Anyone else interested in acunpuncture, etc.?

[unsung]

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I would love to take part in researching the mechanisms underlying acupuncture as well as other facets of TCM... it's a pity such effective treatments aren't more widely known! So far the only studies I've seen relate acupuncture with endorphin release.

Anyway... just wondering what specialties would be most salient for getting into this kind of research. I'm also very interested in nutrition/longevity research (i.e. calorie restriction). Any ideas?

 

[Maxprime]

I decided to neglect acupuncture when I read the paper showing it to be as effective as a placebo needle mechanism.

 

[emt30119]

I work in a Surgical ICU (RN) at a large university teaching hospital. We had a staff doc order acupunture on a patient for nausea. A side note, the resident stuck herself with the needle and required an exposure workup.

 

[deleted128562]

I would love to take part in researching the mechanisms underlying acupuncture as well as other facets of TCM... it's a pity such effective treatments aren't more widely known! So far the only studies I've seen relate acupuncture with endorphin release.

Anyway... just wondering what specialties would be most salient for getting into this kind of research. I'm also very interested in nutrition/longevity research (i.e. calorie restriction). Any ideas?

The best specialties for your goals would be used-car sales, televangelism, or drug-dealing. Those will come the closest to allowing you research into what drives acupuncture and TCM.

 

[Cytotoxic]

I decided to neglect acupuncture when I read the paper showing it to be as effective as a placebo needle mechanism.

Exactly. A search of the acupuncture literature shows any effects, if observed, are short-term (aka placebo effect). Sorry to burst your bubble unsung, but TCM is a load of crap. Hell, even the Chinese government is trying to get rid of it.

If you're really interested in "longevity research," go into a cell biology lab and study cell senescence.

Sorry, quackery and miracle cures don't quite fit into evidence-based medicine.

 

[Maxprime]

The best specialties for your goals would be used-car sales, televangelism, or drug-dealing. Those will come the closest to allowing you research into what drives acupuncture and TCM.

We don't know how blood-letting works and it shows little to no therapeutic benefit, but let's just do it to patients anyways.

 

[Kthanksbye]

You should check out this thread:

http://forums.studentdoctor.net/showthread.php?t=466632

 

[sanchopanza]

I decided to neglect acupuncture when I read the paper showing it to be as effective as a placebo needle mechanism.

This is a pretty short-sighted and ignorant response to acupuncture. Effectiveness, in the language of Western science, is only one aspect in the web of health, disease, and treatment.

I understand your view and where it comes from, but I sincerely hope that where I go to medical school next year has some people who are more open-minded.

 

[Maxprime]

This is a pretty short-sighted and ignorant response to acupuncture. Effectiveness, in the language of Western science, is only one aspect in the web of health, disease, and treatment.

I understand your view and where it comes from, but I sincerely hope that where I go to medical school next year has some people who are more open-minded.

How is it short-sighted to require some sort of theraputic evidence to justify sticking needles into highly innervated structures?

I hope I don't go to school with people that are open-minded enough to disregard science to the detriment of their patients.

 

[Cytotoxic]

This is a pretty short-sighted and ignorant response to acupuncture. Effectiveness, in the language of Western science, is only one aspect in the web of health, disease, and treatment.

I understand your view and where it comes from, but I sincerely hope that where I go to medical school next year has some people who are more open-minded.

Have you considered chiropractic school? They're a fairly open-minded bunch.

 

[sanchopanza]

How is it short-sighted to require some sort of theraputic evidence to justify sticking needles into highly innervated structures?

I hope I don't go to school with people that are open-minded enough to disregard science to the detriment of their patients.

I hear you, and I do require some sort of therapeutic evidence for justification for a treatment. I've read enough about acupuncture, however, to trust its effectiveness myself. Reading one paper that suggests that it serves merely as a placebo effect, and then completely throwing your faith into that paper...that's bad science.

There are treatments out there these days that require much more than a mere scientific understanding to consider fully and accurately their mechanisms of working. That'll be one of the challenges of being a physician in this increasingly globalized century.

