Posts Tagged ‘history’

Arthur Yin Fan1,2 , Jun Xu1,3, and Yong-ming Li1,3

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

The original white paper was published in Chinese Journal of Integrative Medicine:   [AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]

1. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (I) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Jan;23(1):3-9. doi: 10.1007/s11655-016-2630-y.
2. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (II) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Feb;23(2):83-90. doi: 10.1007/s11655-017-2800-6
3. Fan AY, Xu J, Li YM. 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; (3):163-165. doi: 10.1007/s11655-017-2542-x.

The white paper includes in 7 topics:
1. What Is Dry Needling? [page3]
2. Who First Used Dry Needling in the West? [page5]
3. Has Dry Needling Been Used in China? [page7]
4. Does Dry Needling Use Acupuncture Points? [page9]
5. What Is New About Dry Needling Points (Trigger Points)? [page13]
6. Is Dry Needling a Manual Therapy? [page16]
7. Summary of Dry Needling [page17]
(1) Academic perspective [page17]
(2) The Problems Dry Needling caused [page18]
(3) Our Position [page20]

Summary[AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]
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 professionals, 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.

We conclude that DN is the use of dry needles alone, either solid filiform acupuncture needles or hollowcore 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, TrP acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is an over-simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a
portion of Ashi point (Ah-yes point, or tender point) acupuncture from traditional Chinese acupuncture. As developed by Travell & Simons, C. Chan Gunn and Peter Baldry, et al, it seeks to redefine Acupuncture by re-translating reframing its theoretical principles in a Western manner. It reflects the effort of de-acupoint, and de-theory of Chinese medicine by some healthcare professionals and researchers. DN with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles as Dr. Travell described has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has been used 2000 years, and its indications, is not limited to treating and preventing musculoskeletal disorders or illness including so called the myofascial pain.
Medical doctors Travell, Gunn, 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. 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. 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.
DN is not merely a technique but a medical therapy and a form of acupuncture practice. As a form of acupuncture, an invasive practice, it is not in the practice scope of physical therapists (PTs). DN has been “developed” simply by replacing 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 amount of non-acupuncturists, including in PTs, as students and
customers in recent years. The national organizations of PT profession, such as APTA and FSBPT, started to support the practice of DN by PTs around 2010. Currently, there are probably more PTs involving 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 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 get certified in medical acupuncture. However, a typical DN course run only 20-30 hours, 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 basic standards required for licensed acupuncturists or physicians.
KEYWORDS dry needling, acupuncture, biomedical acupuncture, authoritative evidence, experts’ opinions, consensus


AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM


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Dr. Arthur Yin Fan’ s two articles

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
January 19, 2015 | Arthur Yin Fan (doi: 10.1016/S2095-4964(15)60158-3)
Title: The earliest acupuncture school of the United States incubated in a Tai Chi Center in Los Angeles
Authors: Arthur Yin Fan
Abstract | Full text | PDF

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2013-10-24 14:46:59 人民网



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Original article at http://www.jcimjournal.com/jim/FullText2.aspx?articleID=jintegrmed2013041
Journal of Integrative Medicine: Volume 11, 2013   Issue 4
Dialogue with Dr. Lixing Lao: from a factory electrician to an international scholar of Chinese medicine
Arthur Yin Fan (McLean Center for Complementary and Alternative Medicine, PLC Vienna, VA 22182, USA )

DOI: 10.3736/jintegrmed2013041

Fan AY. Dialogue with Dr. Lixing Lao: from a factory electrician to an international scholar of Chinese medicine. J Integr Med. 2013; 11(4): 278-284.

Received May 12, 2013; accepted June 6, 2013.

Open-access article copyright ? 2013 Arthur Yin Fan.

Correspondence: Arthur Yin Fan, PhD, MD, LAc; Tel: +1-703-499-4428; Fax: +1-703-547-8197; E-mail: ArthurFan@ChineseMedicineDoctor.US

