Publications by authors named "Arthur Yin Fan"

43 Publications

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care.

J Integr Med 2021 Jun 8. Epub 2021 Jun 8.

Department of Critical Care Medicine, Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China. Electronic address:

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient's breath rate, SpO, heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient's breathing function, increased SpO, and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.
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http://dx.doi.org/10.1016/j.joim.2021.06.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186062PMC
June 2021

[Discussion on published in ].

Zhongguo Zhen Jiu 2021 Apr;41(4):359-64

American TCM Society, New York NY 10016, USA.

Professor ' team from Chengdu University of TCM published in on July 29, 2019, which demonstrates that acupuncture as an adjunctive therapy is safety and effective for mild and moderate chronic stable angina. Sixteen experts at home and abroad conducted serious discussions on the research design, evaluation methods, principles and mechanisms, clinical significance and enlightenment of future acupuncture research, and provided practical suggestions for acupuncture and moxibustion to go global and gain international recognition.
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http://dx.doi.org/10.13703/j.0255-2930.20190929-k0003DOI Listing
April 2021

Acupuncture modulates immunity in sepsis: Toward a science-based protocol.

Auton Neurosci 2021 05 27;232:102793. Epub 2021 Feb 27.

American TCM Association, Vienna, VA 22182, USA; Eastern Roots Wellness, PLC, McLean, VA 22101, USA.

Sepsis is a serious medical condition in which immune dysfunction plays a key role. Previous treatments focused on chemotherapy to control immune function; however, a recognized effective compound or treatment has yet to be developed. Recent advances indicate that a neuromodulation approach with nerve stimulation allows developing a therapeutic strategy to control inflammation and improve organ functions in sepsis. As a quick, non-invasive technique of peripheral nerve stimulation, acupuncture has emerged as a promising therapy to provide significant advantages for immunomodulation in acute inflammation. Acupuncture obtains its regulatory effect by activating the somatic-autonomic-immune reflexes, including the somatic-sympathetic-splenic reflex, the somatic-sympathetic-adrenal reflex, the somatic-vagal-splenic reflex and the somatic-vagal-adrenal reflex, which produces a systemic effect. The peripheral nerve stimulation also induces local reflexes such as the somatic-sympathetic-lung-reflex, which then produces local effects. These mechanisms offer scientific guidance to design acupuncture protocols for immunomodulation and inflammation control, leading to an evidence-based comprehensive therapy recommendation.
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http://dx.doi.org/10.1016/j.autneu.2021.102793DOI Listing
May 2021

Estimated Number of Acupuncture Practitioners in Mainland China in 2018: Multiperspectives.

Med Acupunct 2020 Oct 19;32(5):310-319. Epub 2020 Oct 19.

Nanjing University of Chinese Medicine The Third Hospital, Nanjing, China.

Acupuncture and Oriental medicine are widespread, practiced in >183 countries and regions. As such, it has played an important role in the world health care system. However, there are no official statistics available on the number of acupuncture practitioners in China. The aim of this study is to calculate the number ranges of acupuncture practitioners in China in 2018. In total, 33.708 million was used as the total number of patient visits for acupuncture in 2018 in China. This number was calculated using the data released by the National Administration of Traditional Chinese Medicine (China), in which the average daily workload of all acupuncture practitioners in China was 134,832 patient visits. Acupuncture practitioners in China are part of Chinese Medicine doctors (CMDs) at the physician level, called "acupuncture doctors." This number 134,832 was divided by the workload of a single doctor of acupuncture, which was 19.4 or 7.0 patient visits per day. These numbers were from a survey by the authors. There are also the numbers 16.0 or 9.4 patient visits per day; these numbers were calculated from the salary level of acupuncture practitioners at 10,000 Yuan per month (providing the doctor's net income was 30% or 50% in his/her gross income). From these 2 sources, the authors then obtained 2 sets of ranges of acupuncture practitioners in China in 2018. There were 9,927 CMDs in 49 big hospitals, of which 619 were acupuncture practitioners; the ratio of acupuncture practitioners to the whole of all CMDs was 6.23%. Using this ratio multiplied by the whole number of CMDs in 2018, then the number of acupuncture practitioners in China in 2018 could be obtained as well. Calculating based on the workload, the range of acupuncture practitioners in China in 2018 was from 6,950 to 19,262. Calculating based on the salary level, the range was 10,618 to 17,697. Calculating based on the ratio of the number of acupuncture practitioners to the whole population of CMDs, the number was 28,360. The reasonable range of acupuncture practitioners in China in 2018 was 10,618 to 17,697, with a median of 14,157. Considering that some acupuncture practitioners are also engaged in teaching, research, and management, the mentioned number is enlarged by 30% to produce 18,404, which would be reasonable. It was also concluded that the density of acupuncture practitioners was 1.31 per 100,000 residents.
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http://dx.doi.org/10.1089/acu.2020.1439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7583322PMC
October 2020

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis.

