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Posts Tagged ‘Acupuncture in USA’

新华社华盛顿9月26日电 新闻分析:针灸看到了被美国主流医学接受的机遇 (2017-09-27 20:29:36 来源: 新华社) http://www.xinhuanet.com//world/2017-09/27/c_1121734808.htm

新华社记者林小春

如果说传统中医作为一个整体在美国还处境艰难,那么针灸的命运要好得多。经过业内人士长达40多年的努力,美国50个州中有46个州以及华盛顿特区已立法让针灸行医合法化。由于美国阿片类止痛药物滥用与成瘾危机日益严重,针灸在美国面临着大发展乃至被主流医学界所接受的良机。

一周前,美国35个州、华盛顿特区以及美属波多黎各的检察长联名发出公开信,呼吁美国健康保险计划联合会的1300个会员公司修改保险政策,将针灸等非药物止痛疗法纳入在内。此前,美国马里兰州、华盛顿州、阿拉斯加州等已将针灸纳入医疗保险体系。

美国针灸界26日发表一份21页的英文白皮书,列举一系列科研证据,表明针灸能作为一线疗法安全有效地治疗急性与慢性疼痛。

“针灸的春天也许来了,”在华盛顿特区从业的执照针灸师樊蓥对新华社记者说,“这次美国的阿片类药物危机,将让非药物疗法正式有了一席之地,包括针灸、整脊和医疗按摩,但也不能说没有春寒。”

自去年3月时任美国总统奥巴马提出止痛药物滥用问题,在新泽西州行医的执照针灸师李永明就意识到“这或许是一个针灸新时代的开始”。他第一个提出,美国正在开展“新鸦片战争”,这个说法在华人针灸师内部得到广泛认同。

“在各种非药物疗法中,针灸治疗疼痛效果最好,对替代阿片类止痛药最具特异性,所以这对针灸界无疑是个好消息和发展机遇,几十年不遇,为针灸进入主流医学提供了良机,”李永明说。

对于美国各州检察长的呼吁,他乐观地认为,美国保险公司照办的概率很大,一个原因是针灸成本不高,而“阿片类药物中毒急诊住院治疗平均每次9万多美元。够一个针灸师一年的工资。保险公司是要算成本的”。

全美中医药学会会长田海河强调,美国各州检察长的公开信只是一个提议,采纳与否不知道,但这确实可能意味着针灸在美国大发展的机遇即将来临,接下来的问题是怎么抓住机遇。

田海河说,目前美国有4.5万名针灸师,首先技术一定要过硬,能有本领去帮助病人止痛,使病人没有理由、没有借口去用止痛药,也就不会成瘾。“我们要有这个金刚钻,才能揽这个瓷器活。”

他还提醒,即使各州检察长的提议被接受,美国还有很多提供针灸治疗的私人诊所与个体医生并不在医疗保险体系内。保险体系内的一些医生也提供针灸服务,但称之为“干针”,认为这与中医无关。“干针”反而有可能抢先利用这个机遇,这是需要针灸师们解决的问题。

“如果针灸能被纳入医保范围内,这太好不过了。但这将是一个漫长的过程。结果不是等来的,需要我们提供科学证据,证明针灸止痛安全、有效,”田海河说。

对于各州检察长的提议,美国健康保险计划联合会通信与公共关系主管凯瑟琳·唐纳森告诉新华社记者,他们已在探索加强使用已被证明有效止痛的非药物疗法。

唐纳森说:“对于许多患者而言,诸如针灸、瑜伽和锻炼等疗法都是有效的一线疗法,但这视患者个体的不同情况而言,必要时再改而使用药物疗法。”

那么,美国学术界目前到底怎么看待针灸呢?

美国国家补充和综合健康中心官网在对针灸的介绍中指出,只要由有经验的、受过培训的针灸师施针,针消过毒,总体是安全的,但不当施针能引发严重副作用。一系列研究表明,针灸可能有助减轻腰痛、颈痛和骨关节炎疼痛,也有可能帮助减少紧张性头痛发生频率并预防偏头痛。

美国国家科学、工程和医学学院也于今年7月发布一份题为《疼痛管理与阿片类药物流行》的报告指出,近几十年来针灸止痛已成为普遍做法,包括针灸在内的一些非药物干预手段是止痛的有力工具。

2015年,美国医疗保健机构凯泽·珀默嫩特公司曾在6000多名会员慢性疼痛患者中开展问卷调查,结果发现,32%的患者接受了针灸治疗,47%的患者接受了整脊治疗,21%的患者说同时使用这两种疗法。

研究第一作者、凯泽·珀默嫩特公司健康研究中心的查尔斯·埃尔德对新华社记者说,针灸是帮助治疗慢性肌肉骨骼疼痛的一种重要手段,有越来越多的科学证据支持使用针灸止痛。因为慢性疼痛很难治疗,所以针灸治疗就显得很重要。

“通常我们使用的药物效果不佳或者副作用太大,所以医生和患者都期待替代疗法,”埃尔德说,“针灸的作用应该在我们的医保体系里继续增强,这将很有意义。比如,俄勒冈州现在要求医疗保险覆盖包括针灸在内的补充医学方法治疗背痛患者。我预计我们将来会看到更多这样的要求。”

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GLOBAL VIEWS
Dr. Gene Bruno: The beginning of the acupuncture profession in the United States (1969–1979) — acupuncture, medical acupuncture and animal acupuncture  | PDF |

http://www.jcimjournal.com/jim/

June 23, 2015 | Arthur Yin Fan, Sarah Faggert (doi: 10.1016/S2095-4964(15)60186-8)
 | PDF |

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Dr. Fan’ s new article was published recently.

