Hungarian Military Use of Acupuncture: Recent Clinical Trials and Accumulated Survey Data

Abstract

ABSTRACT

There has been a considerable increase in the use of acupuncture and other practices of complementary and alternative medicine (CAM) throughout Hungary. As a result, acupuncture is among the CAM modalities taught routinely to medical students in Hungarian universities, and these CAM practices are increasingly regulated. With the influx of veterans and wounded warriors from recent wars into Hungarian hospital populations, certain CAM treatments have become the treatments of choice by civilian physicians treating the soldiers. This report discusses the extent of acupuncture and other CAM treatments use by military medical personnel in Hungary.

Introduction

Acupuncture is included in Hungarian legislation concerning the use of complementary and alternative medicine (CAM), and is in use in the Hungarian military. An 11/1997 Health Ministry policy¹ and a 40/1997 piece of legislation² regulated the functioning of CAM in this country. Consequently, complementary medicine or natural healing is a legal part of health services and patient care here.³

In the last 15 years since the statutes originated, Hungarian academic institutions have progressed in CAM teaching, and practitioners include CAM in daily practice. Government-required tests, for MDs, are given at the CAM department of the Medical University at Pècs, Hungary, or at secondary health education schools for non-MDs (if these institutions have such classes). In addition, in 1998, 2003, and 2010, the medical department of the Hungarian Academy of Sciences⁴ accepted a number of types of CAM as being scientifically proven and acceptable for use by MDs, while other types of CAM were considered acceptable for practice by non-MDs. Acupuncture performed only by MDs was included among this latter group of modalities, which included acupressure and a U.S.-based National Acupuncture Detoxification Association protocol used to treat substance abusers, provided by non-MDs.

Included among the areas now studied are applications of CAM for active military personnel and veterans. One study, instituted by Dr. Hegyi 20 years ago, examines the feasibility of rehabilitation of patients who had strokes by embedding permanent biostimuli on acupoints in the scalps of military personnel.*

The European Union (EU) is extremely interested in CAM acceptance and has provided a grant† to the CAMbrella Project‡ for 2 years (2010–2012) to examine the use of CAM throughout the EU. The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to:

• Establish an EU network involving centers of research excellence for collaborative projects;

• Develop consensus-based terminology to describe CAM interventions;

• Create a knowledge base that facilitates the understanding of patient demand for CAM and its prevalence;

• Review the current legal status and policies governing CAM provision;

• Explore the needs and attitudes of EU citizens with respect to CAM.

Based on this information, a roadmap will be created that will enable sustainable and prioritized future European research in CAM. CAMbrella encompasses 16 academic research groups§ from 12 European countries.

Recent Health Survey Statistics On Military Use Of Acupuncture

To document military use of CAM, the National Health Service of Hungary recently completed a health survey that provided information on the pervasiveness of CAM in military use, including data on acupuncture use in this population.** The results included the following:††

• 44% of Hungarian military personnel use CAM procedures.

• Of those that do, 24% use herbal therapies, 9% use acupuncture (see Tables 1 and 2). Of those military personnel who use CAM, acupuncture, at 24%, and herbal therapies, at 26%, were most commonly used to treat a long-term health condition (Table 3). Military personnel agreed that physicians were helpful (Table 4), but many elected self-help forms of CAM, including yoga and meditation (Table 5).

• The most common ailment treated using CAM among military personnel were cervicobrachiale syndrome and cervical migraine (Table 6).

• As noted, an ongoing trial on civilian and military personnel for stroke rehabilitation using the Yamamoto Scalp technique has been underway for 20 years.

Table 1.

Use of CAM in Hungarian Military Personnel

Modality	%
Herbal medicines	24%
CAM massage therapies	23%
Manual medicine (osteopathy, chiropraxia)	13%
Acupuncture/TCM	9%
Neural therapy	6%
Reflexology	13%
No use	12%
CAM, but MDs provider only	44%

CAM, complementary and alternative medicine; TCM, Traditional Chinese Medicine.

Table 2.

Types of Practitioners Consulted

Type of practitioner	% who consulted
Non-MD practitioner	11%
Physician	29%
Homeopath	12%
Chiropractor /manual medicine practitioner)	8%
Acupuncturist/TCM	6%
None	34%

TCM, Traditional Chinese Medicine.

Table 3.

Reasons for Using CAM

Have you received any of the following complementary treatments from a physician in the last 12 months?	Number of times received this treatment in the last 12 months? (# of sessions)	For an acute illness/condition, one that lasted <1 month (% of respondents)	To treat a long-term health condition (one that lasted >1 month) or its symptoms (% of respondents)
Acupuncture/TCM	5–10	10%	24%
Herbal medicine	5–12	16%	26%
Homeopathy	4–5	8%	17%
Manual medicine	3–5	7%	8%
Neural therapy	5–10	5%	12%
Reflexology	8–12	12%	13%

CAM, complementary and alternative medicine; TCM, Traditional Chinese Medicine.

Table 4.

Satisfaction with CAM Treatment

Level of satisfaction	% of respondents
Very	44%
Somewhat	32%
Not at all	14%
Don't know	10%

CAM, complementary and alternative medicine.

Table 5.

Types of Self-Help CAM Used

		Reason for use
Have you used any of the following self-help practices in the last 12 months?	Number of times you used this practice in the last 12 months	For an acute illness/condition, one that lasted less than 1 month	To treat a long-term health condition (one that lasted more than 1 month) or its symptoms	To improve well-being
Meditation	26%	5%	12%	9%
Yoga	18%	8%	5%	5%
Qigong (Chi Kung)	7%	1%	2%	4%
T'ai chi	14%	2%	4%	8%
Relaxation techniques	17%	5%	7%	5%

Note: Acupuncture was not included among types of self-help CAMs used.

