dimension is being measured suggests that the questions may require further analysis. This survey may however continue to be useful in practice as a marketing and patient attraction tool.  As such it is hoped that its use creates increased health awareness in the person completing it.   

Key Words:

QoL, survey, health, PROMIS, validation, Qi Quotient

Student Researcher(s):

Christina Captain, DAOM, MSAcOM, MSHN, MA, LAc

The effects of acupuncture on cerebral blood flow: A randomized placebo-controlled trial in sports-related concussion (TREAT-TBI) (DAOM, Moll)

Study Area:

traumatic brain injury, acupuncture, cerebral blood flow

Project Description:

Sports-related concussions (SRC) can cause significant changes in physical, cognitive, and psychological health that range from acute to chronic and disabling. With an estimated 1.6 to 3.8 million TBIs occurring annually in the United States, it is imperative that effective, evidence-based therapies for recovery are identified and utilized in immediate care and out-patient settings. A decrease in cerebral blood flow (CBF) occurs immediately following SRC, at a critical time when there is an increased need for cerebral glucose metabolism. This metabolic imbalance creates a window of vulnerability lasting for a minimum of 7 to 10 days. Acupuncture has been used in the treatment of a wide range of neurological and vascular diseases, and has been shown to increase CBF in both animal and human studies. This pilot study utilized transcranial Doppler imaging, neuropsychological testing and concussion symptom assessments to determine if acupuncture during the acute phase following sparring in mixed martial artists (MMA) modulated CBF velocity and affected sparring-related symptoms from head trauma. The study found no evidence of aberrant CBF velocity following sparring sessions, and no significant change in CBF following acupuncture. We therefore conclude that this group of MMA fighters either did not have aberrancies in CBF in the acute stage following sparring, or that TCD[MS1]  ultrasound lacks the sensitivity to measure CBF pathologies in mild traumatic brain injury (mTBI) and SRC populations. MMA fighters did report a subjective improvement in physical and cognitive symptoms following acupuncture. Further research is needed involving more sensitive brain imaging technology to determine the mechanisms of action of acupuncture on alleviating commonly experienced physical symptoms during the acute stage following SRC.

Key Words:

acupuncture, sports-related concussion, mild traumatic brain injury, transcranial D[MS1] oppler ultrasound

Student Researcher(s):

Amy Moll, DAOM, LAc

CAMS Success! Clinical And Management Skills: A Quality Enhancement Plan (DAOM, Hamilton)

Abstract

Purpose: AOMA Graduate School of Integrative Medicine (AOMA) needed a quality enhancement plan (QEP) to enhance learning outcomes in its masters of acupuncture and Oriental medical program (MAcOM) for reaffirmation of regional accreditation. A gap-analysis and literature review conducted in 2012 revealed a need to bolster confidence and competence of interns within the clinical training. This study reports on outcomes of this QEP.

Intervention: By providing three stages of internship progressively advancing with learning opportunities, it was proposed that interns will develop competence and confidence as well as the ability to practice in integrative settings, specialty settings, or fast-paced settings upon graduation. This quality enhancement plan applies to all interns who began internship in fall 2013 and later.  The first change converted the 2 levels of internship which were nearly identical into three levels with distinctive differences that progressively advance. The second change developed different means of assessing competence and confidence for each of the levels that evaluate progressive development. The third change added new clinical learning opportunities to challenge and inspire learners to work in integrative and/or fast-paced environments, or within areas of specialty (patient population, disease/disorder specialty, or treatment style).

Results: AOMA attempted to gauge improved learner competence and confidence in a number of ways; although mention herein the primary study on confidence will be reported separately. Of the competence measures, the practical clinical exams provided the most robust view of intern competence. Although the pre-QEP interns’ aggregate mean score on the practical exams exceeded the QEP interns (1a: 88.47 and 86.26; 2b: 89.75 and 88.98, respectively), it was showed to be insignificant (p>0.05), and the timing of the exams for the QEP interns was 9-12 months earlier in the clinical curriculum. This points to equivalent if not improved performance. In addition, QEP interns showed significant improvement from the 1a exam to the 2b exam (p=0.0041), whereas the pre-QEP interns did not (p=0.467).

Conclusions: Overall the quantifiable evidence is inconclusive for accepting or rejecting the null hypothesis that AOMA’s students who experience the QEP clinical education will graduate with strong competence.

Key Words:

medical education, quality enhancement plan, clinical training, acupuncture, graduate education

Student Researcher:

Lesley Hamilton, DAOM, MACM, LAc

HEYA (The Human Experience and Ayahuasca): A Quality of Life Assessment (DAOM, Bey)

Abstract:

Background: Ayahuasca is a plant based decoction that is legal in several countries, but classified as a Schedule I hallucinogenic in the United States. Despite its scheduled drug classification, individuals, communities, and organizations continue to defy legal mandates in order to use this decoction, and current legislation appears to serve only as a minor deterrent.

