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Acupuncture beats drug to treat hot flashes: study

 
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squinchboy



Joined: 16 Dec 2006

PostPosted: Tue Sep 30, 2008 6:45 pm    Post subject: Acupuncture beats drug to treat hot flashes: study Reply with quote

Acupuncture beats drug to treat hot flashes: study
Mon Sep 22, 2008 3:24pm EDT

By Will Dunham

WASHINGTON (Reuters) - Acupuncture works as well as a drug commonly used to combat hot flashes and other menopausal symptoms that can accompany breast cancer treatment, and its benefits last longer, without bad side effects, researchers said on Monday.

They tested acupuncture, which began in China more than 2,000 years ago and involves inserting needles into the body, against the Wyeth antidepressant Effexor, for hot flashes in breast cancer patients.

Acupuncture was just as effective as Effexor, also called venlafaxine, in managing symptoms including hot flashes and night sweats, according to researchers led by Dr. Eleanor Walker of Henry Ford Hospital in Detroit.

After 12 weeks of treatment, symptoms were reduced for 15 additional weeks for women who had undergone acupuncture, compared with two weeks for those who had taken Effexor, Walker said.

"It was a more durable effect," Walker, whose findings were presented at an American Society for Therapeutic Radiology and Oncology meeting in Boston, said in a telephone interview.

There were no bad side effects with acupuncture, and women reported increased energy, overall sense of well-being and sexual desire, the researchers said.

Those taking Effexor reported side effects including nausea, headache, difficulty sleeping, dizziness, increased blood pressure, fatigue and anxiety.

The study adds to a growing body of evidence of the value of acupuncture. Earlier research had shown it can reduce chemotherapy-induced nausea and post-operative pain.

"It's been tested directly against a drug that we use regularly. And it's more effective. It has benefits, as opposed to any side-effects," Walker said.

"If you only have to give women treatment three to four times a year as opposed to having to take a pill every day, that's going to be more cost-effective for insurance companies and the patient," Walker added.

Breast cancer patients can develop menopausal symptoms such as hot flashes after treatment with chemotherapy and anti-estrogen hormones. Hormone replacement therapy is often used to treat such symptoms in women without breast cancer, but breast cancer patients cannot use that therapy because it may raise the risk of the cancer's return.

Effexor, one of a class of antidepressants called selective serotonin reuptake inhibitors, is one of the most commonly used drugs to treat hot flashes in these women.

But the researchers said some women opt not to take such drugs out of concern over side effects.

Forty-seven breast cancer patients took part in the study, about half getting acupuncture and half getting Effexor. The women kept track of the number and severity of hot flashes before, during and after the 12 weeks of treatment.

Walker said it is unclear exactly how acupuncture is working. Experts say it may help the activity of the body's natural pain-killing chemicals among other things.
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cj1976



Joined: 26 Oct 2005

PostPosted: Tue Sep 30, 2008 10:24 pm    Post subject: Reply with quote

I was under the impression that acupuncture belongs in the same alternative medicine category as homeopathy, chiropractic and crystal healing. Meaning there is little or no firm scientific evidence to suggest they are anything other than popular placebos.
I tried chim here in Korea when I had sore back. I found that the 'doctor' made it worse, rather than better.
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RACETRAITOR



Joined: 24 Oct 2005
Location: Seoul, South Korea

PostPosted: Tue Sep 30, 2008 11:08 pm    Post subject: Reply with quote

What is this, pseudoscience day?

What'll you post next, "Phrenology proven more accurate than career aptitude tests?"
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ED209



Joined: 17 Oct 2006

PostPosted: Wed Oct 01, 2008 2:39 am    Post subject: Reply with quote

Problems with this 'clinical' trial

http://www.sciencebasedmedicine.org/?p=216


Quote:
The fatal problem with this study is that it is not blinded - there is no sham acupuncture. Patients, therefore, knew if they received the novel treatment that was being studied. The long list of non-specific �benefits� perceived by the subjects who received acupuncture (such as an increased sense of well-being) is evidence for the placebo effect in this group. This weakness is enough to condemn the study.

Further, the study is small, with only 47 subjects. This is especially a problem for an equivalence outcome - the study showed no difference in degree of benefit between acupuncture and Effexor (although there was a difference in duration). This could simply mean that the study was not powerful enough to see any difference.

