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http://www.mdweekly.com.cn/m/view.php?aid=3452, accessed 071617

针刺联合西药治疗多囊卵巢综合征获得重要进展 ——吴效科团队研究成果刊发于国际顶级期刊《美国医学会杂志》

由国家中医临床研究基地妇儿病团队首席科学家、黑龙江中医药大学附属第一医院妇产科主任吴效科教授领衔完成的国家重大科技专项——“针刺联合西药克罗米芬治疗多囊卵巢综合征不孕症”研究成果,近日被全文刊发于国际顶级综合医学期刊《美国医学会杂志》(JAMA,影响因子44分)。该项课题基于我国PCOS疾病特征,规范评价中西医结合方法治疗多囊卵巢综合征的生殖和代谢临床疗效,这在中医临床研究上尚属开创之举。

多囊卵巢综合征(PCOS)是生育年龄妇女常见的一种复杂的内分泌及代谢异常所致的疾病,以慢性无排卵(排卵功能紊乱或丧失)和高雄激素血症(妇女体内男性激素产生过剩)为特征,主要临床表现为闭经、多毛、肥胖及不孕四大病症,患者可具备以上典型症状,也可以只有部分症状,治疗起来十分困难。吴效科团队的该项临床试验,采用的是被国际同行所高度认可的统计学上析因设计方案。课题组共筛选病例4645例,入组病例1000例,分布在国内25家医院,平均年龄28岁,不孕时间约2年,针刺和用药4个月,妊娠随访10个月。结果显示,试验受孕总数320例,妊娠总数达218例,活产人次205例,共出生婴儿数218名。

吴效科教授团队研究发现,针刺的两种方案联合西药一线促排卵药“克罗米芬”的“针药联合”方案,治疗多囊卵巢综合征(PCOS)不孕症妇女的4个月累积排卵率达93.2%,活产率约28.7%;针刺的两种方案联合西药安慰剂4个月排卵率达69.9%,活产率为15.4%;双胎妊娠率前者为9%,后者下降到3%。研究还发现,一线促排卵药克罗米芬会使PCOS女性妊娠晚期的腰背痛显著增加16.4%,而针刺干预能有效降低腰背痛发病率约6.6-14.3%。二次分析数据发现,克罗米芬的使用会加重PCOS妊娠女性的糖脂代谢异常,针刺则能明显改善这一代谢异常,并降低向心性肥胖参数。本项研究还首次在大样本量与严格的纳排标准的PCOS人群中,系统阐明了PCOS患者的痰湿、血瘀和肝郁等中医症候不同分类客观化特征。相关论文还在今年6月中旬在香港举办的第25届亚太妇产科学大会上被评为“最佳演讲论文”。

自2013年到现在,吴效科教授团队在系列研究中,规范评价了中西医多种方法医治PCOS的生殖和代谢临床疗效;利用模型动物和人体生物样本,系统而深入探讨了PCOS疾病病机和药效机制,首次发现PCOS综合中枢边缘系统(杏仁核与海马)GABA能神经元中5-羟色胺、r-氨基丁酸等改变情志、子宫内膜糖代谢障碍和胰岛素抵抗机理、卵巢亢进参数指标等。有关论文陆续发表于《美国科学院院刊》、《科学报道》、《人类生殖》等,并被《自然》系列杂志、《新英格兰医学杂志》、《英国医学会会刊》、《内分泌述评》等权威期刊多次引用。

另据介绍,本研究的运行模式是在国内外、中西医领域顶级团队合作的基础上,采用美国国立卫生研究院生殖医学协作网模式。功能委员会包括:方案优化委员会、项目执行委员会、数据协作委员会、数据与安全监测委员会、论文发表委员会,形成了重大研究的“图纸设计团队”、项目“施工团队”、质量“监管团队”、“受试者保护团队”、“成果产出团队”。以上临床试验中的专门机构设计和运行,为上述课题进行“全过程”和“纵深度”的国际合作,推进中医临床研究向国际化的大踏步迈进,提供了高度学术保障与组织运行保证。该项目成果的发表,凸显了国家中医临床研究基地的创新体系,在中医药“双一流”的学术发展中的带动作用。

(责任编辑:毕雪立)

这个报道刻意回避了针灸无效这个在JAMA上报道的结论

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Source: Evidence and Expert Opinions: Dry Needling versus Acupuncture (Ⅲ) —The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016

FAN Arthur Yin1,2, XU Jun1,3, and LI Yong-ming1,3. Evidence and Expert Opinions: Dry Needling versus Acupuncture (Ⅲ) —The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med 2017 Mar;23(3):163-165

