KPJ <kpj@sics.se> writes:
> Since
>
> (a) acupuncture actually does work for a other purposes,
> (b) nobody seems to have made any studies of _why_ it works,
> (c) it appears rather obvious a neurological mechanism is involved,
> (d) humans can change their metabolism using e.g. hypnosis,
>
> then it would seem possible that acupuncture may also be used to do this.
(b): there have been many studies, and the current overall opinion
seems to be that it works by the pain-gateways in the spinal cord -
one form of stimulation (the needle) can shut out another form of
stimulation (the pain of the disease). And of course there is plenty
of placebo too.
As for studies, in medline I found:
(1) Questions the value of the treatment, but I don't know the
strength of the evidence presented.
(2) Tested it, and had negative results.
(3) Shows that acupuncture can indeed affect the sympathetic and
parasympathic systems, which could be an explanation *if* it
works.
(4) Claims it works, but do not describe exactly what was done in the
abstract. It is representative for a number of similar papers in
the same journal, which give a somewhat biased impression given
the abstracts.
(5) A meta-review of other papers. Overall, the results seem to be
contradictory and methodologically flawed. The best trials did not
show any effect.
Obes Surg 1993 May;3(2):197-200
Operations that are Questionable for Control of
Obesity.
Fobi MA
Departments of Surgery, Cedars-Sinai Medical
Center, Bellwood General Hospital and the
Center for Surgical Treatment of Obesity, Los,
Angeles, CA, USA.
[Record supplied by publisher]
At the last review of the literature, there
were 43 different operations or modifications
thereof used for the control of obesity. An
effective operation for obesity control should
produce a significant weight loss (>/= 25%
excess weight loss) to ameliorate the
associated medico-sociopsycho-economic
ramifications of the obesity. The operative and
postoperative significant morbidity should be
less than 20% and mortality less than 1%. The
weight lost should be maintained for a long
period (>/= 5 years). The effects of the
operation should be reproducible and
documentable by more than two authors working
independently. For the purpose of this paper,
operations which do not meet these criteria are
considered questionable and not recommended for
general use. Based on these criteria,
questionable operations for treatment of
obesity include: tooth wiring, acupuncture,
hypothalamic center manipulation, liposuction,
balloon insertion, unbanded gastric
partitioning, vagotomy, gastrogastrostomy,
horizontal gastroplasty, gastric wrap,
gastroclip, and any variety of gastroplasty
without a reinforced stoma, intestinal bypass,
duodenal bypass and biliointestinal
bypass. Data to substantiate this
classification will be presented and
discussed. Since the surgical treatment of
obesity is evolving, there is need to collect
data from and make modifications to improve the
effects of all operations. There is not enough
data at this time to prohibit the use of any
operation, but the data presented will justify
limiting the use of certain operations to
institutions dedicated to meticulous follow-up
and research.
Eat Weight Disord 1999 Dec;4(4):198-202
Failure of acupuncture in the treatment of
obesity: a pilot study.
Mazzoni R, Mannucci E, Rizzello SM, Ricca V,
Rotella CM
Department of Clinical Pathophysiology,
University of Florence Medical School, Italy.
Acupuncture has been anecdotally reported to
induce weight loss in obese patients. This
pilot study examines its efficacy in a
randomised, placebo-controlled clinical
trial. Forty (33 F, 7 M) obese (BMI > 30 kg/m2)
outpatients were randomised to either placebo
or acupuncture (12 weekly sessions of minimal
acupuncture and somatic moxibustion-acupuncture
associated with auriculopuncture
respectively). BMI, eating attitudes (BES),
anxiety (STAI), depression (BDI), and
obesity-related quality of life (ORWELL 97)
were measured at the beginning and end of the
treatment. Six (30%) patients in the treatment
group and 12 (60%) in the placebo group dropped
out. Intention-to-treat analysis did not show
any significant effect of acupuncture on BMI
and obesity-related quality of life; eating
attitudes improved in both groups, possibly
because of the placebo effect. A significant
improvement in anxiety and depression was only
observed in the acupuncture group. In
conclusion, acupuncture does not promote weight
loss and is not recommendable in the treatment
of obesity. It may, however, improve the
psychological status of obese patients.
J Auton Nerv Syst 2000 Feb 14;79(1):52-9
Effect of sensory stimulation (acupuncture) on sympathetic and
parasympathetic activities in healthy subjects.