In recent years, thousands of patients, medical professionals, spiritualists, and the adventurous, have participated in indigenous healing rituals using Ayahuasca, and have reportedly experienced remarkable results. Many have reported improved physical conditioning, spiritual insight, mystical experiences, a sense of purpose and connection, cured from addictions, improved emotional and mental health.

Objective: The objective of this study was to investigate quality of life of Ayahuasca users, also referred in the proposal as “participants” and gain insight as to why participants choose to use the plant decoction, and what benefits and/or risks are received.

Significance: Literature is now forthcoming on the effects of Ayahuasca on QOL in modern society. MAPS Canada, MAPS US, has an ongoing survey for Ayahuasca users for PTSD began in 2017 (1), (2).

The impact of Ayahuasca on quality of life is still not clear. This study was to highlight and determine the impact of Ayahuasca on the quality of life and potential benefits and possible risks associated with its usage.

Population or Respondents: 29 screened participants.

Period of the Study: Beginning date April 19th, 2018 to Date Closed Oct. 4th, 2018

Method of Research Used: An observational study was initiated with both quantitative and qualitative research design methods to conduct this study.

Research Instrument: Validated Screening & Surveys- not used

Sampling Design: There is no exact data available about the prevalence of Ayahuasca sample sizes. Therefore this study was designed to solicit a broad population to determine the power in future studies by recruiting participants in ongoing Ayahuasca ceremonies.

Key Words:

quality-of-life, ayahuasca, ethnopharmacology

Student Researcher:

Simel Beys, DAOM, LAc

Asking NADA: A Needs Assessment Process to Inform a Training Manual Revision (DAOM, Voyles)

Abstract:

The National Acupuncture Detoxification Association (NADA) provides training in “acudetox,” a standardized auricular acupuncture protocol integrated with biopsychosocial models of care to support behavioral health, including emotional response to trauma and disaster. NADA has a corps of Registered Trainers, defined competencies and a Training Resource Manual, last revised significantly in 2008. The training manual and methods have fallen behind the times and are past due for revision.

This project conducted an assessment of the NADA training needs towards improving the manual materials and methods available to trainers. The study garnered information and expertise from the NADA leadership and training community, and by the process of inclusion, sought buy-in for new developments. A mixed methods study was undertaken to identify the curriculum and methods renewal needs, including brief interviews with thought leaders; a needs assessment survey of trainers; a World Café™ model work group of trainers; and a focus group of trainees. Collectively these processes yielded rich recommendations for change.

Every year, NADA trains hundreds of Acupuncture Detoxification Specialists (ADS), the designation for someone who has successfully attained competency in the protocol. International NADA affiliates use the NADA models of training to train thousands per year. This study identified training and curriculum needs to guide the next manual iteration. This study results could facilitate the creation of better materials and methods and an ongoing renewal system. The study process was consistent with what the organization calls the “Spirit of NADA,” in terms of respect, inclusion, and consensus.

Key Words:

NADA, acudetox, auricular acupuncture for behavioral health, needs assessment, curriculum renewal, healthcare education, World Café™

Student Researcher(s):

Claudia Voyles, DAOM, LAc

Systematic Review of Acupuncture and Traditional Chinese Medicine Research in Treatment of Gastroesophageal Reflux Disorder (DAOM, Carey)

Abstract:

BACKGROUND: Gastroesophageal Reflux Disorder (GERD) is a common health condition that affects an estimated 20-

40% of the general population in the United States and is also a common malady in many countries outside the US.(1-7)

In an epidemiological study published in 2012 by Peery et al, GERD was shown to be the most common GI diagnosis with

approximately 8.9 million visits in a primary care setting, and the leading diagnosis in outpatient clinics visits in the United

States in 2009. (8) Estimated costs for the treatment of GERD in 2000 totaled approximately $10 billion in direct and

indirect costs. (9) According to a 2001 to 2004 retrospective data analysis by Brook et al. GERD can also be responsible for

loss of productivity and work time, and reduction in daily activities The study suggested that GERD “was associated with a

mean incremental cost of $3355 US per employee” in direct and indirect medical costs, and represents a great financial

impact on employers. (10) Current standard of care for GERD consists of over the counter and prescription medications

such as proton pump inhibitors (PPI), H2 blockers, or prokinetic agents and reflux inhibitors, which are limited in their

effectiveness, have side effects, may lack patient compliance for long-term remission or resolution, and can affect patient

quality of life. (11-16) Acupuncture and Traditional Chinese Medicine (TCM) have been used for many centuries in Asian

medicine for the treatment of gastrointestinal symptoms, including symptoms of GERD, but is not well known as a

treatment alternative or complement to current standard of care. (17) The awareness of acupuncture for various health

issues has increased since the 1990s reflecting increasing interest by both the public and researchers (18,19)). Thus, it is

important to assure safety and efficacy of acupuncture and TCM for the treatment of GERD, requiring high quality studies

to provide evidence-based support. (20, 21)

OBJECTIVE: The objective of this systematic review is to identify studies that support the safety and effectiveness of

Acupuncture and TCM for the treatment of GERD.

