Safety of Acupuncture: Overview of Systematic Reviews

Chan, M.; Wu, Xin; Wu, Justin C. Y.; Wong, Samuel Yeung Shan; Chung, Vincent Chi‐Ho

doi:10.1038/s41598-017-03272-0

Cited by 106 publications

(74 citation statements)

References 27 publications

(87 reference statements)

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“…Although the number of participants in these trials is small, and the reporting of adverse events is incomplete, it appears that acupuncture seems not to be associated with any reported serious adverse events. This is consistent with findings from other research (Chan 2017). Better evidence is required to inform clinical practice.…”

Section: Authors’ Conclusionsupporting

confidence: 94%

Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome

Choi

Wieland

Lee

et al. 2018

Cochrane Database of Systematic Reviews

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Background Carpal tunnel syndrome (CTS) is a compressive neuropathic disorder at the level of the wrist. Acupuncture and other methods that stimulate acupuncture points, such as electroacupuncture, auricular acupuncture, laser acupuncture, moxibustion, and acupressure, are used in treating CTS. Acupuncture has been recommended as a potentially useful treatment for CTS, but its effectiveness remains uncertain. We used Cochrane methodology to assess the evidence from randomised and quasi-randomised trials of acupuncture for symptoms in people with CTS. Objectives To assess the benefits and harms of acupuncture and acupuncture-related interventions compared to sham or active treatments for the management of pain and other symptoms of CTS in adults. Search methods On 13 November 2017, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus, DARE, HTA, and NHS EED. In addition, we searched six Korean medical databases, and three Chinese medical databases from inception to 30 April 2018. We also searched clinical trials registries for ongoing trials. Selection criteria We included randomised and quasi-randomised trials examining the effects of acupuncture and related interventions on the symptoms of CTS in adults. Eligible studies specified diagnostic criteria for CTS. We included outcomes measured at least three weeks after randomisation. The included studies compared acupuncture and related interventions to placebo/sham treatments, or to active interventions, such as steroid nerve blocks, oral steroid, splints, non-steroidal anti-inflammatory drugs (NSAIDs), surgery and physical therapy. Data collection and analysis The review authors followed standard Cochrane methods. Main results We included 12 studies with 869 participants. Ten studies reported the primary outcome of overall clinical improvement at short-term follow-up (3 months or less) after randomisation. Most studies could not be combined in a meta-analysis due to heterogeneity, and all had an unclear or high overall risk of bias. Seven studies provided information on adverse events. Non-serious adverse events included skin bruising with electroacupuncture and local pain after needle insertion. No serious adverse events were reported. One study (N = 41) comparing acupuncture to sham/placebo reported change on the Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) at three months after treatment (mean difference (MD) −0.23, 95% confidence interval (CI) −0.79 to 0.33) and the BCTQ Functional Status Scale (FSS) (MD −0.03, 95% CI −0.69 to 0.63), with no clear difference between interventions; the evidence was of low certainty. The only dropout was due to painful acupuncture. Another study of acupuncture versus placebo/sham acupuncture (N = 111) provided no usable data. Two studies assessed laser acupuncture versus sham laser acupuncture. One study (N = 60), which was at low risk of bias, provided low-certainty evidence of a better Global Symptom Scale (GSS) score with active treatment...

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Section: Authors’ Conclusionsupporting

confidence: 94%

Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome

Choi

Wieland

Lee

et al. 2018

Cochrane Database of Systematic Reviews

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“…Additionally, the majority of the analyzed data were case reports. Even though organ or tissue injuries, infections and local events were reported, severe adverse effects seemed to occur only rarely; however, case control studies ought to be done to further investigate the frequency of adverse effects, determine causes and improve the quality of treatment [67].…”

