Vol.4 Issue 1
Asthma

In the United States, asthma is a major chronic illness that is associated with substantial morbidity and mortality. Current data indicate that 31.3 million Americans have been diagnosed with asthma at some point in their lives, while 20.3 million people have a current diagnosis of asthma. In 2000, there were 10.4 million outpatient asthma visits to private physician offices and hospital clinics, 465,000 asthma hospitalizations, and 4,487 deaths. While Western medicine is effective for managing asthma symptoms once they develop, the above statistics illustrate its limitations for preventing attacks. As a result, patients and clinicians alike are seeking adjunctive treatments that will reduce the occurrence of asthma attacks without interfering with effective Western treatments. One promising adjunctive treatment is acupuncture, a Traditional Chinese Medicine (TCM) therapy that focuses on prevention.

When I was an acupuncture student, one of my professors told me that treating asthma was like “shooting fish in a barrel.” This statement has been borne out in my clinical practice, where I have seen excellent and lasting results accomplished quickly. TCM textbooks give clear explanations of the pathophysiological mechanisms that underlie asthma attacks, as well as how to properly diagnose and successfully treat asthma patients. And patients and practitioners agree that TCM treats asthma effectively and without side effects! Yet, there are very few studies in the literature on the efficacy of acupuncture to prevent attacks in stabilized patients. Where is the research?

Here is the problem: we can't design double-blind, randomized, controlled “gold standard” trials of acupuncture and still uphold the integrity of the treatment. First, it is impossible to conduct a double-blind study. As a licensed acupuncturist, I know if the points that I am needling and the techniques I am using are appropriate to the case or not. Second, “placebo acupuncture” is an imperfect control condition. Part of the benefit of acupuncture is derived from the care and time and attention each patient receives. The mere act of sitting with a caring professional for half an hour describing one's situation is therapeutic in itself. To follow that with therapeutic touch, even if it is at “non-points” or using “sham acupuncture,” likely provides further relief.

A very real benefit of sitting with patients for a prolonged intake is the formulation of a fine-tuned diagnosis, yet another limitation to conducting clinical trials. In TCM, each patient is a unique individual with a unique disease picture. Each patient may receive acupuncture, cupping, massage, and/or herbs, depending on his or her needs, but the specificity within these options is very high. If one were to conduct a chart review of 50 asthma patients, one would likely see one or two acupuncture points common to all of the patients, and perhaps a few more points common to certain subgroups of patients. Beyond that there would be few similarities, as the treatment is targeted on restoring strength to the individual patient rather than attacking a disease. While this makes TCM special, and powerful, it also makes clinical trials difficult.

So how can we be sure that acupuncture works? It is not a faith-based medicine – I have seen equally impressive results in my most skeptical and my most trusting patients. I cannot explain to you in biomedical language why this ancient form of healing works, nor can I describe its mechanism. I can tell you that it is a system of power and beauty, one that is difficult to learn and that requires real academic and intellectual rigor to practice. But don't take my word for it. See an acupuncturist. Come into our offices and look at what we do, ask us questions, get some treatment. And then decide for yourself.

Carrie Murphy, LAc

Pacific College of Oriental Medicine

Chicago, Illinois