Over 2500 years of practice of acupuncture and efficacy had resulted in a wealth of technical know-how that lead to a wide range of diseases and conditions that could be effectively treated with this approach. Unlike many other traditional methods of treatment, which tend to be specific to their national or cultural context, acupuncture has been used throughout the world, particularly since the 1970s. In the recognition of the increasing worldwide interest in the subject, the World Health Organization (WHO) conducted a symposium on acupuncture in June 1979 in Beijing, China. Physicians practicing acupuncture in different countries were invited to identify the conditions that might benefit from this therapy. The participants drew up a list of 43 suitable diseases.
List 1: List of 43 diseases (WHO 1979)
Upper respiratory tract diseases: acute sinusitis (and chronic), acute rhinitis (and chronic), Influenza, Tonsillitis acute (and chronic)
Respiratory Diseases: Acute Tracheitis (and chronic), bronchial asthma
Eye Diseases: Conjunctivitis, Acute Central Serous Chorioretinopathy (CSCR), Myopia, Cataracts
Oral Disease: Toothache, pain after tooth extraction, gingivitis, acute and chronic laryngitis
Diseases of the Digestive System: Achalasia of the esophagus and cardia, hiccough, gastric ptosis, acute and chronic gastritis, gastric hyperacidity, acute and chronic duodenal ulcer, acute colitis (and chronic). Acute bacillary dysentery (and chronic), constipation, diarrhea, paralytic ileus
Illnesses of nerve, muscle, and bone: Headache, migraine, trigeminal Neuralgia, Palsy, paralysis post-traumatic polyneuropathy, acute anterior poliomyelitis, Meniere’s disease, neurological bladder, enuresis, intercostal neuralgia shoulder-hand syndrome, scapulohumeral, periarthritis tennis elbow, sciatica, low back pain, osteoarthritis.
In 1991, a progress report on traditional medicine and modern health care was submitted by the Director-General of WHO to the Forty-fourth World Health Assembly. The report pointed out that in countries where acupuncture forms part of the cultural heritage, its use in an integrated approach to modern and traditional medicine presents no difficulty.
However, in countries where modern Western medicine is the foundation of health care, the ethical use of acupuncture requires objective evidence of its efficacy under controlled clinical conditions.
In 1996, a draft report on the clinical practice of acupuncture was reviewed at the WHO Consultation on Acupuncture held in Cervia, Italy. The participants recommended that WHO should revise the report, focusing on data from controlled clinical trials. This is the outcome of that publication.
The objective of this publication is to provide a review and analysis of controlled clinical trials of acupuncture therapy, as reported in the current literature, with a view to strengthening and promoting the appropriate use of acupuncture in health care systems throughout the world. Information on the therapeutic mechanisms of acupuncture has also been incorporated. Another list of 28 diseases was drawn by WHO in the year 2002.
List 2: List of 28 diseases (WHO 2002)
Pain: Including musculoskeletal (knee, back, neck, shoulder periarthritis, tennis elbow, sciatica, sprain-j facial, headache, resulting from dental surgery, post-operative
Rheumatism: rheumatoid arthritis
Colic (stones) bile, renal colic
The Gastrointestinal System: nausea and vomiting, epigastric pain acute, acute bacillary dysentery
Throat: allergic rhinitis
Circulatory system: essential hypertension, primary hypotension, leucopenia 9low white blood cells in the blood), stroke
Pregnancy: Nausea related to pregnancy, repositioning of the fetus, labor induction to delivery
Side effects associated with radiotherapy and chemotherapy.
WHO published the reports for review and analysis of the clinical trials.
Certain notable suggestions made by the publication are:
The conditions of the health service in a given country or area should also be considered in evaluating acupuncture practice. In developing countries, where medical personnel and medicines are still lacking, the need for acupuncture may be considerable and urgent; proper use of this simple and economic therapy could benefit a large number of patients. On the other hand, in developed countries, where the health systems are well established, with sophisticated technology, adequate personnel, and well-equipped infrastructure, acupuncture might be considered to be of great value in only a limited number of conditions. It could still serve as a valuable alternative treatment for many diseases or conditions for which modern conventional treatments are unsuccessful.
It is also valuable in situations where the patient is afraid of the potential risk or adverse effects of modern conventional treatments. In fact, in some developed countries, the diseases for which patients seek help from acupuncturists tend to be beyond the scope of orthodox medicine. It is difficult to accurately assess the effectiveness of acupuncture based on objective and reproducible modern Western science. The first reason probably is that acupuncture was discovered in the East and is still predominant in this part of the world where we reason differently. It now belongs to practitioners of Chinese medicine in the West to establish protocols to better measure the effects of acupuncture – is what is being developed.