World Health Organaisation
WHO Acupuncture-Dr.A.Ravindranathkennedy M.D(Acu)-View
Acupuncture literally means to puncture with a needle. However, the application of needles is often used in combination with moxibustion—the burning on or over the skin of selected herbs—and may also involve the application of other kinds of stimulation to certain points. In this publication the term “acupuncture” is used in its broad sense to include traditional body needling, moxibustion, electric acupuncture (electro-acupuncture), laser acupuncture (photo-acupuncture), microsystem acupuncture such as ear (auricular), face, hand and scalp acupuncture, and acupressure (the application of pressure at selected sites).
Need for evaluation
Acupuncture originated in
Although acupuncture was introduced to
This publication reviews selected studies on controlled clinical trials. Some of these studies have provided incontrovertible scientific evidence that acupuncture is more successful than placebo treatments in certain conditions. For example, the proportion of chronic pain relieved by acupuncture is generally in the range 55–85%, which compares favourably with that of potent drugs (morphine helps in 70% of cases) and far outweighs the placebo effect (30–35%) (1–3). In addition, the mechanisms of acupuncture analgesia have been studied extensively since the late 1970s, revealing the role of neural and humoral factors.
Unlike the evaluation of a new drug, controlled clinical trials of acupuncture are extremely difficult to conduct, particularly if they have to be blind in design and the acupuncture has to be compared with a placebo. Various “sham” or “placebo” acupuncture procedures have been designed, but they are not easy to
perform in countries such as
A more practical way to evaluate the therapeutic effect of acupuncture is to compare it with the effect of conventional therapy through randomized controlled trials or group studies, provided that the disease conditions before treatment are comparable across the groups, with outcome studies developed for all patients.
Because of the difficulty of ruling out the placebo effect, a comparative study with no treatment as the control may not be convincing in the evaluation of acupuncture practice. Retrospective surveys, in which the effect of acupuncture therapy is compared with past treatments, may not be of significance either, particularly if they have not been well designed. Non-comparative studies are certainly of little significance, particularly when acupuncture is used for the treatment of a self-limited disease. However, if rapid improvement can be achieved in the treatment of a long-standing, chronic disease, or if there is definite improvement in a disease that is generally recognized as intractable to conventional treatment, the effect of acupuncture should be viewed in a more favourable light, even when a well-designed, controlled study has not been carried out.
Another difficulty in evaluating acupuncture practice is that the therapeutic effect depends greatly on the proficiency of the acupuncturists—their ability and skill in selecting and locating the acupuncture points and in manipulating the needles. This may partly explain the disparities or inconsistencies in the results reported by different authors, even when their studies were carried out on equally sound methodological bases.
Evaluating acupuncture practice and arriving at generally accepted conclusions is no easy task, therefore. While effectiveness is doubtless of the utmost importance, other factors, including safety, cost, availability and the condition of local health services must also be considered. Given the same effectiveness, these other factors may lead to different evaluations of acupuncture in different countries and areas. However, conclusions are needed that apply to worldwide use, particularly for countries and areas where proper development of acupuncture practice would bring a great deal of benefit. Evaluations should not therefore be confined to those diseases for which modern conventional treatments are inadequate or ineffective.
Because of the success of surgical procedures carried out under acupuncture analgesia, the treatment of pain with acupuncture has been extensively studied. For other conditions often treated with acupuncture, there are fewer reports that have adequate methodology.
Article posted – Arun Acupuncture Clinic Founder and the Chief Consultant -Dr.A.Ravindranathkennedy M.D(Acu), Singampunari, Sivagangai District, Tamilnadu State, India-630502. E-Mail. firstname.lastname@example.org