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Acupuncture

The occupational discipline of the traditional Chinese methods of Acupuncture Therapy for treating Disease by inserting Needles along specific pathways or Meridians.

Acupuncture  is a form of alternative medicine in which thin needles are inserted into the body. It is a key component of traditional Chinese medicine (TCM). TCM theory and practice are not based upon scientific knowledge, and acupuncture is a pseudoscience. There is a diverse range of acupuncture theories based on different philosophies, and techniques vary depending on the country. The method used in TCM is likely the most widespread in the United States. It is most often used for pain relief, though it is also used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment.

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent, which suggests that it is not effective. An overview of Cochrane reviews found that acupuncture is not effective for a wide range of conditions. A systematic review of systematic reviews found little evidence of acupuncture's effectiveness in treating pain. The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits. Some research results suggest acupuncture can alleviate pain, though the majority of research suggests that acupuncture's effects are mainly due to the placebo effect. A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias. A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care, while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain.

Acupuncture is generally safe when done by an appropriately trained practitioner using clean needle technique and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. Accidents and infections are associated with infractions of sterile technique or neglect of the practitioner. A review stated that the reports of infection transmission increased significantly in the prior decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.

Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points, and many modern practitioners no longer support the existence of life force energy (qi) flowing through meridians, which was a major part of early belief systems. Acupuncture is believed to have originated around 100 BC in China, around the time The Yellow Emperor's Classic of Internal Medicine (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment. Acupuncture grew and diminished in popularity in China repeatedly, depending on the country's political leadership and the favor of rationalism or Western medicine. Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, starting with France. In the 20th century, as it spread to the United States and Western countries, the spiritual elements of acupuncture that conflict with Western beliefs were abandoned in favor of tapping needles into nerves.

  • Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.

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    Abstract Title:

    Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.

    Abstract Source:

    Acupunct Med. 2014 Oct ;32(5):376-80. Epub 2014 Aug 27. PMID: 25164776

    Abstract Author(s):

    Yasemin Cayir, Gokhan Ozdemir, Mine Celik, Hulya Aksoy, Zekeriya Akturk, Esra Laloglu, Fatih Akcay

    Article Affiliation:

    Yasemin Cayir

    Abstract:

    OBJECTIVE:To evaluate the effect of acupuncture on the serum matrix metalloproteinase-2 (MMP-2) level and activity in patients with migraine.

    METHODS:After baseline testing, eligible patients with migraine according to the criteria of the International Headache Society who volunteered to join the study were included (n=27). The patients received 10 sessions of acupuncture treatment. The points selected were bilateral ST8, ST44, LI4, LI11, LIV3, SP6, GB1, GB14, GB20, GV14, GV20, Yintang, Taiyang and ear Shenmen. Pain was measured using a visual analogue scale (VAS). Short form-36 (SF-36) was used to determine their quality of life. Blood samples were taken before treatment and after the first and last sessions of acupuncture for measurement of MMP-2 concentration and activity.

    RESULTS:The mean VAS was 85.5±16.6 before acupuncture and was significantly decreased to 39.8±20.6 after 10 sessions of acupuncture (p<0.0001). There was a significant increase in all SF-36 scores after acupuncture compared with values before treatment (p<0.0001). No significant differences were found in MMP-2 concentrations before treatment and after the first and last sessions (p>0.05). However, there were significant changes in MMP-2 activity (p<0.0001).

    CONCLUSIONS:The results of this study showed a clinically relevant decrease in MMP-2 activity in patients with migraine treated with acupuncture. The mechanism underlying the effect of acupuncture in alleviating pain may be associated with a decrease in MMP-2 activity.

  • Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine📎

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    Abstract Title:

    Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.

    Abstract Source:

    Acupunct Med. 2014 Oct ;32(5):376-80. Epub 2014 Aug 27. PMID: 25164776

    Abstract Author(s):

    Yasemin Cayir, Gokhan Ozdemir, Mine Celik, Hulya Aksoy, Zekeriya Akturk, Esra Laloglu, Fatih Akcay

    Article Affiliation:

    Yasemin Cayir

    Abstract:

    OBJECTIVE:To evaluate the effect of acupuncture on the serum matrix metalloproteinase-2 (MMP-2) level and activity in patients with migraine.

    METHODS:After baseline testing, eligible patients with migraine according to the criteria of the International Headache Society who volunteered to join the study were included (n=27). The patients received 10 sessions of acupuncture treatment. The points selected were bilateral ST8, ST44, LI4, LI11, LIV3, SP6, GB1, GB14, GB20, GV14, GV20, Yintang, Taiyang and ear Shenmen. Pain was measured using a visual analogue scale (VAS). Short form-36 (SF-36) was used to determine their quality of life. Blood samples were taken before treatment and after the first and last sessions of acupuncture for measurement of MMP-2 concentration and activity.

    RESULTS:The mean VAS was 85.5±16.6 before acupuncture and was significantly decreased to 39.8±20.6 after 10 sessions of acupuncture (p<0.0001). There was a significant increase in all SF-36 scores after acupuncture compared with values before treatment (p<0.0001). No significant differences were found in MMP-2 concentrations before treatment and after the first and last sessions (p>0.05). However, there were significant changes in MMP-2 activity (p<0.0001).