GLOBAL VIEWS
Nevada: the first state that fully legalized acupuncture and Chinese medicine in the Unites States — In memory of Arthur Steinberg, Yee Kung Lok and Jim Joyce who made it happen
February 27, 2015 | Arthur Yin Fan | J Integr Med 2015; 13 (2) : 72–79
doi: 10.1016/S2095-4964(15)60158-3
ABSTRACT | FULL TEXT | PDF |

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Letters to JAMA Exposing Acupuncture Research Flaws Applauded by TCMAAA

http://www.marketwatch.com/story/letters-to-jama-exposing-acupuncture-research-flaws-applauded-by-tcmaaa-2015-02-19

Published: Feb 19, 2015 8:01 a.m. ET

TCMAAA calls for stricter adherence to research ethics and well-designed acupuncture studies among the integrative medicine community

TAMPA, Fla., Feb 19, 2015 (BUSINESS WIRE) — In five letters to the editor published in the latest issue of JAMA, the Journal of the American Medical Association, acupuncture clinicians and researchers around the world point to key flaws that call into question the validity and research methods used in a randomized clinical trial published in JAMA in October of 2014. The Australian study, Acupuncture for chronic knee pain: a randomized clinical trial, by Hinman, et al., concluded, “In patients older than 50 years with moderate or severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function. Our findings do not support acupuncture for these patients.” Many American acupuncturists were outraged when the October 2014 article was published in JAMA and have called for a review of the study’s design and protocols.

Yong Ming Li, MD, Ph.D., of New Jersey challenges that the researchers altered the aims and hypotheses of the study after the data was collected and the trial was closed. According to the original aims and hypotheses submitted to the official clinical trials registry in 2009 the objective of the study was not to evaluate the effectiveness of traditional needle acupuncture against sham laser acupuncture, but to evaluate laser acupuncture against sham laser acupuncture with needle acupuncture serving as a positive control for laser acupuncture. Protocols originally filed with the registry as well as the authors’ baseline publication do not describe sham laser acupuncture as being a control for needle acupuncture. Dr. Li’s letter furthermore debates the validity of using sham laser acupuncture as a control for needle acupuncture, as it is not generally accepted as a valid control for needle acupuncture.

Hongjian He, AP, Ph.D., of Florida also questions design choices: she specifically points to the use of non-standardized point selection for chronic knee pain. Also some patients received treatments once a week, while others got treated twice a week. This lack of consistency throws into question the validity of the statistics extrapolated from the data collected during the study.

David Baxter, TD, DPhil, MBA, and Steve Tumilty, Ph.D., questioned in their letters why the researchers chose to use laser dosages below the threshold necessary to have a therapeutic effect and why they failed to specify wavelength used in the study and why those levels were chosen.

Lixing Lao, Ph.D., MB, and Dr. Wing-Fai Yeung, BCM, Ph.D., point out in their letter that patients were assessed after 12 weeks and then again after one year, but that without treatment for chronic knee pain after one year, the condition naturally will deteriorate, so that the findings after a year are irrelevant. With these key flaws revealed the conclusion of this randomized clinical trial is clearly undermined.

No group has been more involved in this issue than the Traditional Chinese Medicine American Alumni Association (TCMAAA). Through its broad social media in the USA and around the world, TCMAAA has orchestrated a series of professional forums and discussions on research ethics and design for acupuncture studies after the Australian study was published in JAMA.

“This collection of letters represents a merging of licensed acupuncturists and integrative medicine practitioners who demand the same gold standards of ethics and design quality for clinical acupuncture research as conventional medical studies,” stated Haihe Tian, Ph.D., AP., the President of TCMAAA.

Even with the challenges acupuncture poses in gold-standard randomized clinical trials this valuable treatment method should not be overlooked. With properly designed and well-thought-out studies acupuncture can be evaluated fairly and thoroughly, with conclusions founded upon careful reasoning, accepted controls, and irrefutable evidence.

About TCMAAA:

Registered in Florida, TCMAAA (website: http://www.tcmaaa.org) is a nonprofit organization with one thousand members of licensed acupuncture practitioners formally trained in accredited medical education institutions in China. As a leading organization among Chinese Medicine practitioners, TCMAAA continues to support its members’ professional growth across the United States.

SOURCE: TCMAAA

For TCMAAA
Selene Hausman, L.Ac., 480-510-2259
seleneph@gmail.com

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