Acupuncture has won medical acceptance
By Judy Foreman, Globe Staff | March 22, 2005

http://www.boston.com/news/globe/health_science/articles/2005/03/22/a
cupuncture_has_won_medical_acceptance?pg=2


I lie down on the table at Wellspace Inc. in Cambridge, sighing in
grateful anticipation as my longtime acupuncturist, Jen Forrest
Evans, goes to work. Some days, she gently pokes needles into my
chronically tight lower back. Other days, she focuses on my pesky
sinuses. Still other days -- the best ones -- the goal is a general
tune-up of my Qi (pronounced ''chee"), the Chinese term for vital
(and sometimes, not vital enough) energy.



This ancient Chinese technique of sticking needles into the skin to
relieve pain, nausea and many other ills never fails to make me feel
better -- more mellow and more energized. I used to think this
lovely state was mostly due to the placebo effect.

But a growing body of evidence -- brain scans, ultrasound and other
techniques -- now shows that acupuncture triggers direct, measurable
effects on the body, including perhaps activation of precisely the
regions of the brain that would be predicted by ancient Chinese
theory. This is potentially good news for the millions of Americans
now scrambling for pain relief in the wake of conflicting government
recommendations on painkillers Vioxx and Celebrex.

At the University of California at Irvine, researchers have shown
that when a needle is placed in a point on the side of the foot that
Chinese theorists associate with vision, sure enough, the visual
cortex in the brain ''lights up" on functional magnetic resonance
imaging scans, though the cause and effect are not totally clear.

Neuroscientist Seung-Schik Yoo of Brigham and Women's Hospital has
shown that when a needle is placed in a point called pericardium 6
on the wrist, known in Chinese medicine as a sensitive point for
nausea, the part of the brain that controls the vestibular system
(which affects balance and nausea) lights up on scans.

While much about acupuncture remains mysterious, at least to
Westerners, a great deal is becoming clearer, thanks to an explosion
of studies using Western scientific techniques.

''The quality and amount of research being conducted now on
acupuncture is improving greatly," said Peter Wayne, director of
research at the New England School of Acupuncture, which has
received $3.2 million in federal grants to study acupuncture.

Acupuncture, an extraordinarily safe technique, has been used so far
by 8.2 million Americans, according to the National Center for
Complementary and Alternative Medicine, a government agency. Some
insurers also now pay for acupuncture.

More than 40 clinical trials have shown that acupuncture reduces
nausea following chemotherapy or surgery, said Ted Kaptchuk, an
assistant professor of medicine at Harvard Medical School who is
also a doctor of Chinese medicine.

The data on chronic pain and headache are somewhat mixed, but
acupuncture clearly helps with dental pain, Kaptchuk said. A recent,
randomized, controlled study of 570 people with osteoarthritis of
the knee showed that real acupuncture, as opposed to a fake form
used as a control, reduced pain and increased function by about 30
percent. ''This is roughly the same effect size" as with ibuprofen-
type drugs, said Dr. Brian Berman, the study leader and director of
the Center for Integrative Medicine at the University of Maryland
School of Medicine. At the moment, Berman recommends that patients
use acupuncture with, not instead of, pain medications, though it
may help reduce the amount of medication needed.


But perhaps the most intriguing scientific question is not whether
acupuncture works but how.

In acupuncture theory, there are 360 major points in the skin that
lie along the 12 major channels, or meridians, in the body, through
which the Qi energy flows. In Western terms, the acupuncture points
correspond to areas of decreased electrical resistance on the skin.

Since the 1970s, Western researchers have known that one of the ways
acupuncture works is by releasing endorphins, the body's natural
painkillers.

Acupuncture seems to calm precisely the part of the brain that
controls the emotional response to pain, said Dr. Kathleen K. S.
Hui, a neuroscientist at the Martinos Center for Biomedical Imaging
at Massachusetts General Hospital, which has a $5 million federal
grant to study acupuncture's effects on the brain. Her brain-scan
studies show decreased activation in deeper brain structures in the
limbic system, which governs emotions and other physiological
functions.

Researchers also have shown that acupuncture boosts levels of
serotonin, which is often deficient in depression, and lowers levels
of norepinephrine and dopamine, which are often elevated in stress
and pain.

Precisely how signals travel from acupuncture points to the brain is
still a matter of some debate. Most researchers, Hui among them,
believe that electrical signals travel along nerve tracts that
branch off from the brain stem to the limbic system.

Others, like Dr. Helene Langevin, a neurologist at the University of
Vermont College of Medicine, believe signals may pass also along the
12 major acupuncture ''meridians" that run through the body.

For years, Western scientists doubted the existence of these
meridians. But, in a series of studies using ultrasound, Langevin
has found evidence that the meridians lie along the sheets of
connective tissue that surround organs. By analyzing meridians in
the arm of a cadaver, Langevin said she discovered ''that 80 percent
of the acupuncture points coincided to where the major connective
tissue plane was. We also did a statistical analysis -- this was not
due to chance."

The bottom line? At long last, Western scientists are beginning to
show, by their standards, just what Chinese acupuncturists have been
saying for millennia: That the effects of acupuncture are real. And
that, at least for certain problems and to some degree, acupuncture
can help relieve pain and suffering.