J Integr Med 2020 09 31;18(5):385-394. Epub 2020 Jul 31.

American TCM Association (ATCMA), Vienna, VA 22182, USA; East Roots Wellness, PLC, McLean, VA 22101, USA.

Background: There is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.

Objective: This systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19.

Search Strategy: Six electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.

Inclusion Criteria: Randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.

Data Extraction And Analysis: Two evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled.

Results: Seven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (-1.30 by SMD, 95% CI [-2.43, -0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; -11.82 by MD, 95% CI [-17.95, -5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.

Conclusion: Current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.
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http://dx.doi.org/10.1016/j.joim.2020.07.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834293PMC
September 2020

Universities of Chinese Medicine Enter the Global Stage of Best Universities Rankings in 2020.

Med Acupunct 2020 Jun 16;32(3):136-142. Epub 2020 Jun 16.

American TCM Association, Vienna, VA, USA.

Chinese Medicine (known as acupuncture and Oriental Medicine (AOM) in the United States), has spread far and been utilized in more than 183 countries or regions. It has played an important role in the health care systems of many countries. Licensed acupuncturists' contribution to the U.S. market alone is more than 3.5 billion dollars. The aim of the current study was to determine the ranking status of Chinese Medicine schools on the global or international level in 2020. Databases of PubMed.gov, wanfangdata.com.cn, cnki.net, and google.com were searched, using the keywords: , or , both in English and Chinese. If the ranking did not show up in the results directly, the authors moved on to find global or international higher education (universities or colleges) ranking agencies or institutions. Then the authors used the websites of ranking agencies or institutions to conduct more research, using the keywords: , , or . is the only recognized authority that reported the ranking status of universities of Chinese Medicine in its 2020 edition, in which the best global universities were ranked. A total of 1500 universities in 81 countries and regions were included. Based on the overall academic strength of each university, Shanghai University of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as numbers 1376, 1390 and 1440, respectively. In clinical medicine, 750 universities were ranked among the strongest in the world; Nanjing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Guangzhou University of Chinese Medicine were ranked as 688th, 734th, and 738th, respectively. In pharmacology and toxicology, 250 universities were among the strongest in the world; Shanghai University of Traditional Chinese Medicine and Nanjing University of Chinese Medicine were ranked as 153rd and 209th, respectively. In oncology, 250 universities were ranked as strongest in the world; Nanjing University of Chinese Medicine was ranked as 243rd in the world. Chinese Medicine schools are more accepted and more highly ranked than they had been in the past.
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http://dx.doi.org/10.1089/acu.2019.1403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310207PMC
June 2020

Controversial conclusions from two randomized controlled trials for acupuncture's effects on polycystic ovary syndrome or in vitro fertilization support.

J Integr Med 2020 03 21;18(2):89-91. Epub 2020 Jan 21.

American TCM Association, Vienna, VA 22182, USA; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA 22182, USA.

Two reports of trials investigating the potential effect of acupuncture in increasing live birth rate (LBR) in women with polycystic ovary syndrome (PCOS) or those undergoing in vitro fertilization (IVF) were published by Journal of American Medical Association in 2017 and 2018 respectively. The trial investigators did not recommend acupuncture for the women with PCOS or IVF based on their findings. This paper raises the concern that the findings that acupuncture did not increase LBR for women with PCOS or undergoing IVF may be the result of methodological flaws in the studies and unintended bias such as use of an invalid control intervention and underestimation of the true acupuncture effect. Therefore, their findings may not be a valid reflection of acupuncture's effect in improving LBR in women with these clinical conditions.
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http://dx.doi.org/10.1016/j.joim.2020.01.007DOI Listing
March 2020

Dry Needling: Is It Derived From Acupuncture? How Did Nonacupuncturists Start Using It?

Altern Ther Health Med 2020 May;26(3):40-46

Context: In the United States. and other Western countries, dry needling (DN) has been a disputed topic in both the academic and legal fields.