DATA SOURCES A systematic review of literature from 2000-2015 was conducted on the Acupuncture and TCM

treatment of GERD in databases such as Cochrane, Medline, PubMed Health (NIH), Escience Central, China Journal Full-

Text Database, SearchMedica, peer-reviewed journals such as the American Journal of Gastroenterology, Gut,

Gastroenterology, and non-peer reviewed articles from American Cancer Society, Wiley Online Library, International

Foundation for Functional Gastrointestinal Disorders, Elsevier Journal Online Today, Acupuncture Today, and California

Journal of Oriental Medicine.

CONCLUSION/IMPLICATIONS: Three studies of the 127 articles reviewed met all study criteria. One study used a

combination of electroacupuncture and Chinese herbal medicine (Zhi Zhu Kuan Zhong capsules. (22) The second study

used acupuncture versus doubling the dosage of the proton pump inhibitor. (23) The third study used acupuncture alone

with a control group using Omeprazole. (24) All 3 studies suggested favorable results and improvement with the use of

Acupuncture and herbal medicine when compared with standard of care pharmaceuticals, but long term efficacy was

similar to pharmaceutical results in that after a period of time symptoms could recur. Therefore this review does suggest

limited evidence supporting the use of Acupuncture and TCM in the treatment of GERD, especially when compared to the

current standard of care. More high-quality studies are needed to establish the safety and efficacy of Acupuncture and

TCM for the treatment of GERD.

Key Words:

TCM, GERD, systematic review

Student Researcher(s):

Patti Carey, DAOM, LAc

The Efficacy of acupuncture on macular degeneration: A literature review (DAOM, Fuller)

Abstract

Introduction: Age-related Macular Degeneration (ARMD) is the loss of vision over time from the loss of retinal pigmentary epithelium. ARMD has two forms: (1) wet (exudative or neovascular), and (2) dry (atrophic or non-neovascular).(Damjanov, 2012)  Traditional Chinese Medicine (TCM) has been in practice for thousands of years, with one of the essential writings being the Huang-Di-Nei-Jing. (Yeung, 2007)  Traditional Chinese Medicine supports the theory of visceral organs having a close relationship with other distant sensory organs. For the eyes, the kidney and liver have the closest relationship. (Rosenfarb, 2016) Acupuncture has been used historically to treat sensory organ deficiency, with the direction of a physiological approach to the body and health as a whole. Western medicine is entering the realm of treating specific diseases with a scientific focus based on anatomy, physiology, biochemistry, and molecular biology. (Yeung, 2007) On the contrary, TCM has many different diagnoses for macular degeneration, whereas Western medicine only has two. Research has shown that, in some cases, Western medicine may stave off the deterioration of both the retina and macula.

Method: Moreover, TCM and Acupuncture may help to reduce deterioration and even reverse the effects of this disease.  A literature review, prepared using the Cochrane Collaboration’s RevMan 5 software to evaluate the literature on acupuncture and macular degeneration, concluded that acupuncture might help with the symptoms of macular degeneration.  Eligibility criteria were reduced to articles published in English and focused solely on acupuncture as a treatment.  Sources from PubMed, Ebscohost, and other scholarly sites were chosen, information was processed through the application allowing for a more concise method of results and charting.

Results: Of the five thousand five hundred and forty-four (5,544) research articles, a total of thirteen (13) articles related to acupuncture and ARMD. 

Discussion: Based on an extensive literature search about the efficacy of Acupuncture on Macular degeneration, particularly of older texts, there is sufficient evidence to warrant a full study comparing current acupuncture methods on age-related macular degeneration. Much of the literature denotes acupuncture as being effective for macular degeneration, although most of the literature is older than five years. Literature that is within the five-year period commonly consists of acupuncture and its effects on ophthalmologic diseases. 

Key Words:

macular degeneration, acupuncture, aged-related macular degeneration, ARMD

Student Researcher

Brandon Fuller, DAOM, AP

Case Report: Electro-Acupuncture and Taxane Induced Peripheral Neuropathy (DAOM, Guthery)

Abstract:

Taxane induced peripheral neuropathy (TIPN) is a significant cause of disability in patients who receive this class of chemotherapy drugs for cancer. The treatment of TIPN is less than optimal and frequently involves narcotics and other long-term medications. Individuals with pre-existing peripheral neuropathy can be vulnerable to worsening and disabling symptoms. This is a case study of a 59-year-old female who received a series of weekly acupuncture treatments for the treatment of TIPN.  The patient had already received one course of chemotherapy prior to starting acupuncture treatments and presented with significant neuropathic pain in her hands and feet.  The acupuncture treatment included micro-current electro-acupuncture method using a transcutaneous electrical stimulator (TENS) unit in each treatment was the Pantheon 8 channel intermittent mode  100 micro amps at 5 hertz (hz) once a week (LI 11 to SJ 5 bil, GB 34 to GB 40 bil and across bai xie and ba feng).   She experienced complete resolution of her neuropathic pain from the acupuncture treatments and was able to complete all six courses of chemotherapy. Electro-acupuncture facilitated this patient in completing her chemotherapy regimen. 

