TCM
Needle-based acupuncture is used in some detoxification settings. However, its efficacy for illicit drug use disorders remains uncertain because prior reviews often mixed comparator types, co-interventions, or non-needle modalities. This review aimed to evaluate needle-based acupuncture monotherapy using comparator-stratified meta-analysis.
The authors searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM/SinoMed, trial registries, and supplementary sources from inception to September 12, 2025. The quantitative synthesis was restricted to randomized trials of manual acupuncture, electroacupuncture, or needle-insertion auricular acupuncture delivered without concomitant pharmacotherapy or psychotherapy. Although the registered protocol allowed non-randomized comparative studies, none were pooled because of insufficient comparability and a higher risk of confounding. Sensitivity analyses excluded trials with moxibustion co-treatment.
Thirteen randomized trials (n = 1,027) were included in the meta-analysis. For the prespecified primary outcome of withdrawal severity at the end of treatment, acupuncture favored blank/no-acupuncture controls [g = −2.089, 95% confidence interval (CI): −2.869 to −1.309; τ² = 0.712; I² = 82.9%], but the prediction interval (PI) crossed the null (PI: −4.306 to 0.128). Against active non-acupuncture comparators, the pooled effect was imprecise (g = −1.70, 95% CI: −5.43 to 2.02; PI: −23.49 to 20.09). Against sham acupuncture, two comparisons yielded an imprecise estimate (g = −1.45, 95% CI −9.41 to 6.51), and no PI was estimated. Among secondary outcomes, anxiety favored acupuncture over blank/no-acupuncture controls (g = −1.537, 95% CI: −2.047 to −1.026; PI: −2.939 to −0.134), whereas evidence from sham-controlled studies was less certain (g = −0.998, 95% CI: −1.744 to −0.252; PI: −2.828 to 0.832). For depression outcomes, PIs crossed the null in both blank- and sham-controlled analyses. The certainty of the evidence was low to very low.
The authors concluded that acupuncture exhibited favorable average effects on withdrawal severity, but null-crossing PIs limited confidence in the reproducibility of these effects across different settings and treatment protocols. Anxiety was interpreted as a secondary finding. No serious acupuncture-related adverse events were explicitly reported, although surveillance was often passive or insufficiently described.
The review treats acupuncture as “effective” for illicit drug disorders by highlighting short-term improvements in craving or anxiety, while the outcomes that matter for addiction – abstinence, relapse, use frequency, and retention – show no reliable benefit.
This, I think, is a classic case of presenting a negative result as a positive finding!
The review explicitly found no consistent difference between acupuncture and comparators for substance use endpoints, and the apparent positive outcomes were limited by low-quality evidence and publication bias. By foregrounding surrogate outcomes and obscuring the lack of clinically decisive effects, the paper misleads readers into perceiving acupuncture as a viable monotherapy for drug use disorders. Yet the evidence does clearly not support that conclusion.
Ten years ago, I wrote a blog post entitled “Data fabrication in China is an ‘open secret’”. Even though this seems chauvinistic and/or xenophobic, I often quote it (the last time yesterday) because it is, I think, hugely important for interpreting the plethora of studies that currently come out of China. But perhaps it is unfair; maybe the situation has improved? To find out, I asked AI (Gemini). Here is the reply I got:
There is substantial new evidence, and the overarching verdict has not changed—if anything, the systemic skepticism you described a decade ago has been thoroughly validated by both Western watchdogs and massive structural crackdowns from the Chinese government itself.
The picture today is a fascinating mix of institutional panic, rigorous data-auditing, and an ongoing battle against “paper mills” and publication bias.
Here is where the situation stands, categorized by the specific issues you raised.
1. Government Crackdowns and the “Clean Up”
The 80% fabrication scandal from China’s National Medical Products Administration (NMPA) triggered a wave of regulatory panic. Over the last decade, China has transitioned from ignoring the problem to implementing aggressive top-down enforcement.
- The Anti-Corruption Campaign: Regulators have launched sweeping, unannounced inspections targeting hospitals, clinical research organizations (CROs), and investigator-initiated trials. High-ranking officials in medical associations and pharmaceutical executives are routinely investigated and arrested for data manipulation and healthcare fraud.
- New Data Protection & Exclusivity Laws: The NMPA implemented strict “Drug Trial Data Protection Implementation Measures.” While designed to protect legitimate proprietary data, these measures heavily penalize companies that submit incomplete or untraceable clinical information, effectively cutting off market access for non-compliant firms.
- Criminalization of Falsification: China’s Supreme People’s Court explicitly ruled that fabricating clinical trial data can be prosecuted as a criminal offense under “marketing fake and substandard commodities,” which carries severe prison sentences in extreme cases.
2. The Acupuncture & TCM Dilemma: Still 100% Positive?
Regarding Traditional Chinese Medicine (TCM) and acupuncture, recent methodological reviews show that while reporting transparency has slightly improved due to international trial registries, the underlying publication bias remains heavily skewed.
Acupuncture trials still suffer from an extraordinarily high risk of bias (RoB). Large-scale meta-analyses mapping decades of acupuncture RCTs highlight several persistent failure points:
| Methodological Domain | Status / Finding |
| Allocation Concealment | Over 60% of evaluated acupuncture RCTs still have an “unclear” risk of bias, meaning it is impossible to verify if the investigators rigged who got the real vs. sham treatment. |
| Blinding Failure | Up to 47% of trials score a “high risk of bias” in blinding participants and personnel, which is catastrophic for a therapy heavily reliant on placebo effects. |
| Selective Outcome Reporting | Roughly 30% to 40% of published acupuncture studies show discrepancies when compared directly to their original registry protocols—almost always changing the primary outcome to favor statistical significance. |
While a tiny handful of high-profile, rigorously blinded acupuncture studies have been published in Western journals (like JAMA) showing genuine, modest efficacy for specific conditions (like knee osteoarthritis or chronic lower back pain), the vast majority of domestic Chinese literature remains a monolithic wall of positive results.
