Acupuncture to Alleviate Nausea

Feeling nauseous, or as if you have to vomit, is one of the most common side effects of chemotherapy. Fortunately, it can usually be controlled-usually with medicines, but increasingly with certain non-traditional therapies, including acupuncture.

A Centuries-Old Body of Evidence

Acupuncture is one of the oldest, most commonly used medical procedures in the world. Originating in China more than two centuries ago, it first became widely known in the United States in 1971 when New York Times reporter James Reston wrote about how doctors in Beijing, China used needles to ease his abdominal pain after surgery.

Traditional Chinese medicine theorizes that more than 2,000 acupuncture points on the human body connect with 12 main and 8 secondary pathways, called meridians. Acupuncture practitioners believe these meridians conduct energy, or qi, between the surface of the body and internal organs.

Qi is influenced by the opposing forces of yin and yang, according to practitioners. When yin and yang are balanced, they work together with the natural flow of qi to help the body achieve and maintain health. Acupuncture is believed to balance yin and yang, keep the normal flow of energy unblocked, and restore health to the body and mind.

A number of studies by Western researchers have documented acupuncture's effects, but they have not been able to fully explain how acupuncture actually works. Western scientists have found meridians hard to identify because they do not directly correspond to nerve or blood circulation pathways.

Nonetheless, the wealth of anecdotal evidence is becoming too hard to ignore.

For example, the British Medical Journal recently took the remarkable step of proclaiming acupuncture as a viable treatment option for combating nausea, pain, and certain other illnesses. "There is reasonable scientific evidence acupuncture is effective for chronic illnesses where sufferers usually take pain-killers for a long period of time," said Dr. Vivienne Nathanson on behalf of the British Medical Association (BMA).

The report, entitled "Acupuncture: Efficacy, Safety and Practice," which was researched by the BMA's Board of Science and Education, recommended that acupuncture be integrated into the British National Health Service. It specifically identified its beneficial role in alleviating nausea and vomiting, back and dental pain, and migraine headaches.

Electroacupuncture

A particularly difficult anti-nausea challenge involves breast cancer patients undergoing bone marrow transplants (high-dose chemotherapy), where nausea and vomiting are major concerns yet strong medicines cannot be tolerated. However, an intriguing report published in The Journal of the American Medical Association suggested that electroacupuncture-using acupuncture needles with a small electric charge flowing through them-might help to prevent nausea and vomiting.

Dr. Joannie Shen of the National Institutes of Health in Bethesda, Maryland and colleagues gave 37 patients electroacupuncture at two classic acupuncture points, in addition to basic anti-nausea medication that was acceptable to bone marrow transplant patients at that time. Thirty-four other patients were given traditional (non-electric) acupuncture plus anti-nausea medications, and 34 were given just the anti-nausea medications.

During a follow-up period of 5 days, the electroacupuncture group had a median number of 5 episodes of vomiting per patient, compared to 10 for those receiving traditional acupuncture, and 15 for those using drug therapy alone.

As a result of these findings, the researchers suggested that acupuncture-either electric or traditional-might be useful in some patients for whom medications simply will not alleviate their nausea and vomiting.

Risks

The Food and Drug Administration only approved acupuncture needles for use by licensed practitioners in 1996 and now requires manufacturers of acupuncture needles to label them for strictly single use. The National Institutes of Health finally published official guidelines for the use of acupuncture in 1997.

Relatively few complications from the use of acupuncture have been reported to the FDA when one considers the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. When not delivered properly, acupuncture can cause serious adverse effects, including infections and puncturing of organs.

A Growing Trend

A recent poll by InterSurvey found revealed that two-thirds of Americans have tried some form of complementary or alternative therapy. Based on a representative sample of 1,148 adults, the survey found that half of the respondents had taken vitamin supplements during the previous two weeks. More than a third of those surveyed reported trying herbal medicines, chiropractic and massage. Interestingly, massage, yoga and acupuncture were rated the highest for total overall effectiveness.

SOURCES:
National Center for Complementary and Alternative Medicine (http://nccam.nih.gov)
The American Academy of Medical Acupuncture (http://www.medicalacupuncture.org)
The National Acupuncture and Oriental Medicine Alliance (http://www.acuall.org)
The American Association of Oriental Medicine (http://www.aaom.org)
British Medical Journal, June 25, 2000
The Journal of the American Medical Association, December 6, 2000; 284:2755-2761

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