Eastern Ref

A SCIENTIFIC LOOK AT ALTERNATIVE MEDICINE

Eastern Approaches

Part 5: References

Thomas J. Wheeler, Ph.D.

Associate Professor (retired), Department of Biochemistry and Molecular Biology,

University of Louisville School of Medicine, Louisville KY

thomas.wheeler@louisville.edu

Revised 2019

This original version of this material was a handout for an elective course given to medical students at the University of Louisville.

Copyright 2019. Permission to copy for non-profit uses is granted as long as proper citation of the source is given.

DISCLAIMER: The material presented here is not medical advice. It represents the author's summary of scientific evidence concerning various topics. For medical advice, see your physician.

A pdf file containing all parts and references can be downloaded from ARTICLES or EASTERN.


CONTENTS OF PART 5

References for:

Traditional Chinese medicine - general

Acupuncture

  • News and general

  • Practice and scope

  • Mechanisms of action

  • Critiques

  • Side effects

Electroacupuncture

Auriculotherapy

Dry needling

Acupressure

Moxibustion

Cupping

Tai chi

Chinese and Japanese herbal medicine

Other miscellaneous Chinese therapies

Ayurvedic medicine

  • Overview and news

  • Herbal and other remedies

  • Critiques - general

  • Critiques - Deepak Chopra

  • Critiques - other specific topics

Yoga

Unani and Siddha

Arabic and Islamic medicine

Note - see text for additional references for research studies and reviews

Traditional Chinese medicine - general

Huston P. 1995. China, chi, and chicanery: Examining traditional Chinese medicine and qi theory. Skeptical Inquirer 19(5):38-42, 58

Beyerstein BL, Sampson W. 1996. Traditional medicine and pseudoscience in China: A report of the second CSICOP delegation (Part 1). Skeptical Inquirer 20(4):18-26

Sampson W, Beyerstein BL. 1996. Traditional medicine and pseudoscience in China: A report of the second CSICOP delegation (Part 2). Skeptical Inquirer 20(5):27-34

Zhang GG, Lee W, Bausell B, Lao L, Handwerger B, Berman B. 2005. Variability in the traditional Chinese medicine (TCM) diagnoses and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis. J Altern Complement Med 11(3):415-421 [abstract]

Kim M, Cobbin D, Zaslawski C. 2008.Traditional Chinese medicine tongue inspection: an examination of the inter- and intrapractitioner reliability for specific tongue characteristics. J Altern Complement Med. 14(5):527-36 [abstract]

Palmer J. 2013 Jun 13. Do some harm. Aeon

Barrett S. 2014. Why traditional Chinese medicine diagnosis is worthless. Acupuncture Watch

Gorski DH. 2015. Science sells out: Advertising traditional Chinese medicine in three supplements. Skeptical Inquirer 39(3):46-8

Ernst E. 2016 Oct 4. Data fabrication in China is an "open secret." Edzard Ernst

Gorski D. 2017 Jan 2. In the tradition of Chairman Mao, traditional Chinese medicine gets a new boost by the Chinese government. Science-Based Medicine

Crislip M. 2017 Jan 20. Chinese biomedical research: Sturgeon’s law in action. Science-Based Medicine

Hall H. 2017 Sep 26. TCM (traditional Chinese medicine): New developments. Science-Based Medicine

Hall H. 2017 Dec 26. A misguided study to test the reliability of traditional Chinese medicine pulse diagnosis. Science-Based Medicine

Gorski D. 2018 Mar 19. ICD-11: A triumph of the “integration” of quackery with real medicine. Science-Based Medicine

Cyranoski D. 2018 Apr 26. Chinese physician released after 3 months in jail for criticizing a traditional medicine. Nature.com

Cyranoski D. 2018. Why Chinese medicine is heading for clinics around the world. Nature. 561(7724):448-50

Gorski D. 2018 Sep 7. European Atherosclerosis Society: Publishing quackademic pseudoscience about traditional Chinese medicine in its official journal. Respectful Insolence

Gorski D. 2018 Oct 4.The World Health Organization: Embracing traditional Chinese medicine pseudoscience in ICD-11. Respectful Insolence