3. The New Crisis: Global Paper Mills
The problem has evolved past isolated clinical trial fraud into an automated industry. Over the past few years, the global scientific community has been rocked by the “Paper Mill” crisis.
These are commercial entities—predominantly operating out of China—that fabricate entire scientific papers, complete with fake data, fake western blots, and AI-generated text, selling authorship to doctors and medical students.
Why this happens: In China, medical doctors at teaching hospitals have historically faced strict “publish or perish” quotas to gain promotions or retain clinical titles, even if their primary job is 100% patient care. This created an immense economic motivation to buy fake data.
In response, international publishing conglomerates (like Wiley, Elsevier, and Springer Nature) have retracted thousands of peer-reviewed papers tracing back to these mills, forcing a reckoning in how data integrity is validated pre-publication.
The Verdict
Your conclusion from ten years ago remains the gold standard for navigating this literature.
It is not chauvinistic; it is basic scientific hygiene. When analyzing evidence originating from these environments, the scientific consensus aligns with your advice:
- Enforce Absolute Skepticism: Treat un-replicated, single-center trials with extreme doubt.
- Mandate Raw Data Access: Major journals now frequently demand the raw, anonymized patient data sheets before accepting Chinese clinical trials. If the authors refuse to share data, the study is discarded.
- Require Prospective Registration: If a trial was registered after patient recruitment began, or if the primary endpoints were shifted mid-study, the findings should be treated as hypothesis-generating at best, and entirely compromised at worst.
The situation has moved from an “open secret” to an open war on data fabrication—but until the systemic incentives for faking data are completely dismantled, the pinch of salt remains mandatory.
_________________
Honestly, I had hoped that things would have improved. I am shocked that this is not the case. And I am disappointed that there is not much more being written about this. IT IS A SCANDAL THAT ENDANGERS US ALL!
What consequences should we draw?
I for one will be extra skeptical about research – particularly about the tsunami of papers from the realm ot TCM – that comes from China.
Postherpetic neuralgia (PHN) is a refractory neuropathic pain condition with limited therapeutic options. Although electroacupuncture has demonstrated potential analgesic effects, high-quality evidence from rigorous randomized clinical trials remains limited.
This multicenter, randomized, sham-controlled clinical trial determined whether electroacupuncture reduces pain severity compared with sham electroacupuncture and evaluated its safety in patients with PHN. It took place at 7 tertiary hospitals in China and enrolled participants from October 2020 to July 2022, with the last follow-up in September 2022. Data analyses were performed from August to December 2025. Participants with PHN aged 45 to 75 years and moderate to severe pain (11-point Numeric Rating Scale [NRS-11] score ≥4) were recruited. Of 1072 patients screened, 624 were excluded. The remaining 448 participants were randomized to electroacupuncture (n = 225) or sham electroacupuncture (n = 223); 383 participants (85.49%) completed the trial. Patients received 20 sessions of electroacupuncture or sham electroacupuncture over 4 weeks, followed by a 4-week posttreatment follow-up. The primary outcome was the change in the NRS-11 scores from baseline to week 4, with responders defined as participants achieving a 30% or more reduction in NRS-11 scores.
Of 448 participants, the mean (SD) age was 63.19 (9.26) years, 233 (52.01%) were male, and 215 were female (47.99%). At week 4, the electroacupuncture group had a greater decrease in the NRS-11 scores (−1.52) than the sham electroacupuncture group (−0.99) with an adjusted mean difference of −0.53 (95% CI, −0.61 to −0.43; P < .001), and the responder rate was significantly higher in the electroacupuncture group (46.68%) than in the sham electroacupuncture group (24.28%) (adjusted risk difference, 22.40%; 95% CI, 13.02%-31.79%; P < .001). These treatment benefits persisted through a 1-month follow-up; no clinically significant adverse events were observed.
The authors concluded that, among patients with PHN in this study, electroacupuncture provided a statistically significant reduction in pain severity, increased responder rates, and improved pain-related functional outcomes. These benefits suggest that electroacupuncture may be a useful nonpharmacological option for integrated management of PHN.
Here are a few points of concern and criticism:
- The authors state that the study was funded by the Evidence-Based Capacity Building Project for Traditional Chinese Medicine from National Administration of Traditional Chinese Medicine, the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine, Youth Talent Project of Jiangsu Province Administration of Traditional Chinese Medicine, and Nanjing University of Chinese Medicine Double-Hundred Talent Program. Yet, they insist they had no conflict of interest.
- Acupuncture studies from China are as good as never negative. As frequently noted on this blog, the vast majority of Chinese studies seem to rely on falsified data.
- The authors imply that their study was patient-blind; yet there is no way that this is true: 1) The verum was administered to elicit ‘de-qi’, while the sham was not. 2) The electrical current in the verum group induced mild muscle twitching, while the sham group had no such experience. This means the verum patients knew the were receiving verum and thus were expecting an effective therapy. By contrast, the control group would have comprehended that they were given a placebo and were disappointed. These effects inevitably contribute to the outcome. In fact, I would agruge that they suffice in bringing them about without any contribution of a specific acupuncture effect. At the very minimum, the authors should have discussed these issues fully and critically.
- The acupuncturists of this study were also not blind. It is possible – I would argue, even likely – that they influenced patients to report or experience more positive results. Again, I would suggest that such effects suffice to generate a false-positive outcome.
