Evidence Based Acupuncture: Paediatric Acupuncture – Evidence Summary
IEvidence Based Acupuncture: Paediatric Acupuncture – Evidence Summary Natalie Saunders and Katherine Berry
EJOM Vol. 9 No. 4 (2019)
13-27 per cent of children are now being affected by chronic childhood conditions. These may last into adulthood and can have a significant impact on the whole family as well as the affected child. Therefore, it is unsurprising that many families are now seeking complementary and alternative medicine (CAM) therapies for their children’s conditions. This article looks at reviews which have found acupuncture to show particular promise in the treatment of paediatric pain, cerebral palsy, nocturnal enuresis, tic disorders, amblyopia, nausea and vomiting, digestive disorders, autistic spectrum disorder, and respiratory disorders.
Impact of Opioid Epidemic on Mothers and Infants: Could Acupuncture be a Solution for NAS?
Impact of Opioid Epidemic on Mothers and Infants: Could Acupuncture be a Solution for the Dramatic Rise in Neonatal Abstinence Syndrome (NAS)? Natalie Saunders and Katherine Berry
EJOM Vol. 9 No. 4 (2019)
One aspect of the opioid crisis which is less frequently discussed is the impact on the next generation, in particular the increased incidence of neonatal abstinence syndrome (NAS). The increased prescribing of prescription opioids over the past two decades has transformed this into a problem affecting all socioeconomic groups. Acupuncture has long been used in the setting of detox clinics, leading researchers to investigate whether this traditional therapy could also prove useful in the treatment of NAS. Early findings are extremely promising, as this article outlines.
Acupuncturists and the Coronavirus Pandemic: A Survey of UK Acupuncturists in June 2020
EJOM Vol. 9 No. 6 (2021)
In the aftermath of the first national lockdown, 251 practitioners participated in an online survey on how they had been affected. The survey was available for completion from 6th June to 7th July 2020. Consisting of both multiple-choice and long-answer questions, the survey gathered information on the financial impact, mental health and emotional responses, health and safety, and planning and concerns for the future. The study generated much valuable data which may assist all acupuncturists if further emergencies arise. It may also assist acupuncture governing bodies as they prepare guidance for other potential future crises.
Five Element Acupuncturists' Experiences of Building Rapport
Five Element Acupuncturists' Experiences of Building Rapport and a Therapeutic Relationship with Patients - A Qualitative, Exploratory Study Sally Anderson
EJOM Vol. 9 No. 3 (2019)
A qualitative, exploratory study, investigating the experiences of six Five Element Acupuncturists in building therapeutic relationships and rapport with new patients. UK-based, semi-structured individual interviews were audio-recorded and transcribed verbatim. Descriptive data was analysed for emerging themes using inductive thematic analysis. Within the categories of (1) ‘Creating a safe environment’, (2) ‘Building trust’, (3) ‘Therapeutic skills’, and (4) ‘Constitutional Factor interaction’ practitioners described actions they took to actively build or promote rapport and relationship. Rapport emerged as a multidimensional, multifactorial phenomenon. Patients were offered a therapeutic relationship through the lenses of the element identified to be their Causative Factor, by means of Five Element Acupuncturists altering their own emotions, behaviours and discourses to ‘meet’ the patient in their element and on the level of body, mind or spirit.
A Treatment of Knee Osteoarthritis - A Chinese Medicine Approach
A Treatment of Knee Osteoarthritis – a Chinese Medicine Approach with a Combination of Acupuncture and Moxibustion Kian Fui Yong, Bao Ling Hoo and Ling Shing Wong
EJOM Vol. 9 No. 2 (2018)
Knee osteoarthritis (KOA) is related to serious syndromes; persistent knee pain, swollen knee joints and stiffness, and can lead to disability. In Chinese medicine, acupuncture is considered to have a good analgesic effect on knee pain. In this study, the effect of warming needle treatment was observed on four subjects with serious KOA. The results showed significant reduction of knee pain, and this pilot study suggests that a larger study of warming needle method in the treatment of KOA is justified.
Can Acupuncture Improve the Quality of Life for People Suffering from Parkinsons Disease?
Can Acupuncture Improve the Quality of Life for People Suffering from Parkinson’s Disease? Helen Were
EJOM Vol. 9 No. 2 (2018)
Parkinson’s disease (PD) affects one in five hundred people, but while the impact of acupuncture on alleviating PD symptoms has been studied, its effectiveness is still in question. This study will review recent trials on the use of acupuncture as an adjunct to Western medicine to determine if sufficient recent evidence now exists to make a more definitive statement about the effectiveness of acupuncture for PD patients. While the methodologies and sample sizes of some trials could be improved, this study shows that evidence is building to support the use of acupuncture to alleviate PD symptoms.
Critical Review and Case Reports on the Effect of Acupuncture and Traditional Chinese Medicine in Ca
Critical Review and Case Reports on the Effect of Acupuncture and Traditional Chinese Medicine in Cancer Care Dan Jiang, Fanyi Meng and Lily Li
EJOM Vol. 9 No. 2 (2018)
Although traditional Chinese medicine (TCM) has been widely used in China and other East Asian countries for helping cancer patients and clinical research is strongly supporting the use of it, it is not available to most patients who are treated on the NHS in the UK, due to the fact that there is not enough evidence for using TCM in cancer patients. The authors reviewed the currently available clinical reports regarding TCM treatment of cancer patients, and propose a role for TCM as an assistant therapy to the mainstream therapies. Four clinical practice cases in the UK, diagnosed as cancer by the mainstream, are also included.
Acupuncture in the Supportive Care of Colorectal Cancer Survivors: Four Case Studies, Part 2
Acupuncture in the Supportive Care of Colorectal Cancer Survivors: Four Case Studies, Part 2 Beverley de Valois and Rob Glynne-Jones
EJOM Vol. 9 No. 1 (2018)
Colorectal cancer is one of the most prevalent cancers worldwide, yet there is little information about using acupuncture to support people living with and beyond the disease. A philanthropically funded hospital-based outpatient acupuncture service facilitated long-term treatment for colorectal cancer survivors experiencing consequences of cancer treatment. In this two-part paper, the authors present four case studies illustrating how acupuncture affected a range of troublesome symptoms experienced by patients who had completed cancer treatments (surgery, radiotherapy and chemotherapy). This is part two of the article, and discusses two cases with multiple long-term consequences and comorbidities. The cases are enriched by comments written by the patients themselves and by their oncologist, providing a broader view of the effects of acupuncture treatment.
NADA Acupuncture at Al Manaar Mosque post Grenfell
NADA Acupuncture at Al Manaar Mosque post Grenfell Rachel Peckham
EJOM Vol. 9 No. 1 (2018)
NADA acupuncture has been used across the globe to help people suffering trauma following a catastrophic event. Following 9/11, an integrative stress management programme was set up close to the World Trade Center site to offer treatment for the community in Manhattan and New York. Between 2001 and 2007 there were 40,000 visits to the programme. People chose their treatments: 1 per cent chose counselling, 44 per cent chose massage/energy therapy and 55 per cent chose to have NADA acupuncture.
NADA GB and World Medicine are running a NADA clinic one morning a week at the Al Manaar Cultural Centre in North Kensington to offer treatment to the community in the aftermath of the Grenfell fire. Over a 24-week period, data collected so far shows there have been 322 treatments given to 126 people. People are returning for treatment, some every week. A large proportion are reporting that it is helping them.