Objective: The research team intended to examine whether DN is a technique independent from acupuncture and also how nonacupuncturists, such as physical therapists (PTs), started practicing DN.

Design: The research team completed research, examined critical issues related to DN, and published a white paper in 2017 that discussed evidence and expert opinions from academic scholars, for health care professionals, administrators, policy makers, and the general public that demonstrate that DN is acupuncture. This article continues that endeavor.

Results: DN is not merely a technique but a medical therapy that is a simplified form of acupuncture practice. To promote DN theory and business, some commercial DN educators have recruited a large number of nonacupuncturists, including PTs, athletic trainers, and nurse practitioners, in recent years. PTs did not initiate the practice of DN and DN does not fit into the practice scope for PTs because it is an invasive practice. The national organizations of the PT profession, such as the American Physical Therapy Association and the Federation of State Boards of Physical Therapy, began to support the practice of DN by PTs in approximately 2010. Currently, more PTs are involved in DN practice and are teaching than any other specialty.

Conclusions: Acupuncturists and physicians must complete extensive acupuncture training in accredited programs and pass national examinations to become licensed or certified to practice acupuncture. However, a typical DN course runs only 20-30 h, often in the course of 1 weekend, and the participants may receive a DN certificate without any national examination being required. For the safety of patients and professional integrity, the research team strongly suggests that all DN practitioners and educators should have to meet the same basic standards as those required for licensed acupuncturists or physicians.
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May 2020

Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on OkCopay.com.

J Integr Med 2019 Sep 28;17(5):315-320. Epub 2019 Jun 28.

McLean Center for Complementary and Alternative Medicine, PLC., Vienna, VA 22182, USA.

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.
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http://dx.doi.org/10.1016/j.joim.2019.06.003DOI Listing
September 2019

The 4th American Traditional Chinese Medicine Congress: Where Spirit, Medicine, and Tradition Connect.

Med Acupunct 2019 Feb 7;31(1):15-18. Epub 2019 Feb 7.

American Traditional Chinese Medicine Association, Vienna, VA.

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http://dx.doi.org/10.1089/acu.2018.1319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386774PMC
February 2019

Discussions on real-world acupuncture treatments for chronic low-back pain in older adults.

J Integr Med 2019 Mar 26;17(2):71-76. Epub 2019 Jan 26.

American TCM Association (ATCMA), Vienna, VA 22182, USA; Eastern Roots Wellness, PLC, McLean, VA 22101, USA.

Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity; therefore, it should be effective for CLBP in older adults.
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http://dx.doi.org/10.1016/j.joim.2019.01.005DOI Listing
March 2019

Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2018.

Complement Ther Med 2018 Dec 22;41:295-301. Epub 2018 Oct 22.

Highland Hospital, Alameda Health System, Oakland, CA 94602, USA.

This study was conducted to identify the approximate number and density of actively licensed acupuncturists, as well as the number of schools in acupuncture and oriental medicine (AOM) by January 1, 2018 in the United States (U.S.). We contacted the appropriate department governing acupuncturists, such as the Board of Acupuncture or Board of Medicine, etc. in each state and U.S. territories, to collect the data. We also conducted online license information searches in order to collect the most accurate numbers of licensed acupuncturists, especially for those states in which a board could not be reached. We found that the number of actively licensed acupuncturists as of January 1, 2018 in the U.S. was 37,886. The ten states with the largest number of acupuncturists (28,452 or 75.09% of the U.S. total), in order by total, included California, New York, Florida, Colorado, Washington, Oregon, Texas, New Jersey, Maryland and Massachusetts. The number of practitioners was greater than 1000 for each of these states. Among them, the largest three were California (12,135; 32.03%), New York (4438; 11.71%) and Florida (2705; 7.13%). These three states accounted for more than half of the overall total. The number of total licensed acupuncturists has increased 257% since 1998. The overall acupuncturist density in the U.S. - measured as number of acupuncturists per 100,000 - was 11.63 (total number of licensed acupuncturists: 37,886, divided by the total population: 325,719,178 at the start of 2018). There were 20 states with an acupuncturist density of more than 10 per 100,000 population. Hawaii (52.82) was the highest, followed by Oregon (34.88), Vermont (30.79), California (30.69) and then New Mexico (30.27). There were 62 active, accredited AOM schools which altogether offered 100 programs: 32 master degrees in Acupuncture, 53 master degrees in Oriental medicine, 13 postgraduate doctorate degrees and 2 entry-level doctorate degrees. Among these active accredited schools, institutions in the West and East Coast states comprised 77.42% of the national total. California, Florida, and New York represented 41.94%. There were 48 jurisdictions (47 States and the District of Columbia) with acupuncture practice laws in place. States without acupuncture laws included Alabama, Oklahoma and South Dakota. The data suggests that acupuncture profession has steadily grown in the United States.
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http://dx.doi.org/10.1016/j.ctim.2018.10.015DOI Listing
December 2018

Effectiveness of two different acupuncture strategies in patients with vulvodynia: Study protocol for a pilot pragmatic controlled trial.

