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The Science of Acupuncture
Ming Liu is a Professor of Neurology, West China Hospital of Sichuan University, Chengdu, China..
by Ming Liu
Like many other traditional Chinese medicines, acupuncture has for many centuries been viewed suspiciously in the West. It seems to work, but how? Is a scientific answer possible?
Most Chinese doctors and patients have, for example, long regarded acupuncture as an effective treatment for stroke, using it to improve motor, speech, and other functions that have been destroyed. One survey showed that 66% of Chinese doctors use acupuncture routinely to treat the effects of stroke, with 63% of the doctors surveyed believing it to be effective. Some 36% of Chinese doctors think the effectiveness of acupuncture remains uncertain, perhaps because the scientific basis for it remains so new.
Recently, however, systematic scientific studies of acupuncture’s effects in such treatment has begun. Almost all trials on acupuncture as a treatment for stroke conducted within China have been positive. But another recent study done in the UK showed that research conducted in several countries was uniformly favorable to acupuncture as a treatment for the damage caused by stroke. Indeed, all the trials performed before June 1995 in China, Japan, Hong Kong, and Taiwan were deemed positive by the British researchers.
The Cochrane Collaboration, an international non-profit organization providing healthcare information, conducted a systematic review of the benefits of acupuncture, including 14 trials, of which 10 were conducted in China, involving 1,208 patients. Acupuncture started within 30 days of stroke onset, with control groups receiving a placebo – sham acupuncture – or no treatment. Compared to patients who received sham acupuncture or no treatment, far fewer of those who received acupuncture died or became invalid within three months. After three months or more of treatment, the numbers rose even more significantly in favor of those treated by acupuncture.
Oddly, when comparing acupuncture with sham acupuncture, the statistical difference concerning death or the need for institutional care was small. Indeed, another analysis, including 14 randomized trials with 1,213 patients six months after a stroke, compared the effects of conventional stroke rehabilitation with and without acupuncture as a supplement. Acupuncture was found to have no additional effect on motor recovery, but a small positive effect on disability, which may be due to a true placebo effect, or to the varied quality of the trials.
Indeed, the efficacy of acupuncture without stroke rehabilitation remains uncertain, mainly because of the poor quality of such studies—a problem that has affected most of trials undertaken so far. For example, many trials did not describe their method of measuring statistical relevance, and only called themselves “randomized controlled trials.” Only four trials, with 373 patients, could provide data on death or dependency (becoming dependent on others for activities of daily living). And only three trials—all conducted in Europe—used sham acupuncture as a control, whereas no acupuncture trials controlled with placebos or sham acupuncture have been reported in China, owing to high cultural barriers.
Part of the problem in China is choosing the patients to be studied. After all, patients come to hospitals that practice traditional Chinese medicine because they already believe in acupuncture and are likely to be using it to treat another illness. Getting such patients to accept being put into a control group where no acupuncture is applied is almost impossible. This difficulty makes random studies of the effects of acupuncture treatment on stroke patients particularly difficult in a traditional Chinese medicine hospital.
More fundamentally, however, Chinese doctors who use traditional medicine argue that outcome measures of acupuncture as a treatment for stroke should be different from conventional measures used in Western trials, because the theory of acupuncture is different. But no one has yet specified what the appropriate outcome measures for acupuncture should be.
A recent study conducted in China, including 862 patients who were between the second and tenth day after onset of acute stroke, is the largest truly randomized trial using death or dependency as the primary outcome. The patients were randomly allocated to an acupuncture group receiving acupuncture treatment plus routine treatment or a control group receiving routine treatment alone. The results will be reported after analysis of the trial data and could prove useful for therapy of stroke patients. At present, however, there is insufficient evidence for routine use of acupuncture in stroke. More high-quality trials are needed. We do know that acupuncture is a safe, inexpensive, widely accepted, and potentially effective therapy. Particularly at a time when standard rehabilitation is not available for most Chinese stroke patients, few will wait to try acupuncture until its role is confirmed or refuted by reliable evidence.
Copyright: Project Syndicate, 2006.
www.project-syndicate.org
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Kirlian Erotica
Her Infitinte Variety
The Leap Of Faith. A Nasty Fall? Well Leap Again.