Acupuncture in the Supportive Care of Colorectal Cancer Survivors: Four Case Studies, Part 1
Acupuncture in the Supportive Care of Colorectal Cancer Survivors: Four Case Studies, Part 1 Beverley de Valois and Rob Glynne-Jones
EJOM Vol. 8 No. 6 (2017)
Colorectal cancer is one of the most prevalent cancers worldwide, yet there is little information about using acupuncture to support people living with and beyond the disease. A philanthropically funded hospital-based outpatient acupuncture service facilitated long-term treatment for colorectal cancer survivors experiencing consequences of cancer treatment. In this two-part paper, the authors present four case studies illustrating how acupuncture affected a range of troublesome symptoms experienced by patients who had completed cancer treatments (surgery, radiotherapy and chemotherapy). The cases are enriched by comments written by the patients themselves and by their oncologist, providing a broader view of the effects of acupuncture treatment.
Sports Injuries – Improved Healing Processes due to Integrative TCM Therapy
Sports Injuries – Improved Healing Processes due to Integrative TCM Therapy Karl Zippelius and Angela Schwarzinger
EJOM Vol. 8 No. 5 (2017)
Sport injuries are, both in hobby and professional sport, something that happens regularly. In a worst case scenario they may end a sports career. A fast and painless comeback with a minimum in performance loss is therefore of the highest priority. Integrative TCM therapy to unblock qi and Blood stagnation stimulates healing and shortens recovery time, producing better results than conventional therapy
The Role of Communication in Traditional Acupuncture: Findings from an exploratory study
The Role of Communication in Traditional Acupuncture: Findings from an exploratory study using thematic qualitative analysis of practitioner interviews Jonquil Westwood Pinto
EJOM Vol. 8 No. 5 (2017)
This paper reports on a thematic analysis, semi-structured interview study of practising traditional acupuncturists, with a range of clinical experience and styles of practice. The aim of the study was to gain an insight into how these practitioners communicate Chinese medicine (CM) concepts to Western, English-speaking patients and consider why this communication may be important. Specific methods of communicating CM concepts are reviewed (psychological, metaphorical, somatic and narrative). The report considers how approaches to practitioner-patient communication can have therapeutic benefits and proposes a tentative model of the key types of communication and the therapeutic functions of communication in traditional acupuncture.
How do Acupuncturists Engage with Research in their Practice?
How do Acupuncturists Engage with Research in their Practice? Stephanie McGrath
EJOM Vol. 8 No. 5 (2017)
By means of semi-structured interviews and thematic analysis, the meanings and interpretations of research, utilisation of research literature in practice and experience of participation in research studies made by six tradionally based acupuncturists, each with more than ten years clinical experience, were explored. Findings are discussed, and conclusions offered.
Talking the Same Language: A Systemic Esperanto for a Global Chinese Medicine
Talking the Same Language: A Systemic Esperanto for a Global Chinese Medicine Yan Schroën
EJOM Vol. 8 No. 4 (2016)
Chinese medicine, especially acupuncture, is becoming increasingly accepted in Western society. Within the field of complementary medicine, acupuncture is now one of the most consulted therapies, leading to an increasing economic interest in Chinese medicine. Governments and health insurers want to engage with complementary medicine, and so with Chinese medicine. Acupuncture and Chinese medical associations look to health insurance companies and governments for recognition and compensation for their members. But do these governments and health insurance companies have the knowledge and expertise necessary to develop guidelines and rules? In our profession's search for legitimacy and authenticity we oscillate between validating what we do by referencing either modern research or the ‘classics’.
Balance Acupuncture for Pain Relief in Cancer Patients in a Multibed setting
Balance Acupuncture for Pain Relief in Cancer Patients in a Multibed setting – An Internal Feasibility Audit Briony F. Hudson, Robin Burby, Natalie Silverdale and Lesley Storey
EJOM Vol. 8 No. 4 (2016)
This study explores the potential of offering balance acupuncture in a multibed setting for cancer patients experiencing pain. Nine cancer patients attended a six-week course of balance acupuncture delivered in a multibed setting. Two validated assessment measures (MYCaW (Measure Yourself Concerns and Wellbeing) and the pain thermometer) were used to assess changes at baseline, after three weeks of treatment and at the end of a six-week course of treatment. It was found that balance acupuncture in a multibed setting was effective in reducing pain intensity in this patient sample. Formalised research in this area is warranted.
Limiting Chemotherapy Side Effects by Using Moxa Beverley de Valois, Teresa Young, Rob Glynne-Jones, Clare Scarlett and Friedrich Staebler
EJOM Vol. 8 No. 3 (2016)
This trial aims to investigate the feasibility of teaching cancer patients undergoing chemotherapy within the NHS to self-administer daily indirect moxibustion to St 36 zu san li. This will begin to assess whether this intervention can reduce chemotherapy induced pancytopenia, specifically neutropenia, anaemia, and thrombocytopenia, and facilitate patients completing chemotherapy without delays or dose reduction.
TCM in Metastatic Lung Cancer: Prognosis and Complementary Treatment of Advanced Pulmonary NSCLC
TCM in Metastatic Lung Cancer: Prognosis and Complementary Treatment of Advanced Pulmonary Non-Small-Cell Lung Cancer (NSCLC) Jan Baak, Michael McCulloch, Carl-Hermann Hempen.
EJOM Vol. 8 No. 2 (2015)
The most frequently occurring lung cancer type is non-small-cell cancer (NSCLC). Over the past three decades, the median survival time of advanced NSCLC has increased from approximately six months in the 1980's to nine months twenty years later; mortality rates are still very high. This article looks at recent studies which have given a strong positive signal that complementary/supportive TCM-herbal treatment next to conventional platinum-based chemotherapy improves prognosis in advanced NSCLC patients. Several of the TCM herbs used have an immune-stimulating effect, of particular interest for nivolumab-treated patients. Additional research needed to obtain definitive clinical evidence for the prognosis-improving effect of TCM treatment in conjunction with platinum-based chemotherapy is also discussed, and recommendations made for supportive clinical management of NSCLC with complementary TCM at the present time, until such data is available. Read the whole article.
Using the NADA Protocol to Improve Wellbeing for Prostate Cancer Survivors: Five Case Studies
Beverley de Valois and Tarsem Degun EJOM Vol. 8 No. 1 (2015)
This paper presents case studies of five men diagnosed and treated for prostate cancer, who participated in a project to assess the potential for using the NADA ear acupuncture protocol to improve wellbeing. Selected for their diversity, they illustrate the range of diagnoses, treatments, and associated bothersome symptoms experienced by prostate cancer survivors. They also illustrate the variety of ways that NADA acupuncture in a group setting can contribute to overall wellbeing. Examining the progress of these individuals through treatment provides valuable insights into the effects of NADA treatment. These cases may influence perceptions of clinicians, patients, acupuncturists and funders about NADA's potential role in the ongoing support of men with cancer of the prostate. They also suggest that future research is warranted.
Survey of Patient Profiles Attending for Acupuncture
Mary Pender EJOM Vol. 8 No. 1 (2015) Acupuncture is now considered an evidence-based treatment for multiple conditions and is being incorporated into mainstream healthcare1. Many factors influence patients’ decisions to attend for acupuncture treatment.
The aim of this study is to review the demographics of patients who attended an established acupuncture clinic over a period of 20 years, to determine their diagnosis, referral source, and factors influencing their decision to attend for treatment.
A questionnaire was given to people when they attended for treatment. The majority answered the questions while at the office. Some people took them away and returned them at a later date. The design was simple, comprised three pages and took about five minutes to complete.
With the help of this questionnaire we looked at patients’ age groups, how many times they attended, who recommended them, what problems they suffered with and what their expectations were regarding the treatment and the treatment outcome.
