By Keir Liddle
If there is one thing that annoys me more than anything else about the media it’s articles about alternative health treatments that appear to be little more than adverts for the services of various quacks. I have ranted about this at length before when the Daily Record promoted the services of Nuffield health and when the Scotsman uncritically sang the praises of reflexology and now it appears it is the turn of the Press and Journal to bear the brunt of my ire.
The reason they have roused my anger? Running a story that amounts to almost nothing more than an advert for acupuncturists. The article describes how “acupunturists claim” they can cure fertility problems, insomnia, irritable bowel syndrome, migraine and perhaps most galling of all depression.
Is there any evidence to back up the claims of Acupuncturists regarding what they can and can’t treat?
In the case of depression a systematic review summarise the existing evidence on acupuncture as a therapy for depression. RCTs were included, in which either manual acupuncture or electroacupuncture was compared with any control procedure in subjects with depression. For meta-analysis seven randomised comparative trials involving 509 patients were included. The results of these seven trials are contradictory and even systematic reviews of these data do not arrive at uniform conclusions. However the authors of this review determined that concluded that the evidence from controlled trials is insufficient to conclude whether acupuncture is an effective treatment for depression.
A systematic review of systematic reviews was also conducted to explore if acupuncture could treat depression and eight systematic reviews including seventy-one primary studies were found. Five of the reviews arrived at positive conclusions and three did not. All the positive reviews and most of the positive primary studies originated from China and there are reasons to believe that these reviews are less than reliable. The authors conclude that the effectiveness of acupuncture as a treatment of depression remains unproven.
Claims that acupuncture can treat insomnia were addressed by another systematic review in which We identified 433 possible relevant articles however the methodological quality of these was poor and only included 10 acceptable RCTs. None of these suggested any benefits from acupuncture on sleep scores and the authors concluded that because of the paucity and of the poor quality of the data, the evidence for the effectiveness of acupuncture for the symptomatic treatment of insomnia is limited. Although they suggest that there is room for further, rigorously designed trials to confirm these results.
The authors also conducted a systematic review to determine the overall effectiveness of acupuncture to illustrate again how poor research is in this are out of Seven hundred and nine possibly relevant studies identified only 10 RCTs meet the inclusion criteria. Even still the methodological limitations of the included trials make their contribution to the current clinical evidence of acupuncture somewhat limited. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions. The authors note however that acupuncture remains steeped in controversy as some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response.
The above information can be found in “Complementary Medicine: the Evidence so far” a document produced by Edzard Ernst and his former research team.
The journalist who wrote this puff piece concludes that because the following day they are tired, but relaxed and generally more at ease with the world that they can finally see the point of acupuncture. Perhaps rather than relying on their own personal experience they should have looked at the evidence before advising to “bring on the needles”.
(*Those unawares of the relevance of the headline are advised to look here)