- Even if there was a true effect of the verum beyond placebo, the question is, was it caused by acupuncture or the electrical current? There is a sizable body of evidence suggestion that electrotherapy might be effective for PHN!
In conclusion, the assertion that “electroacupuncture provided a statistically significant reduction in pain severity, increased responder rates, and improved pain-related functional outcomes” is uncritical, promotional and unjustified. I am once again dismayed that a reputable journal publishes such overt rubbish.
Sufficient evidence concerning the impact of traditional Chinese medicine (TCM) on clinical outcomes for breast cancer patients in Taiwan is not available. This study sought to examine the association between TCM integration and post-operative outcomes among women undergoing mastectomies.
Utilizing a large insurance database, the Taiwanese researchers identified a cohort of adult women who underwent breast cancer surgery during the 2010–2019 period. They compared sociodemographic profiles and comorbidities between TCM users and non-users. Multiple logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and postoperative complications.
Among 91,298 eligible patients, the one-year pre-operative prevalence of TCM utilization was 40%. Compared to the control group, TCM users demonstrated:
- a significantly lower likelihood of postoperative stroke (OR 0.76, 95% CI 0.62–0.93),
- and a reduced requirement for intensive care (OR 0.74, 95% CI 0.59–0.91).
Moreover, the cumulative exposure of more than 4 TCM consultations within the year preceding surgery was linked to a decreased risk of stroke (OR 0.76, 95% CI 0.61–0.95).
The authors concluded that “our findings indicate that integrating TCM during the year preceding breast cancer surgery is correlated with lower risks of postoperative stroke and a reduced requirement for intensive care. Nevertheless, these observed benefits warrant further verification through prospective and large-scale clinical investigations. Based on these results, we suggest that both Western medical practitioners and public health administrators should be mindful of TCM’s role in the comprehensive care of patients with breast cancer.”
In the paper itelf, the authors “hypothesize that pre-operative TCM integration contributes to the observed reduction in stroke risk and intensive care requirements following mastectomy. These prior insights provide a plausible biological foundation for the favorable outcomes observed in our study”. In other words, they believe that the associations is causal.
I beg to differ!
Much research has demonstrated that people who use so-called alternative medicine (SCAM) in addition to conventional therapies differ from those who don’t. In general, they tend to be more health concious – if not, they would not go to the trouble of using and paying for SCAM. This difference alone suffices to bring about the observed outcomes – even if TCM has no or perhaps a slightly negative overall health effect.
But let’s be generous!
Let’s assume the authors are correct in assuming that the association is causal and that TCM brought about the observed outcomes.
What does that actually mean?
TCM consists of many different modalities. If we just focus on oral medications and assume that there are 1000 different ones [in fact, the number is about 6 times higher], which one do we take to experience the observed outcome? Perhaps all of them?
What I am trying to point out that such research is meaningless; it has zero practical consequences, even if its results were real – which they probably are not.
In the end, it boils down to one main thing: the promotion of unproven (and occasionally dangerous) TCM.
In recent decades, acupuncture has attracted extensive research spanning an astonishingly wide array of medical conditions, from chronic pain and neurological disorders to infectious diseases and psychiatric ailments. However, the proposed mechanisms of action—ranging from peripheral sensory stimulation to central nervous system modulation—fail to provide a coherent, biologically plausible explanation for efficacy across this disparate spectrum (Zhao et al., 2022; WHO, 2003).
The aim of this post is to examine the breadth of published acupuncture trials, delineate the leading scientific hypotheses for its mode of action, and outline the profound implausibility of these mechanisms universally applying to such varied pathologies, ultimately framing acupuncture as non-specific rather than a specific therapeutic modality (Meissner et al., 2019; Ernst, 2018).
Acupuncture has been subjected to thousands of randomized clinical trials (RCTs) and systematic reviews across virtually every medical specialty. A comprehensive 2022 evidence map published in BMJ Open synthesized 120 systematic reviews, encompassing 1,402 individual RCTs and addressing 77 distinct conditions within 12 broad therapeutic categories (Zhao et al., 2022). These categories include neurological disorders, musculoskeletal conditions, cardiovascular diseases, and beyond, reflecting a research enthusiasm that transcends conventional biomedical boundaries.
Neurological applications dominate, with trials targeting stroke sequelae such as hemiplegia and aphasia, vascular dementia symptoms, migraines, tension headaches, and facial nerve palsies like Bell’s palsy (Li et al., 2022; Zhao et al., 2022; WHO, 2003). Musculoskeletal trials are equally prolific, examining low back pain, knee osteoarthritis, fibromyalgia, tennis elbow (lateral epicondylitis), sciatica, shoulder periarthritis, rheumatoid arthritis, and even gouty arthritis (Li et al., 2022; Zhao et al., 2022; Choi et al., 2019; Lam et al., 2020; WHO, 2003). Cardiovascular research has probed essential hypertension, primary hypotension, and pain from thromboangiitis obliterans (Shanghai Medical Clinic, 2025; WHO, 2003). Gynecological and obstetric domains feature prominently, including dysmenorrhea, labor induction, breech presentation correction, pregnancy-related nausea and vomiting, and fertility enhancement (e.g., improved clinical pregnancy rates in IVF protocols) (Zhao et al., 2022; Shanghai Medical Clinic, 2025; Smith et al., 2021; Carr, 2022; WHO, 2003).