This small study size is also exacerbated by the fact that there was no placebo group - acupuncture was being compared to Effexor. It is therefore possible that in this study neither treatment worked - since we do not have a placebo control to gauge the absolute effectiveness of either treatment.

Prior studies indicate that Effexor is only �moderately� effective in treating hot flashes. So it is not an unreasonable control treatment, but the modest effectiveness of Effexor as a treatment makes the small sample size even more problematic.

Also, Effexor does have side effects because it is biologically active. It may be that Effexor has moderate benefit for hot flashes but these benefits are offset by the side effects in some cases. Meanwhile, acupuncture may have no effects or side effects -and so the net effect may have been similar.
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mindmetoo



Joined: 02 Feb 2004

PostPosted: Wed Oct 01, 2008 2:50 am    Post subject: Reply with quote

Unless this study uses, at least, sham acupuncture, this study is utterly worthless. Sorry, any study where the patient and the doctor know when the independent variable is changed is a worthless study to science. The question is why are people doing small preliminary studies in acupuncture when bigger blinded trials have been done, and done, and have shown no effect? Most biomedical research starts with small studies like the above to simply provide a base line, demonstrate it won't kill the patient, etc. and then progresses to larger blinded multicentered trials. That's how science really works. And such trials have been done with acupuncture and have turned up negative. Other than a make work project and PR, there appears to be little value doing small unblinded trials. Come on.

http://www.cochrane.org/reviews/en/ab000009.html

Search the Cochrane reviews some time on the efficacy of acupuncture and the conclusions are not at all impressive.

Quote:
Forty-seven breast cancer patients took part in the study, about half getting acupuncture and half getting Effexor. The women kept track of the number and severity of hot flashes before, during and after the 12 weeks of treatment.


Self reporting on a subjective dependent variable where the subject expects the independent variable to have some effect. I'm curious if the OP took any experimental design in university. Let's make it simple: Give 100 people a cheap wine and tell them it's $200 a bottle and most will report it's the finest wine they've ever tasted. See the problem now?
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RACETRAITOR



Joined: 24 Oct 2005
Location: Seoul, South Korea

PostPosted: Wed Oct 01, 2008 6:19 pm    Post subject: Reply with quote

One good way to test acupuncture I think would be to test the pressure points as determined by traditional Chinese medicine versus random points on the body. Most likely, there would be no discernible difference between the two.
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the_beaver



Joined: 15 Jan 2003

PostPosted: Wed Oct 01, 2008 9:40 pm    Post subject: Reply with quote

RACETRAITOR wrote:
One good way to test acupuncture I think would be to test the pressure points as determined by traditional Chinese medicine versus random points on the body. Most likely, there would be no discernible difference between the two.


In the back of my mind I seem to recall a study that found exactly that. Acupuncture was shown to reduce some kinds of pain and discomfort, and the locations where needles were inserted didn't matter.
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mindmetoo



Joined: 02 Feb 2004

PostPosted: Thu Oct 02, 2008 2:56 am    Post subject: Reply with quote

the_beaver wrote:
RACETRAITOR wrote:
One good way to test acupuncture I think would be to test the pressure points as determined by traditional Chinese medicine versus random points on the body. Most likely, there would be no discernible difference between the two.


In the back of my mind I seem to recall a study that found exactly that. Acupuncture was shown to reduce some kinds of pain and discomfort, and the locations where needles were inserted didn't matter.


Better studies at least test that way. If you put the needles in the "true" points or in random points, you get the same effect. Either the patient expects to feel better or a bit of poking with a pin releases some pain killers. It doesn't at all argue for the eastern notion of chi flowing through the body.

Better control is where the needles don't go in but just *beep* the person a bit, making them think they've had needles put in them. Again, oddly, patients getting this sham acupuncture again do just as well.

The down side is in all of these the doctor still knows who is getting it and who isn't. His expectation who he is "truly" helping can also affect outcomes.

There's also the gold standard which is a complicated rig where needles are shielded from both doc and patient. They have some kind of sheath. Needles are randomly assigned. Some only *beep*, some go thru the skin. But the doctor does not know what kind of needle he gets. Again, oddly, patients do as well regardless.

Really good, blinded studies with large number of patients have been done and have shown to have no affect beyond placebo.
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mindmetoo



Joined: 02 Feb 2004

PostPosted: Mon Nov 17, 2008 8:22 am    Post subject: Reply with quote

http://www.theness.com/neurologicablog/?p=419

Acupuncture again fails placebo controls. The stuff plum doesn't work.
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