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ACUPUNCTURE: REVIEW AND ANALYSIS OF REPORTS ON CONTROLLED CLINICAL TRIALS

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Acknowledgements

Acknowledgements
The World Health Organization acknowledges its indebtedness to the experts who participated in the WHO Consultation on Acupuncture held in Cervia, Ital in !""#, at which the selection criteria $or the data included in this publication were set% &pecial thanks are due to 'r (hu)*an +ie, Honorar 'irector o$ the Institute o$ Integrated ,edicines, *irst Hospital o$ -ei.ing ,edical /niversit , China, who dra$ted, revised and updated this report% *urther, 'r +ie made numerous Chinese language documents available in 0nglish% We also thank 'r Hongguang 'ong, 1eneva /niversit Hospital, &witzerland $or providing additional in$ormation% Appreciation is extended to the 2orwegian 3o al ,inistr o$ Health and &ocial A$$airs $or providing the $inancial support to print this review%

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Contents

Contents
Acknowledgements.............................................................................................iii Contents v Introduction 1 Background......................................................................................................1 Objectives........................................................................................................ 2 Use of the ublication.......................................................................................2 1. !eneral considerations....................................................................................." 1.1 #efinition....................................................................................................." 1.2 $eed for evaluation....................................................................................." 1." %valuation methodolog&.............................................................................." 1.' (afet&.......................................................................................................... ' 1.) Availabilit& and racticabilit&........................................................................) 1.* (tudies on thera eutic mechanisms............................................................) 1.+ (election of clinical trial re orts..................................................................* 2. ,eview of clinical trial re orts............................................................................2.1 .ain............................................................................................................. 4%!%! Head and $ace%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%" 4%!%4 5ocomotor s stem%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%" 4%!%6 1out%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!7 4%!%8 -iliar and renal colic%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!7 4%!%9 Traumatic or postoperative pain%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!7 4%!%# 'entistr %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!! 4%!%: Childbirth%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!! 4%!%; &urger %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%!! 2.2 Infections..................................................................................................11 2." $eurological disorders..............................................................................12 2.' ,es irator& disorders................................................................................1" 2.) #igestive disorders....................................................................................1" 2.* Blood disorders.........................................................................................1' 2.+ Urogenital disorders..................................................................................1' 2./ !&naecological and obstetric disorders.....................................................1) 2.- Cardiovascular disorders...........................................................................1*
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2.10 .s&chiatric disorders and mental disturbances........................................1* 2.11 .aediatric disorders.................................................................................1+ 2.12 #isorders of the sense organs.................................................................1/ 2.1" (kin diseases..........................................................................................1/ 2.1' Cancers...................................................................................................12.1) Other re orts...........................................................................................1". #iseases and disorders that can be treated with acu uncture..................................................................21 '. (ummar& table of controlled clinical trials........................................................................................2) ,eferences........................................................................................................ */

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Introduction

Introduction

Background
Over its 4977 ears o$ development, a wealth o$ experience has accumulated in the practice o$ acupuncture, attesting to the wide range o$ diseases and conditions that can be e$$ectivel treated with this approach% /nlike man other traditional methods o$ treatment, which tend to be speci$ic to their national or cultural context, acupuncture has been used throughout the world, particularl since the !":7s% In recognition o$ the increasing worldwide interest in the sub.ect, the World Health Organization <WHO= conducted a s mposium on acupuncture in >une !":" in -ei.ing, China% ?h sicians practising acupuncture in di$$erent countries were invited to identi$ the conditions that might bene$it $rom this therap % The participants drew up a list o$ 86 suitable diseases% However, this list o$ indications was not based on $ormal clinical trials conducted in a rigorous scienti$ic manner, and its credibilit has been @uestioned% The past two decades have seen extensive studies on acupuncture, and great e$$orts have been made to conduct controlled clinical trials that include the use o$ AshamB acupuncture or AplaceboB acupuncture controls% Although still limited in number because o$ the di$$iculties o$ carr ing out such trials, convincing reports, based on sound research methodolog , have been published% In addition, experimental investigations on the mechanism o$ acupuncture have been carried out% This research, while aimed chie$l at answering how acupuncture works, ma also provide evidence in support o$ its e$$ectiveness% In !""!, a progress report on traditional medicine and modern health care was submitted b the 'irector)1eneral o$ WHO to the *ort )$ourth World Health Assembl % ! The report pointed out that in countries where acupuncture $orms part o$ the cultural heritage, its use in an integrated approach to modern and traditional medicine presents no di$$icult % However, in countries where modern Western medicine is the $oundation o$ health care, the ethical use o$ acupuncture re@uires ob.ective evidence o$ its e$$icac under controlled clinical conditions% In !""#, a dra$t report on the clinical practice o$ acupuncture was reviewed at the WHO Consultation on Acupuncture held in Cervia, Ital % The participants recommended that WHO should revise the report, $ocusing on data $rom controlled clinical trials% This publication is the outcome o$ that process%

Traditional medicine and modern health care. Progress report by the Director-General. 1eneva, World Health Organization, !""! <unpublished document A88C!7=%
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AcupunctureD review and anal sis o$ controlled clinical trials

Obj c!"# $
The ob.ective o$ this publication is to provide a review and anal sis o$ controlled clinical trials o$ acupuncture therap , as reported in the current literature, with a view to strengthening and promoting the appropriate use o$ acupuncture in health care s stems throughout the world% In$ormation on the therapeutic mechanisms o$ acupuncture has also been incorporated% &ince the methodolog o$ clinical research on acupuncture is still under debate, it is ver di$$icult to evaluate acupuncture practice b an generall accepted measure% This review is limited to controlled clinical trials that were published up to !""; <and earl !""" $or some .ournals=, in the hope that the conclusions will prove more acceptable% &uch trials have onl been per$ormed $or a limited number o$ diseases or disorders% This should not be taken to mean, however, that acupuncture treatment o$ diseases or disorders not mentioned here is excluded%

U$ o% !& 'ub("ca!"on
This publication is intended to $acilitate research on and the evaluation and application o$ acupuncture% It is hoped that it will provide a use$ul resource $or researchers, health care providers, national health authorities and the general public% It must be emphasized that the list o$ diseases, s mptoms or conditions covered here is based on collected reports o$ clinical trials, using the descriptions given in those reports% Onl national health authorities can determine the diseases, s mptoms and conditions $or which acupuncture treatment can be recommended% The data in the reports anal sed were not alwa s clearl recorded% We have made ever e$$ort to interpret them accuratel , in some cases maintaining the original wording in the text and summar table presented here% 3esearch on traditional medicine, including acupuncture is b no means eas % However, researchers should be encouraged to ensure the highest possible standards o$ stud design and reporting in $uture research in order to improve the evidence base in this $ield%

Dr )"aoru" *&ang
Acting Coordinator Traditional ,edicine <T3,= 'epartment o$ 0ssential 'rugs and ,edicines ?olic <0',= World Health Organization

!% 1eneral considerations

1. General considerations

+,+ D %"n"!"on
Acupuncture literall means to puncture with a needle% However, the application o$ needles is o$ten used in combination with moxibustionEthe burning on or over the skin o$ selected herbsEand ma also involve the application o$ other kinds o$ stimulation to certain points% In this publication the term AacupunctureB is used in its broad sense to include traditional bod needling, moxibustion, electric acupuncture <electro) acupuncture=, laser acupuncture <photo)acupuncture=, micros stem acupuncture such as ear <auricular=, $ace, hand and scalp acupuncture, and acupressure <the application o$ pressure at selected sites=%

+,- N d %or #a(ua!"on


Acupuncture originated in China man centuries ago and soon spread to >apan, the Forean peninsula and elsewhere in Asia% Acupuncture is widel used in health care s stems in the countries o$ this regionG it is o$$iciall recognized b governments and well received b the general public% Although acupuncture was introduced to 0urope as long ago as the earl seventeenth centur , scepticism about its e$$ectiveness continues to exist in countries where modern Western medicine is the $oundation o$ health care, especiall in those where acupuncture has not et been widel practised% ?eople @uestion whether acupuncture has a true therapeutic e$$ect, or whether it works merel through the placebo e$$ect, the power o$ suggestion, or the enthusiasm with which patients wish $or a cure% There is there$ore a need $or scienti$ic studies that evaluate the e$$ectiveness o$ acupuncture under controlled clinical conditions% This publication reviews selected studies on controlled clinical trials% &ome o$ these studies have provided incontrovertible scienti$ic evidence that acupuncture is more success$ul than placebo treatments in certain conditions% *or example, the proportion o$ chronic pain relieved b acupuncture is generall in the range 99H;9I, which compares $avourabl with that o$ potent drugs <morphine helps in :7I o$ cases= and $ar outweighs the placebo e$$ect <67H69I= < 13=% In addition, the mechanisms o$ acupuncture analgesia have been studied extensivel since the late !":7s, revealing the role o$ neural and humoral $actors%

+,. E#a(ua!"on / !&odo(og0


/nlike the evaluation o$ a new drug, controlled clinical trials o$ acupuncture are extremel di$$icult to conduct, particularl i$ the have to be blind in design and the acupuncture has to be compared with a placebo% Jarious AshamB or AplaceboB acupuncture procedures have been designed, but the are not eas to per$orm in countries such as China where acupuncture is widel used% In these countries, most patients know a great deal about acupuncture, including the special sensation that should be $elt a$ter insertion or during manipulation o$ the needle% ,oreover, acupuncturists consider these procedures unethical because the are alread convinced that acupuncture is e$$ective% In
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AcupunctureD review and anal sis o$ controlled clinical trials $act, most o$ the placebo)controlled clinical trials have been undertaken in countries where there is scepticism about acupuncture, as well as considerable interest% A more practical wa to evaluate the therapeutic e$$ect o$ acupuncture is to compare it with the e$$ect o$ conventional therap through randomized controlled trials or group studies, provided that the disease conditions be$ore treatment are comparable across the groups, with outcome studies developed $or all patients% -ecause o$ the di$$icult o$ ruling out the placebo e$$ect, a comparative stud with no treatment as the control ma not be convincing in the evaluation o$ acupuncture practice% 3etrospective surve s, in which the e$$ect o$ acupuncture therap is compared with past treatments, ma not be o$ signi$icance either, particularl i$ the have not been well designed% 2on)comparative studies are certainl o$ little signi$icance, particularl when acupuncture is used $or the treatment o$ a sel$)limited disease% However, i$ rapid improvement can be achieved in the treatment o$ a long)standing, chronic disease, or i$ there is de$inite improvement in a disease that is generall recognized as intractable to conventional treatment, the e$$ect o$ acupuncture should be viewed in a more $avourable light, even when a well)designed, controlled stud has not been carried out% Another di$$icult in evaluating acupuncture practice is that the therapeutic e$$ect depends greatl on the pro$icienc o$ the acupuncturistsEtheir abilit and skill in selecting and locating the acupuncture points and in manipulating the needles% This ma partl explain the disparities or inconsistencies in the results reported b di$$erent authors, even when their studies were carried out on e@uall sound methodological bases% 0valuating acupuncture practice and arriving at generall accepted conclusions is no eas task, there$ore% While e$$ectiveness is doubtless o$ the utmost importance, other $actors, including sa$et , cost, availabilit and the condition o$ local health services must also be considered% 1iven the same e$$ectiveness, these other $actors ma lead to di$$erent evaluations o$ acupuncture in di$$erent countries and areas% However, conclusions are needed that appl to worldwide use, particularl $or countries and areas where proper development o$ acupuncture practice would bring a great deal o$ bene$it% 0valuations should not there$ore be con$ined to those diseases $or which modern conventional treatments are inade@uate or ine$$ective% -ecause o$ the success o$ surgical procedures carried out under acupuncture analgesia, the treatment o$ pain with acupuncture has been extensivel studied% *or other conditions o$ten treated with acupuncture, there are $ewer reports that have ade@uate methodolog %

+,1 Sa% !0
1enerall speaking, acupuncture treatment is sa$e i$ it is per$ormed properl b a well) trained practitioner% /nlike man drugs, it is non)toxic, and adverse reactions are minimal% This is probabl one o$ the chie$ reasons wh acupuncture is so popular in the treatment o$ chronic pain in man countries% As mentioned previousl , acupuncture is comparable with morphine preparations in its e$$ectiveness against chronic pain, but without the adverse e$$ects o$ morphine, such as dependenc % 0ven i$ the e$$ect o$ acupuncture therap is less potent than that o$ conventional treatments, acupuncture ma still be worth considering because o$ the toxicit or adverse e$$ects o$ conventional treatments% *or example, there are reports o$ controlled clinical trials showing that acupuncture is e$$ective in the treatment o$ rheumatoid arthritis < 46=, although not as potent as corticosteroids% -ecause, unlike corticosteroids, acupuncture treatment, does not cause serious side)e$$ects, it seems reasonable to use acupuncture $or treating this condition, despite the di$$erence in e$$ectiveness%

!% 1eneral considerations

+,2 A#a"(ab"("!0 and 'rac!"cab"("!0


The availabilit and practicabilit o$ acupuncture are also important $actors to consider% The advantages o$ acupuncture are that it is simple, convenient and has $ew contraindications% Although the success rate o$ acupuncture therap in treating kidne stones, $or example, is con$irmed b comparative studies with other therapies < 7=, it is b no means as high as that o$ surgical intervention% However, acupuncture treatment o$ kidne stones is still worth recommending because o$ its simplicit , which makes it more acceptable to patients% There are also instances where acupuncture is not more practicable than conventional therap % *or example, the e$$ectiveness o$ acupuncture treatment o$ acute bacillar d senter has been shown to be comparable with that o$ $urazolidone < 81 =, but this is o$ rather academic signi$icance because oral administration o$ $urazolidone or other antid senteric drugs is more convenient% The conditions o$ the health service in a given countr or area should also be considered in evaluating acupuncture practice% In developing countries, where medical personnel and medicines are still lacking, the need $or acupuncture ma be considerable and urgentG proper use o$ this simple and economic therap could bene$it a large number o$ patients% On the other hand, in developed countries, where the health s stem is well established, with sophisticated technolog , ade@uate personnel and a well)e@uipped in$rastructure, acupuncture might be considered to be o$ great value in onl a limited number o$ conditions% It could still serve as a valuable alternative treatment $or man diseases or conditions $or which modern conventional treatments are unsuccess$ul% It is also valuable in situations where the patient is $rightened o$ the potential risks or adverse e$$ects o$ modern conventional treatments% In $act, in some developed countries, the diseases $or which patients seek help $rom acupuncturists tend to be be ond the scope o$ orthodox medicine%

+,3 S!ud" $ on !& ra' u!"c / c&an"$/$


Clinical evaluations indicate whether the therap worksG research on the mechanisms involved indicates how it works and can also provide important in$ormation on e$$icac % Fnowing that acupuncture is e$$ective and wh makes the practitioner con$ident in its use, and also allows the techni@ue to be used in a more appropriate wa % The clinical evaluation ma precede studies on the mechanisms, or vice versa% *or acupuncture, in most instances the clinical e$$ect has been tested $irst% /se o$ the techni@ue ma then be $urther expanded on the basis o$ the results o$ research on the mechanisms% *or example, experimental studies o$ the e$$ect o$ acupuncture on white blood cells led to a success$ul trial o$ the treatment o$ leukopenia caused b chemotherap % To date, modern scienti$ic research studies have revealed the $ollowing actions o$ acupunctureD inducing analgesia protecting the bod against in$ections regulating various ph siological $unctions%

In realit , the $irst two actions can also be attributed to the regulation o$ ph siological $unctions% The therapeutic e$$ects o$ acupuncture are thus brought about through its regulator actions on various s stems, so that it can be regarded as a nonspeci$ic therap with a broad spectrum o$ indications, particularl help$ul in $unctional disorders%
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AcupunctureD review and anal sis o$ controlled clinical trials Although it is o$ten used as a s mptomatic treatment <$or pain, $or instance=, in man cases it actuall acts on one o$ the pathogenic links o$ a disease% Although di$$erent acupuncture points and manipulations ma have an e$$ect through di$$erent actions, the most important $actor that in$luences the direction o$ action is the condition o$ the patient% 2umerous examples reveal that the regulator action o$ acupuncture is bi)directional% Acupuncture lowers the blood pressure in patients with h pertension and elevates it in patients with h potensionG increases gastric secretion in patients with h poacidit , and decreases it in patients with h peracidit G and normalizes intestinal motilit under +)ra observation in patients with either spastic colitis or intestinal h potonia <11=% There$ore, acupuncture itsel$ seldom makes the condition worse% In most instances, the main danger o$ its inappropriate application is neglecting the proper conventional treatment% &ince its therapeutic actions are achieved b mobilization o$ the organismKs own potential, acupuncture does not produce adverse e$$ects, as do man drug therapies% *or example, when release o$ h drocortisone pla s an important role in the production o$ a therapeutic e$$ect, the doses o$ this substance released b acupuncture are small and $inel regulated, thereb avoiding the side)e$$ects o$ h drocortisone chemotherap <1!=% On the other handEand $or the same reasonEacupuncture has limitations% 0ven under conditions where acupuncture is indicated, it ma not work i$ the mobilization o$ the individualKs potential is not ade@uate $or recover %

+,4

S ( c!"on o% c("n"ca( !r"a( r 'or!$

In recent decades, numerous clinical trials have been reportedG however, onl $ormall published articles that meet one o$ the $ollowing criteria are included in this reviewD randomized controlled trials <mostl with sham acupuncture or conventional therap as control= with an ade@uate number o$ patients observedG nonrandomized controlled clinical trials <mostl group comparisons= with an ade@uate number o$ patients observed and comparable conditions in the various groups prior to treatment%