Section: Acupuncture-about Popular Usage and Questionable Effect Sizesmentioning

confidence: 99%

A critical examination of the main premises of Traditional Chinese Medicine

Eigenschink

Dearing

Dablander

et al. 2020

Wien Klin Wochenschr

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Traditional Chinese Medicine (TCM) consists of a plethora of therapeutic approaches aiming to both characterize and treat diseases. Its utilization has gained significant popularity in the western world and is even backed by the World Health Organization's decision to include TCM diagnostic patterns into the new revision of the International Classification of Diseases code, the global standard for diagnostic health information. As these developments and potentially far-reaching decisions can affect modern healthcare systems and daily clinical work as well as wildlife conservation, its underlying factual basis must be critically examined. This article therefore provides an overview of the evidence underlying the basic TCM concepts, such as Qi, meridians, acupuncture, pulse and tongue diagnostics as well as traditional herbal treatments. Moreover, it discusses whether scientific literature on TCM reflects the current standard for evidence-based research, as described in good scientific practice and good clinical practice guidelines. Importantly, misinformation regarding the therapeutic efficacy of animal-derived substances has lead and currently leads to problems with wildlife preservation and animal ethics. Nevertheless, the (re-)discovery of artemisinin more than 50 years ago introduced a novel development in TCM: the commingling of Eastern and Western medicine, the appreciation of both systems. The need for more rigorous approaches, fulfilment of and agreement to current guidelines to achieve highquality research are of utmost relevance. Thereby, ancient knowledge of herbal species and concoctions may serve as a possible treasure box rather than Pandora's box.

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“…Based on data from a plenty of clinical trials, acupuncture effectively treats pain and may be a reasonable option for the treatment of chronic pain, and side effects of acupuncture intervention have been well-defined. In recent years, acupuncture has rapidly developed and gradually become part of mainstream medicine worldwide (Barnes & Bloom, 2008;Burke, Upchurch, Dye, & Chyu, 2006;MacPherson, Sinclair-Lian, & Thomas, 2006;Xue et al, 2007), although the minor and rare serious adverse events can occur during the treatment (Chan, Wu, Wu, Wong, & Chung, 2017;Wu et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The response‐time relationship and covariate effects of acupuncture for chronic pain: A systematic review and model‐based longitudinal meta‐analysis

Pei

Chen

et al. 2020

European Journal of Pain

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Background and Objective Critical clinical questions regarding how soon and how long the analgesic effect will be achieved by acupuncture, as well as who will be responsive to acupuncture, need further address. The aim of the study was to investigate the response‐time relationship and covariate effects of acupuncture. Databases and Data Treatment PubMed and EMBASE were searched up to December 2018 for randomized controlled trials that involved sham acupuncture, true acupuncture and conventional therapy. We used a model‐based longitudinal meta‐analysis to characterize the response‐time profile of these treatments. Results Seventy‐seven randomized clinical trials involved chronic shoulder, neck, knee and low back pain were included. The response‐time analysis suggested that the treatment duration of acupuncture will be 5 weeks or more to achieve 80% of maximum analgesic effect. Moreover a lower baseline pain intensity and the location of low back pain resulted in a lower pain relief of acupuncture intervention. The absolute maximum analgesic effects of sham acupuncture and conventional therapy were 22.6 and 15.8 points at a 0–100 NRS scale. The absolute effect of true acupuncture was 26.1 points for low back pain (relative effect of 3.5 and 9.4 points to sham and conventional therapy), 34.9 points for other pain body locations (relative effect of 12.3 and 19.1 points to sham and conventional therapy), in patients with a baseline pain intensity of 60 points. Conclusion The treatment duration of acupuncture will not be less than 5 weeks to achieve 80% maximum analgesic effect. Higher analgesic effect was related to higher baseline pain intensity and pain location of neck, shoulder and knee. Significance Our systematic review and meta‐analysis provides the clear evidence for the treatment duration and significant related covariates of acupuncture intervention for chronic pain. These results provide useful suggestion for acupuncture intervention in clinical pain management.

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Safety of Acupuncture: Overview of Systematic Reviews

Cited by 106 publications

References 27 publications

Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome

Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome

A critical examination of the main premises of Traditional Chinese Medicine

The response‐time relationship and covariate effects of acupuncture for chronic pain: A systematic review and model‐based longitudinal meta‐analysis

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