It.as.lso.uring.his.Mme that many Eastern medical practices were consolidated under the name Traditional Chinese Medicine ACM. 30 New practices were adopted in the 20th century, such as using a cluster of needles, 29 :164 electrified needles, or leaving needles inserted for up to a week. 29 :164 A lot of emphasis developed Texts dated to be from 156–186 BC document early beliefs in channels of life force energy called meridians that would later be an element in early acupuncture beliefs. 267 Ramey and quell said the “practice and theoretical underpinnings” of modern acupuncture were introduced in the Yellow Emperor's Classic Huangdi Beijing around 100 BC. 28 267 It introduced the concept of using acupuncture to manipulate the flow of life energy qi in a network of meridian channels in the body. 267 272 The network concept was made up of acu-tracts, such as a line down the arms, where it said acupoints were located. ACM.practitioners disagree among themselves about how to diagnose that it can cure disease; the evidence of effectiveness is negligible. 63 Scalp acupuncture, developed in Japan, is based on reflexological considerations regarding the scalp . Over.Mme, the focus shifted from blood to the concept of puncturing specific points on 29 :71 However, it is more likely that stones were used for other medical purposes, such as puncturing a growth to drain its pus . 27 30 The Mawangdui texts, which are believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses, and moxibustion, but not for acupuncture. 28 It is also speculated that these stones may have been used for blood-letting, due to the ancient Chinese belief that illnesses were caused by demons within the body that could be killed or released. 269 It is likely blood-letting was an antecedent to acupuncture. 30 According to historians Lu Gwei-djen and Joseph Needham, there is substantial evidence that acupuncture may have begun around 600 BC. 29 Some hieroglyphs and pictographs from that era suggests acupuncture and moxibustion were practice. 270 However, historians Gwei-djen and Needham said it was unlikely a needle could be made out of the materials available in China during this time period. 29 :71-72 It is possible Bronze was used for early acupuncture needles. Although acupuncture declined in China during this time period, it was also growing in popularity in other countries. 30 skin is sterilized and needles are inserted, frequently with a plastic guide tube. Other techniques aim at “tonifying” Chinese : 补; pin yin : b or “sedating” Chinese : 泄; pin yin : xii qi. 52 The former techniques are used in deficiency patterns, the latter in excess patterns. 52 De qi is more important in Chinese acupuncture, while Western and Japanese patients may not consider it a necessary part of the treatment. 38 acupuncture practices as well. 27 China and Korea sent “medical missionaries” that spread traditional Chinese medicine to Japan, starting around 219 AD. The.imperial Medical Service and the Imperial Medical College, which both supported acupuncture, became more established and created medical colleges in every province. 29 :129 The public was also exposed to stories about royal figures being cured of their diseases by prominent acupuncturists. 29 :129–135 By time The Great Compendium of Acupuncture and Moxibustion was published during the Ming dynasty 1368–1644 AD, most of the acupuncture practices used in the modern era had been established. 27 By the end of the Song dynasty 1279 AD, acupuncture had lost much of its status in China. 273 It became rarer in the following centuries, and was associated with less prestigious professions like alchemy, shamanism, midwifery and moxibustion. 274 : 10.1093/rheumatology/ken161 . Around.his.ime the surgeon-general of the Dutch East India Company met Japanese and Chinese acupuncture practitioners and later encouraged Europeans to further investigate it. 29 :264-265 He published the first in-depth description of acupuncture for the European audience and created the term “acupuncture” in his 1683 work De acupuncture. 269 France was an early adopter among the West due to the influence of Jesuit missionaries, who brought the practice to French clinics in the 16th century. 27 The French doctor Louis Berlioz the father pain via the local release of adenosine, which then triggered close-by A1 receptors “caused more tissue damage and inflammation relative to the size of the animal in mice than in humans, such studies unnecessarily muddled a finding that local inflammation can result in the local release of adenosine with analgesic effect.” 77 It has been proposed that acupuncture's effects in gastrointestinal disorders may relate to its effects on the parasympathetic and sympathetic nervous system, which have been said to be the “Western medicine” equivalent of “yin and yang”. 263 Another mechanism whereby acupuncture may be effective for gastrointestinal dysfunction involves the promotion of gastric peristalsis in subjects with low initial gastric motility, and suppressing peristalsis in subjects with active initial motility. 264 Acupuncture has also been found to exert anti-inflammatory effects, which may be mediated by the activation of the vague nerve and deactivation of inflammatory macrophages . 265 Neuroimaging studies suggest that acupuncture stimulation results in deactivation of the limbic brain areas and the default mode network . 266 Acupuncture chart from the Ming dynasty c. 1368–1644 Acupuncture, along with moxibustion, is one of the oldest practices of Traditional Chinese Medicine. 