Dr. Lixing Lao, an internationally known scholar of Chinese medicine renowned for his clinical and mechanisms research, is the Director of the Traditional Chinese Medicine (TCM) Program at the Center for Integrative Medicine, University of Maryland (UM) School of Medicine; the Co-Chair of the Acupuncture Research Society; and the former Editor-in-Chief of the American Acupuncturist, the official journal of the American Association of Acupuncture and Oriental Medicine. The Baltimore Magazine has listed Dr. Lao as one of the nation’s top acupuncture practitioners (Figure 1).
Dr. Lao has played a pivotal role in the advancement of TCM in the United States. As the first full professor of acupuncture and TCM appointed to a conventional medical school in the United States, he was invited to be a key speaker at both the 1994 United States Food and Drug Administration (FDA) hearing on acupuncture[1,2] and the 1997 National Institutes of Health (NIH) consensus conference on acupuncture[2]. As a result of the hearing, the FDA reclassified acupuncture needles as a medical device, no longer an investigational device. The NIH conference led to preliminary confirmation of the safety and efficacy of acupuncture. These two conferences were milestones that opened the way to wider clinical use of acupuncture.
Besides research and clinical practice, Dr. Lao has been involved in TCM education for over 20 years. On October 20, 2012, the author, Arthur Yin Fan, interviewed him in the President’s Office of the Virginia University of Oriental Medicine in Annandale, Virginia, USA.
Fan: Dr. Lao, it is nice to see you again. What have you been doing recently?
Lao: As a professor in UM’s Center of Integrative Medicine, I’ve mainly been doing research, and conducting clinical trials and experiments on the safety and efficacy of acupuncture and herbs. As an academic, I’m also involved in teaching.
Fan: I heard you’ve attended some conferences recently.
Lao: Yes, I have participated in quite a number of conferences, domestically and internationally. In November, I will go to Beijing, China, for the anniversary celebration of the Beijing University of Chinese Medicine, which will be combined with an international acupuncture conference. I’ll be one of the main speakers.
Fan: You have been involved in TCM for over thirty years. Now you are an international, leading scholar in this field. What led you to this profession?
Lao: It’s a long story. During the Chinese Cultural Revolution in the late 1960s, formal education stopped. All students became involved in what was called “Stopping Class to Conduct the Revolution” [停课闹革命; Dr. Fan notes: This was similar to school strikes and student occupations in the West, from December 1966 to October 1967]. At that time, “barefoot doctors”— practitioners using acupuncture, herbal medicine, and basic medical procedures like first aid — began to treat the poor rural farmers [Fan notes: more than 90% of the Chinese population lived in impoverished rural areas and lacked basic health care before the barefoot doctors movement]. Such a career was attractive to many young people, including me. There was no strict regulation of acupuncture during the Chinese Cultural Revolution (Fan notes: because the traditional or “old” regulations were dismantled by Chairman Mao Zedong, who was a supporter of barefoot doctors). Many young adults learned TCM in various ways and became barefoot doctors during that period. There was no formal schooling during the Cultural Revolution, and I long to learn something real and useful. I became interested in acupuncture because I had heard many moving stories about the barefoot doctors, which triggered my interest in medicine and health care.
Another reason for me to learn acupuncture or TCM was because of an incident in 1970 during the so-called “Returning to School to Make Revolution (复课闹革命, Fan notes: after October, 1967)”. It was what would have been my last year of high school; students were assigned to factories for half a year and rural areas for the other half to get “real knowledge.” First I was sent to learn farming on Chongming Island, a county of Shanghai City, in the middle of the Yangzi River. One night I began experiencing severe acute abdominal pain, which was later diagnosed as an intestinal obstruction. It was the middle of the night. With great difficulty and the help of my classmates, I walked for miles to see a doctor, Madam Lin, a very nice, extremely proficient old lady who was the doctor assigned to provide medical care for the students from my high school on the island. At that time there was no highway to Shanghai, and the Shanghai ferry ran only during the day. So there was no choice — I could not go to Shanghai despite the emergency. Acupuncture was the only treatment available. It was really magical: Dr. Lin needled me in two places. The pain quickly disappeared and then I slept. I woke up the next morning with no pain. After asking me several questions, Dr. Lin felt there was no need to send me to the hospital in Shanghai and let me go back with the other students. That experience affected me greatly.
Later, during a down period when there was not much to do on the farm, Dr. Lin arranged a class for students. She taught us basic medical knowledge, including the prevention of illness and some basic treatments. I wanted to see how she treated patients and handled difficult cases, so I carried her medical kit when she made home visits. In effect, I was her apprentice, although it was not a formal apprenticeship.
The second half of that year was spent in a factory in the city of Shanghai. There was an elective project —learning medical knowledge. As high school students we had a chance to participate in a three-month training program for suburban barefoot doctors at a district hospital, but only two students per class could be enrolled. I was the class president and had a strong interest in medicine, so I got the chance to attend, and I learned a lot. At that time we were 16 or 17 years old and eager to learn. The school no longer taught normal classes, and the students wanted something to fill their empty brains. The program started with two weeks of classroom teaching; teachers (they were medical doctors) with different specialties taught acupuncture and Western medicine as well as topics such as rescue methods to be used after atomic bomb explosions, how to hold a scalpel when performing an operation, how to interpret an electrocardiogram, and so forth. I remember that when the doctor taught acupuncture, he taught us 30 acupoints a day, including point location, main effects, and insertion techniques for each point. The next day, we would have to stand up to answer questions. We two high school students were always very participatory and liked to answer the questions, while the barefoot doctor candidates, mostly young suburban mothers, were afraid to answer. They were so busy with field and house work after class and they had little time to go over the lessons. That class gave me great pleasure.
After the classroom learning, we interned in each department, starting with the pharmacy. Under supervision, we prepared Western drugs and patent herbs according to the prescriptions that patients brought in. After three days, we were familiar with the names of many drugs and patent herbs and their actions. Then we went to the department of internal medicine. The first few days we copied the doctor’s prescriptions and observed the physical examinations. After that, we could see patients and prescribe medicine under the doctor’s supervision. I started seeing patients on the second day because my supervising doctor considered me ready to practice. We were in a district hospital, patients often came from local factories and the illnesses and disorders were simple. Mostly, I took a patient’s blood pressure, asked some questions, and then refilled a previous prescription; or something like low back pain and patients just wanted pain killers or an excuse for sick leave; rather simple stuff; that was it. My classmate and I sat at two office tables all morning and counted up our patients, competing as to who had seen the most — that was fun and got me interested in medicine.
After that department, we interned in injection room and then in the acupuncture and moxibustion department. There was a doctor, half blind, a graduate of the Tuina (Chinese therapeutic massage) Program from the Shanghai College of TCM. Maybe because of his poor vision, his memory was very strong; he could recall all the acupuncture points and tuina manipulations. At that time, he was single and lived in the hospital dorm near my home. So every night I went to his dorm and learned from him. He talked about the acupuncture and tuina he had learned in college, and I took notes. I became very interested in acupuncture at that time, and it was something like a real apprenticeship. We became good friends.
In 1971, the “old-three grades (老三届) settling in the countryside and mountains” movement (上山下乡; launched by the government) stopped, and middle and high school students and graduates again had a chance to stay in the city. One reason I’d learned acupuncture and moxibustion was to give me a way to take care of myself if I had to live in the countryside. I wanted to be prepared to serve rural patients and my fellow schoolmates who might be resettled there. But when I graduated from high school, I was assigned to the Shanghai Xingzhong Power Machinery Factory (新中动力机器厂) as a factory worker. After training in several jobs, I became an electrician, maintaining the normal operation of the electronic devices there. If there were problems with a device, I would have to work very hard to fix it as quickly as possible in order to avoid a delay of production; otherwise, I’d wait in the office without much to do.
My Shifu (teacher and supervisor) graduated from Shanghai Jiao Tong University. He preferred being an electrician to being a technician, and he taught me a lot. He was a nice man, and to this day we remain friends. My Shifu not only taught me practical skill of repairing electronic devices but also taught me theory of electricity, so I learned faster because I understood the mechanisms. One night, he invited me and his good friend and former classmate, to dinner at his home. His friend arrived with acute low back pain, which began during his bus trip over to dinner. He said to me, “I heard you know acupuncture. Please give me a treatment; I am very hurt.” At that time, I carried acupuncture needles around with me in a pen-like tube. There were no regulations for doing acupuncture at that time, so I gave him a treatment and after removing the needles asked him to move his back as much as possible. To his surprise, his pain was gone; the back muscle spasms disappeared immediately after the treatment. The result pleased him and my Shifu, so by word of mouth, many people found out that I was good at acupuncture.
