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WHO and Acupuncture

October 3rd, 2009 No comments

The World Health Organization has on its website an article entitled Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials (Link).  Not many western physicians are aware of this document and it’s recommendations.  It boggles my mind to no end how some folks can still, with a straight face, proclaim acupuncture as being effective only because of placebo effect.  For those who want to download, here’s a PDF.

The Document says,

People question whether acupuncture has a true therapeutic effect, or whether it works merely through the placebo effect, the power of suggestion, or the enthusiasm with which patients wish for a cure. There is therefore a need for scientific studies that evaluate the effectiveness of acupuncture under controlled clinical conditions.

I totally agree.  If only to silence skeptics.

This publication reviews selected studies on controlled clinical trials. Some of these studies have provided incontrovertible scientific evidence that acupuncture is more successful than placebo treatments in certain conditions. For example, the proportion of chronic pain relieved by acupuncture is generally in the range 55-85%, which compares favourably with that of potent drugs (morphine helps in 70% of cases) and far outweighs the placebo effect (30-35%) (1-3). In addition, the mechanisms of acupuncture analgesia have been studied extensively since the late 1970s, revealing the role of neural and humoral factors.

Did you hear that skeptics?  “…incontrovertible scientific evidence…”  And since the LATE SEVENTIES.  There’s no excuse not to know about the research.

Anyway, I shan’t bore the casual reader with the rest of the details, except for the final list published by WHO.

1. Diseases, symptoms or conditions for which acupuncture has been proved-through controlled trials-to be an effective treatment:

Adverse reactions to radiotherapy and/or chemotherapy
Allergic rhinitis (including hay fever)
Biliary colic
Depression (including depressive neurosis and depression following stroke)
Dysentery, acute bacillary
Dysmenorrhoea, primary
Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)
Facial pain (including craniomandibular disorders)
Headache
Hypertension, essential
Hypotension, primary
Induction of labour
Knee pain
Leukopenia
Low back pain
Malposition of fetus, correction of
Morning sickness
Nausea and vomiting
Neck pain
Pain in dentistry (including dental pain and temporomandibular dysfunction)
Periarthritis of shoulder
Postoperative pain
Renal colic
Rheumatoid arthritis
Sciatica
Sprain
Stroke
Tennis elbow
2. Diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown but for which further proof is needed:

Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm)
Acne vulgaris
Alcohol dependence and detoxification
Bell’s palsy
Bronchial asthma
Cancer pain
Cardiac neurosis
Cholecystitis, chronic, with acute exacerbation
Cholelithiasis
Competition stress syndrome
Craniocerebral injury, closed
Diabetes mellitus, non-insulin-dependent
Earache
Epidemic haemorrhagic fever
Epistaxis, simple (without generalized or local disease)
Eye pain due to subconjunctival injection
Female infertility
Facial spasm
Female urethral syndrome
Fibromyalgia and fasciitis
Gastrokinetic disturbance
Gouty arthritis
Hepatitis B virus carrier status
Herpes zoster (human (alpha) herpesvirus 3)
Hyperlipaemia
Hypo-ovarianism
Insomnia
Labour pain
Lactation, deficiency
Male sexual dysfunction, non-organic
Ménière disease
Neuralgia, post-herpetic
Neurodermatitis
Obesity
Opium, cocaine and heroin dependence
Osteoarthritis
Pain due to endoscopic examination
Pain in thromboangiitis obliterans
Polycystic ovary syndrome (Stein-Leventhal syndrome)
Postextubation in children
Postoperative convalescence
Premenstrual syndrome
Prostatitis, chronic
Pruritus
Radicular and pseudoradicular pain syndrome
Raynaud syndrome, primary
Recurrent lower urinary-tract infection
Reflex sympathetic dystrophy
Retention of urine, traumatic
Schizophrenia
Sialism, drug-induced
Sjögren syndrome
Sore throat (including tonsillitis)
Spine pain, acute
Stiff neck
Temporomandibular joint dysfunction
Tietze syndrome
Tobacco dependence
Tourette syndrome
Ulcerative colitis, chronic
Urolithiasis
Vascular dementia
Whooping cough (pertussis)
3. Diseases, symptoms or conditions for which there are only individual controlled trials reporting some therapeutic effects, but for which acupuncture is worth trying because treatment by conventional and other therapies is difficult:

Chloasma
Choroidopathy, central serous
Colour blindness
Deafness
Hypophrenia
Irritable colon syndrome
Neuropathic bladder in spinal cord injury
Pulmonary heart disease, chronic
Small airway obstruction
4. Diseases, symptoms or conditions for which acupuncture may be tried provided the practitioner has special modern medical knowledge and adequate monitoring equipment:

Breathlessness in chronic obstructive pulmonary disease
Coma
Convulsions in infants
Coronary heart disease (angina pectoris)
Diarrhoea in infants and young children
Encephalitis, viral, in children, late stage
Paralysis, progressive bulbar and pseudobulbar

Nuff said.  That’s the WHO talking.  Again, this was way back in 2003.  How can anyone NOT acknowledge this?

Makes my Liver Yang rise.

