German large controlled clincal trials

[Guest guest]

let me correct my numbers from a previous post about the German study -

 

one articles says 40,000 people participated as patients in the first phase

of the trial. Of those 40,000, 89.9% reported alleviation of their chronic

pain from acupuncture treatments (only real treatments).

 

same article says 4,000 patients would participate in the the second phase,

which would involve comparison of western tx, acupuncture and sham acupuncture.

-roseanne s.

[Guest guest]

As usual, the devil is in the details. I got the full text on the knee

pain and migraine studies the other day. The 'acupuncturists' are

physicians with 140 hours or 350 hours of training who are doing the

study, not real 'acupuncturists'. Non medical acupuncturists were

excluded from the study. Chinese syndrome diagnosis is not mandatory.

Sham points were used, but not double blinded (high non-specific effects

were reported). Haven't finished reading through it, but seems that as

in most research, if someone needs to poke some holes (sorry...),

they're there if needed.

 

Geoff

 

> __________

>

> Message: 19

> Tue, 16 Mar 2004 21:05:35 -0000

> " " <

> Re: German large controlled clincal trials in

> acupuncture for 4 conditions

>

> ,

> " wainwrightchurchill " < w.churchill_1-@t...> wrote: It

> > is reported that acupuncture hasn't been found to work better than

> > sham needling for chronic back pain, chronic arthritis of

> the knees,

> > tension headache and migraine.

>

[Guest guest]

I don't know where or what people are getting taught, but I'm not sure

most people are getting a solid TCM in the West. I have been very happy

with the TCM I was taught and it has been about all I've needed. I've

had many patients who have been to more 'energetic style' practitioners

without results for health problems with western diagnoses. I don't

think TCM is the end-all-be-all for sure, and either are 'energetic

systems' - they're just various tools in the box. What I found in

school was that most students (NOT ALL) enrolled in a TCM program who

strongly clung on to the 5-e and Japanese approaches were very weak in

basic TCM and would give diagnoses like foot pain due to Liver and

Kidney Yang deficiency and Sp Qi deficiency with Phlegm misting the mind

and GB excess - or some rambling list like this. I've been to GREAT

'energetic style' practitoners and have had good results myself, but

they have had great training as well either in Japan or with a solid TCM

background. There's a reason why TCM is the way it is - it was

developed to be very effective for many patients. Bob Flaws wrote a

great piece on how TCM was developed and (hope you don't mind the

paraphrasing here Bob) about how he had looked down on TCM since it was

a 'communist' system and after he actually got into detailed study of

the classics, he found that the jewels from the classics were in TCM.

 

Geoff

 

> __________

>

> Message: 4

> Wed, 17 Mar 2004 04:56:23 -0000

> " " <

> Re: German large controlled clincal trials in

> acupuncture for 4 conditions

>

> , " Alon Marcus "

> <alonmarcus@w...> wrote:

> > Even the background of these mega-studies is fascinating. In October

> 2000, the German authorities decided that the evidence for

> acupuncture was not sufficiently convincing for inclusion in

> the list of interventions qualifying for reimbursement from

> health insurance companies. Henceforward Germans would have

> to pay for acupuncture out of their own pockets, as do most

> people in Britain.

> >

> > >>>>This can be the beginning of the end. Studies with 500,000

> patients are very significant and if sham and real work the

> same what do we need a profession for? Very troublesome news indeed

[Guest guest]

TCM is the end-all-be-all for sure, and either are 'energetic

systems' - they're just various tools in the box.

>>>I agree with this

Alon

 

 

[Guest guest]

At 11:41 PM +0000 3/16/04, wrote:

>this does not bode well for those concerned about chiros taking 300 hour

>courses.

--

At 1:05 AM -0600 3/17/04, Geoffrey Hudson wrote:

>The 'acupuncturists' are

>physicians with 140 hours or 350 hours of training who are doing the

>study, not real 'acupuncturists'. Non medical acupuncturists were

>excluded from the study. Chinese syndrome diagnosis is not mandatory.

--

 

 

If Geoffrey's assertion turns out correct, then it seems like an

excellent argument against 300 hour courses. It's what " we " have been

trying to claim all along, and " they " have done the study that proves

our point...no?

 

Rory

 

--

 

 

 

[Guest guest]

, Rory Kerr <rorykerr@o...> wrote:

> At 11:41 PM +0000 3/16/04, wrote:

> >this does not bode well for those concerned about chiros taking 300 hour

> >courses.

