Citation | Population | Type of acupuncture | Control | Outcomes relevant to TSR components | Number of relevant studies (total) included | Interpretation of results | How well was the study done to minimize bias? |
---|---|---|---|---|---|---|---|
Headache (n = 5) | |||||||
Sun et al. [62] | 3,916 subjects with chronic headache (migraine, tension-type or both) | electro | sham, pharmacologic, physiological, CAM | headache frequency/intensity, response rate | 31(31) RCTs | Positive | ++ |
Linde et al. [63] | 1,151 subjects with migraine and tension-type headaches | traditional Chinese | no treatment, sham, pharmacologic, physiotherapy | headache diary, number of migraine days, migraine hours, frequency/duration of headache attack, headache severity, amount and type of rescue medication, nausea and vomiting frequency, pain intensity, number of pain days | 22(22) RCTs | Positive | ++ |
Linde et al. [64] | 2,317 subjects with episodic and/or chronic tension-type headache | traditional Chinese | no treatment, sham, pharmacologic, physiological | analgesic usage, CGI, headache frequency/intensity/duration/location, global patient rating, PDI, VAS, CPG | 11(11) RCTs | Positive | ++ |
Melchart et al. [65] | (ND) subjects with recurrent headaches (tension-type, migraine, various) | manual, ear | sham, pharmacologic, physiological, no treatment, behavioral/psychosocial | headache attack frequency, global assessment of headache, number of days with headache, pain intensity, VAS | 20(22) RCTsa | Positive, Poor methods | ++ |
Granato et al. [66] | 2,317 subjects with episodic or chronic tension-type headaches | manual | no treatment, sham, physiotherapy, CAM | frequency of analgesic use, number of headache days, VAS | 11(11) RCTs | Positive | + |
Chronic pain (n = 25) | |||||||
White et al. [67] | 2,362 subjects with knee pain | manual, electro | sham, behavioral/psychosocial, no treatment, pharmacologic | WOMAC, pain scales | 13(13) RCTs | Positive | ++ |
Kwon et al. [68] | 1,891 subjects with peripheral joint osteoarthritis | manual, electro | no treatment, sham, behavioral/psychosocial, physiotherapy, pharmacologic | VAS, WOMAC, MPQ, NRS, TUGT, HSS knee function scale, walking/climbing stairs time, starting pain, night pain, walking pain, pain descending stairs, pain threshold, Lysholm Score, PGA, present pain intensity, stiffness, active knee flexion, passive range of movement, total pain, effective rate, recurrence rate, Lequesne indices | 18(18) RCTs | Positive | ++ |
Manheimer et al. [69] | 176 subjects with low back pain | Western | sham, physiotherapy, no treatment, acupressure, pharmacologic | VAS, drug use, fit for work score, global score, physician assessment of functionality | 4(33) RCTsb | Positive | ++ |
Fu et al. [70] | 7,173 subjects with neck pain | manual, electro | sham, no treatment, physiotherapy, CAM | MPQ, NDI, PDI, ROM, self-reported pain, VAS | 14(14) RCTs | Positive | ++ |
Ezzo et al. [71] | 393 subjects with knee osteoarthritis | electro, manual | sham, no treatment, physiotherapy | pain, patient global assessment, physical function | 7(7) RCTs and quasi-RCTs | Positive | ++ |
Wang et al. [72] | 536 subjects with rheumatoid arthritis | manual, electro | sham, pharmacologic | CRP, DAS28, duration of morning stiffness, ESR, GHQ, HAQ, SJC, VAS | 8(8) RCTs | Inconclusive/Mixed | ++ |
Jung et al. [73] | 134 subjects with temporomandibular joint disorders | manual | sham | MO, NRS, muscle tenderness, VAS | 6(7) RCTsa | Inconclusive/Mixed | ++ |
Manheimer et al. [74] | 3,498 subjects with osteoarthritis of the knee and/or hip | manual | sham, no treatment, other | WOMAC | 16(16) RCTs | Inconclusive/Mixed | ++ |
La Touche et al. [75] | 401 subjects with temporomandibular disorders | manual, electro | no treatment, sham | ADL, Anamnestic Index, Anamnestic Questionnaire, articular sounds/stereostethoscope, CDS, distribution of pain, index for occlusal state, incisal and occlusal tooth wear, maximum interincisal opening, NRS, pain frequency, PPT, subjective dysfunction score, VAS | 8(8) RCTs | Positive, Poor methods | ++ |
