Acupuncture for Migraine: A Systematic Review (Scott and Deare)
The Use of Evidence in Acupuncture Clinical Practice (Ryan)
Writing Chinese Medicine Case Reports: Guidelines for the Australian Journal of Acupuncture and Chinese Medicine (Ferrigno, Ryan and Deare)
Oculomotor Palsy Treated with Electroacupuncture: A Case Report (Kim)
Scott SW, Deare JC. Acupuncture for migraine: a systematic review. Aust J Acupunct Chin Med 2006;1(1):3-14.
Background: Migraine is a highly prevalent and often severely disabling disorder. Migraine patients often employ therapies such as acupuncture. To date a systematic review of acupuncture for migraine headache alone has not been published. Given that migraine has a pathophysiology that is distinct from other headaches, it is appropriate and timely that the studies of acupuncture for the treatment of migraine be systematically reviewed. Objectives: To determine whether acupuncture is more effective than no treatment for migraine, more effective than 'sham' or placebo acupuncture for migraine, or as effective as other interventions used to treat and prevent migraine. Selection criteria: Randomised controlled trials of needle acupuncture that breaks the skin for migraine headache. Data collection: The authors used a standardised collection form to abstract data independently. Information on acupuncture protocol, STRICTA criteria, methodological quality (Jadad, IVS) and treatment outcomes were collected. Results: Twenty-five studies with a total of 3004 patients (median = 62; range = 30-794) met the inclusion criteria. Three trials compared acupuncture to waiting list. Eleven trials compared acupuncture to sham acupuncture studies. The results were heterogeneous. Five studies found no significant effects over the sham procedure. Four studies reported a trend in favour of acupuncture. The remaining two small studies reported results in which the acupuncture group did significantly better than those in the sham group. Thirteen studies compared acupuncture to various pharmacotherapies and all found acupuncture to be at least as effective as drug treatment. Conclusion: The current evidence suggests that acupuncture is significantly superior to waiting list, at least as good as sham acupuncture, and of comparable efficiency to several proven drug therapies for the treatment and prevention of migraine.
KEYWORDS: acupuncture, migraine, headache.
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Ryan JD. The use of evidence in acupuncture clinical practice. Aust J Acupunct Chin Med 2006;1(1):19-23.
This paper reports on a qualitative study of beginner acupuncture clinicians' experiences of clinical practice. An analysis of the 42 interview transcripts revealed that these practitioners relied primarily upon traditional, experiential and reflexive knowledge in clinical decision-making. None of the practitioners interviewed used evidence arising from formal research in clinical practice decision-making. A subsequent review of acupuncture research reports showed that most acupuncture research had been undertaken to prove the therapeutic efficacy of acupuncture rather than generate knowledge that could be used to inform clinical decision-making. This paper suggests that the dominant acupuncture research emphasis of proving therapeutic efficacy, compounded with a paucity of research-generated knowledge relevant to acupuncture clinical decision-making, has been detrimental to the development of evidence-based acupuncture practice. The paper proposes that partnerships between researchers and practitioners are essential in developing research that informs practice, improves the quality of practice and leads to the heightened use of evidence in acupuncture clinical decision-making.
KEYWORDS: acupuncture, evidence-based practice, clinical practice, research.
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Ferrigno P, Ryan JD, Deare JC. Writing Chinese medicine case reports: guidelines for the Australian Journal of Acupuncture and Chinese Medicine. Aust J Acupunct Chin Med 2006;1(1):25-30.
Case reports, like other styles of research, form part of the much larger tradition of knowledge transmission. The case report offers an ideal starting point for presenting accounts from clinical practice, stimulating discussion and pointing the way for future research. Even though the presentation of case reports may be considered a weaker form of evidence-based data in comparison to that which arises from controlled clinical studies, the importance of these should not be underestimated. Within the domain of Chinese medicine, case reports are critical in knowledge transmission and the advancement of clinical practice. This paper offers an overview of the role of case reports and asks two questions: what should one report? and how should one do it? The authors argue that case reports are brief and concise accounts of new material, which follow a structured approach in organising and presenting evidence from clinical practice. This article also presents guidelines for reporting clinical cases in the Australian Journal of Acupuncture and Chinese Medicine.
KEYWORDS: case reports, Chinese medicine, research.
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Kim, YS. Oculomotor palsy treated with electroacupuncture: a case report. Aust J Acupunct Chin Med 2006;1(1):31-3.
Oculomotor palsy is a mononeuropathy, which causes sudden unilateral ptosis and double vision. It often affects older people who have concurrent diabetes and/or hypertension. Oculomotor palsy generally resolves over three to four months as regeneration of affected nerve fibres. There is no effective biomedical treatment. In this report, I present a 76-year-old man who experienced left-sided oculomotor-nerve palsy. Biomedical intervention had been unsuccessful and electroacupuncture led to complete symptom relief after four weeks of treatment.
KEYWORDS: electroacupuncture, oculomotor-nerve palsy, case report.
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