The basic concepts used in
traditional Chinese medicine have about as much in common
with Western medicine as Mandarin does with English.
So it's no surprise that when acupuncture was first
introduced to the West in the 70s, it was greeted with
much trepidation. Never mind that it had been in practice
for over 2000 years in China, in the West it existed
on the fringe of conventional medicine. The theory that
inserting needles into the body could cure disease and
relieve pain must've seemed a tad outré to North
American scientists at the time. Experts from these
two opposing worlds of medicine simply didn't speak
the same language. There were no clinical trials or
hard research data back then to prove that acupuncture
actually worked.
Professor Cedric Chang, the national
president of the Chinese Medicine and Acupuncture Association
of Canada, was one of Canada's acupuncture pioneers
— he opened his practice in London, Ontario, in
1970. "Back then the medical community saw acupuncture
as a form of witchcraft," he laughs. "Perception
has changed a lot since then, especially in the last
20 years. Acupuncture has gained more acceptance now."
Acupuncture owes its newfound Western credibility to
a growing body of pretty positive research results.
The data shows that it does improve a host of different
maladies such as headache, chronic pain and certain
musculoskeletal conditions to name a few. Some medical
schools in North America, such as UCLA, even include
acupuncture training in their curriculum.
In 1994, around 15% of Canadians
aged 18 or older used some form of alternative healthcare.
By 2003, the number rose to 20%, according to the Canadian
Community Health Survey. Acupuncture is only partially
covered by some provincial programs, so use of this
therapy tends to rise with income. In 2003, around 26%
of Canadians in the highest household income bracket
used alternative care compared to only 13% of those
in the lowest income group.
"I get a lot of MDs referring
patients to me for pain," says Colleen Leo, a naturopathic
specialist who also practises acupuncture. A certified
pharmacologist who practises in Toronto, he's part of
the new school of alternative medicine practitioners
who have been trained in both Western and traditional
Chinese medicine. "I think there's a need for more
understanding between conventional and alternative medicine.
It would help doctors to know how traditional medicine
integrates into Western medicine — a lot of patients
are using both," says Mr Leo.
"Acupuncture is a complete
form of medicine," he explains. And, just like
Western medicine, this ancient practice is changing
as new technology becomes available. "The public
isn't aware of all the different forms. There's electroacupuncture,
which uses a micro current instead of needles, and laser
acupuncture, which is also needle-less." Here are
some recent studies on acupuncture and its treatment
benefits.
FERTILE
GROUND
A recent study shows that acupuncture can benefit male
infertility. The research published in the July issue
of Fertility and Sterility shows that the treatment
improves sperm quality in idiopathic male infertility.
Researchers from Shanghai University looked at 40 men
with idiopathic oligospermia, asthenospermia, or teratospermia.
Twenty-eight of them received acupuncture twice a week
for five weeks. Their semen samples were then compared
to samples from the 12 men who didn't undergo acupuncture.
Transmission electron microscopy of the samples revealed
that the sperm from the acupuncture group were increased
in number and had fewer structural defects. "The
treatment of idiopathic male infertility could benefit
from employing acupuncture," conclude the study
authors. Previous uncontrolled trials using acupuncture
on infertile men have reported a positive effect on
sperm concentration and motility, an increase in testosterone
and luteinizing hormone levels.
HEADY
RESULTS
A study published online on July 29 in the British
Medical Journal shows that acupuncture cuts tension
headache rates by almost half. Acupuncture is widely
used for tension type headaches but its effectiveness
is strongly debated. German researchers from the Universitat
Munchen in Munich set out to determine just how beneficial
acupuncture is for this type of headache. They enrolled
270 (including controls) mostly female patients with
episodic or tension type headache and studied them over
an eight-week period.
The traditional acupuncture group
saw their headache rates drop by almost half after four
weeks. Those who underwent minimal acupuncture enjoyed
a measure of improvement — although not as much
as the traditional acupuncture group. Moreover, this
improvement lasted for months after discontinuing treatment.
