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Wissenschaft - Klinische Studien | ||||
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NCCAM Center for Addiction and Alternative Medicine Research Patricia D Culliton, Alternative Medicine Division, Hennepin County Medical Ctr, Minneapolis, MN The economic cost of substance abuse to the United States is estimated at $257 billion annually (Sirica and Coimbra, 1995). This figure is based on factors such as health care expense and lost productivity. The negative impact of substance abuse can be measured in every social institution including the community, the workplace, schools, and the family. While a variety of treatment options are available, conventional interventions have demonstrated limited success in clinical trials. The research group at Hennepin County Medical Center in Minneapolis, Minnesota has been conducting research to determine the efficacy of Traditional Chinese Medicine therapies for substance abuse for 20 years. Milton Bullock MD and Patricia Culliton began studying the effects of acupuncture for chronic alcoholism in 1981. They first received National Institutes of Health (NIH) funding from the National Institute on Drug Abuse (NIDA) in 1990 to study the use of acupuncture for the treatment of cocaine abuse. This research addressed three basic issues in cocaine acupuncture treatment. 1. What are the treatment outcome size effects associated with true and sham acupuncture? 2. What is the treatment dose response curve for varying doses of true acupuncture? 3. To what extent does placebo response contribute to acupuncture treatment outcome? In 1994 another NIH project was funded through the National Institute on Alcoholism and Alcohol Abuse (NIAAA). This project addressed three basic issues in alcohol acupuncture treatment.
The Center for Addiction and Alternative Medicine Research (CAAMR) was one of the first two Centers established through a grant from the Office of Alternative Medicine (OAM), at the NIH in 1994. The CAAMR under the direction of Tom Kiresuk PhD, is a program of the Minneapolis Medical Research Foundation (MMRF) at Hennepin County Medical Center (HCMC). In September 1998, the CAAMR was awarded an additional five years of funding to continue and expand the study of complementary and alternative medicine in the treatment of substance abuse. The CAAMR has three studies in progress that examine the use of various TCM modalities for the treatment of substance abuse that will be addressed here.
Electro-acupuncture to alleviate nicotine or opiate withdrawal symptoms. The long-term goal of this project is to identify the neural substrates involved in the development and maintenance of drug abuse. A Chinese herbal formula with Kudzu as the main ingredient for the treatment of alcohol abuse. This formula has demonstrated positive effects in an animal model. This preliminary work will be extended by studying the compound in human populations. An herbal formula for the treatment of symptoms related to hepatitis C. Hepatitis C affects the majority of i.v. drug abusers and is common among individuals with chronic alcoholism. The CAAMR also devotes resources to a career development program to support trainees seeking education and research experience in alternative medicine and the addictions. The Pediatric NCCAM
Center at the University of Arizona: Rosa N Schnyer, University of Arizona, Tucson The Pediatric Center for Complementary and Alternative Medicine at the University of Arizona focuses on pediatric health issues. A major portion of the program is designed to train pediatric fellows in the area of complementary and alternative medicine. The Center is augmented by an administrative core with a biostatistical component and four cores including bioenergetics, biopsychosocial, biopharmacologic, and biomechanical cores. The program incorporates allopathic physicians and complementary and alternative medicine practitioners from various disciplines to form a cohesive program to advance knowledge in regard to alternative approaches in pediatric patients. There are three projects:
This presentation will focus primarily on Project 2, which involves the use of acupuncture in the treatment of spastic Cerebral Palsy. Cerebral Palsy CAM protocol: Dr. Buris Duncan, Principal Investigator After a year of developing the infrastructure and establishing the details of implementation, the protocol and study design have been fine-tuned and finally established. The primary objectives of the study are to explore osteopathic manipulation and/or acupuncture in:
During a six month intervention the children either receive a total of 14 treatment sessions (1/2 hour each - 7 hours) of osteopathy craniosacral manipulation & myofascial release, or a total of 30 acupuncture treatment sessions (1/2 hour each - 15 hours) which include scalp, body and auricular points. The control arm of the study involves non-therapeutic play (total of 11 hours). As a pilot study, a few children have been selected to receive a combination of osteopathic and acupuncture therapies; these children receive a weekly sequence of osteopathic manipulation followed by acupuncture for a total of 13 osteopathic and 26 acupuncture treatment sessions in six months. Children and their families self-select themselves for this pilot study, given the enormous time commitment. A total of 43 children have been enrolled in the study. 27 children are currently actively receiving treatment, and 3 are in the process of receiving baseline evaluations. 11 children have dropped out and 2 have been deemed ineligible. Reasons for dropping out include: child is having surgery, difficulty with the time commitment, or the child was moved into a different foster home. The acupuncture protocol has been manualized; the manual was written by Joe Balensi the main acupuncture provider in the study with Rosa N. Schnyer, Burris Duncan and Sharon Mc Donough-Means; the first draft is available for comments at: www.chinesemedicinesampler.com/CPHTML/critiquerequest.htm
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