Harmony TCM Weblog
Updates on Gerry Harrington's Chinese Medicine practice, Chinese medicine in the news, whimsical explorations. The posts in this blog do not constitute medical advice. They are for informational purposes only. If you have a medical condition or concern, please consult with a health care professional.
February 03, 2011
August 23, 2010
Studying Acupuncture, One Needle Prick at a Time
This article questions the value of using of the placebo-controlled study as a way to test acupuncture's effectiveness.
From the New York Times Website:
August 23, 2010, 5:37 pm
Studying Acupuncture, One Needle Prick at a Time
By TARA PARKER-POPEFor at least 2,000 years Chinese healers have used acupuncture to treat pain and other ailments. Now Western doctors want proof that it works.
There is little dispute that people feel better after receiving the treatment, in which thin needles are inserted deeply into the skin at specific points on the body. But are they benefiting from acupuncture itself, or just getting a placebo effect?
The debate was fueled last week by a study in the journal Arthritis Care and Research. Researchers from MD Anderson Cancer Center in Houston found that among 455 patients with painful knee arthritis, acupuncture delivered no more relief than a sham treatment.
Actually, patients got significant pain relief from both treatments — an average reduction of one point on a scale of 1 to 7. And critics contend that the study was poorly designed.
For one thing, they note, patients in both groups received treatment with needles and electrical stimulation; the main difference was that in the sham group, the needles were not inserted as deeply and the stimulation was far shorter in duration.
In the real world, however, a trained acupuncturist would customize the treatment to a patient’s specific symptoms. But in this study, the patients in the “real” acupuncture group all received needles inserted in the same way.
Rather than proving that acupuncture does not work, in other words, the study may suggest that it works even when administered poorly. But the real lesson, acupuncture supporters say, is how difficult it can be to apply Western research standards to an ancient healing art.
“People argue that there really are no inactive acupuncture points — pretty much wherever you put a needle in the body is an active point,” said Dr. Alex Moroz, a trained acupuncturist who directs the musculoskeletal rehabilitation program at New York University. “There is a body of literature that argues that the whole approach to studying acupuncture doesn’t lend itself to the Western reductionist scientific method.”
But the study’s lead author, Dr. Maria E. Suarez-Almazor, notes that the sham treatment was developed with the help of trained acupuncturists. In a drug study, an equal response in the treatment and placebo groups would prove the drug does not work, she says.
“We really worked with acupuncturists who are trained in the Chinese traditional style and asked them to come up with a sham that could be credible,” Dr. Suarez-Almazor said. “We didn’t plan a study trying to show that acupuncture didn’t work. The results came out with no difference between the groups.”
The MD Anderson research and other recent acupuncture studies have fueled speculation that the prick of a needle, whether from real acupuncture or a sham version, can influence the way the body processes and transmits pain signals. A 2007 study of 1,200 back-pain patients, financed by insurance companies in Germany, showed that about half the patients in both real and sham acupuncture groups had less pain after treatment, compared with only 27 percent of those receiving physical therapy or other traditional back care.
When the German researchers tracked how much pain medicine the patients used, they detected a noticeable difference between real acupuncture and the sham treatment. Only 15 percent of patients in the acupuncture group required extra pain drugs, compared with 34 percent in the sham group. The group receiving conventional back therapy fared even worse than those receiving fake acupuncture: 59 percent of those patients needed extra pain pills.
The researchers, who published their findings in Archives of Internal Medicine, speculated that inserting needles in or around an area of pain may have caused a “super placebo” effect, touching off a series of reactions that changed the way the body experienced pain.
Still another study, this one financed by the National Institutes of Health and published in 2004, found that acupuncture significantly reduced pain and improved function in knee arthritis patients compared with a sham treatment or routine knee care.
But that result has been called into question because the patients in the sham group probably figured out they were not getting the real thing. They received only two needle insertions in the abdomen, while a needle was simply pressed along nine areas of the leg and taped to the skin to mimic acupuncture. A mock electrical stimulation machine whirred and blinked nearby, but didn’t deliver any current to the body.
This year, researchers at Henry Ford Hospital in Detroit solved the problem of creating a sham acupuncture treatment: they didn’t have one. Instead, they compared acupuncture to a proven remedy — the drug Effexor, an antidepressant that has been shown to significantly reduce hot flashes in breast cancer patients.