    CONCLUSIONS:The results of this study showed a clinically relevant decrease in MMP-2 activity in patients with migraine treated with acupuncture. The mechanism underlying the effect of acupuncture in alleviating pain may be associated with a decrease in MMP-2 activity.

  • Acupuncture elicits neuroprotective effect by inhibiting NAPDH oxidase-mediated reactive oxygen species production in cerebral ischaemia.

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    Abstract Title:

    Acupuncture elicits neuroprotective effect by inhibiting NAPDH oxidase-mediated reactive oxygen species production in cerebral ischaemia.

    Abstract Source:

    Sci Rep. 2015;5:17981. Epub 2015 Dec 10. PMID: 26656460

    Abstract Author(s):

    Guang-Xia Shi, Xue-Rui Wang, Chao-Qun Yan, Tian He, Jing-Wen Yang, Xiang-Hong Zeng, Qian Xu, Wen Zhu, Si-Qi Du, Cun-Zhi Liu

    Article Affiliation:

    Guang-Xia Shi

    Abstract:

    In the current study, we aimed to investigate whether NADPH oxidase, a major ROS-producing enzyme, was involved in the antioxidant effect of acupuncture on cognitive impairment after cerebral ischaemia. The cognitive function, infract size, neuron cell loss, level of superoxide anion and expression of NADPH oxidase subunit in hippocampus of two-vessel occlusion (2VO) rats were determined after 2-week acupuncture. Furthermore, the cognitive function and production of O2(-) were determined in the presence and absence of NADPH oxidase agonist (TBCA) and antagonist (Apocynin). The effect of acupuncture on cognitive function after cerebral ischaemia in gp91phox-KO mice was evaluated by Morris water maze. Acupuncture reduced infarct size, attenuated overproduction of O2(-), and reversed consequential cognitive impairment and neuron cell loss in 2VO rats. The elevations of gp91phox and p47phox after 2VO were significantly decreased after acupuncture treatment. However, no differences of gp91phox mRNA were found among any experimental groups. Furthermore, these beneficial effects were reversed by TBCA, whereas apocynin mimicked the effect of acupuncture by improving cognitive function and decreasing O2(-) generation. Acupuncture failed to improve the memory impairment in gp91phox KO mice. Full function of the NADPH oxidase enzyme plays an important role in neuroprotective effects against cognitive impairment via inhibition of NAPDH oxidase-mediated oxidative stress.

  • Acupuncture elicits neuroprotective effect by inhibiting NAPDH oxidase-mediated reactive oxygen species production in cerebral ischaemia📎

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    Abstract Title:

    Acupuncture elicits neuroprotective effect by inhibiting NAPDH oxidase-mediated reactive oxygen species production in cerebral ischaemia.

    Abstract Source:

    Sci Rep. 2015;5:17981. Epub 2015 Dec 10. PMID: 26656460

    Abstract Author(s):

    Guang-Xia Shi, Xue-Rui Wang, Chao-Qun Yan, Tian He, Jing-Wen Yang, Xiang-Hong Zeng, Qian Xu, Wen Zhu, Si-Qi Du, Cun-Zhi Liu

    Article Affiliation:

    Guang-Xia Shi

    Abstract:

    In the current study, we aimed to investigate whether NADPH oxidase, a major ROS-producing enzyme, was involved in the antioxidant effect of acupuncture on cognitive impairment after cerebral ischaemia. The cognitive function, infract size, neuron cell loss, level of superoxide anion and expression of NADPH oxidase subunit in hippocampus of two-vessel occlusion (2VO) rats were determined after 2-week acupuncture. Furthermore, the cognitive function and production of O2(-) were determined in the presence and absence of NADPH oxidase agonist (TBCA) and antagonist (Apocynin). The effect of acupuncture on cognitive function after cerebral ischaemia in gp91phox-KO mice was evaluated by Morris water maze. Acupuncture reduced infarct size, attenuated overproduction of O2(-), and reversed consequential cognitive impairment and neuron cell loss in 2VO rats. The elevations of gp91phox and p47phox after 2VO were significantly decreased after acupuncture treatment. However, no differences of gp91phox mRNA were found among any experimental groups. Furthermore, these beneficial effects were reversed by TBCA, whereas apocynin mimicked the effect of acupuncture by improving cognitive function and decreasing O2(-) generation. Acupuncture failed to improve the memory impairment in gp91phox KO mice. Full function of the NADPH oxidase enzyme plays an important role in neuroprotective effects against cognitive impairment via inhibition of NAPDH oxidase-mediated oxidative stress.

  • Acupuncture Enhances Effective Connectivity between Cerebellum and Primary Sensorimotor Cortex in Patients with Stable Recovery Stroke📎

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    Abstract Title:

    Acupuncture Enhances Effective Connectivity between Cerebellum and Primary Sensorimotor Cortex in Patients with Stable Recovery Stroke.