Key Words:

neuropathic pain, Taxane, Taxane induced peripheral neuropathy, electro-acupuncture, case report

Student Researcher:

Donna Guthery, DAOM, LAc

The Moonlit Bridge: An Overview of Systematic Reviews and Randomized Controlled Trials about Acupuncture during Pregnancy and Birth with an Epistemological Examination through the Lens of Critical Theory and Postmodern Postcolonial Feminism (DAOM, Gregg-Flax)

Abstract:

Background: Perinatal acupuncture has a long and venerable history in Chinese

Medicine but is relatively understudied by Western medical research.

Objectives: The purposes of this study are to assess evidence from systematic

reviews and randomized controlled trials about the use of acupuncture therapies

during pregnancy and childbirth and examine the epistemological implications of

Positivist research methodologies being used to assess the complex Whole Systems

medicine of acupuncture. Critical Theory, Feminism, and Postmodern Postcolonial

Feminist traditions will support the examination of evidence-based medicine

research methods.

Data sources: The overview systematically searched PubMed, Cochrane Library

and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The time

period in this search was July 1, 2008 to May 26, 2017.

Study Eligibility Criteria, participants, Interventions: Criteria for inclusion

encompassed English language articles of systematic reviews on acupuncture,

acupressure, electrical stimulation on acupuncture needles, or moxabustion during

pregnancy and childbirth, including reviews of many interventions for a particular

prenatal condition as long as it included at least 1 trial using the intervention of

acupuncture, acupressure, electrical stimulation on acupuncture needles, or

moxabustion. Also included were RCTs published after the most recent systematic

review. Excluded were systematic reviews of acupuncture treatments for a nonpregnant

condition, crossover studies and quasi-randomized RCTs.

Risk of Bias: Bias was assessed using Overview Quality Assessment Questionnaire

(OQAQ) to evaluate the validity and quality of systematic reviews and the Cochrane

Handbook of Systematic Review checklist for evaluating bias in randomized

controlled trials.

Study appraisal and synthesis methods: The results are summarized in narrative

and table formats. Due to the heterogeneity of the systematic reviews and included

studies, this systematic review does not include a meta-analysis.

Results: Thirty systematic reviews and 4 randomized controlled trials were

identified for the treatment of nausea, anxiety, and depression, lower back and

pelvic pain, breech presentation, induction of labor, and pain management in labor.

One article on safety was found, although it was not a specific search term.

Synthesis of results: Favorable evidence supports prenatal acupuncture therapies

(manually stimulated acupuncture, electro-acupuncture, acupressure and

moxabustion). Acupuncture, the data suggests, is most effective at treating perinatal

nausea and vomiting, intraoperative nausea related to caesarean section anesthesia,

depression, lower back and pelvic pain, and pain intensity during childbirth.

Acupressure shows promise in relieving nausea and decreasing pain intensity

during childbirth. Electrical acupuncture resulted in less epidural analgesia.

Moxabustion combined with postural techniques was more effective than postural

techniques for reducing breech positions, and moxa did have secondary outcome

benefits such as decreasing augmentation with oxytocin before and during labor, as

well as caesarean sections. However, a new study of moxa versus laser placebo finds

no significant difference. Evidence is also limited for induction of labor but

acupuncture significantly reduces pain intensity. Promising evidence shows

acupuncture reduces the following: the length of active labor by more than an hour

on average, the use of instruments (e.g., forceps) in vaginal deliveries, and the

amount of pharmacological analgesia required. It also increases maternal

satisfaction and relaxation. Safety studies show that acupuncture has minor adverse

side effects and conclude that research on acupuncture should continue as a safer

alternative to many treatments for pregnancy with known adverse effects.

Limitations: Evidence is limited by the Positivist research methodologies of the

randomized controlled trial and systematic review.

Conclusions and implications of key findings: Favorable evidence supports

perinatal acupuncture therapies (i.e., manually stimulated acupuncture, electroacupuncture,

acupressure and moxabustion) for nausea, back and pelvic pain,

breech presentation, pain relief during childbirth, depression and intraoperative

nausea during caesarean section. Quality, methodologies, and bias ranged but most

were relatively high quality. Generalizability may be limited by small effect sizes.

Randomized controlled trials are poorly suited to understanding the complexity of

the healing encounter in the acupuncture clinic, and Whole Systems Research may

hold more promise for developing a fuller knowledge base about perinatal

acupuncture.