 

[Cytotoxic]

I hear you, and I do require some sort of therapeutic evidence for justification for a treatment. I've read enough about acupuncture, however, to trust its effectiveness myself. Reading one paper that suggests that it serves merely as a placebo effect, and then completely throwing your faith into that paper...that's bad science.

There are treatments out there these days that require much more than a mere scientific understanding to consider fully and accurately their mechanisms of working. That'll be one of the challenges of being a physician in this increasingly globalized century.

No, not one paper...the acupuncture literature, as a whole, shows little more than a placebo effect.

The last part of your post makes no sense and sounds like typical anti-pharma, anti-medical establishment quack mumbo jumbo.

 

[sanchopanza]

.

 

[mountainhare]

Heh. If the pro-acupuncture people could post a link to the most convincing paper in favor of acupuncture, and the anti-acupuncture people could post a link to the most convincing paper that argues against acupuncture, and maybe if someone posted links to labs at medical schools that are doing research on acupuncture (if there are any), this thread might actually be informative and useful to somebody (e.g., the OP). Otherwise, it's just a bunch of hot air and my-scientificness-is-bigger-than-your-scientificness talk.

 

[Maxprime]

I hear you, and I do require some sort of therapeutic evidence for justification for a treatment. I've read enough about acupuncture, however, to trust its effectiveness myself. Reading one paper that suggests that it serves merely as a placebo effect, and then completely throwing your faith into that paper...that's bad science.

There are treatments out there these days that require much more than a mere scientific understanding to consider fully and accurately their mechanisms of working. That'll be one of the challenges of being a physician in this increasingly globalized century.

I will admit that I haven't read all the studies of acupuncture or any other "alternative" treatment that I don't put faith in.

My replies:
1) Why are so many doctors withholding treatment that will help people?
2) Why does an effective treatment show no benefit on massive populations of people, when compared to placebo?
3) What treatments require more than a scientific understanding to understand how they work?
4) I do know that acupuncture does not use all the same endogenous placebo pathways. But I think that this is a perfect example of where allopathic and alternative medicine differ. Allopathic medicine wants to find a drug to abuse this new pathway to control pain, alternative medicine wants to keep sticking pins in people's nerves when it doesn't work very well.

 

[Depakote]

We don't know how blood-letting works and it shows little to no therapeutic benefit, but let's just do it to patients anyways.

a good bleeding still has it's place...

 

[ihatescience]

Well, talk about neglecting the fact that a person's health is the sum of their physical, social, and cultural well-being. Healing's not all about science, folks.

No, not one paper...the acupuncture literature, as a whole, shows little more than a placebo effect.

The last part of your post makes no sense and sounds like typical anti-pharma, anti-medical establishment quack mumbo jumbo.

 

[Maxprime]

Ha.

Having done a lot of traveling myself, I happen to have a great interest in traditional, more indigenous medicine. I've seen first-hand some techniques that work, period, after my initial disbelief, and I'm looking forward to continuing my understanding of other ways of thinking about health and disease in medical school.

I think it's precicely a PRO-medical way of thinking, actually.

I've never understood this. 'Traditional' medicine was the use of herbs with lower amounts of active ingredients that resemble the drugs we use. Over time, we've gained the knowledge to actually improve upon this, why stick to the less effective versions? If something is natural, that does not necessarily make it better.

You can put someone in a trance and operate on them, see it work, etc. That does not mean that's how we should do things - it means it worked, once. The whole point of 'Western medicine' is to get away from some guy walking into the room and saying "slap him in the mouth while he is upside-down, that's how you cure rickets!"

 

[Cytotoxic]

Ha.

This is obviously something that many of us will disagree over and I regret starting an argument. Having done a lot of traveling myself, I happen to have a great interest in traditional, more indigenous medicine. I've seen first-hand some techniques that work, period, after my initial disbelief, and I'm looking forward to continuing my understanding of other ways of thinking about health and disease in medical school.

I think it's precicely a PRO-medical way of thinking, actually.

There is nothing pro-medicine about anecdotal "evidence." Medicine has advanced as much as it has in the past century precisely because that sort of mentality has been all but abandoned by the medical community.

 

[Maxprime]

a good bleeding still has it's place...

