Chapter 2

Review of Related Literature and Studies

This chapter presents the literature and studies related that have some bearing in the present

work. These related studies provided the researchers with insights and direction in the conduct of the

study.

Acupuncture

Acupuncture is an alternative medicine methodology originating in ancient China that treats

patients by manipulating thin, solid needles that have been inserted into acupuncture points in the skin.

According to Traditional Chinese medicine, stimulating these points can correct imbalances in the flow

of qi through channels known as meridians. However, scientific research has not found any histological

or physiological correlates for qi, meridians and acupuncture points, and some contemporary

practitioners needle the body without using the traditional theoretical framework. (Janice M. Mann –

2012)

Current scientific research supports acupuncture's efficacy in the relief of certain types of pain

and post-operative nausea. Other reviews have concluded that positive results reported for acupuncture

are too small to be of clinical relevance and may be the result of inadequate experimental blinding, or

can be explained by placebo effects and publication bias. The invasiveness of acupuncture make it

difficult to design an experiment that adequately controls for placebo effects.

(http://ernakulam.com/st.joseph_hospital/)

The use of acupuncture for certain conditions has been tentatively endorsed by the United

States National Institutes of Health, the National Health Service of the United Kingdom, the World

Health Organization, and the National Center for Complementary and Alternative Medicine, though
most of these endorsements have been criticized for being unduly credulous and not including

objections to or criticisms of the research used to support acupuncture's effectiveness. (BBC 2010)

There is general agreement that acupuncture is safe when administered by well-trained

practitioners using sterile needles and carries a very low risk of serious adverse effects. Many of these

are not intrinsic to acupuncture but rather to bad practices (such as improper needling or unsterile

needles), which may be why such complications have not been reported in surveys of adequately-

trained acupuncturists. (https://www.crystalinks.com/acupuncture.html)

STATISTICS

There are about 250 000 practitioners of traditional medicine in the country. Approximately five

to eight chiropractors are practising in the Philippines (45). There are no privately owned hospitals

providing formal traditional or complementary/alternative medical services. As of 1999, only a handful

of Government hospitals offered acupuncture services to the general public.

(https://apps.who.int/medicinedocs/en/d/Jh2943e/9.13.html).

HISTORY OF ACUPUNCTURE IN THE PHILIPPINES

The history of acupuncture in the Philippines goes back to 1972, when a group of lady physicians

went to China on a cultural medical educational tour. They trained in acupuncture and when they

returned, they developed a course and taught local and foreign doctors, in 1973.

However. in 1975 the Professional Regulation Commission banned the practice of acupuncture

except for research, hence the private practitioners lost interest. The ban was however lifted in 1983

and the Board of Medicine allowed the practice of acupuncture by properly trained physicians.
 The Ministry of Health started sending physicians to China for training in acupuncture since

1975. However, some of those who trained have left the government service and only about a dozen of

them have remained.

This core group of trained acupuncturists in a seminar – workshop in 1984 shared their

experience in acupuncture practice. They have obtained 90% success in the treatment of about 35

common disease conditions. They recommended the integration of acupuncture in the health care

delivery system.

The core group was given an advanced training by an expert from China to upgrade their skills

and to implement a massive training program for government doctors in rural health units and in

provincial district hospitals.

Training centers for acupuncture have been set up in the different regions of the country, which

offer basic acupuncture training courses and by the end of this year some 100 physicians shall have been

trained in acupuncture and moxibustion therapy.

(https://iris.wpro.who.int/bitstream/handle/10665.1/6616/WPR_RC036_TD_InfoDoc07_1985_en.pdf )

SYNTHESIS

According to a study, the general theory of acupuncture is based on the premise that bodily

functions are regulated by an energy called qi which flows through the body; disruptions of this flow are

believed to be responsible for disease. Acupuncture describes a family of procedures aiming to correct

imbalances in the flow of qi by stimulation of anatomical locations on or under the skin (usually called

acupuncture points or acupoints), by a variety of techniques. The most common mechanism of

stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are

manipulated manually or by electrical stimulation. Research suggests that traditional forms of

acupuncture are more effective than placebos in the relief of certain types of pain and post-operative

nausea. Recent systematic reviews found that acupuncture also seems to be a promising treatment

option for anxiety, sleep disturbances, and depression, but that further research is needed in these

regards. Although minimally invasive, the puncturing of the skin with acupuncture needles poses

problems when designing trials that adequately controls for placebo effects. A number of studies

comparing traditional acupuncture to sham procedures found that both sham and traditional

acupuncture were superior to usual care but were themselves equivalent; findings apparently at odds

with traditional Chinese theories regarding acupuncture point specificity.