Key Words:

acupuncture, child birth, pregnancy, critical theory, postmodern postcolonial feminism

Student Researcher:

Pamela Gregg Flax, DAOM, FABORM, DOM

Signaling Systems: The Organization of Form and Spirit (DAOM, Phillips)

Abstract:

Physiological signaling mechanics governed and regulated by Fibroblast Growth Factors (FGFs) play important pleiotropic roles embryologically in organ and morphogenesis.  This source level regulation continues after birth and is maintained throughout adult life.  While we understand small parts regarding individual functions and associations of a particular FGF, guidelines regarding mutual interaction, dependency and control is largely unexplored and unknown.

We propose that Chinese Medicine (CM), a well-developed system of quantum logic equations, can be used to map potential source level interactions that fundamentally dictate and govern morphogenesis at all levels of being. 

We found that the specific functions, associations, and tissue correspondences of individual FGFs correlate well with classical CM medical theory.  This discovery provides a rich context to better discuss classical CM concepts as well as providing the foundation for more systematic study of specific tools in clinical treatment.  Additionally it provides a viewpoint and potential model regarding the inter-relational mechanics of FGF interactions and how these interactions directly inform structure and function.

Key Words:

Fibroblast growth factor (FGF), Klotho, Chinese medicine, zangfu theory, FGFR

Student Researcher:

J. S. Phillips, DAOM, LAc

The Treatment of Rhabdomyolysis with Chinese Herbal Medicine (DAOM, Phiakhamta)

Abstract:

The causes of rhabdomyolysis are categorized into three types: traumatic or muscle compression (e.g., muscular injury, prolonged immobilization), non-traumatic exertional (e.g., strenuous exercise, untrained athletes, or metabolic disorders), and non-traumatic non-exertional (e.g., drugs, infections, or electrolyte imbalance). An exercise-induced or exertional rhabdomyolysis (exRML) is a pathophysiological disorder resulting in muscular cell damage due to excessive, strenuous exercise. The clinical presentation typically will present itself with muscle stiffness, weakness, pain, fatigue, and myoglobinuria. Herein, this case will report on a healthy 37-year-old male patient who reported the symptoms of exertional rhabdomyolysis but only sought medical help one week after the injury. The possible danger of this case is that the patient could have further injured himself due to the lack of awareness of the condition, itself. The uniqueness of this case is that this is the third occurrence that the patient has reported these symptoms while utilizing the exact same exercise routine of stationary cycling and then weight lifting. Physicians and members of the public such as athletes, coaches, trainers, and gym-goers need to be better educated in the symptoms and treatment of Rhabdomyolysis, as a syndrome.

Key Words:

Rhabdomyolysis, Exercise-Induced, Chinese Herbal Medicine

Student Researcher:

Joe Phiakhamta, DAOM, LAc

NAET Treatment of Autism (DAOM, Lew)

Abstract:

The purpose of this study is to determine whether Nambudripad’s Allergy Elimination Technique (NAET) would be effective at alleviating autism symptoms in children.   Autism affects 1 out of 68 children in 2013, a 30% increase from 2012.  The primary focus of many parents, and caregivers, is the mobilization of time and resources towards the care of the autistic child, which places stress on families, marriages, finances, and personal responsibilities.  NAET is a natural, holistic medicine technique that involves acupuncture, acupressure, and homeopathy. The study is a randomized, placebo-controlled therapeutic trial conducted on children with Autism Spectrum Disorder (ASD) between the ages of 2-10 years of age.  To determine if any changes occurred in behavior and symptoms, parents filled out the Childhood Autism Rating Scale (CARS) assessment and Allergy Symptom Rating Scale (ASRS) questionnaire at the first and last visits.  The study is designed to test the alternative hypothesis that there is a measurable difference between the behaviors and symptoms of children in the experimental group compared to the placebo group, after undergoing the 37-treatment NAET protocol.

Key Words:

autism, acupuncture, NAET

Student Researcher:

Patricia Lew, DAOM, LAc

PICS: Palpation Intensive Cohort Study (DAOM, Zachary)

Abstract:

It is of significant educational interest to consider the content and quantity of training for medical students, considering that all training incurs a cost in both time and financial resources, often in the form of student debt. This study sought to establish a method of doing a thorough investigation into how palpation is valued and whether its training is sufficient in East Asian Medicine (EAM[1]) academic settings. The study sought to establish whether palpation is considered an essential part of EAM students’ training through surveying the experience and attitudes of students, faculty, and alumni of AOMA Graduate School of Integrative Medicine (AOMA) in Austin, Texas.  It sought to elicit faculty and field expert opinions on methods of measuring palpatory training, and if a short, intensive course on palpation could produce measurable educational outcomes.  The different branches recruited participants from different AOMA and EAM populations composed of faculty, students, and alumni.  The first branch was a survey to teachers and professionals, and the second was a cohort study using self-assessment surveys, practical exams, and academic records. Responses in the first branch by and large agreed with each other. In the second branch the surveys demonstrated increased confidence and competence, and less anxiety. The experimental group also scored higher on their Point Location finals.  This suggests that the palpatory class had a positive influence on their learning.