I make no comment whatsoever on the issue of how long it is possible to keep a good scam running. Or how enduring is an ancient truth. But is it really necessary for me to draw attention to what the person responsible for these two comments has had to say about Christianity and Judaism?
Ah well. I guess there is a certain type of person who simply must have faith in something. No matter what. How terribly bitter must be the disillusion when it comes.
Acupuncture has become
Acupuncture has become increasingly accepted by allopathic practitioners and it is not uncommon to find medical centres where at least one GP has trained in and practises acupuncture. Hospitals are also beginning to explore its uses and while progress may be slow by comparison with the runaway success of pharmaceuticals and whizz-bang machines it is progress all the same.
Acupuncture stimultes the energy meridians of the body. The Chinese believe that illness occurs where body energy, chi, is interrupted in its flow. They also believe that the body as a whole must be taken into account when treating conditions, unlike the narrow and obsessive focus of allopathic medicine.
Interestingly these ancient Chinese 'points' or energy meridians match up with energy points identified with Kirlian photography and with more modern scanning equipment. Hardly surprising of course. If it did not work it would not have been around for a thousand years or more.
I am sure, like all treatments, acupuncture works better for some than it does for others. But where it does work at optimum levels the results are impressive.
Acupuncture is also very successful with animals and this clearly is not the result of the placebo effect, unless the animals 'pick up' the beliefs, attitudes, faith, of their owners and the doctor. Then again, let's not knock placebo. What is the most effective treatment that studies show time and again? Placebo! Why it works is another issue but it stands its ground solidly against the drug deluge.
Acupuncture is probably easier to 'prove' empirically than is homeopathy because it must be possible to monitor and record the 'energy response' caused by the application of the acupuncture needle.
But, beyond any need for proof surely the important thing is that a. acupuncture works, and b. (unlike drugs and surgery) it has no contra-indications and no nasty side-effects. Ditto for homeopathy.
In our best of worlds, which we may have one day, allopathic practitioners will use such methods alongside their tests, drugs and scalpels.
The Placebo Effect On The Wallet
My local vet practises acupuncture, and sometimes recommends the treatment on the old dog when his arthritis or bad back is playing up (the dog I mean), even though his training is orthodox. (The vet I mean). He did a course, you see. (I still mean the vet).
At about $50 a session for a series of at least six sessions, of course the treatment works. At that cost naturally it must work. Well it's enough to convince me it works. Otherwise I wouldn't always be so quick to agree to the treatment just to make sure everything that can be done for the dog is being done.
The dog, on the other hand, isn't in a position to say, one way or the other. Ah well. I've never heard him complain about the treatment. Anyway, he still gets the full range of available drugs, injections, ointments and the occasional operation (he's had two, at about $5,000 each, but who's counting?). Just to make sure, you understand. Just in case the acupuncture doesn't work.
acupuncture is merely a placebo effect
Controlled experiments have demonstrated this by, for example, using a control group where the acupuncture needles were placed in precisely the WRONG places and the reported pain relief was the same as when they were placed in the correct places according to acupuncture theory ("energy meridians" whatever that means). This shows that it is the patient's belief in the treatment that actually had a pain-relieving effect, not the treatment per se.
Just as with any other placebo treatment, not everyone responds. The important factors are (a) that the problem being treated has a significant psychosomatic component, and (b) that the patient believe strongly in the treatment. I once suffered a severe muscle spasm in my neck that was extremely painful; conventional medical treatment did not help, so I tried acupuncture. It had no effect either.
Mike: Acupuncture has
Mike, acupuncture has been around for thousands of years. It is hardly likely to be the longest 'hoax' in history. What matters is that it works for many if not most even if it did not work for you on one occasion which can hardly be considered a real 'test.' Not all drugs work either but I suspect you do not then dismiss then as placebos. Operations have been performed on people who remain conscious and yet have had acupuncture to remove any sensation of pain. That's impressive.
A bit of information on energy meridians:
Excerpt: In 1978 Luciani produced Kirlean photographs of the LED (light emission diode) effect of acupoints along the small intestine meridian and the large intestine meridian.
