Special Issue "Acupuncture – Basic Research and Clinical Application"

A special issue of Medicines (ISSN 2305-6320).

Deadline for manuscript submissions: closed (30 April 2018).

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Guest Editor
Prof. Dr. Gerhard Litscher

TCM Research Center Graz, Research Unit for Complementary and Integrative Laser Medicine, and Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, the Medical University of Graz, Auenbruggerplatz 39, 8036 Graz, Austria
Website | E-Mail
Phone: +436641140879
Fax: +43 316 385 13908
Interests: evidence-based complementary medicine; integrative medicine; laser medicine; high-tech acupuncture; neuromonitoring

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the further investigation, development, and modernization of acupuncture in basic research settings, as well as in clinical applications.

We welcome papers reporting latest evidence-based results of high-tech acupuncture research, and those exploring acupuncture in general. Studies concerning modern technology in acupuncture research are especially welcome. Manuscripts should deal with, but are not limited to, the keywords listed below.

  • Modernization of acupuncture
  • basic research
  • traditional and modern needle acupuncture
  • laser acupuncture
  • electroacupuncture
  • ear acupuncture
  • animal experimental studies in acupuncture
  • evidence-based complementary medicine
  • acupuncture in clinical application and practice

Prof. Dr. Gerhard Litscher
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicines is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Modernization of acupuncture
  • basic research
  • traditional and modern needle acupuncture
  • laser acupuncture
  • electroacupuncture
  • ear acupuncture
  • animal experimental studies in acupuncture
  • evidence-based complementary medicine
  • acupuncture in clinical application and practice

Published Papers (13 papers)

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Editorial

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Open AccessEditorial
Introduction to the Medicines Special Issue on Acupuncture—Basic Research and Clinical Application
Received: 3 September 2018 / Accepted: 3 September 2018 / Published: 4 September 2018
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Abstract
This Medicines special issue focuses on the further investigation, development, and modernization of acupuncture in basic research settings, as well as in clinical applications. The special issue contains 12 articles reporting latest evidence-based results of acupuncture research, and exploring acupuncture in general. Altogether [...] Read more.
This Medicines special issue focuses on the further investigation, development, and modernization of acupuncture in basic research settings, as well as in clinical applications. The special issue contains 12 articles reporting latest evidence-based results of acupuncture research, and exploring acupuncture in general. Altogether 44 authors from all over the world contributed to this special issue. Full article
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Open AccessEditorial
Laser Acupuncture Research: China, Austria, and Other Countries—Update 2018
Received: 15 August 2018 / Accepted: 15 August 2018 / Published: 20 August 2018
Cited by 2 | PDF Full-text (436 KB) | HTML Full-text | XML Full-text
Abstract
This editorial contains an overview of the current status of published articles (pubmed) on the subject of laser acupuncture research. Ordered by country, a rough analysis is carried out. Full article
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Research

