George S. Beltz
NCCAOM Diplomate of Acupuncture
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World Health Organization
Evidence Based Acupuncture
A VALID SOURCE OF MEDICAL INFORMATION ON ACUPUNCTURE
W.H.O. Official Position:
Author: Bartosz Chmielnicki MD (translation: Elżbieta Torbus)
In 2003 World Health Organization published a report about clinical trials researching the effectiveness of acupuncture. More than one hundred indication were discussed and divided into four groups concerning the strength of existing evidence.
It was June 1979 when World Health Organization conducted a symposium on acupuncture in Bejing, China. Doctors who participated in this symposium created a list of 43 diseases that might benefit from acupuncture. This list however was not based on well design clinical trials with appropriate control. The need for performing such studies was mentioned.
Almost twenty years later, in 1997, National Institutes of Health published Consensus Statement, summarizing the state of knowledge drawn from clinical trial concerning acupuncture efficacy. The Authors concluded that there were “promising results showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain” In other conditions, mostly various kinds of pain, acupuncture “might be useful as an adjunct treatment or an acceptable alternative”
One year before publication of the statement mentioned above, the meeting of scientists, called WHO Consultation on Acupuncture, was organized in beautiful Italian town of Cervia. That meeting resulted in creation of official report on the effectiveness of acupuncture based on data from controlled clinical trials. The report was finally published in 2003. The results of 255 trials published before the end of 1998 or beginning of 1999 were included.
Diseases, symptoms or conditions for which acupuncture has been proved to be an effective treatment through controlled trials:
1. Adverse reactions to radiotherapy and/or chemotherapy
2. Allergic rhinitis (including hay fever)
3. Biliary colic
4. Depression (including depressive neurosis and depression following stroke)
5. Dysentery, acute bacillary
6. Dysmenorrhoea, primary
7. Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)
8. Facial pain (including craniomandibular disorders - TMJ, Bell's Palsy, Trigeminal syndromes)
10. Hypertension, essential
11. Hypotension, primary
12. Induction of labour
13. Knee pain
15. Low back pain
16. Malposition of fetus, correction of
17. Morning sickness
18. Nausea and vomiting
19. Neck pain
20. Dental Pain (including temporomandibular dysfunction)
21. Periarthritis of shoulder
22. Postoperative pain
23. Renal colic
24. Rheumatoid arthritis
28. Tennis elbow
Diseases, symptoms or conditions for which the therapeutic effect of acupuncture has been shown but for which further proof is needed:
1. Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm)
2. Acne vulgaris
3. Alcohol dependence and detoxification
4. Bell’s palsy
5. Bronchial asthma
6. Cancer pain
7. Cardiac neurosis
8. Cholecystitis, chronic, with acute exacerbation
10. Competition stress syndrome
11. Craniocerebral injury, closed
12. Diabetes mellitus, non-insulin-dependent
14. Epidemic haemorrhagic fever
15. Epistaxis, simple (without generalized or local disease)
16. Eye pain due to subconjunctival injection
17. Female infertility
18. Facial spasm
19. Female urethral syndrome
20. Fibromyalgia and fasciitis
21. Gastrokinetic disturbance
22. Gouty arthritis
23. Hepatitis B virus carrier status
24. Herpes zoster (human (alpha) herpesvirus 3)
28. Labour pain
29. Lactation, deficiency
30. Male sexual dysfunction, non-organic
31. Ménière disease
32. Neuralgia, post-herpetic
35. Opium, cocaine and heroin dependence
37. Pain due to endoscopic examination
38. Pain in thromboangiitis obliterans
39. Polycystic ovary syndrome (Stein–Leventhal syndrome)
40. Postextubation in children
41. Postoperative convalescence
42. Premenstrual syndrome
43. Prostatitis, chronic
45. Radicular and pseudoradicular pain syndrome
46. Raynaud syndrome, primary
47. Recurrent lower urinary-tract infection
48. Reflex sympathetic dystrophy
49. Retention of urine, traumatic
51. Sialism, drug-induced
52. Sjögren syndrome
53. Sore throat (including tonsillitis)
54. Spine pain, acute
55. Stiff neck
56. Temporomandibular joint dysfunction (TMJ)
57. Tietze syndrome
58. Tobacco dependence
59. Tourette syndrome
60. Ulcerative colitis, chronic
63. Vascular dementia
64. Whooping cough (pertussis)
Diseases, symptoms or conditions for which there are only individual controlled trials reporting some therapeutic effects, but for which acupuncture is worth trying because treatment by conventional and other therapies is difficult:
2. Choroidopathy, central serous
3. Colour blindness
6. Irritable colon syndrome
7. Neuropathic bladder in spinal cord injury
8. Pulmonary heart disease, chronic
9. Small airway obstruction
Diseases, symptoms or conditions for which acupuncture may be tried provided the practitioner has special modern medical knowledge and adequate monitoring equipment:
1. Breathlessness in chronic obstructive pulmonary disease
3. Convulsions in infants
4. Coronary heart disease (angina pectoris)
5. Diarrhoea in infants and young children
6. Encephalitis, viral, in children, late stage
7. Paralysis, progressive bulbar and pseudobulbar
Described report is the only official WHO opinion about the effectiveness of acupuncture. Nevertheless, the level of evidence existing in 1998 was not high. The Authors included findings from Chinese trials which were not evaluated as highly reliable. For that reason the report and acupuncture itself was criticized by many scholars.
The Authors of first WHO report shall and will be remembered forever as brave scientists who dared to prepare wide review of evidence based data concerning the method which was not thought of as “scientific”. Their work was literally groundbreaking and begun a revolution in the perception of acupuncture. The amount of well-designed, published randomized controlled trials on acupuncture started growing rapidly in XXI c. During last fifteen years the results of many RCTs were published, as well as metaanalyses of the effectiveness of acupuncture in the treatment of various diseases. Existing level of evidence is much higher than in 1999.
This website is designed to show current available evidence concerning the effectiveness, safety and economic evaluation of acupuncture.
Copyrights © Bartosz Chmielnicki 2014. All Rights Reserved.