20171022 The use of acupuncture for the elderly by Dr. Jaung-Geng Lin

1. Jaung-Geng Lin
Chair Professor
School of Chinese Medicine
China Medical University
The use of
acupuncture for
the Elderly

2. The definition of Elderly
According to WHO guidelines, most developed
world countries have accepted the age of 65 years
as a definition of ‘elderly’ or older person.
2

3. Elderly in Taiwan
3
The ratio of elderly people is an important issue. For example, it is
estimated that the elderly people in Taiwan will account for 40% of the
population in 2060.

4. Pain, nervousness, depression,
anxiety and insomnia are common
medical conditions among elderly
people.
Can acupuncture be used in the
elderly ?
My answer is “Yes”.
4

5. Introduction
Acupuncture is one of the most
commonly used medical procedures
worldwide.
It involves the stimulation of specific
locations of the body (acupoints) by
penetration with thin metal needles and
their manipulation.
5

6.  Manual acupuncture (MA)
 the insertion of an acupuncture needle
into acupoints is followed by twisting
the needle up and down or rotating the
needle by hand
 Electroacupuncture (EA)
 stimulating current is delivered to
acupoints via the inserted needle
 Other forms, such as laser or
acupressure (massage the acupoints)
6
MA and EA

7. Publications of WHO’s work on acupuncture
1989
A standard international acupuncture nomenclature:
memorandum from a WHO meeting
1995 Guidelines for clinical research on acupuncture
1995 Guidelines on basic training and safety on acupuncture
2000
Acupuncture: review and analysis of reports on controlled
clinical trials
2002 WHO Traditional Medicine Strategy 2002-2005
2007
WHO international standard terminologies on traditional
medicine
2008 WHO standard acupuncture point locations

8. WHO standard acupuncture point locations
WHO international standard
terminologies on traditional medicine
WHO Traditional Medicine Strategy 2002-2005

9. The World Health Organization (WHO)
published a special issue on acupuncture,
the "World Health", in 1979, which
included 7 thesis papers and 30 photos
to introduce acupuncture and listed 43
indications for acupuncture.
WHO & Acupuncture Medicine

10. In November 1996 in Milan, Italy, the
World Health Organization (WHO) extended
acupuncture indications from 43 to 64.

11. 1. Medical Practice –
The indications of acupuncture approved
by the WHO
Upper Respiratory Tract
Acute sinusitis
Acute rhinitis
Common cold
Acute tonsillitis
Respiratory System
Bronchial asthma
Acute bronchitis

12.  Disorders of the Eye
 Acute
conjunctivitis
 Central retinitis
 Myopia (in children)
 Cataract
 Disorders of the mouth
Gingivitis
Toothache
Post-extraction pain
Acute and chronic pharyngitis

13.  Gastro-intestinal Disorders
 Constipation
 Diarrhea
 Gastroptosis
 Hiccups
 Spasms of esophagus and cardia
 Acute duodenal ulcer
 Chronic duodenal ulcer
 Gastric hyperacidity
 Acute and chronic gastritis
 Acute and chronic colitis
 Acute bacillary dysentery
 Paralytic ileus

14.  Neurological disorders
 Sciatica
 Headache
 Migraine
 Trigeminal neuralgia
 Paresis following a stroke
 Cervicobrachial syndrome
 Meniere’s disease
 Neurogenic bladder dysfunction
 Sequelae of poliomyelitis
 Peripheral neuropathy
 Facial palsy (within 3 to 6 months)
 Intercostal neuralgia
 Nocturnal enuresis

15.  Musculoskeletal Disorders
 Frozen shoulder
 Tennis elbow
 Low back pain
 Osteoarthritis

16. The 64 WHO indications include
pain, nervousness, depression,
anxiety and insomnia, and
gastrointestinal disturbance.
These are also common symptoms in
elderly people.
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17. Evidence-Based Medicine
• 1. Background
• 2. Origin
• 3. Name
• 4. Definitions
• 5. How do we actually practice EBM?

18. We would like to acknowledge the Committee on
Chinese Medicine and Pharmacy, Department of Health,
Executive Yuan for providing a two-year grant.
A Literary Review of Curative Effects Of
Acupuncture (2-1)
CCMP93-RD-017 (Jan, 2004-Dec, 2004)
A Literary Review of Curative Effects Of
Acupuncture (2-2)
CCMP94-RD-104 (Jan, 2005-Dec, 2005)
Our study: A Literary Review of
Curative Effects Of Acupuncture

19. Our study: A Literary Review of
Curative Effects Of Acupuncture
 The information was divided into 10 groups. 29
reviews and 234 papers were funded by the two-
year grant.

20. Conclusion for EBM in Acupuncture
 Acupuncture has best efficacy in pain
relief.
 Conditions with higher scores of
curative effects were centralized in
the muscle and skeletal systems, e.g.,
OA, low back pain.
 There were conditions with better
scores of curative effects that were
not in the muscle and skeletal systems,
e.g., asthma, vomiting, insomnia,
anxiety.

