Today’s blog is written by guest author Barry A. Wilson, a RAND research programmer and co-authour of such works as A Question of Balance: Political Context and Military Aspects of the China-Taiwan Dispute (2009); Measuring Interdiction Capabilities in the Presence of Anti-Access Strategies: Exploratory Analysis to Inform Adaptive Strategy for the Persian Gulf (2002); Dire Strait? : Military Aspects of the China-Taiwan Confrontation and Options for U.S. Policy(2000); Ground Combat in the JICM(1995); Analytic War Plans: Adaptive Force-Employment Logic in the RAND Strategy Assessment System (RSAS) (1990) and The Secondary Land Theater Model (1987).  These and other RAND publications are available in the RAND online bookstore http://www.rand.org/pubs/.

Like many Westerners, I suppose, I have never had much contact with acupuncture and Oriental Medicine (OM) and only thought of it vaguely as a folk art that worked more or less by accident.  I’ve since come into a much closer relationship with Oriental Medicine and have found that it makes sense to me in terms of my own profession, computer modeling. 

A truism about any model of the real world, computer or otherwise, is that it is wrong.  All models are abstractions of the world, and therefore inaccurate.  The question is, can you do useful work with a bad model, and the answer is of course, yes, as long as you remember that the model is not reality.  You can get insight into the real system by working with the simpler model.

Western science has created a model of the human body through the powerful technique of scientific analysis, taking the system apart and understanding each piece in detail.  To paraphrase an excellent author on understanding OM, The Web That Has No Weaver by Ted J. Kaptchuk,

Western medicine is concerned mainly with identifying and controlling disease.  The Western physician starts with a symptom, and then looks for a cause.

Pre-scientific people created models, too.  It’s what we humans do.  The ancient Chinese observed people for thousands of years and created a model along the lines of their Daoist philosophy of the balance of opposites in nature, Yin and Yang.  Again paraphrasing Kaptchuk,

The Chinese physician looks at everything about a person, all psychological and physiological characteristics, in order to see what is not in balance.  The question is not “Is X causing Y?” but “What is the relationship between X and Y?”  They do not look for a specific disease or cause to treat, but rather to discern the configuration of the signs and symptoms and then to bring that configuration into balance, to restore harmony.

The limitation of the analytic approach is that by focusing on the details it can miss the complex balances and flows that arise between the parts.  The ancient Chinese built their model through synthesis of the entire person and their relationship with the world.  Western medical science is just beginning to understand how important the mind is to health, and how personality does not stop at the skin.  The limitation of synthesis is that it remains largely an art, the human system seen as a whole is so complex that the experienced practitioner may not be aware of the thousands of tiny signs they are synthesizing into their sense of the balance and energy in the patient.

OM’s human model is in no way a simpler model.  Although it describes using simple opposites – hot/cold, dry/damp, Yin/Yang – each balance has its opposite within it, Yin within Yang, to potentially infinite regress.  And although it uses words that have been translated into the English words  such as heart or liver, these describe abstract functions in the model that are not related to any actual body part.

Where a Western physician might see 6 patients with similar symptoms and diagnose the same condition in each, an OM physician will see 6 very different individuals each in a different state of balance and would likely treat each very differently.  But because it sees each person as unique, it cannot be codified into cut-and-dried rules and taught as Western medicine is taught.  Western medicine has developed powerful techniques to treat severe illnesses.   My friends in OM would say, if you have pneumonia go see a Western doctor, but if you have a problem of systemic balance, such as chronic pain, fertility, recurring headaches, go see a person trained in observing your whole self.

As an abstract model, OM represents the human being better in some ways than others.  No doubt some parts are very poor representations.  But as a holistic model, you can’t carve off some parts and leave the whole intact.  OM is an incredibly sophisticated and complex model of the human system built through close observation of people over thousands of years.  In the hands of an experienced practitioner it can achieve results that are simply not possible using the analytic techniques of Western medicine.  The strengths and weaknesses of each approach should be understood and valued for what they are.

Acupuncture has been used to treat seasonal allergies for centuries with great success. According to traditional medicine, treatment is directed toward clearing the nasal passages, supporting the immune system and strengthening the systems of the body to prevent allergic reactions from recurring.

 What are Seasonal Allergies?

Commonly called hay fever or allergic rhinitis, a seasonal allergy is an allergic reaction to a trigger that is typically only present for part of the year, such as spring or fall. Pollens that are spread by the wind are usually the main cause of seasonal allergies. People who are allergic to pollens are also often sensitive to dust mites, animal dander, and molds.

