Professional Chinese medicine is an evidence-based medicine.
It is grounded in the theories and accumulated experiences of
a hundred generations of physicians and billions of patient
interactions. This massive foundation of evidence is the reason
Chinese medicine can be so effective for so many various
ailments with so little negative side effects. This base of clinical
experience is unparalleled in both its size and the claims it is
able to support.
Modern science and the contemporary medical system based on that approach to rational investigation are slowly realizing, demonstrating through clinical research, the effectiveness of Chinese medicine. Current scientific theories, methods, and techniques are new and, thus, it will take time for them to fully appreciate the scope and power of Chinese medicine. However, there is already many, high quality studies available reflecting the effectiveness of Chinese medicine, mostly through the modality of acupuncture.
A few words of advice before your search...
Bear in mind, due to the nature of contemporary scientific
research, studies are typically conducted on very specific
topics. For example, the question "Does acupuncture work"
cannot be investigated because it is too general. Similarly
acupuncture for pain is too broad a topic for which to locate
specific clinical trials (though there may be articles addressing
such general topics). Instead, try looking for "knee pain" or
"back pain".
Also keep in mind, modern research is based on very different fundamental principles than Chinese medicine. For example, Chinese medicine has always focused on the unique aspects of a patient, individualizing treatments for their specific disease presentation. Compare this to modern medicine where diseases are the topic of discussion and research; patients, themselves, exist in the background of the clinical picture.
Also, modern research makes great effort to reduce a treatment's effect to very specific causes. For instance, it strives to eliminate as many influences on a patient's condition, except for the therapeutic intervention, as possible. This allows such research to make a stronger claim about what, exactly, caused the outcome. That is, where there were few other influences on the patient, the claim that the treatment "caused" the outcome is much stronger. Though eminently logical, this is a very poor model of an actual clinical encounter. In medicine as it's practiced out in the real world there are always numerous, truly an unknowable amount of influences on any given patient during therapy. Importantly, the treatment itself consists of many different aspects, each contributing to the end treatment outcome. Chinese medicine does not try to rigorously isolate and identify narrow "causes" of effect, e.g., which twist of which acupuncture needle caused what percentage of change in the patient's fever irrespective of other aspects of the patient's condition or the therapy overall. Instead it always looks at the larger picture to learn what worked and what didn't. Over countless treatments occurring over hundreds of years, Chinese medicine has been able to identify what herbs and what acupuncture points tend to do what in the clinic. One, thus, gets limited information about what Chinese medicine can do for them from any given study. Their treatment will never be exactly what was done in the study because Chinese medicine always treats you and your condition as unique. Modern research, thus, in its search for exactness, compromises its usefullness for actual patient interactions. Nonetheless, the research below is still of interest.
Lastly, there is a widely held assumption that Western medicine is backed by clinical research, the very same research which fails to support Chinese medicine. In seeking evidence of effectiveness of acupuncture, for example, one is often acting on the assumption that such evidence exists for biomedicine and that acupuncure, too, needs to live up to this standard for medical care. The rigors of science require we challenge this assumption. The highly esteemed British Medical Journal did just this with the following results:
"...what can Clinical Evidence tell us about the state of our current knowledge? What proportion of commonly used treatments are supported by good evidence, what proportion should not be used or used only with caution, and how big are the gaps in our knowledge? Of around 2500 treatments covered 13% are rated as beneficial, 23% likely to be beneficial, 8% as trade off between benefits and harms, 6% unlikely to be beneficial, 4% likely to be ineffective or harmful, and 46%, the largest proportion, as unknown effectiveness."
Source: https://www.ncims.com/wp-content/uploads/2016/01/HWClinical-Evidence.pdf
Modern Clinical Research into Acupuncture and Chinese Medicine
Note - There are very few individual studies listed below. Instead, most of the research below are systematic reviews and meta-analyses, the highest level of modern clinical research.
For ease of finding research on specific ailments, it is recommended you use your browser's search function, for example, pressing "CTRL + F" and entering the ailment which you are curious about.
High Quality Reviews of the Acupuncture Treatment of Pain
A March, 2011 overview aimed at evaluating and summarizing transparent and rigorous Cochrane reviews of acupuncture in the treatment of pain. All the reviews were of high methodological quality and eight of them concluded that acupuncture is effective for migraines, neck disorders, tension-type headaches, and peripheral joint osteoarthritis. http://www.ncbi.nlm.nih.gov/pubmed/21359919
Acupuncture Gets an “A” for Treating Chronic Low Back Pain
In the June 15th, 2009, issue of American Family Physician, acupuncture was given an evidence rating of “A”, the same rating given to analgesics, such as acetaminophen and Ultram, and non-steroidal anti-inflammatory medications (NSAIDs) – That’s the same strength of evidence, but without all the potential damage to the kidney and gastrointestinal systems!
http://www.aafp.org/afp/2009/0615/p1067.html
Osteoarthritis, low back pain, and elbow pain
An overview of systematic reviews (SRs being the
highest level of modern clinical evidence) coming out
of the journal Rheumatology concluded that there is
“sufficiently sound” evidence to “warrant positive
recommendations” of acupuncture for osteoarthritis,
low back pain, and elbow pain.
http://www.ncbi.nlm.nih.gov/pubmed/20591833
Acupuncture Research – Knee Pain
This study, published in 2007, was aimed at evaluating the effects of acupuncture on pain and function in patients with chronic knee pain. It included a systematic review and meta-analysis of randomized controlled trials (RCTs). Studies were chosen that randomly assigned patients to either acupuncture, sham acupuncture, usual care, or an active intervention.
