David Ramey, no single “method or theory” was ever predominantly adopted as the standard. 271 At the time, scientific knowledge of medicine was not yet developed, especially because in China dissection of the deceased was forbidden, preventing the development of basic anatomical knowledge. 27 It is not certain when specific acupuncture points were introduced, but the autobiography of lien Chhio from around 400–500 BC references inserting needles at designated areas. 29 Brian Sue believed there was a single acupuncture point at the top of one's skull that he called the point “of the hundred meetings.” 29 :83 2008. Although acupuncture declined in China during this time period, it was also growing in popularity in other countries. 30 292 293 This usage has been criticized owing to there being little scientific evidence for explicit effects, or the mechanisms for its supposed effectiveness, for any condition that is discernible from placebo. 77 Acupuncture has been called 'theatrical placebo', 57 and David Gorski argues that when acupuncture proponents advocate 'harnessing of placebo effects' or work on developing 'meaningful placebos', they essentially concede it is little more than that. 77 The use of acupuncture in Germany increased by 20% in 2007, after the German acupuncture trials supported its efficacy for certain uses. 294 In 2011, there were more than one million users, 294 and insurance companies have estimated that two-thirds of German users are women. 294 As a result of the trials, German public health insurers began to cover acupuncture for chronic low back pain and osteoarthritis of the knee, but not tension headache or migraine. 295 This decision was based in part on socio-political reasons. 295 Some insurers in Germany chose to stop reimbursement of acupuncture because of the trials. 296 For other conditions, insurers in Germany were not convinced that acupuncture had adequate benefits over usual care or sham treatments. 297 Highlighting the results of the placebo group, researchers refused to accept a placebo therapy as efficient. 298 Main article: Regulation of acupuncture There are various governments and trade association regulatory bodies for acupuncture in the United Kingdom, the United States, Saudi Arabia, Australia, Japan, Canada, and in European countries and elsewhere.
The.mperial.edical.ervice.nd.he Imperial Medical College, which both supported acupuncture, became more established and created medical colleges in every province. 29 :129 The public was aalso exposed to stories about royal figures being cured of their diseases by prominent acupuncturists. 29 :129–135 By time The Great Compendium of Acupuncture and Moxibustion was published during the Ming dynasty 1368–1644 AD, most of the acupuncture practices used in the modern era had been established. 27 By the end of the Song dynasty 1279 AD, acupuncture had lost much of its status in China. 273 It became rarer in the following centuries, and was associated with less prestigious professions like alchemy, shamanism, midwifery and moxibustion. 274 Minister of Health, Labour and Welfare after passing an examination and graduating from a technical school or university. 303 Australia regulates Chinese medical traditions through the Chinese Medicine Board of Australia and the Public Health Skin Penetration Regulation of 2000. The.Judy also includes warnings against practising acupuncture on infants, as well as on children who are over-fatigued, very weak, or have overeaten. 240 When used on children, acupuncture is considered safe when administered by well-trained, licensed practitioners using sterile needles; however, a 2011 review found there was limited research to draw definite conclusions about the overall safety of paediatric acupuncture. 3 The same review found 279 adverse events, 25 of them serious. 3 The adverse events were mostly mild in nature e.g. bruising or bleeding. 3 The prevalence of mild adverse events ranged from 10.1% to 13.5%, an estimated 168 incidences among 1,422 patients. 3 On rare occasions adverse events were serious e.g. cardiac rupture or hemoptysis ; much might have been a result of substandard practice. 3 The incidence of serious adverse events was 5 per one million, which included children and adults. 3 When used during pregnancy, the majority of adverse events caused by acupuncture were mild and transient, with few serious adverse events. 241 The most frequent mild adverse event was needling or unspecified pain, followed by bleeding. 241 Although two deaths one stillbirth and one neonatal death were reported, there was a lack of acupuncture-associated maternal mortality. 241 Limiting the evidence as certain, probable or possible in the causality evaluation, the estimated incidence of adverse events following acupuncture in pregnant women was 131 per 10,000. 241 Although acupuncture is not contraindicated in pregnant women, some specific acupuncture points are particularly sensitive to needle insertion; these spots, as well as the abdominal region, should be avoided during pregnancy. 