YES, we do indeed obtain clinical results in acupuncture, and this for an astonishing variety of health disorders.
It is interesting to note that prognoses could be influenced, according to Eastern etiology, by several elements: the stage of evolution of the imbalance, the therapist's skill, patient involvement... Current first-level evidence confirms several dozen health disorders for which acupuncture proves effective.
The numerous confirmed clinical applications of acupuncture, the safety of its procedures, as well as its excellent cost-effectiveness ratio, are stimulating the integration of acupuncture into primary health care worldwide.
The international scientific community has been studying the clinical applications of acupuncture for many years. In 2016, Brazil still dominates the volume of publications on evidence regarding acupuncture clinical trials.
Although we were among the world pioneers in regulating the practice of acupuncture in Quebec, we are already lagging behind in terms of unilateral integration of acupuncture in hospital settings.
The 'achievements'....
Autonomous American entities;
-National Institute of Health
as well as autonomous global entities;
-World Health Organization (WHO)
-Cochrane Group, an international network dedicated to indexing articles published in medical journals;
have all officially credited the efficacy of acupuncture for several isolated conditions, including those listed below. Furthermore, the community of NIH researchers declared '...all evidence indicates that future studies will shed light on many other areas of application for acupuncture.'
The National Institute of Health has certified the efficacy of acupuncture for the following conditions: postoperative and post-chemotherapy pain/nausea/vomiting, addictions, asthma, stroke rehabilitation, headaches, menstrual cramps, fibromyalgia, epicondylitis, carpal tunnel syndrome, muscle pain, osteoarthritis, low back pain.
The World Health Organization has credited the efficacy of acupuncture for the following conditions:
...Acupuncture has demonstrated its efficacy in relieving postoperative pain, nausea during pregnancy, nausea and vomiting associated with chemotherapy, as well as dental pain with extremely few side effects. It also makes it possible to reduce anxiety, panic disorders, and insomnia.
The Cochrane Group has also established a list and detailed efficacy rating of acupuncture for the following conditions;
nausea and vomiting associated with surgical interventions and chemotherapy treatments, stroke (CVA), facial paralysis, asthma, allergic rhinitis, insomnia, weight loss, pain following dental surgery, headache, lateral epicondylitis pain, pain associated with rheumatoid arthritis, osteoarthritis and joint disorders, knee osteoarthritis, low back pain, nausea and low back pain associated with pregnancy, pelvic and low back pain during the last trimester of pregnancy, interstitial cystitis, labor induction (delivery), female infertility, dysmenorrhea
A National Institutes of Health (NIH) consensus in 1997 confirms that endorphins and other peptides released in the central and peripheral nervous systems as well as the induction of changes in neuroendocrine functions are related to the efficacy of acupuncture.
The WHO (2002), based on the literature of the time, produced a list of diseases and dysfunctions for which acupuncture had been evaluated through controlled clinical research. This evaluation corresponds to the data from the NIH (1997) and confirms the data from the British Medical Association (2000)
Here is the list of diseases, symptoms, and conditions for which acupuncture proved to be an effective treatment in these controlled clinical research studies:
Headaches and migraines
Cervical pain
Biliary colic
Nephritic colic
Labor induction
Diarrhea
Facial pain, including temporomandibular joint problems
Postoperative pain
Primary dysmenorrhea
Side effects of radiation and chemotherapy
Sprains
Gastralgia (peptic ulcer, acute and chronic gastritis, gastric cramps)
Primary hypertension
Primary hypotension
Leukopenia
Morning sickness
Knee osteoarthritis and rheumatic pain
Tendinitis
Fetal version
Currently...
According to evidence collected in the literature review published in January 2017 by McDonald et al., here is a presentation that summarizes the applications for which the efficacy of acupuncture has been demonstrated. (22)
Several recent meta-analyses present positive validation of acupuncture for the effective treatment of a diverse array of conditions, summarized here:
Chronic pain
Osteoarthritis
Irritable bowel syndrome
Stroke sequelae
Aphasia
Amblyopia
Certain vasculogenic cognitive impairments
Migraine
Depression
Post-stroke depression
Chronic prostatitis
Menopausal symptoms
Decreased breech presentations and cesarean sections
Increased pregnancies and births following IVF
These conditions are for the most part often addressed in acupuncture clinics, but much research remains to be done, as it appears that acupuncture is effective for a much larger number of conditions, as demonstrated by clinical experience, as well as a large number of studies and meta-analyses not listed here, which lead to promising conclusions, despite the presence of certain methodological shortcomings from the perspective of current international statistical standards. But before further meta-analyses are published, much more research will need to be conducted.
