Defining the Quality of Acupuncture

Abstract

Background. The quality and dose of acupuncture used in a clinical trial affects the outcome, as with the quality and dose of any intervention. The dose of acupuncture treatment may be characterized by the frequency of treatment, needle type and depth, length of needle retention, point selection, and combination. The dose in trials of acupuncture has at times been described as low or inappropriate but is seldom assessed in systematic reviews of acupuncture trials. This article examines the research evaluating acupuncture for cancer-related fatigue to determine what characteristics of treatment may contribute to a quality acupuncture intervention. Methodology. English and Chinese language databases were searched from inception to December 2013 for randomized controlled trials of acupuncture for the treatment of cancer-related fatigue. Assessment of the quality of the acupuncture intervention was undertaken using the domains and items from the NICMAN framework. Results. Seven studies with a total of 690 patients were included. Four of the studies were designed as feasibility or pilot studies, and the other 3 studies were described as "effectiveness" trials. The treatment paradigm for the active intervention was based on traditional Chinese medicine in all studies, yet few of the studies were explicit as to how the active intervention was justified within a traditional Chinese medicine paradigm. Acupuncture point prescriptions were developed by a small consensus panel or based on typical points and/or "clinical experience." No discussion of traditional Chinese medicine theory or literature review was reported in any studies. Acupuncture point location was adequately described in 4 of the 7 studies. Frequency of treatment was twice per week in 2 studies; all others were once per week. Two studies did not apply needle manipulation or stimulation, and no justification was given. Conclusion. The 7 trials reviewed meet some criteria for a quality acupuncture intervention. However, frequently elements of the intervention were not addressed, and it is possible that the dosage trialed was suboptimal. Systematic reviews of acupuncture are likely to continue to be inconclusive while comparisons are conducted of heterogeneous interventions without providing.

Systematic Review and Meta-analysis of Nonpharmacological Interventions for Lung Cancer Fatigue

“…TEAS is also a type of acupuncture that uses electrodes placed on the surface instead of acupuncture needles to add an electrical stimulation pulse to the target acupoints (Tu et al, 2018). Consistent with previous studies (Grant et al, 2015;, our results indicated that acupuncture and acupressure may be efficient methods for relieving fatigue among lung cancer patients. Because physical therapies are promising for relieving fatigue in lung cancer patients, health care professionals may consider incorporating them as usual components of oncology practice.…”

Effect of acupuncture at 3 anti-fatigue acupoints in the treatment of cancer-related fatigue in patients with cancer

“…[23] In addition, ST36 is able to Tonify qi and blood, relieve abdominal discomforts and digestive or elimination dysfunctions. [24] Particularly, ST36 regulates immunity and reduces inflammation, which can improve the long term effects cause by related cancer treatments. [25,26] Another recent study concluded that acupuncture at ST36 and PC6 significantly lowered the level of the data of heart rate and oxygen consumption, indicating a fatigue relief.…”

Effect of Acupuncture on Lung Cancer-Related Fatigue: Study Protocol for a Multi-center Randomized Controlled Trial

“…With the development of complementary and alternative medicine more and more cancer patients tend to choose acupuncture as a main treatment method to treat fatigue. Recently, several studies have shown that acupuncture can effectively improve the symptom of CRF [32][33][34][35][36]. However, there is currently a lack of multi-center, large sample and sham-controlled, randomized clinical trials for CRF [29,37].…”