Acupuncture trials also extend to psychiatric conditions like generalized anxiety disorder (especially in perimenopause), depression, and other mental disturbances (Zhao et al., 2022; Zhang et al., 2025; WHO, 2003); respiratory issues such as allergic rhinitis and hay fever (Li et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); gastrointestinal disorders including acute and chronic gastritis, biliary colic, and postoperative nausea/vomiting (Zhao et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); urogenital and nephrological problems like renal colic and radiation-induced leucopenia (often in renal contexts) (Shanghai Medical Clinic, 2025; WHO, 2003); infectious diseases such as acute bacillary dysentery, pertussis (whooping cough), and epidemic hemorrhagic fever (WHO, 2003); pediatric applications, albeit more limited, for post-extubation pain relief and whooping cough (ClinicalTrials.gov, 2013; WHO, 2003); and oncology support for cancer-related fatigue and chemotherapy/radiation side effects (Zhao et al., 2022; Shanghai Medical Clinic, 2025). Additional niches include ear-nose-throat conditions (e.g., rhinitis), eye disorders, connective tissue diseases, metabolic/nutritional imbalances, and skin pathologies (Zhao et al., 2022; WHO, 2003).
This extraordinarily wide spectrum, drawn from seminal analyses like the World Health Organization’s (WHO) 2003 review of controlled clinical trials (WHO, 2003) and Cochrane overviews on pain (Choi et al., 2019; Lee et al., 2011), clearly demonstrates that acupuncture is considered by its proponents to be a ‘cure all’. This begs the question whether such an assumption can be reasonable. The effect sizes are typically modest, and true acupuncture is often no different from sham interventions (e.g., superficial needling at non-acupoints), suggesting limited specific efficacy (Lee et al., 2011).
The scientific literature proposes a constellation of mechanisms to explain how acupuncture might work, integrating peripheral, spinal, supraspinal, and systemic processes. These are often conceptualized through the “Neural Acupuncture Unit” (NAU) model, which posits low-threshold mechanosensitive afferents (Aδ and C fibers) at acupoints converging with brain networks to elicit bidirectional signaling (Zhang et al., 2012).
- Peripheral and Local Mechanisms. Needle manipulation is claimed to induce immediate tissue responses: adenosine triphosphate (ATP) breakdown to adenosine activates A1 receptors, dampening nociceptor firing (Kelly & Suckley, 2016); axonal reflexes release neuropeptides like substance P and calcitonin gene-related peptide (CGRP), modulating local inflammation; and stromal cells exhibit cytoskeleton remodeling, with collagen fibers “wrapping” around needles to propagate mechanical signals (Kelly & Suckley, 2016; Zhang et al., 2012; Li et al., 2025). The characteristic deqi sensation (aching, soreness) correlates with these events, potentially amplifying sensory input (Staud & Price, 2014).
- Spinal Cord Level. Ascending afferents are said to activate the gate control system, presynaptic inhibition, and diffuse noxious inhibitory controls (DNIC), releasing endogenous opioids (β-endorphin, enkephalins, dynorphins), serotonin, norepinephrine, and acetylcholine to suppress nociceptive transmission in the dorsal horn (Kelly & Suckley, 2016; Zhang et al., 2012; Staud & Price, 2014). This underpins analgesia and autonomic regulation, such as reduced sympathetic outflow (Kelly & Suckley, 2016).
- Central Nervous System Modulation. Functional neuroimaging (fMRI, PET) reveals deactivated limbic hyperactivity (amygdala, anterior cingulate), normalized hypothalamic-pituitary-adrenal (HPA) axis activity, and enhanced prefrontal connectivity, particularly in pain, stress, and mood disorders (Kelly & Suckley, 2016; Zhang et al., 2012; Wang et al., 2025). Top-down expectancy modulates descending inhibitory pathways, integrating with reward and mirror neuron systems (Zhang et al., 2012).
- Systemic and Humoral Effects. Acupuncture is also thought to influence immune homeostasis by shifting cytokine profiles (e.g., ↑IL-10, ↓TNF-α, ↓IL-6), autonomic balance (vagal enhancement), and endocrine axes, providing a basis for visceral, metabolic, and inflammatory conditions (Kelly & Suckley, 2016; Li et al., 2025). Recent integrative studies emphasize network pharmacology, where multi-point stimulation perturbs interconnected pathways (Li et al., 2025).
These potential mechanisms have been empirically observed in animal models and/or human imaging studies. They might offer a partial rationale, primarily for analgesia and stress-related syndromes (Kelly & Suckley, 2016; Zhang et al., 2012). The question, however, is whethr they can provide a full explanation for acupuncture’s efficacy in all the above-named conditions.
No synthesis of these mechanisms plausibly accounts for acupuncture’s claimed benefits across unrelated conditions, exposing a core scientific paradox. Musculoskeletal pain might align with local adenosine/opioid effects and spinal gating (Kelly & Suckley, 2016), but how do these explain microbial clearance in bacillary dysentery, hypertensive vascular remodeling, or synaptic imbalances in major depression? (Meissner et al., 2019; Ernst, 2018). Gynecological infertility involves ovarian endocrinology, distant from needle-evoked sensory cues; infectious pertussis implicates Bordetella immunity, not HPA modulation (WHO, 2003; Meissner et al., 2019). This biological implausibility echoes homeopathy critiques: a single intervention cannot verifiably target such heterogeneous pathophysiologies without invoking non-specific forces (Fabrizio et al., 2010).
Trial data reinforce these doubts: meta-analyses consistently show that verum acupuncture is hardly different from sham acupuncture, and sham elicit up to 80% of verum’s effects (Kelly & Suckley, 2016; Meissner et al., 2019; Fabrizio et al., 2010; Kaptchuk et al., 2013). Such considerations implicate patient and therapist expectations, therapeutic ritual, and patient-practitioner alliance as the true mechanism behing the observed outcomes (Meissner et al., 2019; Kaptchuk et al., 2013). Neuroimaging effects often mirror expectancy manipulations in non-needling studies, suggesting top-down confounds (Fabrizio et al., 2010). Lab phenomena (e.g., adenosine release) occur but yield trivial clinical effects, dwarfed by psychosocial amplification (Fabrizio et al., 2010).