A few days later, a very old employee in the finance department of the factory came to see me. He had bad intercostal neuralgia. He said he had had three onsets: the first had been cured by a famous TCM doctor, Shi Xiaoshan (石筱山); the second was cured by another famous doctor — I forget the name. Now it was the third onset; he said he’d already seen many doctors and tried many medications, both Chinese and Western, and nothing helped. So he used a lot of pain-killers that only masked the pain for two to three hours, and also upset his stomach. He wanted me to give him acupuncture. I told him I had not treated anyone with such a condition but I would try. His pain was active, so I treated him. He got immediate results and was very pleased. After that, I became very busy — before, people called me only for something electrical, and now people began to call me for their health issues too, especially low back pain and sciatic pain. I had to keep two sets of equipment — my electrician’s tools plus the acupuncture needles and some alcohol swabs for disinfection. I enjoyed helping people for their illness and treated them for free, as a colleague.
Fan: How old were you at that time and when you started your college study?
Lao: I started at that factory when I was 17, and stayed about 7 years. The college entrance examination (CEE) started up again in 1977 after the Culture Revolution stopped in 1976. So I was 24 when I entered college in the fall of 1978. During the Cultural Revolution, I had had formal education only up to actual fifth grade level (although I was a high school graduate) because the classes were disbanded to “make revolution.” I did not think I had enough knowledge to pass the CEE, but my high school math teacher encouraged me to try. I then borrowed middle and high school textbooks and started self-study with some help from my math teacher and my Shifu. I was lucky enough to pass the exam in July 1978 after about 5 months of extensive study.
Fan: How was your experience in college?
Lao: I was accepted and admitted to the Shanghai College of TCM and assigned to the acupuncture major. I initially thought I already knew enough acupuncture and wanted to the major in Chinese herbal medicine. But soon after I started the course work, I found I actually knew very little about acupuncture. The clinical experience I had earlier helped me to better understand TCM and acupuncture theory as well as other courses, including Western medicine. I studied hard and enjoyed the five-year learning opportunity and did not want to waste time that had been lost during the Cultural Revolution. I was elected president of our class and vice president of the Student Union of the college.
Fan: Very impressive experience. Then you enrolled in the University of Maryland for PhD study in physiology and also got your acupuncture license in the State of Maryland?
Lao: After graduating in 1983, I was appointed to the Acupuncture Department of my college as a teacher and researcher. Then China encouraged young people to go abroad for study, which was one of the important policies of the reform. I applied to the Physiology Department of the Dental School at UM because it has a pain research group as I was interested in the mechanisms of acupuncture for pain relief. At that time, the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM) initiated an acupuncture certificate examination oriented mostly toward TCM. Because of my teaching background, I was invited to review point locations for a group of a local acupuncture school students who were preparing for that examination. Local acupuncturists also told me I was eligible to apply for an acupuncture license in the State of Maryland. So in 1988 I became licensed as No. 300, the 200th licensed acupuncturist in Maryland (the license number starts at No. 101). Later I also passed the exams and obtained NCCAOM certification of acupuncture and Chinese herbal medicine.
Fan: At that time, acupuncturists worked under the supervision of an MD. How did you start your clinic?
Lao: I had to work under an MD’s supervision. A local acupuncturist referred me to Dr. Sores, a very nice Filipino-American doctor. She told me that she had just visited China with a group of American physicians and was deeply impressed by the acupuncture anesthesia she’d observed. One MD could supervise three acupuncturists at that time; I became her second one. Dr. Sores was so kind to let me use her clinic, which was near the Johns Hopkins University, when there were rooms available. She waived the rent for the first several months; even later, she charged a fairly low rent. I studied for my Ph.D. during the day and worked in the clinic from 6:00 to 9:00 pm two or three days a week until graduation.
Fan: How did you get your academic appointment at the University of Maryland School of Medicine?
Lao: A year before my graduation, I had a period of deep confusion. If I took a postdoc position in a laboratory for physiological research, I’d have to move (to other states) and leave my flourishing acupuncture practice; if I stayed in my Maryland practice, I’d have to leave my academic career. I’d studied acupuncture for five years and spent five more on my PhD in physiology. Giving up either would be a pity. By luck, in 1991 I saw an announcement in the school magazine and the Baltimore Sun saying that an MD, Brian Berman, had been awarded a million dollars to set up a complementary medicine program to study the safety and efficacy of acupuncture, Chinese and other traditional medicine, and alternative medicine in the Department of Anesthesia, UM School of Medicine. After I talked to him about possibility to work with him, he offered me a research assistant professor position and wanted me to start work at once. I still hadn’t completed my dissertation and actually couldn’t. But we became friends. In one occasion, I successfully treated his two-year-old daughter with tuina and became his family acupuncturist. On June 15, 1992, the day after my dissertation defense, I started work as an assistant professor in his program.
It was the right time, right place, and right people. In 1992, the NIH established the Office of Alternative Medicine (OAM). Dr. Berman was on their advisory board and took me to many meetings. In 1993, the OAM formally started to award fairly small, $30 000 research grants to about thirty awardees. We applied and were awarded two grants in 1994. I was the principal investigator (PI) of one project named “Acupuncture and Postoperative Oral Surgery Pain”; Dr. Berman was the PI and I was the co-investigator of the second program “Acupuncture Safety/efficacy in Knee Osteoarthritis”. After this seed funding, we got bigger grants, NIH Research Project Grants, also known as R01 grants, to continue both these projects. The clinical trial of acupuncture on knee osteoarthritis (OA) had a great impact. This large sample (N=570) trial found that acupuncture was significantly more beneficial for patients with knee OA than those in sham control[3]. We continued such work on arthritic pain and now are involved in other modalities such as Chinese herbal medicine, laser acupuncture, and moxibustion.
In 1998, we got a Center Grant known as P50 from the National Center for Complementary and Alternative Medicine (NCCAM, former OAM), which consists of funding for three projects focused on a research question; I served as the Project Leader on mechanisms of acupuncture in inflammatory pain and established our first laboratory for the basic science research on acupuncture and TCM. Since the establishment of the lab, we have published many basic science studies on acupuncture and herbology. You were there three years, Arthur. Thank you for your great contribution to our lab’s research on the mechanisms of Chinese herbal medicine. Because of our significant achievements from earlier, we’ve gotten several big grants (known as P50, P01 and U19) over the last ten years and also many smaller ones.
Fan: Your clinical trials, especially on acupuncture for knee OA[3] and on nausea and vomiting caused by chemotherapy, made great contributions toward persuading commercial healthcare insurance companies to cover the use of acupuncture for such illnesses. Since then, more and more insurance companies have begun to pay for acupuncture treatments.
Lao: You’re right. I feel we have done the right thing — choosing to study illnesses commonly seen in clinic and publishing our results in major medical journals. Positive results give practitioners great support.
Some acupuncturists and research colleagues didn’t understand why we chose to study arthritis. They told us, “We use acupuncture to treat arthritis every day. It’s been done for thousands of years, especially in China, and with good results. Unquestionably, acupuncture can treat arthritis. Why waste time doing a clinical trial on that?” The fact is, although there is a consensus among acupuncturists and Oriental medicine professionals and some patients, many Western-trained doctors and their patients have no understanding of the safety and efficacy of acupuncture. We need to demonstrate the effect and safety of acupuncture in treating common illnesses for which medications aren’t too effective. In America there is a high incidence of arthritis, which doesn’t respond well to conventional medication. Most arthritis, especially knee OA, is chronic. Pain medications are only briefly effective, and must be used long term, which lead to serious adverse effects. And the safety and effectiveness of acupuncture on OA is easy to evaluate. In an illness such as diabetes, which has many complications, treatment results may be hard to measure.
Our strategy was to study the condition most suitable to acupuncture treatment first. Positive results would help the mainstream medical profession to start accepting acupuncture, and then we can tackle more difficult diseases. If we had chosen a difficult one first and not gotten a positive result, people might believe that acupuncture is simply ineffective, not that we got a poor result because we didn’t choose a suitable subject. So we picked something less complex first. Also, we wanted to pick a common disease, and there are many OA patients.
I researched textbooks, clinical trials, and case reports to decide which acupoints and acupuncture strategies we should use, and then tested these in a small group of patients to ensure they’d be effective in clinical conditions. Additionally, as you know, success depends on the “right time, right place, and right people”. There was a strong need to show whether acupuncture is safe and effective, and we had a good team. Besides Dr. Berman, me, and our TCM research personnel, we invited Dr. Marc C. Hochberg, a doctor in our school of medicine at UM and an internationally known knee expert, to provide a set of evaluation and assessment methods for knee OA. His support was essential to the project’s success.
