Is there a "vital force" like chi, prana, that permeates all living matter, as vitalism posits? Quite possibility.
Might that supposed vital force, if it does exist, play a role in the demonstrated health benefits of acupuncture? Probably not:
Before you can say this, I think that a more in-depth study of the theory and practice of acupuncture is required.
it's more likely that the health benefits of acupuncture are mediated by its demonstrated ability to release endorphins in the cerebrospinal fluid,
† by acupuncture's ability to modulate the autonomic nervous system activation,
† by its ability to reduce pro-inflammatory cytokines,
† by acupuncture's ability to reduce the Th1 immune response and boost the Th2 immune response (which incidentally would be a
bad thing for viral ME/CFS),
† and so forth.
This is all very interesting, and I found your references fascinating. It should be noted that acupuncture does not always cause a Th1 to Th2 shift, as it is often used to treat asthma, which requires damping down the Th2 immune response.
What you've done essentially is to map the effects of acupuncture (or at least some of them) onto a Western medical understanding of how the body works. This is fine, as long as you understand the limitations of such an approach; it cannot explain anything that Western medicine does not already understand. For example, how do you explain meridians? They're completely nonphysical, there are no nerves connecting all the points in a meridian, no blood vessels that do - nothing. Yet the meridians seem to have some sort of real existence - all the acupuncture points are lined up on them. And why does proper acupuncture always work better than "sham" acupuncture (i.e., acupuncture where the points are not real acupuncture points)? What's so special about the acupuncture points? Once again, anatomically, there's nothing special there. Western medicine cannot explain this.
By contrast, saying something like "acupuncture clears blockages in chi" not only has no measurable empirical basis, but it does not have any practical or medical consequences either.
In order to make such a statement, you have to have studied acupuncture enough to know the theory behind it. Good acupuncturists can feel where the chi is blocked, and then take steps to make it flow properly. I've had acupuncturists do this to me many times, explaining what they're doing, and often I can feel things shifting, even before their explanation.
Isn't this thread meant to be about a study that claims an astronomical cure rate for "cfs". I would rather look at why this study is utter crap.
To state that the study is "utter crap" without further analysis is certainly not a very scientific approach; it assumes you know the outcome of your enquiries before you make them. Collectively, we have heard countless times (especially from our doctors, who should know better), "The illness you are describing is not something that fits our understanding of physical illness. Therefore, what you are telling me is utter crap." We have all seen where that attitude leads.
Note: to read the discussion of the original article:
Interferential current therapy via electroacupuncture: significant benefits / recovery from ME/CFS, look here.
Does anybody have access to the full paper?
The paper is short, and the first two pages (out of three) can be accessed for free. Here is the second page, which contains almost all the useful information:
Even from the abstract you can see huge problems. The first is the subject group -- n = 60 based on the CDC diagnositic criteria which is notoriously good at misdiagnosing fatigued people with chronic fatigue syndrome. The second problem is no blinding and their control groups. The stated recovery rate using this treatment was stated to be 43.3%. The study authors define recovery as "the major symptoms and complications were completely gone, and the patient can adapt to normal social life and work".
Yes; this study, which was done in China and published in a Chinese medical journal, does not seem to have been done with the greatest medical rigor. It's hard to blame them for using the CDC definition, as that's the most widely used one in the world; at least they didn't use the empirical definition, or some definition of their own. The CDC definition is repeated verbatim in paragraph 1.1; although that's clearly not a good definition for ME, people who just have fatigue due to depression (or some other cause) without any other symptoms won't qualify, unlike the Oxford definition. What bothers me more than the cure rate (for reasons I'll explain below) is the following statement on the first page:
According to the statistics, the incidence rate has approached 10%-20% in white-collar workers[3].
Either "CFS" is being notoriously overdiagnosed, or else China is in really big trouble. Or both.
It's interesting that white-collar workers are mentioned specifically here. China's cities are notoriously polluted, and that may have an effect on ME/CFS there.
So we have a study that certainly appears to be flawed here. This does not mean it's completely worthless (or "utter crap"); it simply means that a high degree of skepticism is called for when examining the results. The results cannot simply be taken at face value unless factors such as the huge difference in prevalence rates can be explained, which seems unlikely. Nevertheless, to put things conservatively and not assigning any numbers, it would appear that at least some people with ME/CFS are being significantly helped by electro-acupuncture, and an even higher number are being helped when interferential current therapy is added.
If you can get 43 percent of people with 'CFS' back to work by totally removing their symptoms then why aren't droves of people claiming that this kind of electrostimulation is curing them of CFS?
Droves of people aren't using this method in this country. In fact, do we know anyone who's tried the exact method described in the paper?
I have actually heard of many people with ME being helped (not cured, but helped) by acupuncture in this country. For this reason, I have tried it a number of times with different acupuncturists, but so far with no results.
I have a friend who had a moderate case of ME using the ICC definition; she also had FMS and a severely dislocated spine from an accident. She's Canadian, and she was being treated in Canada for these conditions with little success, although a chiropractor was slowly helping her with her spine. However, she then started developing rheumatoid arthritis (RA), which is not unusual for people with ME. As she had lived in Asia most of her life, she got herself to Vietnam while she still could; even with a wheelchair all the way, the trip was barely possible. She went to Ho Chi Minh City (Saigon), and started getting treatment almost daily at the main city hospital. (The frequency appears to be key; once a week just doesn't cut it with serious illness.) She was helped there somewhat, but the doctors there thought her case needed the best specialists available, so she was referred to a special hospital that's usually available only to Vietnamese government employees. By this time, her RA had gotten so bad that she had the classic "claw" hands; she could hardly use them for anything. For the next year, she was treated solely with acupuncture and traditional Chinese herbs.
