Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. Its proponents variously claim that it relieves pain, treats infertility, treats disease, prevents disease, or promotes general health.
The earliest written record of acupuncture is found in the Huangdi Neijing (黄帝内经; translated as The Yellow Emperor's Inner Canon), dated approximately 200 BCE. Acupuncture typically incorporates traditional Chinese medicine as an integral part of its practice and theory. However, many practitioners consider 'Traditional Chinese Medicine' (TCM) to narrowly refer to modern mainland Chinese practice. Acupuncture in Japan and Korea, and to a certain extent Taiwan, diverged from mainland China in theory and practice. In European countries such as the UK almost half the practitioners follow these non-TCM practices. The most notable difference is that these other approaches often are primarily acupuncture, and do not incorporate Chinese herbal medicine.
The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points. Different variations of acupuncture are practiced and taught throughout the world.
There is no anatomical or scientific evidence for the existence of qi or meridians, concepts central to acupuncture. The evidence for acupuncture's effectiveness for anything but the relief of some types of pain and nausea has not been established. Systemic reviews have found conflicting results regarding the prevention of postoperative nausea and vomiting though a 2009 Cochrane review concluded stimulation of the P6 acupuncture point was as effective as antiemetic medications. Acupuncture also appears to have a small effect in the short-term management of some types of pain though a 2011 review of review articles concluded that, except for neck pain, acupuncture was of doubtful efficacy. It has been suggested that the positive results reported for acupuncture can be explained by placebo effects and publication bias and researchers have pointed out the difficulty in designing an adequate scientific control for any placebo effect acupuncture might have due to its invasiveness. The development and inclusion of retracting needles as a form of placebo control has resulted in a much larger number of studies concluding acupuncture's effects are due to placebo.
There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles but does carry small but serious risks and adverse effects including death, particularly when performed by untrained practitioners. Accompanied by calls for more research, the use of acupuncture for certain conditions has been tentatively endorsed by the United States National Institutes of Health and National Center for Complementary and Alternative Medicine, the National Health Service of the United Kingdom, and the World Health Organization, though most of these endorsements have been criticized and it has been questioned whether research on acupuncture is a good use of limited research funding.
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