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Open AccessArticle
Acupuncture and Lifestyle Myopia in Primary School Children—Results from a Transcontinental Pilot Study Performed in Comparison to Moxibustion
Received: 9 August 2018 / Revised: 29 August 2018 / Accepted: 30 August 2018 / Published: 31 August 2018
Cited by 1 | PDF Full-text (1861 KB) | HTML Full-text | XML Full-text
Abstract
Background: Lifestyle risks for myopia are well known and the disease has become a major global public health issue worldwide. There is a relation between reading, writing, and computer work and the development of myopia. Methods: Within this prospective pilot study in 44 [...] Read more.
Background: Lifestyle risks for myopia are well known and the disease has become a major global public health issue worldwide. There is a relation between reading, writing, and computer work and the development of myopia. Methods: Within this prospective pilot study in 44 patients aged between 6 and 12 years with myopia we compared possible treatment effects of acupuncture or moxibustion. The diopters of the right and left eye were evaluated before and after the two treatment methods. Results: Myopia was improved in 14 eyes of 13 patients (15.9%) within both complementary methods. Using acupuncture an improvement was observed in seven eyes from six patients out of 22 patients and a similar result (improvement in seven eyes from seven patients out of 22 patients) was noticed in the moxibustion group. The extent of improvement was better in the acupuncture group (p = 0.008 s., comparison before and after treatment); however, group analysis between acupuncture and moxibustion revealed no significant difference. Conclusions: Possible therapeutic aspects with the help of evidence-based complementary methods like acupuncture or moxibustion have not yet been investigated adequately in myopic patients. Our study showed that both acupuncture and moxibustion can improve myopia of young patients. Acupuncture seems to be more effective than moxibustion in treating myopia, however group analysis did not prove this trend. Therefore, further Big data studies are necessary to confirm or refute the preliminary results. Full article
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Open AccessArticle
Individual Differences in Responsiveness to Acupuncture: An Exploratory Survey of Practitioner Opinion
Received: 3 July 2018 / Revised: 28 July 2018 / Accepted: 31 July 2018 / Published: 6 August 2018
Cited by 1 | PDF Full-text (1957 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: Previous research has considered the impact of personal and situational factors on treatment responses. This article documents the first phase of a four-stage project on patient characteristics that may influence responsiveness to acupuncture treatment, reporting results from an exploratory practitioner survey. Methods: [...] Read more.
Background: Previous research has considered the impact of personal and situational factors on treatment responses. This article documents the first phase of a four-stage project on patient characteristics that may influence responsiveness to acupuncture treatment, reporting results from an exploratory practitioner survey. Methods: Acupuncture practitioners from various medical professions were recruited through professional organisations to complete an online survey about their demographics and attitudes as well as 60 questions on specific factors that might influence treatment. They gave categorical (“Yes”, “No”, and “Don’t know”) and free-text responses. Quantitative and qualitative (thematic) analyses were then conducted. Results: There were more affirmative than negative or uncertain responses overall. Certain characteristics, including ability to relax, exercise and diet, were most often considered relevant. Younger and male practitioners were more likely to respond negatively. Limited support was found for groupings between characteristics. Qualitative data provide explanatory depth. Response fatigue was evident over the course of the survey. Conclusions: Targeting and reminders may benefit uptake when conducting survey research. Practitioner characteristics influence their appreciation of patient characteristics. Factors consistently viewed as important included ability to relax, exercise and diet. Acupuncture practitioners may benefit from additional training in certain areas. Surveys may produce more informative results if reduced in length and complexity. Full article
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Open AccessArticle
The Effect of Acupuncture on Visual Function in Patients with Congenital and Acquired Nystagmus
Received: 9 April 2017 / Revised: 15 May 2017 / Accepted: 18 May 2017 / Published: 23 May 2017
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Abstract
Background: The aim of this study is to examine the short-term effect of visual function following acupuncture treatment in patients with congenital idiopathic nystagmus and acquired nystagmus (CIN and AN). Methods: An observational pilot study on six patients with confirmed diagnosis of nystagmus [...] Read more.
Background: The aim of this study is to examine the short-term effect of visual function following acupuncture treatment in patients with congenital idiopathic nystagmus and acquired nystagmus (CIN and AN). Methods: An observational pilot study on six patients with confirmed diagnosis of nystagmus (three CIN and three AN patients (2♀, 4♂; mean age 42.67; SD ± 20.57 y)), was performed. Acupuncture treatment was done following a standardized protocol applying needle-acupuncture on the body and the ears. The treatment was scheduled with 10 sessions of 30 min duration over five weeks. To assess the effect of the treatment, we performed before, between, and after acupuncture objective measurement of the BCVA (EDTRS charts), contrast vision (CSV-1000, Vector Vision), nystagmography (Compact Integrated Pupillograph), complemented by evaluation questionnaires. A placebo non-acupuncture control group (Nr: 11, 22 eyes; 8♀, 3♂; mean age: 33.34 y (SD ± 7.33 y)) was taken for comparison. Results: The results showed that, following acupuncture treatment, CIN and AN patients showed improvement (SD± mean) in their binocular BCVA (baseline: 0.45 ± 0.36; between: 0.53 ± 0.34 and post-treatment: 0.51 ± 0.28), and in their monocular contrast sensitivity (baseline: 11.29 ± 12.35; between: 11.43 ± 11.45 and post-treatment: 14.0 ± 12.22). The post-/baseline-difference showed a significant improvement in contrast vision and in BCVA for CIN and AN patients, but not for controls (p = 0.029 and p = 0.007, respectively). The effect of the eye showed also, within CIN and AN, significant values for the examined parameters in the post-/baseline difference (p = 0.004 and p ≤ 0.001). Evaluated only binocularly, the respective between-/baseline and post-/baseline difference in the CIN and AN group showed significant values (p < 0.045). Two AN patients reported reduction of oscillations. Among general subjective symptoms, our patients reported reduction of tiredness and headache attacks, improvement of vision, and shorter sleep onset time. Conclusion: The applied acupuncture protocol showed improvement in the visual function of nystagmus patients and thus, in their quality of life. Further studies are mandatory to differentiate which group of nystagmus patients would benefit more from acupuncture. Full article
