Accupunture Therapy

Acupuncture (from Lat. acus, "needle", and pungere, "prick") or in Standard Mandarin, zhēn biān (a related word zhēn jiǔ refers to acupuncture together with moxibustion)[3] is a technique of inserting and manipulating filiform needles into points on the body with the aim of relieving pain and for therapeutic purposes.[4]. Acupuncture is thought to have originated in China and is most commonly associated with Traditional Chinese Medicine (TCM). Different types of acupuncture (Classical Chinese, Japanese, Tibetan, and Korean acupuncture) are practiced and taught throughout the world.
The effectiveness of acupuncture remains controversial in the scientific community, according to a review by Edzard Ernst and colleagues in 2007, which found that the body of evidence was growing, research is active, and that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions".[5] Researchers using the protocols of evidence-based medicine have found good evidence that acupuncture is moderately effective in preventing nausea.[6][7] There is conflicting evidence that it can treat chronic low back pain,[8][9] and moderate evidence of efficacy for neck pain[10][11] and headache.[12] For most other conditions[13] reviewers have found either a lack of efficacy (e.g., help in quitting smoking[14]) or have concluded that there is insufficient evidence to determine whether acupuncture is effective (e.g., treating shoulder pain[15]). While little is known about the mechanisms by which acupuncture may act, a review of neuroimaging research suggests that specific acupuncture points have distinct effects on cerebral activity in specific areas that are not otherwise predictable anatomically.[16]
The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have also studied and commented on the efficacy of acupuncture. There is also general agreement that acupuncture is safe when administered by well-trained practitioners, and that further research is warranted.[17][18][19]
Traditional Chinese medicine's acupuncture theory predates the use of the modern scientific method, and has received various criticisms based on modern scientific thinking. There is no generally-accepted anatomical or histological basis for the existence of acupuncture points or meridians.[17] Acupuncturists tend to perceive TCM concepts in functional rather than structural terms, i.e. as being useful in guiding evaluation and care of patients. [20] [21] Scientists have reported a cultural bias in scientific studies of acupuncture.[2][3]
Contents[hide]
1 History
2 Traditional theory
2.1 Traditional Chinese medicine
2.2 Acupuncture points and meridians
2.3 Traditional diagnosis
2.4 TCM perspective on treatment of disease
2.5 Criticism of TCM theory
3 Clinical practice
3.1 An example of acupuncture treatment
3.2 Indications according to acupuncturists in the West
4 Scientific theories and mechanisms of action
4.1 Neurohormonal theory
4.2 Histological studies
4.3 Issues in study design
5 Scientific research into efficacy
5.1 Evidence-based medicine
5.2 Evidence from neuroimaging studies
5.3 NIH consensus statement
5.4 American Medical Association statement
5.5 German study
5.6 Nonacupuncture points
6 Safety and risks
6.1 Common, minor adverse events
6.2 Other injury
6.3 Risks from omitting orthodox medical care
6.4 Safety compared with other treatments
7 Legal and political status
8 See also
9 Bibliography
10 Footnotes
11 External links
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[edit] History
In China, the practice of acupuncture can perhaps be traced as far back as the stone age, with the Bian shi, or sharpened stones. Stone acupuncture needles dating back to 3000 B.C. have been found by archeologists in Inner Mongolia. [22][23] Clearer evidence exists from the 1st millennium BCE, and archeological evidence has been identified with the period of the Han dynasty (202 BC–220 AD). Forms of it are also described in the literature of traditional Korean medicine where it is called chimsul. It is also important in Kampo, the traditional medicine system of Japan.
Recent examinations of Ötzi, a 5,000-year-old mummy found in the Alps, have identified over 50 tattoos on his body, some of which are located on acupuncture points that would today be used to treat ailments Ötzi suffered from. Some scientists believe that this is evidence that practices similar to acupuncture were practiced elsewhere in Eurasia during the early bronze age. According to an article published in The Lancet by Dorfer et al., "We hypothesised that there might have been a medical system similar to acupuncture (Chinese Zhenjiu: needling and burning) that was practiced in Central Europe 5,200 years ago... A treatment modality similar to acupuncture thus appears to have been in use long before its previously known period of use in the medical tradition of ancient China. This raises the possibility of acupuncture having originated in the Eurasian continent at least 2000 years earlier than previously recognised."[4], [5].
Acupuncture's origins in China are uncertain. The earliest Chinese medical text that first describes acupuncture is the Yellow Emperor’s Classic of Internal Medicine (History of Acupuncture) Huangdi Neijing, which was compiled around 305–204 B.C. However, the Chinese medical texts (Ma-wang-tui graves, 68 BC) do not mention acupuncture. Some hieroglyphics have been found dating back to 1000 B.C. that may indicate an early use of acupuncture. Bian stones, sharp pointed rocks used to treat diseases in ancient times, have also been discovered in ruins; some scholars believe that the bloodletting for which these stones were likely used presages certain acupuncture techniques.[6]
According to one legend,[7], acupuncture started in China when some soldiers who were wounded by arrows in battle experienced a relief of pain in other parts of the body, and consequently people started experimenting with arrows (and later needles) as therapy.
R.C. Crozier in the book Traditional medicine in modern China (Harvard University Press, Cambridge, 1968) says the early Chinese Communist Party expressed considerable antipathy towards classical forms of Chinese medicine, ridiculing it as superstitious, irrational and backward, and claiming that it conflicted with the Party’s dedication to science as the way of progress. Acupuncture was included in this criticism. Reversing this position, Communist Party Chairman Mao later said that "Chinese medicine and pharmacology are a great treasure house and efforts should be made to explore them and raise them to a higher level."[8]
Representatives were sent out across China to collect information about the theories and practices of Chinese medicine. Traditional Chinese Medicine is the formalized system of Chinese medicine that was created out of this effort. TCM combines the use of acupuncture, Chinese herbal medicine, tui na, and other modalities. After the Cultural Revolution, TCM instruction was incorporated into university medical curricula under the "Three Roads" policy, wherein TCM, biomedicine, and a synthesis of the two would all be encouraged and permitted to develop. After this time, forms of classical Chinese medicine other than TCM were outlawed, and some practitioners left China.
The first forms of acupuncture to reach the United States were brought by non-TCM practitioners -such as Chinese rail road workers- many employing styles that had been handed down in family lineages, or from master to apprentice (collectively known as "Classical Chinese Acupuncture").
In Vietnam, Dr. Van Nghi and colleagues used the classical Chinese medical texts and applied them in clinical conditions without reference to political screening. They rewrote the modern version: Trung E Hoc. Van Nghi was made the first President of the First World Congress of Chinese Medicine at Bejing in 1988 in recognition of his work.
In the 1970s, acupuncture became vogue in America after American visitors to China brought back firsthand reports of patients undergoing major surgery using acupuncture as their sole form of anesthesia. Since then, tens of thousands of treatments are now performed in this country each year for many types of conditions such as back pain, headaches, infertility, stress, and many other illnesses.