2 Four adverse events associated with moxibustion were bruising, burns and cellulitis, spinal epidural abscess, and large superficial basal cell carcinoma. 16 Ten adverse events were associated with cupping. 16 The minor ones were keloid scarring, burns, and bullae ; 16 the serious ones were acquired haemophilia A, stroke following cupping on the back and neck, factitious panniculitis, reversible cardiac hypertrophy, and iron deficiency anaemia . 16 A 2013 meta-analysis found that acupuncture for chronic low back pain was cost-effective as a complement to standard care, but not as a substitute for standard care except in cases where co morbid depression presented. 19 The same meta-analysis found there was no difference between sham and non-sham acupuncture. 19 A 2011 systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain. 20 A 2010 systematic review found that the cost-effectiveness of acupuncture could not be concluded. around assumed reAlex zones of the hand. It.as.lso during this time that many Eastern medical practices were consolidated under the name Traditional Chinese Medicine ACM. 30 New practices were adopted in the 20th century, such as using a cluster of needles, 29 :164 electrified needles, or leaving needles inserted for up to a week. 29 :164 A lot of emphasis developed pain via the local release of adenosine, which then triggered close-by A1 receptors “caused more tissue damage and inflammation relative to the size of the animal in mice than in humans, such studies unnecessarily muddled a finding that local inflammation can result in the local release of adenosine with analgesic effect.” 77 It has been proposed that acupuncture's effects in gastrointestinal disorders may relate to its effects on the parasympathetic and sympathetic nervous system, which have been said to be the “Western medicine” equivalent of “yin and yang”. 263 Another mechanism whereby acupuncture may be effective for gastrointestinal dysfunction involves the promotion of gastric peristalsis in subjects with low initial gastric motility, and suppressing peristalsis in subjects with active initial motility. 264 Acupuncture has also been found to exert anti-inflammatory effects, which may be mediated by the activation of the vague nerve and deactivation of inflammatory macrophages . 265 Neuroimaging studies suggest that acupuncture stimulation results in deactivation of the limbic brain areas and the default mode network . 266 Acupuncture chart from the Ming dynasty c. 1368–1644 Acupuncture, along with moxibustion, is one of the oldest practices of Traditional Chinese Medicine. 29 Most historians believe the practice began in China, though there are some conflicting narratives on when it originated. Acupuncture 27 30 Academics David Ramey and Paul quell said the exact date acupuncture was founded depends on the extent dating of ancient texts can be trusted and the interpretation of what constitutes acupuncture. 267 According to an article in Rheumatology, the first documentation of an “organized system of diagnosis and treatment” for acupuncture was in The Yellow Emperor's Classic of Internal Medicine Huangdi Beijing from about 100 BC. 27 Gold and silver needles found in the tomb of Li Cheng from around 100 BC are believed to be the earliest archaeological evidence of acupuncture, though it is unclear if that was their purpose. 267 According to Dr. The.exceptions.o this conclusion included the use of acupuncture during embryo transfer as an adjunct to in vitro fertilization. 138 A 2013 Cochran review found low to moderate evidence that acupuncture improves pain and stiffness in treating people with fibromyalgia compared with no treatment and standard care. 139 A 2012 review found “there is insufficient evidence to recommend acupuncture for the treatment of fibromyalgia.” 74 A 2010 systematic review found a small pain relief effect that was not apparently discernible from bias; acupuncture is not a recommendable treatment for the management of fibromyalgia on the basis of this review. 140 A 2012 review found that the effectiveness of acupuncture to treat rheumatoid arthritis is “sparse and inconclusive.” 74 A 2005 Cochran review concluded that acupuncture use to treat rheumatoid arthritis “has no effect on ear, CPR, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics.” 141 A 2010 overview of systematic reviews found insufficient evidence to recommend acupuncture in the treatment of most rheumatic conditions, with the exceptions of osteoarthritis, low back pain, and lateral elbow pain. 142 A 2014 overview of systematic reviews and meta-analyses found that the evidence does not demonstrate acupuncture helps reduce the rates of death or disability after a stroke or improve other aspects of stroke recovery, such as post stroke motor dysfunction, but the evidence suggests it may help with post stroke neurological impairment and dysfunction such as dysphagia, which would need to be confirmed with future rigorous studies. 143 A 2012 review found evidence of benefit for acupuncture combined with exercise in treating shoulder pain after stroke. 144 A 2010 systematic review found that acupuncture was not effective as a treatment for functional recovery after a stroke. 