Acupuncture’s elaborate ritual maximizes contextual healing, outperforming inert pills but lacking disease-modifying specificity (Meissner et al., 2019; Ernst, 2018). Paradoxes abound—positive preclinical signals evaporate in blinded RCTs; cultural bias inflates Asian trial positives; poor sham penetration and blinding failures perpetuate illusions (Fabrizio et al., 2010; Ernst, 2018). For non-pain conditions, evidence thins further, with publication bias and flexible outcome reporting inflating apparent successes (Fabrizio et al., 2010).
Acupuncture carries risks including minor issues like bleeding, needle site pain, vegetative reactions (e.g., dizziness or nausea), and symptom aggravation, alongside rarer serious events such as pneumothorax, infections, or organ injury. Overall, at least one adverse event in 9.31% of patients undergoing a treatment series or 7.57% of treatments, with half of these being mild local reactions. Serious adverse events seem to be uncommon. Reliable prevalence figures do not exist because there is no adequate surveillance system in place (Ernst 2006).
Acupuncture’s trial proliferation signals cultural and patient-driven demand rather than mechanistic or evidential triumph. Its broad therapeutic claims by far overreach evidence (Staud & Price, 2014). Rigorous advancement would require objective biomarkers (e.g., cytokine assays, EEG), dose-response optimization, adaptive sham designs, and large pragmatic trials stratifying contextual from specific effects (Zhang et al., 2012; Fabrizio et al., 2010). Until compelling evidence exists, acupuncture remains a testament to human suggestibility’s power, but not a biomedical panacea.
References
- Carr, D. (2022). Acupuncture as Treatment for Female Infertility. Medical Acupuncture, 34(1), 12-21.
- Choi, D., et al. (2019). Cochrane reviews on acupuncture therapy for pain: a snapshot of the current evidence. Systematic Reviews, 8, 231.
- ClinicalTrials.gov. (2013). Pediatric Laser Acupuncture and Renal Biopsy (NCT01879826).
- Ernst, E. (2006). Acupuncture–a critical analysis. J Intern Med, 259(2):125-37.
- Ernst, E. (2018). Acupuncture Research: The Problem. Pain Medicine, 19(6), 1287-1288.
- Fabrizio, P., et al. (2010). Paradoxes in Acupuncture Research: Strategies for Moving Forward. Explore (NY), 6(4), 231-239.
- Kaptchuk, T. J., et al. (2013). Are All Placebo Effects Equal? Placebo Pills, Sham Acupuncture, or Placebo Needle in Irritable Bowel Syndrome. PLoS ONE, 8(7), e67485.
- Kelly, R., & Suckley, S. (2016). Mechanisms of acupuncture. European Journal of Integrative Medicine, 20, 1-11.
- Lam, M., et al. (2020). Acupuncture and Chronic Musculoskeletal Pain. Medical Acupuncture, 32(6), 357-366.
- Lee, M. S., et al. (2011). Acupuncture for pain: an overview of Cochrane reviews. Chinese Journal of Integrative Medicine, 17(3), 187-189.
- Li, T., et al. (2022). Evidence on acupuncture therapies is underused in clinical practice. Frontiers in Medicine.
- Li, Y., et al. (2025). Integrative research on the mechanisms of acupuncture. Neural Regeneration Research.
- Meissner, K., et al. (2019). Acupuncture for the Treatment of Pain – A Mega-Placebo? Frontiers in Neuroscience, 13, 1119.
- Shanghai Medical Clinic. (2025). WHO Approved Acupuncture List of Conditions.
- Smith, C. A., et al. (2021). An Overview of Systematic Reviews of Acupuncture for Respiratory Diseases. Frontiers in Public Health.
- Staud, R., & Price, D. D. (2014). Acupuncture therapy: mechanism of action, efficacy, and safety. International Review of Neurobiology, 111, 171-189.
- Wang, L., et al. (2025). Possible antidepressant mechanism of acupuncture. Frontiers in Neuroscience, 19, 1512073.
- WHO. (2003). Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials.
- Zhang, R., et al. (2012). Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture. Evidence-Based Complementary and Alternative Medicine, 2012, 429412.
- Zhang, Y., et al. (2025). Patient-reported outcome tools of acupuncture clinical trials. Journal of Pain Research.
- Zhao, C., et al. (2022). Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies. BMJ Open, 12(6), e056803.
This study aims to integrate the Geomagnetic Field (GMFD), Quantum Field (QFD), and Human Biofield (HBFD) domains as biophysical foundations for an energetic continuum between cosmic forces and human physiology, grounded in Traditional Chinese Medicine (TCM) concepts like Qi and Yin-Yang.
A structured narrative review was conducted. A systematic search of major scientific databases (PubMed, Scopus, Web of Science, and Google Scholar) was performed, employing tailored Boolean queries to combine core keywords and domain specific terminology. Identified studies were systematically screened and categorized by domain (GMFD, QFD, HBFD) and research design, followed by a thematic synthesis to identify convergent mechanisms and biophysical linkages.
Evidence indicates GMFD activity modulates neurophysiological and immune processes, including alpha band desynchronization (p < 0.05), autonomic regulation under ultra-low frequency oscillations (r = 0.46, p < 0.01), and reduced leukocyte counts during disturbances (−17.5 cells/mm³, p < 0.001). Fetal head circumference was affected biphasically (β = 0.04 pre-24 weeks; β = −0.25 post-24 weeks, p < 0.05). However, there is an urgent need for more research with reproducible and reliable methods to consolidate these findings. Quantum processes (biophotons, tunneling) and Biofield Therapies provided complementary mechanisms consistent with Qi’s attributes. The Integration Diagram of Energy Domains (IDED) was formulated based on these syntheses.
