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Cervical dystonia case

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IMG_3661

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Today, a friend told me she had acupuncture in our center for two and half weeks, lost weight 6 pounds.

Acupuncture adjusted her appetite and mood.

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Yesterday, a 44 years old lady came and hugged me very tightly for three minutes. And then told me she got pregnant naturally after my acupuncture treatment.

She said she should be my no.76 clients got pregnant–because she had seen there was a notes on the office board-75 pregnancy since 2007.

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OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015)

BIOGRAPHICAL SKETCH

Provide the following information for the Senior/key personnel and other significant contributors.

Follow this format for each person. DO NOT EXCEED FIVE PAGES.

NAME: Fan, Arthur Yin
eRA COMMONS USER NAME (agency login):
POSITION TITLE: Independent researcher in Chinese Medicine, Licensed Acupuncturist

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable.)

INSTITUTION AND LOCATION DEGREE
(if applicable)
Completion Date
MM/YYYY
FIELD OF STUDY
Nanjing University of Chinese Medicine, Nanjing, Jiangsu MD 06/1986 Chinese Medicine
Nanjing University of Chinese Medicine, Nanjing, Jiangsu PHD 06/1998 Chinese Internal Medicine, Brain diseases
Nanjing University of Chinese Medicine, Nanjing Municipal Hospital of Chinese Medicine, Nanjing, Jiangsu Resident 07/1989 Integrative medicine
Nanjing University of Medical Science Brain Hospital, Nanjing, Jiangsu Other training 09/1990 Neurology
Georgetown University School of Medicine, Washington, DC Postdoctoral Fellow 08/2002 Pharmacology, toxicology in herbs, diet and nutrition supplements
University of Maryland School of Medicine, Baltimore, MD Fellow 05/2005 Pain and inflammation; Acupuncture mechanism, herbal medicine efficacy and safety evaluation

A. Personal Statement

Arthur Yin Fan (Fan Ying) is an independent researcher and a leading specialist in Acupuncture and Chinese Medicine with about three decades of clinical experience in both Traditional Chinese Medicine (TCM) and Western medicine. He was awarded an MD degree in Chinese Medicine (1986) and a PhD in Chinese Internal Medicine (1998); he also had one additional year’s training in the neurology as well as a four-year residency combining Chinese and Western internal medicine, i.e. integrative medicine. He was the first NIH fellow in Chinese medicine in 2002-2005.

Dr. Fan has been a reviewer for medical research grants and academical papers for several peer-reviewed Journals for more than fifteen years; he has published over eighty academical papers. He was a consultant for the center for Integrative Medicine at the University of Maryland medical school. As a researcher in acupuncture, he investigated its effect and mechanism on reducing pain and inflammation. He also researched herbal medicine, nutrition supplements’ efficacy and safety at University of Maryland and Georgetown University Medical School.

Practicing in the Washington, DC-northern Virginia area since 2002, Dr. Fan employs acupuncture and Chinese herbal medicine as alternative or complementary treatment for patients with various conditions. He is one of very few doctors who has both MD and PhD background (in Chinese medicine, integrative medicine). Dr. Fan holds the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certificate in Oriental Medicine.

From 1998 to 2001, Dr. Fan was one of the major designers and founders of Nanjing Chinese Medicine Center for Stroke, which combined the medical resources of ICU, neurology, acupuncture, Chinese herbal medicine, physical therapy, hyperbaric oxygen chamber, and other therapies to maximize patients’ survival and recovery in a limited time. Currently, this center is listed as one of the key stroke centers in China. This kind of integrative medicine style already has spread to every city of China since then.

  1. Talpur NA, Echard BW, Fan AY, Jaffari O, Bagchi D, Preuss HG. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol Cell Biochem. 2002 Aug;237(1-2):129-36. PubMed PMID: 12236580.
  2. Zhang RX, Lao L, Wang X, Fan A, Wang L, Ren K, Berman BM. Electroacupuncture attenuates inflammation in a rat model. J Altern Complement Med. 2005 Feb;11(1):135-42. PubMed PMID: 15750372.
  3. Fan AY, Lao L, Zhang RX, Zhou AN, Berman BM. Preclinical safety evaluation of the aqueous acetone extract of Chinese herbal formula Modified Huo Luo Xiao Ling Dan. Zhong Xi Yi Jie He Xue Bao. 2010 May;8(5):438-47. PubMed PMID: 20456842; PubMed Central PMCID: PMC3739922.
  4. Fan AY. The methodology flaws in Hinman’s acupuncture clinical trial, part I: design and results interpretation. J Integr Med. 2015 Mar;13(2):65-8. PubMed PMID: 25797635.

