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Wednesday November 5 6:26 PM EST
NIH Issues Acupuncture Findings
BETHESDA (Reuters) -- A 12-member Consensus panel convened by the National
Institutes of Health (NIH) concluded Wednesday that acupuncture treatment
is effective for postoperative pain, chemotherapy-induced nausea and
vomiting, nausea of pregnancy, and postoperative dental pain.
There are a number of other pain-related conditions in which acupuncture
could be considered an effective adjunct therapy, an acceptable alternative
or part of a comprehensive treatment program, the experts said. While there
is less convincing scientific data to support acupuncture's impact on these
pain-related conditions, panelists listed stroke rehabilitation, headache,
addiction, menstrual cramps, tennis elbow, fibromyalgia, low back pain,
carpal tunnel syndrome, and asthma as conditions for further investigation.
The panel found that the rate of adverse effects associated with
acupuncture is low and often less than side effects associated with
conventional treatments for these painful conditions.
NIH Consensus Development panelists acknowledged that the evidence may not
demonstrate that acupuncture is efficacious in other conditions such as
smoking cessation. However, acupuncture may be effective in smoking
cessation if combined with a comprehensive medical program that involves
behavioral modification techniques, panel member Dr. Leonard A. Wisneski of
One focus of attention by the conference was the role of endogenous opioids
in acupuncture analgesia. Evidence supports the claim that opioid peptides
are released during acupuncture and that the analgesic effects of
acupuncture are at least partially explained by these actions. The finding
that opioid antagonists such as naloxone reverse the analgesic effects of
acupuncture further strengthens this hypothesis, Wisneski said.
Stimulation by acupuncture could also activate the hypothalamus and the
pituitary gland and result in a broad spectrum of systemic effects.
The experts presented data suggesting that acupuncture alters the secretion
of neurotransmitters and neurohormones and regulation of blood flow, both
centrally and peripherally. There is also evidence of immune function
alterations associated with acupuncture. It is presently unclear which of
these and other physiological changes mediate clinical effects, the
Despite efforts to understand the anatomy and physiology of the acupuncture
points, the definition and characterization of these points remains
elusive. The panel stated that further studies are needed to validate the
The panel concluded that there is sufficient evidence of acupuncture's
value to expand its use into conventional medicine and to encourage study
designs that can withstand rigorous scientific scrutiny.
The experts drew attention to a shortcoming of many of the studies that
involved acupuncture. The problem, according to Dr. Marjorie A. Bowman of
the University of Pennsylvania, is that inserting needles into the body
anywhere will have some biologic effects and the fact that sham acupuncture
has intermediate effects that may complicate study findings.
The consensus panel advocated uniform licensing, certification, and
accreditation of acupuncturists among states, and increased patient
communication skills for both acupuncturists and physicians. The panel also
called for broader public access to acupuncture treatment, which could
involve expanded coverage by government and private payors.
The panel issued their consensus statement following an extensive review of
the existing medical literature and a series of presentations by
acupuncture research experts at a three-day NIH Consensus Development
Conference on Acupuncture.
Acupuncture can be traced back for at least 2,500 years. The general theory
of acupuncture is based on the premise that there are patterns of energy
flow (Qi) through the body that are essential for health. Disruptions of
this flow are believed to be responsible for disease, and the belief
underlying the technique is that the acupuncturist can correct imbalances
of flow by inserting needles at identifiable points in the skin.
More than one million Americans are estimated to use acupuncture. In 1993,
the Food and Drug Administration reported that Americans spent $500 million
annually and made about 9 to 12 million patient visits for acupuncture
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