I was sure to say "little to no benefit". To be completely honest, it's because I saw it on Grey's (glad I had to admit that). But it's not the cure we thought it was while we were still digging up bodies for autopsies.

 

[Maxprime]

Well, talk about neglecting the fact that a person's health is the sum of their physical, social, and cultural well-being. Healing's not all about science, folks.

So sticking people with needles improves their social and cultural well-being?

 

[Depakote]

If you're going to prescribe a treatment, you'll want to have some objective evidence to support it. You don't necessarily have to know how the treatment works 100% (we still don't know the mechanisms of a lot of therapeutic modalities), but we have compared them against other treatments and placebos and we know that there is some mechanism at work. You are going into evidence-based medicine, you can't just tell your patient you want to give them a treatment because you think it will help them.

 

[ihatescience]

So sticking people with needles improves their social and cultural well-being?

Like your argument disregarding the efficacy of acupuncture, unless I see a broad scientific study published in the NEJM etc I will not de-legitimize it as a form of treatment. The clinical studies are vast, but not conclusive.

 

[Cytotoxic]

Like your argument disregarding the efficacy of acupuncture, unless I see a broad scientific study published in the NEJM etc I will not de-legitimize it as a form of treatment. The clinical studies are vast, but not conclusive.

You're going about this the wrong way. Treatments are legitimized only after there is sufficient evidence for their efficacy and safety. That's kind of the point of clinical trials and all...

 

[hadokenny]

I hear you, and I do require some sort of therapeutic evidence for justification for a treatment. I've read enough about acupuncture, however, to trust its effectiveness myself. Reading one paper that suggests that it serves merely as a placebo effect, and then completely throwing your faith into that paper...that's bad science.

There are treatments out there these days that require much more than a mere scientific understanding to consider fully and accurately their mechanisms of working. That'll be one of the challenges of being a physician in this increasingly globalized century.

I agree with sanch here. Being a combative sport athlete, I've endured many injuries. Placebo effect or not, I do notice that when I get acupuncture treatments, my injuries usually heal twice as fast as when I just sit around and let them heal. Not saying I have a say in effectiveness of acunpucture just because I've had some experience with it, but I do think it takes more than reading one paper to pass judgment on a subject. Ever wonder why there isn't a lot of research and evidence on acupuncture? Could it be possible that the mechanism of healing from acupuncture is just not fully understood yet? May be it's because some you going into medicine are so close-minded and unwilling to look deeper before making your conclusions, therefore not willing do more research on that subject. Sanch, what do you say we start a little research project on the effectiveness of acupuncture ourselves 😉

I like how when someone is trying to find an answer to an obscure subject all you guys give are sarcastic, ignorant, and negative comments. Future of medicine sure looks bright...

Reading ONE paper doesnt make you an expert on the subject to fully discredit something you know nothing about. Just like getting a few acupuncture treatments wont make me an authority to say whether acunpucture works or not. But I sure do hope most med students i meet next year are more open minded and more willing to look deeper into what's out there.

 

[sanchopanza]

.

 

[QofQuimica]

Folks, please do not hijack the OP's thread, and please watch your language.

Acupuncture is actually one of the better-substantiated alternative medicine treatments, mainly for pain syndromes like fibromyalgia. OP, there is a group at the Mayo Clinic that has been doing some work in this area. Here's an article describing one of their studies from the Mayo website: http://www.mayoclinic.org/news2005-rst/3000.html You should be able to pull up the scientific articles in your school library if you're interested in reading more. I'm not sure if any allo programs offer acupuncture training; this guy is an anesthesiologist.

There is a link to the National Center for Alternative and Complementary Medicine which you might find helpful.

 

[ihatescience]

You're going about this the wrong way. Treatments are legitimized only after there is sufficient evidence for their efficacy and safety. That's kind of the point of clinical trials and all...

That's not the point I'm going after. Legitimacy is not determined solely by clinical trials. There is no way for there to be multiple clinical trials involving one traditional medicine and it's affect on a certain metabolic process. It may be the case for "western" medicine, but certainly not for other forms of treatment that are not legitimized in the ethno-medical sphere due to their obscurity.