Cho et al. [76] | 808 subjects with temporomandibular disorders | manual, electro | sham, no treatment, pharmacologic, physiotherapy | clinical dysfunction scores, NAS, ROM, sounds/locking/deviation in opening of mouth, tenderness, presence/absence of a headache, overall improvement, VAS | 14(14) RCTs | Inconclusive/Mixed, Poor methods | ++ |
Lee et al. [77] | 606 subjects with rheumatoid arthritis | manual | sham, pharmacologic | ACR20, CRP, DAS, ESR, GHQ, HAQ, VAS, total effective rate, pain reduction, swelling index, number of swollen joints | 8(8) RCTs | Inconclusive/Mixed, Poor methods | ++ |
Sim et al. [78] | 442 subjects with carpal tunnel syndrome | manual, laser | sham, pharmacologic, CAM | CMAP, D4MNSCV, D4UNSCV, DML, DSL, GSS, MNCV, NCS, night pain, parethesia, responder rate, SNAP, SSS, W-P SNCV | 6(6) RCTs | Inconclusive/Mixed, Poor methods | ++ |
Liu et al. [79] | 506 subjects with trigeminal neuralgia | manual, electro | pharmacologic | cure rates | 12(12) RCTs | Inconclusive/Mixed, Poor methods | ++ |
Langhorst et al. [80] | 385 subjects with fibromyalgia syndrome | manual, electro | sham | FIQ, MPQ, VAS | 7(7) RCTs | Inconclusive/Mixed, Poor methods | ++ |
Zhu et al. [81] | 67 subjects with endometriosis | ear | CAM | dysmenorrhea score, therapeutic effect | 1(1) RCT | Negative, Poor methods | ++ |
van Tulder et al. [82] | 542 subjects with chronic lower back pain | manual, electro | sham, no treatment, pharmacologic | ADL, global improvement, Lasoque test, pain score, Schober Test, VAS | 11(11) RCTs | Negative, Poor methods | ++ |
ter Riet et al. [83] | (ND) subjects with chronic pain | manual | sham, pharmacologic, acupuncture | ND | 51(51) CCTs | Negative, Poor methods | ++ |
Mayhew et al. [84] | 166 subjects with fibromyalgia | traditional Chinese, electro | sham, no treatment, other | analgesics usage, dolorimetry of tender and control points, FIQ, morning stiffness, MPI, regional pain score, VAS | 5(5) RCTs | Negative, Poor methods | ++ |
Porter et al. [85] | 486 subjects with fibromyalgia | electro, manual | sham, no treatment, pharmacologic | physical, psychological and quality of life outcomes | 7(7) RCTs, 2(2) CCTs | Positive | + |
Ernst et al. [86] | (ND) subjects with chronic pain | ND | manual, electro, ear | ND | 30(30) SRs | Positive | + |
White et al. [87] | 2,362 subjects with osteoarthritis of the knee | electro, manual | sham, no treatment, physiologic, pharmacologic | NRS, PPI, VAS, WOMAC | 13(13) RCTs | Positive | + |
La Touche et al. [88] | 83 subjects with temporomandibular disorders | manual | sham | electronic axiography, incisor opening and lateral movement, manual palpitation, NRS, pain distribution, pressure algometer, temporomandibular joint sounds/stereo-stethoscope, VAS | 4(4)RCTs | Inconclusive/Mixed | + |
Ernst [89] | 437 subjects with osteoarthritis | manual, electro | sham, no treatment, pharmacologic, physiotherapy | analgesic usage, functioning, knee pain threshold, self-reported pain ratings, subjective improvement and ROM, tenderness, VAS | 13(13) RCTs | Inconclusive/Mixed | + |
Manheimer et al. [90] | 1,154 subjects with osteoarthritis | manual, electro | sham, no treatment | WOMAC | 11(11) RCTs | Inconclusive/Mixed | + |
Casimiro et al. [91] | 84 subjects with rheumatoid arthritis | manual, electro | sham, pharmacologic | analgesic usage, CRP, ESR, pain reduction, number of swollen/tender joints, VAS | 2(2) RCTs | Inconclusive/Mixed, Poor methods | + |
Substance abuse (n = 7) | |||||||
Cho et al. [92] | 1,062 subjects with alcohol dependence | ear, ear electro | no treatment, sham, pharmacologic, non-pharmacologic | abstinent rate, alcohol usage, AWSS, breath analyzer, CIWA, completion rates, relapse rates | 10(11) RCTsa | Inconclusive/Mixed, moor Methods | ++ |
Gates et al. [93] | 1,433 subjects with cocaine or crack dependence | ear | sham, no treatment | ASI, cocaine use, HCCS, urine toxicology | 7(7) RCTs | Negative, Poor methods | ++ |
White et al. [94] | 3,486 subjects with tobacco addiction | manual, electro | sham, no treatment, behavioral/psychosocial, pharmacologic | complete smoking cessation | 14(14) RCTs | Negative, Poor methods | ++ |
D'Alberto et al. [95] | 1,356 subjects with cocaine abuse or dependence | ear | sham, CAM | CCQ, urine toxicology | 6(6) RCTs | Inconclusive/Mixed | + |
