Acupuncture - woo or not

[JJM]

Possibly of interest

http://www.sciencedirect.com/scienc...serid=10&md5=b25e81e23f7bf679ee6f2574c99d6ec9

Seems like a legitimate paper, though I don’t know enough about the topic to comment on its quality. It doesn’t seem to identify a mechanism which would explain why ‘real” acupuncture would have an effect not seen in the “sham” control set.

The study you cite, which is nor readily available to me, has been reviewed http://www.sciencebasedmedicine.org/?p=733 elsewhere. It is a flawed study in several ways, and the news items are overblown. First, although they found a difference in MOR, the clinical results were that placebo and true acupuncture were graded the same. Therefore, it shows no therapeutic value. Journalists have run with the idea that the results indicate acu will enhance drug therapy; but that is mere speculation.

The placebo control was strangely inadequate, they used non-penetrating needles; but not at the same acu-sites. For proper comparison, sham acupuncture should either be penetrating needles at the wrong locations, or non-penetrating at the same locations.

That is a synopsis of the review to which I linked, there is more at the link.

 

[Badly Shaved Monkey]

JJM,

I think David Gorski has confirmed my views of the likely importance (or lack of it) of that paper. What was really interesting to see was some background on another institution falling into the quagmire of quackademic medicine. It really is an deep and dangerous morass of stupid.

 

[icerat]

Back to an earlier discussion on this thread, an interesting report today on TCM -

Scientists Help Explain Effects Of Ancient Chinese Herbal Formulas On Heart Health

Apparently "ethnobotany" is still alive and kicking.

 

[fls]

Back to an earlier discussion on this thread, an interesting report today on TCM -

Scientists Help Explain Effects Of Ancient Chinese Herbal Formulas On Heart Health

Apparently "ethnobotany" is still alive and kicking.

It is not unusual for Chinese Herbal Formulas to be adulterated with effective medicines. Nitrate containing medicine or medicine with nitrite reductase activity would be an obvious choice for TCM marketed for heart health.

However, is this a surprise? I thought nitric oxide was involved in biological functions in plants as well as animals, so wouldn't you expect plants to contain enzymes which form nitric oxide?

Although, eating a spinach salad is boring compared to the mysticism surrounding TCM.

Linda

 

[icerat]

It is not unusual for Chinese Herbal Formulas to be adulterated with effective medicines. Nitrate containing medicine or medicine with nitrite reductase activity would be an obvious choice for TCM marketed for heart health.

Now that IS cynical ....

However, is this a surprise? I thought nitric oxide was involved in biological functions in plants as well as animals, so wouldn't you expect plants to contain enzymes which form nitric oxide?

What's a surprise is you think these guys are wasting their time even looking, that they should have prioritised something else.

Although, eating a spinach salad is boring compared to the mysticism surrounding TCM.

Which goes back to my original point - any surrounding mysticism is irrelevant to whether something works or not.

 

[fls]

Now that IS cynical ....

Well, we already know that sometimes they cheat. Would it be better to be unremittingly credulous and only later discover that we had wasted our time chasing a red herring?

What's a surprise is you think these guys are wasting their time even looking, that they should have prioritised something else.

Well, we already know the benefit that nitrates and other substances which increase nitric oxide can have on the cardiovascular system. How much additional benefit is there to confirming that many different plants can serve as a source for substances we already use? Why do we care about multiple redundant sources or multiple redundant pathways to get to the same product? Is it so unreasonable to suggest that something which provides a novel effect or a novel source be given priority?

Which goes back to my original point - any surrounding mysticism is irrelevant to whether something works or not.

It seems to be relevant to whether or not something is granted special status, though. Many (all?) plants also contain niacin. If these Chinese herbs were tested for the presence of niacin, would these researchers similarly claim that the presence of niacin, in some amount, in each of them was similarly proof that the Chinese were on to something (since niacin in therapeutic amounts will lower cholesterol)? If you're not paying attention to the mysticism, then why single out these plants for testing?

Linda

 

[icerat]

Well, we already know that sometimes they cheat. Would it be better to be unremittingly credulous and only later discover that we had wasted our time chasing a red herring?

Not the point. Ignoring any mysticism, there's every reason to expect plants may have medicinal value, so no reason to be incredulous. There's also every reason to suspect centuries, even millenia, of experimentation will have helped narrow down the field.

Contrast with homeopathy, where ignoring any mysticism, there's no reason to expect it will have any medicinal value

Why do we care about multiple redundant sources or multiple redundant pathways to get to the same product?

(a) Different sources can be more cost effective
(b) The presence of different cofactors can make ingredients more effective
(c) It may not have been nitrates having the effect at all, in which case you've discovered something novel

Is it so unreasonable to suggest that something which provides a novel effect or a novel source be given priority?

If you mean by "novel source" a novel source of nitrates, then it is. If you mean by "novel source" a novel source of vasodilator, then you don't know that until you've done the research.

If you're not paying attention to the mysticism, then why single out these plants for testing?

Because of the evidence that they might work - for example, large numbers of people over centuries reporting they work. It may be placebo, it may be something else entirely, but there's no mysticism involved in evaluating that at all.

Anecdotal evidence is generally poor evidence, but it's still evidence.

 

[fls]

Not the point. Ignoring any mysticism, there's every reason to expect plants may have medicinal value, so no reason to be incredulous.

Of course. It was meant to be somewhat of a joke (hence the smiley). However, it is something that you have to keep in mind.

There's also every reason to suspect centuries, even millenia, of experimentation will have helped narrow down the field.

Is there? NCCAM has already spent more than 800 million dollars dredging through this information and has failed to find any support for this idea. The story of the discovery of artemisinin is hardly the story of a narrow search.

Contrast with homeopathy, where ignoring any mysticism, there's no reason to expect it will have any medicinal value

But that's the point. Homeopathy has built up a system of knowledge using exactly the same form of 'experimentation'. Clearly this form of experimentation, regardless of whether it takes place over centuries or millenia, doesn't serve to narrow down the field.

(a) Different sources can be more cost effective
(b) The presence of different cofactors can make ingredients more effective
(c) It may not have been nitrates having the effect at all, in which case you've discovered something novel

If you mean by "novel source" a novel source of nitrates, then it is. If you mean by "novel source" a novel source of vasodilator, then you don't know that until you've done the research.

But if you're interested in these questions, why not run screening tests on a broad range of plant extracts? Why limit yourself to a small sample?

I haven't read the full study, but the abstract in fact states -

The results from this study reveal that all of the TCMs tested reveal NO bioactivity through their inherent nitrite and nitrate content and their ability to reduce nitrite to NO

So there's something else going on. You'd apparently prefer they never do the research to discover this, because it's associated somehow with mysticism. IMO that's illogical and poor science.

I'm saying that if these discoveries are useful, why limit themselves to a narrow sample?

Because of the evidence that they might work - for example, large numbers of people over centuries reporting they work. It may be placebo, it may be something else entirely, but there's no mysticism involved in evaluating that at all.

Just gross inefficiency.

Anecdotal evidence is generally poor evidence, but it's still evidence.

It's not evidence. In this situation, it doesn't make the proposition any more or less likely to be true. Since we already know that even completely ineffective substances will be associated with stories of 'helps the heart', the presence of the story of 'helps the heart' doesn't tell you whether the substance is any more likely to be effective than any other randomly chosen substance.

Linda