    Abstract Source:

    Evid Based Complement Alternat Med. 2014 ;2014:603909. Epub 2014 Mar 9. PMID: 24734108

    Abstract Author(s):

    Zijing Xie, Fangyuan Cui, Yihuai Zou, Lijun Bai

    Article Affiliation:

    Zijing Xie

    Abstract:

    Recent neuroimaging studies have demonstrated that stimulation of acupuncture at motor-implicated acupoints modulates activities of brain areas relevant to the processing of motor functions. This study aims to investigate acupuncture-induced changes in effective connectivity among motor areas in hemiparetic stroke patients by using the multivariate Granger causal analysis. A total of 9 stable recovery stroke patients and 8 healthy controls were recruited and underwent three runs of fMRI scan: passive finger movements and resting state before and after manual acupuncture stimuli. Stroke patients showed significantly attenuated effective connectivity between cortical and subcortical areas during passive motor task, which indicates inefficient information transmissions between cortical and subcortical motor-related regions. Acupuncture at motor-implicated acupoints showed specific modulations of motor-related network in stroke patients relative to healthy control subjects. This specific modulation enhanced bidirectionally effective connectivity between the cerebellum and primary sensorimotor cortex in stroke patients, which may compensate for the attenuated effective connectivity between cortical and subcortical areas during passive motor task and, consequently, contribute to improvement of movement coordination and motor learning in subacute stroke patients. Our results suggested that further efficacy studies of acupuncture in motor recovery can focus on the improvement of movement coordination and motor learning during motor rehabilitation.

  • Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study.

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    Abstract Title:

    Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study.

    Abstract Source:

    Acupunct Med. 2016 Apr 19. Epub 2016 Apr 19. PMID: 27095698

    Abstract Author(s):

    Ching-Hsiung Liu, Yu-Ting Hsieh, Hung-Pin Tseng, Hung-Chih Lin, Chun-Liang Lin, Tai-Yi Wu, Shu-Hua Lin, Szu-Hung Tsao, Hong Zhang

    Article Affiliation:

    Ching-Hsiung Liu

    Abstract:

    OBJECTIVE:To determine the required sample size for, and feasibility of, a RCT examining the effectiveness of early acupuncture for acute ischaemic stroke.

    METHODS:Thirty-eight patients aged 40-85 years with a first episode of acute ischaemic stroke presenting within 72 h of stroke onset were randomly assigned to receive manual acupuncture (MA group; n=20) plus standard care or standard care only (control group, n=18). The acupuncture treatment was provided daily for 2 weeks. The primary outcome was the change in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 4 weeks. Secondary outcomes included changes in the Fugl-Meyer assessment (FMA) and the functional independence measure scores between baseline and 4 weeks, and changes in NIHSS, Barthel Index and modified Rankin Scale scores at 12 weeks.

    RESULTS:Thirty-one patients completed the study (dropout rate=18%) and adverse effects were minimal. No significant differences were seen between groups in the improvements in NIHSS scores, although there tended to be a greater reduction in NIHSS score after 1 week in the MA group relative to the control group (p=0.066). The post-stroke motor activity at 4 weeks was associated with a significantly increased FMA score in the acupuncture group compared with the control group (p<0.05), but not supported by intergroup analysis.

    CONCLUSIONS:This pilot study indicates that acupuncture appears to be safe for patients in the acute stage of ischaemic stroke. A subsequent trial with a larger sample size (estimated at n=122) is required to confirm whether early acupuncture intervention contributes to earlier functional improvement and to assess the longer-term clinical efficacy of acupuncture.

    TRIAL REGISTRATION NUMBER:NCT02210988; Results.

  • Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study.

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    Abstract Title:

    Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study.

    Abstract Source:

    Acupunct Med. 2016 Apr 19. Epub 2016 Apr 19. PMID: 27095698

    Abstract Author(s):

    Ching-Hsiung Liu, Yu-Ting Hsieh, Hung-Pin Tseng, Hung-Chih Lin, Chun-Liang Lin, Tai-Yi Wu, Shu-Hua Lin, Szu-Hung Tsao, Hong Zhang

    Article Affiliation:

    Ching-Hsiung Liu

    Abstract:

    OBJECTIVE:To determine the required sample size for, and feasibility of, a RCT examining the effectiveness of early acupuncture for acute ischaemic stroke.

    METHODS:Thirty-eight patients aged 40-85 years with a first episode of acute ischaemic stroke presenting within 72 h of stroke onset were randomly assigned to receive manual acupuncture (MA group; n=20) plus standard care or standard care only (control group, n=18). The acupuncture treatment was provided daily for 2 weeks. The primary outcome was the change in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 4 weeks. Secondary outcomes included changes in the Fugl-Meyer assessment (FMA) and the functional independence measure scores between baseline and 4 weeks, and changes in NIHSS, Barthel Index and modified Rankin Scale scores at 12 weeks.

    RESULTS:Thirty-one patients completed the study (dropout rate=18%) and adverse effects were minimal. No significant differences were seen between groups in the improvements in NIHSS scores, although there tended to be a greater reduction in NIHSS score after 1 week in the MA group relative to the control group (p=0.066). The post-stroke motor activity at 4 weeks was associated with a significantly increased FMA score in the acupuncture group compared with the control group (p<0.05), but not supported by intergroup analysis.