Gorski D. 2019 Jan 7. Traditional Chinese medicine is science, ma-an! National Geographic promotes quackery. Respectful Insolence

Acupuncture - news and general

Van Hal M, Green MS. 2018. Acupuncture. Stat Pearls [Internet]

National Center for Complementary and Integrative Health. 2017. Acupuncture: In depth

Austin S, Ramamonjiarivelo Z, Qu H, Ellis-Griffith G. 2015. Acupuncture use in the United States: Who, where, why, and at what price? Health Mark Q. 32(2):113-28 [abstract]

Morey SS. 1998. NIH issues consensus statement on acupuncture. Am Fam Physician. 57(10):2545-6; Full consensus statement

Ma Y, Dong M, Zhou K, Mita C, Liu J, Wayne PM. 2016. Publication trends in acupuncture research: a 20-year bibliometric analysis based on PubMed. PLoS One. 11(12):e0168123

Fan AY, Stumpf SH, Faggert Alemi S, Matecki A.2018. Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2018. Complement Ther Med. 41:295-301 [abstract]

Bellamy J. 2018 Jan 19. Legislative alchemy 2017: Acupuncture. Science-Based Medicine

Bellamy J. 2019 Jan 3. Legislative alchemy 2018: Acupuncturists seek practice expansion and competition elimination. Science-Based Medicine


Acupuncture - practice and scope

Langevin HM, Wayne PM. 2018. What is the point? The problem with acupuncture research that no one wants to talk about. J Altern Complement Med. 24(3):200-7 [abstract]

Han JS. 2011. Acupuncture analgesia: areas of consensus and controversy. Pain. 152(3 Suppl):S41-8 [first page preview]

Cherniack EP, Govorushko S. 2018. To bee or not to bee: The potential efficacy and safety of bee venom acupuncture in humans. Toxicon. 154:74-78 [abstract]


Acupuncture - mechanisms of action

Sims J. 1997. The mechanism of acupuncture analgesia: a review. Complement Ther Med. 5(2):102-11 [abstract]

Audette JF, Ryan AH. 2004. The role of acupuncture in pain management. Phys Med Rehabil Clin N Am. 15(4):749-72 [abstract]

Beissner F. 2011. Functional magnetic resonance imaging studies of acupuncture mechanisms: a critique. Focus Altern Complement Ther 16(1):3-11 [abstract]

Takano T, Chen X, Luo F, Fujita T, Ren Z, Goldman N, Zhao Y et al. 2012. Traditional acupuncture triggers a local increase in adenosine in human subjects. J Pain. 13(12):1215-23

Gao P, Gao X, Fu T, Xu D, Wen Q. 2015. Acupuncture: Emerging evidence for its use as an analgesic. Exp Ther Med. 9(5):1577-81

Crislip M. 2016 Jul 22. Acupuncture and endorphins: Not all that impressive. Science-Based Medicine

Acupuncture - critiques

Barrett S. 2011. Be wary of acupuncture, qigong, and "Chinese medicine." Quackwatch

Barrett S. 2017. Acupuncture Watch

Shermer M. 2005. Full of holes: The curious case of acupuncture. Sci Am. 293(2):30

Ernst E, Snyder J, Dunlop RA. 2012. National Center for Complementary and Alternative Medicine-funded randomised controlled trials of acupuncture: a systematic review. Focus Altern Complement Ther 17(1):15-21 [abstract]

Aird M, Cobbin DM, Rogers C. 2002. A study of the relative precision of acupoint location methods. J Altern Complement Med. 8(5):635-42 [abstract] [“These results would rule out any specificity of function of acupoints...”]

