Acupuncture and The Placebo Effect

January 18, 2008

It should stand up to the test of scrutiny. It is just that these types of

medicines (ie., dentistry, surgery, etc.) do not lend themselves to drug-type

placebo controlled double blind studies. No matter how hard one try or how much

one wants to believe; a square peg never fits into a round hole. One needs to

measure outcomes against each other. This is something westerm medicine is VERY

afraid to do. Because then we WOULD see the truth of it.

Dr. Don Snow

:

establishment_man: Fri, 18 Jan 2008 17:56:58 +0000TCM -

Re: Acupuncture and The Placebo Effect

Mark,That is a fair observation.It is not a patent disregard. It is a justified

skepticism. I deal with a lot of doctors and skeptics and critics of TCM.I am

largely parroting the criticisms that they have lodged, but having listened to

such criticisms of acupuncture and TCM for so many years, I have come to agree

with most of them.Why should we continue to advertise clinical effects that have

not been sufficiently scrutinized? Why should Chinese " medicine " be given a free

pass with regard to both the scientific process and the FDA?I think that it

should be squeezed hard to find out what is and is not valid about TCM. If it is

as good as advertised - why should we as acupuncturists fear the scrutiny?And I

do not think that I should be regarded as a TCM heretic for demanding that this

medicine stand up to the test of scientific scrutiny.EM--- In

Chinese Medicine , " Mark Milotay " <mark wrote:>>

EM,> > You seem to have a patent disregard for TCM. I am curious to know why>

you are on this list, if you hold these views?> > Respectfully yours,> > Mark> >

On Jan 18, 2008 9:18 AM, establishment_man <establishment_man wrote:> >

Nam,> >> > I will have to respectfully disagree with many of your statements.>

>> > First among them, that Acupuncture is a Science. I think that I am> > using

a stricter definition of the term - one that includes> > adequately controlled

studies in large samples, that have consistent> > repeatability, and have been

published in peer-reviewed journals.> >> > When acupuncture can repeatedly and

consistently meet that standard,> > I will say that " Acupuncture Is a Science, "

but not until.> >> > Secondly, just because something has a long history, a

specialized> > nomenclature, and a rich past filled with documentation and

peopled> > with respected elders does not make it true. Think of Ptolemy and

the> > Catholic Church - both of whom enjoyed great respect from their> >

contemperaries and held broad authority. But, scietifically - they> > just

turned out to be dead wrong!> >> > Whoops.> >> > So, I think the " It's really

old so it must be true " argument is> > patently unreliable. So is the " How could

billions of people possibly> > be wrong " argument for that matter.> >> > The

ONLY argument that will ultimately silence the critics is the> > properly

controlled, consistently repeated, adequate sample sized> > argument.> >> > And

isn't that the way it should be?> >> > EM> >> > --- In

Chinese Medicine , " dr_namnguyen58 " > >> >> >

<dr_namnguyen58@> wrote:> > >> > > EM,> > > I think most of us and or with

others are considering Acupuncture> > > is not a science, but something else,

may be an art or some kinds of> > > occult or religion.> > > To me, I think

Acupuncture is a science just as WM, not an exact> > > science. WM has always

changed and developed something new> > constantly,> > > for this, it is

recognized as a superior science of all.> > > Science means knowledge. This

knowledge is based on theory ,> > > experiment, work, experience,and results,

then recorded.> > > I have studied and done research on Acupuncture and

herbology my> > > own to disregard OM as science , but I could not. There is

one> > thing I> > > had known, the theory or the reasoning behind the

Acupuncture and> > > Herbology are fixed. I believe sometimes I may call it a "

law " .> > This> > > is a science and it has been recorded years ago, with dated,

and> > named> > > of famous acupuncturists and herbologists. There are books,

stories> > > and cases studies and still we are to disbelieve it to be a> >

science. I> > > do not understand all people, but I think there is a reason for

it> > not> > > to be in a science. It is politics.> > > There is a sad thing,

non-profit, non-organization, and or no one> > > to support us to do

researching, for this we, OM , is left behind> > our> > > younger brother, WM.

We are aging with time.> > > We have not developed any new things or ideas

within hundred of> > > years -except some toys such as machines or equipments,

all we have> > > done is to study and bring the old wisdom out into practice.

