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As I discussed in a previous post, so-called sham acupuncture is not a good control to use in clinical trials. I recent study in Canada used a different approach.
The researchers studied patients suffering from Bell’s palsy. This is a disease which comes on acutely (suddenly) and produces paralysis of the muscles on one side of the face. Patient smile unevenly and may have difficulty in closing their eye on the affected side. The cause is unknown, though it is thought to be a virus that has caused swelling of the facial (VIIth) nerve on one side. In most cases patients recover in a few weeks, although some do so incompletely or even not at all. It is usually treated with corticosteroids (prednisolone) and this seems to improve the chance of a good outcome.
All the patients received both prednisolone and acupucture. The control group’s acupuncture was done gently and superficially; the active group received acupuncture that was sufficiently deep and vigorous to elicit the typical acupuncture sensation (de qi).
The results were assessed by three neurologists who saw videos of the patients carrying out face exercises. The neurologists did not of course know which treatment each person had received.
At six months recovery was assessed to be 70% in those who had received the presumably less effective acupuncture and 90% in those who had received the more effective acupuncture. The difference was statistically significant.
Most acupuncture trials are for pain, which is assesse largely subjectively, by the patients’ reports. In this case the assessment was based on objective criteria, the patients’ abilityto perform movements. Also, all the patients had been needled at the same sites; the only difference was in the vigour of the needling. The trial therefore gets round many of the objections that critics often raise. Of course, only a few kinds of disease are suitable for assessment in this way.
Xu et al., 2 April 2013; 185(6):459. See also accompanying article by John Fletcher