Jason L's Profile

Acupuncture was no more effective than sham acupuncture in reducing migraine headaches although both interventions were more effective than a waiting list control.

Drug treatment with -blockers, calcium antagonists, or other agents has been shown to reduce the frequency of migraine attacks; however, the success of treatment is usually modest and tolerability often suboptimal.³

Most participants were recruited through reports in local newspapers; some patients spontaneously contacted the trial centers.

Study interventions were developed by consensus of acupuncture experts and societies and were provided by physicians trained (at least 140 hours, median 500 hours) and experienced (median 10 years) in acupuncture.

All patients were treated at what are called basic points (gallbladder 20, 40, or 41 or 42, Du Mai–governing vessel 20, liver 3, San Jiao 3 or 5, extra point Taiyang) bilaterally unless explicit reasons for not doing so were given. Additional points could be chosen individually, according to patient symptoms.⁵

Physicians were instructed to achieve "de Qi" (in which patients experience an irradiating feeling considered to be indicative of effective needling) if possible, and needles were stimulated manually at least once during each session.

Number, duration, and frequency of the sessions in the sham acupuncture group were the same as for the acupuncture group

Patients in the waiting list control group did not receive any prophylactic treatment for their headaches for a period of 12 weeks after randomization. After that period they received 12 sessions of the acupuncture treatment described above.

All patients were allowed to treat acute headaches as needed.

The other type does not follow these principles, but has also been associated with positive outcomes in clinical studies."

At the end of the study, patients were asked whether they thought that they had received acupuncture following the principles of Chinese medicine or the other type of acupuncture.

For each of the hierarchical hypotheses, we used the t test with a significance level of P<.05, thus testing in a first step whether acupuncture is more efficacious in reducing the number of days with moderate or severe headache than no treatment and in a second step (only if the first null hypothesis was rejected) whether acupuncture is more efficacious than sham acupuncture.

The mean (SD) number of needles used per session was 17 (5) in the acupuncture group and 11 (3) in the sham acupuncture group.

both interventions were more effective than a waiting list control.

Our study also had high follow-up rates.

participants probably had a more positive attitude toward acupuncture than the typical patient with migraines although experiences from ongoing reimbursement programs in Germany show that a large number of patients with chronic pain seek acupuncture treatment.

some degree of unblinding.

This was probably due to the natural course of the disease or the general effect of being in a study (Hawthorne effect).

We cannot rule out that the acupuncture interventions used in some of the older studies were more appropriate for the treatment of migraine. Nevertheless, we are confident that the consensus-based, semistandardized strategy in our multicenter trial represents a suitable intervention. Another potential explanation for the discrepancy in findings could be an overestimation of effects over sham controls in the smaller, older studies due to bias or chance.

The sham acupuncture intervention in our study was designed to minimize potential physiological effects by needling superficially at points distant from the segments of "true" treatment points and by using fewer needles than in the acupuncture group.

The question investigated in our comparison of acupuncture and sham acupuncture was not whether skin penetration matters but whether adherence to the traditional concepts of acupuncture makes a difference. For this purpose, our minimal acupuncture intervention was clearly an appropriate sham control although it might not be an inert placebo.

"ritual" of needling.

Given the uncertainties regarding the potential physiological effects of sham interventions and the question of enhanced placebo effects, it is crucial that direct head-to-head comparisons of acupuncture and proven standard drug treatments are conducted in addition to sham-controlled trials.

hiccup in the rhythm between Foundations   and
Cosmology

I guess part of what I was expecting/hoping for from a
class titled "Chinese Language, History, and Culture" in a program for
Chinese medicine is closer to something that might be titled "Cultural and
Historical Roots of Chinese Medicine."

Occasionally Jim would go off on a tangent but most of the

time it was just going over the characters. It is also hard to get a

word in with Jim, or ask questions during that class because he likes

to talk so much :)

I do agree that there needs to be more

communication about what is being taught amongst teachers in their

respective classes.

but it seems that the

last couple of classes Heiner gets off topic, or is jumping around

with the info so that I am not quite sure what is going on.

The third years I have talked to say the material starts

coming together in the third year, but I think we can do better, in

fact I know we can do better. I

I am even a bit skeptical about how

classical our program, it just seems like a hybrid of classicalness

and TCM.

We should all know the history of Chinese and history of

the transmission of the medicine and we should know exactly what we

are expected to know as far as the six conformations and the bagua and

the 12 officials and the five phases.

a more comprehensive foundations book

The teachers are here for us and I
think its worth talking with them first.

Jim was probably my least enjoyed

instructor. But strangely, this year, I have found that he rivals

another as my favorite!  Jim has incredible depth of symbolic and

linguistic knowledge.  

Be patient - yet persistent - with yourself and your instructors.

That is my best advice.  My only other 2 cents would be to use this

year of cultivation to truly get inside yourself.  Next year will be

full of memorization and test taking.