Acupuncture and Chinese medicine professionals might also feel that a study on acupuncture for dental extractions[4] is unnecessary since doctors and researchers in China have done acupuncture anesthesia studies showing that acupuncture is an effective anesthetic in major operations. Dental pain is a very small topic. But when I designed the dental project, I wanted to refute the preconceptions of the conventional medicine practitioners and some others who believe that acupuncture is a placebo, i.e., that its apparent effectiveness is only a result of psychological expectation.
In designing that study, I found that there were advantages to doing acupuncture immediately after an extraction. The novel control was established; patients couldn’t easily differentiate between real, needle insertion, and sham, no insertion, acupuncture — right after extraction, the local anesthesia hadn’t worn off and patients were blindfolded, so when acupuncture was performed on Jiache (ST6), Xiaguan (ST7), Yifeng (SJ17) and Hegu (LI4), the patient didn’t see or feel the procedure. Establishing an effective control is a difficult thing in acupuncture studies; sham acupuncture isn’t like a pill that can be the same shape and size as a drug being tested. Although we could have used shallow needle insertion at the real point, these can induce physiological reactions. The best control is non-insertion. Patients might be able to distinguish between insertion and no insertion, but it was not in this project when our subjects were still under local anesthetic.
I modified the model a little for our clinical trial. In the original model, the researchers administered medication about an hour after tooth extraction, when moderate pain starts. I decided to use acupuncture as prevention, with pain-free time being the main indicator, and pain level as the secondary indicator. Before the trial, I did a preliminary study using several patients undergoing tooth extraction. Most actually had no pain after the acupuncture and didn’t need pain medication. My second modification was patient blinding — patients were literally blindfolded during the acupuncture. The test period was only 6 h, very short. A long period might cause a patient to realize if he had received real acupuncture.
The reason I chose postoperative dental pain was because I graduated from the dental school’s PhD program and knew the dental doctors there. I contacted Dr. Bergman, who is an oral surgeon who is interested in acupuncture. We did a few patients to obtain preliminary study data and observed that acupuncture was very good for dental pain after tooth extraction. Then we started a formal collaboration and applied for a research grant from the NIH. Our study showed acupuncture to be much better than sham — or placebo — acupuncture. That study might not have much clinical significance, but it is scientifically significant. It addresses a few questions, such as whether acupuncture is a placebo.
Fan: Those clinical trials that show acupuncture to be no better than placebo — there have been many, such as that of the trial published by a Seattle Group[5]; the results were all similar — I consider the problem to be one of design. First of all, is so-called sham acupuncture really sham? And are its results really placebo effects? Needle insertion effects are not like effects of oral or i.v. medication. Applying a medication model and trial design in an acupuncture study might not produce good research. Also, acupuncture’s time-point effectiveness varies; some effects show up immediately; others require a 10- or 16-session course or six months. Giving 10 sessions of so-called sham and expecting patients not to know if she/he is getting real acupuncture is difficult if not impossible. As you say, if you expect to blind patients but use strong “sham” stimulation, that could induce physiological reactions and amount to actual acupuncture. Also, if the statistical design is wrong, differences won’t show up; this can happen especially if a sample is too small.
Lao: True. I’ll give you an example with a sound methodology, because study methodology is improving so we can have more confidence in the results. A group of researchers in New York led by Vickers did a well-known literature review published in the Archives of Internal Medicine in 2012[6]. Archives of Internal Medicine is one of the archives of the Journal of American Medical Association (JAMA), which is a very prominent journal, and this review was widely reported by the media. Vickers got NIH funding five years ago. He asked researchers who published papers on large acupuncture clinical trials to give him the raw data from their studies. Using those data, Vickers’ team repeated the original statistical analyses to see if they could get the results that were originally published. Twenty-nine high quality acupuncture trials were analyzed, which involved four types of chronic pain lasting more than four weeks: knee OA inflammatory pain; musculoskeletal pain — low back and neck pain; headache — migraine and tension; and shoulder pain. The 29 studies used yielded a total of 18 000 chronic patients divided into at least three groups: acupuncture, sham acupuncture, and routine conventional medicine. The results showed that acupuncture performed much better than the routine conventional treatments and better than sham. The most interesting thing from this paper was that Vickers predicted that if this study were repeated after a few years, the chance of overturning these conclusions would be very low or almost impossible because, statistically, it would take 47 trials of more than 100 patients each, with an effective size of 0.25 in favor of sham controls, to obtain negative results. This study is convincing because it accounted for all possibilities.
Fan: We are both clinical practitioners. So you might agree with my feeling — that the so-called sham acupuncture used in so many clinical trials[5,6]actually is a variation on real acupuncture. Each school of acupuncture has a different style; some use gentle or shallow stimulation in which the patient might not feel the needling sensation at all; some use extra-meridian acupoints. I myself, in different patients and even in the same patient according to different circumstances, conditions, or body parts, might use different stimulation strategies. So it seems to me that gentle or shallow insertion, non-insertion, or extra-meridian insertion isn’t necessarily sham acupuncture. If using a toothpick to mimic acupuncture is sham, then how do we explain the action of the Bian Shi (stone needle), an alternative to the filiform needle? I feel that if metal needles or toothpicks induce a physiological reaction, that’s real acupuncture. In a drug trial the researcher can use an inert pill.
Lao: You are correct. These factors make it more difficult to design an adequate acupuncture sham control. Since the mechanism of acupuncture effectiveness itself is not clear, one can’t design a control that has no such mechanism (like an inert placebo pill). For a conventional medication, its mechanism is relatively clear, such as it works on certain receptors or certain pathways, so it is easy to design a control that does not have that function on these targeted receptors and pathways.
Fan: Why do we still use sham acupuncture in clinical trials?
Lao: The concept of sham control is not bad. The problem is we just don’t know what would be an appropriate “sham”. Some people in the mainstream medical field who have the “speaking rights,” insist on adding so-called sham controls. Although this is not good practice, we have no choice. We have to conform to the status quo. However, in recent years, patient-centered, comparative effectiveness research that more accurately reflects daily acupuncture practice, not using a sham control, has been drawing the attention of many researchers. I believe that type of research will be the next step of acupuncture research – to determine which conditions are most suitable for acupuncture treatment, as compared to conventional treatment.
Fan: What are your comments on the acupuncture research going on in China?
Lao: TCM’s birthplace is China, although none of the papers we’ve discussed were published by scholars in China. I hope that one day soon scholars there will be performing high-quality research. This is why I am so eager to help young scholars in China with study design. As the Chinese economy improves, the Chinese people should take more responsibility for TCM research and produce studies that can’t be dismissed because of poor quality. I want to foster the development of acupuncture and TCM because they really do help patients, are easy to use, and are cost effective. I would like to see researchers in China to conduct more serious and vigorous high-quality studies.
Fan: I admire you. You have been an acupuncture and Chinese herbal medicine researcher for over 20 years and are regarded internationally as a spokesman of TCM research. You’ve met so many difficulties and still have remained mentally strong. What gives you the strength to do so well?
Lao: I am very confident about the development of acupuncture as well as TCM as a whole. Success is based on small daily accumulations. The current situation of acupuncture and herbology is much better than it was a few years ago. Although our profession still has some problems, we should stay optimistic. I believe the proverb: real gold doesn’t fear the fire that smelts it.
Fan: I hope you continue to make contributions, in acupuncture research, in education, and in legislative and political activities.
Lao: Thanks for your interview.
Fan notes: Between June, 1992 (one year after the Center was established) and the present, the center where Dr. Lao works has received more than?35?million dollars in funding from the NIH and other different sources, for carrying out research on acupuncture and Chinese medicine. As a principal investigator or co-investigator, Dr. Lao has been on 28 grants or research projects. Dr. Lao so far has published 142 peer-reviewed papers, 26 non-peer reviewed, invited papers, and 10 book chapters. He is a co-editor of a new acupuncture and moxibustion textbook that will be published by the end of this year. He was the chair of the 2007 Society for Acupuncture annual meeting – “The Status and Future of Acupuncture Research: 10 Years Post-NIH Consensus Conference”, and also chaired the 2010 WFAS (World Federation of Acupuncture and Moxibustion Societies) annual conference in San Francisco, CA.
AcknowledgementsThe author would like to thank Ms. Lyn Lowry for English editing. The interviewer was Dr. Arthur Yin Fan.
Competing interestsDr. Arthur Fan worked in Dr. Lixing Lao’s laboratory and participated in acupuncture and Chinese herbal mechanism studies from 2002 to 2005 as an NIH Fellow in Chinese medicine. The author declares that he has no competing interests.

