Table 1

Systematic reviews of clinical trials of acupuncture & acupressure in pain

Author Year

Indication

Controls

Studies

features

Results

Conclusion

1 / 2 / 3

/ 4 / 5


Chronic

pain

Ezzo 2000

chronic

sham,

51 RCT

y / y / y /

Positive results in 21 studies, negative in 3,

Limited evidence that acupuncture is

[9]

pain

placebo, no

y / n

and neutral in 27. Better studies more often

more effective than no treatment,

treatment,

negative or neutral

inconclusive evidence regarding

standard

placebo, sham and standard care

ter Riet

chronic

sham,

51 CCT

y / y / y /

Trials small and of low quality. 24 with

The efficacy of acupuncture in the

90/89

pain

other, no

y / n

positive and 27 with negative results. Better

treatment of chronic pain remains

[10,11]

treatment

studies more often negative

doubtful

Patel 89 [12]

chronic

sham, no

14 RCT

n / y / n

Overall patients receiving acupuncture were

Available evidence positive but

pain

treatment,

/ y / y

18% (p < 0.01) more likely to experience

definitive conclusions difficult due to

standard

improvement

various potential sources of bias

Smith 2000

back &

sham,

13 RCT

y / y / y /

5 studies positive, 8 studies negative; better

No convincing evidence for the

[13]

neck pain

other, no

y / n

studies reported more often negative results

analgetic efficacy of acupuncture for

treatment

back and neck pain

White 99

neck pain

sham,

14 RCT

y / y / y /

7 studies positive, 7 negative. Of the 8 better

No convincing evidence for the

[14]

other, no

y / n

studies 5 negative, 3 positive

effectiveness of acupuncture for neck

treatment

pain

van Tulder

low back

sham,

11 RCT

y / y / y /

Conclusions of primary authors positive in 8

Authors would not recommend acu-

99 [15,16]

pain

other, no

y / n

studies, by reviewers for 2 studies.

puncture as regular treatment for low

treatment

Methodological quality judged as low

back pain. High quality trials needed

Ernst 98 [17]

back pain

sham,

12 RCT

y / y / y /

OR for improvement compared with all

Acupuncture superior to various

other, no

y / y

control interventions 2.30 (95%CI 1.28–4.13),

control interventions although

treatment

with sham 1.37 (0.84–2.25). Majority of

insufficient evidence whether

studies good quality

superior to sham

Longworth

sciatica

unclear

1 RCT, 6

p / p / n

Most studies of poor quality; a large number

There may be a role for acupuncture

97 [18]

CCT, 31

/ y / n

of patients seem to have benefited

treatment of lumbar disk protrusions

uncontrolled

and sciatica

studies

ter Riet 89

neck and

unclear

16 RCT, 6

y / p / y

Study design was generally poor. Results

Due to the low methodological quality

[19]

back pain

CCT

/ n / n

only discussed for a few better quality

no definitive conclusions can be

studies

drawn

Headache

McCrory

tension-

sham,

6 RCT

y / y / y /

3 of 4 sham-controlled trials positive (best

Insufficient evidence to draw

2000* [20]

type

physio-

y / n

negative), physiotherapy better in 1 of 2 trials

conclusions on the efficacy. Further

headache

therapy

rigorous trials needed

Melchart 99

idiopathic

sham,

22 RCT

y / y / y /

Majority of 14 sham controlled trials with at

Existing evidence suggests that

[21]

headaches

other, no

y / y

least a trend in favour of acupuncture. Trials

acupuncture has a role in headache

treatment

vs. other treatments contradictory

treatment. However, quality and

amount of evidence not fully

convincing

Goslin 99

migraine

sham,

6 RCT

y / y / y /

2 of 3 placebo-controlled trials positive,

Insufficient data on acupuncture to

[22]

other, no

y / n

similar effects as drug treatment in 2 trials

draw conclusions on its efficacy

treatment

Vernon 99**

tension-

sham,

8 RCT

y / y / y /

2 of 4 sham-controlled trials positive, results

Too few trials and contradictory

[23]

type and

other, no

y / n

vs. physiotherapy contradictory

findings precluding definitive

cervicogeni

treatment

conclusions

c

ter Riet 89

tension

sham, other

7 RCT, 1

y / p / y

Small study size and methodological

No definitive conclusions on the

[24]

type

treatment

CCT

/ n / n

problems make the available trials

effectiveness of acupuncture for

headache

uninterpretable

headache can be drawn

ter Riet 89

facial pain

sham

2 RCT

y / p / y

Methodological quality poor

No definitive conclusions possible

[25]

/ y / n

Pain

various

Ernst 98 [26]

acute

sham,

11 RCT, 5

y / p / y

The majority of trials imply that acupuncture

Acupuncture can alleviate dental pain

dental pain

other, no

CCT

/ y / n

is effective in dental analgesia

but additional research necessary

treatment

Ernst 99 [27]

temporoma

other and

3 RCT

y / y / n

3 comparisons with standard treatments and

Available data suggest beneficial

n-dibular

no

/ y / n

2 with no treatment with favorable effects of

effects; more rigorous, sham-

joint

treatment

acupuncture

controlled trials needed

dysfunction


*Disease focused review on a variety of interventions including acupunture and acupressure; **Disease focused review on a variety of complementary medicine interventions including acupunture and acupressure Features: 1 = comprehensive search, 2 = explicit inclusion criteria, 3 = formal quality assessment, 4 = summary of results for each included study, 5 = meta-analysis; y = yes, p = partly, n = no, - = not applicable, ? = unclear RCT = randomized controlled trials, CCT = non-randomized controlled trials, CS = cohort studies; OR = odds ratio, RR = rate ratio

Linde et al. BMC Complementary and Alternative Medicine 2001 1:3   doi:10.1186/1472-6882-1-3

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