Blog Posts on Research
- High Quality Reviews of the Acupuncture Treatment of Pain
- Acupuncture Research - Headaches
- Acupuncture Research - Osteoarthritis, low back pain, and elbow pain
- Acupuncture Research - Irritable Bowel Syndrome (IBS)
- Acupuncture Research - Gastrointestinal Diseases
- Acupuncture Research: Dysmenorrhea (Painful Periods)
- Herbs vs Bugs
- In case you missed it
- Acupuncture Research – Chronic Fatigue Syndrome
- Standards in Chinese Medical Research
- Acupuncture Research – Food Allergies
- Acupuncture Research – Cardiac Arrhythmias
- Clincial Research and Acupuncture
- Acupuncture Research – Physiological Response to Needling
- Acupuncture Research – Quality of Life and Musculoskeletal Complaints
- Acupuncture Gets an “A” for Treating Chronic Low Back Pain
- Acupuncture Research – Pain & Dysfunction in Cancer Patients
- Acupuncture Research – Carpal Tunnel Syndrome
- Acupuncture Research - Alzheimer's Disease
- Acupuncture Research - Low Back Pain
- Acupuncture Research - Endometriosis
- Chinese Herbal Medicine Research - Diabetes
- Acupuncture Research - Fibromyalgia
- Acupuncture Research - Painful Menses (Dysmenorrhea)
- Acupuncture Research - Insulin Resistance
- Acupuncture Research - Insomnia
- Acupuncture Research - Osteoarthritis
- Acupuncture Research - Pain
- Acupuncture Research - Parkinson's Disease
- Acupuncture Research - Knee Pain
- Acupuncture Research - Temporomandibular Disorders
- Acupuncture Research - Polycystic Ovarian Syndrome
- Acupuncture Research - Obesity
- A Note on Research Appearing on this Blog
Herbs vs Bugs
“Superbugs” – We’ve all heard of them. They’re the strains of disease causing microbes that become resistant to the drugs used to kill them, thus becoming more difficult to treat and more deadly.
Instead of creating new drugs, likely only buying us some time until those little bacteria adapt to them, it would seem wise to try a whole new approach.
One of my professors, Dr. Lixin Zhang, MD (China), LAc, would explain how microbes couldn’t “adapt to” and, thus, defeat herbs because of the complex chemistry of herbs, especially when used in formulas of multiple herbs (the proper way to practice Chinese herbal medicine).
In this piece of research, two herbs were tested against some microbes and, guess what, they demonstrated strong anti-microbial effect, comparable, in fact, to the antibiotic vancomycin.
I think we’re onto something, here.
Leach, F. (2011). Anti-microbial properties of Scutellaria baicalensis and Coptis chinensis, two traditional Chinese medicines. Bioscience Horizons 2011 : hzr014v1-hzr014. Retrieved from biohorizons.oxfordjournals.org/content/early/2011/05/04/biohorizons.hzr014.full?maxtoshow=&hits=25&RESULTFORMAT=&andorexacttitle=and&andorexacttitleabs=and&fulltext=Chinese&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct.
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In case you missed it
In case you missed all the wonderful posts on my facebook page, here's some interesting info:
* New research on the benefits of Tai chi
* Acupuncture on CBS news
* Acupuncture for depression, on Fox News
* From the FDA, how to dispose of old medications
* New research on the benefits and challenges to more individualized care
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Standards in Chinese Medical Research
Chinese medicine is like the wizened old man whose words and deeds are rich with his many years of experience. His ways may seem odd to the casual observer, but only because few have walked the path he has – few could fully appreciate the maturity and advanced evolution of his actions, at first glance.
But there is efficacy in what he does, so he gets attention. People stop and look; they’re not sure what they are looking at, but it is clearly worthy of closer investigation. They visit and chat, try his advice, take some of the medicine he offers, and they return – time and time again.
This is the story of Chinese medicine. It is unique, as systems of medicine go, as it is the current expression of a long, unbroken lineage of clinical experience and wisdom. Its reliability is grounded in reoccurring effectiveness over generations of use.
It does look weird. It doesn’t sound or talk like “medicine”, as many know it. But it works.
Part of the responsibility of the modern practitioner of this ancient art is to translate and interpret this evolved medicine to modern terms and worldviews, and this is quite a difficult task.
One may, perhaps, think that medicine is medicine, no matter how, exactly, it looks in the clinic. One may think that science is science, that there are many paths to discover truth, but, ultimately, they are one-in-the-same in seeking reliable theory. However, it is not so.
There are very real differences. Chinese medicine is different at a very deep level. This makes validation of it, from a modern scientific point of view, exceedingly challenging. But it is possible, and we are slowly getting there.