The results were striking. Acupuncture relieved hot flashes just as well as Effexor, with fewer side effects. The acupuncture recipients reported more energy and even an increased sex drive, compared with women using Effexor.
“There are some things you can’t study the same way we do with
drugs,” said Dr. Eleanor M. Walker, director of breast radiation
oncology at the
Henry Ford Health System. “The thing that can’t be argued in my study is
the duration of the effect. It lasts, and the placebo effect doesn’t
last once you stop a treatment.”
But acupuncture believers say it doesn’t really matter whether Western scientific studies find that the treatment has a strong placebo effect. After all, the goal of what they call integrative medicine, which combines conventional and alternative treatments like acupuncture, is to harness the body’s power to heal itself. It doesn’t matter whether that power is stimulated by a placebo effect or by skillful placement of needles.
“In general in integrative medicine, when patients are involved in their healing process, they have a tendency to do better,” said Angela Johnson, a practitioner of Chinese medicine at Rush Children’s Hospital in Chicago who is conducting a pilot study of acupuncture to relieve pain in children. “I believe that’s part of the reason why they get better.”
August 19, 2010
Acupuncture, Real or Fake, Eases Pain
Perhaps "fake" isn't the best term since the group did actually receive acupuncture.
New York Times
August 18, 2010, 11:25 am
Acupuncture, Real or Fake, Eases Pain
By TARA PARKER-POPEFake acupuncture appears to work just as well for pain relief as the real thing, according to a new study of patients with knee arthritis.
The findings, published in the September issue of the journal Arthritis Care and Research, are the latest to suggest that a powerful but little understood placebo effect may be at work when patients report benefits from acupuncture treatment, which involves inserting thin needles deeply into the skin at specific points on the body.
The study, from the M. D. Anderson Cancer Center, tracked 455 patients with painful knee arthritis who received either traditional Chinese acupuncture or a sham treatment. A control group of patients was put on a waiting list for acupuncture treatment. Patients were told only that the study was comparing a traditional versus nontraditional form of acupuncture.
In the real treatment group, needles were inserted at specific points on the body and manipulated in accordance with traditional Chinese acupuncture techniques. In the sham treatment group, needles also were inserted, but not at the locations traditionally used for acupuncture. Electrical stimulation was also used, although those in the sham group received lower voltage and far shorter treatments.
Compared to people on the waiting list for treatment, both the real and sham acupuncture groups had statistically significant reductions in pain, averaging about a one point drop in pain on a scale of 1 to 7. The researchers also found that the enthusiasm of the person inserting the needles had a small but statistically significant effect. Patients reported slightly more pain relief when they were treated by someone who said “I’ve had a lot of success with treating knee pain,” compared with a practitioner who took a more neutral stance, saying “It may or may not work for you.”
The results don’t mean acupuncture doesn’t work, but they do suggest that the benefits of both real and fake acupuncture may have something to do with the way the body transmits or processes pain signals. Other studies have suggested that the prick of a needle around the area of injury or pain could create a “super-placebo” effect that alters the way the brain perceives and responds to pain.
The study design may also have blurred the lines between real and fake acupuncture, muting the effects of the real thing. For instance, in traditional Chinese acupuncture, the needle insertion points are along specific areas called meridians, but the exact point of insertion is decided on a patient-by-patient basis, depending on the patient’s body and area of pain. In the study, however, a standard map was used so that the needle insertion point was the same for every patient. In addition, trained acupuncturists also were asked to administer the fake treatment and insert needles at specific points outside of traditional meridians. Although researchers sometimes stepped into treatment sessions to check on the location of the needles, it’s possible that some of the sham treatments were similar to real acupuncture.
The current findings are similar to a 2007 study of 1,200 patients with back pain who were also given real acupuncture, a sham treatment or traditional back care such as physical therapy or exercise treatment. In that study about half the patients in both the real and fake acupuncture groups reported significant pain relief compared to only 27 percent of those receiving traditional back care. In that study, however, real acupuncture did reduce the need for pain medicine. Only 15 percent of patients who received real acupuncture used extra pain medication, but 34 percent of patients in the sham group and 59 percent of patients in conventional therapy needed extra pain pills.
A 2007 National Health Interview Survey found that an estimated 3.1 million Americans had used acupuncture in the past year. Back pain is the most common reason patients seek acupuncture treatment, followed by joint pain, neck pain, migraines and other forms of recurring pain.