Acupuncture was “superior” to sham acupuncture for both pain and function, in both short-term and long-term follow-up. Acupuncture was also “significantly superior” to usual care.
There were insufficient studies to compare acupuncture with other active interventions.
http://www.ncbi.nlm.nih.gov/pubmed/17215263
Systematic review and meta-analysis of acupuncture to reduce cancer-related pain
“Acupuncture is effective in relieving cancer-related pain, particularly malignancy-related and surgery-induced pain. Our findings suggest that acupuncture can be adopted as part of a multimodal approach for reducing cancer-related pain.”
http://www.ncbi.nlm.nih.gov/pubmed/26853524
For temporomandibular disorders: A systematic review of RCTS using the criteria set out in the Cochrane Handbook demonstrated acupuncture was more effective than physical therapy, indomethacin plus vitamin B1, and a wait-list control group. Additionally, acupuncture had effect beyond placebo effect and that similar to occlusal splint therapy.
Cho, S, Whang, W. Acupuncture for temporomandibular disorders: a systematic review. Journal of Orofacial Pain. 2010; 24(2): 152-62. www.ncbi.nlm.nih.gov/pubmed/20401353. Accessed April 20, 2016.
From a systematic review and meta-analysis of acupuncture for Major Depressive Disorder (MDD): “The efficacy of acupuncture as monotherapy was comparable to antidepressants alone in improving clinical response and alleviating symptom severity of MDD… The incidence of adverse events in acupuncture intervention was significantly lower than antidepressants.”
Zhang, ZJ, Chen, HY, Yip, KC, Ng, R, Wong, V. The effectiveness and safety of acupuncture therapy in depressive disorders: Systematic review and meta-analysis. Journal of Affective Disorders. 2009; doi:10.1016/j.jad.2009.07.005.
In a systematic review of acupuncture for gastrointestinal diseases the quality of life improved in all trials. The authors referred to acupuncture as a “harmless and obviously powerful therapy.”
Schneider, A, Streitberger, K, Joos, S. Acupuncture treatment in gastrointestinal diseases: a systematic review. World Journal of Gastroenterology. 2007; 13(25): 3417-24. www.ncbi.nlm.nih.gov/pubmed/17659687. Accessed April 20, 2016.
A systematic review concluded that, alongside reasonable diet and exercise, acupuncture is “safe and effective” for treatment of simple obesity.
Lin, X et al. [Systematic evaluation of therapeutic effect of acupuncture for treatment of simple obesity]. [Article in Chinese]. Zhongguo Zhen Jiu. 2009; 29(10): 856-60. www.ncbi.nlm.nih.gov/pubmed/19873927. Accessed April 20, 2016.
The journal Neurological Sciences reports that systematic reviews suggest acupuncture is both effective and cost-effective for migraines, as well as tension headaches.
Schiapparelli, P et. al. Acupuncture in primary headache treatment. Neurological sciences. 2011; 32 Suppl 1; S15-8. www.ncbi.nlm.nih.gov/pubmed/21533705. Accessed April 20, 2016.
In a systematic review of acupuncture for insomnia acupuncture was found to be superior to medications for “number of patients with total sleep duration increased >3 hours”; when combined with medications, better than medications alone for total sleep duration; and no serious side effects with acupuncture treatments.
Cao, H, Pan, X, Li, H, Liu, J. Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. The Journal of Alternative and Complementary Medicine. 2009; 15(11); 1171-1186. www.liebertonline.com/doi/abs/10.1089/acm.2009.0041. Accessed April 20, 2016.
The molecule adenosine has been implicated as an important player in the physiological effects of acupuncture on the body, by a team from the University of Rochester Medical Center.
In this piece of research, two herbs, Scutellaria baicalensis and Coptis chinensis, were tested against some microbes and, guess what, they demonstrated strong anti-microbial effect, comparable, in fact, to the antibiotic vancomycin.
Leach, F. (2011). Anti-microbial properties of Scutellaria baicalensis and Coptis chinensis, two traditional Chinese medicines. Bioscience Horizons 2011 : hzr014v1-hzr014. Retrieved from biohorizons.oxfordjournals.org/content/early/2011/05/04/biohorizons.hzr014.full?
maxtoshow=&hits=25&RESULTFORMAT=&andorexacttitle=and&andorexacttitleabs=and
The meta-analysis reviewed 28 papers and concluded that acupuncture is effective for Chronic Fatigue Syndrome.
