Addiction
Gates S, Smith LA, Foxcroft DR. “Auricular acupuncture for cocaine dependence.” Cochrane Database of Systematic Reviews. (1):CD005192, 2006.
This systematic review analyzed the effectiveness of auricular acupuncture treatment for cocaine dependence. Seven randomized control trials with a total of 1,433 participants were included. No differences between acupuncture and sham acupuncture or acupuncture and no acupuncture were found for any measure of cocaine or other drug use. Moderate benefit is not ruled out by these results but there is currently no strong evidence for the use of auricular acupuncture for cocaine dependence.

White AR, Rampes H, Campbell JL. “Acupuncture and related interventions for smoking cessation.” Cochrane Database of Systematic Reviews. (1):CD000009, 2006.
This systematic review looked at 24 randomized trials comparing a form of acupuncture, acupressure, laser therapy or electrostimulation with either no intervention, sham treatment or another intervention for smoking cessation. The long-term result shows no effect of acupuncture compared with sham acupuncture. There was no consistent evidence that acupuncture is superior to any treatment, and no evidence that the effect of acupuncture was different from that of other anti-smoking interventions, or that any particular acupuncture technique is superior to other techniques.

Arrhythmia
VanWormer AM, Lindquist R, Sendelbach SE. The effects of acupuncture on cardiac arrhythmias: a literature review. Heart & Lung. 37(6):425-31, 2008.
Acupuncture has been used for thousands of years in Eastern medicine to
treat multiple medical conditions and has been documented to improve many aspects of cardiovascular functioning. According to the eight studies reviewed, 87% to 100% of participants converted to normal sinus rhythm after acupuncture. Acupuncture seems to be effective in treating several cardiac arrhythmias. Given these results, more rigorous studies are now needed with standardized treatment protocols, diverse patient populations, and long-term follow-up.

Arthritis, Rheumatoid
Casimiro L, Barnsley L, Brosseau L, et al. “Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis.” Cochrane Database of Systematic Reviews. (4):CD003788, 2005.
In this review two studies involving a total of 84 people were included: one using acupuncture and one using electroacupuncture. In the acupuncture study, although not statistically significant, pain in the treatment group improved by 4 points on a 0-100mm visual analogue scale versus no improvement in the placebo group. In the second study, using electroacupuncture, a significant decrease in knee pain was reported in the experimental group, 24 hours post treatment, when compared to the placebo group. A significant decrease was also found at four months post-treatment. Electroacupuncture was shown to be beneficial in reducing symptomatic knee pain in patients with rheumatoid arthritis 24 hours and 4 months post treatment.

Asthma
McCarney RW, Lasserson TJ, Linde K, et al. “An overview of two Cochrane systematic reviews of complementary treatments for chronic asthma: acupuncture and homeopathy.” Respiratory Medicine. 98(8):687-96, 2004 Aug.
Eleven studies with 324 participants were included in this review. When data from two small studies were pooled, no difference in lung function was observed. There is not enough evidence to recommend the use of acupuncture in the treatment of asthma. Further research needs to be undertaken, and this should take into account the different types of acupuncture practiced.

Attention Deficit Hyperactivity Disorder
Lee MS, Choi TY, Kim JI, et al. Acupuncture for treating attention deficit hyperactivity disorder: a systematic review and meta-analysis. Chin J Integr Med. 17(4):257-60, 2011.
This review assessed the effectiveness of acupuncture as a treatment option for attention deficit hyperactivity disorder (ADHD). Three randomized clinical trials were included. One found that electroacupuncture (EA) plus behavioral treatment was better than sham electroacupuncture plus behavioral treatment. Two studies reported a significant benefit of acupuncture or auricular acupuncture over conventional drug therapies. There is limited evidence for the effectiveness of acupuncture as a symptomatic treatment of ADHD.