But> > there> > > are many of us have not learned nor mastered the whole truth

but> > only> > > partial, this is why we all see randomly results as we wish,

not a> > > perfect one.> > > Like a language, such as words comes into being,

replicated or> > > reproduced, it will remain. If not, they are being forgotten

and> > died,> > > we called them " dead language " .> > > How can we expect

something as Acupuncture or herbology remain in> > > existence if they are not

growing nor reproducing something fruitful> > > to go along with or competing

with our brother, WM? For> > reincarnation,> > > we should do something to make

it alive " re-energize " instead of> > > insulting it or exterminate it.> > >> >

>> > > Nam Nguyen> > >> >> >>

January 18, 2008

I really appreciate this discussion because it goes to

show how beautifully diverse we are.

The devil's advocacy of Establishment Man are cute,

but based upon suppositions of science that are in

themselves outdated.

Stated simply rational materialism is an old linear

science that doesn't accommodate the " scientific "

findings of the last century. We're essentially

talking about quantum physics.

Now this may all sound rather cute and irrelevant in

itself but for the fact that it has direct bearing on

" placebo-effect. " From my perspective, placebo is a

scientific construct, is poorly developed concept, and

has varying thresholds which the existence of true

universal placebo questionable.

On this subject placebo, some of you may wish to

explore the writings of William Tiller, Stanford

emeritus professor of engineering. Psychoenergetic

Science: a Second Coperican-Scale Revolution.

I love establishment types. I think they form such an

important role for those who need authority to allow

them to act or think as they should. Establishing TCM

will go a great way toward allowing like-minded

practitioners to meet like-minded patients.

For the rest of us, there are certain philosophical

assumptions in about " placebo " that should be called

into question. First is the supposition that there is

a distinct difference between mind and body. The

supposition that mind cannot work upon matter which is

not supported by the data, faith healings, and qigong.

Simplistic discussions that pit the forces of faith

against science are adorable. We can just turn on the

TV for more of this type of territorialism. Some of

the more sophisticated science projects, however, are

going about measuring phenomena of human

consciousness.

rock on!

y.c.

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January 18, 2008

EM,

I do respect your comments and whatever you have stated, but there

is something which separates us, that is , we are in different

environments with different aspects.

As I mentioned science is knowledge. Acupuncture is a science , not

because it has been established in China, but throughout the world. It

has not been developed recently, does not mean it does not exist nor

not belong to science. WM is still not an exact science neither.

The reason that you keep denying it, I think , you have not studied

CM and you do not care about it. To me, I think if you have known,

just the surface of it and have no knowledge about it at all. There

are millions or billions of people who heard of or known about CM and

deny it. But this does not mean it did not exist nor it does not

belong to science.

To you, perhaps , it is a joke, but you should not judge anything

if you do not have a deep knowledge about it. You are making a fool of

yourself with your arrogance.

We, CM , do not have a profound knowledge of WM, but we at least

have some training and have some touches on it, and we do not judge

it, but to work with it - to complement - for the benefit of our people.

There are so many people such as MD or chiro or others just heard

of CM and have their eyes looked down with contempts, does it mean

they look better ? They should have a mirror and look at themselves

through the mirror and ask " Am I honest ? Am I being fair ? Am I

above Acupuncturists ? Am I superior ? And last do I know Acupuncture

well enough to judge it ?

Thanks,

Nam Nguyen

I am here not to defend nor offend anyone, I am here demanding a fair

chance for all.

January 19, 2008

Come on you all... EM has already told you he's a " dick " and you keep playing

w/him.. as most WM stoogies with their WM blinders on.. want to dis-credit

thousands of years of " Clinical observation " oh wait.. that's like double blinds

studies... Simply put.. TCM works and the clients enjoy the personal medicine

approach. Nobody has to prove anything... Give EM what he is asking for.. a 7

inch needle in DU 1 and send him out the door w/needle in tack.. quit playing

w/him and lets get back to the intent of this group..

Michael Finnell

Therapeutic Health Alternatives

Acupuncture by Michael Finnell

410C SE 3rd St. Suite 109

Lees Summit, MO 64063

816.665.5226

www.michaelfinnell.com

Never miss a thing. Make your homepage.

January 25, 2008

WhateverYourNameIs, would you please stop repeating this claptrap? As a

supposedly skeptical, balanced, scientific person, you are expected to back up

your assertions (which you usually don't - you argue based on reasoning (note

that I didn't say " reason " )), and to refrain from making assertions that

contradict established findings in the field. When you write stuff such as the

material quoted below, you show your ignorance of the research and inability

(unwillingness?) to review the study data.

Not only does it show that you have not critically reviewed the studies

themselves, but it shows that you cannot analyse information. The information

from the studies in question can be useful to elucidate certain points, however,

when compared and correlated with the information from biochemical and

bioelectrical research, it becomes clear that the hypothesis " sham-acu works as

well as acu " is not tenable.