In man published placebo)controlled trials, sham acupuncture was carried out b needling at incorrect, theoreticall irrelevant sites% &uch a control reall onl o$$ers in$ormation about the most e$$ective sites o$ needling, not about the speci$ic e$$ects o$ acupuncture <13=% ?ositive results $rom such trials, which revealed that genuine acupuncture is superior to sham acupuncture with statistical signi$icance, provide evidence showing the e$$ectiveness o$ acupuncture treatment% On the other hand, negative results $rom such trials, in which both the genuine and sham acupuncture showed considerable therapeutic e$$ects with no signi$icant di$$erence between them, can hardl be taken as evidence negating the e$$ectiveness o$ acupuncture% In the latter case, especiall in treatment o$ pain, most authors could onl draw the conclusion that additional control studies were needed% There$ore, these reports are generall not included in this review% The reports are $irst reviewed b groups o$ conditions $or which acupuncture therap is given <section 4=% The clinical conditions covered have then been classi$ied into $our categories <section 6=D !% 'iseases, s mptoms or conditions $or which acupuncture has been provedE through controlled trialsEto be an e$$ective treatment% 4% 'iseases, s mptoms or conditions $or which the therapeutic e$$ect o$ acupuncture has been shown, but $or which $urther proo$ is needed%

!% 1eneral considerations 6% 'iseases, s mptoms or conditions $or which there are onl individual controlled trials reporting some therapeutic e$$ects, but $or which acupuncture is worth tr ing because treatment b conventional and other therapies is di$$icult% 8% 'iseases, s mptoms or conditions in which acupuncture ma be tried provided the practitioner has special modern medical knowledge and ade@uate monitoring e@uipment% &ection 8 provides a tabulated summar o$ the controlled clinical trials reviewed, giving in$ormation on the number o$ sub.ects, the stud design, the t pe o$ acupuncture applied, the controls used and the results obtained%

AcupunctureD review and anal sis o$ controlled clinical trials

4% 3eview o$ clinical trial reports

2. Review of clinical trial reports


-,+ Pa"n
The e$$ectiveness o$ acupuncture analgesia has alread been established in controlled clinical studies% As mentioned previousl , acupuncture analgesia works better than a placebo $or most kinds o$ pain, and its e$$ective rate in the treatment o$ chronic pain is comparable with that o$ morphine% In addition, numerous laborator studies have provided $urther evidence o$ the e$$icac o$ acupunctureKs analgesic action as well as an explanation o$ the mechanism involved% In $act, the excellent analgesic e$$ects o$ acupuncture have stimulated research on pain% -ecause o$ the side)e$$ects o$ long)term drug therap $or pain and the risks o$ dependence, acupuncture analgesia can be regarded as the method o$ choice $or treating man chronicall pain$ul conditions% The analgesic e$$ect o$ acupuncture has also been reported $or the relie$ o$ e e pain due to subcon.unctival in.ection <14=, local pain a$ter extubation in children < 1"=, and pain in thromboangiitis obliterans <16=%

-,+,+ 5 ad and %ac


The use o$ acupuncture $or treating chronic pain o$ the head and $ace has been studied extensivel % *or tension headache, migraine and other kinds o$ headache due to a variet o$ causes, acupuncture has per$ormed $avourabl in trials comparing it with standard therap , sham acupuncture, or mock transcutaneous electrical nerve stimulation <T02&= <17!7=% The results suggest that acupuncture could pla a signi$icant role in treating such conditions% Chronic $acial pain, including craniomandibular disorders o$ muscular origin, also responds well to acupuncture treatments < !831=% The e$$ect o$ acupuncture is comparable with that o$ stomatognathic treatments $or temporomandibular .oint pain and d s$unction% Acupuncture ma be use$ul as complementar therap $or this condition, as the two treatments probabl have a di$$erent basis o$ action < !, 3!=%

-,+,- Loco/o!or $0$! /


Chronicall pain$ul conditions o$ the locomotor s stem accompanied b restricted movements o$ the .oints are o$ten treated with acupuncture i$ surgical intervention is not necessar % Acupuncture not onl alleviates pain, it also reduces muscle spasm, thereb increasing mobilit % >oint damage o$ten results $rom muscle mal$unction, and man patients complain o$ arthralgia be$ore an changes are demonstrable b +)ra % In these cases, acupuncture ma bring about a permanent cure% Controlled studies on common diseases and conditions in this categor have been reported b di$$erent authors, with $avourable results $or acupuncture treatments compared with standard therap , dela ed) treatment controls, control needling, mock T02&, or other sham acupuncture techni@ues% The conditions concerned include cervical spond litis or neck pain due to other causes <3337=, periarthritis o$ the shoulder < 38, 3#= $ibrom algia <4 =, $asciitis <41=,
"

AcupunctureD review and anal sis o$ controlled clinical trials epicond litis <tennis elbow= <4!44=, low back pain <4"4#=, sciatica <" "3=, osteoarthritis with knee pain <"4"6=, and radicular and pseudoradicular pain s ndromes <"7=% In some reports, comparison was made between standard care and acupuncture as an ad.unct to standard care% The conclusion $rom one such randomized controlled trial was that acupuncture is an e$$ective and .udicious ad.unct to conventional care $or patients with osteoarthritis o$ the knee <"8=% 3heumatoid arthritis is a s stemic disease with extra)articular mani$estations in most patients% In this disease, d s$unction o$ the immune s stem pla s a ma.or role, which explains the extra)articular and articular $eatures% Acupuncture is bene$icial in the treatment o$ rheumatoid arthritis < 46=% While acupuncture ma not improve the damage that has been done to the .oints, success$ul pain relie$ has been veri$ied in the ma.orit o$ controlled studies <"8=% The action o$ acupuncture on in$lammation and the d s$unctional immune s stem is also bene$icial <", "#=%

-,+,. 6ou!
In a randomized controlled trial, blood)pricking acupuncture was compared with conventional medication <allopurinol=% The acupuncture group showed greater improvement than the allopurinol group% In addition, a similar reduction o$ uric acid levels in the blood and urine o$ both groups was noted < 6 =% ?lum)blossom needling <acupuncture using plum)blossom needles=, together with cupping <the application to the skin o$ cups which are then depressurized=, has been recommended $or treating gout arthritis <61=%

-,+,1 B"("ar0 and r na( co("c


Acupuncture is suitable $or treating acute pain, provided the relie$ o$ pain will not mask the correct diagnosis, $or which other treatments ma be needed% -iliar and renal colic are two conditions $or which acupuncture can be used not onl as an analgesic but also as an antispasmodic% In controlled studies on biliar colic < 6!64= and renal colic <7$ 6"$ 66=, acupuncture appears to have advantages over conventional drug treatments <such as intramuscular in.ection o$ atropine, pethidine, anisodamine <a Chinese medicine structurall related to atropine, isolated $rom %nisod&s tang&tic&s=, bucinnazine <also known as bucinperazine= or a metamizoleHcam lo$in combination=% It provides a better analgesic e$$ect in a shorter time, without side)e$$ects% In addition, acupuncture is e$$ective $or relieving abdominal colic, whether it occurs in acute gastroenteritis or is due to gastrointestinal spasm <67=%

-,+,2 Trau/a!"c or 'o$!o' ra!"# 'a"n


*or traumas such as sprains, acupuncture is not onl use$ul $or relieving pain without the risk o$ drug dependence, but ma also hasten recover b improving local circulation <687 =% Acupuncture analgesia to relieve postoperative pain is well recognized and has been con$irmed in controlled studies < 7176=% The $irst success$ul operation under acupuncture analgesia was a tonsillectom % This was, in $act, inspired b the success o$ acupuncture in relieving post)tonsillectom pain% ?ost)tonsillectom acupuncture was re) evaluated in a controlled stud in !""7, which not onl showed prompt alleviation o$ throat pain, but also reduction in salivation and promotion o$ healing in the operative wound <76=%

!7

4% 3eview o$ clinical trial reports

-,+,3 D n!"$!r0
Acupuncture has been widel used in dentistr % There are reports o$ randomized controlled trials on the analgesic e$$ect o$ acupuncture $or postoperative pain $rom various dental procedures, including tooth extraction < 7778', pulp devitalization <7#=, and acute apical periodontitis <8 =% According to a s stematic review o$ papers on the use o$ acupuncture in dentistr published between !"## and !""#, !! out o$ !9 randomized controlled studies with blind controls, appropriate statistics and su$$icient $ollow)up showed standard acupuncture to be more e$$ective than a placebo or sham acupuncture% It was there$ore concluded that acupuncture should be considered a reasonable alternative or supplement to current dental practice as an analgesic < 81=% Its use in the treatment o$ temporomandibular d s$unction was also supported in these studies%

-,+,4 C&"(db"r!&
In childbirth, acupuncture analgesia is use$ul $or relieving labour pain and can signi$icantl reduce the duration o$ labour < 8!=% In the case o$ weakened uterine contractions, acupuncture increases the activit o$ the uterus% 0pisiotom and subse@uent suturing o$ the perineum can also be carried out with acupuncture analgesia% In addition, the avoidance o$ narcotics is advantageous $or newborn in$ants%

-,+,7 Surg r0
Acupuncture analgesia has the $ollowing advantages in surgical operations% It is a ver sa$e procedure compared with drug anaesthesiaG no death has ever been reported $rom acupuncture analgesia% There is no adverse e$$ect on ph siological $unctions, whereas general anaesthesia o$ten inter$eres with respiration and blood pressure, $or example% There are $ewer o$ the postoperative complications that sometimes occur a$ter general anaesthesia, such as nausea, urinar retention, constipation, and respirator in$ections% The patient remains conscious and able to talk with the medical team during the operation so that in.ur o$ the $acial and recurrent lar ngeal nerve can be avoided% However, remaining conscious ma be a disadvantage i$ the patient cannot tolerate the emotional stress o$ the procedure% While the bene$its o$ acupuncture analgesia are man , the disadvantages must also be considered% The use o$ acupuncture is more time)consuming and in man cases ma $ail to bring about complete analgesia% It is o$ten not suitable $or abdominal surger because suppression o$ visceral pain and muscle relaxation ma be inade@uate% It is not suitable in children because $ew children will tolerate the needling and keep still during ma.or surger % Also, the surgeon must be @uick and de$t, so that the operation can be $inished be$ore the patient develops tolerance to the needling% In conclusion, acupuncture analgesia as an anaesthetic $or surgical procedures is indicated in selected patients who show a good response to needling in the preoperative trial, particularl when the ma be a poor surgical risk under conventional general anaesthesia% The use o$ ad.uvant drugs to potentiate the e$$ect o$ the acupuncture treatment is pre$erred% Acupuncture can also be used in combination with general anaesthesia to reduce the dosage o$ anaesthetic agents < 83=%

-,-

In% c!"on$

Acupuncture has been reported to be e$$ective $or treating acute bacillar d senter < 8 1 =% Its e$$ect is comparable with that o$ conventional medicines such as $urazolidone, but the use o$ acupuncture in the $irst line o$ de$ence against this disease is not practicableE
!!

AcupunctureD review and anal sis o$ controlled clinical trials dail per$ormance o$ needling procedures is much more complicated than administering oral drug therap % However, when no antid senteric agent is available or the patient is allergic to antid senteric agents, acupuncture ma occasionall be used% The results o$ research on the e$$ects o$ acupuncture treatments that stimulate the immune s stem suggest that acupuncture ma be o$ use in con.unction with other medical therapies $or treating in$ections <84=% The e$$ect o$ acupuncture on the immune s stem has been tested in hepatitis - virus carriers% In a comparative stud , acupunctureHmoxibustion is apparentl superior to herbal medications in producing hepatitis - e core antibodies and reducing hepatitis sur$ace antigen <8"=% *or epidemic haemorrhagic $ever, compared with steroid and supportive treatments, moxibustion shortened the period o$ oliguria and promoted the reduction o$ kidne swelling <86=% Acupuncture ma be use$ul in treating pertussis <whooping cough=, b relieving cough as well as promoting a cure <87=%

-,.

N uro(og"ca( d"$ord r$

In the neurological $ield, headaches, migraines and neuralgia are the common pain$ul conditions treated with acupuncture% &trokes and their se@uelae are another ma.or indication $or acupuncture% 0arl treatment o$ paresis a$ter stroke has proved highl e$$ective% -ecause improvement in the e$$ects o$ stroke also occurs naturall , there has been some doubt about the contribution o$ acupuncture% In recent ears, however, a number o$ controlled clinical evaluations have been undertaken in stroke patients% *or example, in randomized controlled studies, acupuncture treatment o$ hemiplegia due to cerebral in$arction gave better results than conventional medication < 88#3= and ph siotherap <#4$ #"=% There were also bene$icial e$$ects when acupuncture was used as a complement to rehabilitation <#6#8'% In one stud , patients with ischaemic cerebrovascular disease treated with acupuncture were compared with patients treated with conventional drugs% 2erve $unction, as evaluated b electroencephalographic map and somatosensor evoked potential, showed a much more marked improvement in the patients treated with acupuncture < 8#=% This has been $urther con$irmed b experimental studies% In the laborator , a rat model o$ reversible middle cerebral arter occlusion was used% The somatosensor evoked potential recorded be$ore and a$ter the occlusion showed that electric acupuncture markedl promoted the recover o$ the amplitude o$ the ?!H2! wave <to 9;%#I in the electric acupuncture group in contrast to 49%9I in the control group a$ter : da s= < #3=% In addition, recent clinical studies suggest that the e$$ectiveness o$ acupuncture therap can be $urther promoted b using temporal acupuncture < ##$ 1 =% Comparative studies have shown acupuncture treatments to be as e$$ective $or treating hemiplegia due to cerebral haemorrhage as $or that due to cerebral in$arction% &ince earl treatment with ph siotherap is unsatis$actor , it is advisable to use acupuncture as the primar treatment% 0ven in hemiplegia o$ long duration, remarkable improvements can o$ten be achieved% Hemiplegia due to other causes, such as brain surger , can also be improved b acupuncture <1 1=% Aphasia caused b acute cerebrovascular disorders can also be treated with acupuncture <1 !=% Although acupuncture is e$$ective $or man pain$ul conditions, there are onl a $ew reports on post)herpetic neuralgia% Two o$ them were based on randomized clinical trials and provided completel opposite results < 1 3, 1 4=% 0valuation o$ acupuncture in the treatment o$ this pain$ul condition there$ore awaits $urther stud %
!4

4% 3eview o$ clinical trial reports ?eripheral nervous disorders are o$ten treated with acupuncture% *or example, good e$$ects $or -ellKs pals have been reported in randomized controlled trials < 1 ", 1 6=% *acial spasm is another peripheral nervous disorder $or which acupuncture treatment ma be indicated% *or this condition it has been shown that wristHankle acupuncture is signi$icantl better than traditional bod acupuncture <1 7=% Coma is a serious condition that can hardl be cured b acupuncture alone, but in a comparative stud o$ two groups o$ patients with similar levels o$ coma, a signi$icantl greater number o$ patients in the acupuncture group had a 97I or greater neurological recover than those in the control group% This suggests that it is reasonable to incorporate acupuncture along with other therapeutic and supportive measures in the treatment o$ the comatose patient <1 8=% Insomnia can also be treated success$ull with acupuncture% In randomized control trials, both auricular acupressure and auricular acupuncture had a h pnotic e$$ect < 1 #$ 11 '%

-,1 R $'"ra!or0 d"$ord r$


Acupuncture is o$ten used in treating respirator disorders% Allergic rhinitis is one o$ the ma.or indications% In controlled studies, it has been shown that acupuncture is more e$$ective than antihistamine drugs in the treatment o$ allergic rhinitis < 11111"=% AcupunctureKs lack o$ side)e$$ects is a distinct advantage in treating this conditionG however, its protective e$$ect against allergen)provoked rhinitis has not been veri$ied <116=% The acute s mptoms o$ tonsillitis can be e$$ectivel relieved with acupuncture < 117=% &ince there is no in$ormation about the incidence o$ complications secondar to tonsillitis treated with acupuncture, in clinical practice antibiotic therap should still be considered the treatment o$ choice $or acute tonsillitis% *or sore throats $rom other causes, acupuncture treatment provides de$inite bene$its, in contrast to a placebo and acupuncture re$usal <118=% Although there are con$licting results $rom controlled trials in treating bronchial asthma with acupuncture, the ma.orit o$ the reports suggest that acupuncture is e$$ective < 11# 1!3= and that the e$$ect is related to the points used < 1!!=% While bronchial asthma is not cured b acupuncture, it ma be substantiall relieved, at least $or short periods o$ time% The success rates @uoted in the literature are #7H:7I% Acupuncture has a limited role in treating acute asthmatic attacks since it is a weak bronchodilator, but it ma serve as a proph lactic measure over the long term% Controlled trials have shown that acupuncture brings about modest improvement in ob.ective parameters, with signi$icant sub.ective improvement <1!4=% ?rospective randomized single)blind studies o$ the e$$ects o$ real and sham acupuncture on exercise)induced and metacholine)induced asthma revealed that real acupuncture provided better protection than did sham acupuncture < 11#=, but it $ailed to modulate the bronchial h perreactivit to histamine < 1!"=% Corticosteroid)dependent bronchial asthma ma respond better to acupuncture treatment than other t pesD the re@uired dosage o$ corticosteroids graduall decreases during the $irst weeks o$ acupuncture treatment <1!6=% Acupuncture ma also provide s mptomatic improvement in the late stages o$ bronchial asthma, where there are complications o$ disabling breathlessness due to impaired lung $unction <1!7=%

-,2 D"g $!"# d"$ord r$


0pigastric pain is a common s mptom in diseases o$ the stomach, including peptic ulcer, acute and chronic gastritis, and gastric spasm% Acupuncture provides satis$actor relie$ o$
!6

