Acupuncture has become a routine practice in some hospitals. The main indications include control of chronic pain that is resistant to conventional therapy, neuromuscular deficiencies of various causes and other odd situations in which conventional treatment fails to provide satisfactory results.
The theories given to explain acupuncture's effects need to be assessed carefully before a wider endorsement of this treatment option should be given. Positive theories include the pain-control “gate theory” and the neuro-humoral theory, both of which have objective proofs to support them. The negative theories of “placebo effects,” suggestion, and stress-related reactions do not have sufficient rational support.
Clinical trials on acupuncture should follow the same approach used in the clinical testing of pharmaceuticals. However, the use of placebo acupuncture is difficult. Fortunately, adverse events are not serious. In spite of the difficulties encountered in attempting placebo acupuncture standardization and lack of objective assessment tools, the practical side of acupuncture is fully justified, and more-serious research to reveal the physiological events initiated by acupunctures, is indicated.
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References
1.
National Institutes of Health (NIH) Acupuncture. NIH Consensus Statement. Nov 3–5, 1997; 15,5:1–34.
2.
BirchS, KaptchukTJ. History, nature and current practice of acupuncture: An East Asian perspective. ErnstE, WhiteA. Acupuncture: A Scientific Appraisal. Oxford, UK: Butterworth Heinemann, 1999; 11–30.
3.
BannermanRH. Acupuncture: The World Health Organisation View. Geneva: World Health Organization, 1979.
4.
WongTW, WongSL, DonnanSPB. Traditional Chinese Medicine and Western Medicine in Hong Kong: A comparison of the consultation processes and side effects. J. Hong Kong Med Assoc., 1993; 45,4:275–284.
5.
WhiteA, FosterNE, CummingsM, BarlasP. Acupuncture treatment for chronic knee pain: A systematic review. Rheumatology (Oxford)., 2007; 46,3:384–390.
MelzackR, WallPD. Peripheral nerve and spinal mechanisms. The Challenge of Pain. London: Penguin Science, 1966; 81–107.
8.
MelzackR, StillwellDM, FoxEJ. Trigger points and acupuncture points for pain: Correlations and Implications. Pain., 1977; 3,1:3–23.
9.
HanJS. Cholecystokinin octapeptide (CCK8): A negative feedback control mechanism for opioid analgesia. Prog Brain Res., 1995; 105:263–271.
10.
HeCM, HanJS. Attenuation of low rather than high frequency electroacupuncture analgesia following microinjection of beta-endorphin antiserum into periaqueductal gray in rats. Acupunct Sci Int J., 1990; 1:94–99.
11.
AlaviA, LaRicciaPJ, SadekAH, NewbergABet al.Neuroimaging of acupuncture in patients with chronic pain. J Altern Complement Med., 1997; 3,suppl1:S47–S53.
12.
LiP, LonghurstJC. Neural mechanism of electroacupuncture's hypotensive effects. Auton Neurosci., 2010; 157,1–2:24–30.
13.
SohKS. Bonghan Circulatory System as an extension of acupuncture meridians. J Acupunct Meridian Stud., 2009; 2,2:93–106.
14.
PomeranzB. Acupuncture analgesia for chronic pain: Brief survey of clinical trial. PomeranzB, StuxG. Scientific Bases of Acupuncture. Berlin/Heidelberg: Springer-Verlag, 1989.
15.
MelzackR.How acupuncture can block pain. WeisenbergM. Pain: Clinical and Experimental Perspectives. St. Louis: Mosby, 1975.
16.
UlettG.Studies supporting the concept of physiological acupuncture. PomeranzB, StuxG. Scientific Bases of Acupuncture. Berlin/Heidelberg: Springer-Verlag, 1989.
17.
ZaretskyHH, LeeMH, RubinM. Psychological factors and clinical observations in acupuncture analgesia and pain abatement. J Psychol., 1976; 93,1st Half :113–120.
18.
NogierPFM. From Auriculotherapy to Auriculomedicine. Moulins-les-Metz. France: Maisonneuve, 1983.
19.
KroeningRJ, OlesonTD. Rapid narcotic detoxification in chronic pain patients treated with auricular electroacupuncture and naloxone. Int J Addict., 1985; 20,9:1347–1360.
20.
HsiehJC, Stahle-BackdahlM, HagermarkO, Stone-ElanderS, RosenquistG, IngvarM. Traumatic nociceptive pain activates the hypothalamus and the periaqueductal gray: A positron emission tomography study. Pain., 1996; 64,2:303–314.
21.
OlesonTD, KroeningRJ, BreslerDE. An experimental evaluation of auricular diagnosis: The somatotopic mapping or musculoskeletal pain at ear acupuncture points. Pain., 1980; 8,2:217–229.
22.
LaoL. Acupuncture techniques and devices. J. Altern Complement Med., 1996; 2,1:23–25.
23.
WittCM, JenaS, BrinkhausB, LieckerB, WegscheiderK, WillchSN. Acupuncture in patients with osteoarthritis of the knee or hip: A randomized controlled trial with an additional nonrandomized arm. Arthritis Rheum., 2006; 54,11:3485–3493.
24.
LaiSL. Clinical trials of Traditional Chinese Medicine. LaiSL. Clinical Trials of Traditional Chinese Materia Medica. Guangzhou, Guangdong. China: Guangdong People's Publisher, 2001.
25.
LeungPC, XueCX, ChengY-C. Clinical trials using Chinese medicine. A Comprehensive Guide to Chinese Medicine. New Jersey: World Scientific, 2003; 275–300.
26.
LeungPC, ZhangL. Complications and adverse events in clinical trials of acupuncture. Acupunct Med., 2008; 26,2:121–122.
27.
Bhatt-SandersD. Acupuncture for rheumatoid arthritis: An analysis of the literature. Semin Arthritis Rheum., 1985; 14,4:225–231.
28.
VickersAJ. Can Acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. J R Soc Med., 1996; 89,6:303–311.
29.
WuQ, HuangJH, LaiXX. Study on adverse events of acupuncture and moxibustion. Chinese Acupunct Moxibustion., 2002; 22,5:1–25.
30.
LeungPC, ZhangL, ChengKF. Acupuncture: Complications are preventable not adverse events. Chin J Integr Med., 2009; 15,3:229–232.
31.
AguilarMJ. Recovery of motor function after unilateral infarction of the basis pontis: Report of a case. Am J Phys Med., 1969; 48,6:279–288.
32.
BavelierD, NevilleH. Neuro-plasticity, developmental. RamachandranVS. Encyclopedia of the Human Brain. San Diego: Academic Press, 2002; 561–578.