 

[sanchopanza]

.

 

[Depakote]

here's something from the Annals of Internal Medicine.

Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture reject such prescientific notions. Numerous randomized, controlled trials and more than 25 systematic reviews and meta-analyses have evaluated the clinical efficacy of acupuncture. Evidence from these trials indicates that acupuncture is effective for emesis developing after surgery or chemotherapy in adults and for nausea associated with pregnancy. Good evidence exists that acupuncture is also effective for relieving dental pain. For such conditions as chronic pain, back pain, and headache, the data are equivocal or contradictory. Clinical research on acupuncture poses unique methodologic challenges. Properly performed acupuncture seems to be a safe procedure. Basic-science research provides evidence that begins to offer plausible mechanisms for the presumed physiologic effects of acupuncture. Multiple research approaches have shown that acupuncture activates endogenous opioid mechanisms. Recent data, obtained by using functional magnetic resonance imaging, suggest that acupuncture has regionally specific, quantifiable effects on relevant brain structures. Acupuncture may stimulate gene expression of neuropeptides. The training and provision of acupuncture care in the United States are rapidly expanding.

 

[Cytotoxic]

I agree with sanch here. Being a combative sport athlete, I've endured many injuries. Placebo effect or not, I do notice that when I get acupuncture treatments, my injuries usually heal twice as fast as when I just sit around and let them heal. Not saying I have a say in effectiveness of acunpucture just because I've had some experience with it, but I do think it takes more than reading one paper to pass judgment on a subject. Ever wonder why there isn't a lot of research and evidence on acupuncture? Could it be possible that the mechanism of healing from acupuncture is just not fully understood yet? May be it's because some you going into medicine are so close-minded and unwilling to look deeper before making your conclusions, therefore not willing do more research on that subject. Sanch, what do you say we start a little research project on the effectiveness of acupuncture ourselves 😉

I like how when someone is trying to find an answer to an obscure subject all you guys give are sarcastic, ignorant, and negative comments. Future of medicine sure looks bright...

Reading ONE paper doesnt make you an expert on the subject to fully discredit something you know nothing about. Just like getting a few acupuncture treatments wont make me an authority to say whether acunpucture works or not. But I sure do hope most med students i meet next year are more open minded and more willing to look deeper into what's out there.

I don't understand all this anti-science sentiment from all these prospective physicians. You can say all you want about how much faster your injuries heal, but until there is study after study demonstrating conclusive evidence in support of acupuncture, it is simply irresponsible to prescribe it as legitimate medical treatment. Based on your logic, we should be prescribing faith healing and coffee enemas.

 

[ihatescience]

I don't understand all this anti-science sentiment from all these prospective physicians. You can say all you want about how much faster your injuries heal, but until there is study after study demonstrating conclusive evidence in support of acupuncture, it is simply irresponsible to prescribe it as legitimate medical treatment. Based on your logic, we should be prescribing faith healing and coffee enemas.

You have to remember that it's irresponsible to lambast your patient if they are interested in traditional healing, especially since research has not yet conclusively proved/disproved its efficacy.

 

[Depakote]

I agree.

Whether I will "prescribe" acupuncture or not is not relevant here. As a doctor, I'll be supportive of it if the patient is--I happen to trust it from my experience (not just anecdotal, but investigative).

The issue that made me want to post here is the closed-mindedness I sensed on the thread. It's incorrect that a lot of people consider traditional medicine something that conflicts in some way with Western, lab-oriented medicine, and that one must overcome the other. From my experience working with patients in two very different international settings, showing that you are not sensitive to indigenous medicine severely handicaps your ability to get through to your patient and develop the trust relationship that successful doctoring requires. Re-thinking what health and disease really are is a must.

That brings up a good point.

As a physician, you have to accept new treatments (and be willing to prescribe them) when the evidence proves them effective... even if the new treatment happens to be a few thousand years old.

 

[Cytotoxic]

You have to remember that it's irresponsible to lambast your patient if they are interested in traditional healing, especially since research has not yet conclusively proved/disproved its efficacy.