Survey and Audit to Evaluate Our Work - Finding a Model which Describes the Way We Work
Friedrich Staebler EJOM Vol. 8 No. 1 (2015) Survey and audit are useful ways of monitoring our work, of taking a closer look at who has attended our clinic over what period of time, what kind of condition(s) they presented with and how they responded to treatment. This can be done in search of outcome and evidence (audit), or for evaluating our work and learning from the successes and failures, leading to better fine-tuning and ultimately more efficient ways of working (survey).
As I have seen a trend over recent years towards a majority of long-term patients with chronic conditions, not easily classifiable with a diagnosis and often with multifactorial underlying pathology, who required individually tailored, long-term treatments, I had to find a format for surveying the outcome of my work that would be adequate for that task. I studied various commonly employed methods to measure treatment outcome, like MYMOP and the SF-36 health survey, but ended up with a survey format which I developed for myself. This article is an attempt to describe that process.
Vivien Shaw and Claire Aland EJOM Vol. 7 No. 6 (2014) The physical nature of the acupuncture meridian system is currently the subject of enquiry. The original structural descriptions for the meridian system contained in the Huang Di Nei Jing, The Yellow Emperor's Canon of Internal Medicine, are detailed and specific. The Nei Jing states that dissection has been used as a tool for looking at the anatomy of the human body. The words used in the Nei Jing to describe meridians repeatedly contain the character for silk. The fascia of the body resembles silk in appearance. It pervades the body, wrapping around every structure, alternatively separating structures, or connecting them. An obvious question arises: was the character for silk chosen to describe meridians because it was what was observed by dissection by the authors of the Nei Jing? If this hypothesis holds, the nature of the physical substrate for acupuncture could then be literally described in the characters originally used for the meridian network - the silk-like fascial tissue of the body.
What Do We Mean by the 'Nonspecific' effects of Acupuncture Treatment?
EJOM Vol. 7 No. 6 (2014)
People writing about acupuncture often mention its 'nonspecific' effects. However, there are considerable differences of opinion, indeed some confusion, regarding the meaning of this term. The objective of the present paper is to shed some light on this situation. As part of an ongoing project to explore nonspecific feelings elicited by electroacupuncture-related treatment, twenty experienced acupuncture practitioners and researchers were asked about their understanding of the term 'nonspecific'. Sixteen of the twenty professionals responded, and their comments are summarised.
Acupuncture in the Prevention and Control of Postoperative Nausea and Vomiting
C. Ferrari, M. De Ruvo, F. Minuti, R. Gatto and R. Monzani EJOM Vol. 7 No. 6 (2014) Postoperative Nausea and Vomiting (PONV) affects 30 per cent of general surgery patients and can occur in up to 80 per cent of high-risk patients. Acupuncture is the most studied non-pharmacological approach to PONV and its efficacy is validated. Previous studies validated P 6 nei guan as the most effective and versatile point for the prevention of PONV. We sought to implement its stimulation in our setting by non-acupuncturist anaesthesiologists and evaluate its efficacy independently of the type of surgery and anaesthesia.
The Therapeutic role of the Practioner's Heart in Classical Chinese Medicine and Modern Medical Scie
Stephane Espinosa EJOM Vol. 7 No. 5 (2014)
This critical literature review focuses on the therapeutic role of the practitioner’s heart, with emphasis on the acupuncturist’s perspective. The relevant descriptions given in classical Chinese medicine are presented. In particular, the appropriate attitude of the practitioner during treatment is discussed, highlighting the importance of compassion and clarity of intention. This is followed by a description of the acupuncture needle’s role of energetic link with the patient. Parallels were identified with results from modern research showing that positive emotions such as compassion increase the coherence of the cardiac electromagnetic field, and thereby interpersonal effects such as cardiac energy exchange and synchronisation of heart rates and heart-brain wave patterns. The importance of these findings in providing a rationale for a patient-centred approach to treatment is discussed, together with the need for further research within the framework of modern validation of classical Chinese medicine.
A Feasibility Study of Acupuncture for the Treatment of Children with Autism Spectrum Disorder
Jonathan Pledger EJOM Vol. 7 No. 5 (2014)
Autistic Spectrum Disorder (ASD) impacts on every aspect of a child’s life and the number diagnosed with this lifelong condition is growing. Few studies have researched acupuncture and ASD. This study uses an integrated Traditional Chinese Medicine (TCM) and Five Element style of acupuncture and differential diagnosis with individualised treatments.
Exploring Acupuncture for the Treatment of Depression within UK Primary Care
Julia Bletcher EJOM Vol. 7 No. 5 (2014)
Depression is a debilitating condition and patients suffering with depression are prevalent in UK primary care. However, suitability for current treatments leaves up to 30% of patients lacking appropriate care. If proven effective, acupuncture may be a suitable intervention to expand current NHS treatment options. Recent critical literature reviews of studies prior to 2010 highlight a need for more robust studies. The aim of this research is to explore the latest evidence of acupuncture efficacy for depression. An electronic database search was conducted of randomised control trials since 2010 exploring the efficacy of acupuncture. The results showed 19 of 22 studies supported acupuncture for depression. However, a number of methodological limitations were identified and there was limited data concerning long-term benefits. Although outcomes suggest acupuncture could be considered as a treatment for depression in UK primary care, more robust research is still needed. In addition, the majority of existing research does not reflect current clinical practice. Therefore, further investigation using a more pragmatic approach is recommended.
The Purpose of Self-Injury and Clinical Implications for Acupuncturists
Sarah Attwell-Griffiths and Mark Bovey EJOM Vol. 7 No. 5 (2014)
Self-injury is prolific, often chronic and linked to suicide risk. Conventional medical research into self-injury is extensive, but CAM research is limited to a single study (Bell et al, 2011) that demonstrates that self-acupuncture reduces self-injury. This paper uses literature research to derive a TCM interpretation of how self-injury works, and then explores clinical implications.
Acupuncture and Moxibustion in the Management of Non-Cancer-Related Lower Limb Lymphoedema
Beverley de Valois EJOM Vol. 7 No. 4 (2013)
This paper presents case studies of three patients with non-cancer-related lymphoedema of the lower extremities, who participated in a project to assess the potential for using acupuncture and moxibustion as an adjunct to usual lymphoedema care. They illustrate how people with lymphoedema and complex co-morbidities (including morbid obesity) can benefit from treatment, and how reducing the symptom burden increases their ability to self-manage their chronic, incurable condition. They also demonstrate that acupuncture treatment can be effective even when large areas of the body are contraindicated to needling. Also shown are some of the practical challenges of dealing with morbidly obese patients. These case studies may influence existing perceptions of clinicians, patients, and acupuncturists about acupuncture’s potential role in the management of lymphoedema, and they suggest that research into this area is warranted.
Acupuncture patients’ presentation is often complex,longterm and multifaceted. Many have wide expectations of what treatment can offer and value generalised changes in factors such as energy and stress levels, which may not be related to the original presentation. The objectives of this study are to investigate whether research processes and outcome measures used in current acupuncture studies adequately reflect both the treatment process and the factors that patients experience. The data were collected from an observational study at a student acupuncture clinic at the College of Integrated Chinese Medicine (CICM) in Reading, UK. There were 12 clinics, attended by 495 patients, who completed 3 types of questionnaire. The outcome measures were SF-36, CICM, MYMOP, 9-point VAS scale. The majority of responding patients reported major or moderate changes in wellbeing, energy levels, emotions, stress and confidence/self-esteem. Patients could distinguish between the wider factors assessed and their main complaint apart from wellbeing and general health. Most health seekers reported full or major improvement in their main complaint compared to about half of health improvers. Patients’ priorities in treatment change over time; some adjust the focus of their treatment and long-term patients hope for different benefits.