AcupunctureD review and anal sis o$ controlled clinical trials epigastric painEsigni$icantl better than in.ections o$ anisodamine or morphine plus atropine8 as shown in randomized controlled trials < 1!8$ 1!#=% *or gastrointestinal spasm, acupuncture is also superior to in.ections o$ atropine < 13 =, and $or gastrokinetic disturbances, the e$$ectiveness o$ acupuncture is comparable with that o$ conventional medicine <domperidone= <131'% Another common s mptom o$ digestive disorders is nausea and vomiting% This can be due to a disordered $unction o$ the stomach, but it is more o$ten a s mptom or sign o$ generalized disorders% ,orning sickness, postoperative vomiting, and nausea and vomiting related to chemotherap are $re@uentl encountered clinicall % In all these conditions, acupuncture at point n(ig&)n <?C#= seems to have a speci$ic antiemetic e$$ect% A recent s stematic review o$ trials using acupuncture $or antiemesis showed that !! o$ !4 randomized placebo)controlled trials, involving nearl 4777 patients, supported this e$$ect% The reviewed papers showed consistent results across di$$erent investigators, di$$erent groups o$ patients, and di$$erent $orms o$ acupuncture stimulation < 13!=% Irritable colon s ndrome and chronic ulcerative colitis are o$ten di$$icult to treat with conventional medication% *or these diseases, acupuncture ma serve as a complementar or alternative therapeutic measure <133$ 134=% -ecause o$ its analgesic e$$ect, acupuncture can be used in endoscopic examinations, e%g% in colonoscop % It has been reported that the e$$ect o$ acupuncture to relieve pain and discom$ort during the examination is comparable with that o$ scopolamine or pethidine with $ewer side)e$$ects <13"$ 136=% There has been extensive research on the e$$ect o$ acupuncture on the digestive s stem, with extensive data showing its in$luence on the ph siolog o$ the gastrointestinal tract, including acid secretion, motilit , neurohormonal changes and changes in sensor thresholds% ,an o$ the neuroanatomic pathwa s o$ these e$$ects have been identi$ied in animal models <137=% Acupuncture shows good analgesic and antispasmodic e$$ects on the biliar tract and, as indicated previousl , can be recommended $or treatment o$ biliar colic < 6!64=% It also has a cholagogic action, which has been demonstrated in experimental studies% In the treatment o$ biliar colic due to gallstones, acupuncture is not onl e$$ective $or relieving the colick pain, but is also use$ul $or expelling the stones% &atis$actor results were reported when electric acupuncture was used in combination with oral administration o$ magnesium sul$ate <138=% Acupuncture treatment is also worth tr ing $or chronic cholec stitis, even i$ there is acute exacerbation < 13#=%

-,3 B(ood d"$ord r$


Among various blood disorders, leukopenia is the most suitable $or acupuncture treatment% In controlled studies, acupuncture has been shown to be more e$$ective than batilol andCor c steine phen lacetate in the treatment o$ leukopenia due to chemotherap <14 14!= or benzene intoxication <143$ 144'%

-,4 Urog n"!a( d"$ord r$


/rinar retention due to $unctional disorders, with no organic obstruction, is o$ten treated with acupuncture% *or postpartum or postoperative urinar retention, success$ul micturition usuall occurs immediatel a$ter one session o$ needling < 66$ 14"=% It is probabl $or this reason that controlled studies on this sub.ect have been neglected% However, there has been a report o$ a randomized controlled trial on traumatic retention o$ urine, a condition more complicated than postpartum or postoperative retention% In this
!8

4% 3eview o$ clinical trial reports trial, the e$$icac o$ acupuncture was remarkabl in.ection o$ neostigmine bromide<146=% superior to that o$ intramuscular

Acupuncture is not onl use$ul $or relieving renal colic, but also $or expelling urinar stones <i$ the are not too large=, because it dilates the ureter% &atis$actor results have been obtained in comparisons with conventional medication < 7=, but it is better to use acupuncture as a complementar measure in con.unction with medication or lithotrips % &exual disorders are o$ten treated with acupuncture, but conclusive results based on methodologicall sound clinical studies are still lacking% Acupuncture was shown to be more e$$ective than placebo in the treatment o$ non)organic male sexual d s$unction, but the improvement was not statisticall signi$icant < 147=% In another randomized controlled trial, acupuncture had a better e$$ect than the control in the treatment o$ de$ective e.aculation <no e.aculation during intercourse= <148'% Acupuncture ma also be help$ul to patients with chronic prostatitis% As shown in a randomized controlled trial, acupuncture was superior to oral sul$amethoxazole in relieving s mptoms and improving sexual $unction <14#=% In women, it has been shown that acupuncture can lower urethral pressure and relieve urethral s ndrome <1" $ 1"1=% Acupuncture has also been success$ull used as a proph laxis against recurrent lower urinar tract in$ections < 1"!=%

-,7 60na co(og"ca( and ob$! !r"c d"$ord r$


?rimar d smenorrhoea, a pain$ul condition, is one o$ the ma.or indications $or acupuncture in the $ield o$ g naecological disorders% The bene$icial e$$ect o$ acupuncture on this condition has been repeatedl reported in controlled trials < 1"3$ 1"4'% Acupuncture relieves pain and also regulates the motilit o$ the uterus to $acilitate menstrual discharge and $urther alleviate the pain% ?remenstrual s ndrome is characterized b c clical mood changes and is a common condition in women o$ $ertile age% Acupuncture seems to be help$ul to patients with this s ndrome% In a controlled stud , the ma.orit o$ the patients receiving acupuncture gained relie$ $rom s mptoms and no recurrence in the six)month $ollow)up < 1""=% Although acupuncture was reported to be e$$ective in the treatment o$ $emale anovular in$ertilit <1"6=, no methodologicall sound, controlled trials have been reported% However, the mechanism o$ acupuncture in regulating abnormal $unction o$ the h pothalamicHpituitar Hovarian axis has been demonstrated in experimental studies% The data suggest that electric acupuncture with relative speci$icit o$ acupuncture points could in$luence some genetic expression in the brain, thereb normalizing the secretion o$ certain hormones, such as gonadotropin)releasing hormone, luteinizing hormone and estradiol <1"7=% Acupuncture is also worth tr ing in the treatment o$ $emale in$ertilit due to in$lammator obstruction o$ the $allopian tubes, where it seems to be superior to conventional therap with intrauterine in.ection o$ gentamicin, ch motr psin and dexamethasone <1"8=% Acupuncture in pregnant women should be undertaken with care% 2eedling at some points <namel , on the abdomen and lumbosacral region=, as well as strong stimulation o$ certain distant points, such as h*g+ <5I8=, s)ny,n-i)o <&?#= and .h/y,n <-5#:=, ma cause miscarriage% However, this action is use$ul i$ induction o$ labour is desired, such as in prolonged pregnanc G the e$$ect is comparable with that o$ ox tocin b intravenous drip <1"#161=% In earl pregnanc , acupuncture at the upper limb points can be used $or the prevention and treatment o$ morning sickness% The e$$icac o$ acupressure at n(ig&)n <?C#= has been reported repeatedl in placebo)controlled studies < 13$ 16!$ 163'% In order to prevent
!9

AcupunctureD review and anal sis o$ controlled clinical trials miscarriage induced b morning sickness% needling, acupressure is recommended $or the treatment o$

Jarious methods o$ acupuncture, such as pressure at ear points and moxibustion at .h/y,n <-5#:= or .0l1n21 <1-8!=, have been used to correct abnormal $etal position during the last three months o$ pregnanc % The success rates in groups treated with these methods were much higher than the occurrence o$ spontaneous version or in groups treated with knee)chest position or moxibustion at non)classical points < 164167=% Acupuncture stimulates milk secretion a$ter childbirth and can be used to treat de$icient lactation due to mental labilit or depression% It has been observed that acupuncture elevates the blood prolactin level in women with de$icient milk secretion a$ter childbirthG in the ma.orit o$ cases, lactation starts as the blood prolactin level increases < 168=% The clinical use o$ acupuncture to promote lactation has also been demonstrated in a randomized controlled stud <16#=%

-,9 Card"o#a$cu(ar d"$ord r$


Acupuncture is suitable $or treating primar h potension <17 $ 171= and earl essential h pertension <17!176=% It has been reported that the in$luence o$ acupuncture on h pertension might be related to its regulator e$$ect on the level o$ serum nitrogen monoxide <177=% *or primar h potension, acupuncture seems to be more e$$ective than general tonics% *or mild and moderate essential h pertension, the h potensive e$$ect o$ acupuncture is much more potent than that o$ placebos and is comparable with that o$ certain conventional h potensive agents% In addition, acupuncture is o$ten e$$ective $or relieving sub.ective s mptoms, and it has no side)e$$ects% 0ncouraging results have been reported $or a number o$ controlled studies on the treatment o$ heart disease with acupuncture, particularl in ps chosomatic heart disorders, such as cardiac neurosis <178=% In coronar heart disease, acupuncture has been shown b various authors to be e$$ective in relieving angina pectoris% Its bene$icial in$luence has been demonstrated during coronar arteriograph % Cardiological, neuroph siological and ps chological observations, made in mutuall independent studies, indicated that acupuncture improved the working capacit o$ the heart in patients with angina pectoris and activated autoregulator cardiovascular mechanisms in health persons <17#=% In controlled studies, acupuncture has provided signi$icantl greater improvement in s mptoms and cardiac work capacit than either placebo < 18 18!= or conventional medication, such as gl cer l trinitrate < 183$ 184=% 'ilation o$ the coronar arter during acupuncture has been shown to be comparable with that observed during intracatheter in.ection o$ isosorbide dinitrate < 18"=% In addition, acupuncture has a bene$icial e$$ect on the le$t ventricular $unction o$ patients with coronar heart disease, and is also more e$$ective than ni$edipine and isosorbide dinitrate < 186=% 3(ig&)n <?C#= is the point most commonl used $or treating cardiac disorders% The bene$icial e$$ect o$ acupuncture at this point has been demonstrated b serial e@uilibrium radionuclide angiograph <187=% Acupuncture also produces haemorrheological improvement <188=% In order to avoid unexpected accidents, however, special attention should be paid to the treatment o$ heart disease% Acupuncturists must be able to di$$erentiate between angina pectoris and acute m ocardial in$arction%

-,+: P$0c&"a!r"c d"$ord r$ and / n!a( d"$!urbanc $


Acupuncture is being increasingl used in ps chiatric disorders% The e$$ect o$ acupuncture on depression <including depressive neurosis and depression $ollowing
!#

4% 3eview o$ clinical trial reports stroke= has been documented repeatedl in controlled studies < 18#1#4'% Acupuncture is comparable with amitript line in the treatment o$ depression but has $ewer side)e$$ects% In addition, acupuncture has been $ound to be more e$$ective in depressive patients with decreased excretion o$ 6)meth l)8)h drox )phen lgl col <the principal metabolite o$ the central neurotransmitter norepinephrine=, while amitript line is more e$$ective $or those with inhibition in the dexamethasone suppression test < 1#!=% This suggests that these two therapies work through di$$erent mechanisms% There have also been reports that, in controlled trials o$ schizophrenia treatment, acupuncture might have a better e$$ect than chlorpromazine <1#4$ 1#"=% Acupuncture <auricular acupressure= is much more e$$ective than ps chotherap in the treatment o$ competition stress s ndrome, and is worth $urther stud < 1#6=% The possible use o$ auricular acupuncture as a treatment $or opium dependence was $irst noted in !":6 <1#7=% It was $ound that some o$ the patients whose postoperative pain was relieved b acupuncture were hiding a dependence on opium% In !":", a stud carried out .ointl in Hong Fong and 5ondon showed that endorphin concentrations were raised b acupuncture in heroin)dependent persons, resulting in success$ul suppression o$ withdrawal s mptoms% &ince then, acupuncture has been used to treat dependence on a variet o$ substances% ,an substance)abuse programmes use acupuncture as an ad.unct to conventional treatment <1#8=% ,ost o$ the reports are anecdotal, and while there have been several controlled trials <1##! !=, the $indings have not been consistent% This entire $ield o$ research is still at an earl stage, holding some promise, but re@uiring larger)scale and more demanding research studies <1#8=% Acupuncture treatment has also been used in patients who wish to give up smoking% The conclusions o$ di$$erent researchers are con$licting, however% &ome $avour acupuncture, while others dismiss its value <! 3! 7=% ?robabl the most convincing results are $rom randomized controlled trials o$ passive abstinence, with no suggestion or motivation to stop smoking% The patients were told the would receive acupuncture $or other purposes, and the were not asked to stop smoking% A comparison o$ the e$$ects o$ auricular acupuncture and bod acupuncture was madeD :7I o$ the auricular)acupuncture patients and !!I o$ those receiving bod acupuncture either abstained totall $rom smoking or reduced the amount o$ consumption b hal$% In addition, :4I o$ the auricular) acupuncture patients experienced disgust at the taste o$ tobacco < ! 4=% However, in contrast, a meta)anal sis o$ seven reports care$ull selected $rom !# controlled studies o$ smoking cessation indicated that acupuncture did not have an greater e$$ect than the placebo <! 8=% Acupuncture has also been reported to be use$ul $or treating alcohol recidivism% In placebo)controlled trials <with acupuncture at nonspeci$ic points as the control=, the patients in the treatment group expressed less need $or alcohol than did the control patients% ?atients in the treatment group also had $ewer drinking episodes and admissions to a detoxi$ication centre <! #!11=% It is interesting to note that in an experimental stud on health volunteers, acupuncture diminished clinical alcohol intoxication b increasing the alcohol level in expired air and decreasing blood alcohol levels < !1!=%

-,++ Pa d"a!r"c d"$ord r$


'iarrhoea in in$ants and oung children is still a daunting problem worldwide, particularl in developing countries% Acupuncture seems to be worth using, at least as an ad.unct to conventional treatments, because it regulates intestinal $unction and enhances immune response without causing an imbalance in the intestinal $lora as do antibiotics <!13$ !14=%

!:

AcupunctureD review and anal sis o$ controlled clinical trials Convulsions due to high $ever are not in$re@uentl encountered in in$ants and oung children% In a controlled clinical trial, convulsions stopped two minutes a$ter needling was started, a result superior to that o$ intramuscular phenobarbital in.ection < !1"=% Although the speci$ic treatment $or pertussis is antimicrobials, the parox smal coughing is usuall ver distressing% There has been a report that acupuncture could hasten the cure as well as relieving the cough <87=% There are two controlled studies indicating that acupuncture ma be o$ some help in the treatment o$ Tourette s ndrome in children < !16$ !17=%

-,+- D"$ord r$ o% !& $ n$ organ$


'ea$)mute children were once extensivel treated with acupuncture in China, but no methodologicall sound reports have ever shown that acupuncture therap had an real e$$ectiveness% A recent randomized controlled clinical trial on sudden)onset dea$ness in adults $avoured acupuncture treatment <!18=% Acupuncture might be use$ul in the treatment o$ ,LniMre disease $or relieving s mptoms and also $or reducing the $re@uenc o$ attacks% It seems to be more e$$ective than conventional drug therap <betahistine, nicotinic acid and vitamin - #= <!1#=% Tinnitus is o$ten di$$icult to treat% Traditionall acupunture has been believed to be e$$ective $or treating tinnitus, but onl two randomized controlled clinical trials are availableEwith inconsistent results <!! , !!1=% /nexplained earache that is neither primar <due to ear disease= nor secondar <as re$erred pain=, is o$ten regarded as a mani$estation o$ ps chogenic disturbances% Acupuncture has been shown to be e$$ective in this kind o$ earache in a placebo) controlled trial <!!!=% Acupuncture might be help$ul in the treatment o$ simple epistaxis unassociated with generalized or local disease, but onl one report o$ a randomized controlled clinical trial is available% This report indicates that auricular acupuncture provides a more satis$actor e$$ect than conventional haemostatic medication < !!3=%

-,+. Sk"n d"$ a$ $


In some countries, man skin diseases are customaril treated with acupuncture, but ver $ew controlled studies have been published% In a randomized controlled clinical trial on chloasma, acupuncture had a signi$icantl better e$$ect than vitamins C and 0 < !!4=% &ome evidence $avouring acupuncture treatment o$ herpes zoster <human <alpha= herpesvirus 6= has been reported% In a randomized controlled trial, laser acupuncture relieved pain and promoted $ormation o$ scar tissue much more @uickl than treatment with pol inosinic acid <!!"=% Acupuncture is known to have an antipruritic e$$ect% This has been shown experimentall in volunteers, suggesting that acupuncture could be used in clinical conditions associated with pruritus <!!6=% Acupuncture with dermal needles <seven)star or plum)blossom needles= has traditionall been used in the treatment o$ neurodermatitis, but con$irmation o$ its e$$ect in a controlled clinical trial was onl recentl reported < !!7=% *or the treatment o$ acne vulgaris, acupuncture, particularl ear acupuncture, is worth recommending i$ the reported therapeutic e$$ects can be $urther proved < !!8, !!#=%
!;

4% 3eview o$ clinical trial reports

-,+1 Canc r$
2o controlled stud has been reported on the e$$icac o$ acupuncture in the treatment o$ cancer itsel$% However, acupuncture still has uses in cancer treatments% One is to relieve cancer pain, and the other is to control the adverse reactions to radiotherap and chemotherap % *or cancer pain, it has been reported that acupuncture provided an immediate analgesic e$$ect similar to that o$ codeine and pethidine, with a more marked e$$ect a$ter use $or two months < !3 =% The e$$ect was comparable with that achieved using the analgesic steps recommended b WHO < !31=% *or radiotherap and chemotherap , acupuncture can greatl lessen the adverse reactions in the digestive and nervous s stems, as well as providing protection against damage to haematopoiesis < !3!!37=%

-,+2 O!& r r 'or!$


Obesit and h perlipaemia are becoming increasingl important medical issues% I$ acupuncture could help in reducing bod weight and blood lipids, its clinical use could be greatl expanded% Nuite a number o$ reports on this e$$ect have been published, but un$ortunatel , almost none o$ them is methodologicall sound% There are onl two preliminar reports o$ randomized controlled clinical trials that can be cited here < !38$ !3#=, although criticism o$ the stud design cannot be totall avoided% Acupuncture ma be o$ bene$it to patients with non)insulin)dependent diabetes mellitus% Its e$$icac has been shown to be superior to that o$ placebos and comparable with that o$ tolbutamide <!4 $ !41=% Anisodamine is e$$ective in treating excessive salivation induced b antips chotics=, but acupuncture seems to be more e$$ective < !4!=% drugs <usuall

There are also reports on the treatment o$ &.Ogren s ndrome <sicca s ndrome= < !43=, 3a naud s ndrome <!44=, &teinH5eventhal s ndrome <pol c stic ovar s ndrome= < !44=, and Tietze s ndrome <costochondritis= <!4"=, which indicate bene$icial e$$ects $rom acupuncture treatment% &ince these reports have appeared onl in individual papers, con$irmation b $urther stud is necessar %

!"

