The Status and Future of Acupuncture Clinical Research

Abstract

On November 8-9, 2007, the Society for Acupuncture Research (SAR) hosted an international conference to mark the tenth anniversary of the landmark National Institutes of Health Consensus Development Conference on Acupuncture. More than 300 acupuncture researchers, practitioners, students, funding agency personnel, and health policy analysts from 20 countries attended the SAR meeting held at the University of Maryland School of Medicine, Baltimore, MD. This paper summarizes important invited lectures in the area of clinical research. Specifically, included are: a review of the recently conducted German trials and observational studies on low-back pain (LBP), gonarthrosis, migraine, and tension-type headache (the Acupuncture Research Trials and the German Acupuncture Trials, plus observational studies); a systematic review of acupuncture treatment for knee osteoarthritis (OA); and an overview of acupuncture trials in neurologic conditions, LBP, women's health, psychiatric disorders, and functional bowel disorders. A summary of the use of acupuncture in cancer care is also provided. Researchers involved in the German trials concluded that acupuncture is effective for treating chronic pain, but the correct selection of acupuncture points seems to play a limited role; no conclusions could be drawn about the placebo aspect of acupuncture, due to the design of the studies. Overall, when compared to sham, acupuncture did not show a benefit in treating knee OA or LBP, but acupuncture was better than a wait-list control and standard of care, respectively. In women's health, acupuncture has been found to be beneficial for patients with premenstrual syndrome, dysmenorrhea, several pregnancy-related conditions, and nausea in females who have cancers. Evidence on moxibustion for breech presentation, induction of labor, and reduction of menopausal symptoms is still inconclusive. In mental health, evidence for acupuncture's efficacy in treating neurologic and functional bowel disorder is still inconclusive. For chronic cancer-related problems such as pain, acupuncture may work well in stand-alone clinics; however, for acute or treatment-related symptoms, integration of acupuncture care into a busy and complex clinical environment is unlikely, unless compelling evidence of a considerable patient benefit can be established.

Brain encoding of acupuncture sensation – coupling on-line rating with fMRI

“…Many recent clinical trials of acupuncture for chronic pain conditions have reported effectiveness of both real and different forms of sham acupuncture above and beyond a usual care control (Cherkin et al, 2009;Moffet, 2009;Park et al, 2008). Our fMRI results, while demonstrating interesting differences in important brain regions, also demonstrate a noted similarity between ACUP and SHAM in the brain networks modulated by the stimulusassociated sensation.…”

Local Thermal Therapy Effects on Menopausal Symptoms and Bone Mineral Density

“…22 The sensory phenomenon of propagated sensation along meridians provides a possible explanation for the nature of acupuncture points. 23 Polymodal receptors are thought to play an important role because they can be activated by both thermal (moxibustion) and mechanical (acupuncture) stimuli.…”

The Diagnosis of the Origins of Spinal Pain: Implications for the Spinal Surgeon

“…Unfortunately, the injudicious use of this approach is probably responsible for the largest number of apparent ''surgical successes'' as determined by the next set of postsurgical imaging studies in patients who continue to suffer or who seek subsequent care elsewhere. 40,41 An earlier MRI study documented that ''whilst neural compromise may be the best radiologic feature distinguishing patients who may benefit from intervention, it cannot predict quality of life deficits in the diffuse group of patients with LBP.'' 42 Another, arguably documented that there was no association between peridural scar and outcome after lumbar discectomy.…”