Get up to snuff, WYNI.

Hugo

Pejo,

This is just the problem, though. Sham acupuncture in many research

studies DOES give the desired effect. At least as well as Actual

acupuncture in many cases. In other words, the sham protocol

performs on par with the actual acupuncture treatment in many

instances.

EM

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January 26, 2008

Hugo

are you saying that " sham " as not done as well as " real, " or at least

not statistically significant, in many studies?

400 29th St. Suite 419

Oakland Ca 94609

alonmarcus

January 26, 2008

Hey Alon, I am going to post a review of some studies including the recent

GERAC one soon, and get feedback from the group, so that post will answer your

question better.

However, from what I have seen, the design of some of these studies has been

perhaps good, but incomplete. This leaves room for important questions about the

studies themselves. However, what really blows it for me is information that

comes from a different arena - laboratory research. Too many well designed

studies have shown point-specificity in terms of the responses created by

acupuncture. Comparing the two we can at least ask two questions: 1. Are the

laboratory trials as a whole inferior, or 2. are the clinical studies as a whole

inferior? It seems to me that since acupuncture has already shown clear

superiority to non-sham in acute pain, and that many of the laboratory studies

have been of good quality, that the weight of evidence tends to rest in favour

of the chronic pain clinical studies being flawed.

Apart from all that, yes, too many studies have shown that sham is as good as

acupuncture in chronic pain. This is at odds with research from other arenas.

I'll provide refs and such later, but what are your thoughts? Thanks Alon,

Hugo

alon marcus <alonmarcus

Chinese Medicine

Saturday, 26 January, 2008 1:04:48 PM

Re: Acupuncture and The Placebo Effect

Hugo

are you saying that " sham " as not done as well as " real, " or at least

not statistically significant, in many studies?

400 29th St. Suite 419

Oakland Ca 94609

www.integrativeheal thmedicine. com

alonmarcus (AT) wans (DOT) net

January 27, 2008

Hey Hugo

I have also wandered about the difference in what we see in animal and

human studies. The problem we always see is that the larger and

better " controlled " the studiy the less specific effects we see in

human studies of all kind. The high response to sham does indicates a

REAL if not specific effects. Best practice studies, ie just comparing

patients treated with acup to lets say regular care can be helpful but

still would not answer the question, does acupuncture require training

or is it just some type of healing that occurs via interaction of skin

needle stimulation the patient and the practitioner regardless of

training. One thing is for sure, we have not seen any large scale

study that allows acup to be practiced on its on terms, ie flexible

protocols. To me that would be the only truly fair way to study

acupuncture. At the same time that kind of study has its own problem

the main one is that is would be totally operator dependent and if

negative would again bring up the question of skill of the

practitioners. All In All i am quite disturbed that we do not see

larger differences between sham and " real " in studies even if they are

not the best way to study acup. We should see greater effects. Even

most of the positive studies show only a small effects when the

numbers are closely looked at.

400 29th St. Suite 419

Oakland Ca 94609

alonmarcus

January 28, 2008

the placebo effect is always a factor in any kind of treatment, whether

it be a western medication, herbal medication, energy healing, or

surgery. this is why so many precautions are taken with well designed

double blind studies, to " control " so to speak for the effect of the

mind and belief in healing. no doubt one of the most powerful things

in medicine is to get the patient to change their mental state in such

a way that the patient is even more receptive to the help that healing

proceduresprovide. basically, i don't believe the placebo effect to be

more of an influence in acupuncture than in any other modality of

treatment.

marie sepich LAc

January 29, 2008

Placebo is not real. It is a construct, based upon

certain suppositions that are not supported in the

science after Einstein.

For the past ~400 years, the unstated assumption

[methinks not so unstated when visiting the construct

" placebo " ] that ' No human qualities of consciousness,

intention, emotion, mind or spirit can significantly

influence a well-designed target experiment in

physical reality. "

This is a quote from Psychoenergetic Science: A Second

Copernican-Scale Revolution by William Tiller.

Individuals who wish to engage in discussions of

scientific method, scientism, and philosophy of

science would be well served to check out Tiller's

work.

Tiller is a successful material enginer professor

emeritus from Stanford. You can read about the

ridicule he endured. He also makes some interesting

observations about why acupuncture works that are

novel.

