Tuesday, June 01, 2010

More on the “acupuncture study”

Well, it looks like Orac came through again and performed a much more thorough smack down of the acupuncture paper in Nature Neuroscience than I could have ever hoped to do. First he pointed out, which I failed to do, the ridiculous argumentum ad populum in the introduction of the paper. But most importantly he made clear something I only touched on which is that while the paper's title and discussion was about acupuncture the actual research had nothing to do with acupuncture at all.

Now Orac has several advantages on me. In this case, aside from the obvious advantage, that he apparently never sleeps, Orac was up on his acupuncture anatomy and I wasn't. (Maybe he's been sitting in on some of those med school classes at Georgetown University). Anyhow, from his post I learned that the point of needle insertion, the Zusanli point, is actually on the stomach meridian! That's where treatment is applied to alleviate gastric ailments rather than local pain, according to acupuncture claims and practice.

So, if the investigators really wanted to find a mechanism for the claims of acupuncture they should have had their recording devices in the stomach, looking for biochemical or motility changes or who knows what. Not that it would have proven much other than that sticking needles in those poor critters might elicit a nonspecific gastric response. (Sometimes the mere mention of acupuncture turns my stomach, for that matter).

Had the authors (or responsible editors at the journal) omitted all references to acupuncture this might have made a significant contribution. Knowing how adenosine works in blocking pain and how we might manipulate its kinetics could be useful. (Carbamazepine, BTW, prolongs the half life of adenosine. I wonder if that has anything to do with its analgesic properties). As it turns out this paper will do more harm than good. Just look at the silly and credulous popular reaction so far. It would be nice to see an equally vigorous scientific reaction. Maybe someone over at Science Based Medicine will have a thing or two to say about it.

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