Ted Kaptchuk on RCTs

[Guest guest]

Hi all,

 

This week I received an advertisement/informational flier from Kan Herb

Company (http://kanherb.com).

 

85% of this mailing was devoted to an article that talks about recent

clinical trials of acupuncture in the treatment of chronic low back pain.

 

Ted Kaptchuk is of course the author of The Web That Has No Weaver, an

important introduction to Chinese medicine. I think it is one of the best

books out there, and I recommend it for any serious student in or out of

school.

 

But in recent years, I've taken an interest in the placebo effect and kept

seeing Dr. Kaptchuk's name showing up. I recognize that he has really put

some time in to this question and this article that I received seems to

support this.

 

Here are some highlights:

 

Two recent studies (one in Seattle Washington, the other in Germany) did

large studies on acupuncture in the treatment of chronic low back pain. Both

of these studies were set up to test the benefits of acupuncture versus

conventional treatments, and also acupuncture versus sham (or fake)

acupuncture which was their way of mimicking a placebo controlled study.

 

In both cases, acupuncture performed well against other therapies, meaning

it was a cheaper intervention to get to the same end point of pain control.

However, they found that the sham acupuncture performed as well as the

legitimate acupuncture.

 

Dr. Kaptchuk then breaks down the various defenses to this finding of sham

and legit acupuncture producing the same results, some of which appeared on

this list in recent days. Ultimately he provides his own insight that

includes the most amazing finding of them all, that through fMRI imaging, it

became clear that legit acupuncture's mechanisms worked through pain nerve

pathways, while the sham acupuncture's mechanism originated in the emotional

part of the brain.

 

I would restate this as legit acupuncture treats pain, while sham

acupuncture treats suffering.

 

Anyway, it is a great article that really flushes out many of the topics

we've been discussing here and also does a good job of defining the issues

at play, at least when it comes to acupuncture.

 

I've asked Kan Herbs for permission to reprint it at gancao.net, but I don't

know if I'll be able to, in the meantime, if anybody is very interested, go

to http://kanherb.com and use their contact information located conveniently

on their front page and ask for a copy of the " Herbal Crossroads " flier from

march 2010.

 

Disclosure: I have no financial interest in Kan Herbs.

 

-al.

 

--

, DAOM

Pain is inevitable, suffering is optional.

http://twitter.com/algancao