The authors concluded that the integration of GMFD, QFD, and HBFD offers an innovative biophysical model aligning with TCM principles, supporting its scientific legitimacy and promoting its inclusion in integrative health frameworks.
Where to begin?
The paper proposes a speculative biophysical model linking geomagnetic fields, quantum fields, and human biofields to Traditional Chinese Medicine (TCM) concepts like Qi, but it lacks rigorous scientific validation. The study is framed as a “structured narrative review” with a systematic search, yet it relies on selective thematic synthesis rather than quantitative meta-analysis or risk-of-bias assessment. Reported effects, such as geomagnetic influences on alpha waves (p < 0.05) or leukocytes (−17.5 cells/mm³, p < 0.001), stem from heterogeneous, low-quality studies often plagued by small samples, confounding variables (e.g., stress during geomagnetic storms), and non-reproducible methods—the paper itself urges “more research with reproducible methods.” No PRISMA guidelines are followed, enabling cherry-picking of supportive findings while ignoring contradictory evidence, like null effects in controlled magnetoreception trials.
Geomagnetic field (GMFD) effects on physiology are overstated; while weak links exist to circadian rhythms via cryptochromes in animals, human data show inconsistent, correlational impacts (e.g., r = 0.46 for autonomic changes) without causation or mechanistic clarity. Quantum field (QFD) invocations (biophotons, tunneling) misapply fringe quantum biology concepts—biophotons are ultra-weak emissions with no proven regulatory role, and biological quantum effects (e.g., in photosynthesis) do not scale to macroscopic “Qi” phenomena. Human biofield (HBFD) remains pseudoscientific; therapies like Reiki show placebo-level outcomes in rigorous trials, with no detectable energy fields via standard physics instruments.
Equating TCM’s pre-scientific Qi/Yin-Yang to modern biophysics is pure pseudoscience, projecting metaphysical ideas onto preliminary data without falsifiability. The “Integration Diagram of Energy Domains (IDED)” is an untested schematic, not empirical evidence, echoing historical attempts to scientize homeopathy or chakras that failed under scrutiny. True integration demands randomized controlled trials of TCM interventions outperforming placebos, which they consistently do not for most indications.
This model promotes TCM’s “scientific legitimacy” prematurely, risking integration into health frameworks without efficacy proof. It exemplifies “quantum woo”—vague physics jargon to lend credibility to unverified claims—while biofield research faces preclinical challenges like poor reproducibility and placebo confounds.
Or, to put it bluntly:
THIS IS BULLSHIT!
Psoriasis is an immune-mediated inflammatory skin disease. By more than a decade of clinical validation, Jueyin granules (JYG) have demonstrated multi-target synergistic immunomodulatory and anti-inflammatory effects, offering a characteristic Traditional Chinese Medicine (TCM) therapeutic approach for psoriasis.
Aim of this study was to assess the efficacy and safety of oral JYG in treating psoriasis with blood-heat syndrome. Participants with body surface area (BSA) score less than 10 were allocated to receive JYG or placebo treatment in a 1:1 ratio through central area division and block randomization. The primary outcome is reduction of the psoriasis area severity index (PASI) score and proportion of participants achieving a greater than 50 % reduction in PASI scores (PASI50) at week 8.
Between November 2019 and April 2022, 195 participants were randomly assigned to receive JYG (n = 99) or a placebo (n = 96) at five centers. The JYG group demonstrated significantly greater reductions in PASI and BSA scores than the placebo group at week 8 (both P < 0.001) and maintained these improvements at week 16 (P < 0.001 and P = 0.005, respectively). By week 8, 51.09 % of participants in the JYG group achieved PASI50, compared to 20.65 % in the placebo group (P < 0.001). However, there were no statistical differences in dermatology life quality index (DLQI), visual analog scale (VAS) scores, or relapse rate.
The authors concluded that this study provides conclusive evidence that JYG is a safe and effective treatment for patients with mild-to-moderate psoriasis. The current findings support its use as a complementary and alternative therapy for psoriasis.
I think this paper needs a few explanations:
- What are Jueyin granules? This is a formula consisting of eight Chinese herbs (Haliotis diversicolor, Flos Lonicerae Japonicae, Radix Rehmanniae exsiccate, cortex moutan, Herba Hedyotisdiffusae, Folium isatidis, Smilax china L. and Radix Curcumae)
- What is the history? The formula was developed in the 1950s by Han Xia, a Chinese surgeon, and have been used to treat psoriasis for over 50 years by Yueyang Hospital of Integrated Traditional Chinese and Western Medicine.
- How did he develop it? We don’t know.
- Is the formula available outside China? No, not to the best of my knowledge.
- How reliable is this new trial? As we have discussed repeatedly on this blog, there are good reasons to mistrust Chinese studies.
- If we accept the findings nonetheless, are the conclusions valid? No! Firstly, this study cannot establish the safety of the formula. Secondly, a single trial cannot ‘conclusively’ establish the effectiveness of a therapy.
- Why does a respected journal publish such a dubious study? SERACH ME!
The objective of this study was to “critically assess the evidence presented in randomized controlled trials (RCTs) about the effectiveness of acupuncture on fatigue in cancer patients”. In April 2024 a systematic search was conducted searching five electronic databases to find studies concerning the use, effectiveness and potential harm of acupuncture therapy on cancer patients.