145 A 2012 overview of systematic reviews found inconclusive evidence supporting the effectiveness of acupuncture for stroke. 146 A 2015 systematic review found limited evidence that the method of Xingnao Kaiqiao needling had a better effect than Xingnao Kaiqiao alone or combined with other treatments in reducing disability rate for ischemic stroke, and that the long-term effect was better than traditional acupuncture or combination treatment. 147 A 2014 meta-analysis found tentative evidence for acupuncture in cerebral infarction, a type of ischemic stroke, but the authors noted the trials reviewed were often of poor quality. 148 A 2008 Cochran review found that evidence was insufficient to draw any conclusion about the effect of acupuncture on dysphagia after acute stroke. 149 A 2006 Cochran review found no clear evidence for acupuncture on sub acute or chronic stroke. 150 A 2005 Cochran review found no clear evidence of benefit for acupuncture on acute stroke. 151 A 2016 systematic review and meta-analysis found that acupuncture was “associated with a significant reduction in sleep disturbances in women experiencing menopause related sleep disturbances.” 152 For the following conditions, the Cochran collabouration or other reviews have concluded there is no strong evidence of benefit: alcohol dependence, 153 angina pectoris, 154 ankle sprain, 155 156 Alzheimer's disease, 157 attention deficit hyperactivity disorder, 158 159 autism, 160 161 asthma, 162 163 bell's palsy, 164 165 traumatic brain injury, 166 carpal tunnel syndrome, 167 chronic obstructive pulmonary disease, 168 cardiac arrhythmias, 169 cerebral haemorrhage, 170 cocaine dependence, 171 constipation, 172 depressions, 173 174 diabetic peripheral neuropathy, 175 drug detoxification, 176 177 dry eye, 178 primary dysmenorrhoea, 179 enuresis, 180 endometriosis, 181 epilepsy, 182 erectile dysfunction, 183 essential hypertension, 184 glaucoma, 185 gynaecological conditions except possibly fertility and nausea/vomiting, 186 hot clashes, 187 188 189 190 hypoxic ischemic encephalopathy in neonates, 191 insomnia, 192 193 194 inductions of childbirth, 195 irritable bowel syndrome, 196 labour pain, 197 198 lumbar spinal stenos is, 199 major depressive disorders in pregnant women, 200 musculoskeletal disorders of the extremities, 201 myopia, 202 obesity, 203 204 obstetrical conditions, 205 Parkinson's disease, 206 207 polies cystic ovary syndrome, 208 premenstrual syndrome, 209 preoperative anxiety, 210 opioid addiction, 211 212 restless legs syndrome, 213 schizophrenia, 214 sensorineural hearing loss, 215 smoking cessation, 216 stress urinary incontinence, 217 acute stroke, 218 stroke rehabilitation, 219 temporomandibular joint dysfunction, 220 221 tennis elbow, 222 labor induction, 223 tinnitus, 224 225 uraemic itching, 226 uterine fibroids, 227 vascular dementia, 228 and whiplash . 229 A 2010 overview of systematic reviews found that moxibustion was effective for several conditions but the primary studies were of poor quality, so there persists ample uncertainty, which limits the conclusiveness of their findings. 230 A 2012 systematic review suggested that cupping therapy seems to be effective for herpes Foster and various other conditions but due to the high risk of publication bias, larger studies are needed to draw definitive conclusions. 231 Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean-needle technique and sterile single-use needles. 16 17 When improperly delivered it can cause adverse effects. 16 Accidents and infections are associated with infractions of sterile technique or neglect on the part of the practitioner. 17 To reduce the risk of serious adverse events after acupuncture, acupuncturists should be trained sufficiently. 10 People with serious spinal disease, such as cancer or infection, are not good candidates for acupuncture. 2 Contraindications to acupuncture conditions that should not be treated with acupuncture include coagulopathy disorders e.g. haemophilia and advanced liver disease, warfarin use, severe psychiatric disorders e.g. psychosis, and skin infections or skin trauma e.g. burns. 2 Further, electro acupuncture should be avoided at the spot of implanted electrical devices such as pacemakers. 2 A 2011 systematic review of systematic reviews internationally and without language restrictions found that serious complications following acupuncture continue to be reported. 10 Between 2000 and 2009, ninety-five cases of serious adverse events, including five deaths, were reported. 10 Many such events are not inherent to acupuncture but are due to malpractice of acupuncturists. 10 This might be why such complications have not been reported in surveys of adequately-trained acupuncturists. 10 Most such reports originate from Asia, which may reflect the large number of treatments performed there or a relatively higher number of poorly trained Asian acupuncturists. 10 Many serious adverse events were reported from developed countries. 10 These included Australia, Austria, Canada, Croatia, France, Germany, Ireland, the Netherlands, New Zealand, Spain, Sweden, Switzerland, the UK, and the US. 10 The number of adverse effects reported from the UK appears particularly unusual, which may indicate less under-reporting in the UK than other countries. 10 Acupuncture chart from Shisi Ming fahui Expression of the Fourteen Meridians written by Hun thou fl. 1340s, Ming dynasty .