Taking the Plunge…the Perils of Researching Chinese Medicine; and Suggestions on How to Survive Them
Andrew Flower EJOM Vol. 7 No. 3 (2013)
The author prefaces his piece with the comment that, in his experience, "research is a bit like one of those apparently calm and ordered seas which hide subtle currents and not so subtle riptides that can pull the unwary swimmer miles away from their intended destination far out into an unfamiliar and threatening ocean." In the first part of his article, he attempts to chart some of these currents, and then suggests "a few strategic resolutions that could be used to contribute to a safe and successful crossing."
This paper is written in two parts. Rachel Peckham and Jacqueline Mangold both worked as clinicians/clinical supervisors at the Core Trust over a collective period of fourteen years. The Core Trust is a community based rehabilitation programme for people with substance misuse problems. The model used is innovative, interesting and successful; offering acupuncture and counselling / psychotherapy as the main treatments. The paper is written in two parts, reflecting both author’s experience and observations as clinicians at the Core Trust. Rachel ran a study on the role and the impact of the NADA auricular acupuncture group treatment given daily at the project. Twelve participants, at different stages of the programme were interviewed once as a means of data source, and a qualitative analysis was carried out using grounded theory. Jacqueline collected data via MYMOP2 questionnaires from clients that were receiving one-to-one body acupuncture at the onset and end of their treatment.Results from both studies raise interesting questions about the nature of addiction and the positive role acupuncture can play in the recovery of the addicted person.
Using acupuncture in lymphoedema management is controversial, as it is feared that it may introduce infection or exacerbate lymphoedema. This paper presents case studies of four cancer survivors who participated in an exploratory study investigating the use of acupuncture and moxibustion as an adjunct to usual care for lymphoedema to promote wellbeing and improve quality of life. They illustrate how individualised treatment plans meet the diverse and changing needs of patients with a complex, chronic side effect of cancer treatment for which there is currently no cure. They also demonstrate that acupuncture treatment can be effective even when large areas of the body are contraindicated to needling. The stories of these four participants may help influence existing perceptions on the parts of clinicians, patients, and acupuncturists about acupuncture’s potential role in the management of lymphoedema.
The Effectiveness of Acupuncture in the Management of Psychosis - An Evaluation
Dr Helen Rogers (edited and abridged by Dominic Harbinson) EJOM Vol. 6 No. 5 (2010-11)
This article is an edited and abridged version of a report, based on a study conducted in Walsall in 2008-2009, evaluating the effectiveness of acupuncture for people with psychosis. The study’s methodology utilised validated quantitative research tools and semi-structured interviews conducted with participants and their carers, relatives or partners. Strong evidence emerges from both the quantitative and qualitative data that there were significant improvements in service users’ mental health and general wellbeing following a course of acupuncture. These included: significantly improved sleep patterns; reduced anxiety and stress levels; better physical health; better eating habits; and increased self confidence and self esteem. Read the whole article
Acupuncture and Schizophrenia - Effect and Acceptability: Preliminary Results of the First UK Study
This article reports on a small pre-clinical pilot study to explore the acceptability and effects of acupuncture in the treatment of schizophrenia. It outlines the research question and methods used and presents preliminary results of the qualitative and quantitative data gathered. Eleven participants who had been diagnosed with schizophrenia were recruited to the study. They had not had complete remission of symptoms despite treatment, and/or they suffered from the side-effects of antipsychotic medication. In addition to standard care, participants received individual assessment and treatment with acupuncture using a traditional Chinese medicine approach. Treatments were given twice a week for 10 weeks. The preliminary results from this study are very positive, indicating that acupuncture treatment yielded a wide range of benefits in terms of improved quality of life, as well as reductions in the symptoms of schizophrenia and the side effects of anti-psychotic medication. Of particular note are motivational and physical health improvements, especially relating to sleep, energy levels and social engagement. Read the whole article
The Pros and Cons of Sham Acupuncture
Mike Cummings EJOM Vol. 6 No. 4
In this short but penetrating article the author, who serves as Medical Director of the British Medical Acupuncture Society (BMAS) and editor of the journal Acupuncture in Medicine, reviews the arguments for and against the use of sham acupuncture in clinical trials. He suggests that, until the effects of sham techniques are better understood, clinical research should be designed either to compare acupuncture with the best existing conventional treatments, or to evaluate its potential as an adjunct to conventional care compared to conventional care alone.
How Acupuncture is Actually Practised, and Why This Matters to Clinical Research Design
Claire M Cassidy EJOM Vol. 6 No. 4
When practising acupuncturists are asked to explain what they actually do when delivering acupuncture care, a highly fluid and responsive picture of care emerges. This matches well with the East Asian medical explanatory model of Qi Flow. Their practice model gives approximately equal weight to the patient-practitioner relationship and the delivery of techniques of acupuncture such as needling. Most clinical trials of acupuncture care to date have, however, not utilised these features, but instead imposed a rather static 'sham' control model borrowed from biomedicine, which is guided by a different medical explanatory model and practice habits. Imposing one medical model on another medicine creates a methodological fault of model fit validity – in short, until acupuncture is clinically assessed as it is practised, we cannot know much about its capabilities. The author's hopes are that a) there will be more and larger studies of how acupuncturists think about and deliver care, and that b) future clinical trials will increasingly tend the issue of model fit validity and create trials that accurately assess and reflect the capabilities of acupuncture care.
This strategic overview revisits some of the basic assumptions that relate to the clinical valuation of acupuncture. We look at the clinical and mechanistic evidence available to estimate both the specific and nonspecific effect size of acupuncture (efficacy and effectiveness) and consider the placebo within acupuncture trials. We hope that by taking a broad and rigorous approach we may arrive at a realistic and thoughtful evaluation of its relative value in comparison to placebo treatment.
"Defining best practice...? Elementary my dear researcher."
Andrew Flower EJOM Vol. 6 No. 4
In this brief but engaging article, the author ruminates on the political nature of research and on the problems this poses for East Asian Medicine, and points to the fact that the thorny business of defining best (or at least 'good enough') practice is of central importance here. He concludes by offering a richly simple model - based on the Five Phases (wu xing) - for defining what best practice is.
Evaluating the Effect of Treatment from the Patient's Perspective
Charlotte Paterson EJOM Vol. 6 No. 4
This paper argues that acupuncture should be evaluated on the basis of whether it improves people's health in ways that are important to individual patients. This focus on patient-centred outcomes and an individualised approach is in keeping with the underlying philosophy of East Asian medicine. In acupuncture practice there is an ongoing dialogue between the practitioner's expert knowledge and the patient's individual knowledge and experience of their health and illness. However when it comes to research, the patient's perspective and subjective experience is often removed, and other 'objective' criteria are used to assess whether the treatment is helpful. There is now, however, a move towards patient-centred outcomes and there are many scientifically sound questionnaires that can be used. Qualitative research has been used to understand what treatment effects acupuncture patients' experience, to prioritise and to develop a number of patient-centred questionnaires, or sets of questionnaires which attempt to measure these. In this paper I briefly describe this work, focusing especially on individualised questionnaires and their use in evaluating acupuncture and other complementary therapies. Using an example from cancer support care I explore how qualitative and quantitative methods can be combined to provide rich and meaningful evaluations of the effects of treatment.