Spring is traditionally the main season when allergies blossom because of new growth on trees and weeds. But fall, with a whole different set of blooming plants as well as leaf mold, is a close second.

About 26 million Americans endure chronic seasonal allergies, while the number of people with milder symptoms may be as high as 40 million, according to the National Center for Health Statistics.

Seasonal allergies are caused by the body’s hypersensitivity to substances in the environment. Symptoms involve primarily the membrane lining the nose, causing allergic rhinitis, or the membrane lining the eyelids and covering the whites of the eyes, causing allergic conjunctivitis.

While there are many Western medications to treat the symptoms of seasonal allergies, these treatments can cause unwanted side effects, such as drowsiness and immune system suppression as well as an over-reliance on medications. These side effects have drawn many people to search for an alternative approach, such as acupuncture and Oriental medicine to manage their allergies.

How Acupuncture Treatments Provide Relief from Allergies

According to Oriental Medicine, allergic rhinitis is related to Wind and a deficiency of the Protective or Wei Qi. Wei Qi is the Qi that flows at the surface of the body as a protective sheath and is responsible for resistance to colds and other respiratory infections. People with a deficiency of Wei Qi catch colds easily and are more susceptible to allergens.

When treating with Oriental medicine, underlying imbalances within the body are addressed and a treatment plan is developed to relieve the acute symptoms of allergic rhinitis while also treating the root problems that are contributing to the body’s reaction to allergens. Treatments often include dietary modification, the use of specifically chosen herbal formulas, and acupuncture.

Studies on Acupuncture for Allergies

There have been several studies that confirm the efficacy of acupuncture and herbal medicine for allergic rhinitis. One such study recently published in November 2008 in the American Journal of Epidemiology showed that acupuncture can significantly relieve allergic rhinitis symptoms.

In the study, 5,237 men and women were analyzed to evaluate the effectiveness of acupuncture in addition to routine care in patients with allergic rhinitis compared with treatment with routine care alone.

In this trial, patients with allergic rhinitis were randomly allocated to receive acupuncture for a 3 month period or to a control group that received no acupuncture. All patients were allowed to receive usual medical care.

Improvements were noted at the 3 month and the 6 month evaluation for the patients receiving acupuncture. The authors of this trial concluded that treating patients with allergic rhinitis in routine care with additional acupuncture leads to clinically relevant and persistent benefits.

Another study that was published in the September 2004 issue of Allergy: European Journal of Allergy and Clinical Immunology found that hay fever sufferers who received weekly acupuncture treatments and took three daily doses of medical herbal ant tea showed fewer symptoms and were less likely to say their hay fever was infringing on their daily activities than people who received placebo treatment. After six weeks it was found that 85 percent of patients showed overall improvements in their hay fever, compared with only 40 percent of the placebo group.

Current statistics state that one in five couples over the age of 30 have difficulty conceiving after one year of trying. Many of these couples are turning to acupuncture and Oriental medicine for a safe, effective and natural solution to have a healthy baby.

Oriental medicine has a long history when it comes to enhancing fertility for both men and women. In fact, evidence that acupuncture and herbal medicine have been used to aid fertility can be found in early medical literature dating back to 3BCE*.

Fertility treatments were first recorded by Zhang Zhong Jing, a famous physician from the Han Dynasty, in his discussion of diseases in women in the Jin Gui Yao Lue (Essentials of the Golden Cabinet).

According to the principles of Oriental medicine, a person’s health is determined by the quality of Qi, the vital life energy, and blood circulating through the body. When Qi and blood are circulating properly the body is property nourished and functioning optimally which, in turn, enhances fertility.

Researchers have confirmed its benefit in the following areas:

1. Regulate menstrual cycle
2. Improve sperm count and motility
3. Reduce stress and anxiety associated with infertility
4. Normalize hormone and endocrine systems.
5. Improve blood flow in the uterus
6. Decrease chance of miscarriage
7. Increase the chance of pregnancy for women undergoing in vitro fertilization (IVF)

Fertility treatments vary from person to person, but are usually scheduled for at least three consecutive cycles (twelve weeks).  Treatments can include acupuncture, customized herbal therapy, stress reduction and dietary counseling. Treatments work alone but are an excellent addition to any Western intervention.  It is highly recommended that both partners come in for treatment, regardless of which partner has the fertility concerns.  The mutual support that comes from working together is not only a relationship benefit, but there is also the Daoist idea that the health of BOTH partners at the moment of conception is of vital importance for the health of the child.  When both potential parents are getting treatment they are not only increasing their own health, but committing to give their child the very best start possible.

