9.1 Introduction
The aim of this chapter is to give a comprehensive overview
about the scientifically proven or disproved effectiveness of cer-
tain points. It is not the aim of this chapter to prove the effec-
tiveness of acupuncture as such. Based on the latest research,
and 1000 recent human studies with mostly positive results, it is
assumed that acupuncture is effective, despite criticism. If
applied properly it is a well-established, low-risk method with
minimal side effects.
Accordingly, the scope of acupuncture research has developed
from simple questions, such as whether acupuncture works, to
more specific questions such as which acupuncture points can
be used for which conditions and with which stimulation meth-
ods. Furthermore, studies are increasingly designed for precise
diagnoses and treatments based on the principles of Traditional
Chinese Medicine. By the same token, the quality of the bio-
mathematical methods used for the design and analysis of the
studies is increasing. The number of randomised, controlled
studies (RCTs) is also on the rise (Fig. 1).(for example: arthroscopy 5%, beta-blockers 7%, pain medica-
tion 7%, lowering cholesterol medication 8–11%).Fundamental principles for scientific
assessment
One of the prerequisites for including a study in this chapter was
the mention of specific acupuncture points in the abstract. Out
of 1092 studies listed in PubMed until May 2006 under the key-
word ‘acupuncture’, 259 were therefore chosen for this chapter.
In some exceptional cases, studies based on animal experiments
were also considered. Regarding the presentation of the results,
particular emphasis was placed on the role of biomathematical
methods as a parameter for reliability. The terms which allow
assessment of a study in terms of its biomathematical quality
are explained below:
Case study:Usually a retrospective (in hindsight) summary
of results of a particular treatment method in patients with a par-
ticular disorder; no control group or control therapy. Most basic
form of clinical trial.
Controlled study: Usually a prospective (planned in
advance) scientific comparison of a treatment method with a
group of untreated patients or of patients treated with a placebo
or conventional therapy.
Placebo:A form of ‘mock’ or sham therapy. This can take
the form of a pill containing no active ingredient or a therapy
without any authentic foundation. The administration of a
placebo tries to eliminate the non-specific improvement of
the researched disorder (such as the therapist’s care of the
patient and expectations of the patient) compared to the study
group receiving authentic treatment. While the possibilities for
placebo-acupuncture are plentiful, none is free of disadvan-
tages. The effectiveness of acupuncture as a holistic therapy
can be seen as the sum of many psychological as well as
non-specific and specific physiological effects. Depending on
the choice of the acupuncture placebo, certain effects can be
excluded. Based on the concept of the sinew channels, however,
there is an ongoing debate whether non-acupuncture points
exist at all. The highest level of placebo acupuncture is the
so-called ‘sham acupuncture’ where actual deep needling takes
place at non-acupuncture points. The value of a study increases
considerably if it is controlled by a placebo therapy.
Randomisation:The random assignment of a patient to a treat-
ment group, without any influence of either the patient or the
therapist. Randomisation significantly increases the value of a
study.9 Scientific Research
Ingolf Hosbach500
450
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300
250
200
150
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0 RCTsPublications195019581966197019741982198919962003
Fig. 1: Number of all publications and RCTs per year between
1954 and 2005. (Source: PubMed, US National Library of
Medicine, Bethesda, Maryland)
The percentage of RCTs of all publications is nearly 7%, a fig-
ure that compares well with most conventional forms of therapy