Acupuncture/Moxibustion RCT for Distal Sensory Peripheral Neuropathy in HIV/AIDS
Joyce K. Anastasi, Bernadette Capili, Ann M. Chung, Richard Hammerschlag EJOM Vol. 6 No. 4
Distal sensory peripheral neuropathy is a common neurological complication experienced by people living with the human immunodeficiency virus (HIV). Traditional Chinese medicine (TCM) may offer effective interventions in the management of its symptoms. To improve the quality and transparency of reporting acupuncture clinical trials, the Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed in 1996 and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) recommendations were introduced in 2001. Incorporating international guidelines, this paper describes the development of a RCT including rationale, design, methods, procedures and logistics for a pilot study aimed at evaluating acupuncture and moxibustion for neuropathy associated with HIV. Using STRICTA guidelines as a template, aspects of clinical research design are explored to further optimise future studies of TCM.
Moxibustion and Immune Response A Review Study - Part 2
Merlin Young and Jenny Craig EJOM Vol. 6 No. 4
A large amount of published research on the potential immunological effects of direct moxibustion remains relatively unexplored in English. In Part One of this study we featured the many indicators in the classical literature of East Asian medicine which suggest that moxa was used in ways that almost certainly had effects on the immune system and also identified more recent research. Here we explore the more recent research evidence which is often inconsistent, and attempt to draw some useable ideas from it. We also suggest a possible mechanism by which moxa dosage may influence the type of immune response. The conclusions, though tentative, seem worthy of deeper exploration. Specific strategies are suggested which might facilitate this.
Filling the Whole in Acupuncture Part 2: What are we Doing in the Supplementation Needle Technique?
Stephen Birch EJOM Vol. 6 No. 3 (2009)
In the first part of this paper (published in EJOM Vol 6 No 2) the author discussed the purposes, traditional explanations and possible mechanisms of the supplementation needle technique and began to model what might be happening when we apply it. He highlighted local and global qi circulatory effects triggered by the act of needling, and also the effects arising out of the interaction between the person needling and the person being needled. In this concluding part of the paper, he proposes various scientific perspectives and models that could explain the same observed effects of the needling and their various interactional effects, including mental interactional effects. Finally he briefly discusses the implications of this for understanding acupuncture practice.
Direct Moxibustion and Immune Response: A Review Study - Part 1
Merlin Young and Jenny Craig EJOM Vol. 6 No. 3 (2009)
There is a large amount of published research on the potential immunological effects of direct moxibustion which remains relatively unexplored in English. There are also many indicators in the classical literature of oriental medicine that moxa was used in ways that may have had direct effect on the immune system. The purpose of this study is to cast some light on both these sources and to explore their validity based on contemporary context and in the light of clinical experience. The paper is in two parts. In this first part, which explores the more general literature on the subject, we find much inconsistent evidence of immune response but a deficiency of conclusive evidence for specific responses of white blood cells to moxa treatment. There is, however, enough record of a varied immune response to endorse more focused research on the subject.
Filling the Whole in Acupuncture Part 1: What are we Doing in the Supplementation Needle Technique?
Stephen Birch EJOM Vol. 6 No. 2 (2009)
The author contends that traditional forms of acupuncture practice have been hardly, if at all, investigated in the West. While many clinical and scientific studies of acupuncture have been conducted, these almost never involve the traditional practice methods of acupuncture with their clinical observations and theories of practice. In this article - the first of two papers on the subject - he attempts to bridge the gap between traditional practices and their historical sources and theories, and more modern perspectives with their methods of investigation. He discusses the purposes and possible mechanisms of the supplementation needle technique and models what might be happening when we apply it. Effects triggered by the needling itself, focusing especially on local and global qi circulatory effects and traditional explanations of these, are highlighted, as are the effects arising out of the interaction of the person needling and the person being needled, looking in particular at global changes in the vitality of the patient and the role of the mind of the practitioner. Various possible scientific perspectives are described, especially involving electromagnetic phenomena that could explain the effects of the needling and various interactional effects. Implications of this for understanding acupuncture practice are briefly discussed.
Management of Breech Presentation with the use of Moxibustion: A Preliminary Study
Christine Grabowska and Anne Manyande EJOM Vol. 6 No. 1 (2008)
Expectant mothers with a third trimester breech presentation were offered moxibustion treatment to turn the foetus into a cephalic presentation. In the 76 women who were enrolled in the study, the acupoint BI 67 was stimulated for seven days morning and evening by rolls of moxa (Artemisia vulgaris). The women were instructed in how to use the moxibustion at home and to involve their partners if they could not reach their little toes. In this preliminary study, it was shown that moxibustion treatment can bring about spontaneous version from a breech presentation for a cephalic presentation; this occurred in 45% of the women treated. The results indicate that moxibustion was more successful when administered in the afternoon than in the morning (x2 = 27.86, DF = 14, p < .01) 6 (20.5%) vs 23 (79.5%) respectively. This is in line with the Chinese clock where bladder time rises to a maximum in the afternoon. Most of the versions occurred during the 36th week of pregnancy (r = 0.27, n = 47, p < .05).
What is the Scope for Improved Integration of Complementary and Conventional Medicine?
Claire Blanchard, Phil Hanlon and Mhairi Mackenzie EJOM Vol. 5 No. 6
This paper reports on a research project investigating the influences shaping acupuncture practice. Semi-structured interviews were conducted with a convenience sample of twelve acupuncturists based in Glasgow and Edinburgh. Themes discussed by the study population included: an increase in acupuncture usage, difficult but improving relationships between GPs and acupuncture practitioners, a growing acceptance of acupuncture practice within the context of integration with conventional practice with some remaining barriers, and the need for further research into acupuncture efficiency and cost-effectiveness. The study population believed acupuncture to be a way of life and defined health as a state of energy balance, with imbalances leading to ill-health. Emphasis was placed on the importance of a good practitioner-patient relationship and patients’ needs being met for the healing process. Finally, particular weight was given by the study population to the differences that are believed to exist between western and eastern philosophies.
Prepared for Practice? An EJOM Poll of Recent Graduates
EJOM Team EJOM Vol. 5 No. 6
A poll was conducted of graduates from UK acupuncture teaching institutions in the UK who had joined the British Acupuncture Council (BAcC) in 2005-2006. The e-mail survey examined graduates’ views on how they had been prepared by their teaching institutions for the ‘business side’ of acupuncture, particularly setting up, running and building a practice. The findings of this informal ‘finger in the wind’ poll, which elicited responses from about ten percent of those contacted, suggest that these graduates appeared to be dissatisfied with this aspect of their training and are finding it hard to make a living in their new profession.
There seems to be a general consensus within the acupuncture and Chinese herbal community that research is a necessary process to establish our professional status. It may be regarded as a ‘good’ thing, a bold venture to bring Chinese medicine into the cosy confines of evidence based medicine; or perhaps more cynically ‘a necessary twenty-first century evil’ that we need to grit our teeth and get on with. This is an account of the author's foray into the research world to explore the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. He set off on his journey dressed in a shiny suit of optimistic positivist fervour. Now several years down the line he feels more like Don Quixote lining up his intellectual lance and charging heroically towards the next windmill on the horizon. This then is the story of how a naive would-be knight lost his armour, encountered the dark forces of bureaucracy, and depending upon your point of view either grew up or went quietly nuts. Read the whole article
Exploring Acupuncture Outcomes in a College Clinic: Repeated Measures of Subjective Health Status
The College of Integrated Chinese Medicine (CICM) in Reading piloted a range of repeated outcome measures to assess change in health status in patients receiving acupuncture treatment in the student clinic. Data was collected from 495 patients treated from 1996-2004. Patients attending clinics 1-6 (CICM cohort) used a repeated measures programme developed in-house following MacPherson and Fitter (1998). Patients attending clinics 7-12 (MYMOP cohort) used the Measure Your Own Medical Outcomes Profile (MYMOP) (Paterson 1996). The study showed a clear trend towards better health over time for patients receiving acupuncture treatment at the clinic. Results are suggestive of positive benefit from acupuncture for patients with a wide variety of predominantly chronic conditions, and contribute to the growing acupuncture evidence profile.