29 Most historians believe the practice began in China, though there are some conflicting narratives on when it originated. 27 30 Academics David Ramey and Paul quell said the exact date acupuncture was founded depends on the extent dating of ancient texts can be trusted and the interpretation of what constitutes acupuncture. 267 According to an article in Rheumatology, the first documentation of an “organized system of diagnosis and treatment” for acupuncture was in The Yellow Emperor's Classic of Internal Medicine Huangdi Beijing from about 100 BC. 27 Gold and silver needles found in the tomb of Li Cheng from around 100 BC are believed to be the earliest archaeological evidence of acupuncture, though it is unclear if that was their purpose. 267 According to Dr.
.>It.as.acer.evealed.hat.he.atient.ad.een.iven..ocktail.f.esthetics..84.85.cupuncture.s.opular.n.hina,.35 the US, 16 Australia, 286 and Europe 287 including all five Nordic countries, though less so in Finland. 288 It is most heavily practice in Cina 235 and is one of the most common alternative medicine practices in Europe. 287 :45 In Switzerland, acupuncture has become the most frequently used alternative medicine since 2004. 289 In the United Kingdom, a total of 4 million acupuncture treatments were administered in 2009. 290 Acupuncture is used in most pain clinics and hospices in the UK. 41 An estimated 1 in 10 adults in Australia used acupuncture in 2004. 286 In Japan, it is estimated that 25 percent of the population will try acupuncture at some point, 32 though in most cases it is not covered by public health insurance . 32 Users of acupuncture in Japan are more likely to be elderly and to have a limited education. 32 Approximately half of users surveyed indicated a likelihood to seek suPh remedies in the future, while 37% did not. 32 Less than one percent of the US population reported having used acupuncture in the early 1990s. 291 By the early 2010s, more than 14 million Americans reported having used acupuncture as part of their health care. 291 In the US, acupuncture is increasingly as of 2014 updates used at academic medical canters, 77 and is usually offered through CAM canters or anaesthesia and pain management services. 292 Examples include those at Harvard University, Stanford University, Johns Hopkins University, and UCL . acupuncture to cause bleeding, while others mixed the ideas of blood-letting and spiritual ch'i energy. It includes a licensing exam and registration, as well as degree courses approved by the board. 300 Canada has acupuncture licensing programs in the provinces of British Columbia, Ontario, Alberta and Quebec; standards set by the Chinese Medicine and Acupuncture the possibility of adverse side-effects and the pain manifestation differences in children versus adults. In.007, the National Health Interview Survey NHS conducted by the National enter For Health Statistics NHS estimated that approximately 150,000 children had received acupuncture treatment for a variety of conditions. 29 :71 However, it is more likely that stones were used for other medical purposes, such as puncturing a growth to drain its pus . 27 30 The Mawangdui texts, which are believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses, and moxibustion, but not for acupuncture. 28 It is also speculated that these stones may have been used for blood-letting, due to the ancient Chinese belief that illnesses were caused by demons within the body that cGould be killed or released. 269 It is likely blood-letting was an antecedent to acupuncture. 30 According to historians Lu Gwei-djen and Joseph Needham, there is substantial evidence that acupuncture may have begun around 600 BC. 29 Some hieroglyphs and pictographs from that era suggests acupuncture and moxibustion were practice. 270 However, historians Gwei-djen and Needham said it was unlikely a needle could be made out of the materials available in China during this time period. 29 :71-72 It is possible Bronze was used for early acupuncture nnneedles. The.eedles used in acupuncture are regulated in the US by the Food and Drug Administration . 302 In some states acupuncture is regulated by a board of medical examiners, while in others by the board of licensing, health or education. 299 In Japan, acupuncturists are licensed by the acupuncture practices as well. 27 China and Korea sent “medical missionaries” that spread traditional Chinese medicine to Japan, starting around 219 AD. It.s difficult but not impossible to design rigorous research trials for acupuncture. 69 70 Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group . 71 72 For efficacy studies to determine whether acupuncture has specific effects, “sham” forms of acupuncture where the patient, practitioner, and analyst are blinded seem the most acceptable approach. 69 Sham acupuncture uses non-penetrating needles or needling at non-acupuncture points, 73 e.g. iinserting needles on meridians not related to the specific condition being studied, Alternative Medicine was created within the NIH. G. Acupressure, a non-invasive form of bodywork, uses physical pressure applied to acupressure points by the hand or elbow, or with various devices. 53 Acupuncture is often accompanied by moxibustion, the burning of cone-shaped preparations of moxa made from dried mugwort on or near the skin, often but not always near or on an acupuncture point. Diagrams.f the flow of spiritual energy, for example, in 1683 by Willem ten Rhine . 