Double-Blind, Randomized, Placebo-Controlled Trial of AP in Allergic Rhinitis

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Hi All,

 

Another nice one (see below, or see the free FULL-TEXT at

http://tinyurl.com/4enpv ).

 

Daniel K. Ng, Pok-yu Chow, Shun-pei Ming, Siu-hung Hong, Sunny Lau,

Debbie Tse, Wilson K. Kwong, Mui-fong Wong, Wilfred H. Wong, Yu-ming

Fu, Ka-li Kwok, Handong Li, and Jackson C. Ho

 

A Double-Blind, Randomized, Placebo-Controlled Trial of AP for the

Treatment of Childhood Persistent Allergic Rhinitis. PEDIATRICS Vol.

114 No. 5 November 2004, pp. 1242-1247 (doi:10.1542/peds.2004-0744)

 

It ends: To our surprise, AP was more popular than topical nasal

corticosteroid treatment and nasal saline lavage for children,

despite the common perception that AP was more threatening than

topical nasal corticosteroid treatment. These results showed that AP

was an acceptable treatment option even for children. It was also

interesting that parents in the sham AP group were far more likely to

have no preference than were those in the active AP group. This

result probably reflected the lack of effect of sham AP as perceived

by the parents, who were not happy with any of the available

treatment options for allergic rhinitis. The main limitation in this

study would be the selection bias, because the study population, with

subjects who agreed to join the study, might be biased in favor of

AP. It is important to conduct similar studies in other places with

different cultures. Given the observed difference in effect between

active and sham AP in this study, any future study should enroll at

least 80 patients in each arm, to achieve a power of 0.8 with a type

1 error of 0.05. CONCLUSIONS This study showed that active AP was

more effective than sham AP in decreasing the symptom scores for

persistent allergic rhinitis and increasing the symptom-free days.

However, no difference was found in relief medication use, serum IgE

levels, blood eosinophil counts, or nasal eosinophil counts. No

serious adverse effect was identified in this study. A large-scale

study is required to confirm the safety of AP for children.

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

IMO, we need thousands more high-quality studies like this. Let us

keep pressing for replacement of the sham / placebo Tx groups by

positive control groups, based on state-of-the-art WM therapy.

 

That paper also had an interesting comment on COOKBOOK AP (this was a

Cookboook study) versus AP based on individual patterns:

 

" In contrast to the study by Xue et al,14 a standard set of AP points

was selected in the current study. Two Ap sites were common to both

the current study and the study by Xue et al,14 ie, yin tang (EX-HN3)

and zu san li (ST36). The effectiveness of this standard set

suggested that differentiation into different syndromes, according to

the TCM classification, may not be necessary, in contrast to the

recommendation by Xue et al.14 " .

 

IMO, we need a lot of good research to compare COOKBOOK v

INDIVIDUALISED AP. If, as I suspect, in the more straight-forward

cases (such as single-symptom, or single-joint problems, local

dysfunction (as in disk disease, etc)), traditional TCM-Pattern based

AP does not give much better results than simple cookbook-AP, there

will be clear implications for AP training courses.

 

In that event, I would predict 3 distinct classes of AP practitioners

working in the future " integrated system " of western medicine:

 

(a) Those with minimal training (short, focused courses) in anatomy,

physiology, point location, stimulation techniques and Cookbook-AP

and optimal indications for its use. These will be the ground-troops

(foot-soldiers, AP Aides / technicians), who will give the routine AP

needed WITHIN the hospitals and clinics that will offer an

acupuncture service.

 

Some of these may also work as Aides / Technicians to private AP

practitioners (see below).

 

(b) Those with advanced training to Master- or Doctorate- level in

TCM-style AP. These will be much fewer in number within the WM-AP

facilities. They will be the Officers in the Hospital AP clinics;

they will be well paid (on equal salaries to any other Head of

Department in the Hospitals), and will head up the AP units, diagnose

and (in consultation with doctors in other specialties in the

hospitals) will prescribe for the more difficult cases, and guide the

technicians under their supervision.

 

© Private practitioners, with AP training that will vary from from

the minimum legal requirement to be licensed to practise, to very

high standards. These practitioners may hold one or more third-level

degrees in OTHER modalities (physio, medicine, psychology, etc).

 

The busier practitioners may form partnerships with other well

trained colleagues, and employ a few AP Aides (as in (a)) to allow

the practice to handle many more clients efficiently.

 

Best regards,

Phil