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Electronic
Instruments
And Acupuncture Points
Stimulating
acupuncture points with an electronic stimulator is fraught with many
questions: Should the current be micro or milliamps? What frequency
should be selected? Is frequency dispersion appropriate? What should
be the width and shape of the pulse? Is continuous, intermittent, or
rate modulation of concern to the outcome? Is the voltage and current
range selectable, and is it important? Does the device conforms to its
specifications, and is it safe for both the patient and operator? Do
we as physicians have a regulatory role to play?
The electronic acupuncture market abounds with many devices that claim
to benefit the patient. The interesting factor is that the physician's
purchasing knowledge may be that of a recommendation from another colleague.
"I get great results!" The electronic output of the device
and its characteristics may be rarely addressed or understood, and we
decidedly become appliance-users merely concerned about which lead to
connect as positive or negative to the acupuncture point. Should we
fry the acupuncture point with milliamps, or gently promote healing
with microamps? How should we slope the pulse to reduce its physiological
impact on damaged and inflamed tissue? Will we move Qi better with a
continuous pulse, or do we need to open up the meridian with a sharp
rate-modulated pulse? If we dial in 5 Hz, is 5 Hz coming out?
Electronic point detectors and stimulators are especially useful to
determine active acupoints in the ear and provide electrical stimulating
therapy. A review of the current market delineates a variation of the
circuitry, probes, and grounding systems. The ear appears to contain
hundreds of crowded points in a small confined space. The detector probe
must be small enough not to overlap and detect erroneously. One should
consider the diameter of the detecting probe. In the instances where
the same probe is used for electrical stimulation, a bipolar configuration
may be superior to a monopolar probe grounded to a rod in a clenched
fist or wrist strap. The ability to change frequency and intensity is
of paramount importance to obtaining results. It is well established
that the various anatomical locations of the ear are frequency-dependent.
Intensity is also related to patient comfort. Activated ear points can
be either positively or negatively charged. If the electronic circuitry
is not designed to detect both positive and negative potentials, this
is an obvious shortcoming. Improper cleaning and drying of the ear can
be detrimental to detecting and stimulating acupoints.
Physicians have traditionally been leaders in their specialty fields.
We have no choice but to be concerned and to take an active role in
determining the efficacy of various electronic devices that are available
in acupuncture. Research needs to be conducted to determine which electronic
characteristics provide optimal therapy. Should a standard of care be
established to determine the usage of these instruments for various
pathological conditions? Should there be a certification process? In
the short term, an independent testing agency could perhaps be established
to determine whether these devices conform to their stated specifications.
We must demand quality production of the manufacturers. We must decide
how we should interact with the FDA, the regulatory agency now regulating
most of our acupuncture instruments.
Indeed, this is a complicated subject, but other areas in medicine of
equal complexity have achieved standardization. Electronic instrumentation
in the practice of acupuncture will be most challenging for the years
ahead. All of us will profit and most importantly, our patients will
be the recipients of this technological consistency.
I am happy to announce that Medical Acupuncture will now be published
three times a year instead of twice. I am now into my fourth year as
your Editor-in-Chief and wish to thank the AAMA Board, Editorial Board,
and membership for their continuing support. And, as always, many thanks
go to our editorial staff "team." I believe this journal reflects
the current state of medical acupuncture in the United States. As medical
acupuncture rapidly evolves, so does our unique journal.
- Richard C. Niemtzow, MD, PhD, MPH
Editor-in-Chief
EDITOR INFORMATION
Dr Richard Niemtzow is a Colonel in the United States Air Force (USAF),
on loan to the U.S. Navy for a special acupuncture project. Dr Niemtzow
is the first physician practicing acupuncture full-time at the Naval
Medical Center in San Diego, California, with a special interest in
oncology.
Richard C. Niemtzow, MD, PhD, MPH
1835 East Main Street
El Cajon, CA 92021-5255
Phone: 619-447-6806 Fax: 619-447-6881 E-mail: N5EV@aol.com
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