Figures and Tables in this article: 

Figure 1  Dr Lixing Lao at Virginia University of Oriental Medicine This picture was taken by Byung Kim.


1. Fan AY, Fan Z. Dr. Wu: a beautiful, moving and meditative song — in memory of Dr. Jing Nuan Wu, a pioneer of acupuncture and a Chinese medicine doctor in the United States[J] J Chin Integr Med, 2012, 10(8) : 837-840.
2. Fan AY, Fan Z. The beginning of acupuncture in Washington, D.C. and Maryland: an interview with Dr. Yeh-chong Chan[J] J Integr Med, 2013, 11(3) : 220-228.
3. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial[J]. Ann Intern Med, 2004, 141(12) : 901-910.
4. Lao L, Bergman S, Langenberg P, Wong RH, Berman B. Efficacy of Chinese acupuncture on postoperative oral surgery pain[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1995, 79(4) : 423-428.
5. Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, Delaney K, Hawkes R, Hamilton L, Pressman A, Khalsa PS, Deyo RA. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain[J]. Arch Intern Med, 2009, 169(9) : 858-866.
6. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K; Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis[J]. Arch Intern Med, 2012, 172(19) : 1444-1453.

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作者:祝君平安  于 2013-4-6 12:30 发表于 最热闹的华人社交网络–贝壳村


























Read more: 中医针灸在美国第一个州的立法经过 – 祝君平安的日志 – 贝壳村

Dr.Arthur Fan notes: On March 20,2014, I met a patient who is Jim Joyce’s daughter(Marilee Joyce), mentioned her father’s story in Acupuncture legislation in Nevada in 1973. Both of her grander mother and mother had chronic headache, Jim brought them to see Dr.Lok and got recovery. Her father already passed away in 1993 due to his lung disease. Marilee published a book called “Gentle Giant” to tribute her father.

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加 州 中 医 立 法 历 史 年 表       加州中醫歷史文獻館 陳 大 仁 教授(撰稿)
一九九九年十月初搞; 二零零五年十月定稿 二零一零年八月補訂.(原文http://www.caam.us/resources/califonria_legislation082510.pdf)
AB 1500 (Duffy, 1972) —— 加州西醫學會(CMA)策劃
AB 976 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
內容同 AB 1500,但增加一項條款即針灸治療除了可以在核准的醫學院校之內進行,還可在該醫學院校的“校園以外"地方進行。雷根州長予以否決。
AB 1841 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
內容同 AB 976。同時要求撥款四十萬元供作針灸研究之用。雷根州長再次予以否決。
AB 1691 (Duffy, 1972) —— 加州中醫藥針灸學會策劃
要求在醫療職業中增加一種新的醫師助手資格,稱為“針灸醫助"(PHYSICIAN ASSISTANT—ACUPUNCTURE)。承認這種非西醫人員可以在西醫的直接監督之下進行針灸治療,但必須以科學研究為目的。同時規定成立針灸顧問委員會,專司管理“針灸醫助"事務。本案受到針灸界人士的強烈反對,雷根州長亦予以否決。 

SB 2117 (Mascone, 1973) —— 加州中醫藥針灸學會策劃

SB 2118 (Mascone, 1973) —— 加州中醫藥針灸學會策劃

SB 86 (Moscone, 1975) —— 加州中醫藥針灸學會策劃
內容與 SB2117 及 SB-2118 兩案基本相同。這是加州第一個成功的由中醫界自行推動的針灸職業合法化提案。布朗州長七月十二日簽署成為法律。
AB 2424 (Keysor, 1978) —— 加州針灸聯合總會策劃
AB 3105 (Suitt, 1978) —— 加州針灸顧問委員會策劃

AB 3568 (Torres, 1978) ——加州針灸顧問委員會策劃
SB 1488 (Sieroty, 1978) —— 美國針灸協會策劃
SB 1106 (Song, 1978) —— 美國針灸協會策劃
SB 1790 (Campbell, 1978) —— (法案策劃者待查)
AB 1391 (Torres, 1979) ——加州針灸顧問委員會策劃
AB 3040 (Knox, 1980) —— 美國針灸協會策劃
AB 538 (Rosenthal, 1981) —— 美國針灸協會策劃
AB 901 (Rosenthal, 1981) —— 美國針灸協會策劃
AB 837 (Rosenthal, 1981) —— 美國針灸協會策劃
加州議會第一項涉及針灸醫療保險的提案。根據保險業界的建議,議案規定患者每一種疾病每年可以接受 24 次針灸治療。後來由于業界人士不同意數目限制,此提案被撤銷。

AB 3601 (Rosenthal, 1982) ——(法案策劃者待查)
AB 3806 (Rosenthal, 1982) —— 美國針灸協會策劃
SB 1158 (Torres, 1983) ——(法案策劃者待查)
AB 3827 (Filante, 1984) —— 美國針灸協會策劃
SB 314 (Rosenthal, 1984) ——(法案策劃者待查)

規定針灸師必需每兩年修有 30 個學時的繼續教育學分,提案獲得通過并由杜美津州長簽署成為法律。 

SB 2179 (Torres and Rosenthal, 1984) —— 加州針灸大同盟策劃
AB 272 (Filante, 1985) ——美國針灸協會策劃
SB 1642 (Rosenthal, 1986) ——加州針灸大同盟策劃
SB 839 (Torres, 1987) ——加州中醫政治聯盟策劃
SB 840 (Torres, 1987) ——加州中醫政治聯盟策劃
將針灸師在工傷保險系統中列為醫師(PHYSICIAN),有權治療受傷雇員。該案排除針灸師對患者作殘障評估,此外還附有四年期限的“日落條款"。杜美津州長於 1988 年 9 月簽署成為法律。
SB 841 (Torres, 1987) ——加州中醫政治聯盟策劃
SB 1362 (Rosenthal, 1987) ——加州中醫政治聯盟策劃
SB 1544 (Marks, 1987) ——(法案策劃者待查)
AB 4671 (Elder, 1988) ——(法案策劃者待查)