J Integr Med 2018 Nov 10;16(6):384-389. Epub 2018 Oct 10.

American Traditional Chinese Medicine Association, Vienna, VA 22182, USA.

Background: Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse. The study also examines how long the effect of acupuncture lasts in women with vulvodynia.

Methods/design: The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups 1a and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group (Group 2). Patients in Group 1a will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group 1b will receive acupuncture focused on traditional (distal) meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tenderness and trigger points (Ashi points) are also recorded. All measurements will be recorded at baseline (before the treatment), at the end of each week during treatment and at the end of the 6 weeks. Follow-up will be done 6 weeks following the last treatment.

Discussion: Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupuncture focused on distal meridian points for vulvodynia.

Trial Registration: Clinicaltrials.gov: NCT03481621. Register: March 29, 2018.
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http://dx.doi.org/10.1016/j.joim.2018.10.004DOI Listing
November 2018

Distribution of licensed acupuncturists and educational institutions in the United States in early 2015.

J Integr Med 2018 01 12;16(1):1-5. Epub 2017 Dec 12.

McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA 22182, USA.

In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34,481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27,965) and 2004 (n = 22,671), respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.
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http://dx.doi.org/10.1016/j.joim.2017.12.003DOI Listing
January 2018

The National Cancer Institute's Conference on Acupuncture for Symptom Management in Oncology: State of the Science, Evidence, and Research Gaps.

J Natl Cancer Inst Monogr 2017 11;2017(52)

Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Kelly Services, Incorporated, Rockville, MD, and Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD; Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Rockville, MD; McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA; Department of General Oncology/Integrative Medicine Program, MD Anderson Cancer Center, Houston, TX; Health Division, RAND Corporation, Santa Monica, CA; Program in Placebo Studies, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY; Osher Center for Integrative Medicine, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; School of Chinese Medicine, University of Hong Kong, Hong Kong, China; Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Boston, MA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston MA; United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, MD; Department of Symptom Research, MD Anderson Cancer Center, Houston, TX; Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin, Germany; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD.

The Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, at the National Cancer Institute (NCI) held a symposium on "Acupuncture for Cancer Symptom Management" on June 16 and 17, 2016. Invited speakers included 19 scientists and scholars with expertise in acupuncture and cancer research from the United States, Europe, and China. The conference reviewed the NCI's grant funding on acupuncture, analyzed the needs of cancer patients, reviewed safety issues, and assessed both the current scientific evidence and research gaps of acupuncture in oncology care. Researchers and stakeholders presented and discussed basic mechanisms of acupuncture; clinical evidence for specific symptoms; and methodological challenges such as placebo effects, novel biostatistical methods, patient-reported outcomes, and comparative effectiveness research. This paper, resulting from the conference, summarizes both the current state of the science and clinical evidence of oncology acupuncture, identifies key scientific gaps, and makes recommendations for future research to increase understanding of both the mechanisms and effects of acupuncture for cancer symptom management.
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http://dx.doi.org/10.1093/jncimonographs/lgx005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061411PMC
November 2017

Acupuncture's Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management-White Paper 2017.

J Integr Med 2017 Nov;15(6):411-425

University of California, San Diego School of Medicine, San Diego, CA 92093, USA.

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.
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http://dx.doi.org/10.1016/S2095-4964(17)60378-9DOI Listing
November 2017

Re: "Chinese TCM Renaissance and the Global Movement for Integrative Health and Medicine" by Weeks (J Altern Complement Med 2017;23:79-81).

J Altern Complement Med 2017 11 21;23(11):897-898. Epub 2017 Sep 21.

1 McLean Center for Complementary and Alternative Medicine , PLC, Vienna, VA.

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http://dx.doi.org/10.1089/acm.2017.0201DOI Listing
November 2017

Evidence and expert opinions: Dry needling versus acupuncture (II) : The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016.

