The.tudy.lso.ncludes.arnings.gainst practising acupuncture on infants, as well as on children who are over-fatigued, very weak, or have overeaten. 238 When used on children, acupuncture is considered safe when administered by well-trained, licensed practitioners using sterile needles; however, a 2011 review found there was limited research to draw definite conclusions about the overall safety of paediatric acupuncture. 3 The same review found 279 adverse events, 25 of them serious. 3 The adverse events were mostly mild in nature e.g. bruising or bleeding. 3 The prevalence of mild adverse events ranged from 10.1% to 13.5%, an estimated 168 incidences among 1,422 patients. 3 On rare occasions adverse events were serious e.g. cardiac rupture or hemoptysis ; much might have been a result of substandard practice. 3 The incidence of serious adverse events was 5 per one million, which included children and adults. 3 When used during pregnancy, the majority of adverse events caused by acupuncture were mild and transient, with few serious adverse events. 239 The most frequent mild adverse event was needling or unspecified pain, followed by bleeding. 239 Although two deaths one stillbirth and one neonatal death were reported, there was a lack of acupuncture-associated maternal mortality. 239 Limiting the evidence as certain, probable or possible in the causality evaluation, the estimated incidence of adverse events following acupuncture in pregnant women was 131 per 10,000. 239 Although acupuncture is not contraindicated in pregnant women, some specific acupuncture points are particularly sensitive to needle insertion; these spots, as well as the abdominal region, should be avoided during pregnancy. 2 Four adverse events associated with moxibustion were bruising, burns and cellulitis, spinal epidural abscess, and large superficial basal cell carcinoma. 17 Ten adverse events were associated with cupping. 17 The minor ones were keloid scarring, burns, and bullae ; 17 the serious ones were acquired haemophilia A, stroke following cupping on the back and neck, factitious panniculitis, reversible cardiac hypertrophy, and iron deficiency anaemia . 17 A 2013 meta-analysis found that acupuncture for chronic low back pain was cost-effective as a complement to standard care, but not as a substitute for standard care except in cases where co morbid depression presented. 20 The same meta-analysis found there was no difference between sham and non-sham acupuncture. 20 A 2011 systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain. 21 A 2010 systematic review found that the cost-effectiveness of acupuncture could not be concluded. 94 A 2012 review found that acupuncture seems to be cost-effective for some pain conditions. 240 Risk of fBorgoing conventional medical care As with other alternative medicines, unethical or naive practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. 5 241 Profession ethical codes set by accrediting organizations such as the National Certification Commission for Acupuncture and Oriental Medicine require practitioners to make “timely referrals to other health care professionals as may be appropriate.” 242 Stephen Barrett states that there is a “risk that an acupuncturist whose approach to diagnosis is not based on scientific concepts will fail to diagnose a dangerous condition”. 243 Main articles: Qi, Traditional Chinese medicine, Meridian Chinese medicine, and Acupuncture point Old Chinese medical chart of acupuncture meridians Acupuncture is a substantial part of traditional Chinese medicine ACM. 4 Early acupuncture beliefs relied on concepts that are common in ACM, such as a life force energy called qi. 244 Qi was believed to flow from the body's primary organs zang-fu organs to the “superficial” body tissues of the skin, muscles, tendons, bones, and joints, citation needed through channels called meridians. 245 Acupuncture points where needles are inserted are mainly but not always found at locations along the meridians. 246 Acupuncture points not found along a meridian are called extraordinary points and those with no designated site are called “A-Shi” points. 246 In ACM, disease is generally perceived as a disharmony or imbalance in energies such as yin, yang, qi, xuĕ, zàng-fǔ, meridians, and of the interaction between the body and the environment. 247 Therapy is based on which “pattern of disharmony” can be identified. 248 249 For example, some diseases are believed to be caused by meridians being invaded with an excess of wind, cold, and damp. 250 In order to determine which pattern is at hand, practitioners examine things like the colon and shape of the tongue, the relative strength of pulse-points, the smell of the breath, the quality of breathing, or the sound of the voice. 251 252 ACM and its concept of disease does not strongly differentiate between the cause and effect of symptoms. 253 Scientific research has not supported the existence of qi, meridians, or yin and yang. n 1 25 26 A Nature editorial described ACM as “fraught with pseudo-science”, with the majority of its treatments having no logical mechanism of action . 