Medical Acupuncture
A Journal For Physicians By Physicians

Spring / Summer 2000- Volume 12 / Number 2
"Aurum Nostrum Non Est Aurum Vulgi"

POSTER PRESENTATIONS

Hand Acupuncture Treatment
For Chronic Asthma In Children
Roberto Jodorkovsky, MD

OBJECTIVE
    To assess the effectiveness, acceptability, and incidence of adverse effects of hand therapy as an integrative treatment of pediatric asthma.

INTRODUCTION
    Pediatric asthma is the most common chronic disease in children. It is associated with frequent emergency department visits, hospitalizations, and office visits, recurrent school absences, many lower respiratory tract infections, regular use of bronchodilators, steroids, and other drugs, physical limitations, psychological risks, and inflated financial costs.

METHODS
    Data were collected via retrospective chart review, or oral interview in person or over the telephone. A comparison of clinical parameters was conducted 4 months before treatment and 4 months during hand therapy. Outcomes included number of hospitalizations, number of emergency department visits, number of lower respiratory tract infections, treatment with systemic steroids, use of nebulizer or inhaler for symptoms, physical endurance, acceptability of treatment, and adverse effects.

TREATMENT
    Conventional treatment included albuterol (inhaler or nebulizer), steroids (inhaler or nebulizer), antihistamines, leukotriene antagonists, and magnesium supplements.
ACUPUNCTURE TREATMENT
    Hand therapy was conducted at Ren Mo - C 8 (LU 7) - J 2 (KI 6); Lung Back Shu and Mu points; I 10 (BL 13) - C 1 (LU 1); A 24 (CV 25), A 20 (CV 24), A 18 (CV 17), A 12 (CV 12), A 1 (CV 1,) A 3 (CV 3), A 4 (CV 4), and A 8 (CV 8). Points were activated with an e-beam stimulator and pellets.
    Treatment was conducted 3-4 times per week, followed by maintenance therapy every 3-4 weeks.

OUTCOME
    Six children, 3 boys and 3 girls ranging in age from 2.5 to 8 years (median 6 years), were treated. There were no hospitalizations in the 4 months before or the 4 months during treatment. Two patients made 3 trips total to emergency departments for symptomatic episodes before treatment; there were no such visits during treatment. Four patients had 7 episodes of respiratory tract infections before treatment; no infections occurred during treatment. Physical endurance notably improved in all patients.
    Medication use declined significantly with hand therapy. Use of systemic steroids decreased markedly with therapy (15 courses before therapy vs 1 during hand therapy). In addition, average use of albuterol decreased significantly (from 5 to 7 d/wk in all children to 1 d/wk in 5 patients).
    For the other outcome parameters, physical endurance was improved or much improved in all patients. Acceptability of hand therapy was excellent in all patients, and no adverse events were reported.

DISCUSSION
    Hand therapy appears to be an effective complementary modality in the treatment of chronic pediatric asthma. There were no adverse events reported in this study, and the treatment was well accepted in a primary office setting. As a next step, randomized controlled trials with larger cohorts are necessary.

AUTHOR INFORMATION
    Dr Roberto Jodorkovsky is in private practice, specializing in General Pediatrics and Medical Acupuncture. He is Clinical Associate Professor of Pediatrics at the University of Maryland School of Medicine, and an attending Pediatric Nephrologist at the University of Maryland Medical System. Dr Jodorkovsky is Vice-President and Secretary of the Maryland chapter, Medical Acupuncture Society.

Roberto A. Jodorkovsky, MD
7658 Belair Rd
Baltimore, MD 21236
Phone: 410-882-6841
Fax: 410-882-8478
E-mail: rjodorkovsky@hcmt.com

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