    CONCLUSIONS:This pilot study indicates that acupuncture appears to be safe for patients in the acute stage of ischaemic stroke. A subsequent trial with a larger sample size (estimated at n=122) is required to confirm whether early acupuncture intervention contributes to earlier functional improvement and to assess the longer-term clinical efficacy of acupuncture.

    TRIAL REGISTRATION NUMBER:NCT02210988; Results.

  • Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials📎

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    Abstract Title:

    Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials.

    Abstract Source:

    Medicine (Baltimore). 2018 Feb ;97(8):e9838. PMID: 29465566

    Abstract Author(s):

    Yuwei Zhao, Jing Zhou, Qian Mo, Yang Wang, Jinna Yu, Zhishun Liu

    Article Affiliation:

    Yuwei Zhao

    Abstract:

    BACKGROUND:Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients' health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs.

    METHODS:We independently searched 9 databases from beginning to August 15, 2017. Two writers extracted data at the same time independently. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs) and mean difference (MD) with 95% CIs.

    RESULTS:Ten randomized controlled trials (RCTs) with 794 patients were included in this systematic review. The combined results showed that electroacupuncture (EA) may be more effective than sham electroacupuncture (sham EA) in improving the 24-hour nocturia episodes and EA may enhance tolterodine for relieving voiding symptoms and enhancing patients' quality of life. However, more trials with high quality and larger sample sizes will be needed in the future to provide sufficient evidence. Only 15 of 794 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, acupuncture is safe for treating OAB.

    CONCLUSION:Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.

  • Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review

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    Abstract Title:

    Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review.

    Abstract Source:

    Integr Cancer Ther. 2015 Jul 28. Epub 2015 Jul 28. PMID: 26220605

    Abstract Author(s):

    Kyeore Bae, Hwa-Seung Yoo, Gillian Lamoury, Frances Boyle, David S Rosenthal, Byeongsang Oh

    Article Affiliation:

    Kyeore Bae

    Abstract:

    BACKGROUND:Aromatase inhibitors (AIs) are commonly used as adjunctive hormone treatment for early breast cancer patients. The major side effect of AIs is arthralgia, which affects adherence. Previous reviews suggested that acupuncture is effective in the management of cancer-related pain. The aim of this review is to evaluate the effects of acupuncture on arthralgia caused by AIs.

    METHODS:This article examined randomized controlled trials (RCTs) measuring the effects of acupuncture on joint symptoms caused by AIs within 8 medical databases till May 2014. The quality of the articles was evaluated according to the Cochrane risk of bias (ROB) tool.

    RESULTS:Four RCTs were identified in medical journals. Two studies were conducted with manual acupuncture and 2 studies were electroacupuncture. The range of sample size was between 32 and 67. One RCT showed significant improvement in the acupuncture group compared with the sham control group and another RCT showed a statistical difference between the electroacupuncture and waitlist group. The other 2 studies showed no statistical differences between control and acupuncture groups. Two studies conducted blood analysis to elucidate the mechanism of efficacy of acupuncture for arthralgia. The 2 positive studies had a lower ROB and 2 studies had a high ROB.

    CONCLUSIONS:The systematic review suggests that acupuncture has potential benefits to improve arthralgia caused by AIs. However, further trials of adequate sample size, appropriate control group, and longer follow-up are necessary to investigate the efficacy of acupuncture in AI-induced arthralgia.

  • Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review📎

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    Abstract Title:

    Acupuncture for Aromatase Inhibitor-Induced Arthralgia: A Systematic Review.

    Abstract Source:

    Integr Cancer Ther. 2015 Jul 28. Epub 2015 Jul 28. PMID: 26220605

    Abstract Author(s):

    Kyeore Bae, Hwa-Seung Yoo, Gillian Lamoury, Frances Boyle, David S Rosenthal, Byeongsang Oh

    Article Affiliation:

    Kyeore Bae

    Abstract:

    BACKGROUND:Aromatase inhibitors (AIs) are commonly used as adjunctive hormone treatment for early breast cancer patients. The major side effect of AIs is arthralgia, which affects adherence. Previous reviews suggested that acupuncture is effective in the management of cancer-related pain. The aim of this review is to evaluate the effects of acupuncture on arthralgia caused by AIs.

    METHODS:This article examined randomized controlled trials (RCTs) measuring the effects of acupuncture on joint symptoms caused by AIs within 8 medical databases till May 2014. The quality of the articles was evaluated according to the Cochrane risk of bias (ROB) tool.

    RESULTS:Four RCTs were identified in medical journals. Two studies were conducted with manual acupuncture and 2 studies were electroacupuncture. The range of sample size was between 32 and 67. One RCT showed significant improvement in the acupuncture group compared with the sham control group and another RCT showed a statistical difference between the electroacupuncture and waitlist group. The other 2 studies showed no statistical differences between control and acupuncture groups. Two studies conducted blood analysis to elucidate the mechanism of efficacy of acupuncture for arthralgia. The 2 positive studies had a lower ROB and 2 studies had a high ROB.