In its execution, the research encountered several obstacles to collecting data consistently and in a timely fashion.  With some structural changes to address low completion rates and generally small sample sizes, it could be considered a model for future studies on the perceived value and educational effectiveness of various topics in the field of EAM education.  Despite these limitations, this writes to a gap in the available research and literature, expanding the field’s body of knowledge.

[1] East Asian Medicine, EAM will be used in this document to indicate the wide range of traditions and practices, from Traditional Chinese Medicine, Traditional Japanese Acupuncture, Korean acupuncture, family traditions, and more (Morris, 2010).  If the profession formally adopts an updated title, future documents will reflect that.

Key Words:

palpation, medical education, AOMA: Graduate School of Integrative Medicine (AOMA), East Asian Medicine (EAM) / Traditional Chinese Medicine (TCM), acupuncture, Shiatsu, Tuina

Student Researcher:

William J. Zachary, DAOM, LAc

The Longitudinal Data Collection for Patient with Chronic Pain: A Feasibility Study (DAOM, Jin)

Abstract:

Objective: The primary aim is to determine if collecting longitudinal data for a variety of patients seeking acupuncture for chronic pain is feasible. The secondary aim is to assess a data analysis plan that may be able to identify any characteristics associated with changes in chronic pain due to individualized acupuncture treatments, should this study design be shown to be feasible.

Background: Chronic pain is a significant public health problem that contributes to a disability or reduced ability to do activities of daily living, increased anxiety, depression, and sleep disturbances, reduced quality of life, and increased healthcare costs. Traditional Chinese Medicine (TCM) treatments, especially acupuncture, are often used to treat both emotional disorders and a wide range of pain disorders.  But there is no evidence about what characteristics may be associated with clinical outcomes from acupuncture.

Method: Baseline characteristics and baseline scores on the outcome measures were presented by means with standard deviations or by percentages. Three patient-reported-outcomes surveys will be collected between five treatments; these are taken first as Baseline before the first treatment, the second after Treatment 3, and the third (final) after Treatment 5. These surveys, based on National Institute of Health's PROMIS-29 Profile v2.1 study, and the use of the Defense and Veterans Pain Rating Scale (DVPRS), a visual pain scale, were used to identify characteristics associated with changes in chronic pain and quality of life. The data was collected and stored in REDCap online system. The data was analyzed by using IBM SPSS Statistics software.

Result: Conducting this study, as well as analysis of results, provides preliminary data on 1) whether collecting survey data on a limited patient population is feasible, and 2) if  the data analysis plan can identify the emotional change and social activity, which are relevant life factors associated with improvement in chronic pain.

Discussion:  According to relevant results, this study's protocols warrant more extensive research. Recommended changes to the protocol include expanding the study time frame and adding more assistant investigators to increase amount of data collected. The data analysis plan is nonconclusive due to the limited data. A With more data, a T-test (standard distribution data) and nonparametric method, Wilcoxon Signed Ranks Test (non-standard distribution data), may be able to identify any characteristics associated with changes in chronic pain in future studies.

Key Words:

Chronic Pain, Traditional Chinese Medicine, Acupuncture, activities of daily living, anxiety, depression

Student Researcher:

Zhenni Jin, DAOM, LAc (pending)

The treatment of glomus below the heart: A comparative analysis between Zhang Ji and Li Gao (DAOM, Mann)

Abstract

The history of Chinese herbal medicine is something that transcends societies, writing, and one’s ability to understand how effective it has been for such a period that significant herbal usages have remained unchanged for millennia. Many great practitioners of Chinese medicine have graced this profession, but a select few have been granted the fortune and wisdom to provide approaches to the medicine that provide the clinical results that keep their knowledge on the forefront of practice and theory. Zhāng Jī and Lǐ Gǎo are two such physicians that have continued to impact the world since the time that they chose to share their knowledge. These two physicians have made names for themselves specifically because of their individual approaches to treating disease. While their styles may seem different on the surface, and their herbal prescriptions may seem vastly different, at the core of each one’s approach is an expert understanding of the diseases they were facing and a deep knowledge of the medicines they had on hand. This paper is a comparative analysis of each physician’s approach to the specific presentation of ‘glomus under the heart’ (xīn xià pǐ, 心下痞). Several formulas from each physician’s works have been compared discussing the topic of glomus under the heart to see what similarities we can draw from their approaches to a single symptom presentation. In conclusion it has been shown that the approaches of both physicians have very similar foundational approaches to treating glomus below the heart with variations appearing to be based on each individual’s preferences for specific medicinals.

Keywords:

Zhāng Jī, Zhang Zhong-Jing, LǐGǎo, Li Dong-Yuan, Chinese herbs, herbal formulas, Chinese herbal medicine, glomus below the heart, glomus, xī xià pǐ, 心下痞.