AcupunctureD review and anal sis o$ controlled clinical trials

47

6% 'isease and disorders that can be treated with acupuncture

3. Diseases and disorders that can e treated with acupuncture


The diseases or disorders $or which acupuncture therap has been tested in controlled clinical trials reported in the recent literature can be classi$ied into $our categories as shown below% +, D"$ a$ $8 $0/'!o/$ or cond"!"on$ %or ;&"c& acu'unc!ur &a$ b n 'ro# d< !&roug& con!ro(( d !r"a($<!o b an %% c!"# !r a!/ n!: Adverse reactions to radiotherap andCor chemotherap Allergic rhinitis <including ha $ever= -iliar colic 'epression <including depressive neurosis and depression $ollowing stroke= ' senter , acute bacillar ' smenorrhoea, primar 0pigastralgia, acute <in peptic ulcer, acute and chronic gastritis, and gastrospasm= *acial pain <including craniomandibular disorders= Headache H pertension, essential H potension, primar Induction o$ labour Fnee pain 5eukopenia 5ow back pain ,alposition o$ $etus, correction o$ ,orning sickness 2ausea and vomiting 2eck pain ?ain in dentistr <including dental pain and temporomandibular d s$unction= ?eriarthritis o$ shoulder ?ostoperative pain 3enal colic 3heumatoid arthritis &ciatica &prain
4!

AcupunctureD review and anal sis o$ controlled clinical trials &troke Tennis elbow -, D"$ a$ $8 $0/'!o/$ or cond"!"on$ %or ;&"c& !& !& ra' u!"c %% c! o% acu'unc!ur &a$ b n $&o;n bu! %or ;&"c& %ur!& r 'roo% "$ n d d: Abdominal pain <in acute gastroenteritis or due to gastrointestinal spasm= Acne vulgaris Alcohol dependence and detoxi$ication -ellKs pals -ronchial asthma Cancer pain Cardiac neurosis Cholec stitis, chronic, with acute exacerbation Cholelithiasis Competition stress s ndrome Craniocerebral in.ur , closed 'iabetes mellitus, non)insulin)dependent 0arache 0pidemic haemorrhagic $ever 0pistaxis, simple <without generalized or local disease= 0 e pain due to subcon.unctival in.ection *emale in$ertilit *acial spasm *emale urethral s ndrome *ibrom algia and $asciitis 1astrokinetic disturbance 1out arthritis Hepatitis - virus carrier status Herpes zoster <human <alpha= herpesvirus 6= H perlipaemia H po)ovarianism Insomnia 5abour pain 5actation, de$icienc ,ale sexual d s$unction, non)organic ,LniMre disease 2euralgia, post)herpetic 2eurodermatitis Obesit
44

6% 'isease and disorders that can be treated with acupuncture Opium, cocaine and heroin dependence Osteoarthritis ?ain due to endoscopic examination ?ain in thromboangiitis obliterans ?ol c stic ovar s ndrome <&teinH5eventhal s ndrome= ?ostextubation in children ?ostoperative convalescence ?remenstrual s ndrome ?rostatitis, chronic ?ruritus 3adicular and pseudoradicular pain s ndrome 3a naud s ndrome, primar 3ecurrent lower urinar )tract in$ection 3e$lex s mpathetic d stroph 3etention o$ urine, traumatic &chizophrenia &ialism, drug)induced &.Ogren s ndrome &ore throat <including tonsillitis= &pine pain, acute &ti$$ neck Temporomandibular .oint d s$unction Tietze s ndrome Tobacco dependence Tourette s ndrome /lcerative colitis, chronic /rolithiasis Jascular dementia Whooping cough <pertussis= ., D"$ a$ $8 $0/'!o/$ or cond"!"on$ %or ;&"c& !& r ar on(0 "nd"#"dua( con!ro(( d !r"a($ r 'or!"ng $o/ !& ra' u!"c %% c!$8 bu! %or ;&"c& acu'unc!ur "$ ;or!& !r0"ng b cau$ !r a!/ n! b0 con# n!"ona( and o!& r !& ra'" $ "$ d"%%"cu(!: Chloasma Choroidopath , central serous Colour blindness 'ea$ness H pophrenia
46

AcupunctureD review and anal sis o$ controlled clinical trials Irritable colon s ndrome 2europathic bladder in spinal cord in.ur ?ulmonar heart disease, chronic &mall airwa obstruction 1, D"$ a$ $8 $0/'!o/$ or cond"!"on$ %or ;&"c& acu'unc!ur /a0 b !r" d 'ro#"d d !& 'rac!"!"on r &a$ $' c"a( /od rn / d"ca( kno;( dg and ad =ua! /on"!or"ng =u"'/ n!: -reathlessness in chronic obstructive pulmonar disease Coma Convulsions in in$ants Coronar heart disease <angina pectoris= 'iarrhoea in in$ants and oung children 0ncephalitis, viral, in children, late stage ?aral sis, progressive bulbar and pseudobulbar

48

8% &ummar table o$ controlled clinical trials

!. "ummar# ta le of controlled clinical trials


This section provides a tabulated summar o$ all the controlled clinical trials reviewed $or this publication% *or each stud , in$ormation is provided on the author<s=, the ear o$ publication, the number o$ sub.ects involved, the stud design, the t pe o$ acupuncture applied, the controls used and the results obtained%

49

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#
(hu et al.3 1--+ 1672

%o.
2)42)

Design
,andomi5ed controlled trial

&est group
Bod& acu uncture 1manual2

Control Group
,outine 6estern medication 1intra7muscular atro ine and rometha5ine2

Results
,elief of ain was observed in4 2' of the test grou 3 starting 1." min after acu uncture 1+ of the control grou 3 starting 11. - min after injection. After "0 da&s of treatment3 a cure was observed in4 '2./: of the test grou 1-.0: of the control grou .

A dominal pain in acute gastroenteritis 1see also !astrointestinal s asm2

Acne vulgaris 8i et al.3 1--/ 12282 '24'2 ,andomi5ed controlled trial Bod& acu uncture 1manual2 9erbal medication

6ang et al.3 1--+ 12292

;edication 1oral vitamin B* and Acne disa eared after 10 da&s of treatment in4 antibiotics3 local ben5o&l 1-="2 1)-:2 in the test grou . ero<ide ointment2 +=20 1"):2 in the control grou . Adverse reactions to radiotherap# and$or chemotherap# 1see also 8euko enia 1this includes leuko enia caused b& chemothera &2> $ausea and vomiting2 ?ia et al.3 1-/' 12372 '-420 ,andomi5ed controlled Acu uncture during ,adiothera & Acu uncture greatl& lessened digestive and nervous trial radiothera & s&stem reactions 1anore<ia3 nausea3 vomiting3 di55iness3 and fatigue2 due to radiothera & and showed rotection against damage to haemato oiesis. Chen et al.3 1--* (2322 ''42" ,andomi5ed controlled trial ;anual lus electric acu uncture 6estern medication 1metoclo ramide3 etc.2 !astrointestinal reactions were cured in significantl& more of the acu uncture grou 4 -".2: of test grou after )./ @ 2.+ da&s of treatment *).2: of control grou after -.' @ ".' da&s of treatment. Acu oint stimulation thera & was com arable with intravenous metoclo ramide for gastrointestinal reactions3 and with de<amethasone and c&steine hen&lacetate 1leucogen2 for leuko enia. Ahe treatment was effective in4 /+.): of the test grou +).0: of the control grou . Ahe treatment was effective in4 /).*: of the test grou *1.1: of the control grou .

"2420

!rou com arison

Auricular acu uncture

8iu et al.3 1--/ 12352

'04'0

!rou com arison

;agnetic lus electric acu oint stimulation

6estern medication 1metoclo ramide3 etc.2

6ang et al.3 1--+ 12362

-0

,andomi5ed crossover stud&

Bod& acu uncture 1manual2

6estern medication 1metoclo ramide2

4#

8% &ummar table o$ controlled clinical trials

Condition$"tud#
8i et al.3 1--/ 12342

%o.
22420

Design
,andomi5ed controlled trial

&est group
Bod& acu uncture 1manual2

Control Group
Intravenous injection of albumin3 milk fat and amino acid

Results
$atural killer cell activit& and interleukin72 were raised in the test grou 3 but markedl& lowered in the control grou . #uring the "7week observation eriod there was4 no significant change of leukoc&te and thromboc&te counts in the test grou considerable lowering of both counts in the control.

Alcohol dependence' see #e endence3 alcohol Alcohol deto(ification Ahorer et al.3 1--* 12122 ")

(ham controlled trial

Acu uncture at two different traditional oint combinations

Acu uncture at a sham oint or no acu uncture

Clinical measurement using tests of eBuilibrium and ntation3 and s ecific tests of metabolism and elimination of alcohol3 formed the basis of the com arison. Ahere was no difference between the sham acu uncture and no acu uncture control grou s. After both traditional acu uncture oint combinations3 clinical effects of alcohol into<ication were minimi5ed3 while the alcohol level in the e< ired air increased and blood alcohol decreased. Ahe treatment effects were better and lasted longer in the test grou and roduced no adverse effects. At follow7u 1 month after 1) da&s of treatment im rovement was observed in4 -2=100 in the test grou '+=*0 in the control grou . Areatment for 1' da&s was effective in4 -+: of the test grou +)./: of the control grou . Ahe results did not indicate a rotective effect of acu uncture thera & against allergen7 rovoked rhinitis.

Allergic rhinitis )including ha# fever* Chari et al.3 1-// 11112 2)420

!rou com arison

Acu uncture

Antihistamine 1chlor henamine2 ;edication 1 atent herbal combination4 tablets containing 9erba Agastachis and Dlos Chr&santhemi Indici2 Antihistamine 1chlor henamine2

Cin et al.3 1-/- 11132

1004*0

,andomi5ed controlled trial

Acu uncture lus mo<ibustion

9uang3 1--0 11122

12/4120

,andomi5ed controlled trial

Acu uncture lus mo<ibustion

6olkenstein et al.3 1--" 12472

12412

,andomi5ed controlled trial

Acu uncture

(ham acu uncture

4:

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#
Eu et al.3 1--' 11152

%o.
2"04"0

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
Antihistamine 1oral astemi5ole lus nasal dri 1: e hedrine2

Results
At follow7u 1 &ear after ' weeks of treatment3 im rovement was observed in4 -': of the test grou +*.+: of the control grou . Ahe treatment was significantl& more effective in the test grou . %ffective rates were4 /*.0: in the test grou +*.+: in control grou .

8iu3 1--) 11142

)04"0

,andomi5ed controlled trial

Acu uncture at biqiu 1located at the round rominence on the lateral mucous membrane of the lateral nasal cavit&2 Acu uncture

$asal dri of cortisone lus e hedrine

6illiamson et al.3 1--* 11162

102

,andomi5ed controlled trial

(ham acu uncture

Ahe thera eutic effects were similar in the two grou s. In the '7week eriod following the first treatment3 remission of s&m toms was seen in4 "-: of the test grou > mean weekl& s&m tom scores3 1/.'> mean units of medication used3 '.1 ').2: of the control grou > mean weekl& s&m tom scores3 1+.*> mean units of medication used3 ).0.

Angina pectoris' see Coronar& heart disease 1angina ectoris2 Aphasia due to acute cere rovascular disorders 1see also #&s hagia in seudobulbar aral&sis2 Fhang et al.3 1--' 22422 ,andomi5ed controlled (cal acu uncture Conventional su 11022 trial measures

ortive

Assessed b& a scoring method3 the thera eutic effect was much better in the test grou than in the control grou . Before treatment3 the two grou s were com arable in various res ects3 including causal diseases and area of lesions.

Arthritis' see !out& arthritis> Osteoarthritis> .eri rthritis of shoulder> ,heumatoid arthritis Asthma' see Bronchial asthma +ell,s pals# Eou et al.3 1--" 11062 2)42) ,andomi5ed controlled Blood7letting trial acu uncture

;edication 1vasodilator lus steroid3 etc.2

A cure was achieved in4 -*: of the test grou */: of the control grou . After a 27week treatment the cure rate was4 -0.-: in the test grou +*.+: in the control grou .

8in3 1--+ 11052

1-/4*0

!rou com arison

Ahrough acu uncture 1 uncture of two or more adjoining oints with one insertion2

Araditional acu uncture

4;

8% &ummar table o$ controlled clinical trials

Condition$"tud#

%o.

Design

&est group
Acu uncture %lectric acu uncture

Control Group
;edication 1injection of atro ine lus ethidine ;edication 1injection of anisodamine 1a Chinese medicine3 structurall& related to atro ine3 isolated from Anisodus tangutica) lus ethidine2 Anisodamine

Results
Ahe analgesic effect was better in the test grou than in the control grou . Aotal relief of colic was achieved in 1G" min in4 "*=)0 1+2:2 in the test grou 12=)0 12':2 in the control grou . .artial relief was achieved in )G10 min in4 10=)0 in the test grou "2=)0 in the control grou . Ahe treatment was effective in4 -'.": of the test grou /0.0: of the control grou .

+iliar# colic 1see also Cholec&stitis3 chronic3 with acute e<acerbation2 ;o3 1-/+ 1622 +04+* !rou com arison Eang et al.3 1--0 1642 )04)0 !rou com arison

6u et al.3 1--2 1632

1'2

!rou com arison

Acu uncture

+ladder pro lems' see Demale urethral s&ndrome> $euro athic bladder in s inal cord injur& +reathlessness in chronic o structive pulmonar# disease Cobst et al.3 1-/* 11272 12412 ,andomi5ed controlled Acu uncture trial

.lacebo acu uncture 1needling at non7acu uncture HdeadH oints2

After " weeks of treatment3 the test grou showed greater benefit in terms of subjective scores of breathlessness and *7min walking distance. Objective measures of lung function were unchanged in both grou s. Iso renaline was more effective than real acu uncture. Both were more effective than sham acu uncture. Iso renaline was more effective than acu uncture. Both were more effective than lacebo. ,eal acu uncture rovided better rotection against e<ercise7induced asthma than did sham acu uncture. Areatment with real or lacebo acu uncture failed to modulate the bronchial h& erreactivit& to histamine3 suggesting that a single treatment is unlikel& to rovide im rovement in the management of acute bronchial asthma. 4"

+ronchial asthma Eu et al.3 1-+* 11232

20

,andomi5ed cross7over

Acu uncture

Iso renaline or sham acu uncture Iso renaline or lacebo

Aashkin et al.3 1-++ 11212 1methacholine7 induced2 Dung et al.3 1-/* 11192 1e<ercise7induced2 Aandon et al.3 1-/11252 1histamine7induced2

12

,andomi5ed cross7over

Acu uncture

1-

,andomi5ed single7 blind crossover #ouble7blind cross7over

Acu uncture

(ham acu uncture

1*

Acu uncture

Acu uncture at irrelevant oints

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#
9e et al.3 1--' 11202

%o.
'/4'/

Design
,andomi5ed grou com arison

&est group
8aser acu uncture

Control Group
;o<ibustion at same oints as laser acu uncture

Results
.ulmonar& ventilation indices im roved in4 "" of the test grou 20 of the control grou . An anti7asthmatic effect was observed in4 2/="0 of the test grou 1B81"2> best immediate effect 20=2' 8U113 22=2' 8U103 2'="0 8U-3 2'=2/ 8U/3 21=2/ 8U+> good effect '=2' !B'0> least effect. Ahere was no im rovement in as ects of res irator& function measured after acu uncture or sham acu uncture. Ahere was significant im rovement in the Asthma Jualit& of 8ife Juestionnaire and a arallel reduction in bronchodilators. Average recover& time was4 -1 1+)./:2 in test grou after ).* da&s of treatment 12 1'0:2 in control grou after 12 da&s of treatment. Acu uncture treatment had4 immediate analgesic effect similar to 6estern medication more marked analgesic effect than 6estern medication after long7term use for 2 months. An analgesic effect was observed in4 )0.0: of the medication grou +".0: of the acu uncture grou -2.2: of acu uncture lus medication grou . At follow7u I month after 10 da&s of treatment the thera eutic effect was better in the test grou than in the control grou .

?ie et al.3 1--* 11222

100

,andomi5ed controlled trial with artial crossover

%lectric acu uncture at fish 1B81"2 1n I "02

%lectric acu uncture at shosh ng 18U112 1n I2'2 !"#$ 18U102 1n I 2'23 ti!u n 18U-2 1n I "023 #%ngq" 18U/2 1n I 2/23 &iqu' 18U+2 1n I 2/2 or qi( 1!B'02 1n I 2'2 (ham acu uncture

Biernacki et al.3 1--/ 12482 1stable asthma2

2"

,andomi5ed controlled trial3 double7blind crossover

Acu uncture

+ul ar paral#sis after stroke 1see also #&s hagia in seudobulbar aral&sis2 #ing3 1--* 12492 1204"0 !rou com arison with Acu uncture com arable conditions

Conventional 6estern medication 1tro<erutin3 iracetam3 Cerebrol&sin4 a brain e tide re aration2

Cancer pain #ang et al.3 1--) 12302 1stomach carcinoma2

1*41*

,andomi5ed controlled trial

Acu uncture

6estern medication 1codeine3 ethidine2

#an et al.3 1--/ 12312

"'4"+4'2

!rou com arison

Bod& acu uncture or acu uncture lus medication

;edication 1analgesic ste s recommended b& 69O2

Cardiac neurosis Fhou3 1--2 11782

"04"0

,andomi5ed controlled trial

Acu uncture at )*n!+ng 1(A-2

;edication 1 ro ranolol2

67

8% &ummar table o$ controlled clinical trials

Condition$"tud#

%o.

