Acupuncture Research Challenges

by Wendy Whitman, L.Ac.

I first became interested in the field of acupuncture research in 1991 while a student at the Florida Institute of Traditional Chinese Medicine. In one of my classes, I was introduced to data from research conducted in China to quantify the actions of the single point Stomach 36, used traditionally to harmonize the stomach, nourish blood, support correct qi and tonify qi.

Researching Stomach 36

Subjects in the study had been needled at Stomach 36 and then different parameters were observed. Subjects showed an increase in leukocyte count in the blood which became apparent thirty minutes after needling, and lasted for three hours. The increase of any blood component, particularly leukocytes which fight infection, would constitute nourishing blood and supporting correct qi. Other measures showed an increase in the amplitude and frequency of peristalsis in the stomach, and a decrease in stomach emptying time, which supports the idea of harmonizing the stomach function. With respect to tonifying qi, monitoring of subjects' breath during treatment showed that needling Stomach 36 produced an average increase in ventilation capacity of 6.6%.

Twelve years ago, when I first came across this research, no one in the class thought to ask the teacher for the citations for these studies. Most of the studies conducted in China were not translated into English, so most of us would have been unable to even read the abstracts of these studies. Yet, the possibilities this information offered profoundly influenced my decision to work in the field of acupuncture research.

Acupuncture research in China has generally focused on what treatments work best for given conditions, and the ways in which acupuncture affects the body. In contrast, Western countries that embrace allopathic medicine seek to prove the effectiveness of acupuncture using the accepted standards developed for testing the validity of pharmaceuticals, which is the double-blind placebo controlled study. This approach monitors changes in the experimental group (receiving the new medication), and compares them to changes in a control group (receiving a placebo, a sugar pill that looks exactly like the medicine). Double blind means that neither the patient nor the person administering the test knows who is getting which treatment.

There are difficulties in applying this methodology to acupuncture. For example, what is placebo acupuncture? Sham acupuncture, the placing of needles at supposed non-points, has been used as a control in a number of studies. However, the placing of needles at non-points has never been scientifically proven to have no effect at all, and thus cannot be assumed to be a true placebo. In one study in which I worked (1), two of the patients were so happy with their results that they continued to come to my private office for treatment after the study was completed. Both of those patients had been in the so-called placebo group.

Another major difficulty in applying scientific testing methods to acupuncture is the expense incurred. A pharmaceutical company may conduct lengthy and expensive tests to gain approval for a new product, with the expectation that they will recover their costs and possibly reap large profits once the product is approved. However, no one will reap large profits on proving the efficacy of a specific acupuncture treatment.

In 1997, The National Institutes of Health (NIH) held a Consensus Development Conference on acupuncture in Washington D.C. Researchers presented the results of various studies, and participants discussed the difficulty of testing acupuncture only by the double blind method or sham acupuncture. The panelists concluded that acupuncture was shown to be effective by Western medical standards in several studies, particularly for post-chemotherapy nausea and post operative pain from dental surgery. The NIH panel further stated that while controlled trials could provide a basis for use, "other study designs such as those used in clinical epidemiology or outcomes research can also provide important insights regarding the usefulness of acupuncture."(2) Further exploration was deemed appropriate and the NIH has continued to expand funding for acupuncture research.

1. Wendy Whitman provided acupuncture treatments for research studies sponsored by the National Institute on Drug Addiction and the Dade County Court system (91-93), a University of Miami study on "Acupuncture for the Treatment of AIDS", and for the National Institute of Allergies and Infectious Diseases (NIAID) Community Programs for Clinical Research on AIDS (CPCRA), which evaluated acupuncture and amytriptyline hydrochloride for pain due to HIV related peripheral neuropathy (93 to 96).

2. Acupuncture. NIH Consensus Statement 1997 Nov 3-5; 15(5): 1-34. For more information on NIH studies go to http://odp.od.nih.gov/consensus/cons/107/107_ statement.htm

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