Atwood K. 2009 May 15, May 29, Jun 12, Jun 26. "Acupuncture anesthesia": a proclamation from Chairman Mao. Science-Based Medicine blog. Part 1 Part 2 Part 3Part 4

Hall H. 2011. Acupuncture's claims punctured: not proven effective for pain, not harmless. Pain. 152(4):711-2 [First page preview]

Gorski D. 2012 Sep 12. Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we? (2012 edition). Respectful Insolence

Novella S. 2012 Sep 12. An acupuncture meta-analysis. Science-Based Medicine

Pro and con editorials:

Zheng YC, Yuan TT, Liu T. 2014. Is acupuncture a placebo therapy? Complement Ther Med. 22(4):724-30 [abstract]

McGeeney BE. 2015. Acupuncture is all placebo, and here is why. Headache. 55(3):465-9 [abstract]

Liu WH, Hao Y, Han YJ, Wang XH, Li C, Liu WN. 2015. Analysis and thoughts about the negative results of international clinical trials on acupuncture. Evid Based Complement Alternat Med. 2015:671242

Anon. 2015 July 25. Is there any place for acupuncture in 21st century medical practice? Friends of Science in Medicine [pdf file]

Solomon S. 2016. Acupuncture for headache. It's still all placebo. Headache. 57(1):143-6 [1st page preview]

Gorski D. 2016 Apr 18. Acupuncture does not work for menopause: A tale of two acupuncture studies. Science-Based Medicine

Hall H. 2016 Jun 7. The primo vascular system: The N-rays of acupuncture? Science-Based Medicine

Gorski D. 2016 Jul 25. On the pointlessness of acupuncture in the emergency room...or anywhere else. Science-Based Medicine

Gorski, D. 2016 Aug 2. Emergency acupuncture! Respectful Insolence

Gorski, D. 2016 Nov 17. Acupuncture: Getting the point. Respectful insolence

Gelfand AA. 2017. Acupuncture for migraine prevention: still reaching for convincing evidence. JAMA Intern Med. 177(4):516-7 [First paragraph]

Novella S. 2017 Jan 25. Acupuncture for infantile colic. Science-Based Medicine

Jones C. 2017 Jan 27. Acupuncture for infant colic part 2: Acupuncture boogaloo. Science-Based Medicine

Ernst E. 2017 Feb 25. Acupuncture for migraine prevention? Perhaps, but... Edzard Ernst

Gorski D. 2017 Jun 20. Emergency acupuncture! (2017 edition) Respectful Insolence

Novella S. 2017 Dec 6. False claims for acupuncture. Science-Based Medicine

Cummings M, Hróbjartsson A, Ernst E. 2018. Should doctors recommend acupuncture for pain? BMJ. 360:k970 [abstract plus audio segment]

Novella S. 2018 Apr 2. Science and pseudoscience of the interstitium. NeuroLogica

Gorski D. 2018 May 7. PLOS One, peer review, and a "crappy" acupuncture study. Science-Based Medicine [constipation]

Gorski D. 2018 May 17. Surprise! Surprise! (Well, actually, no.) Acupuncture does not work for in vitro fertilization. Respectful Insolence

Ernst E. 2018 Aug 14. Be very careful before accepting any "evidence" about the benefits of acupuncture. Edzard Ernst [postpartum depression]

Hall H. 2018 Oct 9. AAFP promotes acupuncture. Science-Based Medicine [fibromyalgia]

Ernst E. 2018 Oct 22. Acupuncture for alcohol withdrawal syndrome – another ugly fact kills a beautiful hypothesis. Edzard Ernst

Ernst E. 2018 Oct 25. Mini-scalpel acupuncture = maxi-nonsense. Edzard Ernst

Ernst E. 2018 Nov 6. Acupuncture: it is time to stop redundant, foolish, wasteful and unethical pseudo-science. Edzard Ernst [dysmenorrhea]

Ernst E. 2018 Dec 19. Acupuncture for carpal tunnel syndrome – bin the studies and consult a surgeon! Edzard Ernst

Hall H. 2019. Is acupuncture winning? Skeptical Inquirer. 43(1):19-21

Ernst E. 2019 Jan 26. Acupuncture is effective for chronic back pain!!! If you disagree, tell the CMS. Edzard Ernst

Ernst E. 2019 Feb 12. Acupuncture for children?… A little critical thinking would not harm! Edzard Ernst

Ernst E. 2019 Feb 20. A new acupuncture trial published in the "BMJ-Open" seems to smell of scientific misconduct. Edzard Ernst [menopausal symptoms]