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Open AccessArticle
Nonspecific Feelings Expected and Experienced during or Immediately after Electroacupuncture: A Pilot Study in a Teaching Situation
Received: 29 January 2017 / Revised: 17 March 2017 / Accepted: 28 March 2017 / Published: 8 April 2017
Cited by 2 | PDF Full-text (3216 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: Some feelings elicited by acupuncture-type interventions are “nonspecific”, interpretable as resulting from the placebo effect, our own self-healing capacities—or, indeed, the flow of qi. Expectation is thought to contribute to these nonspecific effects. Here we describe the use of two innovative [...] Read more.
Background: Some feelings elicited by acupuncture-type interventions are “nonspecific”, interpretable as resulting from the placebo effect, our own self-healing capacities—or, indeed, the flow of qi. Expectation is thought to contribute to these nonspecific effects. Here we describe the use of two innovative 20-item questionnaires (EXPre20 and EXPost20) in a teaching situation. Methods: Respondents were acupuncture students or practitioners on electroacupuncture (EA) training courses (N = 68). EXPre20 and EXPost20 questionnaires were completed before and after receiving individualised treatment administered by colleagues. Respondents were also asked about their prior experience of EA or transcutaneous electroacupuncture stimulation (TEAS). Results: Respondents expected significantly more items to change than not to change, but significantly fewer were experienced as changing. Increases in given questionnaire items were both expected and experienced significantly more often than decreases. “Tingling”, “Relaxation”, and “Relief” or “Warmth” were most often expected to increase or were experienced as such, and “Pain” and “Tension” to decrease or experienced as decreasing. Expectations of change or no change were confirmed more often than not, particularly for “Tingling” and “Tension”. This was not the result of the personal respondent style. Cluster analysis suggested the existence of two primary feeling clusters, “Relaxation” and “Alertness”. Conclusions: Feelings experienced during or immediately after acupuncture-type interventions may depend both on prior experience and expectation. Full article
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Open AccessArticle
A Population-Based Cohort Study on the Ability of Acupuncture to Reduce Post-Stroke Depression
Received: 17 January 2017 / Revised: 6 March 2017 / Accepted: 8 March 2017 / Published: 15 March 2017
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Abstract
Objective: Post-stroke depression (PSD) is common and has a negative impact on recovery. Although many stroke patients in Taiwan have used acupuncture as a supplementary treatment for reducing stroke comorbidities, little research has been done on the use of acupuncture to prevent PSD. [...] Read more.
Objective: Post-stroke depression (PSD) is common and has a negative impact on recovery. Although many stroke patients in Taiwan have used acupuncture as a supplementary treatment for reducing stroke comorbidities, little research has been done on the use of acupuncture to prevent PSD. Accordingly, our goal is to investigate whether using acupuncture after a stroke can reduce the risk of PSD. Method: This population-based cohort study examined medical claims data from a random sample of 1 million insured people registered in Taiwan. Newly diagnosed stroke patients in the period 2000–2005 were recruited in our study. All patients were followed through to the end of 2007 to determine whether they had developed symptoms of depression. A Cox proportional hazard model was used to estimate the relative risk of depression in patients after being diagnosed as having had a stroke, with a focus on the differences in those with and without acupuncture treatment. Results: A total of 8487 newly-diagnosed stroke patients were included in our study; of these, 1036 patients received acupuncture more than five times following their stroke, 1053 patients received acupuncture 1–5 times following their stroke and 6398 did not receive acupuncture. After we controlled for potential confounders (e.g., age, sex, insurance premium, residential area, type of stroke, length of hospital stay, stroke severity index, rehabilitation and major illness–related depression), we found that acupuncture after stroke significantly reduced the risk of depression, with a hazard ratio (HR) of 0.475 (95% CI, 0.389–0.580) in frequent acupuncture users and 0.718 (95% CI, 0.612–0.842) in infrequent acupuncture users, indicating that acupuncture may lower the risk of PSD by an estimated 52.5% in frequent users and 28.2% in infrequent users. Conclusions: After we controlled for potential confounders, it appears that using acupuncture after a stroke lowers the risk of depression. Additional strictly-designed randomized controlled trials are needed to better understand the specific mechanisms relating acupuncture to health outcomes. Full article
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Open AccessArticle
The Pilot Study of Evaluating Fluctuation in the Blood Flow Volume of the Radial Artery, a Site for Traditional Pulse Diagnosis
Received: 24 January 2016 / Revised: 28 March 2016 / Accepted: 14 April 2016 / Published: 17 May 2016
Cited by 1 | PDF Full-text (1198 KB) | HTML Full-text | XML Full-text
Abstract
Background: Radial artery (RA) pulse diagnosis has been used in traditional Asian medicine. Blood pressure (BP) and pulse rate related to heart rate variability (HRV) can be monitored via the RA. The fluctuation in these parameters has been assessed using fast Fourier transform [...] Read more.
Background: Radial artery (RA) pulse diagnosis has been used in traditional Asian medicine. Blood pressure (BP) and pulse rate related to heart rate variability (HRV) can be monitored via the RA. The fluctuation in these parameters has been assessed using fast Fourier transform (FFT) analytical methods that calculate power spectra. Methods: We measured blood flow volume (Volume) in the RA and evaluated its fluctuations. Normal participants (n = 34) were enrolled. We measured the hemodynamics of the right RA for approximately 50 s using ultrasonography. Results: The parameters showed the center frequency (CF) of the power spectrum at low frequency (LF) and high frequency (HF). More than one spectral component indicated that there were fluctuations. The CF at LF for Volume was significantly different from that for vessel diameter (VD); however, it was significantly correlated with blood flow velocity (Velocity). On the other hand, the CF at HF for Volume was significantly different from that for Velocity; however, it was significantly correlated with VD. Conclusion: It is suggested that fluctuation in the Volume at LF of RA is influenced by the fluctuation in Velocity; on the other hand, fluctuation in the Volume at HF is influenced by the fluctuation in VD. Full article
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Review