B. Positions and Honors

Positions and Employment

1986 – 1989 Resident doctor, Nanjing Municipal Hospital of Chinese Medicine, Nanjing
1990 – 1990 Fellow/trainee, Nanjing Brain Hospital, Nanjing University of Medical Science, Nanjing
1990 – 1995 Attending doctor, Neurology Department, Nanjing Municipal Hospital of Chinese Medicine, Nanjing
1998 – 2001 Associate Professor in Research and in Internal Medicine; Associate Chief doctor, Neurology Department, The Third Hospital of Nanjing University of Chinese Medicine, Nanjing
2001 – 2002 Visiting researcher, postdoc, Dept. Physiology and Biophysics, Georgetown University Medical Center, Washington, DC
2002 – Independent researcher in Chinese Medicine, Licensed Acupuncturist, McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA
2002 – 2005 NIH Fellow in Chinese Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
2004 – 2005 Postdoc, Research assistant, Veteran Affairs Maryland Health Care , Baltimore, MD
2015 – Chair,Scientific Study & Academic Affair Committee, TCMAAA, Traditional Chinese Medicine American Alumni Association, Largo, FL

Other Experience and Professional Memberships

2008 – Member, Acupuncture Society of Virginia
2009 – 2010 Board member, Acupuncture Society of Virginia
2015 – Chair, Scientific Study & Academic Affair Committee, TCMAAA (Traditional Chinese Medicine American Alumni Association, FL, USA).

Honors

1995 Young Scientist Travel Award, International Brain Research Organization
2001 Merit award for Medical Science and Technology Advancement, Jiangsu Provincial Government, China
2011 Member, Editorial Committee, Journal of Integrative Medicine
2013 Editor, Journal of Alternative & Integrative Medicine

C. Contribution to Science

a. Acupuncture clinical trial methodology: design,sample size calculation, statistics, result interpretation
  1. Fan AY. The methodology flaws in Hinman’s acupuncture clinical trial, part I: design and results interpretation. J Integr Med. 2015 Mar;13(2):65-8. PubMed PMID: 25797635.
  2. Fan AY. The methodology flaws in Hinman’s acupuncture clinical trial, Part II: Zelen design and effectiveness dilutions. J Integr Med. 2015 May;13(3):136-9. PubMed PMID: 26006026.
b. Acupuncture mechanism study in pain and inflammation
  1. Zhang RX, Lao L, Wang X, Fan A, Wang L, Ren K, Berman BM. Electroacupuncture attenuates inflammation in a rat model. J Altern Complement Med. 2005 Feb;11(1):135-42. PubMed PMID: 15750372.
c. Herbology efficacy or herb-pharmacology: Huo Luo Xiao Ling Dan; Comparing of the safety between single herb and formula
  1. Fan AY, Lao L, Zhang RX, Wang LB, Lee DY, Ma ZZ, Zhang WY, Berman B. Effects of an acetone extract of          Boswellia carterii Birdw. (Burseraceae) gum resin on rats with persistent inflammation. J Altern Complement Med. 2005 Apr;11(2):323-31. PubMed PMID: 15865500.
  2. Fan AY, Lao L, Zhang RX, Zhou AN, Wang LB, Moudgil KD, Lee DY, Ma ZZ, Zhang WY, Berman BM. Effects of an acetone extract of Boswellia carterii Birdw. (Burseraceae) gum resin on adjuvant-induced arthritis in lewis rats. J Ethnopharmacol. 2005 Oct 3;101(1-3):104-9. PubMed PMID: 15970410
  3. Lao L, Fan AY, Zhang RX, Zhou A, Ma ZZ, Lee DY, Ren K, Berman B. Anti-hyperalgesic and anti-inflammatory effects of the modified Chinese herbal formula Huo Luo Xiao Ling Dan (HLXL) in rats. Am J Chin Med. 2006;34(5):833-44. PubMed PMID: 17080548.
  4. Zhang RX, Fan AY, Zhou AN, Moudgil KD, Ma ZZ, Lee DY, Fong HH, Berman BM, Lao L. Extract of the Chinese herbal formula Huo Luo Xiao Ling Dan inhibited adjuvant arthritis in rats. J Ethnopharmacol. 2009 Jan 30;121(3):366-71. PubMed PMID: 19100323; PubMed Central PMCID: PMC2818782.

d. Efficacy studies on common used herbs and dietary supplements: Maitake mushroom, Qing Gan Jie Du Dan/ Liver purifier

  1. Echard BW, Talpur NA, Fan AY, Bagchi D, Preuss HG. Hepatoprotective ability of a novel botanical formulation on mild liver injury in rats produced by acute acetaminophen and/or alcohol ingestion. Res Commun Mol Pathol Pharmacol. 2001 Jul-Aug;110(1-2):73-85. PubMed PMID: 12090358.
  2. Talpur NA, Echard BW, Fan AY, Jaffari O, Bagchi D, Preuss HG. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol Cell Biochem. 2002 Aug;237(1-2):129-36. PubMed PMID: 12236580.
  3. Rajaiah R, Lee DY, Ma Z, Fan AY, Lao L, Fong HH, Berman BM, Moudgil KD. Huo-Luo-Xiao-Ling Dan modulates antigen-directed immune response in adjuvant-induced inflammation. J Ethnopharmacol. 2009 May 4;123(1):40-4. PubMed PMID: 19429337; PubMed Central PMCID: PMC2925191.

e. Safety and toxicity evaluation of herbal medicine: Huo Luo Xiao Ling Dan; Literature review; acute toxicity investigation and chronic toxicity evaluation; comparing the single herb and compound formula.

