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Acupuncture evidence

Discussion in 'General Issues and Discussion Forum' started by ggm2011, Feb 2, 2012.

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  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Acupuncture Is All Placebo and Here Is Why.
    McGeeney BE
    Headache. 2015 Feb 6.
     
  2. Shane Toohey

    Shane Toohey Active Member

    Absolute total garbage. No science in those opinions. That's more about hwo to work with a closed mind
     
  3. PodAc doc

    PodAc doc Active Member

    This article is a good example of bad scientism. It does make some good points and gives us a useful summary of logical pitfalls to be avoided. One such pitfall is bias - the author mentions it 10 times in the article.

    Yet the article itself clearly shows extreme bias; this is evidenced by the language used, such as gobbledegook, faith, agnostic and worship. Bias is also evident from statements such as "... physicians everywhere who are always empathetic and patient centered." The author shows no awareness that this is highly debatable. Also he asserts: "... there is no role for the CRUEL practice of acupuncture on children ... or on animals" (emphasis added) - but the source he cites (on the use of acupuncture for infants) does not use the word cruel, in fact it concluded that acupuncture was safe and well tolerated. If he really believes that acupuncture is cruel, he is clearly extremely ignorant of the practice. In applying this language to the paper cited, he is guilty of the "misinterpretation" he warns us against. His choice of reference sources is also unsystematic, so he has fallen into the trap of selective citation, thus reinforcing his own prejudices rather than arriving at new knowledge.

    However the main problem is that the author is unaware that his logic is based on false axioms. He discusses acupuncture as if it was just one thing, for example stating: "The acupuncture explanatory narrative is focused on linear pathways on the body known as meridians where life energy, known as Chi, flows." He does not acknowledge that there is another narrative - that of gate theory, endorphins, etc. Thus we must ask whether his assertion that acupuncture has no scientific basis is based on ignorance, or prejudice.

    He does mention, later in the article, that there have been many studies showing objective physiological changes in relation to acupuncture. Rather than applauding these efforts to enhance our biomedical understanding of acupuncture, he dismisses them as "surrogate outcomes" of no relevance to clinicians. Similarly he makes no mention of the many experimental animal studies that have demonstrated alterations in pain behaviour as well as relevant physiological changes. One might criticise these for cruelty but their existence does undermine his main thesis that "Acupuncture Is All Placebo".

    It is a shame that such an article got past the peer reviewing process - it does nothing to enhance the reputation of the journal in which it appeared.
     
  4. NewsBot

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    Last edited by a moderator: Sep 22, 2016
  5. NewsBot

    NewsBot The Admin that posts the news.

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    Editorial
    Acupuncture: what's the point?

    Adam Meakins
    Br J Sports Med doi:10.1136/bjsports-2016-096248
    Published Online First 19 July 2016

     
  6. NewsBot

    NewsBot The Admin that posts the news.

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  7. AtomAnt

    AtomAnt Active Member

    Interesting thread. Seems to evidence both ways and opinions both ways.
    I like the way that those who like acupuncture display their bases by calling others biased.
     
  8. NewsBot

    NewsBot The Admin that posts the news.

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  9. PodAc doc

    PodAc doc Active Member

    More grist to the mill ...
    Acupuncture vs intravenous morphine in the management of acute pain in the ED - The American Journal of Emergency Medicine
    http://www.ajemjournal.com/article/S0735-6757(16)30422-3/abstract

    Abstract
    Background
    Acupuncture is one of the oldest techniques to treat pain and is commonly used for a large number of indications. However, there is no sufficient evidence to support its application in acute medical settings.
    Methods
    This was a prospective, randomized trial of acupuncture vs morphine to treat ED patients with acute onset moderate to severe pain.
    Primary outcome consists of the degree of pain relief with significant pain reduction defined as a pain score reduction ≥50% of its initial value. We also analyzed the pain reduction time and the occurrence of short-term adverse effects. We included in the protocol 300 patients with acute pain: 150 in each group.
    Results
    Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P < .001). Resolution time was 16 ? 8 minutes in the acupuncture group vs 28 ? 14 minutes in the morphine group (P < .005). Overall, 89 patients (29.6%) experienced minor adverse effects: 85 (56.6%) in morphine group and 4 (2.6%) in acupuncture group (P < .001). No major adverse effects were recorded during the study protocol. In patients with acute pain presenting to the ED, acupuncture was associated with more effective and faster analgesia with better tolerance.
    Conclusion
    This article provides an update on one of the oldest pain relief techniques (acupuncture) that could find a central place in the management of acute care settings. This should be considered especially in today's increasingly complicated and polymedicated patients to avoid adverse drug reactions.
     
