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Old 20th March 2017, 01:04 PM   #41
ViewsofMars
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Adding more from what I wrote on the previous page.

The contribution of traditional Chinese medicine to sustainable development: Keynote address at the International Conference on the Modernization of Traditional Chinese Medicine

Dr Margaret Chan
Director-General of the World Health Organization
Singapore
23 October 2016

[. . .]
The World Health Organization welcomes this landmark conference on the modernization of traditional Chinese medicine. You seek, in particular, to give traditional medicine an evidence-based place within a health care system where mainstream modern medicine dominates.

Your agenda says many things. You are looking at China’s experiences in clinics and hospitals where traditional and modern medicine offer integrated services, at the role of health services and policy research, and the use of biomedical knowledge to modernize traditional Chinese medicine.

You are considering how more rigorous testing can meet the scientific standards needed for international recognition and acceptance. You are looking at the absolutely critical issue of safety, as demonstrated in well-designed clinical trials.

You are also looking at the performance of traditional Chinese medicine for specific indications, including digestive disorders, and giving attention to the two forms of traditional medicine most often used in modern health systems, namely acupuncture and herbal remedies.

All of these approaches can contribute to the modernization of traditional Chinese medicine.

I am Chinese, and I have used traditional Chinese medicine throughout my lifetime. I have no doubt that these preparations soothe, treat many common ailments, and relieve pain.

But if I have a bad toothache, I go to the dentist.

[. . .]
http://www.who.int/dg/speeches/2016/...ustainable/en/

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Old 20th March 2017, 01:32 PM   #42
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Originally Posted by ViewsofMars View Post
None of the U.S. institutions that I have presented are promoting pseudoscience.
At least one of the U.S. institutions that you have presented has a list including the pseudoscience of acupuncture. Promoting is a bit strong, but not including that acupuncture is pseudoscience gets close to promoting it.
The NCI has a Complementary and Alternative Medicine for Patients list. The list includes antineoplastons as a CAM which are currently only used by the quack Dr. S. R. Burzynski. There is not even a hint that this is basically a 40 year long scam by a single doctor.

Cherry picking positive studies is not good. It is analysis of all studies whether positive or negative that gives an honest assessment. Acupuncture
Quote:
Acupuncture[note 1] is a form of alternative medicine[2] in which thin needles are inserted into the body.[3] It is a key component of traditional Chinese medicine (TCM). TCM theory and practice are not based upon scientific knowledge,[4] and acupuncture is a pseudoscience.[5][6] There are a diverse range of acupuncture theories based on different philosophies,[7] and techniques vary depending on the country.[8] The method used in TCM is likely the most widespread in the US.[2] It is most often used for pain relief,[9][10] though it is also used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment.[11]

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent.[9][12] An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions, and it suggests acupuncture may be effective only for chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache.[12] A systematic review of systematic reviews found little evidence of acupuncture's effectiveness in treating pain.[9] The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits.[13] Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to placebo.[8] A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias.[14] A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care,[15] while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain.[16]

A keynote speech with a personal anecdote is not science !

Last edited by Reality Check; 20th March 2017 at 01:49 PM.
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Old 20th March 2017, 02:08 PM   #43
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I have said before that I don't use wikipedia. Obviously you don't like the World Health Organization. the U.S. National Library of Medicine from the U.S. Department of Health and Human Services and National Institutes of Health:
NIH: National Center for Complementary and Integrative Health. You don't agree with any of them nor do you agree with the American Cancer Society:

Common techniques used for cancer pain

Acupuncture

In acupuncture, very thin needles are put into the body at certain points and at various depths and angles. Each point is thought to control the feeling of pain in a different part of the body. When the needle is put in, some people feel a slight ache, dull pain, tingling, or electrical sensation for a few seconds. Once the needles are in place, they shouldn’t hurt. The needles are usually left in for 15 to 30 minutes. It doesn’t hurt when the needles are removed. Acupuncture is widely available, but it should only be done by a licensed, certified acupuncturist. Ask your cancer care team where to get acupuncture.

Precaution: If you are getting chemotherapy, talk to your doctor before starting acupuncture.

https://www.cancer.org/treatment/tre...ncer-pain.html

I'm done with this topic.

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Old 20th March 2017, 02:33 PM   #44
Reality Check
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Originally Posted by ViewsofMars View Post
I have said before that I don't use wikipedia.
I do use Wikipedia as a source of scientific references - live with it! Lots of irrelevant fantasies again and no science from you.

What you ignored:
  1. The NCI has a Complementary and Alternative Medicine for Patients list.
    The list includes antineoplastons as a CAM which are currently only used by the quack Dr. S. R. Burzynski. There is not even a hint that this is basically a 40 year long scam by a single doctor.
  2. A keynote speech with a personal anecdote is not science !
A WHO conference where a keynote speaker states their personal opinion about acupuncture is not a scientific study of acupuncture.