On the contrary, I think it's important not to be too harsh regarding CAM when talking to patients, as some will just assume you're part of the medical conspiracy against CAM. I think the responsible thing to do is to explain to the patient what is/is not known about CAM and leave the decision of whether or not to use it up to the him/her (assuming, of course, the CAM treatment isn't contraindicated with any medication the patient is taking).

 

[lawnboy313]

Sorry to burst your bubble unsung, but TCM is a load of crap.

Maybe you should contact the folks at Harvard (among many other places) and tell them they're wasting their time. I'm sure they'd appreciate your expert opinion.

To the OP: getting into acupuncture/CAM research probably depends more upon the resources at your school/hospital than your specialty. The Consortium of Academic Health Centers for Integrative Medicine has a good list of places where acupuncture/CAM research would be a possibility.

 

[Cytotoxic]

Maybe you should contact the folks at Harvard (among many other places) and tell them they're wasting their time. I'm sure they'd appreciate your expert opinion.

To the OP: getting into acupuncture/CAM research probably depends more upon the resources at your school/hospital than your specialty. The Consortium of Academic Health Centers for Integrative Medicine has a good list of places where acupuncture/CAM research would be a possibility.

Perhaps I wasn't clear in my previous statements. I definitely think CAM should be studied, as some of those treatments may very well be effective. My point is that currently there is little evidence for the effectiveness of CAM beyond a placebo effect.

 

[WantsThisBad]

As someone who has benefited a lot from acupuncture and received treatments from one of the best acupuncturists currently alive, I question who is performing the acupuncture in the studies that show it as affective as placebo. I will tell you that it makes a huge difference the experience and knowledge of the acupuncturist performing his skills. You can do a drug study and give the same drug to 1000 people but its hard to replicate acupuncture, and everyone needs a little bit different of a treatment. I cant imagine that these studies would be conducted taking this into account because I can picture them trying to be consistent with placement of needles and what not and the person not actually getting the right treatment for their particular constitution. I'm also not sure but I have heard of studies done where they have measured the temperature change of organs during acupuncture using some type of scan, Ill look it up and see if I can post it. I have been really sick before with a 102 fever and had acupuncture and my fever was down to 99 in 5 minutes more than once. Placebo? I think people would feel differently about this if they actually felt acupuncture working.

 

[Maxprime]

As someone who has benefited a lot from acupuncture and received treatments from one of the best acupuncturists currently alive, I question who is performing the acupuncture in the studies that show it as affective as placebo.

Or maybe someone knowing they have one of the 'best acupuncutrists in the world" increases the placebo effect.

The issue is not whether or not acupuncture works for people - it obviously does. The issue is that it is, except for a few instances, not better than a placebo. With the number of antibiotic-resistant infections lurking around hospitals, it is irresponsible (IMO) to poke a bunch of extra holes in someone with little to no expected therapeutic benefit.

I am completely open to new treatments, even treatments we don't have a mechanism for - if they show therapeutic benefit. I do neuro research, we understand almost NONE of the drugs in the brain. We know their action (open Na+ channel, etc.) and what tissues they work on, but we don't know why it results in this or that.

Are the acupuncture people also into hyperbaric treatments? There's another thing that has been shown to be useless in most cases (except burns, diving injuries, etc.).

 

[Piyush]

Hmm, from accupuncture to BDSM. yep surely thread hijack.

But, back to OP's question, try kinesiology research, they know all about nutrition/calorie restrictions/longitivity to some extent/and some related topics.

For TCM, might be hard, but you can follow a Chinese allopathic doc who believes in TCM since not all might, find a TCM school in your area and hunt down their graduates, goto a Chinese operated grocery store....

Hope that helps the OP.

 

[lawnboy313]

My point is that currently there is little evidence for the effectiveness of CAM beyond a placebo effect.

It's important to realize that CAM encompasses a wide range of treatments and that one cannot make accurate generalized statements about CAM's efficacy or evidence base.

 

[Cytotoxic]

It's important to realize that CAM encompasses a wide range of treatments and that one cannot make accurate generalized statements about CAM's efficacy or evidence base.