Wang, J. et. al. (2009). A meta analysis on randomized controlled trials of acupuncture treatment of chronic fatigue syndrome. Zhen Ci Yan Jiu, 34(6), 421-8. Retrieved from www.ncbi.nlm.nih.gov/pubmed/20209981.
The systematic review, coming out of the Journal of Alternative and Complementary Medicine, included 70 controlled clinical trials and concluded that “acupuncture and several types of meditative practice show the most promise for future scientific investigation [into Chronic Fatigue Syndrome and fibromyalgia].”
Porter, N. et al. (2010). Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of Alternative and Complementary Medicine, 16(3), 235-49. Retrieved from www.ncbi.nlm.nih.gov/pubmed/20192908.
In this review of 234 studies, it was determined that there was clinical evidence supporting the use of acupuncture for IR [Insulin Resistance]. It was further noted by the authors that acupuncture can correct various metabolic disorders that contribute to the development of IR, such as :
- hyperglycemia,
- overweight,
- hyperphagia,
- hyperlipidemia,
- inflammation,
- altered activity of the sympathetic nervous system and insulin signal defect
Liang, F. & Koya, D. (2010). Acupuncture: is it effective for treatment of insulin resistance? Diabetes, Obesity, and Metabolism, 12(7), 555-69. Retrieved from onlinelibrary.wiley.com/doi/10.1111/j.1463-1326.2009.01192.x/abstract
In the following systematic review of acupuncture for insomnia, where several randomized controlled trials (RCTs) were evaluated for their quality, and those of sufficient quality reviewed:
- acupuncture was found to be beneficial,
- acupuncture was superior to medications, regarding “number of patients with total sleep duration increased >3 hours”, and
- acupuncture with medications was better than medications alone, for total sleep duration.
Additionally, there were no serious adverse effects with the acupuncture treatments.
Forty-six randomized trials were included (3,811 patients). The methodology, as far as randomization, blinding, and “intention-to-treat analysis”, was deemed “generally fair”.
Cao, H., Pan, X., Li, H. & Liu, J.(2009). Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. The Journal of Alternative and Complementary Medicine, 15(11), 1171-1186. Retrieved from
www.liebertonline.com/doi/abs/10.1089/acm.2009.0041.
This literature review of clinical trials (randomized, non-randomized, and observational studies) on acupuncture treatment of polycystic ovarian syndrome (PCOS) was conducted by the Faculty of Medicine, South Western Sydney Clinical School, University of New South Wales, in Australia. It concluded that acupuncture is “safe and effective” in the treatment of PCOS and posited, as possible mechanisms of acupuncture treatment:
- increased blood flow to the ovaries,
- reduction of ovarian volume and number of ovarian cysts,
- control of hyperglycaemia through increased insulin sensitivity and decreased blood glucose and insulin levels,
- reduction of cortisol levels, and
- assisting in weight loss and anorexia
Lim, C. & Wong, W. (2010).Current evidence of acupuncture on polycystic ovarian syndrome. Gynecological Endocrinology. 26(6), 473-8. Retrieved from
www.ncbi.nlm.nih.gov/pubmed/20230329.
In this systematic review of acupuncture and gastrointestinal diseases, in all trials reviewed quality of life improved “significantly”, regardless of whether real or “sham” acupuncture was used. Real acupuncture was “significantly” superior to sham acupuncture in Crohn’s disease and Colititis.
Schneider, A., Streitberger, K. & Joos, S. (2007). Acupuncture treatment in gastrointestinal diseases: a systematic review. World J Gastroenterol. 13(25), 3417-24. Retrieved from www.ncbi.nlm.nih.gov/pubmed/17659687.
Acupuncutre and depression: "Patients treated with SGAs [second-generation antidepressants] had a higher risk of experiencing adverse events or discontinuing treatment because of adverse events than patients treated with CBT [cognitive behavioral therapy], acupuncture, or St. John’s wort... the overall findings indicated no statistically significant differences in benefits but a lower risk of adverse events for nonpharmacological treatment options [such as acupuncture]." https://www.ncbi.nlm.nih.gov/pubmed/26764438
Acupuncture and anxiety: "among 514 articles, 67 were selected to be fully read and 19 were included. Among these, 11 were found to have strong evidence levels. Among the six articles about randomized clinical studies, five were found to be of reasonable quality. Two studies used acupuncturist nurses to perform their interventions. Its results showed positive and statistically significant effects from using acupuncture for treating subjects with anxiety." https://www.ncbi.nlm.nih.gov/pubmed/27355312
From the World Health Organization:
"The diseases or disorders for which acupuncture therapy has been tested in controlled clinical trials reported in the recent literature can be classified into four categories as shown below.
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
- 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
Source: http://apps.who.int/medicinedocs/pdf/s4926e/s4926e.pdf
Modern reseArch
into acupuncture and chinese medicine
The Office of Dr. John Aguilar, Jr.
John Aguilar, Jr, DAOM, MA, EAMP, Dipl OM (NCCAOM)
Doctor of Acupuncture and Chinese Medicine
Clinician, Educator