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 9. Teil:

Future directions FOR ASSESSING CLINICAL EFFICACY OF acupuncture

Lixing Lao
Complementary Medicine Program, University of Maryland, Baltimore, MD

With acupuncture seeking acceptance in the West, it is understandable that the large majority of clinical efficacy trials have been framed by biomedical symptoms and designed according to the placebo-controlled model. Yet adapting the Western biomedical model to assess acupuncture and Oriental medicine has been likened to measuring Chinese distances with a Western ruler. The fundamental questions driving clinical research in this field should include: What more can be learned from the traditional health care systems of which acupuncture is a part? and, How can that knowledge be applied to optimize potential health benefits? Answers to these questions will involve integrating diagnoses and treatments from Western biomedicine and Chinese traditional medicine into the same research design. It is a fair test of any medicine that clinical trials should be informed by and mirror clinical practice to the greatest extent possible. The challenge for clinical research is to include real world aspects of both medical practice traditions.

This talk will propose ways to design future clinical trials that integrate aspects of both health care systems, and have suitably flexible yet rigorous research designs. Topics to be explored will include: (1) using double screen procedures to accommodate both Western and TCM diagnoses in the same clinical trial; (2) testing TCM as a system rather than testing separately its component modalities, e.g. acupuncture, moxibustion, herbs; and (3) comparing acupuncture to conventional care or as adjunctive treatment to conventional care.

Future acupuncture research holds many promising possibilities as clinical trials are creatively designed to reflect acupuncture as it is actually practiced. Once the Western and Chinese medical paradigms are brought into the same clinical trial framework, the scope of questions that can be asked is broadened and the potential information gain becomes apparent.

FUTURE DIRECTIONS FOR RESEARCH ON THE PHYSIOLOGICAL BASIS OF ACUPUNCTURE AND ORIENTAL MEDICINE

Richard Hammerschlag
Oregon College of Oriental Medicine, Portland, OR

Most research directed at how acupuncture works is guided by the question, "What biochemical or physiological changes correlate with acupuncture effectiveness?". Evidence from such studies supports clinical findings of acupuncture as a drug-free alternative for treating conditions involving pain, inflammation, and nausea. Acceptance of acupuncture in the West is enhanced by identifying apparent mechanisms through which needling promotes healing, particularly when changes are detected in molecules or cells related to neural, endocrine, immune, cardiovascular, gastrointestinal and other biomedically-defined systems. While the focus on biomedical correlates of acupuncture is clearly important, it also limits the scope of basic science research in acupuncture and Oriental medicine. Equally needed are studies that ask the broader and more challenging question, "What can acupuncture tell us about how the body functions that Western medicine and physiology have not yet discovered?".

This talk will explore research directions guided initially by the second question. A range of techniques used to stimulate acupoints, from electroacupuncture and manual needling to non-invasive Toyo Hari needling and Qigong, will be examined to assess the degree of confidence that neurophysiology-based models can be accepted as the predominant means of explaining acupuncture analgesia. Evidence for possible information signaling and homeostatic regulation by bioelectromagnetic fields -- generated by cells and organs, and emitted by Qigong masters -- will be examined as a follow-up to concepts presented at previous SAR conferences by William Tiller and Beverly Rubik. Recent research will be reviewed suggesting that frequency-specific, weak electromagnetic fields can affect biochemical reactions as well as gene expression. Rather than discarding cellular and molecular models as part of an outmoded, reductionist view of living systems, current studies are revealing how an interconnected web of collagen and other cell-matrix molecules are interconnected to form surfaces along which "information" can flow within and between cells and tissues at rates many-fold greater than signals carried by nerve pathways or hormonal messengers. Finally, we will re-examine the two initial questions to find that biomedical correlates of acupuncture may, in fact, provide novel insights as to "how acupuncture works" just as acupuncture may shed new light on "how the body works" if we allow the phenomena themselves rather than our preconceived ideas to guide us.