    CONCLUSIONS:The systematic review suggests that acupuncture has potential benefits to improve arthralgia caused by AIs. However, further trials of adequate sample size, appropriate control group, and longer follow-up are necessary to investigate the efficacy of acupuncture in AI-induced arthralgia.

  • Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.

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    Abstract Title:

    Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.

    Abstract Source:

    PLoS One. 2017 ;12(4):e0174586. Epub 2017 Apr 4. PMID: 28376120

    Abstract Author(s):

    Wei Zhang, Liyan Ma, Brent A Bauer, Zhishun Liu, Yao Lu

    Article Affiliation:

    Wei Zhang

    Abstract:

    PURPOSE:This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized controlled trials (RCTs).

    METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and the Wanfang Database. Parallel-group RCTs of acupuncture for men with symptomatic BPH were included. Data from the included trials were extracted by two independent reviewers and were analyzed with The Cochrane Collaboration Review Manager software (RevMan 5.3.5) after risk of bias judgments. The primary outcome measure of this review was a change in urological symptoms.

    RESULTS:Eight RCTs, which involved 661 men with BPH, were included. Follow-up varied from 4 weeks to 18 months. Pooling of the data from three trials that compared acupuncture with sham-acupuncture revealed that in the short term (4-6 weeks), acupuncture can significantly improve IPSS (MD -1.90, 95% CI -3.58 to -0.21). A sensitivity analysis of the short-term endpoint showed the same result (MD -3.01, 95% CI -5.19 to -0.84) with a borderline minimal clinical important difference (MCID). Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95%CI -3.43, -0.14). A meta-analysis after medium-term follow-up (12-18 weeks) indicated no significant effect on IPSS when the data from two trials were combined (MD -2.04, 95% CI -4.19, 0.10).

    CONCLUSION:Statistically significant changes were observed in favor of acupuncture in moderate to severe BPH with respect to short-term follow-up endpoints. The clinical significance of these changes needs to be tested by further studies with rigorous designs and longer follow-up times.

    TRIAL REGISTRATION NUMBER:PROSPERO CRD42014013645.

  • Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis📎

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    Abstract Title:

    Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.

    Abstract Source:

    PLoS One. 2017 ;12(4):e0174586. Epub 2017 Apr 4. PMID: 28376120

    Abstract Author(s):

    Wei Zhang, Liyan Ma, Brent A Bauer, Zhishun Liu, Yao Lu

    Article Affiliation:

    Wei Zhang

    Abstract:

    PURPOSE:This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized controlled trials (RCTs).

    METHODS:We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and the Wanfang Database. Parallel-group RCTs of acupuncture for men with symptomatic BPH were included. Data from the included trials were extracted by two independent reviewers and were analyzed with The Cochrane Collaboration Review Manager software (RevMan 5.3.5) after risk of bias judgments. The primary outcome measure of this review was a change in urological symptoms.

    RESULTS:Eight RCTs, which involved 661 men with BPH, were included. Follow-up varied from 4 weeks to 18 months. Pooling of the data from three trials that compared acupuncture with sham-acupuncture revealed that in the short term (4-6 weeks), acupuncture can significantly improve IPSS (MD -1.90, 95% CI -3.58 to -0.21). A sensitivity analysis of the short-term endpoint showed the same result (MD -3.01, 95% CI -5.19 to -0.84) with a borderline minimal clinical important difference (MCID). Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95%CI -3.43, -0.14). A meta-analysis after medium-term follow-up (12-18 weeks) indicated no significant effect on IPSS when the data from two trials were combined (MD -2.04, 95% CI -4.19, 0.10).

    CONCLUSION:Statistically significant changes were observed in favor of acupuncture in moderate to severe BPH with respect to short-term follow-up endpoints. The clinical significance of these changes needs to be tested by further studies with rigorous designs and longer follow-up times.

    TRIAL REGISTRATION NUMBER:PROSPERO CRD42014013645.

  • Acupuncture for Carpal Tunnel Syndrome: A Randomized Controlled Trial Studying Changes in Clinical Symptoms and Electrodiagnostic Tests.

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    Abstract Title:

    Acupuncture for Carpal Tunnel Syndrome: A Randomized Controlled Trial Studying Changes in Clinical Symptoms and Electrodiagnostic Tests.

    Abstract Source:

    Altern Ther Health Med. 2019 Oct 1. Epub 2019 Oct 1. PMID: 31634868

    Abstract Author(s):

    Hamidreza Bahrami-Taghanaki, Hoda Azizi, Hosein Hasanabadi, Mohamad Hassan Jokar, Amir Iranmanesh, Ali Khorsand-Vakilzadeh, Shapour Badiee-Aval

    Article Affiliation:

    Hamidreza Bahrami-Taghanaki

    Abstract:

    Background:Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy in humans. Nonsurgical management is still a matter of debate, and conservative treatments include splinting, local steroid injections, ultrasound, and oral steroids. Acupuncture and electroacupuncture therapy for symptomatic CTS may improve symptoms and aid nerve repair as well as improve sensory and motor functions. However, limited evidence based on comprehensive evaluation methods is available regarding the effects of those treatments.

