November 5, 2009 8:22 AM
Dr. Jon LaPook investigated Duke Integrative Medicine's non-traditional approach to preventing health issues before they happen. Duke believes this is the future of healthcare.
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One of the largest and most methodologically sound trials of acupuncture was conducted by Haake et al and published in the Arch Intern Med in 2007. It showed that acupuncture had a significant effect on pain. compared to sham acupuncture (placing needles in the wrong location).
1. Haake, M., Muller, H. H., Schade-Brittinger, C., Basler, H. D., Schafer, H., Maier, C., Endres, H. G., Trampisch, H. J., and Molsberger, A. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med 9-24-2007;167(17):1892-1898.
Evidence: Haake et al. conducted a double-blind, randomized controlled trial to compare verum acupuncture to sham acupuncture and guideline-based conventional therapy in patients with chronic low back pain (145). One thousand sixty two patients from 340 outpatient practices, aged 18-86 years (mean ± SD age, 50 ± 15 years) with a history of chronic low back pain for a mean length of eight years were included in the trial. Patients underwent ten 30-minute sessions of verum acupuncture, generally two sessions per week, (N=387) according to principles of traditional Chinese medicine; sham acupuncture (N=387) consisting of superficial needling at nonacupuncture points; or conventional therapy, a combination of drugs, physical therapy, and exercise (N=388). Five additional sessions were offered to patients who had a partial response to treatment (10%-50% reduction in pain intensity). Primary outcome was response after six months, defined as 33% improvement or better on three pain-related items on the Von Korff Chronic Pain Grade Scale questionnaire or 12% improvement or better on the back-specific Hanover Functional Ability Questionnaire. Patients who were nonblinded or had recourse to other than permitted concomitant therapies during follow-up were classified as nonresponders regardless of symptom improvement. At six months, response rate was 47.6% in the verum acupuncture group, 44.2% in the sham acupuncture group, and 27.4% in the conventional therapy group. Differences among groups were as follows: verum vs. sham, 3.4% (95% confidence interval: -3.7% to 10.3%; p=0.39); verum vs. conventional therapy, 20.2% (95% confidence interval: 13.4-26.7%; p<0.001); and sham vs. conventional therapy, 16.8% (95% confidence interval: 10.1-23.4%; p<0.001).