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The article discusses an initial framework for a standards for reporting interventions in clinical trials of acupuncture using animal models adaptation. Other topics include the Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting clinical research, the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines, and the Standards for Reporting Interventions in Clinical Trials of Acupunctures (STRICTA) recommendations.

Research into acupuncture has had ripple effects beyond the field of acupuncture. This paper identifies five exemplars to illustrate that there is tangible evidence of the way insights gleaned from acupuncture research have informed biomedical research, practice, or policy. The first exemplar documents how early research into acupuncture analgesia has expanded into neuroimaging research, broadening physiologic understanding and treatment of chronic pain. The second describes how the acupuncture needle has become a tool to enhance biomedical knowledge of connective tissue. The third exemplar, which illustrates use of a modified acupuncture needle as a sham device, focuses on emergent understanding of placebo effects and, in turn, on insights into therapeutic encounters in treatments unrelated to acupuncture. The fourth exemplar documents that two medical devices now in widespread use were inspired by acupuncture: transcutaneous electrical nerve stimulators for pain control and antinausea wrist bands. The final exemplar describes how pragmatic clinical trial designs applied in acupuncture research have informed current general interest in comparative effectiveness research. In conclusion, these exemplars of unanticipated outcomes of acupuncture research comprise an additional rationale for continued support of basic and clinical research evaluating acupuncture and other under-researched therapies. [ABSTRACT FROM AUTHOR]

In the field of acupuncture research there is an implicit yet unexplored assumption that the evidence on manual and electrical stimulation techniques, derived from basic science studies, clinical trials, systematic reviews, and meta-analyses, is generally interchangeable. Such interchangeability would justify a bidirectional approach to acupuncture research, where basic science studies and clinical trials each inform the other. This article examines the validity of this fundamental assumption by critically reviewing the literature and comparing manual to electrical acupuncture in basic science studies, clinical trials, and meta-analyses. The evidence from this study does not support the assumption that these techniques are interchangeable. This article also identifies endemic methodologic limitations that have impaired progress in the field. For example, basic science studies have not matched the frequency and duration of manual needle stimulation to the frequency and duration of electrical stimulation. Further, most clinical trials purporting to compare the two types of stimulation have instead tested electroacupuncture as an adjunct to manual acupuncture. The current findings reveal fundamental gaps in the understanding of the mechanisms and relative effectiveness of manual versus electrical acupuncture. Finally, future research directions are suggested to better differentiate electrical from manual simulation, and implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

On November 8–9, 2007, the Society for Acupuncture Research (SAR) hosted an international conference to mark the tenth anniversary of the landmark NIH [National Institutes of Health] Consensus Development Conference on Acupuncture. More than 300 acupuncture researchers, practitioners, students, funding agency personnel, and health policy analysts from 20 countries attended the SAR meeting held at the University of Maryland School of Medicine, Baltimore, MD. This paper summarizes important invited lectures in the area of basic and translational acupuncture research. Specific areas include the scientific assessment of acupuncture points and meridians, the neural mechanisms of cardiovascular regulation by acupuncture, mechanisms for electroacupuncture applied to persistent inflammation and pain, basic and translational research on acupuncture in gynecologic applications, the application of functional neuroimaging to acupuncture research with specific application to carpal-tunnel syndrome and fibromyalgia, and the association of the connective tissue system to acupuncture research. In summary, mechanistic models for acupuncture effects that have been investigated experimentally have focused on the effects of acupuncture needle stimulation on the nervous system, muscles, and connective tissue. These mechanistic models are not mutually exclusive. Iterative testing, expanding, and perhaps merging of such models will potentially lead to an incremental understanding of the effects of manual and electrical stimulation of acupuncture needles that is solidly rooted in physiology. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether a training process that focused on consensus on Traditional Chinese Medicine (TCM) diagnostic criteria will improve the agreement of TCM diagnosis on patients with rheumatoid arthritis (RA). Design: The design was a prospective survey. Setting: The study was conducted at the General Clinical Research Center, University of Maryland Hospital System, Baltimore, MD. Subjects: The participants were 42 patients with RA. Practitioners: The practitioners included 3 licensed acupuncturists with a minimum of 5 years' licensure and education in Chinese herbs. Methods: A training session of TCM diagnostic procedures was conducted with an open case discussion and “real time” practice. After the training, 3 TCM practitioners examined the same 42 patients with RA separately. Patients filled out a questionnaire to serve as the data for the “Inquiry” component while physical examinations, including observations of tongue and palpation of radial pulse, were conducted by the 3 practitioners. Each practitioner provided a TCM diagnosis based upon the examination results. These diagnoses were then examined with respect to the rate of agreement among the 3 practitioners. Results: The average agreement with respect to the TCM diagnoses among the 3 pairs of TCM practitioners was 73% (64.3%–85.7%). Statistically significant differences were found between this study and the two previous studies ( p < 0.001). Conclusions: After training focused on consensus on TCM diagnostic criteria, we found that these 3 same TCM practitioners who were used in phase II of the study produced a significantly higher agreement when compared to study phase I or phase II. Our study suggests that improved consensus on TCM diagnostic criteria results in increased agreement of diagnosis. [ABSTRACT FROM AUTHOR]