Haker E, Egekvist H, Bjerring P
Department of Physical Therapy, Department of
Physiology and Pharmacology, Karolinska
Institutet, Stockholm,
Sweden. eva.haker@fvfa.ki.se
It has been postulated that sensory stimulation
(acupuncture) affects the cardiovascular system
via the autonomic nervous system. Previously,
skin temperature, thermography, plethysmography
and blood pressure changes have been used in
evaluation of sympathetic nerve activity
following acupuncture. By using power spectral
analysis, the low frequency and high frequency
components of heart rate variability can be
calculated reflecting the sympathetic and
parasympathetic activity. The purpose of this
study was to investigate to what extent
acupuncture applied into the thenar muscle and
into the cavum concha of the ear induced
changes in the sympathetic and/or
parasympathetic nervous system in healthy
subjects. MATERIALS AND METHODS: Twelve healthy
volunteers, six men and six women, mean age
34.4 (range 23-48) participated in three
balanced, randomly distributed sessions. At an
individual initial visit the 12 volunteers were
introduced to the needle sensation by having a
needle inserted into the point LI 11. The
needle sensation was evoked and the subject was
trained to identify the characteristic needle
sensation. The introduction was followed by
three test sessions. SESSION A: A short
acupuncture needle, (Seirin no 3,
∅0.20x15 mm) was inserted perpendicular
into the earpoint, Lu 1, in the left inferior
hemi-conchae. SESSION B: An acupuncture needle
(Hwato, ∅0.30x30 mm) was inserted
perpendicular into the Hegu point (LI 4) in the
middle of the right dorsal thenar
muscle. SESSION C: An acupuncture needle
(Hwato, ∅0.30x30 mm) was inserted
perpendicular superficially into the skin
overlying the Hegu point on the left
hand. Results. Stimulation of the ear induced a
significant increase in the parasympathetic
activity during the stimulation period of 25
min (P<0.05) and during the post-stimulation
period of 60 min (P<0.05). No significant
changes were observed in either the sympathetic
activity, blood pressure or heart
rate. Stimulation of the thenar muscle resulted
in a significant increase in the sympathetic
and the parasympathetic activity during the
stimulation period (P<0.01) and during the
post-stimulation period (P<0.01 and P<0.001,
respectively). A significant decrease in the
heart rate frequency (P<0.05) at the end of the
post-stimulation period was also
demonstrated. The superficial needle insertion
into the skin overlaying the right thenar
muscle caused a pronounced balanced increase in
both the sympathetic and parasympathetic
activity during the post stimulation period of
60 min (P<0.01) while no changes were observed
during the stimulation period. CONCLUSION: It
is indicated that sensory stimulation
(acupunctura) in healthy persons is associated
with changed activity in the sympathetic and
parasympathetic nervous system depending on
site of stimulation and period of observation.
J Tradit Chin Med 1998 Dec;18(4):265-71
Application of acupuncture and moxibustion for keeping shape.
Liu Z, Sun F, Li J, Han Y, Wei Q, Liu C
Nanjing University of Traditional Chinese Medicine.
On the basis of TCM diferentiation, the authors
have treated 359 adult female cases of
non-obesity with undesirable body shape by
combined application of body acupuncture and
moxibustion and auricular acupuncture, and
achieved quite good remoulding and orthopedic
results, suggesting that acupuncture and
moxibustion can very effectively regulate the
somatotypic indexes of body weight,
circumference of the chest, loin, hip and
thigh, the ratio of the loin to hip, sebum
thickness, obesity degree, body mass index and
body fat percentage of the cases in the
overweight group and orthopedic groups 1, 2. It
is therefore concluded that acupuncture and
moxibustion is a good therapy for obtaining a
graceful body shape.
Wien Klin Wochenschr 1997 Jan 31;109(2):60-2
Acupuncture/acupressure for weight reduction? A
systematic review.
Ernst E
Department of Complementary Medicine,
Postgraduate Medical School, University of
Exeter, United Kingdom.
Acupuncture and acupressure are often advocated
and used as a means of controlling appetite and
reducing body weight, supported by case-series
and uncontrolled studies that show encouraging
results. This paper reviews
placebo/sham-controlled clinical trials
published on this topic. Two independent
literature searches identified four such
studies. None of these is without significant
methodological flaws and their results are
contradictory. The two relatively rigorous
trials show no effect on body weight. On
balance, no clear picture emerges to show that
acupuncture/acupressure is effective in
reducing appetite or body weight. Claims that
these forms of treatment have specific effects
on these conditions are therefore not based on
well-performed clinical trials.
-- ----------------------------------------------------------------------- Anders Sandberg Towards Ascension! asa@nada.kth.se http://www.nada.kth.se/~asa/ GCS/M/S/O d++ -p+ c++++ !l u+ e++ m++ s+/+ n--- h+/* f+ g+ w++ t+ r+ !y
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