Design

&est group

Control Group

Results

Cardiopulmonar# disease' see Breathlessness in chronic obstructive ulmonar& disease> Cardiac neurosis> Coronar& heart disease 1angina ectoris2> .ulmonar& heart disease3 chronic Cere rovascular disorders' see A hasia due to acute cardiovascular disorders> Bulbar aral&sis after stroke> Coma> Craniocerebral injur&> (troke Chloasma 8uan et al.3 1--* 12242 *04"0 ,andomi5ed controlled Auricular acu uncture Kitamins C and % After " months of treatment cure was achieved in4 trial lus acu ressure )".": of the test grou 1".": of the control grou . Ahe treatment was effective in4 -).0: of the treatment grou '".": of the control grou . Cholec#stitis' chronic3 with acute e<acerbation 1see also Biliar& colic2 !ong et al.3 1--* 11392 /042' !rou com arison Bod& lus ear Conventional 6estern Clinical cure 1disa earance of s&m toms and acu uncture medication 1uns ecified2 signs3 and marked im rovement of gallbladder motor function as shown b& ultrasonic e<amination2 was achieved in4 -2.): of the test grou "2.1: of the control grou . Cholelithiasis Fhao et al.3 1-+- 11382 )224+' !rou com arison %lectric acu uncture Oral magnesium sulfate (tones were e<creted in4 lus oral magnesium '0-=)22 1+/.':2 in the test grou sulfate 20=+' 12+.':2 in the control grou . Chronic o structive pulmonar# disease' see Breathlessness in chronic obstructive ulmonar& disease Cocaine dependence' see #e endence3 o ium3 cocaine3 heroin Colour lindness Cai3 1--/ 12502 ''4*)4 !rou com arison Bod& acu uncture or $o treatment After 1G" courses of treatment 1+G12 da&s each )" ear acu ressure course23 colour discrimination was im roved4 from 0.2' to 0.'* in acu uncture grou from 0.2+ to 0.)2 in ear acu ressure grou . Ahere was no im rovement in the control grou 1change from 0.2/ to 0."02. Coma Drost3 1-+* 11082 1+41) !rou com arison with Acu uncture at $o acu uncture A neurological recover& of )0: or more similar levels of coma sh*nt+ng 1!K2'2 and 1significant difference2 was observed in4 shu,g-u 1!K2*2 )-: of the test grou 20: of the control grou . Competition stress s#ndrome Jue et al.3 1-/* 11962 1114102 ,andomi5ed controlled Auricular acu ressure .s&chothera & lus lacebo Ahe treatment was effective in4 trial drug -2./: of the test grou +./: of the control grou . 6!

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#

%o.

Design

&est group
Acu uncture at h*g. 18I'2

Control Group
Intramuscular henobarbital

Results
Convulsions sto ed 2 min after starting treatment in4 -/: of the test grou )1: of the control grou . Cardiac work ca acit& 1difference in ressure7rate roduct 1d.,.22 between rest L ma<imum e<ercise L ma<imum .,. during e<ercise3 was measured. $o adverse effect was observed. .atients receiving active acu uncture showed significant increase in cardiac work ca acit& com ared to those receiving sham acu uncture. Ahere was a median reduction of )0: in anginal attack rate and gl&cer&l trinitrate consum tion in both grou s3 with no significant difference between the grou s. Ahe increase in e<ercise tolerance and dela& of onset of ain was significant in the test grou > there were no significant changes in the control grou . Acu uncture was more effective in im roving s&m toms and %C! and ulse do ler ultrasonocardiogra h& indices. Im rovement in s&m toms and %C!3 res ectivel&3 were observed in4 /).+: and *-: of the test grou )+.1: and "/: of the control grou . ;arked relief of angina ectoris and other s&m toms3 with im rovement of %C! L haemorr7 heological indices was observed in the test grou . Ahere was no such effect in the control grou . A marked effect 1no recurrence of angina during the 'G) weeks of treatment2 was observed in4 +': of the test grou )2: of the control grou .

Convulsions in infants and #oung children due to high fever 9e et al.3 1--+ 12152 )14)1 ,andomi5ed controlled trial

Coronar# heart disease )angina pectoris* Ballegaard et al.3 1-/* 1"41" 11802

,andomi5ed controlled trial

Acu uncture

(ham acu uncture 1insertion of needles outside the meridians2

Ballegaard et al.3 1--0 11812

2'42)

,andomi5ed controlled trial

Acu uncture

(ham acu uncture

?ue et al.3 1--2 11862

'242+

,andomi5ed controlled trial ,andomi5ed controlled trial

Acu uncture

;edication 1nifedi ine lus isosorbide dinitrate2 Conventional medication 1gl&cer&l trinitrate3 as irin3 calcium antagonist2

;ao et al.3 1--" 11842

"04"0

Acu uncture lus conventional medication

#ai et al.3 1--) 11822

2041/

,andomi5ed controlled trial

Auricular acu uncture at oint heart

Auricular acu uncture at oint stomach

Cheng3 1--) 11832

)04)0

,andomi5ed controlled trial

Auricular acu ressure

Conventional medication 1gl&cer&l trinitrate3 etc.2

64

8% &ummar table o$ controlled clinical trials

Condition$"tud#
;a et al.3 1--+ 12512

%o.
"042'

Design
,andomi5ed controlled trial

&est group
Bod& acu uncture lus routine 6estern medication 1as irin3 nitrates and calcium antagonist2

Control Group
,outine 6estern medication 1as irin3 nitrates and calcium antagonist2

Results
After 10 da&s of hos itali5ation and treatment3 im rovement in angina ectoris and (A7A3 res ectivel&3 was observed in 4 /).+: and *-: of the test grou )/.": and "".": of the control grou . 8evels of serotonin3 noradrenaline and do amine were higher than normal in both grou s but were significantl& lowered onl& in test grou after the treatment. After 1) da&s of treatment3 clinical cure 1disa earance of the main clinical s&m toms and signs3 and basic recover& of functions2 was observed in4 /*: of the test grou )*: of the control grou . After 2 weeks of treatment3 the effect was highl& statisticall& significant in4 -0: of the test grou +0: of the control grou . After 1 month of treatment3 the cure rate was4 /".": in the test grou )*.+: in the herbal medication grou 12.): in the control !oboes and 8iu regimen grou . Acu uncture lus lacebo drug gave significantl& greater ain relief than sham acu uncture lus lacebo drug or sham acu uncture lus codeine. Acu uncture lus lacebo drug was more effective than acu uncture lus codeine in initial "0 min after surger&> less effective 2G" h after surger&.

Craniocere ral in-ur#' closed #ing et al.3 1--+ 12522 )04)0

!rou com arison

Bod& acu uncture

,outine 6estern medication 1uns ecified2

Deafness' sudden onset 6ang et al.3 1--/ )04)0 12182

,andomi5ed controlled trial

Bod& acu uncture lus routine 6estern treatment 1de<tran3 de<amethasone3 etc.2 Acu uncture

,outine 6estern medication 1de<tran3 de<amethasone3 etc.2

Defective e-aculation' see ;ale se<ual d&sfunction3 non7organic (hui3 1--0 11482 "04"04 ,andomi5ed controlled '0 trial

9erbal medication or the !oboes and 8iu regimens 1treatment included se< instruction3 electric massage3 hormonal thera & and injection of str&chnine and galantamine (ham acu uncture lus lacebo drug3 sham acu uncture lus codeine3 or acu uncture lus codeine

Dental pain (ung et al.3 1-++ 1782 1 osto erative2

'0

,andomi5ed controlled trial

Acu uncture lus lacebo drug

66

AcupunctureD review and anal sis o$ controlled clinical trials

Fheng et al.3 1--0 1792 1after ul devitali5ation2

1)411

,andomi5ed controlled trial

Auricular acu ressure

$o treatment

After '/ h3 there was no ain in4 12=1) 1/0:2 in the test grou '=111"*:2 in the control grou .

Condition$"tud#
8ao et al.3 1--) 1772 1after tooth e<traction2 (ukandar et al.3 1--) 1802 1a ical eriodontitis2 8ao et al.3 1--- 1732 1after oral surger&2

%o.
114/

Design
,andomi5ed controlled trial ,andomi5ed controlled trial

&est group
Acu uncture

Control Group
.lacebo acu uncture

Results
(ubjects treated with acu uncture re orted a significantl& longer eriod without ain and e< erienced less intense ain than controls. Analgesic effect lasting 2' h was obtained in4 *): of the test grou 10: of the control grou . Acu uncture was statisticall& significantl& su erior to the lacebo in reventing osto erative dental ain. ;ean ain7free osto erative time and minutes before reBuesting ain relief medication3 res ectivel&3 were4 1+2.- min and 2'2.1 min in the test grou -"./ min and 1**.2 min in the lacebo grou . Ahere was a significant difference between the two grou s at the end of the stud&> atients in the test grou e< ressed less need for alcohol3 with fewer drinking e isodes. (ignificant treatment effects ersisted at the end of the *7month follow7u > more control atients e< ressed a moderateGstrong need for alcohol and had more than twice the number of drinking e isodes L admissions to deto<ification centres. Abstinence rates during final 2 weeks of /7week treatment were4 auricular acu uncture '': desi ramine 2*: amantadine 1): drug lacebo 1":.

20420

%lectric acu uncture

;ock electric acu uncture

1-420

,andomi5ed controlled trial

Acu uncture

.lacebo acu uncture

Dependence' alcohol Bullock et al.3 1-/+ 12102

2+42+

,andomi5ed controlled trial

Acu uncture at s ecific oints

Acu uncture at non7s ecific oints

Bullock et al.3 1-/12112

'04'0

,andomi5ed controlled trial

Acu uncture at s ecific oints

Acu uncture at non7s ecific oints

Dependence' opium' cocaine and heroin ;argolin et al.3 1--" "2 er grou 12012 1cocaine2

!rou com arison 1 ost hoc2

Auricular

#esi ramine3 amantadine or drug lacebo

68

8% &ummar table o$ controlled clinical trials

6ashburn et al.3 1--" 12022 1heroin2 Cai et al.3 1--/ 12002 1heroin3 late stage of abstinence2

100 *04*0

,andomi5ed controlled trial ,andomi5ed controlled trial

Acu uncture Bod& acu uncture

(ham acu uncture Kitamin B1

(elf7re orted freBuenc& of heroin use was lower in the test grou . ,eduction of anore<ia3 s ontaneous sweating and insomnia in the late stage of abstinence was greater in test grou 3 and statisticall& significant.

Condition$"tud#
Bullock et al.3 1--11992 1cocaine2 Dependence' to acco Dang3 1-/" 12042

%o.
2"*

Design
,andomi5ed controlled trial ,andomi5ed controlled trial 1 atients told the& were receiving acu uncture for other ur oses2

&est group
Auricular acu uncture

Control Group
Acu uncture at sham ear oints or conventional treatment without acu uncture Bod& acu uncture

Results
Ahe data failed to identif& significant treatment differences among the various grou s. Under a regime of assive abstinence with no suggestion or motivation3 auricular acu uncture was su erior to bod& acu uncture in reducing the tobacco consum tion b& more than half in4 +0: of the auricular acu uncture grou 1+2: e< erienced disgust at the taste of tobacco and 1): felt di55& during smoking2 11: of the bod& acu uncture grou . Acu uncture and nicotine gum did not reduce the tendenc& to rela se after one month but were effective in hel ing smokers to sto smoking during the first month in4 '"=22' in the acu uncture grou '*=20) in the grou receiving nicotine gum /=222 in the minimal intervention grou . #ail& cigarette consum tion fell during the treatment in both grou s3 but the reduction was larger in the test grou . (erum concentrations of cotinine and thioc&anate were significantl& reduced after the treatment eriod in the test grou but not in the control grou . Ahere was no significant difference between the two grou s in the mean score for reduction of withdrawal s&m toms.

""42/

Auricular acu uncture

Clavel et al.3 1-/) 12532

22'420)4 222

,andomi5ed grou com arison

Acu uncture

$icotine gum or minimal intervention 1cigarette case with lock controlled b& a time switch3 which could be regulated at will2

9e et al.3 1--+ 12052

2"42"

,andomi5ed controlled trial

Acu uncture at oints used to assist smoking cessation

Acu uncture at oints assumed to have no effect on smoking cessation

6hite et al.3 1--/ 12072

+*

,andomi5ed controlled trial

%lectric acu uncture at a ro riate oints in each ear

(ham rocedure 1auricular acu uncture over the mastoid bone2

69

AcupunctureD review and anal sis o$ controlled clinical trials

6aite et al.3 1--/ 12062

+/

,andomi5ed controlled trial

%lectric acu uncture lus self7retained ear seed 1a herbal seed used to a l& ressure to the oint2 at an active site %lectric acu uncture

Auricular acu uncture lus self7retained ear seed at a lacebo site

Ahe test acu uncture was significantl& more effective in hel ing volunteers to Buit smoking than the control treatment. Cessation of smoking at * months in4 12.): of the test grou 0: of the control grou . Ahere was a similar im rovement in the two grou s but far fewer side7effects in the test grou .

Depression 1see also #e ression after stroke2 8uo et al.3 1-/) 11912 2+420 ,andomi5ed controlled trial

;edication 1amitri t&line2

Condition$"tud#
8uo et al.3 1-// 11922

%o.
1""410/

Design
;ulticentre3 randomi5ed controlled trial ,andomi5ed controlled trial ,andomi5ed controlled trial

&est group
%lectric acu uncture

Control Group
;edication 1amitri t&line2

Results
Ahere was a similar im rovement in the two grou s but a greater effect on an<iet& and fewer side7effects in the test grou . Ahere was a similar im rovement in the two grou s after * weeks. Ahe thera eutic efficac& was similar in the two grou s for de ressive disorders. Ahe thera eutic effect for an<iet& somati5ation and cognitive rocess disturbance was greater and there were fewer side7effects in the test grou . Ahere was a similar im rovement in the anti7 de ressive acu uncture and medication lus traditional acu unture grou s> im rovement was su erior to that in traditional acu uncture grou . Ahe results were better in the test grou > the difference was significant as assessed b& the 9amilton and other scoring methods. Ahe thera eutic effect was similar in the two grou s3 somewhat better in the test grou for cognitive disturbance. (ide7effects occurred in all cases in control grou but in none in test grou . Ahere was a reduction in fasting blood sugar of4 1-.2: in the test grou '.-: in the control grou .

Eang et al.3 1--' 11932 8uo et al.3 1--/ 12542

20420 2-

Acu uncture %lectric acu uncture lus lacebo

;edication 1amitri t&line2 %lectric acu uncture lus amitri t&line

Depression after stroke 8i et al.3 1--' 11902 "'4"'4 ""

,andomi5ed controlled trial

MAntide ressiveN acu uncture 1different selection of oints2 %lectric acu uncture at b/ihu$ 1!K202 and !$nt0ng 1%?79$"2 8aser acu uncture

;edication 1do<e in2 lus traditional acu uncture or traditional acu uncture alone Araditional manual acu uncture Conventional antide ressant 1do<e in3 amitri t&line or a ra5olam2 Acu uncture at 1 Chinese inch 1cun) su eriolateral to (.*

9ou et al.3 1--* 11892 Depressive neurosis Fhang3 1--* 11942

"04"0

,andomi5ed controlled trial with inde endent assessment ,andomi5ed controlled trial

"1 er grou

Dia etes mellitus' non.insulin.dependent 8atief3 1-/+ 12412 20420

,andomi5ed controlled trial

Acu uncture at s n!%n#i o 1(.*2

6#

8% &ummar table o$ controlled clinical trials

Oang et al.3 1--) 12402

1241)4 1"410

,andomi5ed controlled trial

Untimed acu uncture or acu uncture at insulin secretion clima< 1I(CA2 or acu uncture at insulin secretion valle& 1IC(K2

Conventional 6estern medication 1tolbutamide2

Im rovement in fasting blood glucose3 27h glucose3 ost randial blood glucose3 2'7h urine glucose3 and glucos&lated haemoglobin was4 marked in the I(CA grou su erior in the I(CA grou to that in the untimed acu uncture and I(KA grou s similar in the I(CA grou to that of the tolbutamide grou .

Condition$"tud#

%o.

Design

&est group

Control Group

Results

Diarrhoea' see #iarrhoea in infants and children> #&senter&3 acute bacillar&> Irritable colon s&ndrome Diarrhoea in infants and #oung children 8i et al.3 1--+ 12132 "/04')0 !rou com arison Acu uncture at 1"s n&, ;edication 1gentamicin or 1(A"*2 and halo eridol2 ch0ngqi0ng 1!K12

Cure in 1 da& was obtained in4 /2.": of the test grou 1the remainder were cured within " da&s2 '1.": of the control grou . Cure was obtained in4 -/: of test grou within ".'" @ 0."2 da&s /0: of control grou within '.'1 @ 0.'" da&s. Acu uncture relieved s&m toms earlier than fura5olidone. (tool culture became negative in4 -2.': of the test grou -/.2: of the control grou . (tool culture became negative in all atients after + da&s3 but within + da&s in4 /+.+: of the test grou > recurrence rate in 1 &ear3 2.': +'.2: of the control grou > recurrence rate in 1 &ear3 2.):. Both treatments relieved s&m toms and signs3 with no side7effects. (tool culture became negative in4 12/ 1+-:2 in the test grou b& ).1 da&s> recurrence at -7month follow7u in ' cases 1'" 1/+.2:2 in the control grou b& ".2 da&s> recurrence at -7month follow7u in ) cases. 6:

Eang3 1--/ 12142

1004+0

!rou com arison

Bod& acu uncture and mo<ibustion

;edication 1antibiotics and vitamins2

D#senter#' acute acillar# Jiu et al.3 1-/* 192 )-*42/1

!rou com arison

Acu uncture

;edication 1fura5olidone2

8i3 1--0 182

2+*42*-

!rou com arison

Acu uncture

;edication 1s&ntom&cin3 fura5olidone2

Eu et al.3 1--2 1102

1*241*'

,andomi5ed controlled trial

Acu uncture

;edication 1fura5olidone2

D#smenorrhoea' primar#

AcupunctureD review and anal sis o$ controlled clinical trials

9elms3 1-/+ 11532

114114114 10

,andomi5ed controlled trial3 com aring four grou s

Acu uncture

.lacebo acu uncture3 no acu uncture but conventional treatment3 no acu uncture but conventional treatment and control visits to h&sician

Im rovement was observed in4 10=111-0.-:2 in the real acu uncture grou '=11 1"*.':2 in the lacebo acu uncture grou 2=11 11/.2:2 in the conventional treatment control grou 1=10 110:2 in the conventional treatment lus visits control grou .