From all (1599) search results, 15 studies with 1346 patients were included. Acupuncture methods varied – e.g., traditional-, electro-, mind-regulating and ATAS-acupuncture – and were compared to sham acupuncture, usual care, or other controls.
- Studies comparing acupuncture to sham acupuncture reported mixed results: while some found significant effects on cancer-related fatigue, others found no advantages.
- Studies comparing acupuncture to usual care or waitlist controls often reported positive effects. However, the reliability of these findings is limited, as 14 of 15 studies were rated as “high risk of bias” by the RoB-2 tool due to issues like insufficient blinding and incomplete data analysis.
- Only one study, with low risk of bias, showed a significant reduction in fatigue with acupuncture compared to sham acupuncture (p < 0.001).
- GRADE evaluation showed very low certainty of evidence.
The authors concluded that the heterogenous results and methodological limitations of the existing studies prevent us from drawing definitive conclusions about the effectiveness of acupuncture in the treatment of cancer-related fatigue. Despite the inclusion of 15 studies, the overall evidence remains insufficient due to widespread problems in study design and inconsistent results. This analysis highlights the need to use more rigorous designs and more comprehensive assessment tools in future studies to better understand the role of acupuncture in the management of fatigue after cancer treatment.
So, only one study, with low risk of bias, showed a significant reduction in fatigue with acupuncture compared to sham acupuncture. Let’s have a look at it:
Background: Cancer-related fatigue (CRF) is a distressing symptom that is the most common unpleasant side effect experienced by lung cancer patients and is challenging for clinical care workers to manage.
Methods: We performed a randomized, double-blind, placebo-controlled pilot trial to evaluate the clinical effect of acupuncture on CRF in lung cancer patients. Twenty-eight patients presenting with CRF were randomly assigned to active acupuncture or placebo acupuncture groups to receive acupoint stimulation (LI-4, Ren-6, St-36, KI-3, and Sp-6) twice per week for 4 weeks, followed by 2 weeks of follow-up. The primary outcome was the change in intensity of CFR based on the Chinese version of the Brief Fatigue Inventory (BFI-C). As the secondary endpoint, the Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) was adopted to assess the influence of acupuncture on patients’ quality of life (QOL). Adverse events and safety of treatments were monitored throughout the trial.
Results: Our pilot study demonstrated feasibility among patients with appropriate inclusion criteria and good compliance with acupuncture treatment. A significant reduction in the BFI-C score was observed at 2 weeks in the 14 participants who received active acupuncture compared with those receiving the placebo (P < 0.01). At week 6, symptoms further improved according to the BFI-C (P < 0.001) and the FACT-LCS (P = 0.002). There were no significant differences in the incidence of adverse events in either group (P > 0.05).
Conclusion: Fatigue is a common symptom experienced by lung cancer patients. Acupuncture may be a safe and feasible optional method for adjunctive treatment in cancer palliative care, and appropriately powered trials are warranted to evaluate the effects of acupuncture.
Fancy that! The only study to produce some apparently sound evidence turns out to be a pilot study. Such studies are supposed to test feasibility, not effectiveness! In view of all this, it is far, I think, to draw a definitive conclusion, after all:
At present there is no compelling evidence that acupuncture works for cancer-related fatigue.
This study compared the analgesic efficacy of acupressure and magnetic therapy (AMT) versus diclofenac sodium (DFS) in acute renal colic. A total of 138 patients with acute renal colic (visual analog scale [VAS] score ≥ 7) were randomized to AMT or DFS treatment. Primary endpoints included changes in VAS scores at baseline, 1-, 10-, 30-, and 120-min post-intervention, along with analgesic duration. Multiple linear regression evaluated the influence of treatment modality, gender, white blood cell (WBC) count, and other covariates on VAS scores at 10 min. Interaction effect analysis was additionally used to assess how these factors modified treatment efficacy.
The AMT group demonstrated rapid onset, achieving an 86 % VAS reduction at 1-min post-intervention (vs. baseline, P < 0.001), though pain rebound occurred after 30 min. The DFS group exhibited slower onset but significantly prolonged analgesic duration compared to AMT (23.6 ± 2.2 h vs. 2.4 ± 1.0 h, P < 0.001). Multiple linear regression revealed that AMT had the best analgesic effect (B = -6.22, P < 0.001). Male gender (B = 0.78, P = 0.026) and lower baseline WBC counts (B = -0.16, P = 0.026) were associated with higher VAS scores. Interaction analysis indicated enhanced AMT efficacy in male patients and those with lower WBC counts.
The authors concluded that AMT and DFS exhibit complementary “rapid-sustained” analgesic profiles in renal colic management, with gender and WBC levels significantly modulating treatment efficacy. A stratified analgesia protocol based on these factors may optimize patient outcomes.
Apart from the fact that, as an equivalence trial, the study is hopelessly underpowered and its results therefore less than reliable, I have a further reason for not trusting its findings.
A renal colic is an acute and severe loin pain caused by a urinary stone moving from the kidney downwards into the ureter. The pain is often resistant to DFS or other conventional pain-killers and might require opioids. The pain usually peaks sharply, lasts for 20 to 60 minutes, and then subsides into a dull ache before the next “wave” begins. These waves are caused by the ureter’s peristalsis—the tube’s rhythmic muscular contractions—as it tries to squeeze the stone toward the bladder.
So, all I need to do to fake the effectivenesss of a so-called alternative medicine (SCAM) like AMT is to start treating patients when a wave is subsiding. This can easily appear as though AMT had a remarkable effect of 86%. Subsequently, the pain will recur. And this is probably what happened in this study! What I am trying to convey is that I am not convinced that AMT did much at all.
