针灸：什么时候值得尝试
超过3 million Americans, acupuncture is one stop on their journey to find relief from chronic pain, menopause symptoms, and a host of other ailments. It involves inserting thin needles on specific points of the body like pins on a map.
Whether it's effective is "a hotly debated topic,” says Brian Berman, M.D., professor of family medicine and the founder and director of the University of Maryland Center for Integrative Medicine. “Proponents of the practice would point to research that has found it to be effective for conditions such as chronic pain, while the skeptics may question the quality of the research and attribute any benefits to a strong placebo effect.”
贝尔曼说，当研究人员试图证明针灸是否有效时，本质上出现了某些问题。对于初学者来说，研究设计不一致，因此研究人员无法准确比较结果。结果可能会被参与者对针灸的态度摇曳。例如，预计针刺工作的患者可能更有可能报告持续的结果而不是持怀疑态度。
Still, experts aren’t quick to write off acupuncture. “Given the relative lack of side effects associated with acupuncture in contrast to some treatment avenues, such as prescription painkillers, I think this is an area of medicine that warrants further investigation,” Berman says.
什么是针灸？
According to traditional Chinese medicine, hundreds of acupuncture points exist along meridians (pathways) on the body, which carry a form of vital energy called qi (pronounced “chee”). Eastern medical practitioners believe the mechanism that causes disease or pain is an internal imbalance between the basic forces of yin and yang, leading to a blockage of qi. Acupuncture involves stimulating these specific points on the body using various styles and techniques. This technique supposedly restores the flow of qi and thus reestablishes good health.
Modern-day Western researchers have proposed various scientific theories to explain how the ancient Chinese remedy works, but they’ve been unable to pinpoint one clear mechanism. For instance, acupuncture may reduce pain by stimulating the body’s production of analgesic (pain-relieving) chemicals such as endorphins, but studies show that placebo treatments can do that as well.
Acupuncture may have a simple counterirritant effect (purposely causing irritation or inflammation in one area to relieve inflammation in another). It may also affect connective tissue, blood flow, and aspects of the immune and nervous systems. However, none of those mechanisms would explain the supposed benefits of stimulating specific acupuncture points for different conditions or any possible long-lasting benefits.
Acupuncturists, as well as some specially trained doctors, dentists, and other medical professionals perform the treatment. The most common and most studied form of acupuncture involves penetrating the skin with ultra-thin metallic needles that therapists gently manipulate by hand.
针灸通常是安全的,只要进行titioner is trained and uses sterile, disposable needles, as the U.S. Food and Drug Administration requires (FDA regulates their manufacture and labeling). A new set of needles, taken from a sealed package, should be used at each session; the treatment sites should first be swabbed with alcohol or other disinfectant.
从业者通常在远离症状网站的点处插入针头。例如，为了治疗背部疼痛，针灸师可以在脚或耳朵和背部插入针头。专业版的针灸限制针只是一个身体部位，特别是手，耳朵或头皮。
针灸师可以将热量或电脉冲施加到插入点附近;有时候他或她可能会烧掉一个名为Mugwort附近的草本植物，或者将其应用于针尖（一种名为艾灸）的针尖。从业者还可以使用他或她的手指施加压力（一种称为ACURUPRURE的技术）。
In a typical session, the practitioner inserts five to 20 needles and leaves them in for 10 to 30 minutes. Depending on the condition being treated, acupuncture is usually administered once or twice a week for six to 12 weeks.
有些人报告几乎没有。其他人将感觉描述为刺痛，麻木或疼痛。无论您是否体验疼痛或不适，取决于许多变量，特别是从业者的技能和技术，插入的位置和深度，以及您和其他患者的差异。
但是，问题仍然存在：针灸是否有效？虽然许多关于针灸的研究已经被包括太少的参与者有缺陷，但缺乏适当的对照组，或者否则设计不良，近年来一些稳固的研究已经出现。
以下是针灸可能能够在涉及您的健康时提供的益处。
疼痛缓解的证据
One of the most common areas of acupuncture research involves its effect on chronic pain. While some studies suggest that acupuncture and “sham acupuncture” (a scientific control that’s essentially a fake or placebo intervention) have similar effectiveness when it comes to pain relief, both of these appear to be more effective than no treatment at all.
A multicenter meta-analysis, first conducted in 2012 and updated in 2014, included data on 18,000 people from 29 high-quality studies focusing on acupuncture for chronic back,neck, and shoulder pain; osteoarthritis, and chronic headaches. Sham acupuncture was used in about half the studies.