Autism
Lee MS, Choi TY, Shin BC, Ernst E. Acupuncture for Children with Autism Spectrum Disorders: A Systematic Review of Randomized Clinical Trials. J Autism Dev Disord. 2011 Nov 29. [Epub ahead of print]
This study assessed the effectiveness of acupuncture as a treatment for autism spectrum disorders (ASD). Eleven randomized clinical trials were included. Two studies found that acupuncture plus conventional language therapy was better than sham acupuncture plus conventional therapy. Two other studies found that acupuncture produced significant effects compared with conventional language therapy. Three studies suggested that acupuncture plus conventional therapies had beneficial effects compared with conventional therapy alone. Four more studies reported that subjects who received acupuncture experienced significant effects compared with subjects who were placed on a wait list or who received no treatment.

Back Pain
Manheimer E, White A, Berman B, et al. “Meta-analysis: acupuncture for low back pain.” Annals of Internal Medicine. 142(8):651-663, 2005.
To assess acupuncture’s effectiveness for treating low back pain, randomized controlled trials were identified that compared needle acupuncture with sham acupuncture, other sham treatments, no additional treatment, or another active treatment for patients with low back pain. The 33 randomized trials included in this review were grouped according to acute or chronic pain, style of acupuncture and type of control group used. For the primary outcome measure of short-term chronic pain relief, the meta-analysis showed that acupuncture is significantly more effective than sham treatment and no additional treatment. Acupuncture effectively relieves chronic low back pain. No evidence suggests that acupuncture is more effective than other active therapies.

Ernst E, White AR. “Acupuncture for back pain: a meta-analysis of randomized controlled trials”. Archives of Internal Medicine. 158(20):2235-41, 1998.
The data from 9 studies were subjected to meta-analysis. Acupuncture was shown to be superior to various control interventions (the odds ratio of improvement with acupuncture vs. control was 2.30). There was not enough evidence to state that it is superior to placebo.

Furlan AD, van Tulder M, Cherkin D, et al. “Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the Cochrane collaboration.” Spine. 30(8):944-63, 2005
This review looked at randomized controlled trials of acupuncture involving dry-needling for adults with nonspecific acute/subacute or chronic low back pain. Thirty-five randomized clinical trials were combined, and there was evidence of pain relief and functional improvement for acupuncture compared to no treatment or sham therapy immediately after the end of the sessions and in short-term follow-up. The data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low back pain.

Bell’s Palsy
He L, Zhou D, Wu B, et al. “Acupuncture for Bell’s palsy.” Cochrane Database of Systematic Reviews. (1):CD002914, 2004.
The objective of this review was to examine the efficacy of acupuncture in hastening recovery and reducing long-term morbidity from Bell’s palsy. The review included a total of 238 patients in three randomized or quasi-randomized controlled trials involving acupuncture in the treatment of Bell’s palsy. The three included studies showed that the therapeutic effect of acupuncture alone was superior to that of medication or that acupuncture combined with medication was better than medication alone. The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.

Cancer Pain
Paley CA, Johnson MI, Tashani OA, Bagnall AM. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD007753.
Three randomized controlled trials were included in this systematic review. Results indicate that acupuncture may lower cancer pain in adults. However, because of low quality studies further research is needed.

Dental Pain
Ernst E, Pittler MH. “The effectiveness of acupuncture in treating acute dental pain: a systematic review.” British Dental Journal. 184(9):443-7, 1998.
In an analysis of 16 controlled trials, the majority of studies indicate that acupuncture is effective in dental analgesia. Future trials are recommended in order to identify the optimal acupuncture technique and its efficacy compared with conventional analgesic methods.

Dentistry
Rosted P. “The use of acupuncture in dentistry: a systematic review.” Acupuncture Medicine. 16(1):43-8, 1998.
Of 15 studies meeting 60-85% of identified inclusion criteria (reference group, randomization, blinding, appropriate statistics, adequate follow-up), 11 found standard acupuncture either more effective than sham acupuncture or producing better or similar results to an accepted treatment procedure. All studies in the excellent or good categories showed positive results for acupuncture. Acupuncture proved effective in 73% of reviewed papers for the treatment of temporomandibular dysfunction or as an analgesic.

