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[droid]

Yes but surely the evidence of it being accurate from a diagnostic sense,then the treatment speaks for its self.TCM has evolved to what it is now,acupuncture is available on the NHS.My physio uses it to stimulate blood flow.I get what you are saying,but it has worked for me and my wife so i can only comment from a personal point of view.

[Le Stu]

I think it goes like this:

Medical Establishment: This is a load of hooey as there is no hard evidence to back up the claims of TCM practioners.

TCM Practitioners: Wanna do some studies?

Medical Establishment: No.

Well, not many anyway. Sceptics who never play devil's advocate are more accurately described as cynics.

[nullmouse]

Originally Posted by droid

Yes but surely the evidence of it being accurate from a diagnostic sense,then the treatment speaks for its self.TCM has evolved to what it is now,acupuncture is available on the NHS.My physio uses it to stimulate blood flow.I get what you are saying,but it has worked for me and my wife so i can only comment from a personal point of view.

I think the important thing is that every treatment (alternative or not) is properly evaluated for how effective it is, otherwise anyone could claim anything and no-one would be able to refute it.

The availability of acupuncture on the NHS is limited to specific treatments and is part based on successful political lobbying (hello, Prince Charles), part based on the available data suggesting it may be more effective than simply doing nothing. The jury is still out whether acupuncture works as claimed, or is just a special version of the placebo effect: In either case, doing something is better than doing nothing, but the latter calls in to question the method by which acupuncture supposedly works. One argument would be that as long as it's better doing something rather than nothing, then it doesn't matter if acupuncture works due to meridians and qi flow or if it works as nothing but a placebo. A counter-argument to this would be that if acupuncture is just a placebo, then it is not a treatment with any efficacy and to claim it is would be deceitful.

[nullmouse]

Originally Posted by Le Stu

Medical Establishment: This is a load of hooey as there is no hard evidence to back up the claims of TCM practioners.

TCM Practitioners: Wanna do some studies?

Medical Establishment: No.

I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):

We identified 24 reports of studies. The only comparison for which there were sufficient studies to combine meaningfully was acupuncture compared with sham acupuncture. The fixed-effect odds ratio (OR) for the short-term effect was 1.36 (95% confidence interval 1.07 to 1.72), but the studies are heterogeneous and the result is strongly influenced by one individual positive study. The significant short-term effect was lost with the random-effects model for pooling, or by removing the outlying study that led to heterogeneity. The long-term result shows no effect of acupuncture compared with sham acupuncture. There was no consistent evidence that acupuncture is superior to no treatment, and no evidence that the effect of acupuncture was different from that of other anti-smoking interventions, or that any particular acupuncture technique is superior to other techniques.

For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated.

[Graeme]

Originally Posted by nullmouse

I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):



For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated.

Are you like some sort of doctor or something!

[nullmouse]

Originally Posted by Graeme

Are you like some sort of doctor or something!

Luckily not the kind that gets let loose anywhere near patients

[Le Stu]

Originally Posted by nullmouse

I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):



For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated.

Would these trials be on anything like the scale of the trials for the various NRT treatments though? I somehow doubt it. Personally, I believe that acupuncture for addiction issues brings a largely psychological benefit, a true placebo effect, so these results don't surprise me. I'd be more interested in trials concerning ME if you've got any info on that.

Anyway, I'm not really arguing with anything you've posted in this thread as you've obviously got a balanced view.

[droid]

If the NHS are practicing acupuncture then it must have some scientific value!TCM is not just about acupuncture.My practitioner has a degree in physics and is a very intelligent man,if he can't help you,he won't take money off you for the sake of it.

[nullmouse]

Originally Posted by Le Stu

Would these trials be on anything like the scale of the trials for the various NRT treatments though? I somehow doubt it. Personally, I believe that acupuncture for addiction issues brings a largely psychological benefit, a true placebo effect, so these results don't surprise me. I'd be more interested in trials concerning ME if you've got any info on that.

Anyway, I'm not really arguing with anything you've posted in this thread as you've obviously got a balanced view.

A lot of these trials do fall short of having the same numbers as you'd expect from a properly controlled trial, which is why organisations like the Cochrane Library give them less weight when reviewing the available evidence. The more robustly designed trials (of which numerous do exist), are given more weight. Given the breadth of conditions acupuncture is suggested to treat it's not surprising that some of the evidence may get spread a little thin, but it's certainly not non-existent. I'm all for big, carefully controlled experiments for every treatment whatever the outcome, but they're not always practical to perform for a wide range of reasons (cost often being the major one, to be honest).

With regards ME, there's currently a report being compiled by the Cochrane library (the font of all evidence-based medicine fun) on the effectiveness of acupuncture for the alleviation of chronic fatigue syndrome. Unfortunately, that means there's no conclusion to share just now, but here's something I did find from a recent journal review:

Originally Posted by Wang et al, Am J Chin Med 2008

Studies on the treatment of chronic fatigue syndrome (CFS) with acupuncture and moxibustion in China were reviewed. All studies concluded the treatments were effective, with response rates ranging from 78.95% to 100%. However, the qualities of the studies were generally poor, and none of them used a RCT design. The common acupoints/sites used in the treatment of CFS, which may reflect the collective experience of acupuncturists in China based on Traditional Chinese Medicine theories can be used to evaluate the effectiveness of acupuncture for the treatment of CFS in future studies using more scientifically rigorous study designs.

Note that this review only looks at studies from China (who may have a national pride stake in acupuncture working) and none adhered to an RCT design (meaning patients were neither randomly assigned into groups or controlled appropriately). The authors reflect this in their conclusions. Note though, that the reported success rate in these studies is "78.95% to 100%". The old rule of thumb about "if something sounds too good to be true, it probably is" springs to mind - But keeping an objective mind, this would appear superficially promising. To be 100% sure, proper studies would need to be performed that both randomised the patients in to groups and made sure half of them received fake treatment. If, under those conditions, they still got such high success then everyone would be on to a winner. At the moment, all the studies they review are just comparing doing something to doing nothing, which can't tell us if the treatment is anything more than placebo...

[nullmouse]

Originally Posted by droid

If the NHS are practicing acupuncture then it must have some scientific value!TCM is not just about acupuncture.My practitioner has a degree in physics and is a very intelligent man,if he can't help you,he won't take money off you for the sake of it.

TCM isn't just about acupuncture, true - But it's a good example that fits in with the rest of the thread. Irregardless, any TCM should be subject to the same scrutiny as any medical treatment in order to ascertain its effectiveness.

The NHS stance on acupunture is a controversial one, and is based on evidence that doesn't necessarily show that acupuncture is any better than a fake needling session. What the evidence does show is that doing acupuncture is better than doing nothing for some conditions. The key question is if acupuncture actually does anything that random needle placing wouldn't. For the treatments that the NHS prescribe acupuncture for, that it is not yet known.

I can't really comment on your practitioner, from what you say he sounds like a nice guy though.