    Objective:The study intended to compare the short-term effects of acupuncture and conventional medical treatment on CTS patients' clinical symptoms and on the results of their electrodiagnostic tests.

    Design:The research team designed a randomized controlled trial.

    Setting:The study took place at the electrodiagnostic clinic of the School of Persian and Complementary Medicine at Mashhad University of Medical Sciences (Mashhad, Iran).

    Participants:Participants were 60 patients at the clinic with the clinical diagnosis of CTS.

    Interventions:Participants were randomly assigned to 1 of 2 groups. Patients in the control group received 100 mg of Celebrex as tablets, 2 times daily. Patients in the intervention group received 12 sessions of acupuncture, each for 30 min, for 4 wk. The needle insertion points were fixed for all sessions. In addition, wrist braces were provided to wear at night for 1 mo in both groups.

    Outcome Measures:At baseline, postintervention at the end of week 4, and at a 3-mo follow-up at the end of week 16, participants' clinical symptoms-pain, numbness, tingling, weakness/clumsiness, and night awakenings-and the results of their electrodiagnostic studies were evaluated and compared.

    Results:In total, 49 patients completed the study-24 in the control group and 25 in the intervention group. Compared with the control group, the intervention group's clinical symptoms-pain, numbness, tingling, and muscular weakness-based on the subscales of the global symptoms score questionnaire as well as the overall score on that questionnaire improved significantly (P<.05). Regarding the electrodiagnostic studies, only the distal motor latency showed a significantly greater decrease in the acupuncture group in comparison to controls (P = .001).

    Conclusion:All clinical symptoms and the results of the electrodiagnostic tests improved significantly in the intervention group, and the improvements continued during the 3 mo postintervention. The therapeutic results of acupuncture were mostly similar to and in certain cases better than those of the conventional medical treatment. Therefore, acupuncture can be suggested as a safe and suitable therapeutic method in CTS.

  • Acupuncture for central pain affecting the ribcage following traumatic brain injury and rib fractures--a case report.

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    Abstract Title:

    Acupuncture for central pain affecting the ribcage following traumatic brain injury and rib fractures--a case report.

    Abstract Source:

    Acupunct Med. 2006 Sep ;24(3):129-33. PMID: 17013360

    Abstract Author(s):

    Clare P Donnellan

    Article Affiliation:

    Clare P Donnellan

    Abstract:

    This case report describes the use of acupuncture in the management of chronic central pain in a 51 year old man following severe traumatic brain injury and multiple injuries including rib fractures. The patient reported rapid and significant improvements in pain and mood during a course of acupuncture treatment. Chronic pain following traumatic brain injury is a significant problem. Chronic pain after rib fractures is also commonly reported. Acupuncture is widely used in the management of pain but its use has been reported rarely in the traumatic brain injury literature. This case report suggests that acupuncture may be a useful option to consider in these patients. Outcome was assessed formally using a 0-10 verbal numerical rating scale for pain, and the Hospital Anxiety and Depression Scale (HADS) for psychological status before and after the course of treatment. These scales are widely used in clinical practice as well as in research involving patients with traumatic brain injury, although they have not been validated in this population. The changes in this patient's outcome scores were not consistent with the benefits he reported. Treatment of this patient highlighted the difficulties of using standardised self rating scales for patients with cognitive impairment. The report also discusses the effects of acupuncture on this patient's mood.

  • Acupuncture for central pain affecting the ribcage following traumatic brain injury and rib fractures--a case report📎

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    Abstract Title:

    Acupuncture for central pain affecting the ribcage following traumatic brain injury and rib fractures--a case report.

    Abstract Source:

    Acupunct Med. 2006 Sep ;24(3):129-33. PMID: 17013360

    Abstract Author(s):

    Clare P Donnellan

    Article Affiliation:

    Clare P Donnellan

    Abstract:

    This case report describes the use of acupuncture in the management of chronic central pain in a 51 year old man following severe traumatic brain injury and multiple injuries including rib fractures. The patient reported rapid and significant improvements in pain and mood during a course of acupuncture treatment. Chronic pain following traumatic brain injury is a significant problem. Chronic pain after rib fractures is also commonly reported. Acupuncture is widely used in the management of pain but its use has been reported rarely in the traumatic brain injury literature. This case report suggests that acupuncture may be a useful option to consider in these patients. Outcome was assessed formally using a 0-10 verbal numerical rating scale for pain, and the Hospital Anxiety and Depression Scale (HADS) for psychological status before and after the course of treatment. These scales are widely used in clinical practice as well as in research involving patients with traumatic brain injury, although they have not been validated in this population. The changes in this patient's outcome scores were not consistent with the benefits he reported. Treatment of this patient highlighted the difficulties of using standardised self rating scales for patients with cognitive impairment. The report also discusses the effects of acupuncture on this patient's mood.

  • Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

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    Abstract Title:

    Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

    Abstract Source:

    Wien Klin Wochenschr. 2001 Dec 17;113(23-24):942-6. PMID: 11802511

    Abstract Author(s):

    M Rabl, R Ahner, M Bitschnau, H Zeisler, P Husslein

    Abstract:

    OBJECTIVE: The aim of this study was to evaluate whether acupuncture at term can influence cervical ripening, induce labor and thus reduce the need for postdates induction. METHODS: On the estimated date of confinement (EDC) women were prospectively randomized to an acupuncture group (AG) or a control group (CG). Data of 45 women were evaluated (AG, n = 25; CG, n = 20). Inclusion criteria were as follows: confirmed EDC, uncomplicated course of pregnancy, singleton pregnancy in cephalic presentation. Exclusion criteria were as follows: cervical dilation > 3 cm, active labor, premature rupture of membranes, previous cesarean section, pathologies in mother or fetus. Women were examined at 2-day intervals. The cervical length was measured with vaginal ultrasonography, cervical mucus was obtained for a fetal Fibronectin test and the cervical status was assessed according to the Bishop score. In the AG, the points Hegu (Large Intestine 4) and Sanyinjiao (Spleen 6) were pierced on both sides every second day. If women were not delivered 10 days after EDC, labor was induced by administering vaginal prostaglandin tablets. RESULTS: The cervical length in the AG was shorter than that in the CG on day 6 and day 8 after EDC (P = 0.04 for both). In the AG the time period from the first positive Fibronectin test to delivery was 2.3 days, while that in the CG was 4.2 days (P = 0.08). The time period from EDC to delivery was on average 5.0 days in the AG and 7.9 days in the CG (P = 0.03). Labor was induced in 20% of women in the AG (n = 5) and in 35% in the CG (n = 7) (P = 0.3). Overall duration of labor, and first and second stage of labor were not different in the two groups. In 56% of women who underwent acupuncture (n = 14) and in 65% of controls (n = 13), Oxytocin was used to augment labor. (P = 0.54). CONCLUSION: Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.

  • Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

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    Abstract Title:

    Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

    Abstract Source:

    Wien Klin Wochenschr. 2001 Dec 17;113(23-24):942-6. PMID: 11802511

    Abstract Author(s):

    M Rabl, R Ahner, M Bitschnau, H Zeisler, P Husslein

    Abstract:

    OBJECTIVE: The aim of this study was to evaluate whether acupuncture at term can influence cervical ripening, induce labor and thus reduce the need for postdates induction. METHODS: On the estimated date of confinement (EDC) women were prospectively randomized to an acupuncture group (AG) or a control group (CG). Data of 45 women were evaluated (AG, n = 25; CG, n = 20). Inclusion criteria were as follows: confirmed EDC, uncomplicated course of pregnancy, singleton pregnancy in cephalic presentation. Exclusion criteria were as follows: cervical dilation > 3 cm, active labor, premature rupture of membranes, previous cesarean section, pathologies in mother or fetus. Women were examined at 2-day intervals. The cervical length was measured with vaginal ultrasonography, cervical mucus was obtained for a fetal Fibronectin test and the cervical status was assessed according to the Bishop score. In the AG, the points Hegu (Large Intestine 4) and Sanyinjiao (Spleen 6) were pierced on both sides every second day. If women were not delivered 10 days after EDC, labor was induced by administering vaginal prostaglandin tablets. RESULTS: The cervical length in the AG was shorter than that in the CG on day 6 and day 8 after EDC (P = 0.04 for both). In the AG the time period from the first positive Fibronectin test to delivery was 2.3 days, while that in the CG was 4.2 days (P = 0.08). The time period from EDC to delivery was on average 5.0 days in the AG and 7.9 days in the CG (P = 0.03). Labor was induced in 20% of women in the AG (n = 5) and in 35% in the CG (n = 7) (P = 0.3). Overall duration of labor, and first and second stage of labor were not different in the two groups. In 56% of women who underwent acupuncture (n = 14) and in 65% of controls (n = 13), Oxytocin was used to augment labor. (P = 0.54). CONCLUSION: Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.

  • Acupuncture for chronic low back pain: a randomized controlled feasibility trial comparing treatment session numbers.

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    Abstract Title:

    Acupuncture for chronic low back pain: a randomized controlled feasibility trial comparing treatment session numbers.

    Abstract Source:

    Clin Rehabil. 2017 Apr 1:269215517705690. Epub 2017 Apr 1. PMID: 28459161

    Abstract Author(s):

    Lizhou Liu, Margot A Skinner, Suzanne M McDonough, G David Baxter

    Article Affiliation:

    Lizhou Liu

    Abstract:

    OBJECTIVE:To evaluate the feasibility of a randomized controlled trial investigating the optimal number of treatment sessions of acupuncture, used as an adjunct to usual care, for managing chronic low back pain.

    METHODS:In total, 45 participants with chronic low back pain were recruited and randomly allocated to receive usual care plus 4, 7, or 10 sessions of acupuncture (15/group). Primary outcomes were recruitment rate, randomization rate, treatment compliance, completion of the outcome measures, and retention rates. Secondary outcomes included back function, pain intensity and bothersomeness, generic health status, activity disability, and participant satisfaction. Data were collected at baseline and discharge, and at 6 and 12 weeks post randomization.

