Acupuncture outperforms drugs for the treatment of Tourette’s syndrome. In a controlled clinical trial, Heilongjiang Traditional Chinese Medicine University researchers conclude that acupuncture is effective for the treatment of Tourette’s syndrome. Two groups were compared. An acupuncture treatment group achieved a total efficacy rate of 82.5% and a drug control group achieved a total efficacy rate of 62.5%.

Patients in the drug control group received administration of the drug haloperidol, a pharmaceutical antidepressant. Haloperidol is widely used as an antipsychotic medication for the treatment of schizophrenia, but it is also used for controlling Tourette’s syndrome. Based on the data, the researchers conclude that acupuncture outperforms haloperidol for the treatment of Tourette’s syndrome. In addition, they add that "the adverse effect rate of the acupuncture group is significantly lower than that of the drug group." The results indicate that acupuncture is both more effective and safer than administration of haloperidol for the treatment of Tourette’s syndrome.

Patients were evaluated before and after the course of treatment. The severity of Tourette’s syndrome was evaluated based on the Yale Global Tic Severity Scale (YGTSS). After completion of all treatments, the efficacy rate for each patient was categorized into 1 of 4 tiers:

Recovery: Absence of symptoms. Tic severity decreased by >95%.
Significantly effective: Significant absence of symptoms. Tic severity decreased by 61%–95%.

Effective: Symptoms showed improvement. Tic severity decreased by 30%–60%.
Not effective: Symptoms showed no visible improvement. Tic severity decreased by <30%

After 2 courses of treatment, the acupuncture group achieved an efficacy rate of 82.5%. A total of 2 patients recovered, 14 showed significant improvements, 17 showed ‘effective’ improvements, and 4 patients remained unchanged. The control group achieved an efficacy rate of 62.5%. A total of 0 patients recovered, 6 showed significant improvements, 19 showed ‘effective’ improvements, and 15 remained unchanged. The efficacy rates show significant differences between drug therapy and acupuncture therapy. In addition, the acupuncture group had a significantly lower adverse reaction rate compared with the drug group.

Stats
The study involved the selection of 80 patients at the acupuncture or psychology departments of the first affiliated hospital of Heilongjiang Traditional Chinese Medicine University. All patients were diagnosed with Tourette’s syndrome between March 2014 and March 2015. They were randomly divided into an acupuncture treatment group and a drug control group, with 40 patients in each group. The treatment group underwent Traditional Chinese Medicine (TCM) acupuncture therapy and the control group received haloperidol tablets.

The statistical breakdown for each randomized group was as follows. The treatment group was comprised of 32 males and 8 females. The average age in the treatment group was 9 (±3) years. The average course of disease in the treatment group was 20.3 (±5.1) months. The control group was comprised of 30 males and 10 females. The average age in the control group was 9 (±2) years. The average course of disease in the control group was 21.5 (±5.0) years. For both groups, there were no significant differences in terms of their gender, age, and course of disease.

Methods
Patients from the treatment group received acupuncture at the following acupoints:
GV20 (Baihui)
Sishencong (Extra)
GV24 (Shenting)
GV29 (Yintang)
GV26 (Shuigou)
HT7 (Shenmen)
PC6 (Neiguan)
ST36 (Zusanli)
SP6 (Sanyinjiao)
LV3 (Taichong)

Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.35 mm × 40 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. Baihui, Sishencong, Shenting, and Yintang acupoints were obliquely needled to a depth of 15 to 20 mm. The acupoints were stimulated with a mild reinforcing and attenuating technique. Shuigou was needled obliquely (in an upward direction) to a depth of 10 mm and was stimulated with an attenuating technique.

Shenmen, Neiguan, Zusanli, Sanyinjiao, and Taichong were perpendicularly needled to a standard depth. Zusanli, Sanyinjiao, Shenmen, and Neiguan were stimulated with a mild reinforcing and attenuating technique. Taichong was stimulated with a reducing technique. The total needle retention time was 40 minutes per acupuncture session. The acupuncture sessions were conducted once daily, for 10 consecutive days, followed by 1 break day. Each treatment course consisted of 30 days of acupuncture treatment and 3 days of break time. A total of 2 treatment courses were conducted.

For the treatment group, patients initially received 1 mg of haloperidol tablets. Tablets were orally administered twice per day. Every 30 consecutive days of tablet consumption consisted of one treatment course. Two courses of treatment were administered. The dose was adjusted to a maximum of 8 mg daily, based on the severity of the Tourette’s syndrome.

About Acupuncture
The acupuncture point prescription used in this study is based on TCM principles. According to TCM theory, mental activities are controlled by the heart spirit as well as the brain. In the Suwen, it is noted that "the heart holds the office of monarch, whence the bright spirit (mental activity) emanates . . . when the monarch fails to control the bright spirit, the twelve officials (internal organs and vessels) will be in danger." The Yi Xue Zhong Zhong Can Xi Lu (Records of Tradition Chinese and Western Medicine in Combination) notes, "The brain is where the bright spirit flowing into, while the heart is where the bright spirit emanates from." In this study, the selection of acupoints on the Du meridian, heart meridian, and pericardium meridian exactly reflects this understanding.

It is important to note that Tourette’s syndrome in TCM falls under the Ganfeng (liver wind) class of disorders. Liver wind, understood in terms of modern presentations and indications, involves tics, seizures, and sudden movements due to both internal organ disharmonies and exogenous pernicious influences. Thus, distal acupoints were selected to regulate liver wind. Taichong is a Yuan-source acupoint on the liver meridian. Needling this acupoint calms the liver qi. The combination of Taichong and Sanyinjiao calms the liver and extinguishes wind. Zusanli is on the yangming meridian and nourishes the spleen and stomach to generate qi and blood.

Baihui is the confluence of the yang meridians and connects hundreds of vessels. According to ancient TCM literature, it is indicated for "half-body paralysis, fright and palpitations, epilepsy, and many other diseases." In addition, the combination of Baihui, Shenmen, and Neiguan is often used to quiet the heart and spirit.

Sishencong is an extra acupoint. According to the Tai Ping Sheng Hui Fang (Taiping Holy Prescriptions for Universal Relief), it is indicated for "dizziness due to wind attack, manic derangement, and epilepsy." In practice, Sishencong and Baihui are often combined and used for strengthening yang qi and benefiting the brain. Shenting (translated as the center palace of the spirit) is a main point for clearing the heart fire and quieting the spirit. Yintang is located on the Du meridian, and it is indicated for settling fright and quieting the spirit. Similar to Shenting, Shuigou is also a main point for treating shen disturbances and is used for quieting the spirit.

Recommended
The research indicates that acupuncture is both safe and effective for the treatment of Tourette’s syndrome. Importantly, acupuncture’s effective action is rapid. Additionally, both the total effective rates and significant improvement rates outperform a powerful drug, without the undesirable adverse effects. Given the rate of effectiveness and rapid effective action of beneficial results for patients, acupuncture for the regulation of Tourette’s syndrome is an appropriate medical option.

References
Liu H et al. Observations on the Therapeutic Effect of Acupuncture on Tourette’s Syndrome [J]. Shanghai Journal of Acupuncture and Moxibustion, 2016, 35(8):977– 979.

Li, Heng, and Richard Durbin. "Fast and accurate short read alignment with Burrows–Wheeler transform." Bioinformatics 25, no. 14 (2009): 1754-1760.