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Old 20th March 2017, 02:54 PM   #45
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Lots of stuff to read on NICE's website: https://www.evidence.nhs.uk/Search?q...on+acupuncture
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Old 21st March 2017, 03:59 AM   #46
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Originally Posted by Darat View Post
Lots of stuff to read on NICE's website: https://www.evidence.nhs.uk/Search?q...on+acupuncture
A lot of these studies are positive towards acupuncture. Maybe there is something in it after all?
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Old 21st March 2017, 06:38 AM   #47
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Allow me to give an anecdote that I don't understand and can't explain.

My Chinese grandmother-in-law once underwent stomach surgery with no anesthetic aside from acupuncture, because anesthetic was dangerous given her health. I know nothing about this aside from my wife's testimony and it certainly is hard to accept given my skepticism of the practice based on scientific studies. Nonetheless, I regard this testimony as very likely to be accurate.

Given that, I am conflicted about the efficacy of acupuncture. Is it possible that it was purely a placebo effect that allowed her to withstand surgery without pain? I've no idea.

As with all anecdotes, I expect others to take this account with a large grain of salt, but there it is.
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Old 21st March 2017, 07:15 AM   #48
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Originally Posted by Ziggurat View Post
No, you were right the first time. My children can attest to the pain-relieving efficacy of that treatment.
Ha! Very true.
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Old 21st March 2017, 07:26 AM   #49
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As far as I know, sans expertise, acupuncture is identical to homeopathy in every sense: there's no rational basis for it, there's no evidence that rises above noise, and there's a lot of money being made flogging and apologizing for it.

The fact that a physical needle pricks physical skin means nothing at all. I'm too lazy now to look it up, but there's a study where the needles were not pushed into the skin at all (sham acupuncture) and the placebo feelies still kicked-in.

Bottom line, as far as I care, acupuncture is a pointless needle point.
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Old 21st March 2017, 08:09 AM   #50
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Originally Posted by Donn View Post
As far as I know, sans expertise, acupuncture is identical to homeopathy in every sense: there's no rational basis for it, there's no evidence that rises above noise, and there's a lot of money being made flogging and apologizing for it.

The fact that a physical needle pricks physical skin means nothing at all. I'm too lazy now to look it up, but there's a study where the needles were not pushed into the skin at all (sham acupuncture) and the placebo feelies still kicked-in.

Bottom line, as far as I care, acupuncture is a pointless needle point.
Your last line doesn't actually follow from the previous ones. Even if acupuncture is purely a placebo, that doesn't make it pointless, because placebos do work for things like pain. Even if you know it's a placebo. Using acupuncture to cure cancer would be stupid (although as a placebo it might still help with discomfort and appetite from real treatments). Using it to try to treat chronic pain is actually reasonable.

Although this is still my favorite story about placebos. Note in particular the statement near the start about what it can treat, and the statement near the end about its side effects.
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Old 21st March 2017, 10:59 AM   #51
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Originally Posted by Ziggurat View Post
Your last line doesn't actually follow from the previous ones. Even if acupuncture is purely a placebo, that doesn't make it pointless, because placebos do work for things like pain. Even if you know it's a placebo. Using acupuncture to cure cancer would be stupid (although as a placebo it might still help with discomfort and appetite from real treatments). Using it to try to treat chronic pain is actually reasonable.

Although this is still my favorite story about placebos. Note in particular the statement near the start about what it can treat, and the statement near the end about its side effects.

Yeah... I don't know if I agree. If placebos were effective in treating pain would there not be less controversy, more variety and a lot less actual pain?

I find this placebo style argument, which is proper from a skeptical pov, to be an opening through which woo will flow and force the door open.

I suffer from the damnable "IBS" (the vagueness of its definition is another whole topic) and my pain is pretty much constant. I am in trouble and cannot find a way to control it. I feel actual anger when people suggest it's not real, that I can fool myself into feeling better.

(I don't mean your post specifically. My own family still pull the old "just get over it" card. Like I'm making it all up. That article refers to (in quotes, to boot!) "conditions that are defined by “self-observation” symptoms like pain, nausea, or fatigue." I despair.)
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Old 21st March 2017, 12:03 PM   #52
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Originally Posted by rjh01 View Post
A lot of these studies are positive towards acupuncture. Maybe there is something in it after all?

Or perhaps they are biased toward acupuncture due to lack of blinding of the acupuncturist.
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Old 21st March 2017, 01:03 PM   #53
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Originally Posted by Donn View Post
Yeah... I don't know if I agree. If placebos were effective in treating pain would there not be less controversy, more variety and a lot less actual pain?
Not really, because although they work better than doing nothing, they don't always work, and their effects aren't usually dramatic.

Quote:
(I don't mean your post specifically. My own family still pull the old "just get over it" card. Like I'm making it all up. That article refers to (in quotes, to boot!) "conditions that are defined by “self-observation” symptoms like pain, nausea, or fatigue." I despair.)
I can see how that could be interpreted that way, but I don't think it should be read that way. In many cases, chronic pain does seem to be created by the nervous system through some sort of pernicious feedback loop. That doesn't mean that you're making anything up, and it doesn't mean you can just will it away, but it does mean that it's a nervous system issue more than an injury issue. This is where the self-reporting comes in. Acute injuries which cause pain can be assessed by a doctor based on the level of tissue damage. Chronic pain caused by neurological feedback loops cannot be assessed except by the patient. Placebos can do nothing to fix tissue damage, but the mind is a funny thing, and placebos do seem to do something about how the nervous system handles pain sensations.

