Evaluation of acupuncture based on the criteria of Western science has been until now a considerable challenge. Many scientific articles have been published on this subject. We discussed the situation with Manny Pascal , Professor, Department of Acupuncture Rosemont College, and Denis Umbriaco , acupuncturist, Doctor of Neurological Sciences and founding member of the Scientific Committee of the Association of Acupuncturists of Quebec.
Here are the main reasons behind the low number of studies published confirming the efficacy of acupuncture for relatively few conditions.
The difficult standardization
For Traditional Chinese Medicine (TCM), there is no standardized disease as in conventional medicine where cause is isolated viral, bacterial or otherwise, we are trying to eradicate. In TCM , it treats the individual and not the disease. Thus, two people with flu like and apparently caused by the same virus will not necessarily be treated in the same way. Indeed, a person may have been victim of the virus due to cooling and the other due to a weakened immune system, for example. And a third, having been exposed to exactly the same virus, has successfully fought without even being noticed.
Thus, since for the MTC there is no standardized flu , we can apply a standard treatment to hundreds of people with the "same" flu to draw statistical results. In addition, the application of personalized treatment to each patient contrary to the principles of the "objective" assessment of a single treatment, which is the basis of scientific protocols Western. Hence the difficulty of designing studies that do justice to the fundamental principles of TCM while satisfying the criteria of scientific research.
Action baggy
Drugs and western medicine interventions are generally designed to cause a specific action and specific pathogen on a particular organ or function. The effect is direct and relatively easy to measure.
The acupuncture is more holistically and often indirect. To fight a virus, for example, the intervention of acupuncture will help to mobilize the vital force of the person or to stimulate its immune system . It is through this enhanced healing ability of the virus can be fought and that the balance will be restored.
Healing is not only due to the direct action of a drug or treatment, but is also a function of a set of physical and psychological factors (fitness, vitality, state stress , diet, quality of sleep , depressed or optimistic character, etc.).. We understand it is difficult to evaluate the specific role of acupuncture as it is often the trigger of a very complex process.
It's a bit like Western medicine lingered separately to each of the instruments of an orchestra, or strings of a violin, one by one, while the MTC taking into account especially the conductor or orchestra as a whole.
Placebo effect?
In Western science, it is very important to compare a real treatment with placebo (similar but inert) to determine the distinctive action of the real treatment. Despite many efforts in this direction (needle shallow, fake needles, bad acupuncture points), a sham treatment of acupuncture truly inert and effect does not seem to have been found 2 . Indeed, in many studies, real acupuncture treatments gave comparable results (or higher ) to conventional treatment, but were only slightly better than "fake" acupuncture treatments. For many researchers, this demonstrates that fake treatments are not really inert. The mixed results of several studies may be indicative of a methodological problem rather than therapeutic ineffectiveness of acupuncture.
All kinds of acupuncture
There are many forms of acupuncture (Chinese, Japanese, Vietnamese, etc..) and each comes in several schools of thought or style. In addition, training of acupuncturists can vary greatly from one place to another. It is therefore difficult to determine objectively the quality of therapeutic interventions. This lack of standardization makes it particularly dangerous comparisons between different studies.
In addition, most research scientists evaluate acupuncture from a fixed protocol, limited to puncture some predetermined points without considering the characteristics of each patient. This is not representative of how to actually practice acupuncture.
Lack of research funds
Research quality is very expensive, and acupuncture can lead to the marketing of products or treatments patentable. Because of this, apart from government agencies, few companies are willing to invest in such studies. In addition, there are still relatively few funds dedicated to education and academic research in acupuncture and TCM. But the situation tends to improve, particularly in the United States.
The number of studies is limited and they are often more or less good quality. Moreover, a finding that is frequently found in the following summaries of their studies or critical analysis is that it should make more high quality studies ... However, thanks to the creation of new standards for research (CONSORT stricta and, for example), it seems that the quality actually improves recent years 6 .
This is the Chinese
Many studies are written in Asian languages (Chinese, Japanese, Korean, Vietnamese), but few have been translated into English. In addition, the cultural differences that often are not considered valid by the Western scientific community.
The right questions?
As noted by a group of researchers, the reviews that conclude that "acupuncture studies provide no evidence of its effectiveness for valid any affection whatsoever " face the full brunt of the positive results observed yet daily around the world. They ask if we ask really good questions, including taking at all costs to create a placebo acupuncture . And it would not be more important to look primarily at how acupuncture compared with other conventional treatments.
See document Acupuncture
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