©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag Berlin Heidelberg 2017
1. American Alliance for Professional Acupuncture Safety,Greenwich, Connecticut (06878), U.S.A.; 2. American Traditional Chinese Medicine Association, Vienna, Virginia (22182), U.S.A.; 3. American Acupuncture Association of Greater New York, New York, (10016), U.S.A.
Correspondence to: Dr. FAN Arthur Yin, Tel: 1-703-499-4428, E-mail: ArthurFan@ChineseMedicineDoctor.US   DOI: 10.1007/s11655-017-2542-x
Dry Needling Facts AAPAS White Paper (3) In the United States and other Western countries, dry needling (DN) has been a disputed topic in academic and legal fields. This White Paper is to provide the authoritative information that DN is acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by demonstrating the authoritative evidence and expertise regarding critical issues of DN and reaching a consensus. We conclude that DN is not merely a technique but a medical therapy and a form of acupuncture practice. It is a form of over-simplified acupuncture, an invasive procedure, and is not in the practice scope of physical therapists (PTs). DN has been “developed” simply by replacing acupuncture terms and promoted by acupuncturists, medical doctors, and researchers, and it was not initiated by PTs. In order to promote DN theory and business, some commercial DN educators have recruited a large number of non-acupuncturists, including in PTs, as students and customers in recent years. The national organizations of PT profession, such as American Physical Therapy
Association (APTA) and Federation of State Boards of Physical Therapy (FSBPT), started to support the practice of DN by PTs around 2010. Currently, there are probably more PTs involved DN practice and teaching than any other specialties. In most states, licensed acupuncturists are required to attain an average of 3,000 educational hours via an accredited school or program before they can apply for a license. The physician or medical acupuncturists are required to get a minimum of an additional 300 educational hours in a board-approved acupuncture training institution and have 500 cases of clinical acupuncture treatments in order to be certified in medical acupuncture. However, a
typical DN education course run only 20–30 h, often one weekend, and the participants may receive “DN certificate” without any examination. For patients’ safety and professional integrity, we strongly suggest that all DN practitioners and educators should have met the minimal standards required for licensed acupuncturists or physicians.
KEYWORDS dry needling, acupuncture, physical therapist, rebrand, education, regulation, evidence, expertise, consensus

Reporting Error Revealed in Knee Pain Acupuncture Study, Catastrophe Avoided

June 2016 | by Jonathan Gilbert

http://thegilbertclinic.com/reporting-error-revealed-in-knee-pain-acupuncture-study

On October 1st, 2014, the prestigious Journal of the American Medical Association (JAMA) published a study entitled “Acupuncture for Chronic Knee Pain: A Randomized Clinical Trial”[1]. It was a major study whose results stated that neither acupuncture nor laser acupuncture was useful to patients aged 50 and older with moderate-to-severe knee pain. Enter Dr. Arthur Fan…

In March of 2016 Dr. Fan and associates published a reevaluation of this study. It found serious flaws in its methodology and analysis. Not only that, but when properly evaluated, it appears that the study actually showed significant improvement in patients undergoing acupuncture and laser acupuncture in the clinical trial.

Dr. Fan is a consultant and long term researcher in Traditional Chinese Medicine who has been published in many of the world’s foremost medical journals. He has received numerous awards and commendations including a letter of thanks from the President himself. And thanks to him a grave reporting error was averted and an catastrophe avoided.

What is of interest to this writer is how such a mistake could have been made by one of the most respected, peer reviewed, medical publications in the world? I leave that, along with the link to Dr. Fan’s paper, “Acupuncture is Effective for Chronic Knee Pain: A Reanalysis of the Australian Acupuncture Trial”[2] to your discerning minds. Be well. ♥

FAN Arthur Yin (1,2), XU Jun (1,3), and LI Yong-ming (1,3)
©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag Berlin Heidelberg 2017

1. The American Alliance for Professional Acupuncture Safety, Greenwich, Connecticut (06878), USA; 2. American Traditional Chinese Medicine Association, Vienna, Virginia (22182), USA; 3. American Acupuncture Association of Greater New York, New
York (10016), USA
Correspondence to: Dr. FAN Arthur Yin, Tel: 1-703-499-4428, E-mail: ArthurFan@ChineseMedicineDoctor.US
DOI: 10.1007/s11655-017-2800-6

ABSTRACT In the United States and other Western countries, dry needling has been a topic in academic and legal fifi elds. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing
the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding (1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using “fascia” hypothesis) in replace of their
equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain (dry needling promoters redefifi ned it as “myofascial pain”). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in
acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture’s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients’ safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.
KEYWORDS dry needling, acupuncture, trigger points, acupuncture points, invasive therapy, evidence, expertise, consensus

dry-needling-facts-aapas-white-paper-2-010517

FAN Arthur Yin (1,2), XU Jun (1,3), and LI Yong-ming (1,3)
©The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag Berlin Heidelberg 2016
1. American Alliance for Professional Acupuncture Safety, Greenwich, Connecticut (06878), U.S.A.; 2. American Traditional Chinese Medicine Association, Vienna, Virginia (22182), U.S.A.;
3. American Acupuncture Association of Greater New York, New York (10016), U.S.A
Correspondence to: Dr. FAN Arthur Yin, Tel: 1-703-499-4428, E-mail: ArthurFan@ChineseMedicineDoctor.US
DOI: 10.1007/s11655-016-2630-y

ABSTRACT In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professional administrators, lawmakers, and the general public through providing the authoritative evidence and experts’ opinions regarding critical issues of DN versus acupuncture, and then reach consensus. DN is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulation, trigger points (TrP) acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is a form of simplififi ed acupuncture using biomedical language in treating myofascial pain, a contemporary development of a portion of Ashi point acupuncture from Chinese acupuncture. It seeks to redefifi ne acupuncture by reframing its theoretical principles in a Western manner. DN-like needling with fifi liform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and
with hypodermic needles has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since late of 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has a broader scope of indications, not limited to treating the myofascial pain.
KEYWORDS dry needling, acupuncture, biomedical acupuncture, authoritative evidence, experts’ opinions, consensus

dry-needling-facts-aapas-white-paper-1-online-122016