Chin J Integr Med 2017 Feb 7;23(2):83-90. Epub 2017 Mar 7.

The American Alliance for Professional Acupuncture Safety, Greenwich, Connecticut, 06878, USA.

In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding (1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain (dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.
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http://dx.doi.org/10.1007/s11655-017-2800-6DOI Listing
February 2017

Evidence and expert opinions: Dry needling versus acupuncture (III) - The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016.

Chin J Integr Med 2017 Mar 28;23(3):163-165. Epub 2017 Feb 28.

American Alliance for Professional Acupuncture Safety, Greenwich, Connecticut, 06878, USA.

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http://dx.doi.org/10.1007/s11655-017-2542-xDOI Listing
March 2017

Response to Dommerholt and Stanborough Re: "Evidence That Dry Needling Is the Intent to Bypass Regulation to Practice Acupuncture in the United States".

J Altern Complement Med 2017 02 4;23(2):150-151. Epub 2017 Jan 4.

3 LZ & Manhattan Acupuncture , P.C., New York, NY.

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http://dx.doi.org/10.1089/acm.2016.0394DOI Listing
February 2017

Evidence and expert opinions: Dry needling versus acupuncture (I) : The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016.

Chin J Integr Med 2017 Jan 21;23(1):3-9. Epub 2016 Dec 21.

American Alliance for Professional Acupuncture Safety, Greenwich, Connecticut, 06878, USA.

In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professional administrators, lawmakers, and the general public through providing the authoritative evidence and experts' opinions regarding critical issues of DN versus acupuncture, and then reach consensus. DN is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulati on, trigger points (TrP) acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is a form of simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a portion of Ashi point acupuncture from Chinese acupuncture. It seeks to redefine acupuncture by reframing its theoretical principles in a Western manner. DN-like needling with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since late of 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has a broader scope of indications, not limited to treating the myofascial pain.
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http://dx.doi.org/10.1007/s11655-016-2630-yDOI Listing
January 2017

Evidence That Dry Needling Is the Intent to Bypass Regulation to Practice Acupuncture in the United States.

J Altern Complement Med 2016 Aug;22(8):591-3

3 Acupuncture Wellness Center of Cincinnati , Cincinnati, OH.

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http://dx.doi.org/10.1089/acm.2016.0066DOI Listing
August 2016

The history of acupuncture anesthesia for pneumonectomy in Shanghai during the 1960s.

J Integr Med 2016 Jul;14(4):285-90

Acu-Herbs Healing, Citrus Heights, CA 95610, USA.

The success of acupuncture anesthesia (AA) for pneumonectomy in Shanghai in 1960 was a key event for AA gaining practical clinical application. The effort was a close collaboration between the Shanghai First Tuberculosis Hospital and the Shanghai Institute of Acupuncture and Moxibustion. One of the most important factors of AA success was the great financial and political support provided by the Chinese central government and Shanghai local government. In December1965 the State Science and Technology Commission of China issued a formal document acknowledging AA as an important first-level national achievement of the integration of Chinese and Western medicine, and a collaborative effort of the whole scientific community in China. AA was an important influential factor that helped acupuncture spread across the world.
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http://dx.doi.org/10.1016/S2095-4964(16)60253-4DOI Listing
July 2016

Acupuncture is Effective for Chronic Knee Pain: A Reanalysis of the Australian Acupuncture Trial.