The unfortunate control group experienced a negligible
one-tenth drop in headache rates. They were later given
acupuncture treatment as well and showed significant
improvement, although not as much as those treated from
the get go. Of the 195 patients who underwent treatment,
37 reported side effects such as dizziness and bruising.
"The size of the effect [of acupuncture] seems
comparable to those of accepted treatments for tension-type
headaches," note the authors.
NSAID
ALTERNATIVE?
Despite limited clinical evidence, many arthritis sufferers
are turning to acupuncture for relief. "In treating
arthritis, acupuncture can help patients who can no
longer take Vioxx," states Mr Leo. Well, a study
in the July 12 issue of The Lancet confirms his
belief. Scientists from Berlin randomly assigned 300
patients with knee osteoarthritis to acupuncture treatments,
minimal acupuncture sessions and no acupuncture. All
patients were allowed to use NSAIDs throughout the trial.
The Western Ontario and McMaster Universities Osteoarthritis
(WOMAC) index was used to measure symptom improvement.
After 12 sessions of acupuncture over eight weeks, the
150 test subjects in this group had a substantially
better WOMAC score (26 points) than the control group
(50 points), indicating significant improvement in the
treatment group. Those in the minimal acupuncture group
also showed improvement with a final WOMAC score of
36 points ? significant improvement but again not as
much as the traditional acupuncture group. At the one-year
followup, however, there were no differences between
the scores from all three populations. "Acupuncture
treatment had significant and clinically relevant short-term
effects. We now need to assess the longterm effects,"
comments lead investigator Dr Claudia Witt.
NEEDLE
EXCHANGE
So we now know that acupuncture appears to improve certain
disease symptoms and relieve pain but can it also change
behaviour? A large study in BC attempted to answer this
question. They wanted to find out if the treatment would
reduce substance abuse. Acupuncture was offered to recovering
addicts on a voluntary, drop-in basis five days a week
at two community agencies. The program generated 2,755
visits and subjects reported a reduction in overall
use of substances and withdrawal symptom severity. They
claimed to experience less 'shakes', stomach cramps,
insomnia, nausea and suicidal feelings. "Acupuncture
holds promise as an adjunct therapy for reduction of
substance abuse," say the researchers. Their findings
are reported in the June issue of the Journal of
Urban
Health .
ONTARIO
MEETS ORIENT
"The benefits of acupuncture for migraine, fertility
and arthritis are well known and recorded in Chinese
medicine," says Professor Chang. Even so, acupuncturists
welcome these clinical trials. "These studies are
not just validating the benefits of acupuncture but
will add to our understanding of alternative medicine,"
says Mr Leo. "Studies make acupuncture more acceptable.
Even if they can't explain how it works, the statistics
show that it does. Clinical studies will also help separate
the wheat from the chaff in terms of what diseases acupuncture
actually benefits."
As acupuncture and other forms
of Chinese medicine become more prevalent in Canada,
provincial authorities are slowly realizing the need
to regulate its practice. By the end of the year, Ontario
will become the second province in Canada to regulate
traditional Chinese medicine — BC began regulating
this practice in 1999. "We owe it to the people
of Ontario to ensure they are protected. But at the
same time, we have to realize traditional forms of medicine
have helped a great number of people for a very long
time," Health Minister George Smitherman said in
his announcement on July 29. Mr Smitherman says that
regulation will add legitimacy to the practice. The
Chinese Medicine and Acupuncture Association of Canada
has been lobbying for the regulation of their profession
since 1977.
"It's a blessing for Ontarians,"
says Professor Chang who also believes that this move
will help legitimize the practice of traditional Chinese
medicine. "It's important to regulate our profession,"
agrees Mr Leo. "We have to verify the competence
of practitioners of alternative medicine. Safety is
an important issue. We need to regulate how needles
are used and we need to ensure the use of disposable
needles to avoid the transmission of disease,"
he says.
"Studies on acupuncture
will lead to a more integrated practice of Western and
Eastern medicine in the future," predicts Professor
Chang. Professor Chang advises his colleagues in conventional
medicine to keep an open mind. "We should all try
to achieve a mutual understanding and work together
to treat the patient."
|
