针灸（acupuncture）安全吗？

作为一项在中国已经被应用了几千年的治疗技术，其安全性早已被国人所认可，可西方人却仍对此持怀疑态度？

最近，加拿大学者回顾性分析了1400多例儿童接受针灸治疗的相关情况，结果发现“仅有168名儿童被发现有轻微的不良反应，如哭闹或疼痛、出血，另有25名儿童出现较严重的不良反应，如感染、穿透心脏或肺、肠梗阻和晕厥等，但与经治医生经验或训练不够有关”。据此，加拿大学者认为“如若经训练有素的针灸医生操作，该项技术即便是应用于儿童亦是安全的”。

作为一项古老的治疗技术，国人喜欢用“通气或疏通经络～open the channels where a person's Qi (pronounced chee), or life force, is blocked”来解释针灸治疗的疗效，但西方人则认为“正是由于针灸导致了体内镇痛物质（the body's natural painkillers）的释放，才达到了或可发挥治疗作用如镇痛等”。

针灸可以治病吗？当然，就连美国医生都认为针灸可以治疗多种病症，如疼痛、恶心、呕吐、肌肉痉挛、月经不调和哮喘等。据不完全统计，约有300万美国人已经接受过针灸治疗。

Acupuncture Safe for Children, Review Finds

Serious side effects generally related to less well-trained practitioners

MONDAY, Nov. 21 (HealthDay News) -- When done by well-trained professionals, acupuncture can be a safe treatment for children, new research suggests.

In an analysis of 37 studies or case reports, Canadian researchers found that in over 1,400 children treated with acupuncture, just 168 experienced a mild adverse reaction, such as crying or pain. The investigators found 25 reports of serious adverse events.

"In trained hands, acupuncture seems safe in children," said the study's senior author, Dr. Sunita Vohra, a professor in the department of pediatrics at the University of Alberta in Canada.

Results of the study are published online and in the December issue of Pediatrics.

Acupuncture is a treatment that is said to have originated in China thousands of years ago. In Eastern medicine, acupuncture is believed to open the channels where a person's Qi (pronounced chee), or life force, is blocked. In Western medicine, it's more commonly believed that acupuncture works by stimulating the release of the body's natural painkillers, according to the U.S. National Center for Complementary and Alternative Medicine.

Stimulation of certain areas to release the blocked Qi (called acupoints) can be done through the insertion of very thin needles or with heat, pressure or a laser, the study authors pointed out in background information in the article.

Acupuncture is used for a variety of problems, such as pain, nausea, vomiting, anxiety and muscle spasm, according to Vohra and Dr. Raymond Pitetti, the associate medical director of the emergency department at Children's Hospital of Pittsburgh. Jeannie Kang, president of the American Association of Acupuncture and Oriental Medicine, added that acupuncture is also used for sprains, allergies, asthma, and menstrual cramps and irregularities.

In the United States, recent estimates suggest that as many as 3 million people have tried acupuncture therapy.

Because acupuncture is growing in popularity, and no specific studies have been conducted on the safety of acupuncture in children, Vohra and her colleagues wanted to assess the available evidence to determine whether or not acupuncture is a safe treatment for children.

The researchers reviewed all of the available literature on acupuncture in children. They found 37 studies and case reports that met their inclusion criteria.

　　The rate of adverse events was significantly lower in children than what has been reported in adults, the results showed.

　　The current analysis found a mild adverse event rate of nearly 12 percent in children. Mild events included bleeding, pain, crying, bruising and worsening of symptoms.Serious events occurred in 25 children. Twelve children had thumb deformities, and five experienced infections after acupuncture. There were also isolated heart problems, lung problems, bleeding issues, nerve impairment, intestinal obstruction, hospitalization and a reversible coma.

Many of the serious adverse events were believed to be the result of substandard practices, said Vohra.

All three experts recommended making sure your child's acupuncturist is well trained. In Canada, acupuncture is regulated in a standard fashion and acupuncturists have to have specific training. In the United States, requirements vary by state, although most require that acupuncturists be licensed, according to Kang. Vohra and Kang both recommended contacting national acupuncture associations for a practitioner recommendation. Practitioners certified by national organizations will likely have more training.

Kang said that there are some acupuncturists who specialize in acupuncture on children, but that most practitioners will have had some pediatric experience. She said that it's uncommon to do needle insertions on children younger than 11 years old. Instead, she said, acupuncture practitioners will usually use something that "looks like a spiky rolling pin" to put pressure on acupoints.

Pitetti said he didn't know if there were specific areas of the body where acupuncture absolutely shouldn't be used, but "into the neck, into the brain would make me more concerned. Also, when you start to go near major organs, like the heart, or right around the spinal cord, that would make me nervous."

But, he said, "This study should give parents a little reassurance that it's probably a safe procedure, but it should also make them take a hard look at who's doing the acupuncture to make sure that they're reputable and skilled."

And, he added, it would be very helpful for parents if pediatricians were more aware of complementary medicine therapies, as well as the practitioners in the local area.

SOURCES: Sunita Vohra, M.D., professor, department of pediatrics, and director, CARE program, University of Alberta, Canada; Raymond Pitetti, M.D., associate medical director, emergency department, Children's Hospital of Pittsburgh; Jeannie Kang, president, American Association of Acupuncture and Oriental Medicine; December 2011, Pediatrics