254 Quackwatch states that “ACM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. pubbed Abstract lei Z: Clinical observation on therapeutic effect of acupuncture at zusanli for leukopenia. It cannot be identified as an MCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. Pregnant women, patients with lymphedema, those wearing pacemakers, and those with low platelet count should inform their practitioners before receiving treatment. It is important to seek treatment from a qualified acupuncture practitioner who uses a chinese herbal remedies new set of disposable single-use needles for each patient. pubbed Abstract Bragg BP, memos Junior A, Aves FA, et al.: Acupuncture for the prevention of radiationinduced xerostomia in patients with head and neck cancer. Korea is believed to be the first country in Asia that acupuncture spread to outside of China. 30 Within Korea there is a legend that acupuncture was developed by emperor Dan gun, though it is more likely to have been brought into Korea from a Chinese colonial prefecture in 514 AD. 30 :262-263 Acupuncture use was commonplace in Korea by the 6th century. Ca Anesthesiol 41 6: 621-4, 1993. The National Certification Commission for Acupuncture and Oriental Medicine offers national certification examinations for practitioners of acupuncture and traditional Chinese medicine ACM wow.nccaom.org ; most, but not all, states require this certification. Lower quality studies have hampered the widespread acceptability of acupuncture, with some deeming the inter-personal skills of the practitioner to be more powerful than the needle or its equivalent. Four of the studies were ex vino laboratory investigations using blood or tissue samples; 1 - 3, 5 the remaining study was an animal behavioural study testing the effect of acupuncture on chemotherapy -induced nausea and vomiting. 4 The four ex vino studies suggested that acupuncture is useful in anticancer therapy either by actively stimulating immune activity or by preventing chemotherapy suppression of immune activity. 1 - 3, 5 In a study involving normal rats, electro acupuncture EA 1 Hz, 5–20 V, 1-millisecond pulse width, 2 hours applied at the point Zu-Sanli S36 for 2 hours daily on 3 consecutive days enhanced the cytotoxicity of sOlenic natural killer K cells compared with a stimulation of a non acupuncture control point in the abdominal muscle. 3 Another study found that K cell activity and T lymphocyte transformation rate were increased in a mouse model of transplanted mammary cancer compared with a control P < .05 after eight sessions of acupuncture and moxibustion . 2 A study involving tumour bearing mice sarcoma S180 using moxibustion to warm the acupuncture point Guanyuan CV4 once a day for 10 days found significantly increased production of erythrocytes, compared with a non treatment control. 1 The fourth ex vino study used a rat model to investigate the effect of EA on nerve growth factor NSF, which is associated with poly cystic ovary syndrome cos. pubbed Abstract jong DJ, Kim B, Oh JG, et al.: Regulatory effect of cytosine production in asthma patients by SOOJI chem Koryo Hand Acupuncture Therapy. Acupuncture treatments are generally safe and well tolerated by most patients, including paediatric patients and the elderly. Cochran Database cyst Rev 2: CD002285, 2006. Evidence from the body suggests Otzi suffered from these conditions. 31 This has been cited as evidence that practices similar to acupuncture may have been practice elsewhere in Eurasia during the early Bronze Age ; 266 however, The Oxford Handbook of the History of Medicine calls this theory “speculative”. 32 It is considered unlikely that acupuncture was practice before 2000 BC. 265 The Ötzi the Iceman's tattoo marks suggest to some experts that an acupuncture-like treatment was previously used in Europe 5 millennia ago. 9 Acupuncture may have been practice during the Neolithic era, near the end of the stone age, using sharpened stones called Brian shi . 30 :70 Many Chinese texts from later eras refer to sharp stones called “plen”, which means “stone probe”, that may have been used for acupuncture purposes. 30 :70 The ancient Chinese medical text, Huangdi Beijing, indicates that sharp stones were believed at-the-time to cure illnesses at or near the body's surface, perhaps because of the short depth a stone could penetrate. 30 :71 However, it is more likely that stones were used for other medical purposes, such as puncturing a growth to drain its pus . 28 31 The Mawangdui texts, which are believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses, and moxibustion, but not for acupuncture. 29 It is also speculated that these stones may have been used for blood-letting, due to the ancient Chinese belief that illnesses were caused by demons within the body that could be killed or released. 267 It is likely blood-letting was an antecedent to acupuncture. 31 According to historians Lu Gwei-djen and Joseph Needham, there is substantial evidence that acupuncture may have begun around 600 BC. 30 Some hieroglyphs and pictographs from that era suggests acupuncture and moxibustion were practice. 268 However, historians Gwei-djen and Needham said it was unlikely a needle could be made out of the materials available in China during this time period. 30 :71-72 It is possible Bronze was used for early acupuncture needles. pubbed Abstract He BP, Friedrich M, Ertan A, et al.: Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer.
Euro J burg Oncol 11 4: 389-94, 1985. Acupuncture is an integral component of Traditional Chinese Medicine ACM that originated more than 2,000 years ago. Timely diagnosis and early surgery offer the most favourable possibility of a cure for solid tumours.