Depression
Zhang ZJ, Chen HY, Yip KC, et al. University of Hong Kong, China. The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis. Journal of Affective Disorders. 124(1-2):9-21, 2010.
A meta-analysis was conducted on high-quality randomized controlled trials of acupuncture for depression. Of 207 clinical studies 113 (54.6%) were on major depressive disorder and 76 (36.7%) on post-traumatic stress disorder (PSD). Twenty studies of major depressive disorder (1998 patients) and 15 of PSD (1680 patients) were included for meta-analysis. The effectivenss of acupuncture as sole therapy was comparable to antidepressants alone in improving clinical response and alleviating symptom severity of major depressive disorder, but not different from sham acupuncture. No sufficient evidence favored the combination of acupuncture with antidepressants over either one alone in treating major depressive disorder. Acupuncture was superior to antidepressants and waitlist controls in improving both response and symptom severity of PSD. The incidence of adverse events in acupuncture intervention was significantly lower than antidepressants. Acupuncture therapy is safe and effective in treating both health conditions and could be considered an alternative option for the two disorders. The efficacy in other forms of depression remains to be further determined.

Smith CA, Hay PP, MacPherson H. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004046.
Thirty trials with 2,812 participants are included in the meta-analysis. There was insufficient evidence of a consistent beneficial effect from acupuncture compared with a wait list control or sham acupuncture control. Two trials found acupuncture may have an additive benefit when combined with medication compared with medication alone. A subgroup of participants with depression as a co-morbidity experienced a reduction in depression with manual acupuncture compared with serotonin uptake inhibitors. The majority of trials compared manual and electro acupuncture with medication and found no effect between groups.

Wang H, Qi H, Wang BS, et al. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? Journal of Affective Disorders. 111(2-3):125-34, 2008.
In this review of eight randomized control trials, acupuncture was found to significantly reduce the severity of depression as measured by the Hamilton rating scale for depression (HAMD).

Mukaino Y, Park J, White A, et al. “The effectiveness of acupuncture for depression--a systematic review of randomized controlled trials.” Acupuncture in Medicine. 23(2):70-6, 2005
This review summarizes the existing evidence on acupuncture as a therapy for depression. Seven randomized control trials including a total of 509 patients were included, in which either manual acupuncture or electroacupuncture was compared with a control procedure in subjects with depression. The evidence is inconsistent on whether manual acupuncture is superior to sham, and suggests that acupuncture was not superior to waiting list. Evidence suggests that the effect of electroacupuncture may be similar to antidepressant medication. There is inconclusive evidence on whether acupuncture has an additive effect when given as an adjunct to antidepressant drugs.

Smith CA, Hay PP. “Acupuncture for depression.” Cochrane Database of Systematic Reviews. (2):CD004046, 2005.
Seven published and unpublished randomized trials comprising 517 subjects were included in this review of the use of acupuncture in treating depression. There was no evidence that medication was better than acupuncture in reducing the severity of depression or in improving depression, defined as remission versus no remission. There is insufficient evidence to determine the efficacy of acupuncture compared to medication, or to wait list control or sham acupuncture, in the management of depression.

Fibromyalgia
Berman BM, Ezzo J, Hadhazy V, Swyers JP. “Is acupuncture effective in the treatment of fibromyalgia?” Journal of Family Practice. 48(3):213-8, 1999.
Seven studies were included, 3 randomized controlled trials and 4 cohort studies. Only one was rated as a high quality study. This study suggests that real acupuncture is more effective than sham acupuncture for pain relief, increasing pain thresholds, improving global ratings and reducing morning stiffness. Some patients reported no benefit and a few reported worsening of fibromyalgia pain. Duration of benefit as well as the effect of follow up acupuncture sessions were not investigated. Lower quality studies reported similar findings. Further high quality studies are recommended.