Condition$"tud#
(hi et al.3 1--' 11542

%o.
1204''

Design
,andomi5ed controlled trial ,andomi5ed controlled trial

&est group
Acu uncture at s n!%n#i o 1(.*2 Bod& acu uncture

Control Group
;edication 1a aracetamolG ro & hena5oneGcaffeine combination2 8ogemann functional training of lingual muscles

Results
A better and Buicker analgesic effect was observed in the test grou . Cure rates after 1) da&s were4 2* in the test grou 1average /.+ da&s2 * in the control grou . Ahe res onse was significantl& better following acu uncture than lacebo for both "": and )0: ain7relief criteria.

D#sphagia in pseudo ul ar paral#sis 8iu et al.3 1--/ 12552 "04"0

/arache' une(plained ;ekhamer A et al. 1-/+ 12222

-*

,andomi5ed controlled trial

Acu uncture

;ock A%$(

/ncephalitis' see Kiral ence halitis in children /pidemic haemorrhagic fever (ong et al.3 1--2 1862 "/4"2 ,andomi5ed controlled trial

;o<ibustion

6estern medication. 1steroid3 su ortive treatment2 Conventional medication. 1anisodamine2

;o<ibustion shortened the eriod of oliguria and accelerated the fall in urine rotein and reduction in kidne& swelling 1ultrasound2. Ahe treatment was effective in4 -+.*: of the test grou /".-: of the control grou . A marked effect was observed in4 /1: of the test grou /0: of the control grou . Cure 1no recurrence at "7month follow7u 2 was observed in4 /'./: of the test grou 2/.*: of the control grou .

/pigastralgia' acute )in peptic ulcer' acute and chronic gastritis' and gastrospasm* ?u et al.3 1--1 11282 '24"1 ,andomi5ed controlled Acu uncture at trial &i0ngqi 1(A"'2 and 2ish 1B8212 Eu3 1--+ 11292 1*04'0 ,andomi5ed controlled trial Acu uncture 1manual2 at 1"s n&, 1(A"*2

;edication 1mor hine lus atro ine2

/pista(is' simple )without generali0ed or local disease* 8ang et al.3 1--) 12232 -24'2 ,andomi5ed controlled trial

Auricular acu uncture with thumb7tack needle

6estern medication 1carba5ochrome salic&late lus vitamin C2

/#e pain due to su con-unctival in-ection 6;

8% &ummar table o$ controlled clinical trials

(hen3 1--* 1142

2'41)

,andomi5ed controlled trial

Acu uncture at b$no 18I1'2

$o treatment

.ain mostl& disa eared in 0.)G1 min in 22=2' of the test grou but ersisted for "0G*0 min in all of the control atients. .ain levels were more significantl& reduced following acu uncture than following sham acu uncture.

1acial pain )including craniomandi ular disorders* 1see also Aem oromandibular joint d&sfunction2 9ansen et al.3 1-/" 1* ,andomi5ed crossover Acu uncture (ham acu uncture 1292 trial

Condition$"tud#
Cohansson et al.3 1--1 1302

%o.
1) er grou

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
Occlusal s lint or no treatment

Results
Acu uncture was as effective as occlusal s lint. At follow7u 3 subjective d&sfunction scores and visual analogue scale assessments were significantl& lower in the test grou . (&m toms were reduced b& acu uncture and occlusal7s lint thera &. Ahe control grou remained essentiall& unchanged. Acu uncture gave better short7term subjective results than occlusal s lint. ;arked effect 1with effective rate after course of treatment of 1' sessions24 )-.": of test grou after ) sessions of treatment> overall effective rate3 -".+: 2): of the control grou after 11 sessions on average> overall effective rate3 ++./:. %limination of involuntar& twitching with no recurrence at *7month follow7u in4 *-.+: of the test grou "-.' : of the control grou . %ffective rates after 1G2 months of treatment were4 //.": in the test grou 2/: in the control grou .

8ist3 1--2 1312

110

,andomi5ed controlled trial

Acu uncture.

Occlusal s lint or no treatment

Cai3 1--* 1282

"24"*

,andomi5ed controlled trial

Acu uncture with retention of needles for 1G1.) h

Acu uncture with retention of needles for 0.) h

1acial spasm 8iu3 1--* 11072

""4""

,andomi5ed controlled trial

6ristGankle acu uncture

Bod& acu uncture

1emale urethral s#ndrome Fheng et al.3 1--+ 10"4)0 11512

,andomi5ed controlled trial

Bod& acu uncture and mo<ibustion.

;edication 1Urgenin4 herbal e<tract containing 34)4noa s4))u&ata3 effective for irritable bladder> used because antibiotics had roved ineffective in all atients2

6"

AcupunctureD review and anal sis o$ controlled clinical trials

6ang et al.3 1--/ 11502 1from same institute as stud& above2

)*4"+

,andomi5ed controlled trial

Bod& acu uncture and mo<ibustion

;edication. 1Urgenin> used because antibiotics had roved ineffective2

%ffective rates after 1G2 months of treatment were4 /+.): in the test grou 1urod&namic stud& also showed the beneficial effect of acu uncture2 2-.+: in the control grou .

87

8% &ummar table o$ controlled clinical trials

Condition$"tud#

%o.

Design

&est group

Control Group

Results

1ever' see Convulsions in infants and &oung children due to high fever> Aonsillitis3 acute 1i rom#algia #elu5e et al.31--2 1402 "*4"' ,andomi5ed controlled Acu uncture trial with inde endent assessment Gastrointestinal spasm (hi et al.3 1--) 11302 1004100

(ham acu uncture

Ahere was a significant difference between the two grou s with im rovement in4 + of the / arameters in the test grou none of the arameters in the control grou . Aotal relief of ain in "0 min was observed in4 -/ in the test grou +1 in the control grou . %ffective rates 1no significant difference between the two grou s2 were4 -).2: in the test grou -0.2: in the control grou . Ahe test grou showed more marked im rovement than the control grou . ,eduction in blood and urine uric acid was similar in the two grou s. After * weeks of treatment3 marked im rovement was observed in4 100: of the test grou *): of the control grou .

,andomi5ed controlled trial

Acu uncture

Atro ine

Gastrokinetic distur ance Fhang et al.3 1--* 10'4'1 11312

,andomi5ed controlled trial

Acu uncture

Conventional medication 1dom eridone2

Gout# arthritis 8i et al.3 1--" 1602

2"41-

,andomi5ed controlled trial

Blood7 ricking acu uncture

Conventional medication 1allo urinol2

.an3 1--+ 1612

"-420

,andomi5ed controlled trial

.lum7blossom needling lus cu

;edication 1allo urinol2 ing

2aemorrhagic fever' see % idemic haemorrhagic fever 2a# fever' see Allergic rhinitis 1including ha& fever2 2eadache Ahonen et al.3 1-/" 12410 !rou com arison 1172 1m&ogenic2 8oh et al.3 1-/' 1232 1migraine and tension2 '/ Crossover 1incom lete2

Acu uncture

.h&siothera &

(ignificant changes in ain and electrom&ogram in both grou s3 with ' sessions of acu uncture eBuivalent to / sessions of h&siothera &. Benefit was observed in4 )-: of the test grou > "-: with marked im rovement 2): of the control grou > 11: with marked im rovement.

Acu uncture

(tandard drug thera & 1mainl& ro ranolol2

8!

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#
#owson et al.3 1-/) 1202 1migraine2

%o.
2)42"

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
;ock A%$(

Results
"": severit& im rovement was observed in4 )*: 11'=2)2 of the acu uncture grou "0: 1+=2"2 of the control grou . 9eadache freBuenc& was reduced in4 '': 111=2)2 of the acu uncture grou )+: 11"=2"2 of the control grou . Over " months of treatment3 there was a significant reduction of headache freBuenc& and intensit& in the acu uncture and s&chological biobehavioural grou s. Ahere was almost no change in those on the waiting list. Ahere was a significant difference between two grou s4 the test grou e< erienced sustained im rovement over 1 &ear after onl& * treatments in a *7week eriod. Ahe mean decreases in headache e isodes3 headache inde< and analgesic intake3 res ectivel& were4 ''.":3 )/.": and )+.+: in the test grou 21.':3 2+./: and 21.+: in the control grou . Ahe test grou showed better results than the control grou 1reduction in freBuenc& of attacks3 intensit& of ain and amount of medication taken2. Ahere was an Immediate analgesic effect in4 /0: of the test grou '/: of the control grou . Acu uncture at classical oints &ielded a significant thera eutic effect su erior to the control acu uncture. After 20 da&s of treatment3 headache disa eared with no recurrence after * months of follow7u in4 "0=') in the test grou 1*="0 in the control grou .

#oerr7.roske et al.3 1-/) 1192 1migraine2

10 er grou

,andomi5ed controlled trial

Acu uncture

.s&chological biobehavioural treatment or no treatment 1on waiting list2

Kincent3 1-/- 1252 1migraine2

1)41)

,andomi5ed controlled trial

Acu uncture

(ham acu uncture

Aavola et al.3 1--2 1242 1tension2

1)41)

,andomi5ed controlled trial

Acu uncture

(ham acu uncture

Oubiena et al.3 1--2 1212 1migraine2 ?u et al.3 1--" 1272 1migraine2

1)41)

,andomi5ed controlled trial ,andomi5ed grou com arison

Acu uncture

.lacebo acu uncture

)04)0

;anual acu uncture

%lectric acu uncture

6einschPt5 et al.3 1--' 1262 1migraine2 Chen et al.3 1--+ 1182 1migraine2

20420

Controlled trial3 com arable retreatment conditions !rou com arison

Acu uncture at classical oints .enetrating acu uncture

Acu uncture at oints 1G2 cm from those used in test grou $imodi ine

')4"0

84

8% &ummar table o$ controlled clinical trials

Condition$"tud#
8iu et al.3 1--+ 1222 1migraine2

%o.
"04"'

Design
,andomi5ed controlled trial

&est group
(cal acu uncture

Control Group
Dlunari5ine

Results
9eadache was relieved after 1 week treatment in4 +".": of the test grou "/.2: of the control grou .

2eart disease' see Coronar& heart disease 1angina ectoris2> .ulmonar& heart disease3 chronic 2epatitis + virus carrier 6ang et al.3 1--1 1852 +04'2 !rou com arison Acu uncture lus mo<ibustion

9erbal medication 19erba C&mbo ogonis2

After " months of treatment3 carrier status became negative in4 "0: of the test grou 2.': of the control grou . Antibodies to he atitis B e core antigen were roduced in4 )0: of the test grou *.2): of the control grou .

2eroin dependence' see #e endence3 o ium3 cocaine3 heroin 2erpes 0oster )human )alpha* herpesvirus 3* 1see also $euralgia3 ost7her etic2 Chen et al.3 1--' 12252 ""4"2 ,andomi5ed controlled 8aser acu uncture trial

.ol&inosinic acid

#isa earance of ain and formation of scabs3 res ectivel&3 occurred after4 1.'/ and ).+* da&s of laser acu uncture 10.) and 10.' da&s of medication. (ignificant im rovement after "0 da&s of treatment in4 "*='0 1-0:2 in the test grou 11=2) 1'':2 in the control grou . Ahe thera eutic efficac& was similar in the two grou s. Ahere was a similar im rovement with acu ressure and medication. Both were su erior to lacebo. Ahere was a similar im rovement in the two grou s. Ahere were no side7effects in the test grou .

2#perlipaemia 6ang3 1--/ 12392

'042)

!rou com arison

Acu oint injection lus oral administration of simvastatin

Oral administration of simvastatin

2#pertension' essential Iurenev et al.3 1-// 2)4"/ 11732 Fhou et al.3 1--0 11762 1")4*/4 +1 2/04)1

!rou com arison !rou com arison

Acu uncture Auricular acu ressure

Conventional medication 1rescinnamine2 ;edication 1nifedi ine lus ro ranolol2 or lacebo drug Conventional medication 1reser ine2

Eu et al.3 1--1 11752

!rou com arison

Auricular acu ressure

86

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#
6u et al.3 1--+ 11742

%o.
/2411/

Design
!rou com arison

&est group
(cal acu uncture

Control Group
Conventional medication 1nifedi ine2

Results
Ahe effects were similar3 with no statisticall& significant difference3 in the two grou s4 marked res onse in '+.*:3 artial res onse in )0: of the test grou marked res onse in )+.*:3 artial res onse in '0.+: of the control grou . ;onitoring of ambulator& blood ressure showed a similar reduction in 2'7h s&stolic and diastolic blood ressure in the two grou s. Ahe reduction in m&ocardial o<&gen consum tion inde< was greater in the test grou . ;arked im rovement was observed in4 '"=)* 1+*./:2 in the test grou 1hormonal assa& showed a further long7term effect after treatment2 2*=)) 1'+.":2 in the dieth&lstilbestrol grou . Intelligence Buotient increased4 from )".-+ to *).0+ 111.10 @ 2.-*2 in the test grou from )"./+ to )).12 in the control grou . (ocial ada tabilit& behaviour increased4 from +.)1 to /./- 11."/ @ 0."12 in test grou from +.)+ to +./2 in the control grou . After 10 da&s of treatment3 blood ressure was restored to normal in4 ') in the stud& grou 1no im rovement in 12 1) in the control grou 1no im rovement in 2)2. A thera eutic effect was observed after 0.)G1 month of treatment in4 1+2=1/0 1-).):2 in the test grou '*=*0 1+*.+:2 in the control grou .

#an3 1--/ 11722

2*42*

,andomi5ed controlled trial

Acu uncture

Conventional medication 1nifedi ine2

2#po.ovarianism ;a et al.3 1--+ 12562

"04"0

,andomi5ed controlled trial

Bod& acu uncture 1manual2 lus cu ing

;edication 1dieth&lstilbestrol2

2#pophrenia Aian et al.3 1--* 12542

10042)

,andomi5ed controlled trial

Bod& lus ear acu uncture lus a lication of herbal e<tract to acu oints

$o treatment

2#potension' primar# !uo3 1--2 11702

)04)0

,andomi5ed controlled trial

Auricular acu ressure

9erbal tonics

Eu et al.3 1--/ 11712

1/04*0

,andomi5ed controlled trial

Acu uncture at b/ihu$ 1!K202 lus herbal medication 15u 6hong 7i 8i 9ang3 a formula that is routinel& used in herbal medicine for the treatment of h& otension2

9erbal medication 15u 6hong 7i 8i 9ang2

88

8% &ummar table o$ controlled clinical trials

Condition$"tud#
Induction of la our Eu et al.3 1-/1 11612

%o.
104104/

Design
,andomi5ed grou com arison

&est group
Acu uncture at distant oints or local oints

Control Group
Acu uncture at distant lus local oints

Results
Acu uncture at distant oints was su erior to that at local oints in strengthening uterine contractions for induction of labour. Combined use of distant L local oints was best techniBue. (imilar results were obtained in the two grou s3 but uterine contractions were less freBuent and uterine motilit& was less marked in the test grou .

8in et al.3 1--2 11592

*24'/

,andomi5ed controlled trial ,andomi5ed controlled trial

Acu uncture at h*g: 18I'2 and s n!%n#i o 1(.*2

O<&tocin intravenous dri

;a et al.3 1--) 11602

112 %ar acu uncture at 1'2 $o treatment Ahe duration of labour in the four grou s was4 sh*n;*n3 122 Bod& 112 '.'+ @ 0.+* h acu uncture at 122 *./0 @ 1.0' h s n!%n#i o 1(.*2 or 1"2 -.+- @ 2.') h 1"2 Bod& acu uncture 1'2 10.20 @ 2.0' h. at !0ng&+ngqu0n 1!B"'2 Infertilit#' see #efective ejaculation> 9& o7ovarianism> Infertilit& due to inflammator& obstruction of fallo ian tube> ;ale se<ual d&sfunction3 non7organic Infertilit# due to inflammator# o struction of fallopian tu e Ci et al.3 1--* 11582 *'4"*4"0 ,andomi5ed controlled ;anual acu uncture 9erbal medication or ,esults showed that the fallo ian tube obstruction trial lus electric conventional 6estern was totall& removed in4 acu uncture lus medication 1intrauterine /1.": of the test grou > in a 27&ear follow7u 3 mo<ibustion injection of gentamicin3 the regnanc& rate was +): ch&motr& sin and )).*: and )*.+: of the control grou s3 de<amethasone2 res ectivel&> in a 27&ears follow7u 3 the regnanc& rates were )2.+: and '*.+:. Insomnia Fhang3 1--" 11102 *0 er grou !rou com arison Auricular acu ressure ;edication 1dia5e am lus After 1 month of treatment3 slee was restored to chloroh&drate2 normal or markedl& im roved in4 )-=*0 in the test grou 20=*0 in the control grou . 8uo et al.3 1--" 11092 *0 er grou ,andomi5ed controlled trial Auricular acu ressure ;edication 1 henobarbital3 methaBualone or me robamate2 After the course of treatment3 slee im roved in4 -*.+: of the test grou ").0: of the control grou .

