Some people swear that regular sessions of acupuncture help relieve their back pain and headaches. And now there’s evidence they may be right.
In a study published in the Archives of Internal Medicine, researchers led by Andrew Vickers, an epidemiologist and biostatistician at Memorial Sloan Kettering Cancer Center, report that acupuncture is effective in reducing people’s chronic pain — more so than standard pain treatment and slightly better than using sham needles, suggesting that the benefits of real acupuncture are due to something more than the placebo effect.
The findings counter those of the last large study on the subject, which found that the needle technique was no better than a fake acupuncture treatment — using random pricking with toothpicks — in reducing people’s pain. But Vickers says his meta-analysis of the data, in which researchers reviewed 29 previous studies involving 17,922 participants, does a few things the previous studies did not. For one, he and his colleagues began by looking at only the most rigorous trials involving acupuncture and pain relief — those that directly compared acupuncture treatment with some type of sham needle therapy in which needles were either inserted only superficially or placed in locations that are not known by acupuncture standards to be key treatment points in the body. The authors of the analysis contacted each of the researchers on the previous studies to discuss with them how they separated the two treatment groups. By limiting their review to the most robust studies published, the authors could assess with more confidence acupuncture’s true effect on participants’ reports of pain before and after treatment.
Next, rather than simply summing up the total effect of acupuncture reported by researchers in previous studies, Vickers’ team asked for their raw data on individual participants’ self-reports of pain. Not all scientists use the same scale for reporting results, which makes it difficult to compare and consider such measurements of pain as a whole. With the raw data, Vickers and his team were able to standardize the participants’ responses and compare them in a more meaningful way.
(MORE: Healing the Hurt: Finding New Ways to Treat Pain)
The result was a clear and “robust” effect of acupuncture in relieving chronic pain in the back, neck and shoulders, as well as pain due to osteoarthritis and headaches, Vickers’ team found. Compared with people undergoing sham needle treatments, those receiving acupuncture reported drops in back and neck pain of 0.23 standard deviations, and of 0.55 standard deviations compared with those not using acupuncture at all. On a pain scale of 0 to 100, that meant that among the participants, who started out with an average baseline pain score of 60, pain ratings fell to 30 on average for those who got acupuncture, 35 for those who received fake acupuncture, and 43 for people who got usual care and no acupuncture.
“The effects of acupuncture are statistically significant and different from those of sham or placebo treatments,” says Vickers. “So we conclude that the effects aren’t due merely to the placebo effect.”
Acupuncture is an ancient Chinese remedy for a curing a host of chronic ills, from headaches to back pain and menstrual cramps. The practice, like all medical traditions from the East, is built on the concept of maintaining the balance of various body elements — including blood and nutrients along with less measurable ones like the energy force known as chi. Inserting needles at designated point on the body is supposed to intercept or unblock the flow of such elements, and lies at the heart of the centuries-old therapy of acupuncture.
However, these theories are completely foreign, even weird, to Western medicine, which has a harder time accepting unquantifiable entities such as chi. That’s why Western researchers have struggled not only to document objective evidence of acupuncture’s effectiveness, but also to provide some hints about how it may work.
(MORE: Dr. Oz: The End of Ouch?)
Some doctors say the needles may release endorphins, the pleasure-inducing, painkilling chemicals that saturate the brain and numb pain signals. But such theories can’t fully explain why acupuncture patients say their chronic pain episodes become less frequent and less intense over time, with regular, long-term sessions. Some say the benefits of acupuncture are purely in the mind, a psychological placebo effect. But either way, for many pain patients, acupuncture does provide palpable relief.
Asks Dr. Andrew Avins in a commentary accompanying the study, if the treatment works, does it really matter whether the effect is physiological or psychological? “At least in the case of acupuncture, Vickers et al have provided some robust evidence that acupuncture seems to provide modest benefits over usual care for patients with diverse sources of chronic pain,” he writes. “Perhaps a more productive strategy at this point would be to provide whatever benefits we can for our patients, while we continue to explore more carefully all mechanisms of healing.”
In other words, if it works and doesn’t seem to lead to any harms, getting stuck with needles may not be such a weird idea after all.
Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.
(一) 飲食治療
所有糖尿病人均需遵從飲食治療。不同人士的熱量需要有別，患者宜諮詢註冊營養師設計適合自己的飲食餐單，以助控制病情，穩定血糖。一般原則如下：
(1) 均衡飲食，定時定量，以「少食多餐」為原則，有助穩定血糖。
(2) 適量進食含碳水化合物之食物(包括五穀類、根莖類蔬菜、水果、奶品類)。
> 一份五穀類(10克醣質) = 1滿湯匙白飯 / 米粉/上海麵(熟) 1/5碗 / 潮州粥 1/3碗 / 通粉/意大利粉(熟) 1/3碗 / 方包 1/2片(去邊) / 麥皮(熟) 1/2碗
* (一碗 = 300毫升中號飯碗)
> 一份根莖類蔬菜(10克醣質) = 1隻雞蛋體積之薯仔/蕃薯 / 2隻雞蛋體積之南瓜/蓮藕
> 一份水果(10克醣質) = 細蘋果/橙/柑/梨/奇異果1個/ 大蘋果/橙1/2個 / 小提子10粒 / 香蕉1/2隻
> 一份奶品類(12克醣質) = 低脂/脫脂牛奶240毫升/ 脫脂奶粉4平湯匙
Q:我是一名28歲家庭主婦，育有一歲半大兒子，生育後肚皮和面龐一直瘦不下來，美容院游說我做通淋巴治療，費用要萬多元，說通淋巴後便可回復生育前的舊觀，本人很想嘗試，與先生商量後，他着我寫信問問你才決定，故有勞你給我一些專業意見，也許若到醫生處接受通淋巴，價錢會否一樣，還是會貴些呢？ 駱太 上
A:通淋巴是美容界常濫用的名詞，特別用於誇大按摩效用，或標榜某類儀器具卓越排毒功能，甚至連組織上的毒素也可由淋巴排走，聽來似有道理，事實毫無醫學根據。
人體內血液循環先由心臟帶出，經大血管（大動脈）再輸送到中血管、小血管，再到微絲血管，此時血液內的養料、營養物、氧氣及水分等會由血管壁滲透到細胞去，細胞經新陳代謝作用產生的廢物，再回收到血管內，經小靜脈、中靜脈及大靜脈，再回流到心臟淨化，淨化後又變回新鮮血液再循環。
那麼，淋巴是扮演甚麼角色呢？原來有部分細胞外水分和廢物是由淋巴輸導管負責收集，且將它帶回血液循環系統，可以說是血液循環系統的一小支流。這些淋巴液由於不含紅血球，故呈無色，是輔助血液循環夥伴，作用有如去水管，在正常情況下是不會受阻塞，除非有炎症或癌變才會出問題，卻不能以食療或直接在淋巴位置做手術改善，必須清除相關的炎症，或切去相關惡性腫瘤，才能使淋巴組織回復正常功能。
人體假若沒有感染炎症或患惡性腫瘤，淋巴應暢通無阻，假如患上了頑疾，也決非美容師會懂得治療，必須由專科醫生來做手術，美容師的建議並非正確，有誤導嫌疑。
陸宏隆 覆
等氣虛的情況。所以，今次的配搭，就用冬瓜消暑，清除外來的暑邪；出汗以後，就用石斛和麥冬來補充流失的津液；而缺少了的氣，就用較平和的太子參來補充。
（認下叻先！！）
本診所提供務中醫全科服務包括:
內科: 呼吸系統疾病、鼻敏感、腸胃病、腎病、高血壓、糖尿病、中風後調理等
皮膚科: 濕疹、暗瘡、風疹、過敏等
婦科: 月經病(如閉經、痛經等)、更年期綜合症、不孕症、子宮肌瘤、朱古力瘤等
兒科: 哮喘、消化不良、感冒、出疹等
針灸科: 中風後遺症、失眠、抑鬱症、痛症 (椎間盤突出症、頸肩腰痛症、風濕關節痛、網球肘、坐骨神經痛、落枕、肌肉勞損等)、柏金遜病、腦退化症等。
骨傷科: 急性扭傷、脊椎病
其他: 戒毒、電療化療、手術後調理
寫返出黎真係好有趣。
大家若屬以下人士，則有較高機會患上糖尿病：
肥胖是一個引致糖尿病的主要風險因素，因此，我們可以透過預防肥胖，減低患上糖尿病的風險。以下是一些建議預防方法：
- 亞洲人的理想體重指標(Body Mass Index, BMI)為18.5-22.9
- 體重指標 = 體重(公斤) ÷ 身高(米)÷ 身高(米)
由於早期症狀並不明顯，每年適當的身體檢查可助及早偵測疾病。
可參考: 糖尿病的成因和病徵
有一個人有四個兒子，他要這四個兒子分別到遠方去看一棵朵樹。大兒子在冬天去，二兒子在春天去看，三兒子在夏天去，小兒子則在秋天前往。當兒子們回來後，他把這四個兒子都叫到跟前，讓他們分別形容一下自己所見到的情景。
大兒子說：「那棵樹很醜，枯槁、扭曲。」
二兒子說：「不是這樣，這棵樹被青春的嫰芽所覆蓋，充滿了希望。」
三兒子不同意，說：「樹上花朵綻放、充滿了香氣，看起來十分美麗，這美景是我從來沒有見過的。」
小兒子不同意三個哥哥的說法。他說：「樹上結滿了果子，累累下垂，充滿了生氣和滿足。」
父親聽了後，對四個兒子說：「你們都是正確的，因為每個人都只看到了這棵樹一個季節的風景，但是你們又都是不準確的，你們不能用一個季節的風景來評判一棵樹。一棵樹的實質是怎樣，只有經歷過所有季節之後才能衡量。如果你在冬天的時候去看這棵樹，就放棄去看它了，那麼你就會錯過它生命中春天的盼望，夏天的美麗，秋天的收穫。我們不能讓冬天一個季節的痛苦毀掉了其他季節的喜悅和快樂。」
人生總會經歷不同的時期，有高潮，亦有低潮。如果你經常抱怨著，時時想著不如意的事，把人命壞的一面無限放大，那麼你的生命就只會很乾澀，枯槁。曾經和很多吸毒的年輕人會面，他們當中有不少都曾經試過自殺。由於長時間地被低落的情緒，無助的感覺困擾著，所以他們的眼中的生命是不愉快，餘下的人生都是無了期的冬天，因而作了自毀的抉擇。與其自怨自艾，任由自己停留在這個困局當中，何不踏出一步，逐少逐少地發掘生活中美好的事物？我相信只要肯付出，總會活出人生的春天，夏天和秋天。
如果你認為自己的生活不如意，請你想一想這一個小故事。低潮只應是人生的一部分，黑暗過總是光明的。
亦有部分患者可能沒有上述徵狀，因此建議定期檢查身體，避免延誤醫治。
可參考之前的post: 糖尿病是甚麼？