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February 1, 2008

Acupuncture for chronic pain in Japan: a review. Evid Based Complement Alternat

Med. 2007 Dec;4(4):431-8. Many Japanese reports of acupuncture and moxibustion

for chronic pain are not listed in medical databases such as Medline. Therefore,

they are not easily accessible to researchers outside of Japan. To complement

existing reviews of acupuncture and moxibustion for chronic pain and to provide

more detailed discussion and analysis, we did a literature search using 'Igaku

Chuo Zasshi Wed' (Japana Centra Revuo Medicina) and 'Citation Information by

National Institute of Information' covering the period 1978-2006. Original

articles and case reports of acupuncture and moxibustion treatment of chronic

pain were included. Animal studies, surveys, and news articles were excluded.

Two independent reviewers extracted data from located articles in a pre-defined

structured way, and assessed the likelihood of causality in each case. We

located 57 papers written in Japanese (20 full papers, 37 case reports).

Conditions examined were headache (12 trials), chronic low back pain (9 trials),

rheumatoid arthritis (8 trials), temporomandibular dysfunction (8 trials),

katakori (8 trials) and others (12 trials). While 23 were described as clinical

control trials (CCTs), 11 employed a quasi-random method. Applying the 5-point

Jadad quality assessment scoring system, the mean score was 1.5 +/- 1.3 (SD).

Eleven (52%) of the CCTs were conducted to determine a more effective procedure

for acupuncture; these compared a certain type of acupuncture with another type

of acupuncture or specific additional points. In particular, the trigger point

acupuncture was widely used to treat chronic low back pain in Japan. Many

reports of chronic pain treatment by acupuncture and moxibustion are listed in

Japanese databases. From the data, we conclude that there is limited evidence

that acupuncture is more effective than no treatment, and inconclusive evidence

that trigger point acupuncture is more effective than placebo, sham acupuncture

or standard care.

February 2, 2008

oh man. when are we going to get past these flawed studies/conclusions

about the clinical efficacy of acupuncture/CM? our profession really needs

to get folks trained at the doctorate level who can begin created our own

studies of our medicine. hopefully this is not a very widely published

study, so that the collateral damage will be negligible.

in dismay,

kb

On Feb 1, 2008 6:00 PM, Alon Marcus <alonmarcus wrote:

> Acupuncture for chronic pain in Japan: a review. Evid Based Complement

> Alternat Med. 2007 Dec;4(4):431-8. Many Japanese reports of acupuncture and

> moxibustion for chronic pain are not listed in medical databases such as

> Medline. Therefore, they are not easily accessible to researchers outside of

> Japan. To complement existing reviews of acupuncture and moxibustion for

> chronic pain and to provide more detailed discussion and analysis, we did a

> literature search using 'Igaku Chuo Zasshi Wed' (Japana Centra Revuo

> Medicina) and 'Citation Information by National Institute of Information'

> covering the period 1978-2006. Original articles and case reports of

> acupuncture and moxibustion treatment of chronic pain were included. Animal

> studies, surveys, and news articles were excluded. Two independent reviewers

> extracted data from located articles in a pre-defined structured way, and

> assessed the likelihood of causality in each case. We located 57 papers

> written in Japanese (20 full papers, 37 case reports). Conditions examined

> were headache (12 trials), chronic low back pain (9 trials), rheumatoid

> arthritis (8 trials), temporomandibular dysfunction (8 trials), katakori (8

> trials) and others (12 trials). While 23 were described as clinical control

> trials (CCTs), 11 employed a quasi-random method. Applying the 5-point Jadad

> quality assessment scoring system, the mean score was 1.5 +/- 1.3 (SD).

> Eleven (52%) of the CCTs were conducted to determine a more effective

> procedure for acupuncture; these compared a certain type of acupuncture with

> another type of acupuncture or specific additional points. In particular,

> the trigger point acupuncture was widely used to treat chronic low back pain

> in Japan. Many reports of chronic pain treatment by acupuncture and

> moxibustion are listed in Japanese databases. From the data, we conclude

> that there is limited evidence that acupuncture is more effective than no

> treatment, and inconclusive evidence that trigger point acupuncture is more

> effective than placebo, sham acupuncture or standard care.

>

February 2, 2008

Yes,

Chinese medicine is just a bunch of mumbo jumbo and hocus pocus.

Let's call it " quackupuncture " !

I just learned of the term " nocebo " .

Something that is potentially effective becomes nil in it's effects,

because the patient doesn't believe in the process.

It's the opposite of " placebo " .

If the xin-mind doesn't lead, the rest of the kingdom can not follow.

J. Kokko (skeptic acupuncturist...) ha ha.

On Feb 1, 2008 3:00 PM, Alon Marcus <alonmarcus wrote: