The Effectiveness of Individualized Acupuncture Protocols in the Treatment of Gulf War Illness: A Pragmatic Randomized Clinical Trial

Abstract

BackgroundGulf War Illness is a Complex Medical Illness characterized by multiple symptoms, including fatigue, sleep and mood disturbances, cognitive dysfunction, and musculoskeletal pain affecting veterans of the first Gulf War. No standard of care treatment exists.MethodsThis pragmatic Randomized Clinical Trial tested the effects of individualized acupuncture treatments offered in extant acupuncture practices in the community; practitioners had at least 5 years of experience plus additional training provided by the study. Veterans with diagnosed symptoms of Gulf War Illness were randomized to either six months of biweekly acupuncture treatments (group 1, n = 52) or 2 months of waitlist followed by weekly acupuncture treatments (group 2, n = 52). Measurements were taken at baseline, 2, 4 and 6 months. The primary outcome is the SF-36 physical component scale score (SF-36P) and the secondary outcome is the McGill Pain scale.ResultsOf the 104 subjects who underwent randomization, 85 completed the protocol (82%). A clinically and statistically significant average improvement of 9.4 points (p = 0.03) in the SF-36P was observed for group 1 at month 6 compared to group 2, adjusting for baseline pain. The secondary outcome of McGill pain index produced similar results; at 6 months, group 1 was estimated to experience a reduction of approximately 3.6 points (p = 0.04) compared to group 2.ConclusionsIndividualized acupuncture treatment of sufficient dose appears to offer significant relief of physical disability and pain for veterans with Gulf War Illness. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Gulf War Illness Research Program under Award No. W81XWH-09-2-0064. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.Trial RegistrationClinicalTrials.gov NCT01305811

Complex Adaptive Systems Theory and Inter-Rater Reliability: Proposed Answers to Challenging Questions

“…2 in Ref. 9 ), some patients show no improvement for weeks, then experience a sudden improvement (Fig. 1).…”

A Study on Research for Utilization Acupuncture Treatment in Military Medicine

“…군진의학에서 침치료를 활용한 연구는 2000년 14) 부터 발간되기 시작하여 2003년 13) , 2006년 28) , 2009년 16) , 2011년 29) 에 각 1편씩 발표되었고 2013년부터 연구 수가 증가하여 2016년 3월까지 13편 [17][18][19][20][21][22][23][24][25][26][27]30,31) 이 발표되었다 (Fig. 2).…”

“…임상연구의 연구 형태를 분석했을 때 무작위 대조군 연구 가 8편 [16][17][18][19][20][21][22][23] 으로 제일 많았고, 증례 보고 논문이 3편 13,24,25) , 후향적 코호트 연구 26,27) , 교차 단면연구 28,29) 가 각 2편, 전 후 연구 14) , 비무작위 대조군 연구 30) , 예비연구 31) 가 1편이…”

“…임상 논문의 연구 목적별 분류를 해보면 외상 후 스트 레스 증후군 17,20,21,25) , 치료를 위해 침술을 선택하는 이유 에 관한 연구 [27][28][29]31) 가 각 4편, 전쟁 경험과 관련된 통증 논문이 3편 23,26,30) , 상기도 감염 24) , 일시적 소음성 난청 14) , 물질 중독 19) , 근막동통 증후군 16) , 인후통 22) , 금연 18) , 신경…”

“…효과에 대해 긍정적, 효과적으로 평가한 논문이 11 편 16,17,[19][20][21][22][23][24][25][26]30) , 주제와 관련이 없는 논문(치료를 위해 침술 을 선택하는 이유에 대한 연구)이 4편 [27][28][29]31) , 효과 없음으 로 평가한 논문이 2편 14,18) , 효과에 대해 언급하지 않은 논 문이 1편 13) 이었다 (Fig. 3).…”