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- 저자 : Stephen Birch (검색결과 16 건)
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Stephen Birch,Myeong Soo Lee,Terje Alraek,김태훈 한국한의학연구원 2019 Integrative Medicine Research Vol.8 No.3
Background: Recently research on acupuncture for cancer related symptoms has significantly increased. To what extent have medical professionals recommended to use acupuncture in light of that evidence? Methods: Evidence of effectiveness and safety was found by searching Pubmed for reviews to identify for what conditions and general results. Publications that recommend acupuncture in oncology were searched in the database of an ongoing general search for publications that recommend acupuncture. This database was developed by searching google for publications that recommend the use of acupuncture with the terms ‘name of symptom’ and ‘clinical practice guideline’ or ‘treatment guideline’. Results: Acupuncture is moderately or weakly effective for 19 symptoms in patients with cancer and cancer survivors. Acupuncture is a safe therapy in cancer care if administered by trained acupuncturists. Acupuncture is targeted to improve symptoms associated with the cancer and different cancer treatments, not to treat the cancer itself. More than 350 publications by clinical practice guideline groups and expert groups, including public health statements made by national and government agencies recommended the use of acupuncture for 61 cancer related symptoms many with positive evidence of effectiveness. Conclusion: The strength of evidence is weak for many indications, however the evidence for many standard therapies is either not very strong or if stronger, the incidence of adverse events is more, which makes acupuncture a treatment option despite the weak evidence. We have found evidence that many oncologists around the world have started to incorporate acupuncture into the treatment of various cancer related symptoms.
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Stephen Birch 한국한의학연구원 2019 Integrative Medicine Research Vol.8 No.1
Documented mechanisms of acupuncture suggest the possibility of whole body effects in addition to local and regional effects. Traditional theories of acupuncture predict whole body effects. Does this permit the possibility of applying treatment to target overall health improvement of the patient rather than the symptom? After introducing the term ‘health improvement’ this paper explores situations where it might be advantageous to do this, giving examples of how health authorities in some countries have proposed broader treatment approaches that focus on health improvement. It also discusses cases where acupuncture has been recommended as a treatment method in a number of these proposals and gives some clinical examples of this kind of whole body ‘health improvement’ targeted treatment effects. Given that health authorities have already recognised this potential for the application of acupuncture the author then explores evidence of more whole-body ‘health improvement’ effects from systematic reviews and examples of health experts recommending acupuncture to take advantage of them. Research strategies and foci are then proposed and explored to develop this evidence. What are the best treatment approaches to create these effects? By what mechanisms can ‘health improvement’ be produced? How can one measure these effects? It is likely that treatments based on ‘pattern identification’ (PI) may provide the best strategies for producing ‘health improvement’, thus PI-based acupuncture treatments are likely to be the best strategy for clinical research investigating these effects.
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Birch, Stephen Korean AcupunctureMoxibustion Medicine Society 2018 대한침구의학회지 Vol.35 No.2
Acupuncture is a complex intervention that manifests varied theories, treatment methods, diagnostic methods and diagnostic patterns. Traditionally based systems of acupuncture (TBSAs) often have their own diagnostic approaches and patterns. Despite the wide variety that can be found amongst TBSAs, is it possible that they share a common background in clinical observation and practice? Research has shown that multiple physiological pathways and mechanisms can be triggered by different acupuncture techniques and methods. It is highly likely that clinicians will have observed some of the effects of these responses and used those observations as feedback to help construct the patterns of diagnosis and their associated treatments. This review briefly examines this possibility. Pattern identification will have developed out of a complex interaction of factors that include; theories current at the time of their development, historical theories, personal choices and beliefs, training, practice methods, clinical observations and the natural feedback that comes from observing how things change once the treatment is applied. Researchers investigating TBSAs and pattern identification need to be more explicit about the systems they have investigated in order to understand the biological basis of pattern identification and their treatments.
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Stephen Birch 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2
Background: Traditional East Asian Medical (TEAM) practice systems exhibit much variation. Little work has been done to study reasons for this variation. This essay explores cultural and historical explanations for how variety occurs by contrasting the use of two TEAM concepts in diagnosis in Chinese and Japanese systems. Methods: Focussing on two important concepts, xin (heart) and shen (spirit), a literature review is performed to contrast how they developed, are understood and used in diagnosis in Chinese Traditional Chinese medicine, TCM, and Japanese Meridian Therapy, MT. Results: While TCM texts describe many heart-related diagnoses, MT texts do not describe any. While TCM associates ‘shen’ with the mind and emotions coupled with associated diagnoses, MT does neither. Historical and cultural reasons for these differences are identified. Conclusions: In light of these findings, important questions arise about the nature of concepts and diagnoses in TEAM practice systems. They are not objective like biomedical constructs and diagnoses, nor are they clearly articulated and studied yet according to international standards. This suggests a range of research strategies that are needed. There are valid historical and cultural reasons for the differences we see between Japanese and Chinese TEAM systems. In light of these, further research is needed to elaborate and identify critical issues that are important for education, practice and research.
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Historical perspectives on using sham acupuncture in acupuncture clinical trials
Birch Stephen,Lee Myeong Soo,Kim Tae-Hun,Alraek Terje 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.1
Background: Trials of acupuncture in the West began before textbooks about acupuncture were generally available. This placed trials at risk of possible faulty assumptions about the practice of acupuncture and adoption of problematic research assumptions and methods. Further, this lack of information has had an influence on the theories of developing a valid and reliable sham control treatment in clinical trials of acupuncture. This commentary explores these issues. Methods: Literature review focussing on the time line of developments in the field, developments of sham interventions and use thereof and knowledge of physiological effects of needling. Results: Early trials demonstrated a lack of knowledge about acupuncture. As the methodology of trials improved, new sham treatment methods were developed and adopted; however, the sham treatment methods were implemented without physiological studies exploring their potential physiological effects and without examining the broader practice of acupuncture internationally. Conclusions: Mistaken assumptions about the practice of acupuncture reinforced by paucity of physiological investigations are factors that led to use of inappropriate sham interventions for acupuncture trials. These not only lead to confusing or misleading trial results, they, as far as we can see underestimate the effects of acupuncture leading to bias against acupuncture. There are significant problems with sham interventions and how they are applied in trials of acupuncture. Further research is needed to explore the effects of this both for future trials and for interpreting existing evidence. Background: Trials of acupuncture in the West began before textbooks about acupuncture were generally available. This placed trials at risk of possible faulty assumptions about the practice of acupuncture and adoption of problematic research assumptions and methods. Further, this lack of information has had an influence on the theories of developing a valid and reliable sham control treatment in clinical trials of acupuncture. This commentary explores these issues. Methods: Literature review focussing on the time line of developments in the field, developments of sham interventions and use thereof and knowledge of physiological effects of needling. Results: Early trials demonstrated a lack of knowledge about acupuncture. As the methodology of trials improved, new sham treatment methods were developed and adopted; however, the sham treatment methods were implemented without physiological studies exploring their potential physiological effects and without examining the broader practice of acupuncture internationally. Conclusions: Mistaken assumptions about the practice of acupuncture reinforced by paucity of physiological investigations are factors that led to use of inappropriate sham interventions for acupuncture trials. These not only lead to confusing or misleading trial results, they, as far as we can see underestimate the effects of acupuncture leading to bias against acupuncture. There are significant problems with sham interventions and how they are applied in trials of acupuncture. Further research is needed to explore the effects of this both for future trials and for interpreting existing evidence.
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