Student Researcher:

Matthew Mann, DAOM, LAc

Barriers to Traditional and Complementary Medicine in the African American Community of Aurora/Denver, CO (DAOM, Coleman)

Rhoda Coleman, DAOM, LAcAbstract:

Objective: Identify potential barriers to access of Traditional and Complementary Medicine (T&CM) practices within the Black community in the Denver Metro Area of Colorado.

Design: Survey.

Setting: Community.

Participants: 146 community members completed the survey more than half the respondents were non-White, either Americans of African descent (AA) or other People of Color (POC).

Results: Of the 98.3% respondents who reported the use of T&CM, over 70% would prefer to have a provider who is from their own community who shares or can relate to their culture. Nearly 50% of the respondents reported that their healthcare providers are predominately White. Conclusions and Implications: In the sample group, the majority of participants had a history of receiving T&CM, which begs the question of whether the national surveys are reaching out to enough people. If the response is indicative of a larger sentiment, then future research should investigate why there are not more providers of T&CM in the AA community.

Keywords:

cultural competency; African Americans; health disparities; cultural knowledge; cultural assessment; Organizational cultural  competence; Multicultural organizational development; Organizational cultural change; System change; Systemic cultural competence; health equity, race, social determinants of health; United States; Minorities

Student Researcher:

Rhonda Coleman, DAOM, LAc

AOMA-PROMIS: AOMA Patient Reported Outcome Measures Study (future planned)

Study Area:

patient-centered outcomes

Project Description:

AOMA-PROMIS is a prospective study of the changes in quality-of-life (QOL) associated with treatment at AOMA’s academic health clinics. The NIH-developed Patient Reported Outcomes Measure Information System (PROMIS) tolls will be used to collect prospective data focused on patient-centered outcomes and quality-of-life in patients treated by students and faculty in AOMA’s academic health clinics. 

Status:

Pending

Principal Investigator:

TBD

Research Team:

Jing Fan PhD, MD (China), LAc

Institutional Partners:

N/A

Funding and Support:

AOMA

Retrospective analysis of nutrient levels and disease biomarkers during an extended water fast (Faculty)

Study Area:

fasting, caloric restriction, biomarkers

Project Description:

The retrospective analysis of non-identifiable data, that includes over 100 variables  previously obtained from patients at a fasting clinic, will be used to evaluate how nutrient status changes over the length of a fast as well as to determine if fasting improves biomarkers for various diseases, such as diabetes and heart disease.

Status:

Active

Principal Investigator:

John S. Finnell ND, MPH, LAc

Research Team:

Alan Goldhamer DC; Toshia Meyers PhD, Bradley Saul

Institutional Partners:

TrueNorth Health Foundation

Funding and Support:

TrueNorth Health Foundation

Unraveling the Relationship between Biomarkers of Aging and Vitamin D Metabolism (Faculty)

Study Area:

nutrition, vitamin D, aging, Klotho

Project Description:

We are investigating the possibility that correction of vitamin D insufficiency in healthy adults may result in increased expression of Klotho, an anti-aging protein tightly involved in vitamin D homeostasis. Deficiency of Klotho confers an age-like phenotype in multiple mammalian species. Decreased Klotho protein expression has been implicated in rapid aging and increased oxidative stress, and potentially contributes to increased disease risk and all-cause mortality associated with vitamin D insufficiency. We hypothesize that treating vitamin D insufficiency may result in changes in circulating Klotho levels. We expect that this research may lead to a better understanding of the health benefits of sufficient vitamin D status.

Status:

Complete

Principal Investigator:

John S. Finnell ND, MPH, LAc

Research Team:

Ryan Bradley ND, Nataliya Bulayeva PhD, Kevin Rosenblatt MD, PhD

Institutional Partners:

Bastyr University, Kenmore, WA; Rosenblatt Laboratory at the Brown Foundation Institute of Molecular Medicine at UTHSC Houston (BIMM UTHSC Houston)

Funding and Support:

AOMA Graduate School of Integrative Medicine; Diabetes Action Research and Education Foundation; Bastyr University; BIMM UTHSC Houston; NIH National Center for Complementary and Alternative Medicine (NCCAM: 5T32AT000815)

Publications:

Traub, M. L., Finnell, J. S., Bhandiwad, A., Oberg, E., Suhaila, L., & Bradley, R. (2014). Impact of vitamin D3 dietary supplement matrix on clinical response. J Clin Endocrinol Metab, 99(8), 2720-2728. doi:10.1210/jc.2013-3162 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121030/

Fasting and Alternative to Standard Therapeutics (FAST) Safety Study (Faculty)

Study Area:

fasting, safety, adverse events, vegan diet, caloric restriction

Project Description:

This retrospective safety study investigates the safety and tolerability of a residential medically-supervised fasting intervention, compared by age and medical diagnosis to diet-only intervention. This is a population-based cohort study of patients who underwent either a low-salt, low-fat, vegan dietary intervention or a medically-supervised fast (water, juice, or broth) at the TrueNorth Health Center (TNHC) in Santa Rosa, California.  Structured adverse event data, as defined under Common Terminology Criteria for Adverse Events (CTCAE), were collected from the medical records of consecutive patients from 2006 to 2011.

