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Acupuncture: Efficacy and Indications |
Acupuncture has been continuously and widely used as a primary medical modality for over 2,500 years in the most populous civilization on earth (China and its sphere of East Asian cultural influence). As such, acupuncture has both broad and deep clinical experience. Ancient and modern acupuncture texts and collective clinical experience include differential diagnosis and treatment protocols for the full spectrum of illnesses and injuries known to humankind.
With the contemporary concerns for evidence basis of medical treatment, acupuncture has become the subject of over 1,000 published clinical trials, accessible in databases such as PubMed and the National Library of Medicine. Over 100 literature reviews and meta-analyses are now also available at the same sources.
Acupuncture clinical efficacy data has been summarized recently by two panels of non-advocate researchers and scientists convened by public agencies.
In 1997, the U.S. National Institutes of Health (NIH) issued a consensus report that concluded "The data in support of acupuncture are as strong as those for many accepted Western Medical therapies…There is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value" (NIH 1997) .
The World Health Organization also issued a report in 1996 on the efficacy of acupuncture, based on review of an extensive database of clinical trials. The conditions listed below are organized by the degree of evidence of acupuncture efficacy identified in the WHO report. Conditions which are listed in the NIH Consensus Panel’s report are also included below, and indicated thus: (NIH).
“1. Diseases, symptoms, or conditions for which acupuncture has been proved, through controlled trials, to be an effective treatment.”
Dental
Dental pain (NIH)
Head/Ear/Eye/Nose/Throat
Allergic rhinitis (including hay fever)
Infectious Diseases
Dysentery, acute bacillary
Immunological
Rheumatoid arthritis
Internal Medicine
Biliary colic
Epigastralgia, acute (incl. PUD, gastritis, gastrospasm)
Hypertension, essential
Hypotension, primary
Nausea & vomiting
Leukopenia
Renal colic
OBGYN
Dysmenorrhea, primary
Induction of labor
Malposition of fetus
Morning sickness/pregnancy nausea (NIH)
Oncology
Adverse reactions to radiotherapy and/or chemotherapy, incl. nausea & vomiting
Neurology, Orthopedics & Physical Medicine
Facial pain and spasm
Fascitis, myofascial pain
Fibromyalgia (NIH)
Headache (NIH)
Knee pain
Low back pain (NIH)
Neck pain
Periarthritis of Shoulder
Post-operative pain
Sciatica
Sprain
Stroke
Temporo-mandibular joint dysfunction
Tennis elbow or epicondylitis (NIH)
Psychiatry
Depression (including depressive neurosis, and post-stroke)
“2. Diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown but for which further proof is needed.”
Addiction (NIH)
Alcohol dependence & detox
Opium, cocaine, and heroin dependence
Tobacco dependence
Dermatology
Acne vulgaris
Neurodermatitis
Pruritis
Genito-urinary
Female urethral syndrome
Male sexual dysfunction, non-organic
Prostatitis, chronic
Recurrent lower urinary tract infection
Retention of urine, traumatic
Urolithiasis
Head/Ear/Eye/Nose/Throat
Earache
Epistaxis, simple
Eye pain due to subconjunctival injection
Meniere's disease
Sjogren's syndrome
Sore throat (incl. tonsillitis)
Infectious Disease
Epidemic haemorrhagic fever
Hepatitis B virus carrier status
Herpes zoster (human (alpha) herpesvirus 3)
Whooping cough (pertusis)
Internal Medicine
Abdominal pain (acute gastroenteritis or gastrointestinal spasm)
Bronchial asthma (NIH)
Cardiac neurosis
Cholecystitis, chronic, with acute exacerbation
Cholelithiasis
Diabetes mellitus, non-insulin dependent
Gastrokinetic disturbance
Hyperlipaemia
Ulcerative colitis, chronic
OB-GYN
Female infertility
Hypo-ovarianism
Labour pain
Lactation deficiency
Menstrual cramps (NIH only)
Polycystic ovary syndrome
Premenstrual syndrome
Neurology, Orthopedics & Physical Medicine
Bell's palsy
Carpal Tunnel Syndrome (NIH only)
Craniocerebral injury, closed
Osteo- and Gouty arthritis (NIH)
Radicular and pseudoradicular pain
Reflex sympathetic dystrophy
Spine pain, acute
Stiff neck
Stroke rehabilitation (NIH only)
Tietze's syndrome
Tourette's syndrome
Oncology
Cancer pain
Pediatrics
Post-extubation in children
Psychiatry
Competition stress syndrome
Schizophrenia
Vascular
Pain in thromboangiitis obliterans
Raynaud's syndrome, primary
Vascular dementia
Miscellaneous
Obesity
Pain due to endoscopic examination
Post-operative convalescence
Sialism, drug-induced
“3. Diseases, symptoms, or conditions for which there are only individual controlled trials reporting some therapeutic effects, but for which acupuncture is worth trying because treatment by conventional and other therapies is difficult.
Chloasma
Choroidopathy, central serous
Color blindness
Deafness
Hypophrenia
Irritable colon syndrome
Neuropathic bladder in spinal cord injury
Pulmonary heart disease, chronic
Small airway obstruction
WHAT ARE THE BENEFITS OF ACUPUNCTURE?
Evidence from Modern Outcome Studies
General improvements in health status have been observed in conjunction with acupuncture treatment. For example, a study of 762 patients who received 6 acupuncture treatments in an outpatient setting showed significant improvements in 7 of 8 outcome measures (General health, Bodily pain, Vitality, Social functioning, Mental health, and Roles-physical and -emotional ) compared with a no-treatment control group.
General improvement in health status is consistent with models of the physiologic basis of acupuncture that indicate therapeutic effects through a wide range of mechanisms and body systems. The ability of acupuncture to regulate sympathetic/parasympathetic imbalances and promote immune function may account for its general clinical benefits.
The full potential of acupuncture and its supplementary Chinese medical modalities is to bring about more harmonious functioning and general well-being. As patients heal during acupuncture treatment, they often describe profound feelings of peace, clarity, and self-awareness. With repeated treatment, this sense of harmonious well-being may become increasingly the norm experienced by the patient.
Roles of Acupuncture in Modern Health Care:
* Complementary
* Alternative
* Primary
The extensive history of clinical usage and excellent safety record of acupuncture make it a reasonable complementary treatment for most diseases and conditions. Acupuncture has few known contraindications, and is not reported to interfere with other treatments. It may be safely used to complement and enhance other treatments, and reduce adverse effects of other treatments.
For some conditions, conventional treatments may be contraindicated or deemed undesirable because of unfavorable risk : benefit ratios. Patients' prior medical history and experience may also suggest that they are not likely to respond well to certain conventional therapies. In these cases, acupuncture is a reasonable alternative. Acupuncture may be considered a conservative treatment, not only for those conditions where its efficacy has been proved, but also where the efficacy, safety, or appropriateness or other therapies is in doubt.
Increasingly, acupuncture is being practiced in integrative medical settings in conjunction with conventional therapies. Acupuncture may be used to reduce post-surgical pain and swelling, and increase range-of-motion. Acupuncture lowers the need for analgesics, thus reducing risks of adverse drug effects. The NIH report states: "One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions."
Copyright Essential Health Care Network 2003
Do not reproduce without written permission |
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Bill Wright, L.Ac., DNBAO
 Bill offers the ultimate integration of Eastern and Western Functional Medicine practicing the Five Element and Eight Principle models of Acupuncture, as well as Functional Blood Chemistry and Endocrinology. He is Licensed by the State of CA as an herbalist, has a Board Specialty in Acupuncture Orthopedics and has extensive education in nutrition as well.
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