Clinical Acupuncture Trials
In The United States Air Force
The journal Medical Acupuncture is a vertical production aiming its effort to publish the most useful information received from its readership. Most of our articles consist of anecdotal clinical case histories – unfortunately, not justifiable as evidence-based medicine. But, they are useful in offering clinical "clues" for future research/clinical projects as well as being a major resource for our members. The majority of our readership practices medical acupuncture either as an alternative or complementary modality. The published articles may serve as "clinical and financial force multipliers."
Nevertheless, the importance of acupuncture clinical trials cannot be overemphasized for the promulgation of medical acupuncture into mainstream Western medicine so that patients may benefit from this technology. It may be argued that acupuncture cannot be properly evaluated because the use of sham and other blinding techniques is difficult to implement in practice. Furthermore, acupuncture does not test out as a pharmaceutical, its methodology is individualized, and treatments for the same disease/symptoms are different. It is also argued that acupuncture mechanisms may not even operate on the level of Newtonian physics. Despite these considerations, it is possible to circumvent these impediments.
Anecdotal information was useful in the preparation and execution of an acupuncture clinical trial that is ongoing at Malcolm Grow Medical Center (MGMC), Andrews Air Force Base, Maryland, involving acute pain. The design is based on my observation of significant pain attenuation when treating the cingulate gyrus and the thalamic points in the ear. I followed the requirements of the institutional review board and solicited the assistance of Drs. Wayne Jonas and Christine Goertz of the Samueli Institute, Arlington, Virginia. The Emergency Department (ED) at MGMC was receptive to assist with the project. Patients are evaluated by the ED physicians to determine eligibility and then randomized to receive or not receive auriculotherapy. All patients, whether randomized as control or as intervention participant, have adhesive tape placed on both ears to hide the small needles. The ED staff cannot tell who receives acupuncture during the pain evaluation. If after about 15 minutes, the patient still has pain, he/she is treated conventionally with pain medications. Follow-up is done by an independent evaluator. I named this project "Battlefield Acupuncture."
Another clinical trial is ongoing at MGMC based on Dr. Alston Lundgren's article, "Medical Acupuncture For Age-Related Macular Degeneration: A Preliminary Report," in Medical Acupuncture (Vol. 14, No. 2). The Ophthalmology Department became intrigued and one of the physicians volunteered to help. The project is very exciting and we have already treated several patients.
I believe there is much we can do to promote small clinical trials to gather excellent data. If you have an idea and believe in it, share it with your colleagues and hospital. Anecdotal data is important. Watch, look, and listen in your clinic. There is something very important going on right now. Do you see it?
By the time you read this, I will have traveled (in July) with researchers from M.D. Anderson Cancer Center, Houston, Texas, to the Cancer Hospital Fudan University, Shanghai, China, to observe their mutual acupuncture clinical research and to lecture on my rapid acupuncture technique to treat xerostomia in head and neck cancer patients. I will communicate my observations to you at a later date.
— Richard C. Niemtzow, MD, PhD, MPH
Dr Richard C. Niemtzow is a Radiation Oncologist and Colonel in the United States Air Force. He is the Chief Medical Consultant for Alternative Medicine for the Air Force Surgeon General. In addition to his research activities, Dr Niemtzow practices Medical Acupuncture full-time at Malcolm Grow Medical Center, Andrews Air Force Base, Maryland. He is Chairman of the American Academy of Medical Acupuncture (AAMA) Research Committee.
Richard C. Niemtzow, MD, PhD, MPH
9800 Cherry Hill Rd
College Park, MD 20740
Phone: 301-937-7424 • Fax: 301-937-3205
Colonel (Dr) Richard C. Niemtzow
Medical Group (AMC)
Malcolm Grow Medical Center
Andrews AFB, MD 20762