AB 2367 (Filante and Rosenthal, 1989) ——加州中醫政治聯盟策劃
SB 633 (Rosenthal, 1989) ——(法案策劃者待查)
要求針灸考試委員會聘請獨立專家對現行針灸學徒制度以及國外訓練的針灸考生資格進行分析評估。同時要求所有 1988 年 1 月 1 日以 前獲得執照的針灸師在 1993 年 1 月 1 日前完成包括各中西醫學科目的 40 學時繼續教育。杜美津州長簽署成為法律。
SB 654 (Torres, 1989) —— 加州中醫政治聯盟策劃
提案規定健保組織(HMO)或自身保險或殘障保險計劃以外的醫療保險計劃,包括非營利醫院等集體性的醫療保險計劃都必需自 1990 年 1 月 1 日起一律提供針灸醫療福利。此案未獲成功。
AB 3836 (Eastin, 1990) —— 加州中醫政治聯盟策劃
規定將隸屬于加州醫務部屬下之輔助醫療職業處的針灸委員會升格為獨立的加州針灸局(ACUPUNCTURE BOARD)。此案未獲成功。
AB 4368 (Filante, 1990) ——(法案策劃者待查)
所有針灸委員會核准的教育課程必需在 1992 年 12 月 31 日以前,或在針灸委員會核准後 5 年內,再獲得公共教育總監的批准。
AB 400 (Margolin, 1992) —— 加州中醫政治聯盟策劃
ACR 150 (Burton, 1993) ——(法案策劃者待查)
AB 2494 (Conroy, 1994) ——(法案策劃者待查)
SB 1279 (Torre, 1994) —— CSOM 策劃,加州中醫政治聯盟支持
規定執照針灸醫師可以建立針灸專業仲裁委員會(PEER REVIEW COMMITTEE)。威爾遜州長簽署成為法律。
AB 1002 (Burrton, 1995) —— CSOM 策劃,加州中醫政治聯盟支持

AB 1003 (Burrton, 1995) —— CSOM 策劃
SB 1360 (Watson, 1996) ——加州中醫政治聯盟策劃
要求廢除現行勞工法中有關針灸師醫師身份的 “日落條款”。此案未獲成功。
SB 863 (Lee, 1997) ——法案策劃者待查,加州中醫政治聯盟反對
SB 212 (Burton et al, 1997) —— CSOM 策劃,加州中醫政治聯盟支持
AB 174 (Napolitano 1997) —— 加州中醫政治聯盟策劃
AB 410 (Gallegos et al, 1997) —— CSOM 策劃,加州中醫政治聯盟支持
SB 1255 (Polanco, 1997) —— 加州整脊醫師公會策劃,加州中醫政治聯盟支持
AB 2120 (Cedillo, 1998) —— CAAOM 策劃,加州中醫政治聯盟支持
AB 2721 (Miller, 1998) ——(法案策劃者待查)