Tonification of Spleen 21: A Viable Treatment Option within the Akabane Protocol
Richard Graham EJOM Vol. 5 No. 5
This randomised controlled study compares the treatment results in two groups of participants who were found to have Akabane imbalances. Participants in one group were treated using the Akabane protocol currently taught to practitioners of Five Element Acupuncture. Participants in the other group were treated with a bilateral needling of Spleen 21. The group treated using the protocol taught at the College of Traditional Acupuncture, which requires the tonification of luo points of the affected meridians, were found to have improved significantly after treatment (26.55%). However, the group treated using bilateral tonification of Spleen 21 had an even greater measure of improvement (52.12%). This suggests that the bilateral tonification of Spleen 21 appears to be more effective than the tonification of luo points in the treatment of meridian imbalances. Improvement and modernisation of the current testing procedure are recommended. A comparison between the bilateral tonification of Spleen 21, back shu, luo, yuan and jing points, in the treatment of meridian imbalances, is recommended for future clinical trials.
Exploring the Mechanics of Acupuncture: Bioelectromagnetism of the Human Body
Daniel J. Windridge & Harriet Lansdown EJOM Vol. 5 No. 5
This article gives an outline of a BSc (Hons) dissertation submitted as part of the BSc (Hons) Traditional Chinese Medicine (Acupuncture) degree programme at the University of Salford in April 2003. The purpose of this quantitative study (Part One) was to measure the skin resistance and thus conductivity of a given set of the Influential points. The aim was to determine any differences in the conductive properties according to the gender of participants involved. Vacancies were a set sample of 30, which involved stratified criterion non-random sampling. Quantitative comparative descriptive was the method design used. The results of readings were compared and were shown to support the yin and yang theory used in traditional Chinese medicine (TCM). The outcome of Part One established that yang acupoints had the highest conductance compared to yin acupoints. Also it was found that the conductivity of all the yang acupoints measured from the male participants were significantly greater when compared with results obtained from the females.
This article reports on a highly significant, high-quality randomised controlled trial to determine whether GP referral to a short course (up to 10 individualised sessions) of traditional acupuncture might improve longer term outcomes for patients with chronic low back pain in primary care, and at a cost that would be affordable by the NHS. 241 patients were recruited to the trial with 160 being randomised to the acupuncture group and 81 to the control group which received usual GP care alone. The results indicate that when patients in primary care with low back pain are referred to a BAcC acupuncturist for a short course of treatment, they will, on average, improve over time and show greater improvement than if they had received usual GP care alone. Although the course of acupuncture only lasted around 3 months, their situation improved over time, and continued to improve between 12 and 24 months. The authors' recommendation from this study is that GPs should consider referring patients with low back pain to a qualified acupuncturist. Read the whole article
Strengthening the Case that Acupuncture is Safe in Competent Hands
Hugh MacPherson EJOM Vol. 5 No. 1
This article reports on a prospective study, funded by the British Acupuncture Council, looking into the safety of acupuncture treatment. The study involved 1 in 3 members of the BAcC who between them recruited 9,400 patients as survey respondents. The characteristics of the acupuncture patients and their reason for seeking treatment are outlined. Short-term reactions to treatment are described, along with perceived adverse events reported in a 3-month follow-up questionnaire. The data presented belie alarmist claims that non-physician acupuncturists put patients at risk by delaying conventional diagnosis and treatment and/or advising changes in prescribed medication. The conclusion from this large-scale and rigorously conducted study strongly reinforces existing evidence that acupuncture, when practised by qualified acupuncture practitioners, is a safe intervention. It also provides compelling evidence that the standards promoted by the BAcC have led to qualified acupuncturists being safe in their broader role as healthcare professionals. Read the whole article
Acupuncture in the West: Keynote Debate
Stephen Birch, Peter Deadman and Felicity Moir EJOM Vol. 4 No. 4
This is an extract of the keynote debate, which took place at the British Acupuncture Council’s Conference in October 2004, which was chaired by Mike O’Farrell, Chief Executive Officer Executive Officer of the BAcC. The three keynote speakers were Stephen Birch who has co-authored seven books on acupuncture and regularly contributes to the debate on the use of scientific methods in the integration of Traditional East Asian Medicine (TEAM) in the West, Peter Deadman who is Publisher and Editor of the Journal of Chinese Medicine and co-authored the major acupuncture textbook a manual of acupuncture, and Felicity Moir who is a Course Leader and Principal Lecturer at the University of Westminster, School of Integrated Health. Questions or comments follow the introductory views of the keynote speakers, together with the responses of the speakers. Read the whole article
Grasping the Nettle: A Response to Reports of Adverse Events from Acupuncture
Hugh MacPherson and Alison Gould EJOM Vol. 2 No. 5
The authors have drawn from reviews of the literature reports of adverse events, in particular Rampes and James (1995), Norheim (1996), Rosted (1996), Bensoussan and Myers (1996), and Ernst and White (1997) and have ascertained there are four main categories of adverse events: trauma, cross infection, physiological responses such as fainting or allergic reactions, and clinical misjudgement such as inappropriate removal of drug treatment or failure to refer. Based on their research findings, the authors estimate that the risks associated with acupuncture are very small compared to orthodox interventions. This conclusion is supported by a recent report from the USA National Institutes of Health (1997), which states 'one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same condition.'
Where to Now? Leading Acupuncture Research towards Clinical Relevance
Alan Bensoussan EJOM Vol. 1 No. 2
The author urges the close scrutiny of TCM theory, after which the main substance of the article demonstrates the point that most clinical studies of acupuncture have focused on its use in pain management. Findings from studies of the release of different neuro-hormones as a result of acupuncture are summarised. Since these studies were mainly carried out on animals, the author sees them as limited in their ability to further the understanding of TCM theory. He argues that focusing on TCM theory and on the use of acupuncture to promote health is more useful than studying the effect of acupuncture on neuro-transmitters and pain relief. Read the article as a PDF file (493Kb)
Exploring Acupuncture Outcomes in a College Clinic
This article reports on a descriptive outcome study conducted at The College of Integrated Chinese Medicine in Reading, UK. The study, which involved 495 patients, explored patient profile and perception of change after treatment in the College's student clinic during 12 clinical programmes from 1996-2004. The study showed a clear association between acupuncture treatment and positive health outcome as assessed by patients. The majority (82.2%) of responding patients reported a large or moderate change in their main complaint, and 88% a large or moderate change in their general health. These results, from a wide range of predominantly chronic patients, indicate high levels of patient satisfaction.
Criteria for the Appraisal of Published Acupuncture Clinical Trials
Barry Nester EJOM Vol. 5 No. 4
The critical appraisal of acupuncture clinical trials can be important for both the evaluation of the therapeutic effectiveness of acupuncture and for the improvement of clinical practice. A knowledge of how to critically appraise clinical trials is a prerequisite for conducting systematic reviews and meta-analyses, the basis of evidence-based medicine (EBM). The critical appraisal of acupuncture clinical trials also enables practitioners to decide if the findings of trials can be utilised in clinical practice in order to improve client outcomes. This paper provides a brief overview of the criteria for the appraisal of published acupuncture clinical trials for practitioners and novice researchers.
With the profession of acupuncture moving towards statutory self-regulation, developing an evidence base is a challenge that must be met. This article reports on the first study to test for the possibility of commonly perceived barriers to undertaking research among members of the British Acupuncture Council (BAcC). The results show that such barriers do exist, the greatest being not enough time during a normal working day and lack of financial support. 70% of respondents indicate an interest in doing research, 81% think it will improve quality of practice, and 85% feel it is important for the establishment of a knowledge base. The formation of research teams led by an experienced researcher for outcome studies using methods that are efficient, cost-effective and simple to implement could help reduce some barriers and allow practitioners to gain research skills by collaborating with colleagues in the same study.