Objective: To ascertain if previous findings of low levels of agreement of Traditional Chinese Medicine (TCM) pattern diagnoses made by TCM practitioners in patients with rheumatoid arthritis (RA) were a function of practitioner differences or would be replicated with a different sample of clinicians, and to examine the relationship between TCM diagnosis and herbal treatment plans. Design: A prospective survey. Setting: General clinical research center, University of Maryland Hospital System, Baltimore, MD. Subjects: Forty (40) patients with RA. Practitioners: Licensed acupuncturists with at least 5 years’ experience and education in Chinese herbs. Methods: Three (3) TCM practitioners examined the same 40 RA patients separately, following the traditional Four Diagnostic Methods. Patients filled out questionnaires and physical examinations, including observations of the tongue and palpation of radial pulse, were conducted by the 3 practitioners. Each practitioner then provided both a TCM diagnosis and an herbal prescription. These diagnoses/prescriptions were examined with respect to the rate of agreement among the 3 practitioners. Results: The average agreement with respect to the TCM diagnoses among the 3 TCM practitioners was 31.7 % (range, 27.5–35%). The degree to which the herbal prescriptions agreed with textbook recommended practice for each TCM diagnosis was 91.7% (range, 85–100%). The most commonly used TCM assessments in arriving at these diagnoses were inquiry about factors affecting pain and pulse diagnosis. No statistically significant differences were found between this study and our previous study regarding the level of agreement on TCM diagnosis. Conclusion: The average agreement of the diagnoses provided by 3 TCM practitioners was at the same low level as previously reported. No association was found between the diagnostic methods used and the consistency of diagnosis. Both studies, however, found a high degree of consistency between the TCM pattern diagnoses provided and the herbal treatment plans made as a result of those diagnoses. [ABSTRACT FROM AUTHOR]

Acupuncture has traditionally been used in China and is being increasingly applied in Western countries to treat a variety of conditions, including inflammatory disease. However, clinical trials investigating the effectiveness of the anti-inflammatory effects of acupuncture have yielded inconsistent results, andthe underlying mechanisms of acupuncture-produced anti-inflammation are unclear.To evaluate the effectiveness of electroacupuncture (EA) on inflammation in a rat model.Four experiments were conducted on male Sprague-Dawley rats (= 8–9 per group). Inflammation was induced by injecting complete Freund’s adjuvant (CFA) subcutaneously into the plantar surface of one hind paw of the rat. Experiment 1: To determine the effect of EA (10 and 100 Hz) versus sham treatment on inflammation. Experiment 2: To investigate the involvement of the adrenal glands on the effect of EA treatment using adrenalectomized (ADX) rats. Experiment 3: To determine the effects of EA on plasma levels of corticosterone. Experiment 4: To determine the effects of EA treatment versus immobilizationon such stress indicators as heart rate and blood pressure.At 10 Hz EA significantly reduced CFA-induced hind paw edema. The effect was partially blocked in the ADX rats. EA significantly increased plasma levels of corticosterone but produced no noticeable signs of stress.At 10 Hz but not 100 Hz, EA suppresses inflammation by activating the hypothalamus-pituitary-adrenal axis (HPA) and the nervous system. [ABSTRACT FROM AUTHOR]

The article offers information on "The Status and Future of Acupuncture Research: 10 Years Post-NIH Consensus Conference" that was held at the University of Maryland School of Medicine, Baltimore, on November 9-11, 2007. The conference included lectures, panel discussions and poster presentations about acupuncture research.

Comments on the article "Cochrane Systematic Reviews in Acupuncture: Methodological Diversity in Database Searching," by Amit Sood which assesses the source of original literature contributing to Cochrane reviews on acupuncture. Solution for enhancing the language comprehensiveness of Cochrane reviews is to establish more Cochrane centers across the world and to enhance collaboration among Cochrane centers in these different countries; Reference to the use of randomization methods in Chinese randomized controlled trials; Outcome of including or not including foreign language trials in acupuncture reviews.

An abstract of the study "Acupuncture and Mindfulness-Based Stress Reduction Among Female Child Abuse Survivors: A Randomized Waitlist-Controlled Pilot Study," by Catherine Dempsey, Margaret Chesney, Lixing Lao et al. is presented.

An abstract of the study "Transient Receptor Potential Cation Channels and Cytokines Are Involved in Topical Long-Teng-Tong-Luo Gel Inhibition of Bone Cancer Pain," by Ruixin Zhang, Juyong Wang, Changsheng Dong, Liying Jiao, Ling Xu, Jiyong Liu, Zhengtao Wang and Lixing is presented.

The article reports that the Society for Acupuncture Research held its 11th annual symposium in October 2004, in San Francisco, California, sponsored by the University of California, San Francisco Institute for Health and Aging. Abstracts from research reports are published in this issue of The Journal of Alternative and Complementary Medicine. Highlights of the symposium were: Keynote lectures by Donald Abrams, Chief of Hematology and Oncology, at San Francisco General Hospital, and Suzanne Dibble of the Institute of Health and Aging and Physiological Nursing; panel discussions on community and school-based research and herbal research.