SB 1980 (Greene, 1998) —— 加州中醫政治聯盟策劃
規定將隸屬于加州醫務部之輔助醫療職業處管轄下的針灸委員會升格為獨立的加 州針灸局。威爾遜州長簽署成為法律。
AB 204 (Migden, 1998) —— 加州中醫政治聯盟策劃
在工傷法中明確規定雇主及管制醫療組織向工傷雇員提供的醫療服務中都必須加上針灸福利項目;規定雇員有權選定自己的 “私人針灸醫師";規定工傷患者在要求轉換主治醫師時有權選擇針灸師。威爾遜州長簽署成為法律。
AB 1185 (Baugh,1998) —— 加州中醫政治聯盟策劃
AB 1252 (Wildman, 1999) —— 加州足醫公會策劃,加州中醫政治聯盟支持
AB 1252 法案案的內容之一是規定在加州工傷補償處的產業醫務委員會中增加四名委員,包括兩名西醫、一名足醫和一名針灸醫師。戴維斯州長將之簽署成為法律。並於 2000 年一月任命聯合總會名譽會長楊自國醫師為首位中醫委員。
AB 231 (Battin, 1999) —— 外州利益團體策劃,加州中醫政治聯盟反對
SB 466 (Perata, 1999) —— 加州中醫政治聯盟策劃
《中醫師行醫規範提案》,明確並擴大中醫師可以使用的行醫手段。 例如可以使用營養物品、草
AB 1751 (Kuehl, 1999) ——(法案策劃者待查)
即《保障患者訴訟權力法案》。禁止保險公司在合約中強行病家在糾紛中接受仲裁,賦予患者必要 時采取法庭訴訟的權力。這是年來眾多旨在對付管制醫療體制的法案之一。該案未能通過議會而失敗。
AB 2764 (Knox, 2000) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》,内容同 AB410 (Gallegos et al, 1997)。此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。此案未能通過議會而失敗。
SB 341 (Perata, 2001) —— 加州中醫政治聯盟策劃
泊拉塔參議員重新提出《中醫師行醫規範提案》,内容大致同去年的 SB 466。新法案還要求增加一項磁療法。戴維斯州長於二零零一年九月將之簽署成為法律。
AB 208 (Frommer, 2001) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》,内容同 AB410 (Gallegos et al, 1997) 及 AB 2764 (Knox, 2000)。此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。此案未能通過議會而失敗。
AB 249 (Matthews, 2002) —— 加州中醫政治聯盟策劃
《豁免中藥銷售稅提案》此案目的在於爭取豁免中醫師發售中藥的零售稅,如同其他醫務人員銷售維他命等時免收零售稅一樣。AB410 在一九九八年失敗後,AB 2764 在二零零零年再失敗,AB 208 二零零一年也未能通過議會。二零零二年改由馬修斯眾議員重新提出,即 AB 249 法案,終於順利完成了參、眾兩院的全部審議程序。但是戴維斯州長最後以財政短缺為由否決了此項提案。至此,中醫界努力運作近五年的《 豁免中藥銷售稅提案》再次受到挫折。
抗議刪除針灸醫療補助 (2002) —— 加州中醫政治聯盟參與修訂
戴維斯州長在其財政預算中曾一度將針灸醫療補助(MEDI-CAL)在於預算中予以刪除。后經廣大同業的努力遊說,參眾兩院聯合預算委員會曾將此決定否決,使針灸福利得以保留至 2003 年 7 月。
SB 573 (Burton, 2002) —— 加州中醫政治聯盟策劃
內容是將目前只要求商業醫療保險具備“可供選購"( OFFER ) 的針灸福利條款,改成規定所有保險公司都“需要提供"( PROVIDE ) 針灸福利。此案未能通過議會而失敗。
SB 1951 (Figueroa, 2002) —— 外州利益團體支持,加州中醫政治聯盟反對
即“修理加州針灸局提案"。該案給加州針灸局設定諸多苛刻條件,例如謹批准給予針灸局兩年的再復審期限(按慣例應為四年)、要求針灸局召開會議至少必需有五名委員出席方為有效(但針灸局尚有多位委員名額空缺)、要求針灸局必需有一名委員是中醫院校教師( 針灸局為避免利益沖突,歷來不得任用現職教師)等。此外提案還要求由消費者事務廳對加州針灸局工作進行全面審查﹕包括中醫師職業規範、中醫師教育標準、 要求 對外州私人團體的考試權及中醫院校審批權進行評估其適用于加州的可能性,等等。全部評估過程所需之費用要由針灸局支付(來自中醫師的執照費)。戴維斯州長簽署成為法律。
SB 1705 (Burton, 2002) —— 加州中醫政治聯盟策劃
AB 1943 (Chu, 2002) —— 加州中醫政治聯盟策劃並參與修訂,外州利益團體反對。
《中醫專業教育改革法案》規定目前加州官方有關中醫 針灸事務的法律文件一律統稱之為『針灸與東方醫學』,較為符合中醫師的臨床實踐。 AB1943 的最主要條款是對中醫院校的教學大綱及教育課程提出了明 確的要求: 2003 年至 2007 年間入學的新生必需完成 3200 學時專業教育,而從2007 年開始中醫專業教育課程將增加至 4000 學時。由於外州利益團體的強力反對,本案被大幅刪改后通過,(如刪除有關專業名稱之規定,將必修學時減為 3000 等)戴維斯州長簽署成為法律。
SB 582 (Speier, 2003) —— 加州中醫政治聯盟參與修訂
根據中醫政治聯盟提出的修正案,SB582 將添加兩項豁免條款:(1)執照醫務工作者在其行醫規範内的治療過程中可以開麻黃處方或配藥。(2)含有麻黃成分的食物補充產品只能銷售給執照醫務工作者作為治療之用。如此,中醫師繼續使用麻黃的專業權力遂得以保全。戴維斯州長簽署成為法律。
SB 228 (Alarcon, 2003) —— 加州保險業界策劃,加州中醫政治聯盟參與修訂
由參議員阿拉坎提出的 SB228 提案強行將工傷醫療服務的收費標準和明顯低於市場價格的『聯邦醫療照顧』(MEDICARE) 支付標準直接挂鉤。更有甚者,凡聯邦醫療照顧並不提供的醫療項目,例如針灸,其收費則只能和用來救濟低收入家庭的『加州醫療補助』(MEDI-CAL)的支付標準直接挂鉤。
SB 867 (Burton 2003) —— 加州中醫政治聯盟策劃
內容是要求商業醫療保險 提供針灸福利。此案未能通過議會而失敗。
SB 907 (Burton, 2003) —— 加州中醫政治聯盟參與修訂
根據最新版本的 SB907 修正案 ,自然療法醫師的行醫規範有了更加明確的限制:即自然療法醫師
將不得從事執照中醫師根據加州商業及職業法第 4927(c) 條授權從事的各種醫療項目,包括針灸,
小胡佛委員會評估加州中醫行業 (2003-2004) —— 加州中醫政治聯盟積極參與
SB 899 (Poochigian, 2004) —— 加州商會策劃,加州中醫政治聯盟堅決反對並參與修訂
SB 356 (Alarcon, 2004) ——AIMS 策劃,加州中醫政治聯盟支持
SB 840 (Kueh, 2004) —— 加州中醫政治聯盟支持
AB 681 (Vargas, 2005) —— 加州中醫政治聯盟支持
要求將當前工商補償醫療費用標準延長三年(及至 2007 年。)此案未能通過議會。
AB 1549 (Koretz, 2005) —— AIMS 策劃,加州中醫政治聯盟支持
SB 233 (Figueroa, 2005) ——外州利益團體支持,加州中醫政治聯盟反對
AB 871 (Keene, 2005) —— 由保險業者策劃,加州中醫政治聯盟反對
AB 1113 (Yee, 2005) —— 加州中醫政治聯盟策劃
AB 1114 (Yee, 2005) —— 加州中醫政治聯盟策劃
增加中醫師繼續教育提案;將每兩年需要 30 學時繼續教育增加至 50 學時。本案以壓倒性多數通過議會。斯瓦玆內格州長簽署成為法律。
AB 1115 (Yee, 2005) —— 加州中醫政治聯盟策劃
AB 1116 (Yee, 2005) —— 加州中醫政治聯盟策劃
AB 1117 (Yee, 2005) —— 加州中醫政治聯盟策劃
用『亞洲醫學』代替 『東方醫學』提案。本案以壓倒性多數通過議會。斯瓦玆內格州長簽署成為法律。
SB 248 (Figueroa, 2005) —— 加州中醫政治聯盟參與修訂
AB 2287 (Chu, 2006) —— 加州中醫政治聯盟策劃
AB 2152 (Chan, 2006) —— 加州中醫政治聯盟策劃
眾議院衛生委員會主席陳煥英議員提出的『針灸師執照行醫法案』(AB2152),將使用明確的法律條文重申任何人必須擁有加州中醫執照方可施行針灸治療的規定。這項由加州中醫政治聯盟策劃的,專門為保障中醫師基本行醫權益的提案對確保加州公眾獲得安 全可靠的中醫服務意義十分重大。 由於『針灸師執照行醫法案』牽涉到其他醫療職業者的既得利益,特別是勢力強大的西醫界的既得利益,因此我們很清楚:這是一項極具挑戰性的法案。審議一開始就面臨西醫牙醫足醫三大反對勢力強大的聯合攻勢,形勢十分嚴峻。更遺憾的是,業界中又有少數人持有相反意見:以白人針灸師為主体的加州中醫協會(CSOMA)對此案表示不支持,還斷言此案將絕對不會成功。而針灸產業醫學專家協會(AIMS)的米勒醫師則在聽證會上宣稱他希望本提案失敗。所幸絕大多數中醫專業團體(包括華裔,韓裔,日裔,越南裔等職業公會)都認為這項提案完全合情、合理、合法,它宣示了中醫界要維護病家利益及保衛自身權力的堅定決心,明知有難度和風險,但還是要堅決推行。由於外州利益團體的強力反對,本案未能通過議會。
AB 2821 (Huff, 2006) —— 加州中醫政治聯盟策劃
AB 3014 (Koretz, 2006) —— 針灸與綜合醫學專家協會策劃
SB 840 (Kuehl, 2006) —— 加州全民醫療保險法案 提案人:庫尤爾參議員
SB1476 (Figueroa, 2006) —— 醫療職業局日落條款案 提案人:費格洛亞參議員
AB 54 (Dymally, 2007) —— 加州中醫政治聯盟策劃
爭取豁免中藥銷售稅 (1997 – 2009) —— 加州中醫政治聯盟與北加州中藥聯商會共同推動
1997年,加州中醫界曾委托加州眾議員格里高斯醫師提出《豁免中藥銷售稅提案》,編號為AB410案。但未獲成功。後來在1999年,加州中醫政治聯盟又委托加州眾議員諾克斯提出了內容相同的 AB2764 法案作為繼續,也宣告失敗。中醫界再接再厲,在2001年又委托加州眾議員法魯
莫重新提出此案,編號 AB208 。可惜法案第三度被擱置。2002年由加州眾議員馬修斯接手辦理此案,改編號 AB249 。該法案雖然順利完成了參、眾兩院的全部審議程序,但是當年的州長戴維斯卻以財政短缺為由否決了此項提案,最後還是以失敗告終。2008年,中藥課稅問題的不合理性得到平等稅務局(BOARD OF EQUOLIZATION)趙美心局長和余淑婷副局長的關注,終于取得突破性的進展:二零零八年九月四日,中醫藥界代表與平等稅務局官員以及平稅局法律部門和稽查部門的負責人在沙加緬度進行了一次很有成果的會議。隨後,在二零零八年十二月,平等稅務局修改條例,不再將“聲稱有治療疾病功效的中藥定位為藥品"而予以課稅,並宣佈:既然中藥材在加州一向被列為“食物",就應當按食物免徵銷售稅,立即生效。至於“加工后中藥"(如粉劑、片劑、膠囊等產品)的食品定義問題,經過加州中醫政治聯盟的進一步交涉,平稅局法律部門最近提出了新的法律補充解釋:加工過的中藥材只要在其包裝或説明標簽上沒有“SUPPLEMENT”或“ADJUNCT”等字樣,則平稅局將認定此等產品仍然屬於“食品”,免予課稅。至此,抗爭多年的豁免中藥銷售稅問題終于獲得圓滿解決。 

