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Editor's Correspondence |

The Future of Integrative Medicine

Charles Shang, MD
Arch Intern Med. 2001;161(4):613-614. doi:.
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In a recent debate,1 Relman raised the concern that integrative medicine "would not be an advance but a return to the past, an interruption of the remarkable progress achieved by science-based medicine over the past century." Can integrative medicine contribute to the scientific advances beyond conventional biomedicine? Dr Relman's negative conclusion seems premature and has been disproved by current evidence. Among the various modalities of integrative medicine, acupuncture is regarded as one of the better studied.2,3 Hundreds of randomized controlled trials on acupuncture have been published.4 The quality of the trials and the results were often mixed5 and complicated by the numerous difficulties in defining proper treatment, qualification of acupuncture practitioners involved in research, controls,6 and blinding procedures,7 as well as bias in publication.1,8 Nevertheless, positive results of acupuncture trials have been reported in peer-reviewed conventional Western medical journals on a variety of conditions such as chronic obstructive pulmonary disease,9 nasal congestion,10 renal colic,11 migraine,12,13 osteoarthritis,14,15 Raynaud syndrome,16 breech presentation,17 and low sperm activity.18 Many of the results have been repeated. A systematic review of the high-quality, randomized controlled trials of acupuncture used as an antiemetic showed consistent positive results across different investigators, different groups of patients, and different forms of acupuncture point stimulation such as electroacupuncture, laser acupressure,19 and manual acupuncture.20 The positive effect on stroke2124 and cerebral blood flow has also been repeated and corroborated.25 Evidence suggests that acupuncture can have superior efficacy over conventional therapy for certain conditions26 such as low sperm activity,18,27 and it has a superior side effects profile2831 as demonstrated in randomized controlled trials.11,13

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