(https://www.crystalinks.com/acupuncture.html)

According to study in 2003, the World Health Organization's Department of Essential Drugs and

Medicine Policy produced a report on acupuncture. The report was drafted, revised and updated by

Zhu-Fan Xie, the Director for the Institute of Integrated Medicines of Beijing Medical University. It

contained, based on research results available in early 1999, a list of diseases, symptoms or conditions

for which it was believed acupuncture had been demonstrated as an effective treatment, as well as a

second list of conditions that were possibly able to be treated with acupuncture. Noting the difficulties

of conducting controlled research and the debate on how to best conduct research on acupuncture, the

report described itself as "...intended to facilitate research on and the evaluation and application of

acupuncture. It is hoped that it will provide a useful resource for researchers, health care providers,

national health authorities and the general public." ( Peter W. McCarthy, Mark J. Langweiler – 2015)

It was found out on November 16, 2010, acupuncture and moxibustion were recognized by

UNESCO as part of the world's intangible cultural heritage. (  F Obringer - 2011)

FERTILITY AND CHILDBIRTH

Proponents believe acupuncture can assist with fertility, pregnancy and childbirth, attributing

various conditions of health and difficulty with the flow of qi through various meridians.

A 2008 Cochrane review of randomized controlled trials of in vitro fertilization and

acupuncture suggests that acupuncture performed on the day the embryo is transferred to the uterus

may increase the live birth rate, although this effect could be due to the placebo effect and the small

number of women included in acceptable trials. There was no evidence of benefit when the egg was

initially removed and the review did not recommend the routine use of acupuncture during the luteal

phase until better trials were available. (S Cochrane - 2014)

A different review article published in 2010 found that there was no evidence acupuncture

improved pregnancy rates irrespective of when it was performed and recommended against its use

during in vitro fertilization either during egg retrieval or implantation. (Hullender Rubin, 2010)

PAIN

Another 2012 review found acupuncture to provide significantly better relief from knee

osteoarthritis pain and a larger improvement in function than sham acupuncture, standard care

treatment, or waiting for further treatment. Two reviews from 2007 and 2008 had yielded similar

positive results, however, there also was one review that found acupuncture ineffective in treating

knee osteoarthritis. The Osteoarthritis Research Society International released a set of consensus

recommendations in 2008 that concluded acupuncture may be useful for treating the symptoms of

osteoarthritis of the knee. Results for osteoarthritis in other joints suggest insignificant effects in

short-term pain relief, which may be due to placebo or expectation effects. (MA Urruela - 2012)
 Also in 2012, a review found that acupuncture has demonstrated benefit for the treatment of

headaches, but that safety needed to be more fully documented in order to make any strong

recommendations in support of its use. (C Lee - 2012)

A 2011 review of eight Cochrane reviews found that acupuncture is effective in the treatment

of migraines, neck disorders, tension-type headaches, and peripheral joint osteoarthritis. (MS Lee -

2011)

Another 2011 review concluded that there was unanimously positive research supporting

acupuncture for neck pain, but that little truly convincing evidence existed for other types of pain. (E

Ernst - 2011)

(OTHER RELATED LITERATURE)

The uniqueness of the researchers’ present study was they focused on a particular place

which was SMIC. It is a hospital which caters ______________________. The researchers’

respondents are mostly (WHAT’S YOUR SPECIFIC TARGET POPULATION NA PATIENT) civilians

who seek health attention from SMIC. In addition to that, they wanted to find out the significant

relationship of practice and preference to acupuncture treatment of the patients in SMIC. Literature

and studies showed how the practice and preference can affect some aspects of acupuncture

treatment. However, the researchers specifically wanted to know the level, low, average, or high, of

effectiveness of acupuncture treatment to patients that can be reflected on the quality of life of the

person. (RESEARCH QUESTIONS PLEASE, DRAFT ONLY)