The Role of the Pragmatic Trial in the Evaluation of the Effectiveness of Acupuncture
Barry W. Nester EJOM Vol. 5 No. 3
This paper examines the role of the ‘pragmatic trial’ (PT) in the evaluation of the effectiveness of acupuncture. In a PT, the therapeutic effectiveness of a therapy can be evaluated by comparing it with other therapies and/or ‘standard care’ (i.e. the pharmaceutical drug or therapy that is routinely used to treat the condition being studied). The PT provides a method to determine the ‘relative’ therapeutic effectiveness of therapies such as acupuncture for a particular condition or syndrome by comparing it with the effectiveness of other therapies. One strength of using the PT to evaluate the effectiveness of traditional acupuncture is that the ‘sham acupuncture’ control can in some cases be omitted, thereby avoiding any possible ethical concerns regarding participant deception and/or participants not receiving and ‘active’ treatment.
Acupuncture Research and Practice: Some Philosophical Considerations
Allen Parrott EJOM Vol. 5 No. 3
The aim of this article is to set out some of the ways in which the basic philosophical assumptions about knowledge and reality that underpin mainstream scientific thinking, and therefore most current research, can be challenged, and to explore the relevance of such challenges to acupuncture research and practice. The author argues that randomised and double-blind clinical trials may be useful in certain contexts, but they no longer need be esteemed as the ‘gold standard’ to which all serious enquiry should aspire. For most healthcare research, a different ‘lens’ is desirable, for practical and ethical as well as for theoretical or more purely philosophical reasons.
Acupuncture in the Treatment of Psychosis: The Case for Further Research
Dominic Harbinson and Patricia Ronan EJOM Vol. 5 No. 2
The medical treatment of psychosis continues to be limited, often with severe side effects. This paper sets out to examine the literature available on the treatment of psychosis and schizophrenia with acupuncture, to outline the evidence already available and to highlight the case for research into this treatment approach in the UK. A literature search was carried out using Ovid, Medline, Psych-info, Yahoo, Google and author contact to discover what research has taken place to date. This yielded evidence that acupuncture is effective in the treatment of psychosis. Although most of the research is from China and is somewhat dated, a number of studies have also been conducted in the West with promising outcomes. Given the poor prognosis for schizophrenic patients and the side effects implicit in the chronic use of conventional medication, there would appear to be good grounds for further research into acupuncture as a potential treatment modality. Carrying this out under modern scientific research conditions would help clarify whether and how this treatment might work. However obstacles such as ethics, funding and how such a study might be controlled will have to be overcome.
Service Users' Experiences of Acupuncture in the Mental Health Context
Doreen Till EJOM Vol. 5 No. 2
This paper, based on research conducted as part of an MA in Community Mental Health, explores service users’ experiences of acupuncture delivered in a group setting within a mental health day service at the Broadway North Resource Centre in Walsall. The majority of service users felt that acupuncture had improved their health both mentally and physically. Whilst some individuals found a group setting slightly intimidating at first, they also found benefits in the peer support that such a setting facilitated. All participants in the study thought that acupuncture should be more widely available within mental health services, and that a greater range of therapies should also be provided. Acupuncture within a group setting can be a cost-effective way of delivering a popular treatment that service users perceive as helpful to their health.
Patients’ Explanatory Models of Acupuncture: How and Why do They Think it Works?
Sylvia Schroer EJOM Vol. 5 No. 1
This article reports on a small study to investigate how patients explained the workings of acupuncture in the light of their own experience of treatment. 15 patients of different ages and from socio-economic backgrounds were interviewed and issues such as reasons for having treatment, the effects of treatment, and the importance of the therapeutic relationship were discussed to reveal the explanatory models which they used to describe their experiences. One of the findings of the study was that patients’ narratives shifted during the course of treatment from mechanical theories or physical explanations of illness towards theories of equilibrium, of mind-body harmony, and ethical theories, with treatment seen as a cleansing process. The study found that also found that patients themselves, through their experience of treatment, are moving away from a narrow definition of acupuncture as a treatment for the relief of pain or physical symptoms towards a much broader conceptualisation for its therapeutic potential in the context of their lives.
The First Step to Auditing our Practice – A Group Project in Swindon
Hazel Andrews and Janice Booth EJOM Vol. 4 No. 6
This article reports on research conducted by a team of seven BAcC members practising in North Wiltshire. The research comprised a basic practice and patient audit, collecting information on the type of patient coming for treatment, presenting conditions and their duration, and patient perceptions of changes in their symptoms over the first six acupuncture treatments (using MYMOP2 forms).
The case study has been used extensively in many diverse disciplines including medicine, psychology and education. This paper explores the purposes of case study research in the field of Chinese Medicine (CM). Various types of case study including intrinsic case study, instrumental case study and collective case study are examined for their use in research of CM. The case study can be used to understand health, illness and Chinese medicine healing practices holistically. Case studies can provide powerful stories to illustrate the diversity of Chinese medicine practice. They can also be used to document change and development in individuals while having Chinese medicine therapies. Case studies can in some instances generate theoretical positions and sometimes suggest limitations of current theories and practices. Case studies also enable CM students and practitioners to better understand the relation between CM theory and clinical practice.
Modern Research on Traditional Chinese Pulse Diagnosis
Lisheng Xu, Kuanquan Wang and David Zhang EJOM Vol. 4 No. 6
This paper presents modern research on Traditional Chinese Pulse Diagnosis (TCPD). In order to demystify TCPD and prove its efficiency, some fundamental knowledge such as concepts, significance, diagnosis methods, and standard pulse patterns are outlined at the outset. Then we review modern research on TCPD mainly from four aspects: objectifying TCPD, analysis of pulse waveform, the mechanism of pulse formation, clinical observations and comparisons of pulses. For each of these aspects, general background information and brief explanations are given. In particular, it is very important to distinguish the pulse images based on traditional Chinese medicine and those derived from the sphygmogram based on western medicine. As an example, our pulse acquisition system is presented. Furthermore, typical pulse waveforms in our pulse database and their results as processed by modern signal processing methods are demonstrated. Finally, the potential and the problems facing modern research into TCPD are pointed out.
The Experience of Receiving Traditional Chinese Acupuncture
G Walker, B de Valois, T Young, R Davies, and J Maher EJOM Vol. 4 No. 5
This article reports on a study by the Supportive Oncology Research Team at Lynda Jackson Macmillan Centre, Mount VernonHospital, Northwood, Middlesex, to evaluate the experience of women with breast cancer having treatment for the menopausal symptoms associated with Tamoxifen. A total of 16 women participated in focus groups held at least 9 months after their last acupuncture treatment. The discussions addressed the following topics: problems experienced before treatment; anticipation and expectation; experiences of the treatment session itself; effects of treatment; and overall impressions. It was found that traditional acupuncture is an acceptable treatment for women with menopause-like symptoms resulting from Tamoxifen. Patients found the overall experience enjoyable, and felt that their quality of life improved whether or not their symptoms were relieved.
Traditional Chinese medicine has been playing an important role in the prevention and treatment of diseases all over the world. It is invaluable for anyone who learns Chinese medicine to also learn the history of Chinese medicine at the same time. This article is divided into four parts: introduction, institutes and societies, special topics, and journals and bibliographies. The purpose of this article is to collect useful and well-known websites and introduce them to interested people for their further study, using the www.