  1. Zhang RX, Fan AY, Zhou AN, Moudgil KD, Ma ZZ, Lee DY, Fong HH, Berman BM, Lao L. Extract of the Chinese herbal formula Huo Luo Xiao Ling Dan inhibited adjuvant arthritis in rats. J Ethnopharmacol. 2009 Jan 30;121(3):366-71. PubMed PMID: 19100323; PubMed Central PMCID: PMC2818782.
  2. Fan AY, Lao L, Zhang RX, Zhou AN, Berman BM. Preclinical safety evaluation of the aqueous acetone extract of Chinese herbal formula Modified Huo Luo Xiao Ling Dan. Zhong Xi Yi Jie He Xue Bao. 2010 May;8(5):438-47. PubMed PMID: 20456842; PubMed Central PMCID: PMC3739922.

D. Research Support

Completed Research Support

2003/07/31-2004/07/31

Under P50-00084, which was a Feasibility Study

Fan, Arthur Yin (PI)

A Pilot Study on Yang-Deficiency Syndrome And Pain Sensitivity in Rats

Yang-Deficiency (YD, also called Deficiency-cold Syndrome/Pattern, or Yang-Xu Zheng) is a common diagnosis made by traditional Chinese medicine (TCM) in rheumatoid arthritis (RA), osteoarthritis (OA) and other chronic pain or/and chronic inflammatory diseases (CP/CID). YD is marked by chronic cold, frailty or weakness, lethargy, and decreased sexual and reproductive ability or poor body development. TCM Yang-enhancing remedies have demonstrably and effectively corrected these chronic conditions, and the application of such remedies could improve the rehabilitation process of some chronic diseases characterized by YD. In China, YD animal models have been successfully developed by injecting large doses of steroid hormones or by removing the adrenal gland or thyroid gland in rats, mice and rabbits. However, up to now, there has been no study on pain in the YD model or the RA-YD animal model. Our study will consist of two sets of experiments. In part one we will develop YD in Sprague Dawley (SD) rats by injecting them with hydrocortisone acetate daily for one week. We will test their major physiological parameters (body temperature, heart rate, blood pressure); administer endurance tests (anti-fatigue test: 25 ºC room temperature swimming test, anti-cold test under fatigue conditions: 0ºC ice-water swimming test); and measure the functions of three endocrinological axes (cortisone; triiodothyronine [T3], thyroxine [T4]; estradiol [E2], testosterone [T]) using radioimmunoassay (RIA) plasma levels. In part two, we will test the pain sensitivity using behavioral studies (paw withdrawal latency, or PWL) in YD rats compared to normal rats. The data obtained from this study will be used for a future pain and inflammation study, for an herbal remedy study on RA and its Syndromes, and for creating a RA-YD disease-Syndrome integrated animal model.

Role: PI

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Acupuncture helped the mother overcome the migraine and hypertension during pregnancy

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Mr. D. N.,80 years old,  had a stroke in last November (year 2011), the stroke affected  function of his celebellum and stem.  The main problem is dizziness and hearing loss. He had ten acupuncture treatments and’several months physical therapies, did not feel significant improvement.

On August 21,2012, patient started to see me. When he came, he was very dizzy, even the position change, such as  lying down and/or sitting up, causing severe dizziness. He had to use a cane to help the balance, his daughter or son helps his walk too.  For his hearing loss, he said he could answer the phone only when the speaker is on; he could not hear the door-bell ringing and the touch-tone sound of the phone.

After our 4 acupuncture treatments, his dizziness decreased at least 50% and walking much better, faster and balance better,don’t need other to help him; and hearing better.

After 6 treatments, he could hear the door-bell ringing and touch-tone sound of the phone. Very happy and said at least 50% improving. Currently, he is still under extensive acupuncture treatments in our office.

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Dr. Fan,
I hope you remember me, Simara. I used to go to your office for my bad back pain every weekend. I had an emergency at home with my father who got really ill and eventually passed away. I had to stay at home to take care for some things with my mother and the stay I had envisioned prolonged for a little bit. I just wanted to tell you thank you from the bottom of my heart beacuse you really made me feel better and whenever I couldn’t walk whenever I came into your office, an hour later I felt like it never happened. You really care for your patients and you are a really sweet man. I can honestly say you’re the best doctor I’ve ever had and I think you cured my back pain because thru all this time I haven’t been in Virginia, my back doesn’t bother me anymore. I will be back but I just wanted to let you know how grateful I am for basically curing me.
I also want to say that your assistant April, she is the sweetest, most attentive and professional person I’ve ever met. I miss you guys very much and hopefully I will be back very soon. I will go by the office to say hi.
Dr. Fan, thank you so much for being the man that you are and I hope you keep working healing people for a long, long, long time. Xie Xié.
Simara C.
Dr.Arthur Fan notes: acupuncture is one of most effective therapies in low back pain management, according to clinical trials and long term clinical practice.