21. The main results of the study
were compiled into a book
describing EBM in
acupuncture.
This book guides the use of
acupuncture in Taiwan.

22. Pain relief
 Head and neck pain (頭頸部疼痛)
 合谷(LI4)
 列缺 (LU7)
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23. Pain 疼痛
• Waist pain
(腰部疼痛)
•陽陵泉
•(GB34)
•委中
•(BL40)
23

24. Pain
 Abdominal and chest pain
 足三里 (ST36) ．三陽絡 (TE8)
24

25. Nervousness and insomnia
緊張與失眠
Insomnia is one of the most significant
problems of the elderly.
Acupuncture at Shenmen (HT7) may provide
sedative and hypnotic effects.
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26. Nervousness and insomnia
Shenmen (HT7)(神門穴)
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27. Clinical Practice in Cancer
Patients
If elderly people have cancer and are receiving
cancer therapy, acupuncture can be used.
Acupuncture has many beneficial effects in cancer
therapy and in the management of side effects
induced by chemotherapy and radiotherapy.
27

28. Vomiting and nausea
Most studies confirm the excellent
efficacy of acupuncture in vomiting
and nausea, including that induced
by chemotherapy and radiotherapy.
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29. Vomiting and nausea 噁心嘔吐
29
•內關
(PC6)
•支溝
(TE6)

30. Vomiting and nausea 噁心嘔吐
30
•足三里 (S36)

31. Xerostomia 口乾症
 Xerostomia or dry mouth is a very common complication in
patients treated with radiotherapy for head and neck cancer.
The condition is caused by radiation damage to the salivary
glands.
 Even a low dose of radiation can cause a change in the
quantity and quality of saliva,and up to 100% of patients who
undergo radiotherapy for head and neck cancer develop some
degree of xerostomia.
 The symptoms of radiation-induced xerostomia are often
permanent and lead to difficulty in mastication, swallowing,
and speaking.
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32. Xerostomia 口乾症
 Hegu(合谷)
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33. The use of meridian theory in the elderly
 As mentioned above, acupuncture can be used in the elderly.
Besides, the meridian theory can be used in the elderly.
 First, the elderly can do acupressure by themselves.
 Secondly, according to the meridian theory, there are 3 yin
and 3 yang meridians in the hand and foot.
 You can perform Tai Chi Chuan (太極拳) or other Gongfu to
stimulate these meridians.
 But if you have not much time, you can learn my own“Shaking
and swinging hand and foot 3 yin 3 yang meridians qigong”
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34. Shaking and swinging hand and foot 3 yin 3
yang meridians qigong
You can download this video from Youtube.

35. Springer
2010

36. 36
2012
Springer

37. InTech
2011

38. 38
2014
Springer
與哈佛大學合作出版
Chapter 3: Jaung-Geng Lin

39. 39
2014
Springer
與哈佛大學合作出版

40. 40
2014
Springer
與哈佛大學合作出版

41. Acupuncture has drawn the attention of the
UNESCO (the United Nations Educational,
Scientific and Cultural Organization) and
WHO.
 I was invited to deliver lectures in UNECSO and
WHO to talk about
 “Evidence-based Medicine in Acupuncture” for
UNESCO
 “The Use of Acupuncture in Emergency
Medical Services” for WHO
41

42. 9 th
42
I am the expert providing advice for the Intangible
Cultural Heritage (ICH), UNESCO, in the field of TCM
(traditional complementary medicine).

43. 43 2014

44. 44
I was invited to deliver a lecture in the
140th World Health Organization
Executive Board on Jan. 24 2017.

45. 45
You can download this video from Youtube.

46.  Pain and insomnia are also common medical
conditions in the elderly.
 We propose the use of acupuncture for the
relief of these symptoms in the elderly.
46

47. “Personal experience” is at
the lower level of EBM-
based acupuncture analgesia,
but it still provides useful
information to treat patients.
Clinical practice
experience

48. Highest golden burnoose award was conferred by
Saudi Arabia in 1980.
J. G. Lin, C.M.U.
1980

49. Conclusion
 Acupuncture has proven to be particularly effective
for the relief of pain, insomnia and anxiety.
 Pain and insomnia are common medical conditions in
the elderly. We propose the use of acupuncture for
the relief of these symptoms.
 Furthermore, acupuncture has many beneficial
effects on the management of side effects, such as
vomiting, nausea and loss of appetite, xerostomia
and nervousness induced by cancer therapy, such as
chemo- and radio-therapy.
 According to meridian theory, there are 3 yin and
3 yang meridians in the hand and foot. Stimulating
these meridians can promote health of the elderly.
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50. 50
Thank you for your
attention
jglin@mail.cmu.edu.tw