Abstracts des SAR Symposion in Minneapolis

Vom 19. – 20. Oktober 2001 fand im Pillsbury Auditorium, Hennepin County Medical Center, Minnesota das 8. jährliche Symposion der Society of Acupuncture Research statt. 
Das Kongressprogramm war wie 2000 bei dem Symposion in Baltimore hervorragend und fokussierte auf den aktuellen Stand der wissenschaftlichen Forschung zur Akupunktur.
Auch der aktuelle Stand der von den National Institutes of Health geförderten, klinischen Studien wurden in Vorträgen vorgestellt und diskutiert. Wie bereits in den letzten Monaten stellen wir an dieser Stelle die Abstracts des Symposiums als Serie hier ins Netz.
Hier den 5. Teil:

Nature of Qi

Michael O Smith
Lincoln Hospital Recovery Center, Bronx, NY

"How does acupuncture work?" This is not just a foolish question for control freaks. Our response to this problem can show us the basic nature of the acupuncture profession.

Acupuncture helps the body help itself. Acupuncture provides input to an already functioning homeostatic system. Our bodies make constant adjustments on many levels. The aspects of life that are affected by acupuncture include complex functions, which are common to all levels of evolution: microcirculation, immune function, etc. Acupuncture can also affect functions such as sleep and menstruation that occur a significant amount of time after the actual treatment.

Life is far too complicated to be understood in a clear predictable manner. Neither modern science nor traditional metaphor can adequately describe the interlocking microscopic and organic adjustments that living beings continually make.

Why do successful acupuncturists use so many separate and divergent theories? Theories of acupuncture are devices for focusing and organizing treatment efforts. These theories were never intended to be explicit concrete descriptions of life. Using metaphoric language is very appropriate for this kind of theory. Sometimes the Chinese metaphors point toward scientific realities, as we know them in the 21st century. The terms Yin and Yang suggest the critical importance of binary interactive processes such as the autonomic nervous system and many hormonal and neurochemical systems.

The term Jing suggests a degree of complexity that cannot be perceived. The character for Jing is an underground river, therefore, it is nourishing, accessible from the surface, but impossible for us to observe in any accurate detail. Jing contains the "silk" radical, suggesting unaccountable strands of life that function in a smooth, valuable manner. Acupuncture and other Qi-related therapies give the practitioner a unique privilege. We are able to work with a "partner" (the living human body) that has much more capability than we do. Most health methods focus on substances or activities, which act on the body. Practitioners of these methods must rely only on their own knowledge to determine the appropriateness and limitations of the treatments being provided. Hence an obsessive need for control appropriately dominates most health care. Acupuncture and other Qi-related therapies transcend these limitations.

Acupuncture is not a dominant process. It is supportive and integrative. Healing occurs through relationship and not independent action. To develop our relationship with the patient's Qi we must be comfortable with the vast and complex character of bodily Qi. It is indeed a "higher power". We need to accept our subordinate role in this relationship.

What are the research implications of this remarkable state of affairs?

1. Studies on the mechanism of acupuncture will be comparable to studies on the basic biophysical processes of life itself. As presented at previous SAR meetings, we should not be surprised to learn that acupuncture-like effects occur in animals and plants. Studies of mechanism will be much simpler and straightforward using these organisms rather than human models. Use of acupressure beads, magnets, and Qigong may also help design less ambiguous models of Qi activity.
2. Conventional controlled studies are not indicated in a situation where the primary action of change (the response of the patient's own body) cannot be reliably predicted by the therapist. Needling the same point may often produce different effects at different times. Needling different points can produce the same homeostatic bodily reaction. There are exceptional circumstances where acupuncture needling is predictable in a linear Newtonian manner, but the overwhelming amount of significant acupuncture treatment involves a range of responses that cannot be precisely specified. Conventional controlled studies eliminate variables in order to be consistent. Acupuncture, on the other hand, can produce a consistent homeostatic response even in the presence of confounding variables. Since the clinical world is usually full of confounding variables, acupuncture is quite suitable to practical outcome studies.
3. Outcome studies are usually developed on a cooperative basis between acupuncturists and a conventional treatment setting. Such studies should be problem and service oriented so that medical staff outside the acupuncture field can be advocates for the study. These studies should not be defined or perceived as a competition between Western and Eastern medicines. Patients with refractory chronic illnesses attend conventional medical programs even if conventional health care has not been very helpful. Conventional clinics are a source of patients as well as a source of skilled clinicians who can monitor the effectiveness of acupuncture from an independent point of view. Hence outcome studies are based on professional and personal relationships.

Talking about context, relationship, and uncertainty may not seem to be scientific. But we have learned in the past century that physics and biology do not follow linear precise models. We cannot evaluate acupuncture in terms of one-to-one correspondences and actions. Studying acupuncture scientifically can be a gateway to the study of the life itself - if we follow the path.