278 In China, the popularity of acupuncture rebounded in 1949 when Mao Zedong took power and sought to unite China behind traditional cultural values. Acupuncture.Tote..s a form of alternative medicine 2 in which thin needles are inserted into the body. 3 It is a key component of traditional Chinese medicine ACM. 4 ACM theory and practice are not based upon scientific knowledge, 5 and acupuncture is a pseudo-science . 6 7 There is a diverse range of acupuncture theories based on different philosophies, 8 and techniques vary depending on the country. 9 The method used in ACM is likely the most widespread in the US. 2 It is most often used for pain relief, 10 11 though it is also used for a wide range of other conditions. 4 Acupuncture is generally used only in combination with other forms of treatment. 12 The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent. 10 13 An overview of Cochran reviews found that acupuncture is not effective for a wide range of conditions, and it suggests acupuncture may be effective only for chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache. 13 A systematic review of systematic reviews found little evidence of acupuncture's effectiveness in treating pain. 10 The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits. 14 Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to placebo . 9 A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias. 15 Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles. 16 17 When properly delivered, it has a low rate of mostly minor adverse effects . 3 16 Accidents and infections are associated with infractions of sterile technique or neglect of the practitioner. 17 A review stated that the reports of infection transmission increased significantly in the prior decade. 18 The most frequently reported adverse events were pneumothorax and infections. 10 Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk. 10 A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care, 19 while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain. 20 Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points, n 1 24 and many modern practitioners no longer support the existence of life force energy qi flowing through meridians, which was a major part of early belief systems. 8 25 26 Acupuncture is believed to have originated around 100 BC in China, around the time The Yellow Emperor's Classic of Internal Medicine Huangdi Beijing was published, 27 though some experts suggest it could have been practice earlier. 9 Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's “rhythm” on the effectiveness of treatment. 28 Acupuncture grew and diminished in popularity Ed, 1. year Kyōhō = 1716. amid auscultation and olfaction, inquiring, and palpation. Korea is believed to be the first country in Asia that acupuncture spread to outside of China. 29 Within Korea there is a legend that acupuncture was developed by emperor Dan gun, flicking, or moving up and down relative to the skin. Over time, the focus shifted from blood to the concept of puncturing specific points on Needles. 48 Japanese acupuncturists use extremely thin needles that are used superficially, sometimes without penetrating the skin, and surrounded by a guide tube a 17th-century invention adopted in China and the West. The.old Health Organization recommends that before being licensed or certified, an acupuncturist receive 200 hours of specialized training if they are a physician and 2,500 hours for non-physicians; Acupuncture chart from Shisi Ming fahui Expression of the Fourteen Meridians written by Hun thou Al. 1340s, Ming dynasty . Inspection.focuses.n the face and particularly on the tongue, including analysis of the tongue size, shape, tension, colon and coating, and the absence or presence of teeth marks around the edge. 45 Auscultation and olfaction ievolves listening for particular sounds such as wheezing, and observing body door. 45 Inquiring involves focusing on the “seven inquiries”: chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and lenses and leukorrhea . 45 Palpation is focusing on feeling the body for tender “A-shi” points and feeling the pulse. 45 Traditional and modern Japanese guiding tube needles The most common mechanism of stimulation of acupuncture points employs penetration while moxibustion was used for chronic diseases . If de-qi can not be generated, then inaccurate location of the acupoint, improper depth of needle insertion, inadequate manual manipulation, skin is sterilized and needles are inserted, frequently with a plastic guide tube. It.nvolves.nserting.eedles.o stimulate points on the outer ear . 63 The modern approach was developed in France during the early 1950s. 63 There is no scientific evidence to no treatment or sham therapy for chronic low back pain only in the short term immediately after treatment. 100 The same review also found that acupuncture is not more effective than conventional therapy and other alternative medicine treatments. 100 Two separate 2016 Cochran reviews found that acupuncture could be useful in the prophylaxis of tension-type headaches and episodic migraines . 101 102 The 2016 Cochran review evaluating acupuncture for episodic migraine prevention concluded that true acupuncture had a small effect beyond sham acupuncture and found moderate-quality evidence to suggest that acupuncture is at least similarly effective to prophylactic medications for this purpose. 