Headache
Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews.Issue 1. Art. No.: CD007587, 2009.
Eleven trials were reviewed that investigated whether acupuncture is effective in the prophylaxis of tension-type headache. Two large trials investigating whether adding acupuncture to basic care (which usually involves only treating unbearable pain with pain killers) found that 47% of patients who received acupuncture reported a decrease in the number of headache days by at least 50%, compared to 16% of patients in the control groups. Six trials compared true acupuncture with inadequate or ‘fake’ acupuncture interventions. Fifty percent of patients receiving true acupuncture reported a decrease of the number of headache days by at least 50%, compared to 41% of patients in the groups receiving inadequate or ‘fake’ acupuncture. The available evidence suggests that acupuncture could be a valuable option for patients suffering from frequent tension-type headache.

Sun Y and Gan TJ. “Acupuncture for the management of chronic headache: a systematic review.” Anesthesia & Analgesia. 107(6):2038-47, 2008.
This review of 31 studies found that acupuncture is effective in treating chronic headaches. It was superior to medication therapy for headache intensity, headache frequency, and physical function.

Davis MA, Kononowech RW, Rolin SA, Spierings EL. “Acupuncture for tension-type headache: a meta-analysis of randomized, controlled trials.” Journal of Pain. 9(8):667-77, 2008 Aug.
Five studies were included in this meta-analysis. During treatment, the acupuncture group averaged 8.95 headache days per month compared with 10.5 in the sham group. At long-term follow-up, the acupuncture group reported an average of 8.21 headache days per month compared with 9.54 in the sham group. The most common adverse events reported were bruising, headache exacerbation, and dizziness. This meta-analysis suggests that acupuncture compared with sham for tension-type headache has limited effectiveness for the reduction of headache frequency.

Vickers AJ, Rees RW, Zollman CE, et al. “Acupuncture of chronic headache disorders in primary care: randomised controlled trial and economic analysis.” Health Technology Assessment. 8(48):iii, 1-35, 2004.
This review included 401 patients with chronic headache disorder, predominantly migraine. Patients were randomly allocated to receive up to 12 acupuncture treatments over 3 months or to a control intervention offering usual care. Patients in the acupuncture group experienced the equivalent of 22 fewer days of headache per year. Compared with controls, patients randomised to acupuncture used 15% less medication, made 25% fewer visits to GPs and took 15% fewer days off sick. The study suggests that acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine, and it was relatively cost-effective compared with a number of other interventions.

Melchart D, Lide K, Rischer P, White A, Allais G, Vicker A, Berman B. “Acupuncture for recurrent headaches: A systematic review of randomized controlled trials.” Cephalgia. 19(9):779-786, 1999.
Twenty-two trials were reviewed (15 for migraine, 6 for tension headache, 1 for various headaches) for a total of 1042 patients. The majority of the 14 trials comparing true and sham acupuncture showed at least a trend in favor of true acupuncture. The 8 trials comparing acupuncture and other forms of treatment revealed contradictory findings. The authors concluded that the existing evidence suggests that acupuncture has a role in the treatment of recurrent headaches, but that further high quality, large-scale trials are needed to more definitively assess efficacy.

Infertility
Franconi G, Manni L. Aloe L, et al. Acupuncture in clinical and experimental reproductive medicine: a review. Journal of Endocrinological Investigation. 34(4):307-11, 2011.
There is evidence of benefit mainly when acupuncture is performed on the day of embryo transfer (ET) in the live birth rate. Benefit is also evident when acupuncture is performed for female infertility due to polycystic ovary syndrome (PCOS). There is some evidence of sperm quality improvement when acupuncture is performed on males affected by idiopathic infertility. Further studies are necessary to confirm the clinical results and to expand our knowledge of the mechanisms involved.