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September 6, 2012

Doctor Fan,

I want to thank you for using your expert acupuncture techniques to solve my long lasting Restless Leg Syndrome (RLS).

Traditional medicine did not work and your remedies have allowed me to sleep well at night.

Thank you very much.

Sincerely,

P. A.

Dr.Arthur fan notes: after acupuncture, patient feels no longer have restless leg syndrome, and migraine gone, sleep very soundly.

And, very important the mood much calm.

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This morning, a lady reported her pregnancy test strong positive–got pregnant. This is no.65 patient got pregnant, since 2007, by our acupuncture treatments.

She is 33 years old, married for 6 years, and tried seriously to get conceive for over one years. According to her, her husband is healthy and the sperm test was good. She also has a lot acne, so she hope we could adjust her hormones for both acne and fertility.

When she first saw me, she was in day 14 of her period cycle (she had  28-days-cycles before). I gave her acupuncture according to our protocol, and herb pills. after 8 sessions acupuncture, she felt her cervical mucus is slippery and very stretchable, better than before. after another two weeks, her period didn’t come. Then her pregnancy test became positive.

 

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J Sex Med. 2010 Feb;7(2 Pt 2):981-95. Epub 2009 Nov 12.

The ACTIV study: acupuncture treatment in provoked vestibulodynia.

Source

Elements of Health Centre, Victoria, Canada.

Abstract

INTRODUCTION:

Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain.

AIM:

To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD.

METHODS:

Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman’s individual TCM diagnosis. TCM practitioners made qualitative notes on participants’ feedback after each session. Main Outcome Measures. Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant.

RESULTS:

A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants.

CONCLUSIONS:

Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.

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My patients and many others sometime want to know what is the difference between IVF and acupuncture in infertility treatments.

Actually, the difference is significant.

1. IVF, using artificial procedure to help the infertility couple to get baby(s). It is a procedure with the external help(doctors) and get “pregnancy”, like a game.  And, sometime, using donor’s egg or sperm. The result could know in one month. If you see the patient has bleeding after some days post the procedure(embryo transferring), the IVF is failed.

2. Acupuncture, adjusts the hormones and improving the function, which makes patient become a normal people. And then she could get pregnancy in any cycle.

Yesterday, one patient told me she got pregnancy after our acupuncture treatments.

 

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Fertil Steril. 2012 Mar;97(3):599-611. Epub 2012 Jan 11.

Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.

Source

Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China.

Abstract

OBJECTIVE:

To evaluate the effect of acupuncture on in vitro fertilization (IVF) outcomes.

DESIGN:

Systematic review and meta-analysis.

PATIENT(S):

Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects ofacupuncture on IVF outcomes.

SETTING:

Not applicable.

INTERVENTION(S):

The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture.

MAIN OUTCOME MEASURE(S):

The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.

RESULT(S):

Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation.

CONCLUSION(S):

Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.

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Acupuncture Today, April, 2012, Vol. 13, Issue 04      http://www.acupuncturetoday.com/mpacms/at/article.php?id=32551

Real Acupuncture or Real World Acupuncture? Deciphering Acupuncture Studies in the News .  By Matthew Bauer, LAc

Recent studies have concluded that acupuncture is no more effective than various forms of sham or placebo acupuncture, and these conclusions have been reported in the media and used by skeptics to discredit acupuncture.

The Oriental medical (OM) community’s response to these reports has been ineffective, perhaps counterproductive. These studies, and the resulting media coverage, can serve was a wake-up call to the OM community, alerting us that we need to be more proactive in our public education efforts and rethink some long-held beliefs regarding the efficacy of traditional theories.

In the News 

In the last few years, several studies sought to measure the effectiveness of acupuncture in treating common conditions.1,2,3 The findings of these studies were widely reported within the media.4,5,6 The good news for the Oriental medicine (OM) profession is that these studies found that acupuncture was not only effective, but often more effective than conventional therapies. The bad news is that these studies also found that traditional acupuncture techniques – based on the point/channel theories taught inOMschools – were no more effective than what is termed “sham” or “placebo” acupuncture.

The most recent of these studies, published in the May 11, 2009 issue of the Archives of Internal Medicine and sometimes referred to as the “Seattle” study, built on other recent studies and is a good example of current acupuncture research. One of the conclusions this study’s authors reached is particularly striking:

“Collectively, these recent trials provide strong and consistent evidence that real acupuncture needling using the Chinese Meridian system is not more effective for chronic low back pain than various purported forms of sham acupuncture.”

As someone who has treated thousands of people with chronic low back pain using the Chinese meridian system, my first reaction to this statement was to feel the researchers were mistaken. But, I also respect scientific research and feel it would be a great mistake for those of us in the OM profession to criticize these studies just because they tell us something we don’t want to hear, without looking critically at both the studies and our own beliefs.