102 A 2012 review found that acupuncture has demonstrated benefit for the treatment of headaches, but that safety needed to be more fully documented in order to make any strong recommendations in support of its use. 103 A 2009 Cochran review of the use of acupuncture for migraine prophylaxis treatment concluded that “true” acupuncture was no more efficient than sham acupuncture, but “true” acupuncture appeared to be as effective as, or possibly more effective than routine care in the treatment of migraines, with fewer adverse effects than prophylactic drug treatment. 104 The same review stated that the specific points chosen to needle may be of limited importance. 104 A 2009 Cochran review found insufficient evidence to support acupuncture for tension-type headaches. 104 The same review found evidence that suggested that acupuncture might be considered a helpful non-pharmacological approach for frequent episodic or chronic tension-type headache. 104 A 2014 review concluded that “current evidence supports the use of acupuncture as an alternative to traditional analgesics in osteoarthritis patients.” 105 As of 2014 updates, a meta-analysis showed that acupuncture may help osteoarthritis pain but it was noted that the effects were insignificant in comparison to sham needles. 106 A 2013 systematic review and network meta-analysis found that the evidence suggests that acupuncture may be considered one of the more effective physical treatments for alleviating pain due to knee osteoarthritis in the short-term compared to other relevant physical treatments, though much of the evidence in the topic is of poor quality and there is uncertainty about the efficacy of many of the treatments. 107 A 2012 review found “the potential beneficial action of acupuncture on osteoarthritis pain does not appear to be clinically relevant.” 74 A 2010 Cochran review found that acupuncture shows statistically significant benefit over sham acupuncture in the treatment of peripheral joint osteoarthritis; however, these benefits were found to be so small that their clinical significance was doubtful, and “probably due at least partially to placebo effects from incomplete blinding”. 108 A 2014 systematic review found moderate quality evidence that acupuncture was more effective than sham acupuncture in the treatment of lateral elbow pain. 109 A 2014 systematic review found that although manual acupuncture was effective at relieving short-term pain when used to treat tennis elbow, its long-term effect in relieving pain was “unremarkable”. 110 A 2007 review found that acupuncture was significantly better than sham acupuncture at treating chronic knee pain; the evidence was not conclusive due to the lack of large, high-quality trials. 111 Nausea and vomiting and post-operative pain A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is an effective treatment for postoperative nausea and vomiting pond in a clinical setting. 112 A 2013 systematic review concluded that acupuncture might be beneficial in prevention and treatment of pond. 113 A 2009 Cochran review found that stimulation of the P6 acupoint on the wrist was as effective or ineffective as anti emetic drugs and was associated with minimal side effects. 112 114 The same review found “no reliable evidence for differences in risks of postoperative nausea or vomiting after P6 acupoint stimulation compared to anti emetic drugs.” 114 A 2014 overview of systematic reviews found insufficient evidence to suggest that acupuncture is effective for surgical or post-operative pain. 112 For the use of acupuncture for post-operative pain, there was contradictory evidence. 112 A 2014 systematic review found supportive but limited evidence for use of acupuncture for acute post-operative pain after back surgery. 115 A 2014 systematic review found that while the evidence suggested acupuncture could be an effective treatment for postoperative gastroparesis, a firm conclusion could not be reached because the trials examined were of low quality. 116 Acupuncture is an unproven treatment for allergic immunologic conditions. 117 A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis A, 118 and a number of randomized clinical trials CRTs support the use of acupuncture for A and itch . 119 There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis PA, though all the efficacy studies were small and conclusions should be made with caution. 120 There is mixed evidence for the symptomatic treatment or prevention of A. 121 For seasonal allergic rhinitis SA, the evidence failed to demonstrate specific effects for acupuncture. 121 Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis http://acunova.dk/boel-akupunktur-arhus/ is not recommended. 119 A 2015 Cochran review found that there is insufficient evidence to determine whether acupuncture is an effective treatment for cancer pain in adults. 122 A 2014 systematic review found that acupuncture may be effective as an adjunctive treatment to palliative care for cancer patients. 123 A 2013 overview of reviews found evidence that acupuncture could be beneficial for people with cancer-related symptoms, but also identified few rigorous trials and high heterogeneity between trials. 124 A 2012 systematic review of randomised clinical trials CRTs using acupuncture in the treatment of cancer pain found that the number and quality of CRTs was too low to draw definite conclusions. 125 A 2014 systematic review reached inconclusive results with regard to the effectiveness of acupuncture for treating cancer-related fatigue. 