Using Science to Make a Point about Acupuncture

Using science to make a point about acupuncture

By: Kao Chen

Cao Xiaoding

TEN years before the world heard of acupuncture, a young Chinese doctor with a doctorate in physiology from Russia was invited to observe an unusual chest surgery in Shanghai, which used acupuncture in place of an anaesthetic.

That was 1964.

"It was a stunning feat involving a team of three acupuncturists, who worked on 20 pairs of acupressure points," recalls Professor Cao Xiaoding, now 70, of the Shanghai Medical University.

And that was how an overseas-trained modern doctor ended up doing pioneering research in TCM, thanks to "serendipity, what else?", as she puts it.

Prof Cao, who is barely 150 cm tall, enjoys a standing as a researcher of world renown, an expert on acupuncture and adviser to the World Health Organisation on traditional Chinese medicine.

She was one of four foreign experts invited to America's National Institute of Health (NIH) hearing on acupuncture in 1997 - a milestone that led NIH to conclude that the treatment is efficacious for specific diseases, and is safe to practise.

The NIH hearing paved the way for certified acupuncturists to practise in about half of the American states, and made acupuncture expenses recoverable from health insurance in several states.

While proud of the breakthroughs in the field, Prof Cao admits that "it will take many generations before we know the full science behind acupuncture".

She sums up her own career as one of "using modern scientific methodologies to explain TCM theories".

For example, she found that people indeed react differently to the acupuncture needle.

It relaxes some people, whose skin temperatures rise after the insertion of the needle.

But others tense up, and their skin temperatures dip and stay low, she says.

"We found about 70 per cent of those tested fall in the first group, who could substitute the use of anaesthetic - which has uncomfortable side effects - with acupuncture.

"But the other 30 per cent require a combination of acupuncture and anaesthetic in a surgical operation."

Acupuncture, she says, works because the sensation of the needle - a sore, swelling and numbing sensation - acts on the pain-modulating system in the brain, which releases an opiate peptide, suppressing the pain of the operation.

Later, her team conducted research on the use of acupuncture in treating chronic pain and found it effective in treating diarrhoea, constipation and high blood pressure, and in helping stroke patients recover.

She is now director of the Institute of Acupuncture Research and Centre of Clinical Pain Research at her university, and is vice-president of the Beijing-based All-China Society of Acupuncture and Moxibustion (a TCM therapy that relieves muscle pain by burning herbs on the skin surface).

In her more recent work, she focuses on how acupuncture bolsters the body's natural immune system.

However, the study to do a scientific map of jing mai has proved elusive. This is the system of channels and sub-channels joining the acupressure points through which the body's vital energy and body fluids flow, according to TCM theory.

Despite much work by acupuncturists, anatomy experts, physiologists and others, only nerve endings and blood vessels have been found under the acupoints.

During the course of her work, Prof Cao has met many of China's senior leaders. One encounter stuck in her mind.

"I was most taken with Premier Zhou Enlai - he told me that until science could explain how acupuncture works, there will always be doubters."

Dear Dr. King,

Since 1964, there are various further researches have been going on in the West, such as the following works as listed below ( for examople):


In 1995, George A. Ulett, M.D., Ph.D., Clinical Professor of Psychiatry, University of Missouri School of Medicine, stated that "devoid of metaphysical thinking, acupuncture becomes a rather simple technique that can be useful as a nondrug method of pain control." He believes that the traditional Chinese variety is primarily a placebo treatment, but electrical stimulation of about 80 acupuncture points has been proven useful for pain control [1].

Two scientists at the University of Heidelberg have developed a "fake needle" that may enable acupuncture researchers to perform better-designed controlled studies. The device is a needle with a blunt tip that moves freely within a copper handle. When the tip touches the skin, the patient feels a sensation similar to that of an acupuncture needle. At the same time, the visible part of the needle moves inside the handle so it appears to shorten as though penetrating the skin. When the device was tested on volunteers, none suspected that it had not penetrated the skin [2].

In 2004, a University of Heidelberg team proved the worth of their "sham acupuncture" technique in a study of postoperative nausea and vomiting (PONV) in women who underwent breast or gynecologic surgery. The study involved 220 women who received either acupuncture or the sham procedure at the acupuncture point "Pericardium 6" on the inside of the forearm. No significant difference in PONV or antivomiting medication use was found between the two groups or between the people who received treatment before anesthesia was induced and those who received it while anesthetized [3]. A subgroup analysis found that vomiting was "significantly reduced" among the acupuncture patients, but the authors correctly noted that this finding might be due to studying multiple outcomes. (As the number of different outcome measures increases, so do the odds that a "statistically significant" finding will be spurious.) This study is important because PONV reduction is one of the few alleged benefits of acupuncture supported by reports in scientific journals. However, the other PONV studies claiming to show positive results have not been as tightly controlled..

I just wonder, in China, whether have such similar researches have been initiated or fulfilled , so far? You may wish to comment on some of them, please?

Thanks.

Chenkc


References

[1] Ulett GA. Acupuncture update 1984. Southern Medical Journal 78:233­234, 1985

[2] Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet 352:364-365, 1998.

[3] Streitberger K and others. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: A randomised placebo-controlled patient and observer blind trial. Anesthesia 59:142-149, 2004.

Dear Chenkc,
Nice to meet you here again!
As the research is concerned, there have been many kinds of research on acupuncture in China, and also a great number of research institutions as well.
In personal opinion, it's a little difficutl to do the clinical research on acupuncture, especially on the patients. That's because of the manipulations. Everybody would be different more or less in the needling techniques, even with the same technique but in different points, or with the same technique in the same point but in different patient.
In fact you know, the acupuncture physicians cannot do the same technique exactly the same, some would do much better than the others. So, the effect would be quite different. Or sometimes, the same physician would not be so good in the technique, because of the mental or physical factors.
Also, in my personal opinion, it's not so easy to permorm the so-called sham or fake acupuncture in China, for patients would know well how the real acupuncture is felt, so they would be suspicious with the fake acupuncture. So the research will not well do.
That's my personal opinions.