Real Vs. Real World 

The only evidence these studies actually provide is that so-called “real” acupuncture is not more effective than sham acupuncture in a controlled, clinical trial environment. I believe this detail is of critical importance. But, before I explain why this detail is of such importance, I want to critique the response to these studies from within the OM profession.

Up to this point, the sparse response from theOMfield to these studies has been limited to pointing out that there are many acupuncture points including hundreds of extra points, so “sham” acupuncture is still hitting acupuncture points. Regarding studies that use “placebo” techniques in which acupuncture is simulated with the skin unbroken, some acupuncturists have pointed to tapping techniques, common in Japanese acupuncture, that never pierce the skin. While there is some merit to these arguments, they ignore the greater problem with these studies and make theOMprofession sound to the public like we are grasping at straws and making excuses. If researchers can’t help but hit useful points no matter how hard they try to avoid them, why should anyone bother seeking treatment from people trained in the complex traditional theories that stress diagnosing qi imbalances to identify the best point prescriptions?

The primary problem with these studies is not that researchers inadvertently performed real acupuncture when they attempted to do sham or placebo acupuncture, but that the real acupuncture seriously underperformed. Most of these studies show the real acupuncture groups to be somewhere in the 45-60% effective range. Only 45-60%? If I was only getting 45-60% positive effect for my patients, I would never have been able to build my practice and support my family for the last 23 years. Ask any clinically successful acupuncturist, and they will tell you for common pain problems like low back pain, the average range of effectiveness is somewhere between 75-85%.

Obviously, something about the design of these studies does not capture what happens in the real world when using acupuncture to treat these conditions. Unfortunately, we don’t have enough studies that reflect what happens in the real world because most of the money for research has gone to the “controlled” studies using sham and placebo controls, and the type of patient contact that happens in real world treatment is not allowed. None of these recent studies allowed the acupuncturist who did the needling to consult with the patient and choose points and techniques.

In most of these studies, a set of points were prescribed and used repeatedly regardless of the patient’s progress, or lack thereof. TheSeattlestudy was the only study that attempted to mimic actual practice by having a diagnostic acupuncturist see one group of patients before each treatment. This diagnostician chose the points to be used based on traditional diagnostic rationale, but then these points were passed along to the treating acupuncturist who did the actual needling.

Qi Interaction

Will it affect the outcome if the acupuncturist who inserts the needles is not allowed to interact with the patient and choose what points and techniques to use? It shouldn’t matter, if acupuncture only stimulates specific nerve endings, causing mechanical neuro-chemical responses within the body. But, if acupuncture actually works by manipulating qi, as its founders and supporters have claimed for more than 2,000 years, then there is very good reason to believe that the qi dynamic between the acupuncturist and the patient is an important factor that must be considered.

The first day I interned in the private practice of my school’s clinic director, he asked me to take charge of treating a very difficult case. When I balked and said I thought I was too inexperienced to manage such a difficult case, my teacher told me that my sincere enthusiasm created a positive qi that helped to offset my lack of experience. Over the years, I have come to believe the acupuncturist’s qi can be as important as the points themselves. Points do matter, but the effect these points elicit is influenced by the qi of the one stimulating them. Like yin and yang, there is a combination of both factors at play: different points have different tendencies regarding how they influence a patient’s qi dynamics, but that tendency is influenced by the qi of the person manipulating the points. Because this fact is rarely discussed in acupuncture circles, researchers have not taken this into account in their studies.

Skeptics have long contended that acupuncture only works if the patient believes in it (ignoring the effects of veterinary acupuncture or animal studies), but it may be more important that acupuncturists believe in what they are doing. The best practitioners with the highest success rates put everything they have into every treatment – into every needle or patient contact. We choose points and techniques because we believe they are very best for our patients, and that belief influences the effects of the points. Any acupuncturist who puts needles in a patient not believing it to be the very best they can do is inserting those needles with less than optimal qi.

Unlike administering drugs or performing surgery, which manipulates the body in a more mechanical fashion, influencing qi dynamics is more dependant on subtle factors, including the qi of the one doing the manipulating. This may sound like what skeptics call “woo-woo” – irrational, new age mysticism — but it is a key part of acupuncture’s traditional foundation and deserves consideration. Before jumping to conclusions about traditional concepts, we should encourage studies using acupuncture in a way that reflects what takes place in the real world. Let’s study what happens to patients when treated in actual clinic conditions with no blinding or controls, in which the acupuncturist does whatever their years of training and experience leads them to believe is the best they can do for each patient. Don’t limit them in their techniques and communication with the patient, because such limits are not imposed in real world practice. And don’t refer to acupuncture being done under research constrained controls as “real” acupuncture, because it does not resemble the manner in which acupuncture is done in actual practice.

These studies point to sobering realities theOMprofession needs to face. We cannot ignore the fact that in study after study in which researchers stimulated points in a manner that seemed incompatible with traditional Chinese medicine protocols, a respectable percentage of test subjects experienced significant improvement. So while it may be fact that the best trained and most experienced acupuncturists will obtain 75-85% effectiveness rates for their patients, it may also be a fact that poking some needles virtually anywhere will get 40%-50%, sometimes even 60% effectiveness. (See sidebar.) If that is the case, then the value of comprehensive traditional training and years of experience may be in getting that extra 20-30% of successful outcomes.