Ernst E. 2019 Apr 18. Chinese acupuncture researchers have finally discovered the obvious (but sadly, without realising it). Edzard Ernst [asthma]

Acupuncture - side effects

Ernst E. 2010. Deaths after acupuncture: A systematic review. Int J Risk Safety Med 22:131-6 [abstract]

Ernst E. 2018 Dec 15. Death by acupuncture. Edzard Ernst

Chan MWC, Wu XY, Wu JCY, Wong SYS, Chung VCH. 2017. Safety of acupuncture: Overview of systematic reviews. Sci Rep 7(1):3369

Ullah W, Ahmad A, Mukhtar M, Virk HUH, Sarwar U, Figueredo V. 2019. Acupuncture-related cardiac complications: A systematic review. J Invasive Cardiol. 31(4):E69-E72 [abstract]

Electroacupuncture

Langevin HM, Schnyer R, MacPherson H, Davis R, Harris RE, Napadow V, Wayne PM, et al. 2015. Manual and electrical needle stimulation in acupuncture research: pitfalls and challenges of heterogeneity. J Altern Complement Med. 21(3):113-28


Auriculotherapy

Hou PW, Hsu HC, Lin YW, Tang NY, Cheng CY, Hsieh CL. 2015. The History, Mechanism, and Clinical Application of Auricular Therapy in Traditional Chinese Medicine. Evid Based Complement Alternat Med. 2015:495684

Stuyt EB, Voyles CA. 2016. The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Subst Abuse Rehabil. 2016;7:169-80

Salzberg S. 2011 Dec 30. The worst quackery of 2011: Battlefield acupuncture. Forbes

Bellamy J. 2016 Sep 1. Nada for NADA: "Acudetox" not effective in addition treatment. Science-Based Medicine

Gorski D. 2017 Mar 29. “Dr. Seuss monsters”: The quackery that is “battlefield acupuncture” continues to metastasize. Respectful Insolence

Gorski D. 2018 Jan 11. More "auricular" acupuncture: Our veterans deserve science-based medicine, not quackery. Respectful Insolence

Dry needling

Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. 2014. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 19(4):252–65

Fan AY, Zheng L, Yang G. 2016. Evidence that dry needling is the intent to bypass regulation to practice acupuncture in the United States. J Altern Complement Med 22(8):591-3 [first page preview].

  • Letter in response and reply by Fan et al.: Dommerhold J, Stanborough R. 2017. J Altern Complement Med 23(2):149-51

Crislip M. 2016 May 27. Dry needling. Science-Based Medicine

Acupressure

Frost H, Stewart-Brown S. 2006. Acupressure for low back pain. Promising but not proved. BMJ. 332(7543):680-1

Tan JY, Suen LK, Wang T, Molassiotis A. 2015. Sham acupressure controls used in randomized controlled trials: A systematic review and critique. PLoS One. 10(7):e0132989

Ernst E. 2016 May 10. Shiatsu: do the benefits outweigh the risks? Edzard Ernst

Gorski D. 2016 Jul 13. Quackademic medicine and acupressure at my alma mater. Respectful Insolence

Ernst E. 2017 Apr 29. Shiatsu: fatally flawed research is an unethical waste of resources. Edzard Ernst

Ernst E. 2018 Dec 7. Acupressure: you thought it was harmless? Read this, it might change your mind! Edzard Ernst

Moxibustion

Chiu JH. 2013. How does moxibustion possibly work? Evid Based Complement Alternat Med. 2013:198584

Cupping

Ernst E. 2016 Aug 9. The current cupping craze. Edzard Ernst

Novella S. 2016 Aug 10. Cupping - Olympic pseudoscience. Science-Based Medicine

Ernst E. 2016 Aug 12. There is a sucker born every minute – more thoughts on the Olympic cupping craze. Edzard Ernst

Hall H. 2017 Oct 31. Facial cupping: A kinder, gentler, sillier kind of cupping. Science-Based Medicine