It's also important to realize that CAM treatments are designated "CAM" because there is insufficient/inconclusive evidence for their efficacy. One can, therefore, make such a generalization.

 

[michwolverine]

I have received acupuncture treatments over the past few years and it has helped me tremendously. I had chronic sinus infections that Western medicine could not solve. I had sinus surgery and was on almost constant multiple antiobiotic therapy from an infectious disease dr. Acupuncture changed this vicious cycle and restored me to better health.

It does make a difference who the acupuncturist is and what that person's experience level is. I am very fortunate as mine was a dr. in China trained in both Western and Eastern medicine.

I realize this is just one person's experience, but I am sure this was not a placebo effect. I understand that physicians can't prescribe acupuncture b/c of no controlled studies, but drs. should also not be disrespectful of complementary treatment that works when Western medicine has nothing left to offer.

 

[lawnboy313]

It's also important to realize that CAM treatments are designated "CAM" because their is insufficient/inconclusive evidence for their efficacy. One can, therefore, make such a generalization.

From the NCCAM website:

"CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Some health care providers practice both CAM and conventional medicine. While some scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies--questions such as whether these therapies are safe and whether they work for the diseases or medical conditions for which they are used.

The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge."

So designation as CAM isn't purely efficacy-based--it also depends on evidence of safety and adoption into standard care. But whatever...there's probably a better use of our time than to go back and forth about this minor point. 🙂

 

[WantsThisBad]

Or maybe someone knowing they have one of the 'best acupuncutrists in the world" increases the placebo effect.

The issue is not whether or not acupuncture works for people - it obviously does. The issue is that it is, except for a few instances, not better than a placebo. With the number of antibiotic-resistant infections lurking around hospitals, it is irresponsible (IMO) to poke a bunch of extra holes in someone with little to no expected therapeutic benefit.

I am completely open to new treatments, even treatments we don't have a mechanism for - if they show therapeutic benefit. I do neuro research, we understand almost NONE of the drugs in the brain. We know their action (open Na+ channel, etc.) and what tissues they work on, but we don't know why it results in this or that.

Are the acupuncture people also into hyperbaric treatments? There's another thing that has been shown to be useless in most cases (except burns, diving injuries, etc.).

Yeah its sounds like you know a loooooot about what you're talking about.

 

[Green Mountains]

I see a lot of questions on acupuncture and its effectiveness on this forum. I would like to add that acupuncture has been helping people for thousands of years and I am sure it will continue long after us. I hope that the future physicians on this forum and SND will have an open mind, not only for themselves but for their patients. If you refer a patient to a acupuncturist when you are physicians someday then you can be rest assured that acupuncture does work and does have a place within our healthcare system.

Over 2000 years must have some meaning

Here is an article from pubmed.gov
Type in acupuncture and you will find over 12000 scientific articles on acupuncture.
Good luck to all of you as future physicians and leaders in healthcare
Thank you



Acupuncture therapy rapidly terminates intractable hiccups complicating acute myocardial infarction.Liu FC, Chen CA, Yang SS, Lin SH.
Department of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Acupuncture is a well-known alternative therapy in practice worldwide. Its dramatic effect on hiccups has been rarely reported. We describe a 77-year-old male who had hiccups after an acute myocardial infarction. Despite aggressive treatment including breath-holding to interrupt the respiratory rhythm, continuous positive airway pressure, and medication with metoclopramine, prochlorperazine, chlorpromazine, haloperidol, mephenesin, diphenylhydantoin, baclofen, and phenobarbital, the hiccups persisted for 7 days. Eventually, the hiccups were rapidly terminated by acupuncture at acupoint GV14 (Da zhui). To the best of our knowledge, this is the first report of acupuncture's reversing intractable hiccups after an acute myocardial infarction. Acupuncture may be considered for patients with hiccups refractory to conventional therapy.

PMID: 15813167 [PubMed - indexed for MEDLINE]

 

[Hurricane95]

No.

Good luck finding information on THAT mechanism 🙄

 

[DoctorDreamer]

I don't know about research, but if you're interested in studying CAM, look into the combined MD/masters program at Georgetown.