I am not surprised that poking needles anywhere can help a decent percentage of pain-related cases because I believe any acupuncture stimulates the body to produce anti-trauma chemistry such as pain modifiers and anti-inflammatory compounds. That is why I was never strongly opposed to other health care professionals being able to legally do some acupuncture. I have long felt that rather than fighting to prevent other health care professionals from having the right to perform acupuncture, theOMprofession should be trying to educate these other professions that the more comprehensive training allows for that additional 20-30% effectiveness. In a spirit of mutual respect, we could encourage other health care professionals to refer their more difficult cases to us. This suggestion may not be welcomed by some, but theOMprofession must be open to evolve with the times.

Regardless of how we approach the issue of other health care professionals using acupuncture in their practices, the recent studies and media reporting of their findings should make one thing very clear: The OM profession needs to be much more proactive both in encouraging research that better reflects real-world acupuncture and in educating the public and media about OM and the OM profession. TheOMprofession has never mounted a comprehensive, multi-year, public education campaign. We have never seen fit to make such a campaign a priority. This must change. We cannot continue to leave the manner in whichOMis perceived by the public and portrayed within the media to outside forces. For too many years, our profession has acted as if all we have to do is raise education standards and do the good work of helping people and the rest would take care of itself. The conclusions of these studies and the media reports that followed should be making it clear that this is not the case.

Conclusion

If it were true that getting successful results does not depend on where one puts the needles, then every first-year acupuncture intern would get the same results as their most experienced teachers, which is not the case. While it seems to be true that having positive qi can make up for lack of experience, almost any acupuncturist will tell you that they get better results with experience. After training and licensure, acupuncturists typically spend the next several years of their careers learning more techniques and theories to add to their arsenal. Why do we do this? Because we learn that sometimes your Plan A or Plan B does not get results, so you better have a Plan C, D, and E as back-up if you want to get the highest degree of success. If it did not matter where you put the needles, no one would bother to keep learning additional techniques and the robust continuing education offerings out there would cease to exist.

We OM professionals, who work our tails off helping our patients, know how valuable our services are and we know that points do matter. We are buoyed by the gratitude of our patients, even as they tell us how they wished they had known aboutOMsooner and wonder why more people don’t take advantage of this safe healing resource. We don’t have to manipulate the facts to educate the public, media, and policymakers about what we have to offer, but we do have to guard against allowing the facts to be manipulated against us. There are acupuncture researchers who have a greater grasp of the subtle dynamics of clinical acupuncture, including the Society for Acupuncture Research, and the OM profession should do more to familiarize ourselves with their work and to encourage that the real-world effects of OM is given its just due.

References

  1. Haake M, Mueller HH, Schade-Brittinger C, et al. German acupuncture trials (GERAC) for chronic low back pain. Arch Intern Med. 2007;167(17):1892-1898.
  2. Cherkin D, Sherman K, Avins A, et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med. 2009;169(9):858-866.
  3. Moffet HH. Sham acupuncture may be as efficacious as true acupuncture: A systematic review of clinical trials. J Altern Complement Med. 2009;15(3):213-6.
  4. Bankhead C. Acupuncture tops conventional therapy for low-back pain. MedPage Today, 2007. www.medpagetoday.com/PrimaryCare/AlternativeMedicine/6770. Accessed October 11, 2009.
  5. Doheny K. Acupuncture may ease chronic back pain. WebMD Health News, 2009.www.webmd.com/back-pain/news/20090511/acupuncture-may-ease-chronic-back-pain. Accessed October 11, 2009.
  6. Park A. Acupuncture for bad backs: Even sham therapy works. Time.Com, 2009.www.time.com/time/health/article/0,8599,1897636,00.html. Accessed October 11, 2009.
  7. Amaro J. Is most of acupuncture research a “sham?” Acupuncture Today. August 2009;10(8).www.acupuncturetoday.com/mpacms/at/article.php?id=32013. Accessed October 11, 2009.

About the Studies 

The two main trials referenced in this article are the German Acupuncture Trails (GERAC) for chronic low back pain and that carried out in both the Center for Health Studies,Seattle,Wash.and the Division of Research, Northern California Kaiser Permanente,Oakland,Calif.that is sometimes called the “Seattle Study.”

In the German trails, 1,162 patients were randomized into groups receiving “real” acupuncture, “sham” acupuncture, or conventional therapy. Participants underwent 10 30-minute sessions usually at 2 treatments a week for 5 weeks. An additional five treatments were offered to those who had partial response to treatment. The “real” acupuncture groups were needled at points traditionally believed to be beneficial for lower back pain while the sham acupuncture involved superficial needling at non-traditional points. At 6 months, positive response rate was 47.6% in the real acupuncture group, 44.2% in the sham acupuncture group, and 27.4% in the conventional therapy group.