Bridgett R, Klose P, Duffield R, Mydock S, Lauche R. 2018. Effects of cupping therapy in amateur and professional athletes: Systematic review of randomized controlled trials. J Altern Complement Med. 24(3):208-19 [see critique in next item]

Ernst E. 2018 Feb 14. Cupping for athletes: rubbish trials, rubbish review, rubbish journal. Edzard Ernst

Tai chi

National Center for Complementary and Alternative Medicine. 2006. Tai chi for health purposes [pdf file]

Gorski D. 2016 May 23. Tai Chi versus physical therapy for osteoarthritis of the knee: How CAM “rebranding” works. Science-Based Medicine

Chinese and Japanese herbal medicine

White KP. 2009. A crash course in Chinese herbology for the psychopharmocological prescriber. Exp Clin Psychopharmacol. 17(6):384-95 [abstract]

Xu Z. 2011. Modernization: One step at a time. Nature. 480(7378):S90-2

Fuyuno I. 2011. Japan: Will the sun set on Kampo? Nature. 480(7378):S96

Callaway E. 2012 Apr 12. Screen uncovers hidden ingredients in Chinese medicine. Nature

Hawkes D, Benhamu J. 2014. Pharmacological examination of TCM should be evidence based. Trends Pharmacol Sci. 35(3):111-2 [first sentence]

Chan K, Zhang H, Lin ZX. 2015. An overview on adverse drug reactions to traditional Chinese medicines. Br J Clin Pharmacol. 80(4):834-43

Gorski D. 2016 Oct. 26. Applying systems biology to validate prescientific quackery is tooth fairy science. Respectful Insolence

Linde K, Brinkhaus B. 2017. Randomized trials of Chinese herbal medicine: A new extension of the CONSORT Statement. Ann Intern Med 167(2):133-4 [abstract]

Anon. 2017 Nov. 2. Patient deaths show darker side of modern Chinese medicine. Bloomberg News [subscription required]

Cyranoski D. 2017. China to roll back regulations for traditional medicine despite safety concerns. Nature. 2017 Nov 29;551(7682):552-3

Gorski D. 2017 Dec 7. Lowering the bar for traditional Chinese medicine for ideology and profit. Respectful Insolence

Gorski D. 2018 May 8. The case of Tan Qindong shows that in China traditional Chinese medicine is big pharma. Respectful Insolence

Ernst E. 2018 Sep 4. TCM by injection? The idea frightens me. Edzard Ernst

Ernst E. 2018 Oct 30. China’s State Council to sacrifice tigers and rhinos in the name of TCM-quackery. Edzard Ernst

Ernst E. 2018 Nov 22. TCM for cancer? No, I would not recommend it. Edzard Ernst

Ernst E. 2018 Dec 24. Why "Rudolph The Red Nose Reindeer" dislikes X-mas. Edzard Ernst

The Editors. 2019 Apr 1. The World Health Organization gives the nod to traditional Chinese medicine. Bad idea. Scientific American

Other miscellaneous Chinese therapies

Tavel ME. 2014. On the mythical Isle of "Woo" with gua sha spoon therapy. Skeptical Inquirer 38(1):11

Ernst E. 2018 Jun 16. Gua sha, a reasonable therapy? Edzard Ernst

Gorski D. 2010 Sep 2. Acupuncture quackademic medicine infiltrates PLoS ONE. Respectful Insolence [laser acupuncture]

Ernst E. 2016 Dec 2. Slapping therapy? No thanks! Edzard Ernst

Ernst E. 2017 Apr 7. Tui na for radiculopathy: another systematic review bordering on scientific misconduct. Edzard Ernst

Ernst E. 2019 Feb 22. Yang sheng: another SCAM to avoid. Edzard Ernst


Ayurvedic medicine - overview and news

Government of India, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)

• home page

• Ayurveda

Sharma H, Chandola HM, Singh G, Basisht G. 2007. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1--Ayurveda, the science of life. J Altern Complement Med. 13(9):1011-9 [abstract]

Sharma H, Chandola HM, Singh G, Basisht G. 2007. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 2--Ayurveda in primary health care. J Altern Complement Med. 13(10):1135-50