She is now about 60% recovered from a year ago, and is about to start a part-time job in Burma - something that was unthinkable a year ago. She plans to continue her acupuncture treatment, and expects to recover almost completely. The doctors have emphasized that this is not a cure, but that they are essentially putting everything in remission as best they can. They have told her that she will always have to be careful about overdoing things, and may have relapses anyway, but with treatment, those can be overcome.
Her doctors have treated many people with the same condition. Acupuncture is simply seen as a major treatment modality in a way that it's not here.
How is it that this treatment can effectively cure people of a systemic illness that involves all of our major systems?
This is actually the area in which traditional Chinese medicine (TCM) works best. It's based on a holistic approach involving the entire body. Western medicine is used to dealing with malfunctions of specific parts of the body, which is a big reason why this illness has proven to be beyond its grasp so far.
I wonder why it doesn't cure people in the same manner from cancer, HIV, diabetes etc because really according to 'ancient' Chinese medicine it's the chi that's out of whack in all diseases. Well unfortunately, when acupuncture was 'invented' there was no understanding of how the human body worked.
Your last sentence is certainly true. As for cancer, HIV, and diabetes, for the most part, these are rather modern diseases, and TCM was developed over many centuries. Proper diet and often a special diet is heavily emphasized in the treatment of many illnesses. When an illness is caused by improper diet, TCM simply recommends the proper diet - not the use of acupuncture.
As for the cause of the improvement in life expectancy, I certainly wouldn't argue with you. TCM was developed without the knowledge of the germ theory of disease, which handicapped it greatly. But that doesn't mean that TCM is worthless. In Asia today, the two modalities exist side by side. Acupuncture is used extensively, while X-rays and antibiotics are also readily available.
Maybe the IOM will use this study published in a journal to suggest possible treatments for CFS along with CBT and GET.
Very doubtful. Western medicine is conservative, and the IOM is part of Western medicine. They don't want to look silly, and I'm sure that a number of them think that even mentioning the word "acupuncture" would make them look silly.
I have no problem with acupunture, TENS, electrostimulation being used to treat pain but publishing a study that states that their therapy effectively cures 43 percent of people with CFS is beyond what is acceptable.
We seem to be in agreement that that figure is inflated by some large amount. Now it would have been really nice if they had done a much more rigorous study, but they didn't. So we are free to make of it what we want. No one's asking us to endorse that study. I'm glad it was done because I think it provides the foundation for further research. But that's just me.
I think if you look around, you'll find that TCM is not taken seriously by traditional Western medicine, and what comes out of Asia that's not Western medicine is just routinely ignored. So I don't see that this affects our credibility one way or the other. Anyone who reads that paper will see the obvious flaws in it, and those flaws reflect upon the people who did the study - not us.
I agree. The claims of a 20% recovery rate for electro-acupuncture, and a 43% recovery rate for interferential current therapy acupuncture seem like gross hype and exaggeration. Other studies on the benefits of acupuncture for ME/CFS, such as
this one and
this one, have found far more modest improvements in ME/CFS physical and mental fatigue.
I think that this is basically what I've been trying to say, so I think we're fundamentally in agreement here.
The fact that these patients presumably travelled to hospital daily, or several times a week, for the acupuncture treatment suggests that they were fairly healthy to start with.
Well, they certainly weren't the ones the ICC defines as "very severe". But knowing what my friend had to go through to get to the different hospitals and knowing what her state of health was, I would definitely disagree her - she was nowhere near "fairly healthy". Some of the days she was too sick to go to the hospital, but most of the days she went anyway.
My point was that this kind of 'gross hype and exaggeration' should be something you would find in the
National Enquirer rather than a scientific journal.
Personally, I think the National Enquirer would find this much too boring to publish.
It's not a case of 'toning' down what they say, it's a case of crap like this shouldn't be published in any journal. And if it is published then journal it is published in can't be taken seriously.
And as I mentioned above, these journals typically aren't taken seriously in this country.
Then you should write them a letter.
I promised to describe my personal experience with acupuncture, so here it is. I've been using acupuncture since 1975, with hundreds of treatments by professionals, and hundreds of treatments by myself. I've found that it has worked for many things, but not for everything. As I mentioned, I have been to several acupuncturists for treatment of my ME with no results.
On the other hand, I have gotten excellent results for treatment of a foot injury, both before and after a botched operation on the foot. I am walking normally now; I was on crutches for 11 years after the operation (ME does wonders to slow healing), and I'm sure I'd be in a wheelchair now if it weren't for acupuncture. I've also used acupuncture to cure a case of carpal tunnel syndrome, as well as treat tinnitus successfully on a number of occasions. (For many people, tinnitus is yet another complication of ME. It is usually very difficult to treat in Western medicine.) For the carpal tunnel syndrome, I initially just guessed where the points would be, and my guess worked. I later checked out those points, and they were correct. For the tinnitus, I originally had my acupuncturist treat that. After a few visits, I noticed that he always used the same three points for each ear, and they worked very well. So I figured I could probably do the same thing, and sure enough, it worked just as well when I did it.