A recent blog post, coming from Blue Poppy Press, up in Boulder (www.BluePoppy.com), authored by Eric Brand, a leader in the field, speaks to this. He discusses some basic flaws of current research, as well as some difficulties that present due to the unique nature of the medicine. As Eric is an expert in this area, I would like to pass on his brief, but important blog post – Standards in Chinese Medicine, Part Two: Research.
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Clincial Research and Acupuncture
Another article in the NY Times, "Studying Acupuncture, One Needle Prick at a Time", by Tara Parker-Pope, is a well informed discussion of modern research and acupuncture.
Conducting research on acupuncture is challenging, and it's largely due to the nature of modern clinical research. Clinical research methods (CRM) are based on certain paradigms, or fundamental ways of perceiving the world. They incorporate a certain set of assumptions and they guide how one conducts investigations into unknown phenomena.
For example, modern science is 'reductionistic', meaning there is the belief that something can be understood by breaking it down into its constituent parts and analyzing them. This basic assumption leads them to investigate an unknown by trying to break it down into little pieces and studying those pieces.
Obviously, there's nothing inherently wrong with this, but it is only one possible paradigm, one set of underlying assumptions, one way investigating the unknown, and maybe, just maybe, it's not appropriate in all situations. Enter acupuncture.
From day one, literally, in Chinese medical school (a four-year graduate program), we were taught context is everything. Nothing has meaning outside of a given context. In (Chinese) medicine, this means you have to know a whole lot more about a patient, than just that they have a headache, in order to treat them.
'A headache' is meaningless outside of the context of the person experiencing it (even a 'migraine' headache or 'tension' headache isn't enough to treat them properly). We need to 'fill in' the rest of the picture of the patient, their life, their health, and then all kinds of other details about the headache.
Such complexity carries over into the treatment, itself, as well. A proper acupuncture treatment, conducted by a fully trained, licensed acupuncturist, has dozens of different aspects to it (each contributing to the end effect). After arriving at a detailed differential diagnosis (well beyond a simple disease name), a 'point prescription' is created. This prescription consists of several acupuncture points aimed, collectively, at treating that specific issue, in that specific person, at that specific time, and those 'specifically's are written with specific intention (last one, promise).
Acupuncture points are not buttons on the body one pushes and gets a specific (I lied) effect. Points (which is, actually, a poor translation of the original Chinese - 'hole' is much closer) are much better understood to have a list of potential actions and effects. Which effect you get in a treatment depends on a lot of things, including:
- the other points employed in the same treatment
- the type of stimulation effected on the needle after insertion (this stimulation has huge effect on the overall treatment )
- the angle of needle insertion relative to the flow of the channel it's placed in, and
- the time of day, literally ('qi' is energetic in that it moves around the body during the day)
Once you have a point prescription, you insert the needles. Again, there are many different options to choose from, here, depending on the intended therapeutic effect. Order of needle insertion is important. Stimulation of the needle after insertion is very important. How long the needles are left in the body alters the treatment effect. How you remove the needles is also important.
The point is, a proper acupuncture treatment has dozens of variables. Each one of them lends something to the end effect, and each one of them is influenced by and affects all the others. You simply cannot reduce the effect of acupuncture to any one of these variables.
As a practitioner, I absolutely love this. It allows me tremendous flexibility in adjusting treatments to exactly what that patient needs at that moment. Yay!
Research is a whole nother world, though. Again, modern science, and, thus, modern research is reductionistic. They try to understand things by breaking them down into the constituent parts.
What if, you kill the thing you were trying to investigate, though? What if something only exists as a complete whole? What if something only exists as it is, altering it for study means changing it into something else?
Obviously, acupuncture is not the only thing not well suited for such investigation. In my opinion, all the greatest things in life cannot be 'known' by breaking them down into little pieces and analyzing those pieces. You come to know their greatness, their beauty by directly experiencing them, as they are, without logical analysis. I'm thinking music, a good story, a good conversation, god help me, love... But I digress...
There are some ways around this challenge. There are different types of research. By far, the most authoritative, the most well respected, is reductionistic, but there are other ways of getting to know how (and whether) somethings works.
Also mentioned in this article is that in trying to verify the specific efficacy of acupuncture, sometimes they'll test it against 'sham' acupuncture. Of course, even sham acupuncture is stimulation of the body in a way that, according to basic Chinese medical theory, will have some effect.
So, and I love that this author included this, there have finally been studies that test acupuncture treatment against other treatments. Brilliant!! Quit trying to tear it apart to figure out how it works (through the distorted view of reductionism), just test it against other treatments! And, guess what, it's just as good, with fewer side effects (and cheaper, and easier...)