In theSeattlestudy, 638 adults with uncomplicated low back pain of 3-12 months duration were randomized into four groups: individualized acupuncture, standardized acupuncture, simulated acupuncture, and conventional care. In the individualized acupuncture groups, a “diagnostic acupuncturist” considered the patient’s progress and prescribed points according to traditional theory. The prescribed points were then needled by the treating acupuncturist. The standardized group employed a set of points traditionally considered helpful in treating low back pain that were used throughout the treatment series. The simulated group had the same points as used in the standardized group but toothpicks were used to simulate the feeling of acupuncture. The treatments were done using back points so subjects could not see the needles. Treatments in the first three groups were done by experienced acupuncturists and consisted of two treatments a week for three weeks then once a week for four weeks.

At eight weeks, mean dysfunction scores for the first three groups were 4.5, 4.5, and 4.4 points compared to 2.1 points for conventional care. Symptoms improved by 1.6 to 1.9 points in the first three groups and 0.7 in the conventional care group.

While I emphasize the need to distinguish what both of these studies refer to as “real” acupuncture from that which is practiced in the real world of clinical acupuncture settings, the Seattle Study did make note that its design had limitations, including restricting treatment to a single component of TCM (needling), pre-specification of the number and duration of treatment, and limited communication between the patient and acupuncturist. While I applaud this study’s authors for mentioning these limitations, the conclusions they reached regarding the “strong and consistent evidence” that real acupuncture is not more effective than sham acupuncture indicate they did not consider these limitations too significant.


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Dear colleagues & Friends,

A Spring seminar will be hold by Virginia Institute of Traditional Chinese Medicine (VITCM) on April 1, 2012, Sunday. Hope everyone will arrange time to attend, and share your knowledge and experience.

Topics: The Western Diagnosis, TCM Treatments and Research Updates of Common Skin Diseases; Yellow Emperor’s Classics of Internal Medicine.

Location:Potomac Community Center, 11315 Falls Road,Potomac, Maryland 20854;Tel: 240-777-6960.

Skin problems, which affect more than 10 million Americans, can be one of the most frustrating and stubborn group of symptoms to successfully treat. Many pharmaceutical solutions offer quick relief but do not provide a lasting solution, and come with risks such as toxic build-up in the body and weakening of other organ systems. Therefore, more and more people are choosing alternative solutions such as Chinese Medicine, which can be safer and which intends to address the root cause of the symptom instead of covering it up each time it appears. In fact, dermatology is a recognized specialty in traditional Chinese Medicine. Treatments for skin disorders have been described as early as 1100-221 BC in China.  Acupuncture and Chinese herbs offer a natural solution to improving skin conditions with its sophisticated system, both external and internal administration. There are hundreds of herbal formulas available for skin disorders such as herpes, eczema, and psoriasis.

Fee: $208. (Mail check before March 15, 2012, discount rate at $188).

Contact Person: Dr. Arthur Fan,Tel:(703)499-4428, e-mail: ChineseMedicineInstitute@gmail.com. Address: VITCM,8214 Old Courthouse Rd,Vienna, VA 22182.

Lecture Details (included in lecture and discussion):

8:00AM-9:30AM: Tai Chi and Medical Applications. By Drs. Eugene Zhang, Arthur Fan (Outside, in Parking lot; if rain or snow, cancel). 

9:30AM-1:30PM: Western Diagnosis & TCM Management for Common Skin Diseases. By Dr. Yongming Li (this special lecture outline is available in the Blog part)

1:30 PM- 3:00PM:  TCM and Skin Disorder: An Update on Clinical Research. By Dr. Lixing Lao.

3:00PM-5:30PM: Yellow Emperor’s Classics of Internal Medicine: Four Seasons, Five Organs, Yin Yang and Related Experiments. By Dr. Quansheng Lu

Instructors

Dr.Lixing Lao,  CMD, PhD, LAc, Professor of Family Medicine, Director of Traditional Chinese Medicine Research, Center for Integrative Medicine,University of Maryland School of Medicine, Baltimore,MD.

Dr. Lao graduated from Shanghai University of TCM (MD in Chinese medicine) and completed his PhD in physiology at the University of Maryland at Baltimore. He has practiced acupuncture and Chinese medicine for more than 20 years, and has been awarded numerous grants from the NIH and the U.S. Department of Defense to conduct research on acupuncture and alternative medicine. He presents frequently at national and international conferences, including the seminal 1997 NIH Consensus Development Conference on Acupuncture and the White House Commission on Complementary and Alternative Medicine Policy. He was board cochair of the Society for Acupuncture Research, chief editor of American Acupuncturist, the official journal of American Association of Acupuncture and Oriental Medicine.

Dr.Lao was one of funders and professor of former Maryland Institute of Traditional Chinese Medicine (MITCM), which was a well-known school in TCM education during 1990s to 2000s. Currently, he is the honor president and main lecturer of VITCM.