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Open AccessFeature PaperReview
Acupuncture and Neural Mechanism in the Management of Low Back Pain—An Update
Received: 6 June 2018 / Revised: 13 June 2018 / Accepted: 21 June 2018 / Published: 25 June 2018
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Abstract
Within the last 10 years, the percentage of low back pain (LBP) prevalence increased by 18%. The management and high cost of LBP put a tremendous burden on the healthcare system. Many risk factors have been identified, such as lifestyle, trauma, degeneration, postural [...] Read more.
Within the last 10 years, the percentage of low back pain (LBP) prevalence increased by 18%. The management and high cost of LBP put a tremendous burden on the healthcare system. Many risk factors have been identified, such as lifestyle, trauma, degeneration, postural impairment, and occupational related factors; however, as high as 95% of the cases of LBP are non-specific. Currently, LBP is treated pharmacologically. Approximately 25 to 30% of the patients develop serious side effects, such as drowsiness and drug addiction. Spinal surgery often does not result in a massive improvement of pain relief. Therefore, complementary approaches are being integrated into the rehabilitation programs. These include chiropractic therapy, physiotherapy, massage, exercise, herbal medicine and acupuncture. Acupuncture for LBP is one of the most commonly used non-pharmacological pain-relieving techniques. This is due to its low adverse effects and cost-effectiveness. Currently, many randomized controlled trials and clinical research studies have produced promising results. In this article, the causes and incidence of LBP on global health care are reviewed. The importance of treatment by acupuncture is considered. The efforts to reveal the link between acupuncture points and anatomical features and the neurological mechanisms that lead to acupuncture-induced analgesic effect are reviewed. Full article
Open AccessReview
The Effects of Yin, Yang and Qi in the Skin on Pain
Received: 30 November 2015 / Revised: 15 January 2016 / Accepted: 26 January 2016 / Published: 29 January 2016
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Abstract
The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous [...] Read more.
The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang) and antagonists (yin) that help the body control pain. Acupuncture works through modulation of these receptor activities (qi) in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients. Full article
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Other