> --

> At 1:05 AM -0600 3/17/04, Geoffrey Hudson wrote:

> >The 'acupuncturists' are

> >physicians with 140 hours or 350 hours of training who are doing the

> >study, not real 'acupuncturists'. Non medical acupuncturists were

> >excluded from the study. Chinese syndrome diagnosis is not mandatory.

> --

>

>

> If Geoffrey's assertion turns out correct, then it seems like an

> excellent argument against 300 hour courses. It's what " we " have been

> trying to claim all along, and " they " have done the study that proves

> our point...no?

>

> Rory

 

 

 

Its like we all speak different languages or live on different planets. the

study showed that minimal training (medical acupuncture) or no training

(sham acupuncture) both resulted in highly effective acupuncture. how does

this justify MORE training. I could see if the results were equally bad, but

they were equally good. this study proves on many levels that little training

is necessary to practice effective acupuncture. given that I am about to

launch my first solo private practice since moving to California and I planned

to focus on acupuncture, I find this disheartening. It causes me no glee, in

case you thought I was some laughing herbalist looking down on the silly

needlers. not at all.

 

[Guest guest]

Again I repeat, the phrase " no significant difference " in the reporting of

this study in The Guardian is a misrepresentation of the results. The study DID

NOT conclude that there was no significant difference in the efficacy of

treatment between 'real' and 'sham' acupuncture. I hate to see people on this

list getting hysterical over this statement, when the study did not come to this

conclusion. Please take a little time to look at the original articles and

reporting on the study before jettisoning your acupuncture career.

-roseanne s.

[Guest guest]

, " Geoffrey Hudson " <list@a...>

wrote:

> I don't know where or what people are getting taught, but I'm not sure

> most people are getting a solid TCM in the West. I have been very happy

> with the TCM I was taught and it has been about all I've needed.

 

I completey agree with you and the words of a recent licensee are hardly a

deterrent. However in Jason's defense, he is quite knowledgeable in TCM and

was one of the most highly focused students I ever knew. His depth of

knowledge easily exceeded many of his teachers. He also reads chinese. I am

convinced that the effectiveness of acupuncture in the clinic is mainly tied to

personal proclivity. You get the best results with the style you resonate with.

this is the observation of a somewhat detached perspective in that I have

never been rally drawn to acupuncture at all, but have been able to witness

the effects of diverse styles due to my long tenure in teaching clinics (20

hours per week minimum for 11 years now). I am not attached to any style. I

do TCM because it meshes nicely with herbology. However I have recently

been drawn to more classical styles due to Deke's work. I am also studying

orthopedic styles. I can say unequivocally that all the experienced px I know

get largely equivalent results regardless of style. Personal anecdotes from

clinic prove nothing about what is better or worse. they just prove what

floats your boat.

 

[Guest guest]

, " "

wrote:

> , " Geoffrey Hudson "

<list@a...>

> wrote:

> > I don't know where or what people are getting taught, but I'm not sure

> > most people are getting a solid TCM in the West. I have been very

happy

> > with the TCM I was taught and it has been about all I've needed.

>

> I completey agree with you and the words of a recent licensee are

hardly a

> deterrent. However in Jason's defense, he is quite knowledgeable in

TCM and

> was one of the most highly focused students I ever knew. His depth of

> knowledge easily exceeded many of his teachers. He also reads

chinese. I am

> convinced that the effectiveness of acupuncture in the clinic is

mainly tied to

> personal proclivity. You get the best results with the style you

resonate with.

 

This is something that may be true... Your point is well taken and I

will contemplate this... AS far as the study discussed above, I did

not see the results as you state them, so I apologize if I interpreted

the data incorrectly, I must have missed a post. So your point about

sham acupuncture is well taken and I will think about this...

 

If though, a certain acupuncture style works best if one resonates

with it, then what does this say about the acupuncture? Just

intention? I am unsure and will think about that also... In my recent

switch, patients have noticed a significant difference in this non-tcm

style... What do you make of that? Purely Placebo>? I am unsure...

But I am still not convinced (because you say so - Todd) that all

styles get the same results, this is 'the position' that floats your

boat. How can one tell in a clinic filled with students where the

majority of people are getting adjunct therapies (i.e. herbs etc.) - I

don't think your observations from a school clinic are valid either...

and of course everyone claims good results, that goes unsaid right???

