9/8/2010. Practices. World Medicine Systems. Alternative. Systems. Individual
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1 Miles Belgrade, M.D. Medical Director, Fairview Pain Center University of Minnesota Medical Center Adjunct Professor, University of Minnesota Medical School Felix Mann, MB Prof Anton Jayasuriya, MD My Teachers Alternative and Complementary Therapies World Medicine Systems Alternative Health Systems Individual Practices 1
2 Acupuncture in Multiple Civilizations Acupuncture History BC Written documents on acupuncture theory and technique 618 AD Acupuncture officially recognized as an independent specialty by the Imperial Medical Academy of the Tang Government 4th to 10th centuries Acupuncture introduced to other countries like Japan 1822 Acupuncture banned from the Imperial court as Western medicine is introduced to China Mid-20th Century Mao Tse Tung revives the status s of acupuncture in China and nurtures its development 1969 Endorphins are discovered President Nixon opens diplomacy with China and acupuncture is rediscovered by the West 1977 Acupuncture analgesia in humans shown to be reversed by Naloxone 1997 The NIH holds a consensus conference e ce on acupuncture supporting its use in certain conditions 2
3 History of Acupuncture in the USA-- Rise 1940s: Mao Tse Tung July 26 th, 1971: James Reston and Ping-Pong Pong Diplomacy 1970s: Acupuncture fever in the USA 1980s: Research 1997: NIH Consensus Conference NIH Consensus Conference November 1997 Acupuncture is Widely practiced in the US Sufficient evidence as primary therapy: Nausea/vomiting due to post-op op and chemo Post-op op dental pain NIH Consensus Conference November 1997 Sufficient evidence as adjunctive therapy: Addiction Stroke rehab Headache Menstrual cramps Tennis elbow Fibromyalgia and myofascial pain Osteoarthritis Low back pain Carpal Tunnel syndrome Asthma 3
4 What is Acupuncture? A system of medicine that is part of traditional Chinese medicine Stimulation of tissue at well-defined points to achieve a therapeutic effect Acupuncture points lie on channels or meridians Point selection based on traditional principles of Chinese medicine or by formula Acupuncture Meridians Traditional Chinese Medicine Based on Taoist principles Yin and Yang Chi 12 organs Meridians and points Tonification and sedation Tongue and pulse diagnosis Herbal medicine and acupuncture 4
5 Acupuncture Technique Needles Insertion Point location Stimulation Point selection Duration & frequency Point Location Acupuncture Point Selection Local points treat local disorders Tender points (Ashi points) Points on a meridian traversing the problem region Six important distal points treat the head, neck, and trunk Certain points have general effects: e.g. sedation, tonification, homeostasis Ear regions correspond with the body via a homunculus-like like projection 5
6 Local Points Treat Regional Disorders The Six Important Distal Points The Six Important Distal Points 6
7 Dangerous Points Risks of Acupuncture Common Discomfort 40% Bruising 2% Bleeding minimal but common Fainting 1% Uncommon Infection Pneumothorax Retained needle fragment Peripheral nerve injury Spinal cord injury Miscarriage Epidural Hematoma After Acupuncture 7
8 Acupuncture Contraindications Cancer treatment (other than symptom control) Acute bacterial infections Other acute medical conditions requiring i specific treatment Severely debilitated patients Pregnancy (relative contraindication) Acupuncture Indications Musculoskeletal pain acute or chronic Nausea Benign headache Addiction adjunctive therapy Fibromyalgia 8
9 Early Research Into Acupuncture Mechanisms J.S. Han AAPM Honolulu
10 10
11 Anesth & Analgesia
12 12
13 Mayo Clinic Proc June
14 Problems in Acupuncture Research Design Variation in techniques Treatment based on Western diagnostic categories No individual id variation of treatment t t Sham problems Stimulation Sham points Double blinding 14
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