White et al. [96] | 1,433 subjects with smoking addiction | ear, electro | behavioral/psychosocial, pharmacologic, no treatment, acupuncture, CAM | quit rates | 13(13) RCTs | Inconclusive/Mixed | + |
ter Riet et al. [97] | (ND) subjects addicted to cigarette smoking, heroin, or alcohol | manual, electro | ND | acupuncture effectiveness | 22(22) CCTs | Negative | + |
Mills et al. [98] | 1,747 subjects with cocaine addiction | ear | CAM, pharmacologic, behavioral/psychosocial | ASI, frequency/amount of cocaine use, HCCS, HDIRS, self-reported effectiveness, treatment effects, urine assays | 9(9) RCTs | Negative | + |
Sleep disturbance (n = 6) | |||||||
Cao et al. [99] | 3,811 subjects with insomnia | rolling, scalp, ear, abdominal | no treatment, CAM, sham, pharmacologic | duration and quality of sleep, MQ, PFS, PSQI, SDRS, sleep quality, SSDS, SRSS, VAS | 46(46) RCTs | Positive | ++ |
Chen et al. [100] | 673 subjects with insomnia | ear | no treatment, sham, pharmacologic | actigraphic monitoring, ISI, MQ, PSQI, sleeping hours | 6(6) RCTs | Inconclusive/Mixed | ++ |
Yeung et al. [101] | 1,956 subjects with insomnia | manual | sham, no treatment, pharmacologic | NRS, MQ, ISI, AIS, PSQI, SDRS, SSDS, PSG, wrist actigraph monitoring, overnight polysomnogram, VAS | 20(20) RCTs | Inconclusive/Mixed | ++ |
Huang et al. [102] | 1,355 subjects with insomnia | manual, ear, intradermal, rolling | sham, pharmacologic, education | AIS, ISI, PSQI, PFS, sleep diary, sleep time, wrist actigraph monitoring | 2(3) RCTs, 8(9) CCTs, 18(18) case seriesa | Positive, Poor methods | ++ |
Cheuk et al. [103] | 300 subjects with insomnia | electro, traditional Chinese, contemporary | no treatment, sham | self-rated insomnia scale, sleep disturbance on numerical scale, ISI, AIS, MQ, actigraphy monitoring | 4(7) RCTsa | Positive, Poor methods | ++ |
Lee et al. [104] | 842 subjects with insomnia | ear (needle, SV seeds taping, magnetic pearls) | sham, no treatment, pharmacologic | NST, Pittsburgh Sleep Diary, sleep efficiency, sleep quality, Karolinska Sleep Diary, 4-point Sleep Score, self-satisfaction scale | 10(10) RCTs | Inconclusive/Mixed, Poor methods | + |
Depression (n = 6) | |||||||
Zhang et al. [105] | 1,680 subjects with MDD and PSD | manual, electro, ear | sham, no treatment, pharmacologic | HAM-D | 35(35) RCTs | Positive | ++ |
Fan et al. [106] | 2,757 subjects with depression or depressive disorders | manual | sham, pharmacologic | CGI, DSI, efficacy rate, HAM-D, SCL-90, SDS | 19(20) RCTsa | Positive | ++ |
Mukaino et al. [107] | 509 subjects with depression | manual, electro | no treatment, sham, pharmacologic | BRMS, CGI, HRSD | 7(7) RCTs | Inconclusive/Mixed | ++ |
Wang et al. [108] | 447 subjects with major depression or depressive neurosis | manual, electro | sham | HAM-D | 7(8) RCTsa | Inconclusive/Mixed, Poor methods | ++ |
Smith et al. [109] | 2,782 subjects with depression | abdominal, manual | sham, no treatment, pharmacologic | assessment of improvement, BDI, CGI, cure rates, HAM-D, HRSD, medication usage, Melancholia Scale, remission rates | 29(30) RCTsa | Inconclusive/Mixed, Poor methods | ++ |
Leo et al. [110] | 666 subjects with depression | verum, manual, ear, traditional Chinese, electro | no treatment, sham, CAM | BDI, CES-D, CGI, HAM-D | 9(9) RCTs | Inconclusive/Mixed | + |
Anxiety (n = 1) | |||||||
Pilkington et al. [111] | 1,201 subjects with anxiety or an anxiety disorder | traditional Chinese, Western medical, ear, electro | sham, behavioral/psychosocial, pharmacologic | anesthesia dose, CGI, cure rates, HAM-A, MMPI, MYPAS, patient/observer assessment of anxiety, STAI, VAS, X-1 | 8(10) RCTs, 2(2) CCTsa | Positive | ++ |
Cognitive function (n = 1) | |||||||
Zhao et al. [112] | 960 subjects with vascular dementia | manual, electro, targets, ear | sham, pharmacologic | ADL, FAQ, HDS, MMSE-R, overall function | 9(10) RCT, 1(1) quasi- RCTa | Inconclusive/Mixed, Poor methods | ++ |
Fatigue (n = 1) | |||||||
Wang et al. [113] | 1,826 participants with chronic fatigue syndrome | manual, electro | pharmacologic, CAM | improvement in chronic fatigue symptoms, FAI, SCL-90, CFIDS Disability Scale | 22(27) Clinical Trials, 9(13) RCTsa | Positive, Poor methods | _ |