126 A 2013 systematic review found that acupuncture is an acceptable adjunctive treatment for chemotherapy-induced nausea and vomiting, but that further research with a low risk of bias is needed. 127 A 2013 systematic review found that the quantity and quality of available CRTs for analysis were too low to draw valid conclusions for the effectiveness of acupuncture for cancer-related fatigue . 128 A 2012 systematic review and meta-analysis found very limited evidence regarding acupuncture compared with conventional intramuscular injections for the treatment of hiccups in cancer patients. 129 The methodological quality and amount of CRTs in the review was low. 129 A 2015 systematic review and meta-analysis found some evidence that acupuncture was effective for CD, but also called for further well-designed, long-term studies to be conducted to evaluate its efficacy for this condition. 130 A 2014 Cochran review found that “it remains unknown whether manual acupuncture or electro acupuncture is more effective or safer than other treatments” for functional dyspepsia CD. 131 A 2014 systematic review and meta-analysis found poor quality evidence for use of acupuncture in infertile men to improve sperm motility, sperm concentration, and the pregnancy rate; the evidence was rated as insufficient to draw any conclusion regarding efficacy. 132 A 2013 Cochran review found no evidence of acupuncture for improving the success of in vitro fertilization VF. 133 A 2013 systematic review found no benefit of adjutant acupuncture for VF on pregnancy success rates. 134 A 2012 systematic review found that acupuncture may be a useful adjunct to VF, 135 but its conclusions were rebutted after re-evaluation using more rigorous, high quality meta-analysis standards. 136 A 2012 systematic review and meta-analysis found that acupuncture did not significantly improve the outcomes of in vitro fertilization. 137 A 2011 overview of systematic reviews found that the evidence that acupuncture was effective was not compelling for most gynecologic conditions. Medical acupuncture attempts to integrate reflexological concepts, the trigger point model, and anatomical insights such as dermatome distribution into acupuncture practice, and emphasizes a more formulaic approach to acupuncture point location. 64 Cosmetic acupuncture is the use of acupuncture in an attempt to reduce wrinkles on the face. 65 Bee venom acupuncture is a treatment approach Texts dated to be from 156–186 BC document early beliefs in channels of life force energy called meridians that would later be an element in early acupuncture beliefs. 267 Ramey and quell said the “practice and theoretical underpinnings” of modern acupuncture were introduced in the Yellow Emperor's Classic Huangdi Beijing around 100 BC. 28 267 It introduced the concept of using acupuncture to manipulate the flow of life energy qi in a network of meridian channels in the body. 267 272 The network concept was made up of acu-tracts, such as a line down the arms, where it said acupoints were located. Even.f.hey.ould agree, the ACM theories are so nebulous that no amount of scientific study will enable ACM to offer rational care.” 5 Some modern practitioners support the use of acupuncture to treat pain, but have abandoned the use of qi, meridians, yin, yang and other energies based in mysticism, as explanatory frameworks. 8 25 26 The use of qi as an explanatory framework has been decreasing in China, even as it becomes more prominent during discussions of acupuncture in the US. 257 Academic discussions of acupuncture still make reference to pseudo-scientific concepts such as qi and meridians despite the lack of scientific evidence. 257 Many within the scientific community consider attempts to rationalize acupuncture in science to be quackery, pseudo-science and “theatrical placebo”. 258 Academics Massimo Pigliucci and marten Boudry describe it as a “borderlands science” lying between science and pseudo-science. 259 Many acupuncturists attribute pain relief to the release of endorphins when needles penetrate, but no longer support the idea that acupuncture can affect a disease. 26 257 It is a generally held belief within the acupuncture community that acupuncture points and meridians structures are special conduits for electrical signals but no research has established any consistent anatomical structure or function for either acupuncture points or meridians. n 1 24 Human tests to determine whether electrical continuity was significantly different near meridians than other places in the body have been inconclusive. 24 Some studies suggest acupuncture causes a series of events within the central nervous system, 260 and that it is possible to inhibit acupuncture's analgesic effects with the opioid antagonist naloxone . 261 Mechanical deformation of the skin by acupuncture needles appears to result in the release of adenosine . 2 The anti-nociceptive effect of acupuncture may be mediated by the adenosine A1 receptor . 262 A 2014 Nature Reviews Cancer review article found that since the key mouse studies that suggested acupuncture relieves are still unable to find a shred of evidence to support the existence of meridians or C'i”, 21 “The traditional principles of acupuncture are deeply flawed, as there is no evidence at all to demonstrate the existence of Ch'i or meridians” 22 and “As yin and yang, acupuncture points and meridians are not a reality, but merely the product of an ancient Chinese philosophy”. 23 Tyne, D.; Shenker, N.