"142-4 1)42*

Irrita le ladder' see Demale urethral s&ndrome Irrita le colon s#ndrome

89

AcupunctureD review and anal sis o$ controlled clinical trials

6u et al.3 1--* 11332

'14'0

,andomi5ed controlled trial

;o<ibustion

6estern medication

After 2.)G" months of treatment3 a thera eutic effect was observed in4 -2.+: of test grou 1im rovement in )".+:2 *2.): of control grou 1 im rovement in "+.):2.

Condition$"tud#
3nee pain ;aruno3 1-+* 1562 1arthrosis2

%o.
2*42*

Design
,andomi5ed controlled trial

&est group
%lectric acu uncture

Control Group
;anual acu uncture

Results
!ood results 1com lete alleviation of ain2 were observed in4 1+=2* in the test grou 1average no. of treatments reBuired3 *2 11=2* in the control grou 1average no. of treatments reBuired3 102. ,eduction in ain3 analgesic consum tion and objective measurements were significantl& greater in the test grou . Im rovement according to the 6estern Ontario and ;c;aster Universities Osteoarthritis Inde< and 8eBuesne indices was su erior in test grou .

Christensen et al.3 1--2 1542 1osteoarthritis2

1'41)

,andomi5ed controlled trial3 inde endent assessment ,andomi5ed controlled trial

Acu uncture

$o treatment 1waiting for surger&2 (tandard care 1weight loss3 h&sical and occu ational thera &3 medication2

Berman et al.3 1--+" 1582 1osteoarthritis2 4a our' see Induction of labour> 8abour ain 4a our pain Fhang et al.3 1--) 1822 1)041)0 4actation deficienc# Chandra et al.3 1--) 11692

Acu uncture

,andomi5ed controlled trial with inde endent assessment ,andomi5ed controlled trial

Bod& lus ear acu uncture %lectric acu uncture

$o treatment

Acu uncture &ielded a good analgesic effect and e< edited the o ening of the uterine ostium. 8actation increased b&4 -2: in the test grou "0.-: in the control grou . Ahe difference was statisticall& significant. %ffective rates after - da&s of treatment were4 //.': in the acu uncture grou -1.): in the mo<ibustion grou "/.2: in the medication grou . %ffective rates after - da&s of treatment were4 /-.): in the test grou "/.2: in the control grou .

1)41)

$o acu uncture

4eukopenia Chen et al.3 1--1 11412 1chemothera &7 induced2

121411+4 "'

,andomi5ed controlled trial

Acu uncture or mo<ibustion

;edication 1batilol lus c&steine hen&lacetate2

Chen et al.3 1--0 11402 1chemothera &7 induced2

)+4"'

,andomi5ed controlled trial

;o<ibustion

;edication 1batilol lus c&steine7 hen&lacetate2

8#

8% &ummar table o$ controlled clinical trials

Ein et al.3 1--0 11432 1ben5ene7induced2

"042+

,andomi5ed controlled trial

Acu uncture

;edication 1c&steine7 hen&lacetate2

%ffective rates after * weeks of treatment were4 /".": in the test grou )".': in the control grou .

Condition$"tud#
Ein et al.3 1--2 11442 1ben5ene7induced2

%o.
"042)

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
;edication 1rubidate2

Results
Acu uncture was su erior to rubidate in im roving s&m toms and increasing leukoc&te count> effective rates were4 -1: in the test grou */: in the control grou . %ffective rates were4 /2: in the test grou )0: in the control grou . ,eturn to original or eBuivalent work or to lighter work3 res ectivel&3 was ossible in4 1/=2- and 10=2- in the test grou '=2+ and 1'=2+ in the control grou . Im rovement was observed in4 1-=2) in the test grou )=2) in the control grou . Im rovement was observed in4 2* in the test grou 22 in the control grou . Combined average reduction 1 ain score3 activit& ain3 h&sical signs2 was4 +1.': in the acu uncture grou 21.': in the control grou . Ahere was a significantl& greater gain in various measures in the test grou during a "7week in7 atient treatment eriod and at *7month follow7u . 8:

6ang3 1--+ 11422 1chemothera &7 induced2

'-4"'

,andomi5ed controlled trial

;o<ibustion

;edication 1batilol lus c&steine7 hen&lacetate2

4ow ack pain 1see also (ciatica> ( ine ain3 acute2 !unn et al.3 1-/0 1462 2-42+ ,andomi5ed controlled trial

Acu uncture

(tandard thera & 1 h&sical thera &3 remedial e<ercises3 etc.2

Coan et al.3 1-/0 1452

2)42)

,andomi5ed controlled trial

Acu uncture and electric acu uncture

$o treatment 1waiting list2

;endelson et al.3 1-/" 1492

-)

,andomi5ed single7 blind crossover with inde endent assessment ,andomi5ed controlled trial

Acu uncture

8idocaine injection lus sham acu uncture

;ac#onald et al.3 1-/" 1482

/4-

Acu uncture and electric acu uncture

;ock A%$(

8ehmann et al.3 1-/* 1472

1+41/41/

,andomi5ed controlled trial

%lectric acu uncture

A%$( or mock A%$(

5ale se(ual d#sfunction' non.organic 1see also #efective ejaculation2

AcupunctureD review and anal sis o$ controlled clinical trials

A&din et al.3 1--+ 11472

1)41*42-

,andomi5ed controlled trial

Acu uncture

9& nosis or lacebo

(uccess rates were4 *0: in the acu uncture grou +): in the grou treated with h& notic suggestion '"G'+: in the lacebo grou .

8;

8% &ummar table o$ controlled clinical trials

Condition$"tud#

%o.

Design
!rou com arison

&est group
Auricular acu ressure

Control Group
Onee7chest osition

Results
(uccess rates were4 -2.-: in the test grou *+.): in the control grou . After 1 week of treatment3 successful trans osition occurred in4 )1.-: of the test grou 22.2: and 1):3 res ectivel&3 in the control grou s. %fficac& was markedl& su erior in the test grou . Among rimigravidas with breech resentation during the ""rd week of gestation3 mo<ibustion for 1G2 weeks increased fetal activit& during the treatment eriod and resulted in ce halic resentation after treatment eriod L at deliver&. After 1) da&s of treatment3 the s&ndrome was relieved in4 2) in the test grou 1ameliorated in 123 with relief usuall& occurring immediatel& after treatment 1* in the control grou 1ameliorated in 22. Of the + unaffected acu uncture atients3 ) returned to receive medication> all remained unim roved. Of the 1' unaffected control atients3 * returned to receive acu uncture> 2 were cured and 1 im roved. %ffective rates were4 +'.': in "- courses of acu uncture treatment '/.*: in "+ courses of medication.

5alposition of fetus' correction of Jin et al.3 1-/-Q 11672 1004'0

8i et al.3 1--0 11652

2+42+420

!rou com arison

;o<ibustion at 1"&+nq$ 1!B'12

;o<ibustion at 1h$!%n 1B8*+2 1not traditionall& used for fetal trans osition2 or at a non7 classical oint 1located " cm below the head of the fibula2 $o treatment ,outine care but no intervention for breech resentation

8i et al.3 1--* 11662 Cardini et al.3 1--/ 11642

'/4"1 1"041"0

!rou com arison ,andomi5ed controlled trial

%lectric acu uncture at 1h$!%n (B8*+2 ;o<ibustion at 1h$!%n 1B8*+2

56ni7re disease Fhang et al.3 1-/" 12192

""4"2

,andomi5ed controlled trial with artial crossover

Acu uncture

Conventional 6estern medication 1betahistine3 nicotinic acid3 vitamin B*3 cinnari5ine2

5igraine' see 9eadache 5orning sickness 1see also $ausea and vomiting2

8"

AcupunctureD review and anal sis o$ controlled clinical trials

#undee et al.3 1-// 11622

11-41124 11-

,andomi5ed controlled trial

Acu ressure at nigu n 1.C*2 or sham acu ressure 1 a oint near right elbow2

$o treatment

Aroublesome sickness was significantl& less in the acu ressure 12"=11-2 and sham acu ressure 1'1=1122 grou s than in the control grou 1*+=11-2.

Condition$"tud#
#e Alo&sio et al.3 1--2 12582

%o.
**

Design
,andomi5ed controlled trial

&est group
Acu ressure at nigu n 1.C*2

Control Group
(ham acu ressure

Results
%ffective rates were4 *0: in the test grou "0: in the control grou . %ffective rates were4 *-: in the test grou "1: in the control grou . Cure rates after 1 week of treatment were4 -*.+: in the test grou )/.-: in the control grou . Komiting in grou 112 was half that in grou 1"2. Ahere was a significantl& lower incidence of emetic e isodes in the acu uncture grou s 112 and 122 than in the control grou s 1"23 1'2 and 1)2. Ahere were no differences between the control grou s 1"23 1'2 and 1)2. (ickness was significantl& lower in the test grou .

Ba&reuther et al.3 1--' 12592

2"

,andomi5ed single7 blind crossover with inde endent assessment ,andomi5ed grou com arison

Acu ressure at nigu n 1.C*2

(ham acu ressure

Dan3 1--) 11632

1)141)1

;o<ibustion

9erbal medication

%ausea and vomiting 1see also Adverse reactions to radiothera & and=or chemothera &> ;orning sickness2 #undee et al.3 1-/* 2) er grou !rou com arison 112 Acu uncture lus 1"2 ;e ta5inol 12602 me ta5inol3 1'2 (ham acu uncture lus 1 eri7 and 122 Acu uncture lus nalbu hine osto erative2 nalbu hine 1)2 $albu hine

#undee et al.3 1-/+ 12332 1cis latin7associated2 !hal& et al.3 1-/+ 2612 1 osto erative2 6eightman et al.3 1-/+ 12622 1 osto erative2 #undee et al.3 1-/12632 1chemothera &7 related2

10

,andomi5ed crossover trial !rou com arison #ouble7blind randomi5ed controlled trial !rou com arison

%lectric acu uncture at nigu n 1.C*2 Acu uncture lus electric acu uncture Acu uncture at nigu n 1.C*2 Acu uncture at nigu n 1.C*2

%lectric acu uncture at Hdumm&H oint ;edication 1c&cli5ine2 $o acu uncture

"14"1 '*

Acu uncture and electric acu uncture were as effective as medication. Acu uncture erformed during surger& under anaesthesia did not lead to a significant reduction in nausea or vomiting after surger&. %ffective rates were4 -0: in the test grou 10: in the control grou .

20

(ham acu uncture

97

8% &ummar table o$ controlled clinical trials

Barsoum et al.3 1--0 12642 1 osto erative2

1*2

,andomi5ed controlled trial

Acu ressure at nigu n 1.C*2 b& using bands 1with ressure button2

.lacebo bands 1without ressure button2 or injection of rochlor era5ine

Ahe severit& of nausea was significantl& reduced in the test grou com ared with the two control grou s.

Condition$"tud#
9o et al.3 1--0 12652 1 osto erative2

%o.
2) er grou

Design
!rou com arison

&est group
%lectric acu uncture

Control Group
;edication 1intravenous rochlor era5ine ) mg2 or A%$( or no treatment

Results
%mesis e isodes were observed in4 "=2) in the electric acu uncture grou "=2) in the medication grou -=2) in the A%$( grou 11=2) in the untreated grou . Incidence of nausea and of vomiting3 res ectivel& was4 ": and 0: in the test grou '": and 2+: in the control grou . (emi ermanent acu uncture did not reduce the overall incidence of nausea and vomiting after abdominal h&sterectom& but did reduce the severit& of nausea in the second 2'7h eriod and had a greater effect on atients who had nausea L vomiting after a revious anaesthetic. .atients were treated with acu uncture with manual stimulation for ' min after develo ing ost7o erative nausea L vomiting lasting more than 10 min4 )": of atients in the test grou did not reBuire further antiemetic treatment all atients in the control grou reBuired further antiemetic treatment. Ahere was no statisticall& significant difference in total osto erative vomiting between the two grou s.

9o et al.3 1--* 12662 1 osto erative2

*0

,andomi5ed double7 blind controlled trial

Acu ressure bands 1with ressure button2

.lacebo bands 1without ressure button2

Andr5ejowski et al.3 1--* 12672 1 osto erative2

"*

,andomi5ed controlled trial

Acu uncture with semi ermanent needles

.lacebo with needles inserted into sham oints

;cConagh& et al.3 1--* 12682 1 osto erative2

"04)0

,andomi5ed controlled trial

Acu uncture at nigu n 1.C*2

Acu uncture at sham oints

(chwager et al.3 1--* 12692 1 osto erative2

/'

,andomi5ed controlled trial

Acu uncture

.lacebo 1no needle stimulation2

9!

AcupunctureD review and anal sis o$ controlled clinical trials

8iu et al.3 1--+ 12702 1cis latin7associated2

1/'4 1*142)4 2)42"4 224+0

,andomi5ed grou com arison

;agnetic late at nigu n 1.C*24 112 120 mA3 122 *0 mA or 1"2 2000 mA

1'2 120 mA magnetic late at 1"s n&, 1(A"*23 1)2 iron late at nigu n 1.C*23 1*2 steel bead at nigu n 1.C*2 or 1+2 medication 1uns ecified2

Aotal effective rates were significantl& higher in the first two test grou s24 112 -2.': 122 /-.': other grou rates ranged from '+.2: 1+2 to 0:.

Condition$"tud#
Al7(adi et al.3 1--+ 12712 1 osto erative2 (tein et al.3 1--+ 12722 1 osto erative2

%o.
/1

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
.lacebo 1no needle stimulation2

Results
Ahe use of acu uncture reduced the incidence of osto erative nausea or vomiting in hos ital from *): to "): 1for da& cases2 and from *-: to "1: 1after discharge2. .atients who received either acu ressure or lacebo bands lus metoclo ramide rior to initiation of s inal anaesthesia for caesarean section e< erienced much less nausea than atients in the lacebo band lus saline grou . Ahe incidence of vomiting after strabismus surger& was significantl& different for 2): in the test grou /): in the control grou . Ahe overall incidence of vomiting in a 2'7h eriod after strabismus surger& was4 2-.': in the test grou *'.): in the control grou .

+)

,andomi5ed double7 blind controlled trial

Acu ressure bands lus intravenous saline

.lacebo bands lus intravenous metoclo ramide or lacebo bands lus intravenous saline .lacebo laser

(chlager et al.3 1--/ 12732 1 osto erative2

'0420

,andomi5ed double7 blind controlled trial

8aser stimulation of nigu n 1.C*2

Chu et al.3 1--/ 12742 1 osto erative2

"'4"1

,andomi5ed controlled trial assessed b& evaluator blind to treatment

Acu ressure using non7invasive vital oint needleless acu laster 1Ooa3 Ca an2
Acu ressure with wrist band Acu uncture lus acu ressure

.lacebo acu ressure

Alkaissi et al.3 1--12752 1 osto erative2 (henkman et al.3 1--12762 1 osto erative2 %eck pain 94

204204 20 100

,andomi5ed controlled trial ,andomi5ed controlled trial

.lacebo with or without wrist band Acu uncture at sham oints

$ausea decreased after 2' h in all grou s but vomiting and need of relief antiemetic was reduced onl& in the test grou . .erio erative acu ressure and acu uncture did not diminish emesis in children following tonsillectom&.

8% &ummar table o$ controlled clinical trials

Coan et al.3 1-/2 1352

1)41)

,andomi5ed controlled trial

Acu uncture lus electric acu uncture

$o treatment 1waiting list2

;ean ain scores were reduced b&4 '0: in the test grou > im rovement in 12=1) 2: in the control grou > im rovement in 2=1). Im rovement was observed in4 *+.': of the test grou at " weeks3 /+.2: at * weeks )1.": of the control grou at " weeks3 )".-: at * weeks.

8o&3 1-/" 1362

2*42+

,andomi5ed controlled trial

%lectric acu uncture

.h&siothera &

Condition$"tud#
.etrie et al.3 1-/* 1372

%o.
1"412

Design
,andomi5ed controlled trial

&est group
Acu uncture

Control Group
;ock A%$(

Results
At 17month follow7u 3 dail& ill count and disabilit& scores3 res ectivel&4 decreased b& 2".): and 2'.*: in the test grou increased b& /.': and /.': in control grou . Both grou s im roved in res ect of ain and range of movement of neck. Acu uncture was slightl& more effective in atients who had higher baseline ain scores. ,elevant acu uncture contributed to modest ain reduction in ersons with m&ofascial neck ain. Ahe relevant acu uncture grou had significantl& greater re7 and ost7treatment differences in ain than the non7relevant acu uncture and medication grou s. Ahere were no differences in the ain recorded in the two grou s during or after treatment. Ahere was a significant im rovement in ain at the end of treatment in + atients of the lacebo grou and + atients of the acu uncture grou .

#avid et al.3 1--/ 1342

")4")

,andomi5ed controlled trial

Acu uncture

.h&siothera &

Birch et al.3 1--/ 1332

'*

,andomi5ed controlled trial

Acu uncture at s ecific sites relevant for neck ain or acu uncture at s ecific sites not relevant for neck ain Auricular lus bod& acu uncture

$onsteroid anti7inflammator& medication

%euralgia' post.herpetic 8ewith et al.3 1-/" "04"2 11032

,andomi5ed controlled trial

.lacebo 1mock A%$(2

96

AcupunctureD review and anal sis o$ controlled clinical trials

(ukandar et al.3 1--) 11042

+4+

,andomi5ed controlled trial

Acu uncture at #i0#, 1%?7B22 on affected side lus amitri t&lineG trifluo era5ine combo 1amitri t&line ) mg R trifluo era5ine 0.) mg er tablet23 one tablet twice a da& Acu uncture with seven7star needles

Acu uncture at #i0#, 1%?7B22 on contralateral side lus an amitri t&lineGtrifluo era5ine combination

Ahere was a significant difference in analgesia between the test and control grou s. Analgesia was e<cellent in4 all atients in the test grou after * sessions none of the atients in the control grou .