Interestingly, the conditions listed above transcend the classification of organ systems and the various specialties of Western conventional medicine, reflecting very well the holistic dimension of the traditional approach. The remarkable diversification of acupuncture applications deserves in itself to push research forward even further…
It is proposed here that these updated analyses can serve as a foundation for building a coherent discourse with the public regarding the current vision of the international scientific community on the practice of acupuncture. Also, the first two ((1) and (2)) analyses mentioned here are probably the most important to understand in order to maintain current scientific discourse on the practice of acupuncture:
- Acupuncture is indeed a form of acupuncture, with physiological effects of its own. Comparing the efficacy of traditional treatment to this type of control amounts to comparing two types of acupuncture to each other. If either of these groups reveals significant clinical effects, acupuncture probably has a role to play in treating the condition being studied. One cannot therefore say that traditional acupuncture is ineffective if its efficacy is similar to the control group type.(1) This is what would invalidate several studies that led to negative conclusions regarding the practice of acupuncture.
- The placebo myth. We often hear it repeated that the efficacy of acupuncture would be equivalent to placebo. Placebos have, however, been demonstrated to be clinically insignificant. (2) Therefore, any efficacy found in acupuncture treatment is due to the intrinsic value of the acupuncture treatment, and cannot be explained by older conceptions of the placebo effect.
Furthermore, beyond isolated health disorders, Traditional Oriental Medicine (TOM) has taught us to identify WHO it will be able to help. That is, for which terrain (who), regardless of the syndrome (the disease and its symptoms). This is another domain of research intrinsic to this field of expertise to explore, which will play a determining role in establishing reproducible clinical protocols. Historically, this "cultural" factor would have created a bias in the sampling process of several studies, which then lose the fundamental criterion of randomized trials. This type of bias is not exclusive to clinical studies conducted in acupuncture. Indeed, it is reminiscent of what was criticized regarding the sum of publications with preferential sampling that were published in the field of neuroscience. (21)
Research now has no choice but to be inclusive, thus reflecting the real limitations and possibilities of the interventions being studied. This is how these new analyses will now also spur genuine interest in the orientation of international standards. In other words, results and conclusions that may now eventually lead to uniform recommendations and clinical attitudes among health professionals.
Throughout the world, Traditional Medicine (TM) constitutes either the main mode of health care delivery or a complement to it. It constitutes an important and often underestimated facet of health care. It exists in virtually every country in the world, and demand for services in this field is increasing...'' According to the WHO publication: WHO Strategy for Traditional Medicine, 2014-2023: improving access to information and expanding the knowledge base on the quality, safety, and efficacy of traditional medicine would be of paramount importance. It also suggests implementing public guidelines to ensure the safety, quality, and efficacy of services, and defining provisions for the training, qualification, and accreditation of practices based on an assessment of needs and risks. It also proposes deploying a strategy to promote the development of reference criteria, standards, and regulations for the training, accreditation, and reimbursement of different forms of traditional medicine.
WHO Action Plan and Recommendations to Member States.
On page 51, note the strategic actions expected of Member States according to the WHO publication, WHO Strategy for Traditional Medicine for 2014-2023
''Strategic actions for Member States:
1. Improve access to information and expand the knowledge base on the quality, safety, and efficacy of TM/MC.
2. Ensure that TM/MC services (practices and practitioners) are properly controlled by establishing practical regulatory systems adapted to the infrastructure of Member States.
3. Set standards and indicators for monitoring performance within an overall health system.
4. Contribute to the development of a code of conduct to promote ethical practice, in partnership with all stakeholders.
5. Contribute to the design and implementation of guidelines to ensure the safety, quality, and efficacy of TM/MC services.
6. Define provisions on the training, qualification, and accreditation of TM/MC practices and practitioners, based on an assessment of needs and risks. 7. Promote the development of reference criteria, standards, and regulations for the training, accreditation, and reimbursement of different forms of TM/MC.
8. Establish formal communication channels to facilitate teaching, including training.''
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