  10. NewsBot

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    PUBLIC RELEASE: 29-JUN-2017
    Why does acupuncture work?
    New La Biomed study finds it elevates nitric oxide, leading to pain reduction


    LOS ANGELES - The use of acupuncture to treat pain dates back to the earliest recorded history in China. Despite centuries of acupuncture, it's still not clear why this method of applying and stimulating tiny needles at certain points on the body can relieve pain. Recent studies have raised additional questions, with some finding acupuncture reduced chronic pain while others showed that acupuncture has little, if any, impact on pain.

    A new study from LA BioMed researchers offers some answers for why acupuncture may help and why clinical trials have produced mixed results. The researchers found the proper use of acupuncture (with the reinforcement method or coupled with heat, which is often used in acupuncture treatments) can lead to elevated levels of nitric oxide in the skin at the "acupoints" where the needles were inserted and manipulated. They noted that nitric oxide increases blood flow and encourages the release of analgesic or sensitizing substances, which causes the skin to feel warmer and contributes to the beneficial effects of the therapies.

    "Our lab has developed a painless, non-invasive biocapture device that can sample human biomolecules over specific skin regions," said Sheng-Xing Ma, MD, PhD, an LA BioMed lead researcher and corresponding author of the study published in Evidence-based Complementary and Alternative Medicine, Volume 2017. "With this tool, we were able to obtain the first evidence that nitric oxide is released from the human skin surface at a higher level with the proper acupuncture methodology and the use of heat."

    Dr. Ma said several acupuncture clinical trials by conventional researchers have produced negative results, finding little difference in pain relief between the use of acupuncture and "sham acupuncture," in which needles are manufactured and/or inserted unsystematically. He said these studies have puzzled the acupuncture community and led many to question whether the proper acupuncture methodologies were used.

    For the latest study, the LA BioMed researchers used a low force and rate/reinforcement method of acupuncture. They gently inserted acupuncture needles into the skin of 25 men and women, aged 18-60 years, and delicately twisted the needles for two minutes or until they achieved a sensation of "de qi" (soreness, numbness, distension or pain). They then manipulated the needles using gentle amplitude and moderate speed for two minutes every five minutes for a total of 20 minutes.

    They also applied electrical heat for 20 minutes and found elevated levels of nitric oxide at the acupoints. To further validate their findings, they conducted the test with high-frequency and force, which is known as a reduction method, and found nitric oxide levels over the areas of the skin region were reduced.

    Dr. Ma said his team will continue to explore the differences in these two acupuncture techniques to determine the effectiveness of each in pain relief and better understand the cellular and molecular mechanisms involved.

    "Based on traditional Chinese medicine, acupuncture reinforcement is attained by slowly twisting or rotating the needle with gentle force or by heat," Dr. Ma said. "Reduction is attained by rapidly twisting or rotating the needle with great force. Reinforcement results in local feeling of warmness, but reduction causes a local feeling of coldness."
     
  11. Shane Toohey

    Shane Toohey Active Member

    One comment initially is around the issue of placebo. With clinical trials the placebo of sham acupuncture and needling the wrong place compared to the "right' place is not a true placebo as a placebo needs to be inert. The nitric oxide response (which is not the only response!) will occur where ever you needle. The question in these trials isreally about the specificity of the points. When both the "true" and the " not placebo" points are significantly better than "no needles" then the analysis could be not that acupuncture is no better than placebo but that the location of the needling points is not as critical as has been believed.
     
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