    RESULTS:The recruitment method was demonstrated to be successful: recruitment rate was 43.7%, and randomization rate was 100%. Compliance with treatment was high among participants (86.7%, 86.7%, and 100% for the 4-, 7-, and 10-session group, respectively). Outcome questionnaires used in this study were found to be appropriate for a future randomized controlled trial. Participant retention rates were 88.9% at discharge and at 6 weeks post randomization and 84.4% at 12 weeks post randomization. Secondary outcomes (except for pain intensity) favored the 10-session acupuncture group at 12 weeks post randomization. Over 90% of participants indicated that they were"very satisfied"and/or"extremely satisfied"with the acupuncture treatment.

    CONCLUSION:This study demonstrated that a full-scale randomized controlled trial using the methodology described above is feasible, and such a trial is essential to test the dose dependence of acupuncture.

  • Acupuncture for chronic low back pain: a randomized controlled feasibility trial comparing treatment session numbers.

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    Abstract Title:

    Acupuncture for chronic low back pain: a randomized controlled feasibility trial comparing treatment session numbers.

    Abstract Source:

    Clin Rehabil. 2017 Apr 1:269215517705690. Epub 2017 Apr 1. PMID: 28459161

    Abstract Author(s):

    Lizhou Liu, Margot A Skinner, Suzanne M McDonough, G David Baxter

    Article Affiliation:

    Lizhou Liu

    Abstract:

    OBJECTIVE:To evaluate the feasibility of a randomized controlled trial investigating the optimal number of treatment sessions of acupuncture, used as an adjunct to usual care, for managing chronic low back pain.

    METHODS:In total, 45 participants with chronic low back pain were recruited and randomly allocated to receive usual care plus 4, 7, or 10 sessions of acupuncture (15/group). Primary outcomes were recruitment rate, randomization rate, treatment compliance, completion of the outcome measures, and retention rates. Secondary outcomes included back function, pain intensity and bothersomeness, generic health status, activity disability, and participant satisfaction. Data were collected at baseline and discharge, and at 6 and 12 weeks post randomization.

    RESULTS:The recruitment method was demonstrated to be successful: recruitment rate was 43.7%, and randomization rate was 100%. Compliance with treatment was high among participants (86.7%, 86.7%, and 100% for the 4-, 7-, and 10-session group, respectively). Outcome questionnaires used in this study were found to be appropriate for a future randomized controlled trial. Participant retention rates were 88.9% at discharge and at 6 weeks post randomization and 84.4% at 12 weeks post randomization. Secondary outcomes (except for pain intensity) favored the 10-session acupuncture group at 12 weeks post randomization. Over 90% of participants indicated that they were"very satisfied"and/or"extremely satisfied"with the acupuncture treatment.

    CONCLUSION:This study demonstrated that a full-scale randomized controlled trial using the methodology described above is feasible, and such a trial is essential to test the dose dependence of acupuncture.

  • Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis📎

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    Abstract Title:

    Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis.

    Abstract Source:

    Evid Based Complement Alternat Med. 2018 ;2018:2890465. Epub 2018 May 27. PMID: 29977312

    Abstract Author(s):

    Lingping Zhu, Yunhui Ma, Shasha Ye, Zhiqun Shu

    Article Affiliation:

    Lingping Zhu

    Abstract:

    Background:The objective of this study was to compare the efficacy and side effects of acupuncture, sham acupuncture, and drugs in the treatment of diarrhoea-predominant irritable bowel syndrome.

    Methods:Randomized controlled trials (RCTs) assessing the effects of acupuncture and drugs were comprehensively retrieved from electronic databases (such as PubMed, Cochrane Library, Embase, CNKI, Wanfang Database, VIP Database, and CBM) up to December 2017. Additional references were obtained from review articles. With document quality evaluations and data extraction, Network Meta-Analysis was performed using a random-effects model under a frequentist framework.

    Results:A total of 29 studies (n = 9369) were included; 19 were high-quality studies, and 10 were low-quality studies. NMA showed the following: (1) the ranking of treatments in terms of efficacy in diarrhoea-predominant irritable bowel syndrome is acupuncture, sham acupuncture, pinaverium bromide, alosetron = eluxadoline, ramosetron, and rifaximin; (2) the ranking of treatments in terms of severity of side effects in diarrhoea-predominant irritable bowel syndrome is rifaximin, alosetron, ramosetron = pinaverium bromide, sham acupuncture, and acupuncture; and (3) the treatment of diarrhoea-predominant irritable bowel syndrome includes common acupoints such as ST25, ST36, ST37, SP6, GV20, and EX-HN3.

    Conclusion:Acupuncture may improve diarrhoea-predominant irritable bowel syndrome better than drugs and has the fewest side effects. Sham acupuncture may have curative effect except for placebo effect. In the future, it is necessary to perform highly qualified research to prove this result. Pinaverium bromide also has good curative effects with fewer side effects than other drugs.

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