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Acupuncturist : ウィキペディア英語版
Acupuncture

Acupuncture (from Latin, ''acus'' (needle) and ''punctura'' (to puncture)) is a form of alternative medicine〔 and a key component of traditional Chinese medicine (TCM)〔 involving thin needles inserted into the body at acupuncture points.〔 It can be associated with the application of heat, pressure, or laser light to these same points.〔 Acupuncture is commonly used for pain relief,〔〔 though it is also used for a wide range of other conditions.〔 Clinical practice varies depending on the country.〔 There is a diverse range of acupuncture approaches, involving different philosophies.〔 The method used in TCM is likely the most widely adopted in the US.〔 It is rarely used alone but rather as an adjunct to other forms of treatment.〔 TCM theory and practice are not based upon scientific knowledge,〔 and acupuncture has been described as a type of pseudoscience.

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent.〔〔 An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions, and they suggest it may be effective for only chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache.〔 An overview of high-quality Cochrane reviews suggests that acupuncture may alleviate certain kinds of pain.〔 A systematic review of systematic reviews found little evidence of acupuncture's effectiveness in treating pain.〔 The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits.〔 Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to placebo.〔 A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias.〔

Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles.〔〔 When properly delivered, it has a low rate of mostly minor adverse effects.〔〔 Accidents and infections are associated with infractions of sterile technique or neglect of the practitioner.〔 A review stated that the reports of infection transmission increased significantly in the prior decade.〔 The most frequently reported adverse events were pneumothorax and infections.〔 Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.〔 A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care,〔 while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain.〔

Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as ''qi'', meridians, and acupuncture points,〔 and many modern practitioners no longer support the existence of life force energy (''qi'') flowing through meridians, which was a major part of early belief systems.〔〔〔 Acupuncture is believed to have originated around 100 BC in China, around the time ''The Yellow Emperor's Classic of Internal Medicine'' (Huangdi Neijing) was published,〔 though some experts suggest it could have been practiced earlier.〔 Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment.〔 Acupuncture grew and diminished in popularity in China repeatedly, depending on the country's political leadership and the favor of rationalism or Western medicine.〔 Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries,〔 and then to Europe, starting with France.〔 In the 20th century, as it spread to the United States and Western countries, the spiritual elements of acupuncture that conflict with Western beliefs were abandoned in favor of tapping needles into nerves.〔〔〔
== Clinical practice ==

Acupuncture is a form of alternative medicine.〔 It is commonly used for pain relief,〔〔(【引用サイトリンク】url=http://nccih.nih.gov/health/acupuncture/acupuncture-for-pain.htm )〕 though it is also used to treat a wide range of conditions.〔 The majority of people who seek out acupuncture do so for musculoskeletal problems, including low back pain, shoulder stiffness, and knee pain.〔 Acupuncture is rarely used alone but rather as an adjunct to other treatment modalities.〔 Published guidelines recommend the use of acupuncture for the management of non-specific low back pain, among other treatments.〔 For example, the American Society of Anesthesiologists states it may be considered in the treatment for nonspecific, noninflammatory low back pain only in conjunction with conventional therapy.
Acupuncture is the stimulation of specific acupuncture points along the skin of the body using thin needles.〔 It can be associated with the application of heat, pressure, or laser light to these points.〔 Classically, acupuncture is individualized and based on philosophy and intuition, and not on scientific research. In modern acupuncture, a consultation is followed by taking the pulse on both arms and inspecting the tongue. This initial evaluation may last up to sixty minutes.〔 Subsequent visits typically last about a half an hour.〔 The number and frequency of acupuncture sessions vary, but most practitioners do not think one session is sufficient. A common treatment plan for a single complaint usually involves six to twelve treatments, to be carried out over a few months.〔 A typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes. There is also a non-invasive therapy developed in early 20th century Japan using an elaborate set of "needles" for the treatment of children (''shōnishin'' or ''shōnihari'').
Clinical practice varies depending on the country.〔 A comparison of the average number of patients treated per hour found significant differences between China (10) and the United States (1.2). Acupuncturists generally practice acupuncture as an overall system of care, which includes using traditional diagnostic techniques, acupuncture needling, and other adjunctive treatments.〔 Chinese herbs are also often used. There is a diverse range of acupuncture approaches, involving different philosophies.〔 Although various different techniques of acupuncture practice have emerged, the method used in traditional Chinese medicine (TCM) seems to be the most widely adopted in the US.〔 Traditional acupuncture involves needle insertion, moxibustion, and cupping therapy.〔 Traditional acupuncture may be accompanied by various ancillary procedures, such as palpation of the radial artery and other parts of the body and examining the tongue.〔 Traditional acupuncture involves the belief that a "life force" (''qi'') circulates within the body in lines called meridians.〔(【引用サイトリンク】title=Acupuncture )〕 The main methods practiced in the UK are TCM and Western medical acupuncture.〔 The term Western medical acupuncture is used to indicate an adaptation of TCM-based acupuncture which focuses less on TCM.〔 The Western medical acupuncture approach involves using acupuncture after a medical diagnosis.〔 Limited research has compared the contrasting acupuncture systems used in various countries for determining different acupuncture points and thus there is no defined standard for acupuncture points.〔
In traditional acupuncture, the acupuncturist decides which points to treat by observing and questioning the patient to make a diagnosis according to the tradition used. In TCM, the four diagnostic methods are: inspection, auscultation and olfaction, inquiring, and palpation. Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.〔 Auscultation and olfaction involves listening for particular sounds (such as wheezing) and attending to body odor.〔 Inquiring involves focusing on the "seven inquiries": chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea.〔 Palpation is focusing on feeling the body for tender ''"A-shi"'' points and feeling the left and right radial pulses.〔Cheng, 1987, chapter 12.〕

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
ウィキペディアで「Acupuncture」の詳細全文を読む



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