Bagla P. 2011. Piercing the veil of Ayurveda. Science. 334(6062):1491 [summary]

Kessler C, Wischnewsky M, Michalsen A, Eisenmann C, Melzer J. 2013. Ayurveda: between religion, spirituality, and medicine. Evid Based Complement Alternat Med. 2013:952432

Pulla P. 2014. Searching for science in India's traditional medicine. Science. 346(6208):410 [summary]

Ayurvedic medicine - herbal and other remedies

Saper RB, Kales SN, Paquin J, Burns MJ, Eisenberg DM, Davis RB, Phillips RS. 2004. Heavy metal content of ayurvedic herbal medicine products. JAMA 292(23):2868-73

Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, et al. 2008. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 300(8):915-23

Ajanal M, Nayak S, Prasad BS, Kadam A. 2013. Adverse drug reaction and concepts of drug safety in Ayurveda: An overview. J Young Pharm. 5(4):116-20

Parasuraman S, Thing GS, Dhanaraj SA. 2014. Polyherbal formulation: Concept of ayurveda. Pharmacogn Rev. 8(16):73-80 [abstract]

Peterson CT, Denniston K, Chopra D. 2017. Therapeutic uses of Triphala in Ayurvedic medicine. J Altern Complement Med. 23(8):607-14 [abstract]

Mikulski MA, Wichman MD, Simmons DL, Pham AN, Clottey V, Fuortes LJ. 2017. Toxic metals in ayurvedic preparations from a public health lead poisoning cluster investigation. Int J Occup Environ Health. 23(3):187-192

Ernst E. 2018 Mar 20. Ayurvedic medicines to die for. Edzard Ernst

Hall H. 2018 Oct 16. Gold water, silver water, copper water. Science-Based Medicine

Ayurvedic medicine - critiques - general

Carrier M. 2011. Ayurvedic medicine. Skeptic. 16(2):17-9

Barrett S. 2012. A few thoughts on ayurvedic mumbo-jumbo. Quackwatch

Kumar S. 2019. In India, Hindu pride boosts pseudoscience. Science. 363(6428):679-80 [abstract]

Ayurvedic medicine - critiques - Deepak Chopra

Wheeler T. 1994. Some notes on Deepak Chopra and Maharishi Ayur-veda. Bay Area Skeptics Information Sheet. 13(11):1-3;13(12):2-5. KyCAHF Commentary (link to pdf file: Chopra.pdf)

Hassani S. 2016. Deepak Chopra's "Physics." Skeptical Inquirer. 40(1):55-8

Ernst E. 2016 Sep 15. Deepak Chopra's finest hour. Edzard Ernst

Gorski D. 2016 Nov 3. Why do medical conference organizers keep inviting Deepak Chopra to speak? Respectful Insolence

Ayurvedic medicine - critiques - other specific topics

Radford B. 2014. Vegetable oil or snake oil? The pseudoscience of "oil pulling." Skeptical Inquirer. 38(6):26-27

Ernst E. 2018 Sep 8. Oil pulling, a promising alternative therapy – no, I am not pulling your leg! Edzard Ernst

Gorski D. 2011 Nov 21. Woo-omics. Science-Based Medicine


Yoga

Government of India, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH): Yoga

Telles S, Singh N. 2013. Science of the mind: Ancient Yoga texts and modern studies. Psychiatr Clin North Am. 2013 Mar;36(1):93-108 [first page preview]

Palmer B. 2014 Mar 7. God is dead. Long live downward dog. Slate

Cramer H, Lauche R, Langhorst J, Dobos G. 2016. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement Ther Med. 25:178-87 [abstract]

Nisbet MC. 2019. The science of why yoga quiets the mind. Skeptical Inquirer. 43(2):40-2

Rawlins R. 2019 Mar 6. Yoga and the NHS. Edzard Ernst

Unani and Siddha

Government of India, Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)

• Unani

• Siddha

Arabic and Islamic medicine

Azaizeh H, Saad B, Cooper E, Said O. 2008. Traditional Arabic and Islamic medicine, a re-emerging health aid. Evid Based Complement Alternat Med. 7(4):419-24