Dr. Eugene Zhang, CMD, PhD, LAc. has been practicing acupuncture for over 15 years, and is a graduate of famous oriental medical school in the world: the Beijing University of TCM.

In China, Eugene Zhang was a Medical Doctor (MD in Chinese Medicine); here in  US he is one of the top Licensed Acupuncturists inVirginia,Maryland and Washington DC. area. He was a well-respected professor and Clinical Supervisor for the prestigious Maryland Institute of Traditional Chinese Medicine (MITCM). Because of his years of experience, he serves as a consultant for the council of Colleges of Acupuncture and Oriental Medicine (CCAOM).

Dr. Zhang is also a senior Taiji (Tai Chi) and Qigong Instructor, both in the United Statesand in China. He has written a detailed book, “The Ultimate Exercise for Mind and Body” that explains the benefits of Qigong and shows pictorially the different body postures.

Dr. Yongming Li, MD, PhD, LAc (in New York and New Jersey). Our guest speaker.

Dr.Li is a leading doctor in both Chinese medicine and Western medicine. He graduated from Liao-ning college of TCM in 1983, and got PhD, MD in USA.

He is a well-known doctor in dermatology, doctor and scholar in the field of acupuncture and Oriental medicine with more 20 years’ clinical experience. Currently, he also serves as a NIH grant reviewer. He was the president of American Traditional Chinese Medicine Society, which has more than 700 members in New York area.

He has published many academic papers and books,included in “Acupuncture Journey to America”, a new published book in acupuncture history.

Dr. Quansheng Lu, CMD, PhD, L. Ac. Dr.Lu is a licensed acupuncturist in Maryland. He graduated from Henan University of TCM in China and subsequently worked as a resident and attending physician of TCM at a general hospital in China for 8 years. During this period, thousands of patients recovered under his treatment.  Given his outstanding contribution in TCM, Dr. Lu was awarded the Outstanding Doctor Award from the Local government. Dr. Lu pursued his master degree in TCM at Beijing University of TCM.

He continued to expand his education and later received a  PhD in cardiology in Chinese and western integrated medicine  at the China Academy of Chinese medical science. He focused on exploring hypertension molecular mechanisms and looked for new anti-hypertensive natural herbs. His supervisor is Professor Keji Chen; president of The Chinese Association of Integrated Medicine, and academician of the Chinese Academy of Sciences. Dr. Lu was a postdoctoral fellow at Georgetown University Medical Center and Children’s National Medical Center.

Dr. Arthur Yin Fan (Fan Ying),PhD, CMD, LAc, a leading specialist in Acupuncture and Chinese herbology, has more than two decades of clinical experience in both Traditional Chinese Medicine (TCM) and Western medicine. In China, he was awarded an M.D. degree in TCM and a Ph.D. in Chinese internal medicine from famous Nanjing University of TCM. He completed additional one year’s training in the Western medicine diagnosis and treatment of neurological disorders as well as a six-year medical residency combining TCM and Western internal medicine. He was a medical doctor in both TCM and coventional medicine when he worked in a University hospital in China. He was the funder of  Nanjing Stroke Center which is now a China national key center in Stroke rescuing and rehabilitation.

An evaluator of medical science research grant applications for many countries, Dr. Fan is currently a consultant for the Complementary and Alternative Medicine program at the University of Maryland medical school. He has also conducted CAM research for the Georgetown University medical school’s programs in nutrition and herbology.

Dr. Fan holds the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certificate in Oriental Medicine, which comprises Acupuncture, Chinese Herbology and Asian Bodywork. Dr.Fan was awarded the third place prize in Taiji-quan (Tai Chi) in China first national health-sport congress (1985,Shenyang,China). Dr.Fan is the funder of VITCM.

Ron Elkayam, MSTCM, graduated from the Academy of Chinese Culture and Health Sciences in Oakland,California in 2004 where he studied acupuncture and Chinese medicine. While still in school studying Chinese Medicine,  Ron studied with Robert Levine, L.Ac., in Berkeley, where he furthered his understanding of acupuncture, herbal formulas, diagnosis, and pulse taking. Inspired to take his learning to a new level, he moved to Taiwan in 2005 to learn Mandarin as a way of deepening his studies in Chinese medicine.Over the course of almost five years, Ron studied Mandarin in universities in Taipei, Shanghai, and Beijing, received advanced Mandarin language certification, and worked in hospitals (Guanganmen,Tonren hospitals) as interns, where he was able to communicate with doctors and patients in their native language and gain useful clinical experience.

Ron has a background in mind-body disciplines and has a 2nd kyu (brown belt) in aikido. He has also studied qigong (Wild Goose style), taiji (Wu and Chen styles), and Kripalu yoga. He also believes in the importance of diet and exercise in helping patients reach optimum health and happiness.

In late 2010, Ron finally returned to theU.S.to bring his clinical experience to American patients.  He has NCCAOM certification in acupuncture and herbal medicine, in addition to being licensed inVirginia,California, and Rhode Island. Ron is originally from Baltimore,MD.At present time, he works part-time to assist VITCM’s daily work.

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