Insomnia
Huang W, Kutner N, Bliwise DL. A systematic review of the effects of acupuncture in treating insomnia. Sleep Medicine Reviews. 13(1):73-104, 2009.
Thirty studies were included in the review. 93% of the studies showed positive treatment effects of acupuncture in improving various aspects of sleep. Although acupuncture has been demonstrated to be safe and holds great potential to be an effective treatment modality for insomnia, the evidence is limited by the quality of these studies and mixed results from those with sham (or unreal treatment) controls.

Lee MS, Shin BC, Suen LK, et al. Auricular acupuncture for insomnia: a systematic review. International Journal of Clinical Practice. 62(11):1744-52, 2008.
Ten studies were included in this review. In comparison to placebo, subjects who received auricular (ear) acupuncture showed greater sleep efficiency. In addition, when compared to subjects who received conventional sleep-aid drugs (estazolam or diazepam), more favorable effects were reported for auricular acupuncture. Although these findings are encouraging, the poor quality and limited amount of data used limit the conclusions that can be made.

In Vitro Fertilization (IVF)
El-Toukhy T, Sunkara SK, Khairy M, et al. “A systematic review and meta-analysis of acupuncture in in vitro fertilisation.” BJOG: An International Journal of Obstetrics & Gynaecology. 115(10):1203-13, 2008. Thirteen studies, including a total of 2500 women randomised to either acupuncture or control group, were included. Five trials of 877 women evaluated IVF outcome when acupuncture was performed around the time of transvaginal oocyte retrieval, while eight trials of 1,623 women reported IVF outcome when acupuncture was performed around the time of embryo transfer (ET). Meta-analysis of the five studies of acupuncture around the time of egg collection did not show a significant difference in clinical pregnancy. Meta-analysis of the eight studies of acupuncture around the time of embryo transfer also showed no difference in the clinical pregnancy rate. Meta-analysis did not show a significant increase in live birth rate with acupuncture. Currently available literature does not provide sufficient evidence that the addition of acupuncture improves IVF clinical pregnancy rate.

Labor Pain
Smith CA, Collins CT, Crowther CA, Levett KM. Acupuncture or acupressure for pain management in labour. Cochrane Database of Systematic Reviews. (7):CD009232, 2011.
Thirteen trials with data reporting on 1986 women were included. Nine trials reported on acupuncture and four trials reported on acupressure. Less intense pain was found from acupuncture compared with no intervention. One trial increased satisfaction with pain relief compared with placebo control. Reduced use of pharmacological analgesia was found in one trial of acupuncture compared with placebo and compared with standard care. Fewer instrumental deliveries from acupuncture were found compared with standard care. Pain intensity was reduced in the acupressure group compared with a placebo control. Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced
use of pharmacological management. However, there is a need for further research.

Lee H, Ernst E. “Acupuncture for labor pain management: A systematic review.” American Journal of Obstetrics & Gynecology. 191(5):1573-9, 2004.
This systematic review used three randomized control trials to critically evaluate the evidence on analgesic effect of acupuncture during labor. The methodological quality of the trials were generally good. It was concluded that the evidence for acupuncture as an adjunct to conventional pain control during labor is promising and further research is warranted.

Menstruation Pain
Smith CA, Zhu X, He L, Song J. Acupuncture for primary dysmenorrhoea. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD007854.
This systematic review included six trials. Results suggest that acupuncture is effective for reducing menstrual symptoms. However further research with randomized control trials is needed.

Yang H, Liu CZ, Chen X, et al. “Systematic review of clinical trials of acupuncture-related therapies for primary dysmenorrhea.” Acta Obstetricia et Gynecologica Scandinavica. 87(11):1114-22, 2008. Thirty randomized controlled trails (RCTs) and two controlled clinical trials (CCTs) were included. Most of the trials were of low methodologic quality. There were conflicting results regarding whether acupuncture-related therapies were more effective than control treatments. However, there was a small, high quality trial of acupuncture which suggested that acupuncture was more effective than the control. More high quality studies are needed.

