The point isn't whether acupuncture works, the researchers in the original post stated that there was a cure rate of 43% and rather than discussing subject size, cohort selection, researcher/subject bias, lack of proper blinding, there seems to be the need to convince others that acupuncture is an effective treatment. That's not the point. The study was of poor design and the results are therefore not acceptable and my point is that these poorly designed crap studies are damaging to people who are truly ill.
I haven't heard anyone here defending that particular study; as I said before, I think we are in agreement that it is seriously flawed. But there have been serious questions raised about the effectiveness of acupuncture in general, specifically in this thread, and these need to be answered if we are to decide whether or not it is worth pursuing the use of acupuncture for ME. A large number of anecdotal reports indicate that acupuncture may be very helpful for ME; if acupuncture does indeed work (a point about which not everyone here is convinced), then it certainly may be worth following up with additional studies.
Additionally, the question of whether acupuncture works entirely through mechanisms known to Western medicine or whether it uses at least some mechanisms currently unknown to Western medicine is an important one. If the answer is the latter, then it would seem that there are many more possibilities for acupuncture to be of benefit in illnesses such as ME.
NOTE: For discussion of Traditional Chinese Medicine, Chi, etc. look here.
It's the release of endorphins that may make acupunctor helpful for some and hasn't anything to do with the mythical "chi". There have been studies where patients have received accupuncture using the chi meridians and a control group treatment where the needles are placed randomly and there is no difference. I will come back and cite these studies when I find them
As the study that
CFS_for_19_years was a high-quality, meta-analysis of 29 randomized controlled trials (RCTs) involving almost 18,000 patients, published in the prestigious Archives of Internal Medicine (now JAMA Internal Medicine), and this study addressed all the objections raised about the Chinese study, I think we should take it seriously. Acupuncture where the needles are placed randomly is known as "sham acupuncture", and the study's authors felt it was crucial to show a statistically significant greater effect using true acupuncture as compared to sham acupuncture, which they did.
I would recommend reading the whole article, but here is a summary of the findings in the article's own words. From the abstract:
Conclusions Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.
An estimated 3 million American adults receive acupuncture treatment each year,
2 and chronic pain is the most common presentation.
3 Acupuncture is known to have physiologic effects relevant to analgesia,
4,
5 but there is no accepted mechanism by which it could have persisting effects on chronic pain. This lack of biological plausibility, and its provenance in theories lying outside of biomedicine, makes acupuncture a highly controversial therapy.
Note that the authors state both "Acupuncture is effective for the treatment of chronic pain" and "Acupuncture is known to have physiologic effects relevant to analgesia,
4,
5 but there is no accepted mechanism by which it could have persisting effects on chronic pain. This lack of biological plausibility, and its provenance in theories lying outside of biomedicine, makes acupuncture a highly controversial therapy."
So the authors state categorically that while
acupuncture is effective for the treatment of chronic pain, there is no
accepted mechanism in Western medicine whereby this could be true. Acupuncture may lack "biological plausibility", yet it works. (I am merely paraphrasing the study here.) The only logical explanation here is that it works through mechanisms currently unknown to Western medicine. The authors of the study seem comfortable with this position, as it is really the only scientifically sound position open to them. And they are not so arrogant as to believe that Western medicine understands everything at this point.
So if you accept the authors' conclusions of the existence of these unknown mechanisms for the operation of acupuncture, whether or not you call one of them
chi simply becomes a matter of semantics. Since the term
chi is already universally in use among the practitioners of acupuncture, and it is a referent that everyone understands, there seems to be no good reason to change it.
As to the integrity of their studies:
A large number of randomized controlled trials (RCTs) of acupuncture for chronic pain have been conducted. Most have been of low methodologic quality, and, accordingly, meta-analyses based on these RCTs are of questionable interpretability and value.
6 Herein, we present an individual patient data meta-analysis of RCTs of acupuncture for chronic pain, in which only high-quality RCTs were eligible for inclusion. Individual patient data meta-analysis are superior to the use of summary data in meta-analysis because they enhance data quality, enable different forms of outcome to be combined, and allow use of statistical techniques of increased precision.
As for the type of relief obtained,
barbc56 says this:
In the meantime, believing accupuncture will cure this percentage of me/cfs/fm based on shoddy research uand not used as an adjunct therapy that may help some patients get a bit of short term relief, only sidetracks research ilooking into real treatments that will help us.
As noted above, the study looked at treatment for chronic pain, and they found that acupuncture can provide long-term relief. Short-term relief for chronic pain is not difficult; there are plenty of drugs that will give that. If that were all acupuncture did, there would be no need to mention "lack of biological plausibility", and the referral question mentioned directly below would be moot.
So finally, from the concluding Interpretation section:
Our finding that acupuncture has effects over and above those of sham acupuncture is therefore of major importance for clinical practice. Even though on average these effects are small, the clinical decision made by physicians and patients is not between true and sham acupuncture but between a referral to an acupuncturist or avoiding such a referral.
In conclusion, we found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain...
The issue of our being taken seriously by the medical community has been raised in this thread. Let me turn that around. If we reject perfectly sound scientific studies by mainstream Western medicine such as this one, why should we expect Western medicine to pay attention to the studies that we cite in support of the nature of ME?
I'll finish this with some (hopefully relevant) quotes from Mr. Feynman:
Our imagination is stretched to the utmost, not, as in fiction, to imagine things which are not really there, but just to comprehend those things which are there.
The imagination of nature is far, far greater than the imagination of man.
A very great deal more truth can become known than can be proven.
Hell, if I could explain it to the average person, it wouldn't have been worth the Nobel prize.