Or are you basing this on senior practitioners you have observed or

your own personal experience, just curious.. But I still think the

jury is out...

 

Finally, to give a little background on my toyohari (which means

Japanese Acupuncture I think) BIAS?? - I signed up for the course

with one objective -to increase my palpation skills, that is it… I had

no resonance towards it and actually still would rather practice TCM

from a purely time management perspective. I was upfront to everyone

in the class about how skeptical I was, I just went through the

motions – so to speak… When practicing the techniques (just to work my

palpation skills) on my patients MANY would stop half way through and

say I don't know what you are doing, but I am feeling something big..

OR I am feeling incredible that was the best treatment ever etc etc…

This starting happening so much that I had to start thinking about it

more… BTW – I was always happy – or so I THOUGHT with my TCM results.

Just a little food for thought… But hey I might be back to TCM in 2

weeks... who knows...

 

-

[Guest guest]

At 5:51 PM +0000 3/17/04, wrote:

>Its like we all speak different languages or live on different planets. the

>study showed that minimal training (medical acupuncture) or no training

>(sham acupuncture) both resulted in highly effective acupuncture. how does

>this justify MORE training. I could see if the results were equally bad, but

>they were equally good. this study proves on many levels that little training

>is necessary to practice effective acupuncture. given that I am about to

>launch my first solo private practice since moving to California and I planned

>to focus on acupuncture, I find this disheartening.

--

 

you are probably right to be disheartened, but I'm still not

getting it. I had not read the original post and link by Wainright (I

was out of town and returned to hundreds of messages) so missed the

fact that the treatments were effective. I'd assumed that as

insurance was being denied, that it had shown the acupuncture to be

ineffective. However, even if the studies prove that acupuncture

delivered by relatively untrained practitioners is effective, but

only as effective as sham, it really says nothing about how effective

more highly trained practitioners would be...does it?

 

It seems bizarre to me that an effective intervention would be

refused reimbursement by insurance. Clearly it is more effective than

doing nothing, so the practitioner's time should be reimbursed.

 

Rory

--

 

 

 

[Guest guest]

Jason,

 

, " "

with one objective -to increase my palpation skills, that is it…

 

Bravo! I think this is one of the most important aspect of

acupuncture practice, palpation. I was very fortunate to have

practiced shiatsu in Chicago, prior to tcm school. Today, I still

palpate every point prior to insertion. I must say that often, the

point selected is not according to the location I was taught. It

can't be. I also find patients react to the palpation. Perhaps the

palpation itself is half the treatment.

 

To me, there's no such thing as 'sham acupuncture'. When any object

enters the body, a reaction will take place. The body does not know

whether the object is a needle, dirty nail, or a bee sting. All the

body knows is that the object does not belong there. It makes little

difference to the body whether the point is on st36 or 'sham' point.

The body will react. This innate knowledge brings about some form of

reaction in the form of chemistry. Should the object be

placed/inserted on areas of the body where larger sensory/motors

neurons are allotted in the brain, the reaction will be greater.

Areas such as LI4 and Liv3 are an example as well as other points

from the toes to the knees and fingers to the elbows. We all learned

this at school.

 

I'm aware of the various studies conducted to prove the validity of

acupuncture points by measuring their electrical resistance, or lack

of, from the so called 'sham' points. However, and I can't prove

this, there's a possibility that other 'non' points may be reactive

during time of illness or injury. How are new points found?

 

I think different life experiences also account for the effect a

point will have on a person. In my experience, I've found martial

artists to respond to acupuncture faster than someone who lives a

less active life style. Soccer players no doubt will respond better

to points on their feet than a baskeball player and musicians would

most likely respond to hand points favorably. (Obviously, this is

again all conjecture on my part)

 

We know from the classics that any point in the body has the

potential of being an acupuncture point such as ashi points. If it

hurst, needle it, it's point. To limit the body's ability to react

to only 365 or so points, is to limit and understimate its innate

intelligence and the mind of the cells.

 

 

Fernando

[Guest guest]

We know from the classics that any point in the body has the

potential of being an acupuncture point such as ashi points. If it

hurst, needle it, it's point. To limit the body's ability to react

to only 365 or so points, is to limit and understimate its innate

intelligence and the mind of the cells.

 

>>>>The problem is that if sham works as well we do not need professionals to do

acupuncture. Any monkey will do. We need to do studies in which the quality of

acupuncture is not questioned. you stated that 80% got good results. What did the paper actually said? How

was this number defined?

Alon