Migraine
Melchart D, Linde K, Berman B, White A, Vickers A, Allais G, Brinkhaus B. Acupuncture for idiopathic headache. Cochrane Database of Systematic Reviews 2001, Issue 1. Art. No.: CD001218.
Twenty-two trials were reviewed. Six trials investigating whether adding acupuncture to basic care (which usually involves only treating acute headaches) found that those patients who received acupuncture had fewer headaches. Fourteen trials compared true acupuncture with inadequate or fake acupuncture. In these trials both groups had fewer headaches than before treatment, but there was no difference between the effects of the two treatments. In the four trials in which acupuncture was compared to a proven drug treatment, patients receiving acupuncture tended to report more improvement and fewer side effects.

Nausea and Vomiting
Ezzo J, Vickers A, Richardson MA, et al. “Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting.” Journal of Clinical Oncology. 23(28):7188-98, 2005.
In this review, 11 randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were included. By modality, stimulation with needles reduced the proportion of acute vomiting, but not acute nausea severity. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, and acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control.

Vickers, AJ. “Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials.” Journal of the Royal Society of Medicine. 89(6):303-11, 1996.
Thirty-three controlled trials using P6 acupuncture point for the treatment of nausea and/or vomiting associated with chemotherapy, pregnancy or surgery showed acupuncture statistically superior to control in 27 of 29 trials, and equal or inferior to control in four trials in which it was administered under anesthesia. In twelve high quality randomized control trials where acupuncture was not administered under anesthesia, eleven of the trials involving almost 2000 patients showed a positive effect of P6, suggesting it to be an effective antiemetic technique.

Neck Pain
White AR, Ernst E. “A systematic review of randomized controlled trials of acupuncture for neck pain.” Rheumatology. 38(2):143-47, 1999.
Fourteen randomized controlled trials comparing needle or laser acupuncture with a control were equally divided between positive and negative. Acupuncture was either equal to or superior to physiotherapy in three studies but not superior to sham control in four out of five studies. Five of the eight high quality trials were negative. Further well-designed controlled clinical trials are called for.

Obesity
Cho SH, Lee JS, Thabane L, Lee J. Acupuncture for obesity: a systematic review and meta-analysis. International Journal of Obesity. 33(2):183-96, 2009 Feb. In the 31 studies reviewed, acupuncture was associated with a significant reduction in average body weight and an improvement in obesity. In comparison to conventional medicine, acupuncture showed more improved outcomes for both body weight and obesity.

Osteoarthritis
Kwon YD, Pittler MH, Ernst E. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology.
45(11):1331-7, 2006.
Eighteen randomized controlled trials were included. Ten trials tested manual acupuncture and eight trials tested electro-acupuncture. Overall, ten studies demonstrated greater pain reduction in acupuncture groups compared with controls. The meta-analysis showed a significant effect of manual acupuncture compared with sham acupuncture), which is supported by data for knee osteoarthritis. Considering its favorable safety profile acupuncture seems an option worthy of consideration particularly for knee osteoarthritis.

Parkinson’s Disease
Lam YC, Kum WF, Durairajan SS, et al. “Efficacy and safety of acupuncture for idiopathic Parkinson’s disease: a systematic review.”
Journal of Alternative & Complementary Medicine. 14(6):663-71, 2008.
Ten trials were included, each using a different set of acupoints and manipulation of needles. Nine studies claimed a statistically significant positive effect from acupuncture as compared with the control. Only one study indicated that there were no statistically significant differences for all variables measured. Large, well-designed, trials are needed.

Post-operative Pain
Sun Y, Gan TJ, Dubose JW, and Habib AS. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. British Journal of Anaesthesia. 101(2):151-60, 2008.
Fifteen RCTs comparing acupuncture with sham control in the management of acute postoperative pain were included. Postoperative pain intensity significantly decreased in the acupuncture group at 8 and 72 hours compared with the control group. The acupuncture treatment group was
associated with a lower incidence of opioid-related side-effects such as
nausea, dizziness, sedation, pruritus, and urinary retention.

