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Acupuncture – Barak Gaster, MD

Acupuncture – Barak Gaster, MD. Acupuncture. One part of the ancient, rich system of Traditional Chinese Med, generally combined w/ Chinese herbs Yin-Yang - opposing forces in the body. Goal of acupuncture is to restore their balance.

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Acupuncture – Barak Gaster, MD

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  1. Acupuncture – Barak Gaster, MD

  2. Acupuncture • One part of the ancient, rich system of Traditional Chinese Med, generally combined w/ Chinese herbs • Yin-Yang - opposing forces in the body. Goal of acupuncture is to restore their balance. • Qi - Life energy. Runs along channels (meridians). Acupuncture relieves blockages, improves flow • Overarching goal: rebalance, redistribute Yin-Yang and allow Qi to flow more freely. • Western Acup – needles only (without Chinese herbs)

  3. Acupuncture for OA • Large RCT in the Annals (Berman, 2004) • Patients (n=570) were randomized into three arms: 1) true acup 2) sham acup 3) control - educ only • Elaborate sham acupuncture: pressure on random points - without skin puncture. • 2 months of full treatment, followed for 6 months. • Successful blinding (equal number guessed they got “sham” in both arms). Berman. Ann Intern Med 2004:141:901

  4. Acupuncture for OA P=.003 Reduction in Pain Score Ann Intern Med 2004:141:901

  5. Acupuncture for Chronic HA’s • Two large high quality studies done in Germany, both published in 2005. • One studied patients with migraine HA’s (n=302). Other studied patients with tension HA’s (n=270). • Patients were randomized to receive: true acupuncture vs. “sham” needling vs. wait list. • “Sham” needling involved superficial / minimal needling of non-acupuncture points Linde: JAMA 2005 - PMID 15870415 Melchart: BMJ 2005 - PMID 16055451

  6. Acupuncture for Migraines p<.001 HA days per month Linde: 2005 - PMID 15870415

  7. Acupuncture for Tension HA’s p<.001 HA days per month Melchart: 2005 - PMID 16055451

  8. Other high quality RCTs of acupuncture • Fibromyalgia: true acupuncture no better than sham acupuncture - no observation arm Assefi et al. Ann Intern Med 2005;143:10 • LBP: true acupuncture and minimal needling both equally better than no treatment at all Haake et al. Arch Intern Med 2007;167:1892-8 • LBP: large NIH-funded RCT based in Seattle to be published in next few months

  9. Acupuncture - Take Home Points • Past 3 years: there’s suddenly good evidence that people with osteoarthritis or chronic headaches feel better after getting acupuncture. • BUT: positive effects (which persisted) were not too different in patients who got “minimal needling” to random non-acupuncture points. • Still a mystery: how / why do patients get better after acupuncture. Is it just a placebo? • Or are there also positive physiologic effects from minimal needling of non-acupuncture points which are used in the ‘control’ groups?

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