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I. World Health Organization. 2004. New WHO
guidelines to promote use of alternative medicines.
http://www.who.org (accessed July 20(6)
2. World Health Organization. General Guidelines for
J1ethodologies On Research and El'aluatian of
Traditional Medicine. Geneva: World Health
Organization, 2000.
3. World Health Organization. Guidelines on basic
training and safety in acupuncture. Geneva: World
Health Organization, 1999.
4. Maruoka N, Kinoshita K, Waldsaka -So Spinal cord
injury by a brok.en acupuncture needle--a case report.
No Shinkei Geka. 1986 May;I4(6):785-7.
5. ViIke GM. Wulfert EA. Case reports of two patients
with pneumothorax following acupuncture. J Emerg
Med. 1997 Mar-Apr; I 5(2): 155-7.
6. Brettel HF. Acupuncture as a cause of death. MMW
Mll1Ich Med Wochenschr. 1981 Jan 16;123(3):97-8.
7. Norbeim AJ. Complications of acupuncture therapy.
A study of the literature from 1981-92. Tidsskr l','or
Laegeforen. 1994 Apr 20;1l4(lO}:1192-4.
8. Norbeim AI. Adverse efTects of acupuncture: a study
of the literoture for the years 1981-1994. J Altern
Complement Med. 1996 $ummer;2(2):29 1-7 .
9. Niggemann B, Gruber C. Side-effects of
complementary and altemative medjcine. Allergy.
2003 Aug;58(S):707-16.
10. Peuker E. Gronemeyer D. Rare but serious
complications of acupuncture: traumatic lesions.
Acupunct Aled. 2001 Dec; I 9(2):103-8
II. de Groot M. Acupuncture: complications.
contraindications and informed consent. rorsch
Kamp/ementarmed Klass Nalurheilkd. 200 I
Oct;S(5):256-62 .
12. Yamashita H, Tsukayama H. White AR, Tanno Y,
Sugishita C, Ernst E. Systematic review of adverse
events following acupuncture: the JapaneSee literature.
Compleme1lt Ther Aled. 200 I Jun;9(2):98-1 04.
13. Ernst E, White AR. Prospective studies of the safety
of acupuncture: a systematic review. Am J <'\led. 200]
Apr 15;110(6):481-5
14. White A. A cumulative review of the !".mge and
incidence of significant adverse events associated
with acupuncture. AcupuJlc[ Med. 2004
Sep;22(3):122-33.
15. Peuker E. Case report of tension pneumothorax
related to acupum:ture. Acupullct .'I1ed. 2004
Sep;22( 1):40-43.
1'" "'':1 d I jI t
16. W1 l'1fJ ..HIJZ ... ij
Ih::'1f1'lftl http://www.thaiacuplIDcture.net (accessed
July 20(6)
17. World Health Organization. WHO Traditional
Medicine Strategy 2002-]005. Geneva: World Health
Organization, 2000.
18. Peuker F., Filler T. Guidelines for case reports of
adverse event'! related to acupun<;ture. Acupunct Med.
2004 Sep;220 ):29-33.