Study on Essential Hypertension and Traditional Chinese Medicine
Nick Johnson, Dominique Joire, James Tomkinson, Sammy Reid, Lola Boix, Alex Murray and Paloma Sparrow EJOM Vol. 4 No. 2
This study observes and monitors the effect of 6 months of traditional Chinese medicine on a group of NHS patients with essential hypertension. The management was in both terms of symptomatology and blood pressure levels. It provides a background, treatment protocol and results, along with specific reports on 8 patients.
The Gateway Clinic is a Chinese medicine specialist centre within the National Health Service (NHS). It offers acupuncture, Chinese herbal medicine, dietary advice and qi gong classes. The emphasis is on helping people to help themselves; preserving their autonomy and quality of life. Listening to the patient’s perception of the problem is considered essential to the process. This represents a new pioneering approach to the many complex health issues of today. In this audit, which looked at patient satisfaction within the clinic, a simple questionnaire based on SF-36 was used. Some questions were added about the most important symptoms seen in Chinese medicine and about patients’ satisfaction with the service and comments. The audit is well illustrated with graphics and has an interesting appendix containing the final comments from patients.
Continuing Professional Development: A Pilot Study
Emma White EJOM Vol. 3 No. 6
This paper presents the findings from a survey conducted on behalf of the British Acupuncture Council (BAcC). It was conducted among 121 members in June 2001. The aim of the survey was to assist the BAcC to prepare a Continuing Professional Development (CPD) programme for members which takes account of the CPD members are already doing as part of their busy practices, and which also takes into account the acupuncture tradition. This paper sets out the survey design and then goes on to report on three aspects of the survey.
Safety in Numbers: What Practitioners Reported about Adverse Events and Treatment Reactions
Hugh MacPherson, Kate J Thomas, Stephen Walters and Mike Fitter EJOM Vol. 3 No. 6
This is a report on the survey (commissioned by the British Acupuncture Council) on the relative safety of acupuncture. Its main finding is that acupuncture is safe in the hands of competent practitioners. 574 practitioners took part in the survey over a 4 week period in May 2000. Results showed that there were no serious adverse events in 34,407 reported acupuncture treatments, 43 indicating an underlying serious adverse event rate of between 0 and 1.1 per 10,000 treatments. A total of 43 significant minor adverse events were reported, at a rate of 1.3 per 1000.
Feeling the Pulse: Trial to Assess Agreement Level among TCM Students
Sean Walsh, Deirdre Cobbin, Karen Bateman and Chris Zaslawski EJOM Vol. 3 No. 5
This paper reports a study designed to investigate the agreement between TCM students in their discrimination of basic pulse parameters such as speed, depth, volume, length and overall quality of the pulse. Method: a standardised form was used to assess agreement among the sample of students on three occasions: at the beginning of formal pulse diagnosis teaching classes (week 1), at the conclusion of pulse teaching (week 14), and one year later. Students were randomly divided into two groups, with each group randomly assigned three subjects, for whom each member of the group was required to palpate the pulse. Data were analysed using Chi square.
Adverse Events of Acupuncture: A Literature Review
Mary Herbison EJOM Vol. 3 No. 4
This review critically analyses and evaluates two recent British papers dealing with current world wide reports on adverse events of acupuncture. Availability of scientifically based articles and research papers into adverse events resulting from acupuncture has been confined to specialists who manage these complications (Rampes and Peuker 1999), and little is known about adverse events of acupuncture by the general public, apart from occasional anecdotal reports. However from 1996, particularly in Australia, (James, 1996; Bensoussan & Meyers, 1996;) efforts have been made to collate published data and present it logically both in scientific journals and the public arena.
Male Infertility: Clinical Treatments of 248 Cases
Dr Zhang Jia Sheng EJOM Vol. 3 No. 3
This article (translated from Chinese Acupuncture and Moxibustion 1987 Vol. 7 No. 1) reports on the treatment with acupuncture and moxibustion of 248 cases of male infertility over the period 1981-1985. Treatment was deemed effective in 166 cases. Patients with impotence and ejaculatory dysfunction responded better than cases with sperm abnormalities. Translated by Xiao Y Zhang.
Complementary Medicine Research: An Alternative to the Reductionist Approach
Roisin Golding interviews Dr David St. George EJOM Vol. 3 No. 2
During this interview David St George develops a variety of theories and ideas that transcend the limitations of the currently accepted scientific view, which is based on 'atomic materialism' and which sees the building blocks of existence but not the creative forces, including consciousness, which may line them up like a 3-dimensional holographic structure and determine their functioning. The following is a paraphrased quote:An expanding force, originating in the big bang, is pulsating out of the sun, which is counteracted by gravity.Similarly, out of the earth, out of plants, out of every atom and molecule, out of every living being, come these expanding and contracting forces, which are orchestrated by what is called life force, biorhythms, qi or prana.David St George questions a scientific paradigm which is unwilling to discuss evidence that does not fit into the current belief system, reminiscent of the church elders refusing to look through Galileo’s telescope.
Expanding Horizons: Doing Research That Counts - Report on the 4th Acupuncture Research Symposium
Mark Bovey EJOM Vol. 3 No. 1
This article reports on the proceedings at the Fourth Annual Acupuncture Research Symposium organised by the Acupuncture Research Resource Centre and held on May 8, 1999. The Symposium began with David St George who outlined his vision of the future, calling for research that meets the needs of acupuncturists and their patients. Ruth Endicott spoke on the contribution of qualitative research to health care, and Charlotte Paterson reported on her ongoing research into concepts of wellbeing and its measurement using the MYMOP (Measure Yourself Medical Outcomes Profile) questionnaire. Stephen Birch spoke about the difficulties of designing credible research to test traditional forms of acupuncture practice and defined the steps necessary to do this appropriately. Edwina Webb presented a retrospective observational study of her acupuncture practice in Manchester over the period 1989-1996 which included measurement of treatment outcomes and average cost per course of treatment. Hugh MacPherson reported on the ongoing York back pain project and the development of the research protocol for the project’s NHS-funded pragmatic randomised controlled trial. The presentations concluded with Kevin Ergil’s overview of acupuncture research in the USA.
'Let A Hundred Flowers Bloom' - Post Conference Reflections on our Research Agenda
Jennifer Dale EJOM Vol. 3 No. 1
This paper aims to continue the debate arising at the 1998 BAcC conference by arguing the case for a pluralistic approach to research methods. It does not claim to provide a comprehensive overview of methods or the underlying debates about what constitutes ‘evidence’ in research. Rather, it considers some of the varied purposes of research and illustrates some of the ways in which the sorts of questions which arise in the real world of research lend themselves to different methods.
Arnold Desser, Dr Kevin Baker, Nadia Ellis, Roger Newman Turner, and Dr Adrian White EJOM Vol. 2 No. 6
Five practitioners from different backgrounds, including Western medical doctors, an osteopath, a physiotherapist and a university lecturer, express their personal views on this subject. The contributions range from the philosophical to the practical and include views on the effectiveness of acupuncture and its role in health care, and notes on the foibles and idiosyncracies observed in members of the acupuncturist 'species'. Transcribed from the presentations given at the 1998 BAcC Conference.
The Hurts, the Angst, the Blues: The Tangle of Pain, Emotion and Psychopathology
David Mayor EJOM Vol. 2 No. 5
In this second article on chronic pain and its measurement (the first was published in EJOM Vol 2, No 4), Mayor provides a thorough literature analysis about the complex inter-relationships between pain, anxiety and depression. He discusses which comes first - pain or anxiety. He also explores how the emotional state of a patient relates to the task of pain prevention, particularly in regard to chronic pain sufferers.