|
Acupuncture is a component of the health care system of China that can be
traced back at least 2,500 years. The general theory of acupuncture is based
on the premise that there are patterns of energy flow (Qi) through the body
that are essential for health. Disruptions of this flow are believed to be
responsible for disease. Acupuncture may, it has been theorized, correct
imbalances of flow at identifiable points close to the skin.
The practice of acupuncture to treat identifiable pathophysiological
(disease) conditions in American medicine was rare until the visit of
President Richard M. Nixon to China in 1972. Since that time, there has been
an explosion of interest in the United States and Europe in the application
of the technique of acupuncture to Western medicine.
Acupuncture is a family of procedures involving stimulation of anatomical
locations on or in the skin by a variety of techniques. There are a variety
of approaches to diagnosis and treatment in American acupuncture that
incorporate medical traditions from China, Japan, Korea, and other
countries. The most thoroughly studied mechanism of stimulation of
acupuncture points employs penetration of the skin by thin, solid, metallic
needles, which are manipulated manually or by electrical stimulation.
Are there standards for acupuncture needles?
After reviewing the existing body of knowledge, the U.S. Food and Drug
Administration (FDA) removed acupuncture needles from the category of
"experimental medical devices." The FDA now regulates acupuncture needles,
just as it does other devices such as surgical scalpels and hypodermic
syringes, under good manufacturing practices and single-use standards of
sterility.
What are the possible side effects of acupuncture?
The most common serious injury reported from the needles of acupuncture has
been accidental puncture of the lung. This results in a partial collapse of
the lung called pneumothorax. The most common infection reported from
acupuncture treatments is viral hepatitis, a potentially serious infection
of the liver. Other side effects include bacterial infections locally at the
site of needle insertion in the skin and elsewhere in the body. Generally,
side effects seem to relate to poor hygiene and training of the
acupuncturist.
For what conditions has acupuncture treatment been found helpful?
The National Institutes of Health (NIH) Consensus Development Program was
established in 1977 and is designed to assess health technology. The program
organizes major conferences that produce consensus statements and technology
assessment statements on controversial issues in medicine important to
health care providers, patients, and the general public. The following
statement is from the NIH Consensus Development Statement on Acupuncture on
November 3-5, 1997.
Acupuncture as a therapeutic intervention is widely practiced in the United
States. There have been many studies of its potential usefulness. However,
many of these studies provide equivocal results because of design, sample
size, and other factors. The issue is further complicated by inherent
difficulties in the use of appropriate controls, such as placebo and sham
acupuncture groups.
However, promising results have emerged, for example, efficacy of
acupuncture in adult post-operative and chemotherapy nausea and vomiting and
in post-operative dental pain. There are other situations such as addiction,
stroke rehabilitation, headache, menstrual cramps, tennis elbow,
fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel
syndrome, and asthma where acupuncture may be useful as an adjunct treatment
or an acceptable alternative or be included in a comprehensive management
program.
Findings from basic research have begun to elucidate the mechanisms of
action of acupuncture, including the release of opioids and other peptides
in the central nervous system and the periphery and changes in
neuroendocrine function. Although much needs to be accomplished, the
emergence of plausible mechanisms for the therapeutic effects of acupuncture
is encouraging.
The introduction of acupuncture into the choice of treatment modalities that
are readily available to the public is in its early stages. Issues of
training, licensure, and reimbursement remain to be clarified. There is
sufficient evidence, however, of acupuncture's value to expand its use into
conventional medicine and to encourage further studies of its physiology and
clinical value. This statement is representative of the opinions of current
standard medical practice.
How does acupuncture work?
Here are current thoughts from the National Institutes of Health on the
manner by which acupuncture might produce beneficial health results.
Many studies in animals and humans have demonstrated that acupuncture can
cause multiple biological responses. These responses can occur locally,
i.e., at or close to the site of application, or at a distance, mediated
mainly by sensory neurons to many structures within the central nervous
system. This can lead to activation of pathways affecting various
physiological systems in the brain as well as in the periphery. A focus of
attention has been the role of endogenous opioids in acupuncture analgesia.
Considerable evidence supports the claim that opioid peptides are released
during acupuncture and that the analgesic effects of acupuncture are at
least partially explained by their actions. That opioid antagonists such as
naloxone reverse the analgesic effects of acupuncture further strengthens
this hypothesis. Stimulation by acupuncture may also activate the
hypothalamus and the pituitary gland, resulting in a broad spectrum of
systemic effects. Alteration in the secretion of neurotransmitters and
neurohormones and changes in the regulation of blood flow, both centrally
and peripherally, have been documented. There is also evidence that there
are alterations in immune functions produced by acupuncture. Which of these
and other physiological changes mediate clinical effects is at present
unclear.
Information resource:
http://www.medicinenet.com/Acupuncture/article.htm
|