I consider this real-world research. Chinese medicine is based on completely different theories of the human being (not biology, chemistry, etc.), and, as scientists, we should respect that any given theory - be it chemistry or 'qi' in acupuncture channels - is only a model of reality, not reality itself.
So let's honor other coherent, rational, evidence-based models, and simply test whether it works in a clinical setting.
We can seek to understand it, as well, as long as we keep in mind that we are seeking to understand one perspective on the body, one model, via a different model - We're not comparing one against the other because one is 'true' or 'the way the world is' - We are not trying to validate one by comparing it against another.
That is, we can try to understand and explain acupuncture from a biochemical perspective, but let's not withhold treatment until we do. Let's not deny the practice of good, effective medicine because it's different. That's all I'm sayin'.
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Acupuncture Research – Physiological Response to Needling
The two studies discussed, here, aren't about treating disease directly, but rather on investigating the immediate, tangible, physiological response to needling.
In my private practice, I typically asses the effect of a treatment immediately after inserting the needles, through pulse diagnosis. However, for those who are new to acupuncture, and have a hard time believing inserting such thin needles into the hands and feet, for example, "does" anything, these types of studies may be very interesting.
The first (Takayama et al., 2010) showed that the blood flow volume felt at the wrists (the radial artery) decreased with technical stimulation of an acupuncture point on the foot (Tai Chong, Liver 3), as measured by a high-resolution ultrasound echo-tracking system.
In the other study (Lee et al., 2010), it was demonstrated that the acupuncture point Tai Bai (Spleen 3), also located on the foot, "modulates the autonomic cardiovascular responses by enhancing parasympathetic function". Specifically, it decreased the maximum systolic velocity, and effected heart rate variability.
Takayama, S. et al. (2010). Radial artery hemodynamic changes related to acupuncture. Explore, 6(2), 100-5. Retrieved from www.explorejournal.com/article/S1550-8307%2809%2900391-7/abstract
Lee, S. et al. (2010). Short term effects by acupuncture to SP3 on the autonomic blood flow control. Neurological Research, Suppl 1, 37-42. Retrieved from www.ncbi.nlm.nih.gov/pubmed/20034443
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Acupuncture Research – Quality of Life and Musculoskeletal Complaints
The Center for Disease Control (CDC) defines health related quality of life (HRQOL) as “a person or group’s perceived physical and mental health over time.” (1) A patient’s HRQOL speaks to their overall, day-to-day well-being, as opposed to the more strictly defined, narrow parameters defining the nature and severity of their specific illness.
The goal of this observational study, published by the British Medical Acupuncture Society, was not to determine the effectiveness of acupuncture on musculoskeletal disorders, as with randomized controlled trials (RCTs), but, instead, to investigate how receiving acupuncture treatments affected the overall quality of life of patients.
This study compared the HRQOL of patients with a sampling of the general population (n = 1,063) and observed the change in HRQOL during acupuncture treatments.
The HRQOL of the patients, before any treatment was given, was significantly lower (poorer), compared to the general population, including the following areas:
- physical limitations (p<0.001)
- pain (p<0.001), and
- social functioning (p<0.005).
During treatments, the scores increased significantly, including the following areas:
- physical functioning (p<0.001),
- role-physical functioning (p<0.001),
- pain (p<0.001),
- social functioning (p<0.001), and
- vitality (p<0.001).
1. Center for Disease Control (CDC), Health Related Quality of Life website (www.cdc.gov/hrqol/)
van den Berg, I. et al. (2010). Health-related quality of life in patients with musculoskeletal complaints in a general acupuncture practice: an observational study. Acupuncture in Medicine, 28(3), 130-5. Retrieved from www.ncbi.nlm.nih.gov/pubmed/20643729
Please note – The above is not intended as a scholarly review of the respective study. For full details follow the reference link.
*** No individual study constitutes ‘proof’ of the effectiveness of any therapy, and no guarantee of treatment outcome can be made. Please seek an individual consultation with a qualified practitioner for information on a personal health issue.
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A Note on Research Appearing on this Blog
The purpose of my sharing research studies on this blog is to demonstrate where acupuncture and other modalities of Oriental medicine are being validated through modern clinical research and their underlying mechanisms explained, from a biomedical perspective.
This blog is not intended to be an unbiased reporting platform for clinical research. I am intentionally selective in what I report on. That is, I am biased. I most likely will not share studies or reviews that fail to demonstrate efficacy of acupuncture or Oriental medicine (unless they’re particularly interesting…)
Further, this blog is intended for a general, lay audience. My posts on clinical trials are intentionally brief, sharing only basic information. Full reference information is given for those wanting more detail.
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