RESEARCH ON ACUPUNCTURE AND ASTHMA
While it is clear that acupuncture trials have failed to provide clear evidence for efficacy for asthma patients and as such “there is not enough evidence to make recommendations about the value of acupuncture in asthma treatment (and) further research needs to consider the complexities and different types of acupuncture” (Linde & Panto, 2001). Nevertheless, there is still quite a bit of anecdotal evidence from experienced practitioners from around the world that asthma can definitely be effectively treated with acupuncture. To my knowledge there are no reports differentiating the effectiveness on different phenotypes or endotypes of asthma, and as such, more research is definitely necessary. However, there are reports that even steroid dependant patients have been able to recover fully using acupuncture (see below).
Acupuncture in itself is hard method to conduct clinical trials on for different reasons. The first is that in TCM each person is assessed based on their pattern discrimination, which means that the treatment protocols differ for each patient, even if there is an overlap in some of the main points. The second is that sham acupuncture is not so easy to apply, as the body responds to just the insertion of needles regardless of placement. And the third is that there are many ways to treat with acupuncture, and it is difficult to discern how much of the treatment is in the technique and the rapport of the practitioner. Acupuncture studies to date are usually based on small sample sizes and are not highly rated by reviewers. This is reflected in the 1991 review in the Journal Thorax, in which 13 clinical trials were reviewed in the effectiveness of treating asthma. None of the trials received a positive criteria in terms of quality, and the conclusion is that the studies give “contradictory results”. It is based on these types of publications that acupuncture is not recommended in the medical literature as a treatment for asthma. Nevertheless, having practiced acupuncture for many years I know from experience that it is very often a very effective medicine for many conditions. We should not “throw the baby out with the bathwater”, and perhaps look at the anecdotal evidence of experienced practitioners and keep an open mind until the final jury is out. Let us have a look at some examples.
In 1998 the Journal of Traditional Chinese Medicine had an article about the experience of Dr. Shao Jingming who has been treating asthma patients for over 60 years. He has found good therapeutic effects on simple bronchial asthma using UB-13, GV-14 and UB-12 as main points to activate lung function and relieve bronchial constriction. By adding further points based on pattern discrimination Dr. Jingming has found that by treating patients in the summer and fall for 3 years can usually result in a complete remission.
Another report in the same journal describes the outcome of twenty steroid-dependant asthmatics in Germany treated by visiting Dr. Hu Jinsheng from the Institute of Acupuncture and Moxibustion in Beijing. 56% of the patients were able to wean off the steroids completely, the remaining patients were able to reduce their steroid intake with the exception of one patient who experienced no improvement (she had anaphylactic asthma around dogs). The points used were St-36, Sp-6, CV-17, GV-20 and Lu-1 alternating with Dingchuan, Chuanxi, GV-14 and UB-13, and other back shu points. Treatment frequency was initially 4 times per week for two weeks, then 3 times and then 2 times for two week intervals. Within 15 treatments there was marked improvement, but Dr. Jinsheng’s recommendation was to treat each patient at least 30 times with 10 treatments in the following summertime to prevent relapse and attain a complete cure.
Medici et. al. (2002) found that acupuncture may have a positive effect on eosinophilic inflammation related to asthma, although their study did not show a clear benefit to the patients in the acupuncture versus sham acupuncture group.
Zwöfler et al (1993) showed a 70% long-term improvement in 17 patients with bronchial asthma that had been treated over a 10 week period with acupuncture at the University of Vienna Dept. of Anaesthesia and Intensive Care.
A study conducted in Kaifeng City’s Department of Acupuncture in the Second Municipal People’s Hospital in Henan, China, involved 192 patients with bronchial asthma. 75% of patients treated with acpuncture showed significant improvement. Long-term curative effects were also observed to be better with patients who experienced immediate positive results after treatments. Effectiveness was also found to be related to duration of needle retention and intensity of subjective needling sensation.
Linde K, Jobst K, Panton J. Acupuncture for chronic asthma (Cochrane Review). In: The Cochrane Library, Issue 2, 2001. Oxford: Update Software
Zhu Yancen and Wang Minji, A brief introduction to Dr. Shao Jingming's experience in acupuncture, Journal of Traditional Chinese Medicine 1998; 18(2): 106-110.
Chen Anmin, Traditional Chinese medicine in treatment of bronchitis and bronchial asthma, Journal of Traditional Chinese Medicine 1998; 18(1): 71-76.
Subhuti Dharmananda, Ph.D., Acupuncture Treatment of Asthma
Institute for Traditional Medicine, Portland, Oregon (online article)
J. Kleijnen,Gr. Riet,P. Knipschild : Acupuncture and asthma: a review of controlled trials, Thorax 1991: 46:799-802
Medici TC1, Grebski E, Wu J, Hinz G, Wüthrich B. Acupuncture and bronchial asthma: a long-term randomized study of the effects of real versus sham acupuncture compared to controls in patients with bronchial asthma. Altern Complement Med. 2002 Dec;8(6):737-50; discussion 751-4.