ACUPUNCTURE EFFICACY AND INDICATIONS

	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."

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