[edit] Traditional theory

[edit] Traditional Chinese medicine
Main article: Traditional Chinese medicine
Chinese medicine is based on a pre-scientific paradigm of medicine that developed over several thousand years. Its theory holds the following explanation of acupuncture:
Health is a relational condition of balance of yin and yang within the body. Particularly important in acupuncture is the free flow of Qi, a difficult-to-translate concept that pervades Chinese philosophy and is commonly translated as "vital energy"). Qi is immaterial and hence yang; its yin, material counterpart is Blood then, blood becomes yang in relation to body fluids which are yin. this describes the flowing nature of the relational values of yin and yang.(capitalized to distinguish it from physiological blood, and very roughly equivalent to it). Acupuncture treatment regulates the flow of Qi and Blood,and body fluids, tonifying where there is deficiency, draining where there is excess, and promoting free flow where there is stagnation. An axiom of the medical literature of acupuncture is "no pain, no blockage; no blockage, no pain."
Many patients claim to experience the sensations of stimulus known in Chinese as de qi ("obtaining the Qi" or "arrival of the Qi"). This kind of sensation was historically considered to be evidence of effectively locating the desired point. (There are some electronic devices now available which will make a noise when what they have been programmed to describe as the "correct" acupuncture point is pressed).
TCM treats the human body as a whole that involves several "systems of function" generally named after anatomical organs but not directly associated with them. The Chinese term for these systems is Zang Fu, where zang is translated as "viscera" or solid organs and fu is translated as "bowels" or hollow organs. In order to distinguish systems of function from physical organs, Zang Fu are capitalized in English, thus Lung, Heart, Kidney, etc. Disease is understood as a loss of balance of Yin, Yang, Qi and Blood (which bears some resemblance to homeostasis). Treatment of disease is attempted by modifying the activity of one or more systems of function through the activity of needles, pressure, heat, etc. on sensitive parts of the body of small volume traditionally called "acupuncture points" in English, or "xue" (穴, cavities) in Chinese. This is referred to in TCM as treating "patterns of disharmony."