*BCE – “Before common era.” This abbreviation has come to replace the previously used B.C. (“before Christ”), and covers the period of history prior to the birth of Christ.

Acupuncture and In Vitro Fertilization

Women undergoing IVF were 65 percent more likely to become pregnant when they combined the procedure with acupuncture, a recent study has shown.

The remarkable success rate occurred across seven acupuncture trials involving 1,366 women in a systematic review and meta-analysis published in a February, 2008 issue of the British Medical Journal. Acupuncture was delivered either just before or just after embryo transfer – a step in the process of in vitro fertilization (IVF) whereby one or several embryos are placed into the uterus. The research was carried out by scientists from the University of Maryland in the United States and the VU University of Amsterdam in Holland. It is thought that acupuncture stimulates the neurotransmitters that trigger the production of gonadotrophin-releasing hormone, which controls the menstrual cycle and a woman’s ovulation. Acupuncture is also thought to stimulate blood flow to the uterus and boost the production of endogenous opioids, inducing the body to relax.

Acupuncture Improves Sperm Quality

A study published in the July 2005 issue of the journal Fertility and Sterility found that acupuncture helped infertile men by apparently helping improve sperm quality in their semen.

In the research project, 28 men received acupuncture in addition to traditional infertility treatments, while another 12 men received only the traditional treatments. All of the men were diagnosed with infertility of unknown origin. Acupuncture was associated with fewer structural defects in the sperm of men who received it, although it had no effect on other abnormalities, such as sperm immaturity or premature death. Previous studies have shown a link between acupuncture and improved sperm production and motility.

While acupuncture is readily accepted as a viable option for low back pain in mainstream modern medicine, there has been little research to prove that it works.  Now there are studies that support the clinical evidence.

In a German study published in the Archives of Internal Medicine, 1,162 adults with chronic, lower back pain were divided into groups treated with the standard pharmaceutical and exercise therapy commonly used in Western medicine and acupuncture. The researchers reported that acupuncture provided relief and lasting benefit to nearly twice as many lower back pain patients as drugs and exercise. Forty-eight percent of the acupuncture patients reported at least a one-third decrease in pain along with improvement in their ability to function, versus 27 percent of the patients treated with conventional methods reporting such benefits.

In the July 2009 issue of Acupuncture Today, they reported findings from a new study.  Published in the May 2009 issue of Archives of Internal Medicine this new study adds to the growing body of evidence showing the efficacy of acupuncture for back pain.

In this study, 638 patients suffering from back pain were divided into four groups:

Individualized acupuncture: This treatment was prescribed by the diagnostician at the beginning of each visit. There were no constraints on number of needles, depth of insertion or needle manipulation. Needles were retained for 18 minutes. Seventy-four distinct points were used.

Standardized acupuncture: This protocol used a standardized acupuncture prescription considered effective for chronic low back pain, including DU3, UB23 on either side, low back Ashi point, UB 40 on either side and KD 3 on either side. All points were needled for 20 minutes, with needle stimulation at 10 minutes and again just prior to removal.

Simulated acupuncture*: This technique used a toothpick in a needle guide tube. All acupuncture points were stimulated with toothpicks at 10 minutes and again at 20 minutes, just before they were “removed.” The acupuncturists simulated insertion and removal of needles at the eight acupuncture points used in the standardized treatment.

Usual care: Participants in this group only received the care, if any, they and their physicians chose. This was mainly medications, and primary care, and physical therapy visits. All participants received a self-care book with information on managing flare-ups, exercises and lifestyle modifications.

At 8 weeks all patients showed improvement, however, the “usual care” group improved only 2.1 points improvement, scored on a disability questionnaire, as opposed to the individualized, standardized and simulated acupuncture groups who improved by 4.4, 4.5 and 4.4 points respectively.

The greater improvement for the acupuncture groups continued to 52 weeks, the end of the study.

Researchers concluded that compared to usual care, acupuncture had beneficial and persisting effects on chronic back pain.  They stated the acupuncture treatments resulted in clinically meaningful improvements in function, and really, isn’t that the bottom line when you’re getting treatment for pain?

*Simulated acupuncture.  Ironically, this simulated acupuncture is known by practitioners by another name – acupressure.  Additionally, many of the earliest acupuncture practitioners used needles-like implements to stimulate a point but did not insert the implement into the body, or if they did it was a very shallow pricking insertion.  Full insertion into the body came later, so it’s no surprise to any acupuncturist that “simulated” acupuncture would work as well as acupuncture with needle insertion.