Acupuncture: theatrical placebo or caring approach to pain?
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1076 (Published 08 March 2018) Cite this as: BMJ 2018;360:k1076
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This article appears to limit consideration of acupuncture by its comparison of sham-placebo with acupuncture and in doing so appears to place significant doubts upon the overall effectiveness of acupuncture. Consider for a moment that expert acupuncturists can conduct open-heart surgery without anaesthetic if the patient's acupuncture/meridian points are desensitised by acupuncture needles. Despite immense amounts of research the actual mechanisms by which acupuncture works remains unproven yet there are significant observations that continue to be overlooked. Firstly the brain regulates the autonomic nervous system and physiological systems and secondly there is a feedback mechanism by which changes of molecular biology, in particular the levels of proteins which are genetically expressed, influence brain function. We know this because acupuncture stimulates the release of endocannabinoids and drugs are widely used to treat neurological conditions.
To consider acupuncture as a theatrical effect belies its scientific significance. Indeed it serves to emphasise the lack of knowledge currently deployed in contemporary biomedicine; in particular the lack of understanding of how the brain functions, of what it does and how it does it, and how the body may be screened or treated using an understanding of these mechanisms.
Competing interests: No competing interests
Acupotomology: the inheritance and innovation of acupuncture to pain
We are very gratified by the fact that acupuncture can solve severe pelvic girdle pain. Acupuncture is a key component of traditional Chinese medicine (TCM) that originated more than 3000 years ago. It involves the insertion of hair-thin needles into acupoints, which are invariably regarded as an obscure concept.
In recent years, the precise mechanism of analgesia has been studied [1, 2]. Acupuncture is widely used to treat many types of pain and has few adverse effects compared with many drugs and medical procedures. Hence, the popularity of acupuncture has increased in many Western nations over the past few decades. Lucy Chen [3] considered that acupuncture may effectively contribute to pain management in rheumatoid arthritis and back and neck pain, but rigorous study methods and high-level assessment tools are needed.
Acupotome evolving from acupuncture needle is a new-style needle with blade, a flat head and a cylindrical body. It is considered to be minimally invasive surgery in traditional Chinese medicine, combining Chinese acupuncture therapy and modern surgical principles [4]. Acupotome therapy was first introduced in China in 1976, and then was widely used for its good curative effect and reduced cost. It was formally named as acupotomology and became a national second-level discipline in September 2003.
Acupotome treatment of dizziness, headache and vomiting caused by cervical spondylosis involving the first three cervical vertebras, can be proved by current medical imaging of X-ray and MRI. Of course, we also oppose the pseudoscience that acupuncture can treat infertility [5]. For better and faster development of acupotomology, more rigorous randomized controlled trials and high-level assessment tools are urgently needed. Acupuncture and acupotomology may be the best way to treat soft tissue pain, and will be recognized by more and more people in the near future.
References:
1. Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci.2010 Jul; 13(7):883-888.
2. Torres-Rosas R, Yehia G, Pena G, et al. Dopamine mediates vagal modulation of the immune system by electroacupuncture. Nat Med. 2014 Mar; 20(3):291-295.
3. Chen L, Michalsen A. Management of chronic pain using complementary and Integrative medicine. BMJ. 2017 Apr 24; 357:j1284.
4. Liu F, Zhou F, Zhao M, et al. Acupotomy Therapy for Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2017; 2017:6197308.
5. Wu XK, Stener-Victorin E, Kuang HY, et al. Effect of Acupuncture and Clomiphene in Chinese Women with Polycystic Ovary Syndrome: A Randomized Clinical Trial. JAMA. 2017 Jun 27; 317(24):2502-2514.
Competing interests: No competing interests