The analysis found thatacupuncture reduced pain in 50 percent of participants,whereas no treatment or usual care reduced pain in 30 percent of participants. Sham acupuncture reduced pain in 42.5 percent, indicating that most of the observed benefits could be chalked up to placebo effects. Nevertheless, the researchers concluded that acupuncture had “clinically relevant” effects, albeit small ones, on chronic pain over those of sham acupuncture.
Overall, research scrutinizing acupuncture’s ability to relieve pain has been promising. It may be beneficial for:
- Chronic back pain.Sham and real acupuncture may be equally effective at providing short-term relief. According to clinical practice guidelines issued by the American Pain Society and the American College of Physicians, acupuncture is one of several alternative therapies that should be considered when people with chronic lower back pain don’t respond to conventional treatment.
- 颈部疼痛。Acupuncture may help relieve neck pain better than standard care; in small studies, it provided more relief than sham treatments.
- Headaches.Acupuncture can be at least as effective as drugs for the prevention of migraine, tension, or cluster headaches, with fewer side effects; real and sham acupuncture may be equally effective.
- 骨关节炎。真正的和假穴可能类似地有益。
- Postoperative pain.Acupuncture may be more effective than sham acupuncture for reducing pain after surgery and may lessen the need for pain relievers.
- Aromatase inhibitor side effects.Electroacupuncture, which uses electrical currents in acupuncture needles to stimulate various body parts, might quell the hallmark joint pain and stiffness caused by taking aromatase inhibitor drugs, the antihormonal therapy used after breast cancer. It may also relieve other side effects, including fatigue, anxiety, and depression.
管理更年期
许多女性寻求救济无期更年期的症状，如热的闪光和夜间汗水，但传统的激素治疗可能不是每个人的选择 - 特别是患有乳腺癌的女性。虽然一些研究发现，针灸没有优于虚假针灸，最近的两个研究似乎提供了承诺：
• 一种国家卫生院校研究院，在2016年期间在绝经期间出现and conducted at Wake Forest Baptist Medical Center in North Carolina, found that among 209 women ages 45 to 60, acupuncture could reduce hot flashes by up to 36 percent. Researchers cautioned that additional treatment or an expectation that the treatment would work could have affected results. Other research has pointed to acupuncture being no better than sham procedures.
•台湾研究人员对34项试验进行了系统审查和荟萃分析，其中包括2,400多名妇女。他们于2016年2月在线在线发布，他们报告说，使用针灸的女性能够从更年期相关的睡眠干扰中找到一些救济。接受针灸的参与者升高了雌二醇水平，雌激素的形式似乎与更好的睡眠相关。
缓解呼吸问题
若干研究报道，针灸可以帮助患有慢性阻塞性肺病（COPD）的人。2012年的研究发现，12周次会话降低了呼吸急促，并提高了比假针灸更好的运动耐受性和生活质量;两组两组接受了COPD的标准医疗保健。
平静的恶心
Nausea is a common side effect of anesthesia and chemotherapy. Many studies have found benefits from acupuncture in these instances, though results have been inconsistent regarding its superiority to sham acupuncture.
Still, according to the National Cancer Institute, the evidence for a benefit is convincing and consistent. Most of the research has focused on a single acupuncture point known as P6, located on the inside of the forearm just above the wrist.
Not for all conditions
虽然针灸被吹捧，以帮助肠易肠综合征和花粉发烧，益处 - 如果仍然不清楚。缺乏令人信服的证据支持使用针灸的地区包括体重控制，尿失禁，哮喘，高血压，糖尿病和耳鸣（耳朵响起）;没有任何证据，针灸是一般的“免疫力助推器”。
“It’s fine to try acupuncture when conventional therapy doesn’t work or if you’re concerned about side effects from pain relievers, for example, but it’s also important to remember that acupuncture doesn’t work for everyone, and it should never take the place of standard medical treatments or delay diagnosis and treatment,” Berman says. “The bottom line is, if you’re not a candidate for other pain-relief options or you’ve tried other treatments without success, there’s no harm in trying acupuncture, and possibly a lot to gain.”
Finding a practitioner
If you have pain or a medical condition that doesn’t respond to conventional treatments, ask your doctor or other health care provider if acupuncture might help—and if so, ask for a referral to a practitioner. Or contact your local hospital.
去如果你住在一个注册针灸师of the 44 states (plus the District of Columbia) that have licensing. This usually requires at least three years of training and passing a national board-certification exam administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
If you live in a state that does not license acupuncturists (Alabama, Kansas, North Dakota, Oklahoma, South Dakota, and Wyoming), ask to see evidence that the acupuncturi at least three years of training at an accredited institution.
To find a certified acupuncturist in your area, go to NCCAOM.org or call 904-598-1005.
