Sunday, February 15, 2015

Bell's Palsy Research shows experienced Acupuncturists achieve far better result

Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial

Acupuncture has been known and accepted by people around the world especially after the recent quarter of century. However, many researches conducted by the western medical researchers showed outcome lesser preferable or beneficial. Some research say acupuncture can be helpful, however, no different from SHAM acupuncture. Some research even reach a result that acupuncture is not helpful. Why there are such a big difference of outcome perceived by researcher and the people in reality? This study has revealed several important factors in regard with acupuncture which long has been practiced in China. Even though the study was conducted just for patients with Bell palsy. However, the strong-stimulation acupuncture, which can elicit a higher intensity of de qi, significantly improved the therapeutic effect. De qi and its related techniques should be properly appreciated in acupuncture practice and research, and should be considered for inclusion in clinical guidelines for acupuncture.

For researcher, they shall understand the design or planning shall include acupuncturists who are capable of producing De qi sensation from patients. Without De qi, it is nature, they will get a conclusion that their acupuncture is no difference from SHAM acupuncture or minimum effect. It is like picking up surgeon, experienced surgeons vs. college graduates. However, scientific research seems not counting on the experience. Research design is a process. Anyone following a same process, shall get the same result. Sensation of acupuncture is very hard to quarantined. Also there are so many difference school practitioners in US and some were not even trained to pursue the outcome of De qi. Sometimes, it is a pity of some practitioners who are trying to mislead patients by advertising their NO Pain acupuncture. I think practitioner shall be frank to their patients in regard to the acupuncture sensations. It is necessary to have acupuncture sensations of De qi in order to heal/balance their body's condition (imbalance).  "de qi, which is necessary to achieve the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints or meridian points".

For better clinical outcome, acupuncture is not just a practice but also a state of art. The later cannot acquire from text book. It is due to many years of practicing, studying, sharping, pursing and understanding. In regard to needle inserting, Practitioner shall work hard to achieve the utmost De qi effect once their treatment plan has been selected.

following is the paper of treating Bell Palsy research.

Xu S, Huang B, Zhang C, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomised controlled trial. CMAJ. 2013;185(6):473
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612150/


Outcomes among patients in the de qi and control groups at 6 months
VariableMean (95% CI)*Adjusted differences of least squares means (95% CI)*
De qi group
n = 167
Control group
n = 171
Intention-to-treat analysis
Complete recovery, no. (%)150 (89.8)121 (70.8)4.2 (2.2–7.8)§
Facial Disability Index191.8 (189.3–194.3)182.0 (179.6–184.5)9.8 (6.3–13.3)
 Physical function98.2 (96.8–99.5)94.8 (93.5–96.1)3.4 (1.5–5.3)
 Social function93.6 (92.2–95.1)87.2 (85.8–88.7)6.4 (4.3–8.4)
WHO Quality of Life (brief version) score340.1 (334.8–345.4)310.3 (305.0–315.5)29.9 (22.3–37.4)
 Physical domain93.8 (92.1–95.4)86.2 (84.6–87.8)7.6 (5.3–9.9)
 Psychological domain80.5 (79.3–81.8)73.0 (71.8–74.2)7.5 (5.8–9.3)
 Social domain85.6 (83.9–87.2)85.6 (83.9–87.2)7.2 (4.8–9.5)
 Environment domain80.2 (78.7–81.7)72.7 (71.2–74.2)7.5 (5.3–9.6)
Per-protocol analysis
Complete recovery, no. (%)150 (94.3)121 (77.1)6.0 (2.7–13.6)§
Facial Disability Index194.8 (193.4–196.1)185.8 (184.5–187.2)9.0 (7.0–10.9)
 Physical function99.8 (99.3–100.3)97.0 (96.5–97.5)2.8 (2.0–3.5)
 Social function95.0 (93.8–96.1)88.9 (87.7–90.0)6.1 (4.4–7.8)
WHO Quality of Life (brief version) score345.1 (340.5–349.7)315.0 (310.4–319.6)30.2 (23.6–36.7)
 Physical domain95.5 (94.1–96.8)88.0 (86.7–89.4)7.4 (5.6–9.3)
 Psychological domain81.7 (80.6–82.8)74.0 (72.9–75.1)7.7 (6.2–9.3)
 Social domain86.7 (85.2–88.2)79.4 (77.9–81.0)7.3 (5.1–9.5)
 Environment domain81.2 (79.8–82.7)73.7 (72.2–75.1)7.6 (5.5–9.6)

Acupuncture treatment shall start as soon as possible as later treatment has less effectiveness.

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