Reference:

World Health Organization.”Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials” WHO Website, 2003.  3 October 2009 <http://apps.who.int/medicinedocs/en/d/Js4926e/1.html>

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Categories: Acupuncture, Research Tags: , , , ,

British Girl Dies After Cervical Cancer Jab

October 3rd, 2009 No comments

Welcome to Qi Spot’s first ever post.  Interestingly it is not about Chinese medicine, so I am classifying this under “Western Medicine”.  Why have I chosen this for my icebreaker?  Well, this blog was actually born out of some discussions over HPV vaccines (I will not call them “cervical cancer” vaccines) and one exasperated colleague’s suggestion that I “write my crazy ideas down”.  So here we have it.

British Girl Dies After Cervical Cancer Vaccine Jab (from Philippine Daily Inquirer)

LONDON – British drug giant GlaxoSmithKline said Tuesday it was working with health authorities here investigating the death of a schoolgirl following a cervical cancer vaccination.

The 14-year-old died on Monday when the Cervarix vaccine was administered at her school in Coventry, central England, as part of a national vaccination to protect women against the disease.

Health authorities have isolated the batch of vaccine used in the school involved against the Human Papillomavirus (HPV), a sexually-transmitted virus which is the primary cause of cervical cancer.

“The incident happened shortly after the girl had received her HPV vaccine in the school,” said Dr. Caron Grainger, joint head of public health for the National Health Service (NHS) in Coventry and Coventry City Council.

Late Tuesday Grainger said test results revealed the teenager had a “serious underlying medical condition” and the vaccination was therefore “most unlikely” to have caused her death.

“The preliminary post-mortem results have revealed a serious underlying medical condition which was likely to have caused death,” she said.

“We are awaiting further test results which will take some time. However, indications are that it was most unlikely that the HPV vaccination was the cause of death.”

The Department of Health said the vaccination program would continue as planned, stressing that more than 1.4 million doses had been given out in Britain and the vaccine had a “strong safety record”.

“The quarantining of this batch is a purely precautionary measure,” a spokesperson said, adding: “The HPV vaccination program can continue as planned — there is no reason for the campaign to be suspended or interrupted.”

In a statement GSK, which produces Cervarix, said it was working with health authorities “to better understand this case, as at this stage the exact cause of this tragic death is unknown.”

It added: “To date the vast majority of suspected adverse reactions (to Cervarix) have related either to the signs and symptoms of recognized side effects listed in the product information or were due to the injection process and not the vaccine itself.”

Awareness of cervical cancer was boosted earlier this year by the death from the disease of a reality television star, Jade Goody, who garnered publicity notably for the need for women to have regular cervical smear tests.

Natalie Morton died a few hours after being injected with a dose of Cevarix.  Strictly speaking, Cevarix and Gardasil are not vaccines for cancer, but for strains of HPV that are supposed to cause cervical cancer.  A recent Journal of the American Medical Association article with a stated objective of summarizing reports from the Vaccine Adverse Effects Reporting System (VAERS) has led the authors to the following findings:

1) There were 12,424 reports of Adverse Effects.

2) Of these, 772 were considered serious.

The reporting rates per 100 000 qHPV doses distributed were 8.2 for syncope; 7.5 for local site reactions; 6.8 for dizziness; 5.0 for nausea; 4.1 for headache; 3.1 for hypersensitivity reactions; 2.6 for urticaria; 0.2 for venous thromboembolic events, autoimmune disorders, and Guillain-Barré syndrome; 0.1 for anaphylaxis and death; 0.04 for transverse myelitis and pancreatitis; and 0.009 for motor neuron disease. Disproportional reporting of syncope and venous thromboembolic events was noted with data mining methods.

Note the word “disproportional”.  Keep in mind that this is a PASSIVE data system, meaning it doesn’t actively seek out side effect reports, but it sits there waiting for doctors to report them.  I am trying to imagine how many more cases out there are unreported.

and 3) There were 32 deaths.

Okay, 32 deaths out of millions of doses given… that’s not very large.  However, what comes to mind is that I have a daughter of my own.  How would I feel if that daughter of mine were one of that 32?  One of the 772 with “serious” side effects?

Of course, I could look at the other side of the fence and think, what if my daughter gets exposed to HPV?  Develops pre-cancerous lesions?

How to balance the two?

There are two factors that make me lean towards avoiding this vaccine for now.

First is the fact that this vaccine is still relatively new.  Thus, it’s long term effects are still in question.  People now do not recall the Polio Vaccine snafu that happened in the 1950s, when it became apparent that Salk’s polio vaccine actually CAUSED more cases of polio.

Second is the fact that the incidence of cervical cancer is actually lowering.  Instead, we have a rise in detection of carcinoma-in-situ (only seen cellularly).  Why? Pap smears, that’s why!  With regular screening, we can find pre-cancerous lesions, treat early, and prevent cancer.  With diseases like Hepatitis B, we don’t have that luxury.

Methinks I will wait ten years before pronouncing HPV vaccines as safe and reliable.

In the meantime, let’s also look at the applicable Chinese Medicine principles here.  Behaviors influence disease.  In the case of HPV, one is most at risk by having promiscuous sex with several partners.  (Well that was redundant… promiscuous sex with several partners…)  Logic dictates that proper behavior not only protects against HPV but other sexually transmitted infections as well.

Final seemingly-unrelated-thought: I also find it amusing that if a person with an underlying medical problem dies and is found to have been infected with H1N1, authorities are quick to assume that H1N1 caused the death by complicating the underlying problem.  Yet, when a person with an underlying medical problem is jabbed with a vaccine and dies, the same authorities are quick to rule out the vaccine as a cause of death because of the presence of the underlying problem.  As my good friend Garrick would say, “Huh?”

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