Here's another good article about pain, this one written from the perspective of a medical doctor who also coaches strength training:
http://startingstrength.com/article/aches-and-pains
One of the things I've noticed myself after having done weightlifting for a while is that my own perception of pain has shifted. Because I've gotten plenty of delayed onset muscle soreness, I'm better able to assess the nature of my aches and pains. I know exactly what a sore muscle feels like, and a pulled tendon or inflamed ligaments don't feel like that. I got a back ache the other day, and it felt like muscle pain. Muscle pain is annoying, but it's nothing to worry about. So I basically ignored it, and it went away quickly. Previously, I would have been much more concerned about it as a possible sign of injury, and I would have tried to tip-toe around it, with any little tinge a cause for concern. And I'm sure it would have lingered on longer. I don't have any less pain than when I started weightlifting, but it seems to bother me less.

I don't know if there's any way to do anything like that in your situation. I'm not dealing with chronic pain, I'm just dealing with intermittent acute pain (and not severe) that's a normal part of not being young anymore. But the complexity of pain perception in either case is still worth noting.
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Old 21st March 2017, 01:25 PM   #54
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Originally Posted by Ziggurat View Post
Not really, because although they work better than doing nothing, they don't always work, and their effects aren't usually dramatic.



I can see how that could be interpreted that way, but I don't think it should be read that way. In many cases, chronic pain does seem to be created by the nervous system through some sort of pernicious feedback loop. That doesn't mean that you're making anything up, and it doesn't mean you can just will it away, but it does mean that it's a nervous system issue more than an injury issue. This is where the self-reporting comes in. Acute injuries which cause pain can be assessed by a doctor based on the level of tissue damage. Chronic pain caused by neurological feedback loops cannot be assessed except by the patient. Placebos can do nothing to fix tissue damage, but the mind is a funny thing, and placebos do seem to do something about how the nervous system handles pain sensations.

Here's another good article about pain, this one written from the perspective of a medical doctor who also coaches strength training:
http://startingstrength.com/article/aches-and-pains
One of the things I've noticed myself after having done weightlifting for a while is that my own perception of pain has shifted. Because I've gotten plenty of delayed onset muscle soreness, I'm better able to assess the nature of my aches and pains. I know exactly what a sore muscle feels like, and a pulled tendon or inflamed ligaments don't feel like that. I got a back ache the other day, and it felt like muscle pain. Muscle pain is annoying, but it's nothing to worry about. So I basically ignored it, and it went away quickly. Previously, I would have been much more concerned about it as a possible sign of injury, and I would have tried to tip-toe around it, with any little tinge a cause for concern. And I'm sure it would have lingered on longer. I don't have any less pain than when I started weightlifting, but it seems to bother me less.

I don't know if there's any way to do anything like that in your situation. I'm not dealing with chronic pain, I'm just dealing with intermittent acute pain (and not severe) that's a normal part of not being young anymore. But the complexity of pain perception in either case is still worth noting.
I better see your point, thanks. It is subjective, to a degree. I am the one who has to communicate my distress to the doctor, but there are physical signs: I am pale, I sweat, my eyes have dark circles, I am visibly shaking and reacting slowly to the world. Etc.

I don't have direct experience of a placebo that worked, but I cannot be certain that in my life I have not met one. It could be that the tablets I take for pain right now are such. It's a sobering thought.

On the other hand, I don't really think so. I'd have to spend energy I barely have, to investigate it. The irony gets a little dizzying.

My objection comes at the form of the argument:
Acupuncture could have something in it because: placebo, nerves, skin, <waves-hand>. This is not a strong line of argument — it's a xerox for homeopathy, chiropractic, etc.

(Okay, homeopathy has far fewer legs.)

Am I wrong?
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Old 21st March 2017, 08:45 PM   #55
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Originally Posted by phiwum View Post
Allow me to give an anecdote that I don't understand and can't explain.

My Chinese grandmother-in-law once underwent stomach surgery with no anesthetic aside from acupuncture, because anesthetic was dangerous given her health. I know nothing about this aside from my wife's testimony and it certainly is hard to accept given my skepticism of the practice based on scientific studies. Nonetheless, I regard this testimony as very likely to be accurate.

Given that, I am conflicted about the efficacy of acupuncture. Is it possible that it was purely a placebo effect that allowed her to withstand surgery without pain? I've no idea.
Some people have a high pain tolerance. I suspect old Chinese women (my mother-in-law is one of them) generally do. Also, a sharp implement like a scalpel can cut without causing much pain. I've recovered from serious surgery without pain medication, and been sliced open and stitched up in various places without pain medication or significant pain.
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