The existence of the meridian system was further established by French researcher Pierre de Vernejoul, who injected radioactive isotopes into the acupoints of humans and tracked their movement with a special gamma imaging camera. The isotopes traveled thirty centimeters along acupuncture meridians within four to six minutes. Vernejoul then challenged his work by injecting isotopes into the blood vessels at random areas of the body rather than into acupoints. The isotopes did not travel in the same manner at all, further indicating that the meridians do indeed comprise a system of separate pathways within the body.
MERIDIANS
Although reports of acupuncture have been recorded in the west since the 1800's, it wasn't until the 1970's that this method of therapy became well publicized. A reporter for the "New York Times" became ill with appendicitis while traveling in China and had an appendectomy without anesthesia, but with the use of acupuncture. This was widely reported in the western press. Doctors tried to explain the technique by saying it was the "placebo affect". This is the phenomenon in which 30% of people will be shown to be able to self heal in experiments when given a sugar pill instead of the "real medicine". However, this was shown to be a false belief because animals (who couldn't possibly respond to suggestion) also responded to the analgesic properties of acupuncture.
In the 1960s, western scientists developed a special tissue-staining technique that allowed him to identify these meridians in rabbits. Western scientist ignored this research until the 1980s when two French researchers, Drs. Claude Darras and Pierre De Vernejoul repeated Dr. Hans experiment using radioactive tracers on human beings.
http://www.emofree.com/Research/meridianexistence.htm
Meanwhile, a report in the British Medical Journal shows acupuncture is effective in treating low back pain and is cost effective.
http://www.sciencedaily.com/releases/2006/09/060915102553.htm
Also, researchers in Adelaide have found that acupuncture substantially increases IVF success rates.
http://www.abc.net.au/news/newsitems/200606/s1655666.htm
Acupuncture is also increasingly used on animals to good effect.
Excerpt: Despite the fact many of its practices are thousands of years old, Eastern, or non-traditional, medicine is becoming more popular today than ever. Acupuncture is one specialized facet of non-traditional medicine that not only entered the mainstream; it’s become a treatment option for our pets.
http://www.vetmed.wsu.edu/clientED/acupuncture.asp
Acupuncture gains respect. Excerpt: Acupuncture has been used so far by 8.2 million Americans, according to the National Center for Complementary and Alternative Medicine, a government agency. Some insurers now pay for acupuncture, which is considered extremely safe.
http://www.alternativetherapies.com.au/content/view/97/260/
A report from the medical journal of Australia.
Excerpt: Acupuncture is used by about one in seven general practitioners. Its use is associated with middle-aged practitioners, who presumably have more clinical experience. This level of use by experienced doctors suggests that a critical review of the appropriate role of acupuncture in general practice should be considered.
http://www.mja.com.au/public/issues/aug17/easthope/easthope.html
Acupuncture effective in treating headaches according to a BBC report from a medical study.
Excerpt: Acupuncture is an effective treatment for chronic headaches and should be more widely available on the NHS, experts say.
Writing in the British Medical Journal, UK researchers said patients who were given acupuncture had fewer days of headaches than those who were not.
http://news.bbc.co.uk/2/hi/health/3506400.stm
Popular hoaxes often endure, Roslyn
- especially religions and fancy placeboes. I'm not saying acupuncture is not effective, just that its mechanism is the same as that of any other placebo treatment. Placeboes can be ranked in effectiveness by how elaborate they are; thus, a placebo pill tends to be less effective than acupuncture, which is less effective than sham surgery (used as a control in research on the effectiveness of new surgical procedures). The general rule is the more elaborate and convincing the hoax treatment, the more people fall for it. Last night there was an interesting program about a Chinese surgeon who claims he can make people with spinal cord injuries walk again. It was interesting how even though the patient shown could NOT walk after the surgery, he still persisted in believing it was effective! So if you go by patient reports on the effectiveness of treatment, placeboes can look like miracle cures. Objective measures, on the other hand, show otherwise.
Kirlean photography? Give me a break. You are apparently rather gullible and susceptible to hoaxes.
It's Kirlian not Kirlean.
It's Kirlian not Kirlean. Kirlian photography is probably the first attempt to 'record' the body's energy activity ..... a system, albeit in different form, now utilised by the latest scans in modern hospitals.