Even.f.hey.Gould.gree,.he.CM.heories are so nebulous that no amount of scientific study will enable ACM to offer rational care.” 5 Some modern practitioners support the use of acupuncture to treat pain, but have abandoned the use of qi, meridians, yin, yang and other energies based in mysticism, as explanatory frameworks. 8 25 26 The use of qi as an explanatory framework has been decreasing in China, even as it becomes more prominent during discussions of acupuncture in the US. 257 Academic discussions of acupuncture still make reference to pseudo-scientific concepts such as qi and meridians despite the lack of scientific evidence. 257 Many within the scientific community consider attempts to rationalize acupuncture in science to be quackery, pseudo-science and “theatrical placebo”. 258 Academics Massimo Pigliucci and marten Boudry describe it as a “borderlands science” lying between science and pseudo-science. 259 Many acupuncturists attribute pain relief to the release of endorphins when needles penetrate, but no longer support the idea that acupuncture can affect a disease. 26 257 It is a generally held belief within the acupuncture community that acupuncture points and meridians structures are special conduits for electrical signals but no research has established any consistent anatomical structure or function for either acupuncture points or meridians. n 1 24 Human tests to determine whether electrical continuity was significantly different near meridians than other places in the body have been inconclusive. 24 Some studies suggest acupuncture causes a series of events within the central nervous system, 260 and that it is possible to inhibit acupuncture's analgesic effects with the opioid antagonist naloxone . 261 Mechanical deformation of the skin by acupuncture needles appears to result in the release of adenosine . 2 The anti-nociceptive effect of acupuncture may be mediated by the adenosine A1 receptor . 262 A 2014 Nature Reviews Cancer review article found that since the key mouse studies that suggested acupuncture relieves Ed, 1. year Kyōhō = 1716. Sometimes needles were used while they were still hot, creating a cauterizing effect at the injection site. 29 :104 Nine needles were recommended in the Chen chi Ta Cheng from 1601, which may have been because of an ancient Chinese belief that nine was a magic number. 29 :102-103 Other belief systems were based on the idea that the human body operated 292 293 This usage has been criticized owing to there being little scientific evidence for explicit effects, or the mechanisms for its supposed effectiveness, for any condition that is discernible from placebo. 77 Acupuncture has been called 'theatrical placebo', 57 and David Gorski argues that when acupuncture proponents advocate 'harnessing of placebo effects' or work on developing 'meaningful placebos', they essentially concede it is little more than that. 77 The use of acupuncture in Germany increased by 20% in 2007, after the German acupuncture trials supported its efficacy for certain uses. 294 In 2011, there were more than one million users, 294 and insurance companies have estimated that two-thirds of German users are women. 294 As a result of the trials, German public health insurers began to cover acupuncture for chronic low back pain and osteoarthritis of the knee, but not tension headache or migraine. 295 This decision was based in part on socio-political reasons. 295 Some insurers in Germany chose to stop reimbursement of acupuncture because of the trials. 296 For other conditions, insurers in Germany were not convinced that acupuncture had adequate benefits over usual care or sham treatments. 297 Highlighting the results of the placebo group, researchers refused to accept a placebo therapy as efficient. 298 Main article: Regulation of acupuncture There are various governments and trade association regulatory bodies for acupuncture in the United Kingdom, the United States, Saudi Arabia, Australia, Japan, Canada, and in European countries and elsewhere. It restricts the use of words like “Acupuncture” and “Registered Acupuncturist”. citation needed At least 28 countries in Europe have professional associations for acupuncturists. 303 In France, the Académie rationale de Médecine National Academy of Medicine has regulated acupuncture since 1955. 304 ^ From Latin, aces needle and puncture to puncture 1 ^ a b c sigh & Ernst 2008 stated, “Scientists as electrical pulses were found to make a frog's leg twitch after death. 269 The West eventually created a belief system based on travel trigger points that were believed to inhibit pain. ISSN. Acupuncture chart from Shisi Ming fahui Expression of the Fourteen Meridians written by Hun thou Al. 1340s, Ming dynasty .