CAM, complementary and alternative medicine.

Table 6.

Conditions Treated by Acupuncture and Two Other Types of CAM

	# of cases for type of CAM used
Conditions treated	Acupuncture	Laser (shower, locoregional)	Magnet field therapy
Cervicobrachiale syndrome	1242	376	470
Cervical migraine	157	53	N/A
Headache (tension)	174	36	N/A
Periarthritis humeroscapul.	285	169	256
Spondylarthr. ancylopoetica	80	80	78
Polyarthritis (chronic, progressive)	86	54	85
Scheuermann's disease	69	56	76
Lumboischialgie (originated from disc, spondylogenous)	1458	380	1220
Coxarthrosis	342	124	340
Gonarthrosis	279	145	254
Postoperative rehabilitation (flavectomy, etc.)	269	253	258

CAM, complementary and alternative medicine; N/A, not applicable.

Discussion

Researchers have noted that CAM and acupuncture are practiced infrequently by military physicians in Hungary. These researchers offer the following possible reasons to explain trends within the ranks of medical military physicians:

• Older military physicians who learned their acupuncture skills while serving in Korea and Vietnam are now no longer practicing.

• Younger physicians who study acupuncture tend to be medical students at civilian universities because the military does not offer training in acupuncture as part of its curricula for physicians.

• Specific CAM procedures that are used in outpatient surgery at the Central Military Hospital in Budapest include laser and magnet field therapy. These CAM procedures were chosen by the military to be taught to student physicians. In the Hungarian military, the faculty chooses what will be taught.

Conclusions

At this point, we can conclude from surveys among practitioners and health sociologists that the development of CAM is a very real, growing process, and it would be interesting to study its reasons to regulate the field in this branch of medicine. Instead of oppressing or ignoring CAM, we should regulate it strictly to build it into an integrative and uniform medical practice. Of course, this is also the time to make a central issue of quality control of effectiveness and efficiency in the different areas, which is real aim of acceptance occurring in the European CAMbrella Project. With regard to military use, researchers at the CAM department of the University of Pècs medical school are working in concert with the military to include broader study of acupuncture and other CAM procedures. In addition, the National Defensive University of Hungary has accepted two CAM topics for PhD theses since 2010:

(1) CAM methods for elevating psychosomatic well-being of military persons; and

(2) Nonconventional methods for military individuals for stress release. This has been a PhD topic for candidates in the Defensive University of Hungary since 2010.

The terms “complementary medicine” or “alternative medicine” are used interchangeably with traditional medicine in some countries. These terms refer to a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system. There has been a considerable increase in the use of acupuncture and other practices of CAM throughout Hungary. As a result, acupuncture and other alternative medical practices are taught routinely to medical students in Hungarian universities, and CAM practices are increasingly regulated. With the increase of veterans and wounded warriors from recent wars in Hungarian hospital populations, certain CAM treatments have been chosen by civilian physicians who are treating the soldiers.

In conclusion, this study has presented recent data on CAM use among military personnel and indicated how widespread the use of acupuncture and other CAM treatments is by military medical personnel.

Footnotes

Disclosure Statement

No competing financial interests exist.

*

For a complete description of this study, see Gabriella Hegyi and Gyula P Szigeti, “Rehabilitation of Stroke Patients Using Yamamoto New Scalp Acupuncture—A Pilot Study,” which will appear in a future issue of the Journal of Alternative and Complementary Medicine.

†

European Commission, 2010–2012 (FP7/2007–2013) under Grant Agreement No. 241951.

‡

The author of this article is the official Hungarian delegate for the CAMbrella Project. She reported on the recent situation in Hungary regarding civil and military usage of CAM.

§

The Pècs Science University (PTE), Pècs, Hungary, is the 13th member of this consortium.

**

Data gleaned from the national survey about CAM in Military that was carried out in 2011 according to NAFKAM International CAM Questionnaire (I-CAM-Q) with numerous questions.

††

Part of Health Survey Statistics of CAM, 2011; PTE UNI (Health Science University), performed by the ETK (Health Science Faculty) CAM department. Also part of the CAMbrella European Project report () entitled “Statistical Data of Complaints of Military Persons Applying for CAM Treatment (Data of Central Military Hospital, Budapest, Rheumatology Outpatient Department, 1985–2010) N=3500.”

References

1. 11/1997 (V28). NM rendelet a természetgyógyászati tevékenység gyakorlásának egyes kérdéseiröl (Decree of the Ministry of Social Welfare on the practice of CAM), The Government's Law of Hungary; 1997. https://kereses.magyarorszag.hu/jogszabalykereso/SearchLawWindow?struts.portlet.mode=view&struts.portlet.action=%2FsearchLaw%2FrenderDirect&action=e&windowstate=normal&struts.portlet.eventAction=true&mode=view. 2012 February 1.

Korm.rendelet a természetgyógyászati tevékenységröl (Governmental Decree on CAM/1997), The Parliament of Hungary; 1997. http://jogszabalykereso.mhk.hu/cgi_bin/njt_doc.cgi?docid=28987.608032. 2012 February 1.

Törvény az egészségügyról (s. 104 Health Law, Act CLIV/16, 1997). http://net.jogtar.hu/jr/gen/hjegy_doc.cgi?docid=99700154.TV. 2012 February 1.

Attitude of Hungarian Academy of Science Medical Department on CAM in Hungary (Magyar Tudományos Akadémia Orvosi Osztály állásfoglalása). www.elitmed.hu/ilam/hirvilag/komplementer_medicina_a_bizonyitekokon_alapulo_orvoslas_elvei_alapjan_7915. 2012 February 1.