Moreover, I find it daft to conduct a trial where two SCAMs are tested together in one single treatment arm. Even if one would be convinced of the value of AMT – which I am not! – one would need to ask: was it the acupressure or the magnetic therapy that did the trick?
My conclusion is therefore yet again: if you design a silly study, you get a silly result.
The WHO says it is sifting the wheat from the chaff in order to save lives – but critics fear it is pandering to India and China; this TELEGRAPH article is worth reading in full; here I will merely quote a few passages from it.
Mongolian shamans beat wicker drums to summon ancestral spirits. A Peruvian man in a headdress unleashes a piercing ululation. And a man from Kentucky tells me the body can rid itself of cancer if you eat the right shrubs. It is a line-up one might expect at the healing field at Glastonbury but this is a conference centre in New Delhi and the event has been organised by the World Health Organization; the WHO Global Summit on Traditional Medicine. It’s the second gathering of its kind, following an inaugural meeting in Gujarat in 2023, and the three-day event has drawn hundreds of delegates from around the world. Alongside yoga instructors, aromatherapists, Chinese herbal practitioners and a small army of homeopaths, sit senior WHO officials, leading scientists and health ministers from across Africa, Asia and Latin America. Only Gwyneth Paltrow and her wellness website Goop is missing. They are here to “harness the potential” of traditional medicine, a catch-all term for practices that pre-date, and sit outside, modern evidence-based healthcare; therapies that for the most part have long been dismissed as quackery by mainstream science. What counts as “traditional medicine” ranges from drinking herbal teas to Indian Ayurveda, a holistic “wellness system” combining oils, herbs, homeopathy, yoga and meditation to “balance” and “heal” the body. To critics – and there are many – the scene is absurd.
So why is the WHO – a global authority on evidence-based health – giving a platform to this stuff? Has it fallen victim to the seductive power of TikTok-based wellness like so many of the west’s middle classes? Or has it – as some critics allege – been bought off by the traditional medicine super powers of India and China? …
The WHO says its Summit on Traditional Medicine is essentially about repeating this sifting process for traditional remedies used in other parts of the world. It aims to apply rigorous scientific analysis to all them in order to properly assess their claimed benefits and potential harms. By 2034, it says, it will publish a definitive list of which traditional treatments work – and which don’t. “Working on traditional medicine doesn’t mean we will use shortcuts or endorse things that are unproven,” Dr Sylvie Briand, the WHO’s Chief Scientist, told The Telegraph at the conference in New Delhi. The aim was first to document what traditional treatments existed around the world “and then see what could be more useful to address the disease of this century”.
One idea is that some traditional practices like yoga and meditation, while perhaps not offering direct curative benefits, could play an important role in preventative medicine. After all, so-called non-communicable diseases, often caused by lifestyle factors such as poor diet, chronic stress and a lack of exercise are now by far the biggest killers across the globe. “Many traditional systems of medicine take a holistic view and focus on strengthening the person as a whole, not just treating isolated symptoms,” Dr Sung Chol Kim, Unit Head for Traditional, Complementary and Integrative Medicine at the WHO told The Telegraph in Delhi. But others are sceptical. They fear the WHO, which is struggling for funding in the wake of the US leaving the organisation and widespread aid cuts, is simply pandering to India and China where traditional medicine is big business. Even if well intentioned, they worry that the discovery process the WHO has set in motion will end up promoting and legitimising quackery. “I think highly of the WHO. However, by giving a platform to traditional medicine practitioners who promote treatments that are unproven – or even disproven – such as homeopathy, the organisation risks legitimising quackery. That, in my view, is both unethical and irresponsible,” said Dr Edzard Ernst, a British-German academic who specialises in the study of complementary and alternative medicine…
Even within the WHO, there is tension over what is being platformed at the summit. One senior official, speaking on condition of anonymity, described homeopathy … as “complete nonsense”. “There is not one shred of evidence anywhere, absolutely anywhere, that suggests it works,” the official said, while acknowledging pressure to engage rather than alienate powerful member states. Dr Ernst, the British-German academic, said: “Many experts are puzzled by this attitude. The most likely explanation is that the WHO is bowing to political will instead of science.” ….
Globally, an estimated 4.6 billion people already use some form of traditional medicine. In sub-Saharan Africa, millions rely on traditional healers as their first – and sometimes only – point of care. Its use can delay access to appropriate treatment, and some practices have been linked to the spread of disease. This week, 41 people were reported to have died after undergoing rituals to initiate them into manhood in South Africa, a central part of which involves unsafe and brutal circumcisions. Another example, common in places like Uganda, Benin, and Burkina Faso, includes small skin incisions into which herbs are rubbed – sometimes referred to as “vaccinations” – increasing the risk of HIV transmission through the reuse of razors and knives. Efforts to regulate practitioners are underway, but progress remains slow. Malawi’s Minister for Health and Sanitation, Madalitso Baloyi, said her government wants clear guidance from the WHO. “As a Ministry, we want to ensure [traditional remedies] are tested and quality checked,” she told The Telegraph. She added that, at the moment, traditional medicine is being done “behind closed doors”, and that the WHO process would help bring it into the open where it can be better monitored.
Yet the WHO seems undeterred. “Some traditional remedies will probably be found to be really active and really useful. Others will just be a placebo – for example, you feel better when you drink tea,” said Dr Reeder. The WHO argues that investing in traditional medicine could also help tackle the leading killers of the 21st century: non-communicable diseases such as obesity, diabetes, cardiovascular disease and mental illness. Holistic approaches to wellness incorporating exercise, a more considered diet and stress reduction could complement conventional treatments, placing “an emphasis on prevention over cure,” said Dr Tedros…
