Evidence-Based Complementary and Alternative Medicine: Back to Basics

ArticleinThe Journal of Alternative and Complementary Medicine 12(4):349-50 · June 2006with22 Reads
DOI: 10.1089/acm.2006.12.349 · Source: PubMed
    • "However, the inter-practitioner variability, the patient's knowledge and experience of acupuncture and the visual impact of needling may be the potential factors when performed in the acupuncture studies (Tsukayama et al., 2006). Because the two criteria of the sham control are to " mimic those aspects of the real treatment " and " not mimic those aspects of treatment that have beneficial effects " (Hammerschlag and Zwickey, 2006), we do not use the sham control to compare with our acupuncture group. PD is a chronic degenerative disease. "
    [Show abstract] [Hide abstract] ABSTRACT: Complementary therapy with acupuncture for Parkinson's disease (PD) has been studied for quite a long time, but the effectiveness of the treatment still remains unclear. The aim of this study is to evaluate the integrated effects of acupuncture treatment in PD patients who received western medicine. In the short-term acupuncture treatment study, 20 patients received acupuncture therapy twice a week in acupoints DU 20, GB 20, LI 11, LI 10, LI 4, GB 31, ST 32, GB 34 and GB 38 along with western medicine for 18 weeks, and 20 controlled patients received western medicine only. In the long-term acupuncture treatment, 13 patients received acupuncture treatment twice a week for 36 weeks. The outcome parameters include Unified Parkinson's disease rating scale (UPDRS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-Version 2 (BDI-II), and WHO quality of life (WHOQOL). In the short-term clinical trial, a higher percentage of patients in the acupuncture group had score improvement in UPDRS total scores (55% vs. 15%, p = 0.019), sub-score of mind, behavior and mood (85% vs. 25%, p < 0.001), activity of daily living (65% vs. 15%, p = 0.003), mobility (40% vs. 15%, p = 0.155) and complication of treatment (75% vs. 15%, p < 0.001), BDI-II score (85% vs. 35%, p = 0.003), and WHOQOL score (65% vs. 15%, p = 0.003) when compared to control group at the end of the 18 weeks' follow up. After 36 weeks of long-term acupuncture treatment, the mean UPDRS total scores and sub-score of mentation, behavior and mood, sub-score of complications of therapy and BDI-II score decreased significantly when compared to the pretreatment baseline. In conclusion, acupuncture treatment had integrated effects in reducing symptoms and signs of mind, behavior, mood, complications of therapy and depression in PD patients who received Western medicine.
    Full-text · Article · May 2015
    • "Preliminary reading on the current status of acupuncture research identified the development of a placebo control as one of the key challenges faced by the acupuncture research com- munity1415161718. Commentaries and papers questioning whether or not these controls should be considered as placebo have for the most part focussed on the potentially meaningful physiological responses that they may induce56789. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction Clinical guidelines depend on the analysis of randomised controlled trials in systematic reviews. How to interpret the results of acupuncture vs. sham-placebo procedures is a controversial aspect of the evidence base for acupuncture. Two inferences can be drawn from the acupuncture vs. sham-placebo randomised controlled trials. The first is whether acupuncture has a physiological basis. The second is whether there is any validity in traditional concepts of acupuncture practice. The degree to which sham acupuncture controls can physiologically be considered placebo controls has been challenged. However, whether these procedures should be considered ‘inert’ in terms of Chinese medicine theory has yet to be fully examined. Therefore this review aims to evaluate the extent to which sham-placebo procedures used in randomised controlled trials should be considered inert, with particular reference to traditional Chinese medicine theories. It also considers sham-placebo controls from a biomedical perspective. Methods Sham-placebo procedures were identified through reviews examining acupuncture controls. Results Four main types of sham-placebo control were identified. The procedures are heterogeneous and should not necessarily be considered as equivalent within systematic reviews. Conclusion These procedures cannot be considered as inert controls from either a Chinese medicine or biomedical perspective. There is a need to develop appropriate Acupuncture Control Assessment Guidelines to assess the risk of bias from sham-placebo controls when undertaking systematic reviews. The terminology used to describe control procedures needs to be developed and standardised.
    Full-text · Article · Apr 2014
    • "In addition, evidence of correlations between loose connective tissue anatomy and the acupuncture system is emerging as a viable alternative to the prevailing neurobiological models [62,69]. A cautionary note regarding translational research bridging physiology and efficacy of acupuncture is that lack of a clear understanding of the events initiated by acupuncture needle insertion confounds the design of an appropriate sham acupuncture procedure for clinical trials [77,78]. "
    [Show abstract] [Hide abstract] ABSTRACT: The rising incidence of chronic disease and stress-related illness in the West, coupled with an expanding awareness of the unwanted side effects of pharmaceutical treatment, has led to an increased utilization of acupuncture as a contemporary health care option. This increase in utilization, in turn, has paralleled a response to the call for evidence, with the result that acupuncture is now supported by a broad range of surveys of safety, clinical trials and basic science studies of physiologic action. The combined impact of these studies is linked to a growing acceptance of this traditional medical practice. The present review takes a wide-angle look at these three major areas of acupuncture research, namely: safety and the risks of serious adverse events; clinical efficacy and effectiveness; and physiologic action. We identify advances in knowledge and present a point counterpoint approach to controversial issues, with the aim of offering clarification if not a measure of resolution.
    Full-text · Article · Aug 2012
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