Altern Ther Health Med 2016 Mar;22(3):32-36

Context • In the October 2014 issue of the Journal of the American Medical Association (JAMA), Hinman et al published the results of an Australian clinical trial on acupuncture in a paper entitled "Acupuncture for Chronic Knee Pain: A Randomized Clinical Trial" (JAMA report), in which they concluded that neither acupuncture nor laser acupuncture had any greater effects than sham laser acupuncture for pain or function for patients aged 50 y and older with moderate-to-severe knee pain. That study has been criticized extensively by international scholars for its validity because serious methodological flaws existed throughout the study's design, implementation, and conclusions. Objective • The current study intended to re-examine the prior study's conclusions about the efficacy of acupuncture for chronic knee pain. Design • The current research team performed a reanalysis of relevant data from the JAMA report. Intervention • The original study included 4 groups: (1) an acupuncture group, which received needle acupuncture, inferred by the current authors to have been set up to be a positive control in the original study; (2) a laser acupuncture group, which received laser acupuncture; (3) a sham laser acupuncture group, which received sham laser acupuncture and acted as the negative controls for the laser acupuncture intervention; and (4) a control group, which received conventional care but no acupuncture or laser treatments. The study lasted 12 wk. Outcome Measures • The measures included evaluations in the following areas: (1) poststudy modifications-an evaluation of the consistency of the JAMA report with the study's intentions as identified for a grant that was originally approved and funded by the Australian National Health and Medical Research Council (NHMRC) in 2009, as indicated in the study's trial registration, and as compared with the published protocols and to the study's originally stated objectives; (2) high heterogeneity-an assessment of the heterogeneity among the 4 groups for the overall outcome related to pain; (3) ineffectiveness of laser acupuncture-an analysis of laser acupuncture's efficacy for chronic knee pain as stated in the JAMA report, using effect size (ES); (4) effectiveness of acupuncture-a reanalysis of acupuncture's efficacy for chronic knee pain in comparison with the original analysis in the JAMA report, using ES; and (5) acupuncture after data adjustment-a new analysis of acupuncture's efficacy for chronic knee pain using data from the original study that was discussed in the JAMA report, using ES, with an estimation after data adjustment and elimination of the dilution effect of the Zelen design. Results • Contrary to a general impression that acupuncture was the focus, laser acupuncture was the primary intervention tested in the actual study, "Laser Acupuncture in Patients With Chronic Knee Pain: A Randomized, Placebo Controlled Trial." The study discussed in the JAMA report was neither a truly randomized, controlled trial (RCT) for acupuncture nor was it an appropriately designed, randomized study in general. High heterogeneity was found among its groups in the evaluation of overall pain in patients. Both the ES of 0.60 that had been set by Hinman et al for the minimal clinically important difference (MCID) and the resulting interpretation of results in the JAMA report were not appropriate. Using the original study's criteria of efficacy, the reanalysis has confirmed that the laser acupuncture was not effective, whereas the acupuncture was found to be moderately effective for chronic knee pain (P < .05) for both overall pain and function at 12 wk, with an ES of 0.58, or after the adjustment of the data, with an ES of 0.67. Conclusions • The JAMA study was neither a conventional RCT nor an appropriately randomized trial, and its results are probably invalid. The ES of 0.60 for the MCID that was used in the JAMA study and the resulting explanation were not appropriate. Even with an ES of 0.60 for the MCID, acupuncture remained effective after data adjustment. Consequently, compared with conventional care, acupuncture treatment was found to be moderately effective for chronic knee pain in patients aged 50 y and older.
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March 2016

The legendary life of Dr. Gim Shek Ju, the founding father of the education of acupuncture and Chinese medicine in the United States.

Authors:
Arthur Yin Fan

J Integr Med 2016 May;14(3):159-64

McLean Center for Complementary and Alternative Medicine, PLC, Vienna, VA 22182, USA.

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http://dx.doi.org/10.1016/S2095-4964(16)60260-1DOI Listing
May 2016

Dr. William Prensky: The birth of the acupuncture profession in the United States (1969-1979) - the Institute for Taoist Studies and the National Acupuncture Association.

Authors:
Arthur Yin Fan

J Integr Med 2016 Jan;14(1):5-11

McLean Center for Complementary and Alternative Medicine, PLC. Vienna, VA 22182, USA.

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http://dx.doi.org/10.1016/S2095-4964(16)60236-4DOI Listing
January 2016

Dry needling is acupuncture.

Acupunct Med 2016 06 15;34(3):241. Epub 2015 Dec 15.

Oriental Family Medicine, Clearwater, Florida, USA.

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http://dx.doi.org/10.1136/acupmed-2015-011010DOI Listing
June 2016

Dr. Gene Bruno: The beginning of the acupuncture profession in the United States (1969-1979)--acupuncture, medical acupuncture and animal acupuncture.

J Integr Med 2015 Sep;13(5):281-8

McLean Center for Complementary and Alternative Medicine, PLC., Vienna, VA 22182, USA.

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http://dx.doi.org/10.1016/S2095-4964(15)60186-8DOI Listing
September 2015

The methodology flaws in Hinman's acupuncture clinical trial, Part III: Sample size calculation.

Authors:
Arthur Yin Fan

J Integr Med 2015 Jul;13(4):209-11

McLean Center for Complementary and Alternative Medicine, PLC., Vienna, VA 22182, USA.

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http://dx.doi.org/10.1016/S2095-4964(15)60184-4DOI Listing
July 2015
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