Status:

Complete

Principal Investigator:

John S. Finnell ND, MPH, LAc

Research Team:

Alan Goldhamer DC; Toshia Meyers PhD, Bradley Saul

Institutional Partners:

TrueNorth Health Foundation

Funding and Support:

AOMA; National Health Association; TrueNorth Health Foundation

Publications:

(in review)

The Safety of Fasting in a Medically Supervised Setting, a Retrospective Cohort Study (DAOM, Vaughn)

Abstract:

Background: Fasting has been a common practice throughout history for a variety of health and

religious reasons. Numerous studies have highlighted the efficacy of fasting in the treatment of

common health conditions that developed countries face such as hypertension, heart disease,

diabetes, depression and obesity. In addition to reversing chronic illnesses, fasting is well known

throughout many cultures as a practice to increase one’s longevity. In order for fasting to be

considered a viable form of therapy for its numerous health benefits, it must first be established

that fasting is safe. This study aims to establish the safety of fasting when conducted in a

medically-supervised setting.

Methods: This study follows patients who participated in a medically supervised fast at TrueNorth

Health Center (TNHC), a residential, multi-disciplinary

treatment facility from the years 2005-2011. Adverse events experienced by patients during their

stay were recorded into daily logs, coded according to the Common Terminology Criteria for

Adverse Events (CTCAE) and analyzed according to their prevalence, per each type of dietary

intervention utilized.

Results: 275 patients participated in a dietary intervention in the form of

water fasting, which represented the vast majority of participants, juice fasting or diet-only

intervention. The patients participated in one of these three types of interventions over a course

of 5,615 days at the facility. CTCAE adverse events grades 1-3 were very common, while no

grades 4-5 occurred.

Conclusion: Minor disturbances such as fatigue, nausea and headaches

occurred frequently in all three groups. There were no CTCAE adverse events grades 4 or 5,

such as life threatening consequences or death. This data suggests that medically supervised

fasting is a safe practice under the evaluation and care of qualified medical professionals in an

in-patient treatment facility.

Key Words:

fasting, safety, adverse events

Student Researcher:

Debbie Vaughn, DAOM, LAc

Post-Natal Essence, Neurogenesis, and Neuroplasticity in Chinese Medicine (DAOM, Phillips)

Abstract:

This is a Systematic Search and Review considering the possible relationship between the Chinese Medical concept of post-natal essence and the biomedical concept of neurogenesis and neuroplasticity. This work will look at traditional expressions of these ideas in conjunction with modern research on Chinese Medicine and its effects on these areas of brain formation, specifically exploring the indications of the points and herbs that show effect or lack of effect to indicate the relationship to essence.

Methods: The work is in two parts. The first part will be a theoretical consideration of the CM medical system with a comparison to the biomedical understanding of the processes of neurogenesis and neuroplasticity. It will discuss how those physiological processes could be contextualized in the CM system, specifically considering the relationship of essence to brain function as a key point of comparison. The second part of the work will look at current studies on CM and both neurogenesis and neuroplasticity to see if the points or herbs used in these studies showed any preference for a particular CM diagnosis or system which would indicate the link between essence and neuronal processes.

Results: Many of the acupuncture research focused on using scalp points for direct brain stimulation, and the secondary points were chiefly indicated for qi and blood building. In the herbal research there were several herbs that did focus on building essence, with a large group of selected herbs coming from categories that move qi and blood, rather than build or support. The testing done at this point was almost exclusively done on animals, and typically in cases of induced pathologies such as cerebral ischemia.

Discussion: It is difficult with the limited research, the limitations of testing needle therapies on animal models, and the preference toward the treatment of induced pathologies, which in the CM model would represent qi and blood stasis and justify the use of those herbal categories to draw a strong conclusion about the relationship of essence to neurogenesis and neuroplasticity. Some of the herbs used certainly demonstrated this connection, and the aspect of post-natal qi supporting post-natal essence justifies the use of many of the points, but the data is severely limited at this time. Due to the strength of the theoretical basis the next step would be to structure research to more specifically test that connection with a focus not on the biomedical pathology being treated, but on the CM treatment protocol to test efficacy of the approach.

Conclusion: While the theoretical correlation between post-natal essence and neurogenesis and neuroplasticity is strong, there is insufficient evidence at this time in the existent research to demonstrably prove the connection.

Key Words:

Jing, Post-Natal Essence, Neuroplasticity, Neurogenesis, Chinese Medicine

Student Researcher:

Justin Phillips, DAOM, LAc