Re: Fw: Will Florida Outlaw Naturopathy?

From: Anders Sandberg (asa@nada.kth.se)
Date: Fri May 26 2000 - 04:59:51 MDT


KPJ <kpj@sics.se> writes:

> Since
>
> (a) acupuncture actually does work for a other purposes,
> (b) nobody seems to have made any studies of _why_ it works,
> (c) it appears rather obvious a neurological mechanism is involved,
> (d) humans can change their metabolism using e.g. hypnosis,
>
> then it would seem possible that acupuncture may also be used to do this.

(b): there have been many studies, and the current overall opinion
seems to be that it works by the pain-gateways in the spinal cord -
one form of stimulation (the needle) can shut out another form of
stimulation (the pain of the disease). And of course there is plenty
of placebo too.

As for studies, in medline I found:

(1) Questions the value of the treatment, but I don't know the
    strength of the evidence presented.

(2) Tested it, and had negative results.

(3) Shows that acupuncture can indeed affect the sympathetic and
    parasympathic systems, which could be an explanation *if* it
    works.

(4) Claims it works, but do not describe exactly what was done in the
    abstract. It is representative for a number of similar papers in
    the same journal, which give a somewhat biased impression given
    the abstracts.

(5) A meta-review of other papers. Overall, the results seem to be
    contradictory and methodologically flawed. The best trials did not
    show any effect.

Obes Surg 1993 May;3(2):197-200
                                                                        

                       Operations that are Questionable for Control of
                       Obesity.

                       Fobi MA

                       Departments of Surgery, Cedars-Sinai Medical
                       Center, Bellwood General Hospital and the
                       Center for Surgical Treatment of Obesity, Los,
                       Angeles, CA, USA.

                       [Record supplied by publisher]

                       At the last review of the literature, there
                       were 43 different operations or modifications
                       thereof used for the control of obesity. An
                       effective operation for obesity control should
                       produce a significant weight loss (>/= 25%
                       excess weight loss) to ameliorate the
                       associated medico-sociopsycho-economic
                       ramifications of the obesity. The operative and
                       postoperative significant morbidity should be
                       less than 20% and mortality less than 1%. The
                       weight lost should be maintained for a long
                       period (>/= 5 years). The effects of the
                       operation should be reproducible and
                       documentable by more than two authors working
                       independently. For the purpose of this paper,
                       operations which do not meet these criteria are
                       considered questionable and not recommended for
                       general use. Based on these criteria,
                       questionable operations for treatment of
                       obesity include: tooth wiring, acupuncture,
                       hypothalamic center manipulation, liposuction,
                       balloon insertion, unbanded gastric
                       partitioning, vagotomy, gastrogastrostomy,
                       horizontal gastroplasty, gastric wrap,
                       gastroclip, and any variety of gastroplasty
                       without a reinforced stoma, intestinal bypass,
                       duodenal bypass and biliointestinal
                       bypass. Data to substantiate this
                       classification will be presented and
                       discussed. Since the surgical treatment of
                       obesity is evolving, there is need to collect
                       data from and make modifications to improve the
                       effects of all operations. There is not enough
                       data at this time to prohibit the use of any
                       operation, but the data presented will justify
                       limiting the use of certain operations to
                       institutions dedicated to meticulous follow-up
                       and research.

Eat Weight Disord 1999 Dec;4(4):198-202

                       Failure of acupuncture in the treatment of
                       obesity: a pilot study.

                       Mazzoni R, Mannucci E, Rizzello SM, Ricca V,
                       Rotella CM

                       Department of Clinical Pathophysiology,
                       University of Florence Medical School, Italy.

                       Acupuncture has been anecdotally reported to
                       induce weight loss in obese patients. This
                       pilot study examines its efficacy in a
                       randomised, placebo-controlled clinical
                       trial. Forty (33 F, 7 M) obese (BMI > 30 kg/m2)
                       outpatients were randomised to either placebo
                       or acupuncture (12 weekly sessions of minimal
                       acupuncture and somatic moxibustion-acupuncture
                       associated with auriculopuncture
                       respectively). BMI, eating attitudes (BES),
                       anxiety (STAI), depression (BDI), and
                       obesity-related quality of life (ORWELL 97)
                       were measured at the beginning and end of the
                       treatment. Six (30%) patients in the treatment
                       group and 12 (60%) in the placebo group dropped
                       out. Intention-to-treat analysis did not show
                       any significant effect of acupuncture on BMI
                       and obesity-related quality of life; eating
                       attitudes improved in both groups, possibly
                       because of the placebo effect. A significant
                       improvement in anxiety and depression was only
                       observed in the acupuncture group. In
                       conclusion, acupuncture does not promote weight
                       loss and is not recommendable in the treatment
                       of obesity. It may, however, improve the
                       psychological status of obese patients.

J Auton Nerv Syst 2000 Feb 14;79(1):52-9

                       Effect of sensory stimulation (acupuncture) on sympathetic and
                       parasympathetic activities in healthy subjects.

