Effect of Electroacupuncture on Urinary Leakage Among Women With Stress
Zhishun Liu, Yan Liu, Huanfang Xu, et al.
JAMA. 2017;317(24):2493-2501.
Key Points
Question Is electroacupuncture involving the lumbosacral region effective in reducing urine leakage for women with stress urinary incontinence?
Findings In this randomized clinical trial that included 504 women, the mean decrease in urine leakage, measured by the 1-hour pad test from baseline to week 6, was 9.9 g with electroacupuncture vs 2.6 g with sham electroacupuncture, a significant difference.
Meaning Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks.
Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome
Xiao-Ke Wu, Elisabet Stener-Victorin, Hong-Ying Kuang, et al.
JAMA. 2017;317(24):2502-2514.
Key Points
Question Does acupuncture alone or combined with clomiphene increase the likelihood of live births among women with polycystic ovary syndrome?
Findings In this randomized clinical trial that recruited 1000 Chinese women with polycystic ovary syndrome, the live birth rate was significantly higher in the group of women who received clomiphene compared with placebo (28.7% vs 15.4%, respectively). However, it was not significantly different between the groups who received active vs control acupuncture (21.8% vs 22.4%, respectively), and there was no significant interaction between active acupuncture and clomiphene.
Meaning Acupuncture, alone or with clomiphene, was not effective as an infertility treatment in women with polycystic ovary syndrome.
纽约中医论坛
美国医学会杂志JAMA于2017年6月27日同刊发表了两篇来自中国的针灸研究报告。一个来自黑龙江中医药大学等医院的研究表明针刺治疗多囊卵巢不孕症无效；另一个来自中国中医科学院等医院的研究证明针灸治疗女性压力性尿失禁确实有效。
中国针灸研究团队能把临床研究成果发表在世界一流的医学杂志上是件非常有意义的事，反应了中国近年来中医药研究的进步和科研资金的充足。
JAMA 杂志多年来发表的有关针灸的文章质疑多于肯定，这次发表的“一阴一阳”两文令人深思，反应了临床针灸科学研究的现状。说明用严格的科学方法证明针灸的临床疗效是可行的，引起了主流医学的重示，具有临床指导意义。
有评论认为，美国因滥用止痛药药已经造成了巨大的社会问题，针灸作为一种非药物疗法正面对一个难得的发展契机，科学研究会有助针灸进入主流医学。还应注意，针灸的实用性、有效性及经济价值，可能会引发未来中国和美国关于知识产权的争议。
美国近年兴起的神经刺激疗法“斯巴克”（SPARC）其实就是针灸疗法的变种，但研究和使用者在专利和研究报告中通常只字不提针灸。
有意思的是，NIH补充整合健康中心主任在同刊JAMA的评论文章中，开头即引用纽约时报记者赖斯顿在北京的针灸故事，恰好道出了美国针灸的渊源