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  Acupuncture Wins Support of U.S. Panel
By MARLENE CIMONS, Times Staff Writer

WASHINGTON —In another indication of the growing acceptance of alternative medical approaches, a federal advisory panel Wednesday strongly endorsed the ancient Chinese medical practice of acupuncture for treating certain conditions, including nausea and postoperative dental pain.

     The panel also noted that the 2,500-year-old discipline appears to be effective in relieving other common disorders, such as menstrual cramps, headaches, low back pain, muscle pain, carpal tunnel syndrome, stroke side effects and asthma. But it cautioned that more research is needed before reaching final conclusions about its impact on these ailments.

     "It's time to take it [acupuncture] seriously," said the panel's chairman, Dr. David J. Ramsey of the University of Maryland. "There are a number of situations where it really does, in fact, work—the evidence is very clear-cut. It has few side effects, and is less invasive than many other things we do."

     While acupuncture itself is ancient, its introduction into Western medical practice is a relatively recent phenomenon. Few Americans were even aware of the discipline until after the United States established normal relations with China in the 1970s. Even as public and professional interest grew, the paucity of research data made it difficult for the medical establishment to evaluate its effectiveness.

     The advisory committee was convened by the National Institutes of Health, which several years ago established a special office to study and fund research into alternative medical approaches. The conclusions of such panels, while not binding, are widely disseminated among health professionals and typically wield considerable influence.

     Millions of Americans already use acupuncture, a component of traditional Chinese medicine that involves the use of hair-thin metallic needles inserted under the skin to stimulate specific points in the body. Sometimes it is combined with moxibustion, the use of a special compressed powdered substance known as moxa, which is burned at or near the point to be stimulated.

     The theory behind acupuncture is that the body is made up of channels of energy flow, known as Qi, and that blockages of this energy flow result in pain and disease. Acupuncturists believe that stimulating these specific acupuncture points unblocks the channels and restores the body's balance, thus relieving pain and other symptoms.

     Panel members said there is no evidence that confirms this theory. But research does support the idea that acupuncture stimulates the production of the body's own natural painkilling chemicals, which could explain its success, they said.

     The panel's report noted that Western acceptance of any new or unfamiliar treatment can be difficult. But it urged health professionals to consider acupuncture, particularly the idea of integrating its use with conventional medicine after a thorough medical work-up.

     This approach could, for example, enable physicians to reduce the amount of pain medication or anesthesia that consumers otherwise would require.

     "If I had chronic pain and was being treated with [drugs], I would try acupuncture — why not?" said Dr. Leonard Wisneski, a panel member who is medical director of American WholeHealth in Bethesda, Md., which combines conventional and alternative approaches.

     Dr. Bradley Williams, president of the American Academy of Medical Acupuncture, an organization of physicians, said he was pleased that the panel's conclusions supported the academy's "mission to offer the highest quality health care to patients by combining the best of both worlds."

     Panel members said the evidence is "clear-cut" that acupuncture is valuable in treating postoperative and chemotherapy-induced nausea and vomiting, nausea in pregnancy, and postoperative dental pain.

     The 12-member committee, made up of nongovernmental medical experts, reviewed all available research and concluded that there is not yet sufficient evidence to draw the same firm conclusion about acupuncture's impact on other ailments. But panel members said that they were impressed with its potential for pain relief for a diverse group of conditions.

     "The research suggests some exciting potential areas for the use of acupuncture [but] the quality or quantity [of research] is not sufficient," the panel said, recommending an expansion of research.

     "The acceptance of acupuncture as a reliable therapeutic choice in Western medicine will depend on such rigorous studies," Ramsey said.

     The panel called for more uniform licensing, certification and accreditation of acupuncturists to help the public identify qualified practitioners.

     In 1972, California passed legislation allowing nonphysician acupuncturists to practice with physician supervision for purposes of research. It was the first of a series of laws that led to exceptionally high educational standards for acupuncturists within the state.

     Thirty-four states license or otherwise regulate the practice by nonphysicians and have training standards for certification to practice acupuncture. In addition, the Food and Drug Administration regulates the needles as part of its medical device authority.

     There are about 10,000 acupuncturists in the United States, including 3,000 who are physicians, according to the World Health Organization. In 1993, the FDA estimated that Americans were spending $500 million annually on acupuncture.

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