                       Haker E, Egekvist H, Bjerring P

                       Department of Physical Therapy, Department of
                       Physiology and Pharmacology, Karolinska
                       Institutet, Stockholm,
                       Sweden. eva.haker@fvfa.ki.se

                       It has been postulated that sensory stimulation
                       (acupuncture) affects the cardiovascular system
                       via the autonomic nervous system. Previously,
                       skin temperature, thermography, plethysmography
                       and blood pressure changes have been used in
                       evaluation of sympathetic nerve activity
                       following acupuncture. By using power spectral
                       analysis, the low frequency and high frequency
                       components of heart rate variability can be
                       calculated reflecting the sympathetic and
                       parasympathetic activity. The purpose of this
                       study was to investigate to what extent
                       acupuncture applied into the thenar muscle and
                       into the cavum concha of the ear induced
                       changes in the sympathetic and/or
                       parasympathetic nervous system in healthy
                       subjects. MATERIALS AND METHODS: Twelve healthy
                       volunteers, six men and six women, mean age
                       34.4 (range 23-48) participated in three
                       balanced, randomly distributed sessions. At an
                       individual initial visit the 12 volunteers were
                       introduced to the needle sensation by having a
                       needle inserted into the point LI 11. The
                       needle sensation was evoked and the subject was
                       trained to identify the characteristic needle
                       sensation. The introduction was followed by
                       three test sessions. SESSION A: A short
                       acupuncture needle, (Seirin no 3,
                       &emptyv;0.20x15 mm) was inserted perpendicular
                       into the earpoint, Lu 1, in the left inferior
                       hemi-conchae. SESSION B: An acupuncture needle
                       (Hwato, &emptyv;0.30x30 mm) was inserted
                       perpendicular into the Hegu point (LI 4) in the
                       middle of the right dorsal thenar
                       muscle. SESSION C: An acupuncture needle
                       (Hwato, &emptyv;0.30x30 mm) was inserted
                       perpendicular superficially into the skin
                       overlying the Hegu point on the left
                       hand. Results. Stimulation of the ear induced a
                       significant increase in the parasympathetic
                       activity during the stimulation period of 25
                       min (P<0.05) and during the post-stimulation
                       period of 60 min (P<0.05). No significant
                       changes were observed in either the sympathetic
                       activity, blood pressure or heart
                       rate. Stimulation of the thenar muscle resulted
                       in a significant increase in the sympathetic
                       and the parasympathetic activity during the
                       stimulation period (P<0.01) and during the
                       post-stimulation period (P<0.01 and P<0.001,
                       respectively). A significant decrease in the
                       heart rate frequency (P<0.05) at the end of the
                       post-stimulation period was also
                       demonstrated. The superficial needle insertion
                       into the skin overlaying the right thenar
                       muscle caused a pronounced balanced increase in
                       both the sympathetic and parasympathetic
                       activity during the post stimulation period of
                       60 min (P<0.01) while no changes were observed
                       during the stimulation period. CONCLUSION: It
                       is indicated that sensory stimulation
                       (acupunctura) in healthy persons is associated
                       with changed activity in the sympathetic and
                       parasympathetic nervous system depending on
                       site of stimulation and period of observation.

J Tradit Chin Med 1998 Dec;18(4):265-71

                       Application of acupuncture and moxibustion for keeping shape.

                       Liu Z, Sun F, Li J, Han Y, Wei Q, Liu C

                       Nanjing University of Traditional Chinese Medicine.

                       On the basis of TCM diferentiation, the authors
                       have treated 359 adult female cases of
                       non-obesity with undesirable body shape by
                       combined application of body acupuncture and
                       moxibustion and auricular acupuncture, and
                       achieved quite good remoulding and orthopedic
                       results, suggesting that acupuncture and
                       moxibustion can very effectively regulate the
                       somatotypic indexes of body weight,
                       circumference of the chest, loin, hip and
                       thigh, the ratio of the loin to hip, sebum
                       thickness, obesity degree, body mass index and
                       body fat percentage of the cases in the
                       overweight group and orthopedic groups 1, 2. It
                       is therefore concluded that acupuncture and
                       moxibustion is a good therapy for obtaining a
                       graceful body shape.

Wien Klin Wochenschr 1997 Jan 31;109(2):60-2
                                                      

                       Acupuncture/acupressure for weight reduction? A
                       systematic review.

                       Ernst E

                       Department of Complementary Medicine,
                       Postgraduate Medical School, University of
                       Exeter, United Kingdom.

                       Acupuncture and acupressure are often advocated
                       and used as a means of controlling appetite and
                       reducing body weight, supported by case-series
                       and uncontrolled studies that show encouraging
                       results. This paper reviews
                       placebo/sham-controlled clinical trials
                       published on this topic. Two independent
                       literature searches identified four such
                       studies. None of these is without significant
                       methodological flaws and their results are
                       contradictory. The two relatively rigorous
                       trials show no effect on body weight. On
                       balance, no clear picture emerges to show that
                       acupuncture/acupressure is effective in
                       reducing appetite or body weight. Claims that
                       these forms of treatment have specific effects
                       on these conditions are therefore not based on
                       well-performed clinical trials.

-- 
-----------------------------------------------------------------------
Anders Sandberg                                      Towards Ascension!
asa@nada.kth.se                            http://www.nada.kth.se/~asa/
GCS/M/S/O d++ -p+ c++++ !l u+ e++ m++ s+/+ n--- h+/* f+ g+ w++ t+ r+ !y


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