The National Center for Complementary and Alternative Medicine offers an extensive review of the research on acupuncture, including studies of acupuncture for back pain, knee arthritis, post traumatic stress, fibromyalgia and fertility treatment.
Tai Chi eases Fibromyalgia symptoms - NY Times
By PAM BELLUCK
The ancient Chinese practice of tai chi may be effective as a therapy for fibromyalgia, according to a study published on Thursday in The New England Journal of Medicine.
A clinical trial at Tufts Medical Center found that after 12 weeks of tai chi, patients with fibromyalgia, a chronic pain condition, did significantly better in measurements of pain, fatigue, physical functioning, sleeplessness and depression than a comparable group given stretching exercises and wellness education. Tai chi patients were also more likely to sustain improvement three months later.
“It’s an impressive finding,” said Dr. Daniel Solomon, chief of clinical research in rheumatology at Brigham and Women’s Hospital in Boston, who was not involved in the research. “This was a well-done study. It was kind of amazing that the effects seem to carry over.”
Although the study was small, 66 patients, several experts considered it compelling because fibromyalgia is a complex and often-confusing condition, affecting five million Americans, mostly women, according to the Centers for Disease Control and Prevention. Since its symptoms can be wide-ranging and can mimic other disorders, and its diagnosis depends largely on patients’ descriptions, not blood tests or biopsies, its cause and treatment have been the subject of debate.
“We thought it was notable that The New England Journal accepted this paper, that they would take fibromyalgia on as an issue, and also because tai chi is an alternative therapy that some people raise eyebrows about,” said Dr. Robert Shmerling, clinical chief of rheumatology at Beth Israel Deaconess Medical Center in Boston, co-author of an editorial about the study.
“Fibromyalgia is so common, and we have such a difficult time treating it effectively. It’s defined by what the patient tells you,” he added. “It’s hard for some patients’ families and their doctors to get their head around what it is and whether it’s real. So, that these results were so positive for something that’s very safe is an impressive accomplishment.”
Recent studies have suggested that tai chi, with its slow exercises, breathing and meditation, could benefit patients with other chronic conditions, including arthritis. But not all of these reports have been conclusive, and tai chi is hard to study because there are many styles and approaches.
The fibromyalgia study involved the yang style of tai chi, taught by a Boston tai chi master, Ramel Rones. Dr. Solomon and other experts cautioned that bigger studies with other masters and approaches were necessary.
Still, patients, who received twice-weekly tai chi classes and a DVD to practice with 20 minutes daily, showed weekly improvement on an established measurement, the Fibromyalgia Impact Questionnaire, improving more than the stretching-and-education group in physicians’ assessments, sleep, walking and mental health. One-third stopped using medication, compared with one-sixth in the stretching group.
Dr. Chenchen Wang, a Tufts rheumatologist who led the study, said she attributed the results to the fact that “fibromyalgia is a very complex problem” and “tai chi has multiple components — physical, psychological, social and spiritual.”
The therapy impressed Mary Petersen, 59, a retired phone company employee from Lynn, Mass., who said that before participating in the 2008 study, “I couldn’t walk half a mile,” and it “hurt me so much just to put my hands over my head.” Sleeping was difficult, and she was overweight. “There was no joy to life,” she said. “I was an entire mess from head to foot.”
She had tried and rejected medication, physical therapy, swimming and other approaches. “I was used to being treated in a condescending manner because they couldn’t diagnose me: ‘She’s menopausal, she’s crazy.’ ”
Before the study, “I didn’t know tai chi from a sneeze,” said Ms. Petersen, who has diabetes and other conditions. “I was like, ‘Well, O.K., I’ll get to meet some people, it will get me out of the house.’ I didn’t believe any of it. I thought this is so minimal, it’s stupid.”
After a few weeks, she said she began to feel better, and after 12 weeks “the pain had diminished 90 percent.” She has continued tai chi, lost 50 pounds and can walk three to seven miles a day.
“You could not have convinced me that I would ever have done this or continued with this,” she said. “I wouldn’t say it’s a cure. I will say it’s an effective method of controlling pain.”
