Asthma and Acupuncture. Why Even Bother?

Asthma and Acupuncture.  Why Even Bother?

"If I have seen further than other men it's because I have stood on the shoulders of giants."

Newton said that, but being a bit of snot it has been suggested that he was also poking fun at Robert Hooke, who was on short side.

For the most part science and medicine build upon prior work and over time the mistakes and issues of prior studies are weeded out. It is certainly not a clean or easy process, but progress is made and there are increasingly better approximations of reality.

Not so in the world of pseudo-medicine. They keep doing variations of the same flawed and useless study, evidently unaware of any of the studies that preceded them.  Acupuncture proponents are  particularly good at ignoring the past and are condemned to repeat it.

In 2011 there was what I could consider a classic article in the NEJM, Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma. That study demonstrated that placebo interventions will improve the subjective,but not objective, components, of asthma. Patients report feeling better with any intervention, but only albuterol improved lung function.

As far as the authors of A randomized, controlled, crossover study in patients with mild and moderate asthma undergoing treatment with traditional Chinese acupuncture. are concerned, this reference is not applicable to their study.

The took patients with mild asthma and gave them

10 real weekly acupuncture sessions, followed by a 3-week washout period and 10 sham weekly acupuncture sessions; and Group B - 43 patients underwent 10 sham weekly acupuncture sessions, followed by a 3-week washout period and 10 real weekly acupuncture sessions.

So you know that there will be improvement in subjective complaints just by having the intervention. 

The patients could all the real medications they wanted and use them they did

During each study period, patients suffering an asthma exacerbation were rescued with β-agonists (both short-and long-acting) and inhaled glucocorticoids. During the period of treatment, 36 patients used short-acting β–2 agonists as rescue medications, 6 patients used inhaled corticosteroids, 49 patients used a combination of short-acting β–2 and long-acting β–2 agonists with inhaled corticosteroids, 3 patients used β–2 short-acting agonists with inhaled corticosteroids and a leukotriene modifier and 2 used theophylline and a short-acting β–2 agonist.

and so any improvement could not be credited to acupuncture. 

They did not report inhaled steroid use in those who had subjective or objective improvements. They did not see who believed in acupuncture nor whether blinding was successful. They do not describe what constituted real and sham acupuncture except that "sham acupuncture treatment with points not related to the treatment of asthma in traditional Chinese medicine". And they had a high drop out rate, 111 of 185.

So given the methodologies there is no way to conclude much of anything about acupuncture for asthma, especially given that

Sham acupuncture also led to significant differences in symptoms, but these were not different from those seen with real acupuncture. Spirometry and exhaled NO levels did not show a difference between sham and real acupuncture treatment. In addition, no significant difference was demonstrated between treatments regarding the quality of life evaluation.

The best you can say is that sham acupuncture was no different from real acupuncture and in reality based medicine we would conclude that acupuncture does nothing.

They cannot bring themselves to admit acupuncture probably did nothing, suggesting all the flaws in the study are actually hiding real acupuncture effects

However, the number of volunteers who quit this study may have compromised the measurement of the real effect of acupuncture, prohibiting us from making a more positive assumption about the effect of acupuncture. The lack of a significant difference between the sham and real acupuncture treatments also prevented us from deducing the effectiveness of real acupuncture.

Really. Why did they even bother?

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