Excerpt: Human beings are "a spectacular panorama of colors, whole galaxies of lights...." Throughout the 1960's extraordinary
descriptions by prominent Soviet scientists appeared in the Soviet
press of what humans looked like as seen by a newly developed
form of photography. We're a world of "luminescent labyrinths,"
"fantastic galaxies," "alluring ghostly lights," and "multicolored
flares," they said.
By the 1970's Americans, too, had constructed similar apparatus
and were exploring a new picture of human beings: "a fascinating
new world," "brilliantly colored bubbles and blotches," "the fabric
of organic and inorganic life," flares pulsing out energy "like water
from a fireman's hose."
Researchers East and West were viewing a brilliant emanation from
the human body, which became visible when the body was placed
in a field of high frequency electrical currents. A Russian husband
and wife team had developed a new way to make photographs,
movies, and to visually observe brilliantly colored light plays
surrounding and moving through the human body, animals, plants,
and all living things. They call it the " Kirlian Effect" (pronounced
keer-lee-an) after its inventors Semyon and Valentina Kirlian. They
had labored on their own for decades to develop and perfect this
new form of photography with high frequency fields.
Since the mid sixties, teams of Soviet scientists from Moscow to
Siberia have plunged into the study of these beautiful colored lights
in living things and have come up with some intriguing new
conceptions about the nature of life itself.
Among the initial findings: Disease shows up in a disturbed pattern
of flares long before it manifests in the physical body in any
diagnosable form. If portions of the physical body are cut away, the
energy matrix or "phantom" of the missing part is still clearly
visible in the photograph, although there is no tangible, physical
substance there. Patterns vary according to mood and health and
even thoughts.. Hypnosis and drugs also alter the flare pattern and
colors.
And no, popular hoaxes do not endure. Things only endure when they have substance. Religion and various medical treatments fall into the same category .... they may be surrounded with 'placebo' effects, manipulative goals, and myth and fantasy, but at the end of the day they survive because they have substance.... because at core, they 'work.'
There is always an element of the mystical involved in human life and death and the function of the body. Aboriginal people die from 'pointing the bone', not because they are ill but because they believe they will die. Then again, one suspects that not everyone dies. Human beings are different and some people are more susceptible than others.
Oncologist Bernie Siegel and physician Larry Dossey have both written extensively on the impact that belief and thought has on the human condition. A doctor, like shaman's of old, needs to have ability and knowledge but he or she also needs to give the patient a sense of faith and he or she will have an impact on the patient's condition depending upon what he or she believes.
Yes, I saw the programme on the Chinese doctor some time ago when I was in the UK. Clearly the focus of the programme did not have a positive outcome but clearly the doctor in question has had successes. The television programme was not detailed enough to establish how effective the doctor was or was not. Again, I suspect that whatever he does may work for some and not for others. He may also be more charlatan than doctor but that is impossible to assess without knowing more about him.
Then again, the leading cause of death and injury in the United States for example is iatrogenic - doctor induced.
Excerpt: A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million. (1) Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics. (2, 2a)
The number of unnecessary medical and surgical procedures performed annually is 7.5 million. (3) The number of people exposed to unnecessary hospitalization annually is 8.9 million. (4) The total number of iatrogenic [induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures] deaths is 783,936.
The 2001 heart disease annual death rate is 699,697; the annual cancer death rate is 553,251. (5) It is evident that the American medical system is the leading cause of death and injury in the United States.
Ouch!
Acupuncture faces two principal barriers to acceptance in the West. Firstly, it cannot be patented. There is therefore no one willing to champion it, and lots and lots of companies and people who will lose a lot of money if acupuncture replaces conventional treatment.
The second problem is that acupuncture challenges conventional western scientific theory. If Science was honest, this wouldn’t matter. Evidence should trump theory any day, no matter how many learned professors are forced to eat their tassels.
Research
The big question is how it works!
We now should have the technology to establish this - measures of hormones, brain scans, CAT scans etc.
Until this is done the rest is just fiddling around the edges.
And we are all robbed of understanding a very important therapy that could help solve the coming cost-of-medicine crisis.
Evan