Dr. Shmerling said that though tai chi is inexpensive compared with other treatments, some patients would reject such an alternative therapy. And Dr. Gloria Yeh, a Beth Israel Deaconess internist and co-author of the editorial, said others “will say, ‘It’s too slow, I can’t do that.’ ”
But she said it offered a “gentler option” for patients deterred by other physical activities. “The mind-body connections set it apart from other exercises,” she said, adding that doctors are seeking “anything we can offer that will make patients say ‘I can really do this.’ ”
August 11, 2010
Nice intro to acupuncture
From Arthur Rosenfeld of Huffingtonpost.com:
Recently I've been involved in creating and hosting a series of documentaries on integrative medicine. The three films are aimed at healthcare professionals. The first is about the science of tai chi, the second is about the science of meditation and the third is about the science of acupuncture. I've just wound up the last on-location filming (interviewing experts) for the acupuncture film, and am struck by how this ancient healing modality is blossoming in popularity across the country.
A healing tool of Traditional Chinese Medicine (TCM), acupuncture has been successfully administered for more than 2,500 years. According to the TCM view, a vital energy called qi flows through the body along channels called meridians......
July 21, 2010
New Manhattan Office
I'm pleased to announce that beginning in August, I will be seeing patients in Manhattan at:
928 Broadway
Suite 904
New York, NY 10010
(347) 563 - 3861
Astoria hours will remain unchanged.
Hope to see you there!
Gerry
July 13, 2010
June 08, 2010
Frankincense: Could it be a cure for cancer? - BBC article
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/middle_east/8505251.stm
Published: 2010/02/09 10:59:45 GMT
The gift given by the wise men to the baby Jesus probably came across the deserts from Oman. The BBC's Jeremy Howell visits the country to ask whether a commodity that was once worth its weight in gold could be reborn as a treatment for cancer.
Oman's Land of Frankincense is an 11-hour drive southwards from the capital, Muscat.
Most of the journey is through Arabia's Empty Quarter - hundreds of kilometres of flat, dun-coloured desert. Just when you are starting to think this is the only scenery you will ever see again, the Dhofar mountains appear in the distance.
On the other side are green valleys, with cows grazing in them. The Dhofar region catches the tail-end of India's summer monsoons, and they make this the most verdant place on the Arabian peninsula.
Warm winters and showery summers are the perfect conditions for the Boswellia sacra tree to produce the sap called frankincense. These trees grow wild in Dhofar. A tour guide, Mohammed Al-Shahri took me to Wadi Dawkah, a valley 20 km inland from the main city of Salalah, to see a forest of them.
"The records show that frankincense was produced here as far back as 7,000 BC," he says. He produces an army knife. He used to be a member of the Sultan's Special Forces. With a practised flick, he cuts a strip of bark from the trunk of one of the Boswellia sacra trees. Pinpricks of milky-white sap appear on the wood and, very slowly, start to ooze out.
"This is the first cut. But you don't gather this sap," he says. "It releases whatever impurities are in the wood. The farmers return after two or three weeks and make a second, and a third, cut. Then the sap comes out yellow, or bright green, or brown or even black. They take this."
Shortly afterwards, a frankincense farmer arrives in a pick-up truck. He is white-bearded, wearing a brown thobe and the traditional Omani, paisley-patterned turban.
He is 67-year-old Salem Mohammed from the Gidad family. Most of the Boswellia sacra trees grow on public land, but custom dictates that each forest is given to one of the local families to farm, and Wadi Dawkah is his turf.
Camel train
He has an old, black, iron chisel with which he gouges out clumps of dried frankincense.
"We learnt about frankincense from our forefathers and they learnt it from theirs" he says. "The practice has been passed down through the generations. We exported the frankincense, and that's how the families in Dhofar made their livings."
And what an export trade it was. Frankincense was sent by camel train to Egypt, and from there to Europe. It was shipped from the ancient port of Sumharan to Persia, India and China. Religions adopted frankincense as a burnt offering.
That is why, according to Matthew's Gospel in the Bible, the Wise Men brought it as a gift to the infant Jesus. Gold: for a king. Frankincense: for God. Myrrh: to embalm Jesus' body after death.
The Roman Empire coveted the frankincense trade. In the first century BCE, Augustus Caesar sent 10,000 troops to invade what the Romans called Arabia Felix to find the source of frankincense and to control its production. The legions, marching from Yemen, were driven back by the heat and the aridity of the desert. They never found their Eldorado.
Oman's frankincense trade went into decline three centuries ago, when Portugal fought Oman for dominance of the sea routes in the Indian and the Pacific Oceans.
