Akupunktur und Schmerz – eine Historie in 3 Teilen: Teil 2: Der Weg der Akupunktur in die moderne Schmerztherapie

Background

In modern pain therapy, a more integral view on the patient has become prevalent. Interdisciplinary approaches for diagnosis and treatment have become established, especially regarding patients suffering from chronic pain. Besides the application of conventional pain medicine, alternative therapy options are being implemented. Here, especially acupuncture has become important since it emphasizes the unity of body, mind, and soul.

Aim

The historical evolution of the integration of acupuncture into pain therapy as well as the scientific knowledge regarding this therapeutic approach will be explained.

Methods

Extant literature about the development of pain therapy, acupuncture techniques, as well as results of basic research was interpreted in the context of daily clinical practice.

Results

Considering the changes that pain therapy experienced over the last century, the integration of acupuncture into increasingly important interdisciplinary treatment approaches appears almost as a logical consequence. The bio-psycho-social model representing the basis of modern pain therapy emphasizes the interrelation of pain syndromes and purely physical factors, the patient's life situation, and social background, in the same way as done in acupuncture therapy. In this context, the development of western acupuncture styles besides the traditional Chinese techniques is of special interest.

Discussion

The summary of the historical and scientific background of acupuncture and pain medicine reveals that interdisciplinary therapy and, especially the integral point of view represent relatively new approaches. Thus, further progress in the treatment of chronic pain patients can be expected.     

„Was ist möglich mit Akupunktur und Related Techniques sowie Diätetik und chinesischer Arzneitherapie bei Kindern?”: Ergebnisse einer ExpertInnenbefragung

Objective

To reach a consensus in the use of acupuncture and related techniques as well as dietetics and Chinese herbal therapy for pediatric illnesses.

Methods

40 specialists in Chinese Medicine in paediatrics were asked to evaluate the effectiveness of the above-mentioned techniques for a given number of indications. Evaluation was classified in a threefold way: useful, less useful or not useful. Further questions referred to specific diagnostic and therapeutic modes as well as to studies in this field.

Results

Seven paediatricians returned the questionnaire. The list of indications was extended to 22, mainly for indications rated as „less useful.” The answers were fairly consistent for paediatric disturbances such as headache, abdominal pain and allergic diseases, and less consistent for only seven out of 22 indications. Most evaluations were based on personal experience, and less on the limited amount of controlled studies in the paediatric field.

Discussion

Differences in evaluation may be due to the different therapeutic focus in the applied techniques. Therapeutic procedures varied the most, when therapy was based on the complementary use of Chinese herbal therapy and Western medicine. A comparison between the techniques applied is hardly possible due to the the different stages of chronicity of the diseases in different clinics.

Conclusions

This study produced a rather homogenous consensus with regard to the effectiveness of acupuncture and related techniques as well as dietetics and traditional Chinese herbal therapy in paediatrics based on expert evaluation (EBM-level IV). Expert opinion is supported by studies (in part EBM-level I and II).