Post-operative Nausea and Vomiting
Lee A, Done ML. “The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis.” Anesthesia & Analgesia. 88(6):1362-9, 1999.
This systematic review looked at the results of 19 randomized trials utilizing acupuncture, electroacupuncture, transcutaneous electrical nerve stimulation, acupoint stimulation and acupressure. Nonpharmacologic techniques were equal to antiemetic drugs in preventing early vomiting and late vomiting in adults, and were better than placebo for early nausea and early vomiting. No benefit was found in children.

Rheumatoid Arthritis
Lee MS, Shin BC, Ernst E. “Acupuncture for rheumatoid arthritis: a systematic review.” Rheumatology. 47(12):1747-53, 2008.
A total of 236 potentially relevant studies were identified and eight randomized controlled tirals were included. Four of these compared the effects of manual or electro-acupuncture with sham acupuncture and failed to show specific effects of acupuncture on pain or other outcome measures. One study compared manual acupuncture with indomethacin and suggested favorable effects of acupuncture in terms of total response rate. Three trials tested acupuncture combined with moxibustion, vs conventional drugs and failed to show that acupuncture plus moxibustion was superior to conventional drugs in terms of response rate, pain reduction or joint swelling. More rigorous research seems to be warranted.

Wang C, de Pablo P, Chen X, et al. “Acupuncture for pain relief in patients with rheumatoid arthritis: a systematic review.” Arthritis & Rheumatism. 59(9):1249-56, 2008. Eight studies with a total of 536 subjects were included. Six studies reported a decrease in pain for acupuncture versus controls. Four studies reported a significant reduction in morning stiffness but the difference was not significant vs. controls. Five studies observed a reduction in inflammatory markers. Despite some favorable results, conflicting evidence exists on the effectiveness of acupuncture for rheumatoid arthritis. Rigorous and well-controlled randomized trials are warranted.

Safety
Adams D, Cheng F, Jou H, et al. The Safety of Pediatric Acupuncture: A Systematic Review. Pediatrics. 2011 Nov 21. [Epub ahead of print]
A total of 279 adverse effects were identified, 146 from randomized controlled trials, 95 from cohort studies, and 38 from case reports/series. Twenty-five adverse events were serious, 1 was moderate (infection), and 253 were mild. The mild adverse events included pain, bruising, bleeding, and worsening of symptoms. Mild adverse events incidence was calculated at 11.8%. Many of the more serious ones might have been caused by substandard practice. Results support those from adult studies, which have found that acupuncture is safe when performed by appropriately trained practitioners.

Shoulder Pain
Green S, Buchbinder R, Hetrick S. “Acupuncture for shoulder pain.” Cochrane Database of Systematic Reviews. (2):CD005319, 2005.
Nine randomized trials of varying methodological quality were included in this review of acupuncture compared to placebo or another intervention in adults with shoulder pain. Acupuncture was of benefit over placebo; however, by four months, the difference between the acupuncture and placebo groups, while still statistically significant, was no longer likely to be clinically significant. Additional well designed clinical trials are necessary to determine the benefit of acupuncture for shoulder pain.

Temporomandibular Joint Dysfunction
Ernst, E, White, AR. “Acupuncture as a treatment for temporomandibular joint dysfunction: a systematic review of randomized trials.” Archives of Otolaryngology – Head & Neck Surgery. 125(3):269-72, 1999.
A review of randomized controlled trials testing acupuncture vs. sham acupuncture, standard therapy or no treatment at all showed acupuncture’s effectiveness for temporomandibular joint dysfunction, but did not control for a placebo effect.

Traumatic Brain Injury
Wong V, Cheuk DK, Lee S, Chu V. Acupuncture for acute management and rehabilitation of traumatic brain injury. Cochrane Database Syst Rev. 2011 May 11;5:CD007700.
This systematic review included four randomized controlled trials. Results suggest that acupuncture is effective for traumatic brain injury although because of low quality further research is needed.

Content last modified on Dec 9, 2011