Nowadays, hardly any Omani frankincense is exported. Partly, this is because bulk buyers, such as the Roman Catholic Church, buy cheaper Somalian varieties. Partly, it is because Omanis now produce so little.
"Years ago, 20 families farmed frankincense in this area," says Salem Mohammed Gidad. "But the younger generation can get well-paid jobs in the government and the oil companies, with pensions. Now, only three people still produce frankincense around here. The trade is really, really tiny!"
Cancer hope
But immunologist Mahmoud Suhail is hoping to open a new chapter in the history of frankincense.
Scientists have observed that there is some agent within frankincense which stops cancer spreading, and which induces cancerous cells to close themselves down. He is trying to find out what this is.
"Cancer starts when the DNA code within the cell's nucleus becomes corrupted," he says. "It seems frankincense has a re-set function. It can tell the cell what the right DNA code should be.
"Frankincense separates the 'brain' of the cancerous cell - the nucleus - from the 'body' - the cytoplasm, and closes down the nucleus to stop it reproducing corrupted DNA codes."
Working with frankincense could revolutionise the treatment of cancer. Currently, with chemotherapy, doctors blast the area around a tumour to kill the cancer, but that also kills healthy cells, and weakens the patient. Treatment with frankincense could eradicate the cancerous cells alone and let the others live.
The task now is to isolate the agent within frankincense which, apparently, works this wonder. Some ingredients of frankincense are allergenic, so you cannot give a patient the whole thing.
FRANKINCENSE FACTS
Dr Suhail (who is originally from Iraq) has teamed up with medical scientists from the University of Oklahoma for the task.
In his laboratory in Salalah, he extracts the essential oil from locally produced frankincense. Then, he separates the oil into its constituent agents, such as Boswellic acid.
"There are 17 active agents in frankincense essential oil," says Dr Suhail. "We are using a process of elimination. We have cancer sufferers - for example, a horse in South Africa - and we are giving them tiny doses of each agent until we find the one which works."
"Some scientists think Boswellic acid is the key ingredient. But I think this is wrong. Many other essential oils - like oil from sandalwood - contain Boswellic acid, but they don't have this effect on cancer cells. So we are starting afresh."
The trials will take months to conduct and whatever results come out of them will take longer still to be verified. But this is a blink of the eye in the history of frankincense.
Nine thousand years ago, Omanis gathered it and burnt it for its curative and cleansing properties. It could be a key to the medical science of tomorrow.
Jeremy Howell reports for
on BBC World News.
June 2010 Newsletter
Harmony TCM Newsletter: June 2010
Welcome to the June 2010 Newsletter for Harmony TCM / Gerry Harrington L.Ac..
In this newsletter you will find:
- Summer office hours
- Watermelon, the ultimate summer fruit
- Like massage? Try Tui-Na!
- In the News
Summer Office Hours:
The Yoga Room. 38-01 35th Ave, 2nd Fl, Astoria, NY 11101 (718) 274-0255
- Wednesday 11am-8pm
- Thursday 4pm-9pm
- Saturday 2pm-6pm
Watermelon, the ultimate summer fruit:
Watermelon, or Xi Gua in Chinese, is a great fruit to keep cool with this summer. Being both cold and sweet, watermelon provides a balancing comfort to summer's sweltering heat. According to the Chinese Herbal Medicine Materia Medica, watermelon "clears summerheat" to cool you down, "replenishes fluids" to prevent dehydration, and "promotes urination" to further clear heat from the body. Watermelon's diuretic effect is also helpful for relieving jaundice in patients with hepatitis. The peel of watermelon, "xi gua pi", can be applied directly to minor burns to cool the skin and promote healing. Watermelon is easily the best tasting Chinese "herb."
Want a massage? Try Tui Na! ("Twee Na")
What is Tui Na? Tui Na is style of bodywork that is based on Chinese medicine theory. Tui Na uses a variety of hand techniques to stimulate the body’s meridians, relax muscles and connective tissue, and restore the body’s alignment. Acupressure, the stimulation of acupuncture points without needles, is part of Tui Na. Herbal liniments and oils are often used to aid in healing. Tui na can be useful for orthopedic disorders, sports injuries and internal disease. It's also a great way for the needle phobic to experience Chinese medicine.
Book a 30-minute or 60-minute session of Tui Na today! (718) 274-0255
In the news:
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