AB 1260 (Huffman, 2009) —— 加州中醫政治聯盟反對
意圖修改加州針灸局職能的 AB1260 法案提出取消對考生臨床實習的要求,以及要讓外州的認證機構參與加州針灸局對中醫院校的審批工作等項,有可能降低加州中醫師素質,從而對加州中醫事業帶來負面影響。加州中醫政治聯盟予以反對。作者賀弗曼眾議員后來對本案條文作出重大的修訂—僅保留原提案的第一部分,(即將七人加州針灸局的議事法定人數由五名降為四名,包括至少一名針灸師);其餘不利加州中醫事業的條款已經全部予以刪除。
AB 1391 (Eng, then McLeod, 2010) —— 加州中醫政治聯盟支持
允許加州針灸局繼續運作至2013年的 AB1391 提案由伍國慶眾議員提出,其內容後來納入麥克利歐的 SB294.目前該案已經通過參眾兩院,等待州長的簽署。
爭取農夫保險公司支付針灸 (Eng, 2010) —— 加州中醫政治聯盟參與推動
加州針灸合法化以來,作為美國最大汽車保險公司之一的農夫保險公司 (FARMER INSURANCE COMPANY) 數十年來堅持不支付汽車意外受傷者針灸醫療費用。伍國慶眾議員通過和農夫保險公司高層領導人的多次直接溝通、協商、交涉,終於獲得公司方面的讓步,同意改變公司的理賠政策,

1973 – 1975年間,針灸在美國許多州已經取得合法地位。但是,政治上的合法化并不等于學銜上的被承認。代表西醫界的美國醫學會直到1996年還不承認針灸的醫學價值。其官方立場是“針灸在美國還屬實驗性質”。基于這種立場,負責管制醫療器械的美國食品及藥物管理局(FOOD AND DRUG ADMINISTRATION)只能勉強將針灸針列為“三級醫療器具”,即所謂的“實驗研究用器具”(INVESTIGATIONAL DEVICE),規定只能用于科學研究目的。1994年,針灸界人士委托華盛頓的斯萬金-陀諾(SWANKIN & TURNER)律師事務所,采取公民請願(CITIZEN PETETION)的法律程序嚴正要求藥管局根據專家們提出的研究報告,重新考慮針灸針在美國醫療保健體系中的地位,將之從三級器具提升為二級即 “核准醫療器具”(APROVED MEDICAL DEVICE)。藥管局的專家們足足用了近一年半時間對針灸界提出的研究報告進行分析評估,終于在1996年3月作出了裁決。
HR1038 (Hinchey, 1996) ~ HR646 (Hinchey, 2009) —— 加州中醫政治聯盟支持
聯邦健保改革法案(FEDERAL HEALTH CARE REFORM ACT, 2009-2010)—— 加州中醫政治聯盟支持


陳大仁:完善中醫教育 才是正名根本

加州中醫師聯合總會榮譽會長陳大仁嘆 SB628法案正名僅是「贈予」地位而非認同 提昇中醫專業教育進一步為中醫正名才是中醫界所樂見




但可惜的是,目前博大精深的中醫只能被侷限在「針灸局」(Acupuncture Board)底下,中醫師也只能稱針灸技師,醫術方面也受到限制,有多種中醫方濟還有正骨手法不可使用。因此陳大仁表示,現在最急迫的其實是趕快對中醫正名,並且提昇中醫的專業教育。他說,連眼鏡驗光師都得是博士學位,中醫當然更要是具有完備的教育體制。

陳大仁一家幾乎都是醫生,對中醫尤其專精,他說,針灸師其實早已超出針灸的範圍,是真正在行使中醫職業的專業人士,廣大中醫師都期望以中醫(Chinese Medicine)或東方醫學( Oriental Medicine)來取代針灸(Acupuncture)一詞。但在2002年及2006年分別有提出立法,都遭到西醫的阻撓而失敗。




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http://www.positivearticles.com/Article/The-History-of-Acupuncture-in-the-United-States/16719 By: ashu

Acupuncture has been an excepted medical practice throughout Asia for thousands of years. The history of acupuncture in the United States is less lengthy.

The History of Acupuncture in the United States

Acupuncture found its way into the United States in the same manner that so many other things have reached this country. It was brought with the immigrants. In this case, it was with Chinese immigrants brought into the West to work on railroads and in the fields. Large Chinese enclaves grew up in San Francisco, Los Angeles, and in New York City on the east coast. Acupuncture was a standard form of treatment in these settlements just as it had been back home in China. The Chinese had been using acupuncture for centuries and also had very little trust for Western Medical treatments.

Although there were a few incidents of Westerners becoming involved with the study and practice of acupuncture in the United States during the 19th century, it was never widely practiced outside Chinese areas. It also was never widely accepted. It was considered superstition and totally unscientific and little attempt to understand it was ever made. When the Communist Government started a campaign to rid China of all traces of Classical Chinese Medicine, many acupuncturists made their way abroad. Some of these came to the United States which increased the number, but still little was done to understand and adapt it to Western use.

One of the big turnarounds for acupuncture in the United States occurred during a State visit to China by Richard Nixon in the 1970’s. During this visit, a member of the U.S. delegation was given an emergency appendectomy. The only anesthesia that was used was acupuncture. The President was duly impressed and when he returned to the US, he called for further study of the procedure. It was the beginning of the move of acupuncture from a foreign voodoo-hoodoo type of thing to a respectable and accepted alternative Medical treatment procedure.

In 1994, the Washington Post was reporting that almost 15 million Americans had tried acupuncture. This was almost 6% of the total population. In 1995, The United States Federal Drug Administration classified acupuncture needles as medical instruments. The biggest turnaround came in 1997 when the National Institute of Health issued a report titled, “Acupuncture: The NIH Consensus Statement.” This report stated that acupuncture was indeed very useful in the treatment of certain conditions. It also stated that the side effects of acupuncture were less adverse than those resulting from either surgery or drugs.

The NIH report further encouraged Insurance Companies to give full coverage to acupuncture treatments for certain conditions. This was a major endorsement of the procedure. Today, acupuncture is becoming more and more accepted as an alternative treatment and is gaining acceptance by the Western Medical Community. Some Medical schools including UCLA have begun to offer acupuncture as part of the curriculum.

Acupuncture has been an excepted medical practice throughout Asia for thousands of years. The history of acupuncture in the United States is less lengthy.

Dr.Fan notes: Some of the points are not correct, such as the Nixon’s team member got sick and had operation under acupuncture anesthesia.

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