May 2000) -- "Acupuncture as an aid in
respiratory ailments might be safer than the
prolonged use of drugs," according to Kim Jobst,
M.D., of University of Oxford (United Kingdom), in
an article written for the Journal of
Alternative and Complementary
statement appears difficult to defend when you
consider that today we have more potent drugs with
which we can treat asthma than ever before. We also
know more about risk factors, causes and
predisposing factors for asthma. In fact, this
March, there was even a patent issued to a company,
Magainin Pharmaceuticals, for a gene called
Met-IL9; individuals who inherit it appear to be
less susceptible to allergy and
As it is
among the most common chronic conditions in the
United States, affecting an estimated 15 million
people, it seems that we do need safer and more
effective treatment alternatives for asthma. But is
acupuncture a reasonable alternative?
Jobst makes a convincing case for acupuncture based
on the following
or durable symptomatic improvement and
enhanced quality of life as judged by the
subjective and objective
patient management as measured by
discontinuation or diminished use of
medication, physiotherapy and other
of the therapy.
to Dr. Jobst, evidence exists that in bronchial
asthma, chronic bronchitis and chronic disabling
breathlessness, acupuncture fulfills these criteria
to varying degrees.
confounding impact of sham
published studies reviewed, according to Jobst, 16 were judged
to be of good quality, and acupuncture was effective in 10 (62.5%). However,
this assessment probably is conservative as a result of the use of "sham"
acupuncture points, which were believed to be inactive but, according to
traditional Chinese principles, are active in pulmonary disease. This lead
to a reassessment of response by combining ''real'' with sham acupuncture
vs. baseline values. Under these conditions, 13 of 16 studies (81%) showed
treatment tended to have a greater effect than
acupuncture alone. However, medication was
significantly reduced when combined with
acupuncture. Jobst concluded that although more
well-designed studies are needed, there is no
reason to withhold acupuncture treatment from
patients with bronchial asthma and chronic
obstructive lung disease (Jobst, 1995).
criteria should we judge
clear that acupuncture alters the physiologic
processes associated with an asthmatic attack.
Patients with allergic asthma who are treated with
acupuncture show significantly decreased
concentrations of SIgA and total IgA (in saliva and
in nasal secretions) and levels of IgE in sera
after treatment (Yang et al, 1995).
These results suggest that attacks of delayed and
immediate allergic asthma could be effectively
inhibited by acupuncture. However, the theory means
little to a patient in the middle of an asthma
What are we
to make of a study that reports no objective
evidence of improvement, but concludes that
acupuncture is of value because patients report an
improved quality of life? Biernacki and Peake at
the Pontefract General Infirmary in the United
Kingdom conducted a randomized, double-blind study
of 23 nonsmoking adult asthmatics with forced
expiratory volume (FEV1) 59±16% of predicted.
Each patient received either real or sham
acupuncture. Measurements were repeated within one
hour of treatment and again after two weeks.
Patients also recorded peak expiratory flow rate
(PEFR) throughout the study. After two weeks, those
who received real treatment on the first visit
received sham treatment and vice
fact that there was no improvement in any objective
measure of respiratory function after either form
of acupuncture, patients reported significant
improvement in their quality of life plus a
reduction in the use of
issue presented in this research and in the
literature review by Jobst is the confounding
potential of "sham" acupuncture. Biernacki and
Peake concluded that "the exact site of needle
puncture on the chest is unimportant." This may be
true. However, it is also possible that "sham"
acupuncture is simply a flawed procedure. As Jobst
suggests, acupoints may not be static locations on the body,
but dynamic points of sensitivity that are able to initiate a physiological
response when the conditions are right.
Jr., PharmD, is senior vice president of medical
communications at Vicus.com. He is a pharmacist and
medical writer with more than 20 years of
experience in medical education.
Peake MD. Acupuncture in treatment of stable
asthma. Respir Med. 1998 Sept;
Chang C, Hackman RM, Stern JS, Gershwin
ME. Acupuncture in the treatment
of asthma: a critical review. Allergol
Immunopathol (Madr). 1998 Nov-Dec;
Jobst KA. A
critical analysis of acupuncture in pulmonary
disease: efficacy and safety of the acupuncture
needle. J Altern Complement
Med. 1995 Jan;
Pharmaceuticals. Magainin issued additional patent
for IL9 asthma gene. March 28, 2000.
(see investor resources, press releases)
Yang Y, Chen
H, Zhao C, Wang R. Studies on regulatory effects of
acupuncture on mucosal secretory IgA in patients
with allergic asthma. Chen Tzu Yen
Chiu. 1995; 20(2):68-70.