Open AccessCase Report
Evaluation of the Effectiveness of Acupuncture in the Treatment of Knee Osteoarthritis: A Case Study
Received: 11 December 2017 / Revised: 31 January 2018 / Accepted: 1 February 2018 / Published: 5 February 2018
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Abstract
Background: Osteoarthritis is a widespread chronic disease seen as a continuum of clinical occurrences within several phases, which go from synovial inflammation and microscopic changes of bone and cartilage to painful destructive changes of all the joint structures. Being the most common joint [...] Read more.
Background: Osteoarthritis is a widespread chronic disease seen as a continuum of clinical occurrences within several phases, which go from synovial inflammation and microscopic changes of bone and cartilage to painful destructive changes of all the joint structures. Being the most common joint disease, it is the leading cause of disability in working individuals above 50 years of age. In some cases, conventional treatments produce just a mild and brief pain reduction and have considerable side-effects. Contemporary Traditional Chinese Medicine (TCM) is a model of systems biology based on a logically accessible theoretical background. It integrates several therapeutic approaches, among them acupuncture, which has shown effective results in the treatment of knee and hip osteoarthritis, minimizing pain, improving functionality and consequently leading to a better quality of life. Methods: The present case study included two patients with clinical signs of osteoarthritis and diagnosis of medial pain, as defined by the Heidelberg Model of TCM. Over 6 weeks, those patients were treated with acupuncture, with a frequency of one session a week. The sessions lasted for thirty minutes and were based on the needling of 4 local acupoints. Before and after each session, pain and mobility assessments were performed. Results: The results were positive, with significant reduction of pain and increased knee joint flexion amplitude and mobility. Conclusion: Acupuncture was effective as an alternative or complementary treatment of knee osteoarthritis, with high levels of improvement within a modest intervention period. Full article
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Open AccessBrief Report
Treatment of Sciatica Following Uterine Cancer with Acupuncture: A Case Report
Received: 5 December 2017 / Revised: 6 January 2018 / Accepted: 7 January 2018 / Published: 15 January 2018
Cited by 1 | PDF Full-text (466 KB) | HTML Full-text | XML Full-text
Abstract
For women, gynaecological or obstetrical disorders are second to disc prolapse as the most common cause of sciatica. As not many effective conventional treatments can be found for sciatica following uterine cancer, patients may seek assistance from complementary and alternative medicine. Here, we [...] Read more.
For women, gynaecological or obstetrical disorders are second to disc prolapse as the most common cause of sciatica. As not many effective conventional treatments can be found for sciatica following uterine cancer, patients may seek assistance from complementary and alternative medicine. Here, we present a case of a woman with severe and chronic sciatica secondary to uterine cancer who experienced temporary relief from acupuncture. Full article
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Open AccessOpinion
Why We Need Minimum Basic Requirements in Science for Acupuncture Education
Received: 21 June 2016 / Revised: 26 July 2016 / Accepted: 1 August 2016 / Published: 5 August 2016
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Abstract
As enthusiasm for alternatives to pharmaceuticals and surgery grows, healthcare consumers are turning increasingly to physical medicine modalities such as acupuncture. However, they may encounter obstacles in accessing acupuncture due to several reasons, such as the inability to locate a suitable practitioner, insufficient [...] Read more.
As enthusiasm for alternatives to pharmaceuticals and surgery grows, healthcare consumers are turning increasingly to physical medicine modalities such as acupuncture. However, they may encounter obstacles in accessing acupuncture due to several reasons, such as the inability to locate a suitable practitioner, insufficient reimbursement for treatment, or difficulty gaining a referral due to perceived lack of evidence or scientific rigor by specialists. Claims made about a range of treatment paradigms outstrip evidence and students in acupuncture courses are thus led to believe that the approaches they learn are effective and clinically meaningful. Critical inquiry and critical analysis of techniques taught are often omitted, leading to unquestioning acceptance, adoption, and implementation into practice of approaches that may or may not be rational and effective. Acupuncture education for both licensed physicians (DOs and MDs) and non-physicians needs to include science (i.e., explanation of its effects based on contemporary explanations of biological processes), evidence, and critical thinking. Erroneous notions concerning its mechanisms such as moving “stuck Qi (Chi)” or “energy” with needles and that this energy stagnates at specific, tiny locations on the body called acupuncture points lead to mistakes in methodologic design. For example, researchers may select sham and verum point locations that overlap considerably in their neural connections, leading to nonsignificant differences between the two interventions. Furthermore, attributing the effects of acupuncture to metaphorical and arcane views of physiology limits both acceptance and validation of acupuncture in both research and clinical settings. Finally, the content and quality of education and clinical exposure across acupuncture programs varies widely, with currently no minimum basic educational requirements in a scientific methodology. Considering the pressures mounting on clinicians to practice in an evidence-based and scientific manner that also demonstrates cost-effectiveness, acupuncture schools and continuing medical education (CME) courses need to provide their students a strong foundation in rational approaches supported by research. Full article
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