%eurodermatitis 9uang et al.3 1--/ 12272

*04*0

,andomi5ed controlled trial

Conventional local treatment

Cure rates were4 100: in the test grou 1*.+: in the control grou . Aimes taken to achieve balanced voiding were4 )+.1 @ 22.* da&s in the test grou /).2 @ 2+.' da&s in the control grou . Ahe difference was statisticall& significant.

%europathic ladder in spinal cord in-ur# Cheng et al.3 1--/ '04'0 12772

Controlled trial

%lectric acu uncture

Conventional bladder7training rogramme

Condition$"tud#

%o.

Design
,andomi5ed controlled trial

&est group
Auricular acu uncture

Control Group
(ham acu uncture

Results
(u ression of a etite was noticed in4 -): of the test grou 0: of the control grou .

8 esit# 1see also (im le obesit& in children2 ,ichards et al.3 1--/ *0 12382

8pium dependence' see #e endence3 o ium3 cocaine3 heroin 8steoarthritis Cunnila3 1-/2 1552 1*41* !rou com arison 1seBuential2

.ain was relieved b&4 *1: 1 month after a series of acu uncture treatments> no side7effects "2: after ' months of iro<icam thera &> itching of the skin3 intestinal bleeding3 or tiredness occurred in 1-:. 9ain' see Abdominal ain in acute gastroenteritis> Biliar& colic> Cancer ain> #ental ain> #&smenorrhoea3 rimar&> %arache> % igastralgia3 acute> %&e ain due to subconjunctival injection> Dacial ain 1including craniomandibular disorders2> !astrointestinal s asm> 9eadache> Onee ain> 8abour ain> 8ow back ain> $eck ain> $euralgia3 ost7her etic> Osteoarthritis> .ain due to endosco ic e<amination> .ain in thromboangiitis obliterans> .eriarthritis of shoulder> .lantar ain due to fasciitis> .osto erative ain> ,adicular and seudoradicular ain s&ndromes> ,enal colic> (ciatica> (ore throat> ( ine ain3 acute> ( rain> (tiff neck> Aennis elbow 9ain due to endoscopic e(amination 6ang et al.3 1--2 1004100 !rou com arison Acu uncture (tandard medication Analgesia was similar in the two grou s but there 11352 1sco olamine but&lbromide3 were significantl& fewer side7effects in the test 1colonosco &2 ethidine2 grou .

Acu uncture

;edication 1 iro<icam2

98

8% &ummar table o$ controlled clinical trials

6ang et al.3 1--+ "04211"*2 1colonosco &2 9ain in throm oangiitis o literans Jiu3 1--+ 1162 *04"0

,andomi5ed controlled trial !rou com arison

%lectric acu uncture at 1"s n&, 1(A"*2 and shng#<( 1(A"+2 Bod& acu uncture 1manual2

.ethidine analgesia

Analgesia was similar in the two grou s3 but there were fewer side7effects in the test grou . %ffective rates were4 -".': in the test grou > ain relief started 2G 10 min after needling and lasted for ).* h )*.+: in the control grou > ain relief started 1)G2) min after injection and lasted for ".1 h. Ahe thera eutic effect was su erior in the test grou > the difference was significant. Cure rates were4 **.1: in the test grou after 2.2 treatments "1.+: in control grou s after /.2 treatments.

;edication 1intramuscular bucinna5ine> also known as bucin era5ine2

9eriarthritis of shoulder Oinoshita3 1-+" 1382 1)41) (hao3 1--' 1392 *24*2

,andomi5ed controlled trial ,andomi5ed controlled trial

Acu uncture at s ecific L basic oints Acu uncture at )#i n 18I22

Acu uncture at basic oints alone Acu uncture at traditional oints

99

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#

%o.

Design

&est group

Control Group

Results

9ertussis' see 6hoo ing cough 1 ertussis2 9lantar pain due to fasciitis Oaren et al.3 1--1 1412 1) er grou

,andomi5ed controlled trial

Acu uncture

(ham acu uncture or conventional s orts thera &

Arue acu uncture roduced greater im rovement in ain records than conventional s orts thera & at the end of the treatment eriod 1' weeks2 and at the end of the follow7u eriod 1" weeks2. Ahere was also a statisticall& significant difference between true and sham acu uncture. Clinical cure 1assessment of clinical s&m toms3 ultrasonic e<amination and radioimmunoassa& of se< hormones2 was observed in4 -': of the test grou *2.): of the control grou . If lar&ngos asm develo ed3 atients were immediatel& given acu uncture at shosh ng 18U112 or 1h-ngf. 18U12. Ahe lar&ngos asm was relieved within 1 min in all atients. Ahe incidence of lar&ngos asm occurring after tracheal e<tubation in children was4 ).": in the test grou 2".+: in the control grou . Clinical cure in was observed in4 1" in the test grou > marked im rovement in "0> cure and im rovement rate3 /*: + in the control grou > marked im rovement in 21> cure and im rovement rate3 )*:. Im rovement of muscular strength and activities after 10 da&s of treatment was observed in4 1' in the test grou / in the control grou . Ahe ethidine reBuirements of each atient were recorded. Ahe Buantit& of ethidine consumed b& the test grou was half that consumed b& the control grou .

9ol#c#stic ovar# s#ndrome )"tein:4eventhal s#ndrome* ;a et al.3 1--* 12452 )04'/ ,andomi5ed controlled trial

;anual acu uncture lus electric acu uncture lus mo<ibustion

Conventional 6estern medication 1clomifene2

9oste(tu ation in children 8ee et al.3 1--/ 1152 "/4"/

,andomi5ed controlled trial

Acu uncture 1blood7 letting at shosh ng 18U112 at the end of o eration2

$o acu uncture

9ostoperative s#mptoms' closed craniocere ral in-ur# #ing et al.3 1--+ 12522 )04)0 ,andomi5ed controlled trial

Conventional 6estern medication lus acu uncture

Conventional 6estern medication 1no further details available2

9ostoperative convalescence ?u3 1--/ 11012 1)41) 1hemi legia after meningioma removal2 9ostoperative pain Christensen et al.3 1-/- 1722 1after lower abdominal surger&2

!rou com arison

Bod& acu uncture

,outine medical treatment 1intravenous iracetam2

10410

,andomi5ed controlled trial

%lectric acu uncture

$o treatment

9#

8% &ummar table o$ controlled clinical trials

Condition$"tud#
6ang et al.3 1--0 1762 1after tonsillectom&2 8P et al.3 1--" 1742 1after anal surger&2

%o.
""4""

Design
!rou com arison

&est group
Acu uncture

Control Group
;edication 1 enicillin lus #obell gargle2 Bucinna5ine

Results
Alleviation of ain3 reduction in salivation and s eed of wound healing were su erior in the test grou . A marked analgesic effect was obtained in4 ++: of the test grou 2+: of the control grou . Although less effective than narcotic analgesics3 acu uncture rovided adeBuate analgesia in )0: of atients3 L noticeabl& alleviated severit& of osto erative com lications 1nausea3 vomiting3 retention of urine3 intestinal aresis3 im aired drainage function of bronchi2. *0 min and 2' h after treatment3 ain scores on a visual analogue scale were lower in the test grou . .eri7incisional dermatomal A%$( and A%$( at 5usanli were eBuall& effective in decreasing osto erative o ioid analgesic reBuirement and in reducing o ioid7related side effects. Both of these treatments were more effective than the nonacu oint or sham A%$(. Aotal relief of s&m toms with no recurrence in * months of follow7u was observed in4 -1.+: of the test grou *": of the control grou . ,elief of s&m toms and im rovement in se<ual function were su erior in the test grou . Acu uncture and electric acu uncture reduced subjective itch intensit& more effectivel& than lacebo acu uncture. Ahe difference was significant. Ahe results suggest that the two test rocedures could be tried in clinical conditions associated with ruritus. 9:

*24"0

,andomi5ed controlled trial

Acu uncture

Asibuliak et al.3 1--) 1752 1various2

22-4-14 22-

!rou com arison

Acu uncture

%lectric stimulation or narcotic analgesics 1omno on 1a Chinese o ium alkaloid23 trime eridine2

Delhendler et al.3 1--* 12782 1after knee arthrosco &2 Chen et al.3 1--/ 1712 1after abdominal h&sterectom& or m&omectom&2

'0

,andomi5ed controlled trial ,andomi5ed controlled trial

Acu ressure 1firm ressure across classical acu oints2 A%$( at 1"s n&, 1(A"*2 or dermatomal A%$( at the level of the surgical incision

.lacebo 1light ressure in the same area2 $onacu oint A%$( or sham A%$( 1no electric current2

2) er grou

9remenstrual s#ndrome 8i et al.3 1--2 11552 10/410/

,andomi5ed grou com arison

Acu uncture

9erbal medication

9rostatitis' chronic 8uo et al.3 1--' 11492

1004/1

,andomi5ed controlled trial ,andomi5ed crossover trial

Acu uncture at 1h$bi n 1B8)'2 and s n!%n#i o 1(.*2 ;anual or electric acu uncture

;edication 1oral sulfametho<a5ole2 .lacebo acu uncture 1su erficial insertion of needle with no s ecific sensation2

9ruritus' e(perimentall# induced 8underberg et al.3 1-/+ 10 12262

AcupunctureD review and anal sis o$ controlled clinical trials

Condition$"tud#

%o.

Design
,andomi5ed controlled trial

&est group
!inger mo<ibustion lus acu oint injection

Control Group
,outine 6estern treatment 1o<&gen inhalation3 antibiotics and bronchodilators2

Results
After 1.)G2 months of treatment3 im rovement was observed in4 2+="0 1-0:2 of the test grou > in 17&ear follow7u 3 acute res irator& infection occurred in + 12=2- 1'1.':2 of the control grou > in 17&ear follow7u 3 acute res irator& infection occurred in 2*. 8aser acu uncture was more effective than lacebo in 20 out of 21 atients. ;ean duration of the ca illar& flowsto reaction induced b& local cooling test decreased from +1 s to 2' s 1week 1 com ared to week 123 = I 0.0012 in test grou . Changes in control grou werenSt significant. Authors concluded that Chinese acu uncture is a reasonable alternative in treating atients with rimar& ,a&naud s&ndrome. Ahere was a significant decrease in the freBuenc& of attacks b&4 *": in the test grou and 2+: in the control grou . .ro ortions remaining free of lower urinar&7tract infection during*7month observation eriod were4 /): in the acu uncture grou )/: in the sham acu uncture grou "*: in the untreated grou . Acu uncture was beneficial. Both grou s e< erienced a significant decrease in ain levels3 with the acu uncture grou im roving slightl& more. (ide7effects occurred in4 0=22 in the test grou +=1* in the control grou .

9ulmonar# heart disease' chronic Fou et al.3 1--/ 12792 "042-

Radicular and pseudoradicular pain s#ndromes Orec5i et al.3 1-/* 1572 21 ,andomi5ed single7 blind crossover trial Ra#naud s#ndrome' primar# A iah et al.3 1--+ 1+41* ,andomi5ed controlled 12442 trial

8aser acu uncture Acu uncture

;ock laser acu uncture $o treatment

Recurrent lower urinar#.tract infection Aune et al.3 1--/ 11522 *+

,andomi5ed controlled trial

Acu uncture

(ham acu uncture or no treatment

Refle( s#mpathetic d#stroph# Oho3 1--) 12802 2/ Renal colic 8ee et al.3 1--2 1652 2241*

#ouble7blind lacebo7 controlled trial ,andomi5ed controlled trial

Acu uncture Acu uncture

(ham acu uncture ;edication 1injection of a metami5oleGcam&lofin combination2

9;

8% &ummar table o$ controlled clinical trials

Condition$"tud#
Fhang et al.3 1--2 172

%o.
12*411/

Design
!rou com arison

&est group
Acu uncture

Control Group
;edication 1injection of atro ine lus ethidine2

Results
An analgesic effect was observed in4 --.2: of the test grou +1.2: of the control grou . ,elief of ain was observed in4 all atients in the test grou in 2) min on average -0: of the atients in the control grou in )0 min. Ahe thera eutic effect of acu uncture was markedl& su erior to that of neostigmine injection. Cure rates were4 '*=/* 1'-.):2 e&es in test grou > average duration of treatment reBuired3 )0.* da&s )2=1'* 1").*:2 e&es in control grou > average duration of treatment reBuired3 *".* da&s. .ain relief was observed in4 -0: of the treatment grou 10: of the control grou . (ubjective im rovement was observed in4 all atients in the test grou 1 atient in the control grou . ;arked im rovement was observed in4 *).): of the test grou 2*./: of the control grou . After * weeks of treatment3 marked im rovement was observed in4 +/: of the test grou "-: of the control grou .

8i et al.3 1--" 1662

2)42+

,andomi5ed controlled trial

Acu uncture

;edication 1injection of atro ine lus rometha5ine and bucinna5ine2

Retention of urine' traumatic .an et al.3 1--* 11462 +*4"2 Retinopath#' central serous Eu et al.3 1--+ 12812 /"41")

,andomi5ed controlled trial !rou com arison

Acu uncture

;edication 1intramuscular neostigmine bromide2 ;edication 1rutoside3 vitamin C3 tro<erutin2

Acu uncture 1manual2

Rheumatoid arthritis ;an et al.3 1-+' 142

10410

!rou com arison

%lectric acu uncture

(ham acu uncture

,uchkin et al.3 1-/+ 152

104*

#ouble7blind controlled trial

Auricular electric7 acu uncture

(ham electric acu uncture 1no electrical stimulation2

(un et al.3 1--2 162

"+/4)*

!rou com arison

6arming acu uncture

Acu uncture

"chi0ophrenia Cia et al.3 1-/* 11952

2'41"

Controlled trial

8aser acu uncture

;edication 1chlor roma5ine2

9"

AcupunctureD review and anal sis o$ controlled clinical trials

Fhang et al.3 1--' 12822

"/4"1

,andomi5ed controlled trial

%lectric acu uncture lus conventional medication 1various2

Conventional medication 1various2

Ahe thera eutic effect was significantl& greater in the test grou .

Condition$"tud#
"ciatica Oinoshita3 1-+1 1502

%o.
1)41)

Design
,andomi5ed controlled trial ,andomi5ed controlled trial

&est group
Acu uncture with dee insertion of needles 110G"0 mm2 Acu uncture at dch0ngsh 1B82)2 with dee uncture 1* cm2 8ong7needle acu uncture

Control Group
Acu uncture with su erficial uncture 1) mm2 Acu uncture with su erficial uncture 12 cm2

Results
Ahe thera eutic effect was greater in the test grou . Ahe difference was statisticall& significant. Ahe thera eutic effect on tenderness3 8asegueSs sign3 and subjective s&m toms was greater in the test grou . Ahe difference was significant. %ffective rates were4 -*: of the test grou +2: of the control grou . %ffective rates were4 -/: of test grou after 1)./ treatments3 on average /1.': of the control grou after 2+.+ treatments.

Oinoshita3 1-/1 1512

1)41)

(hen3 1-/+ 1532

)04)0

!rou com arison

Classical acu uncture

8i3 1--1 1522

1004+0

!rou com arison

Acu uncture at (ia1hibian

Acu uncture at 1h$bi n 1B8)'2

"e(ual d#sfunction' see #efective ejaculation> ;ale se<ual d&sfunction3 non7organic "ialorrhoea' antips#chotic.induced ?iong et al.3 1--" *04*0 ,andomi5ed controlled Acu uncture 12422 trial

Anisodamine

After 10 da&s of treatment3 marked reduction in salivation was achieved in4 -*.+: of the test grou ").-: of the control grou . Ahe effects of hoto7acu uncture and auricular acu ressure were satisfactor&3 with better results for the former. After " months of acu uncture treatment3 the obesit& indices decreased significantl& and levels of blood li ids3 glucose3 h&drocortisone and triiodoth&ronine were all markedl& im roved.

"imple o esit# in children Eu et al.3 1--/ 12832 10141014 )0

,andomi5ed controlled trial

.hoto7acu uncture or auricular acu ressure

$o treatment

"-;gren s#ndrome

#7

8% &ummar table o$ controlled clinical trials

8ist et al.3 1--/ 12432

21

,andomi5ed controlled trial

Acu uncture

$o treatment

A significant increase in araffin7stimulated saliva secretion was found in both grou s. Ahere were no statisticall& significant differences in unstimulated salivar& secretion between grou s. Ahe stud& showed that acu uncture is of limited value for atients with rimar& (jTgren s&ndrome.

Condition$"tud#

%o.

Design
,andomi5ed controlled trial

&est group
Bod& acu uncture 1'0 min2

Control Group
Bod& acu uncture 120 min and *0 min2

Results
(mall airwa& function in bronchial asthma and chronic bronchitis im roved in all three grou s. Ahe best result was obtained in the test grou .

"mall airwa# o struction Chen et al.3 1--+ 12842 21421421 "moking' see #e endence3 tobacco "ore throat 1see also Aonsillitis3 acute2 !unsberger3 1-+" 100 er grou 11182

!rou com arison

Acu uncture at a single oint or at 2 oints

$o treatment 1acu uncture refusers2 or etroleum jell& lacebo

,esults in the two treatment grou s were significantl& better than in the two control grou s. At '/ h3 -0: of those receiving acu uncture at 2 oints were still re orting ain relief com ared with onl& "0: of those receiving no treatment. Ahe test grou showed significant increases in range of motion3 straight leg raising3 L decreased ain immediatel& after treatment. Control grou showed no im rovement. .ain was relieved after 1 session of treatment in4 "2: of the test grou 1in /': after sessions2 0: of the control grou 1in 1/: after sessions2. .ain was relieved and function restored in4 1G" da&s 1average 1.0* da&s2 in test grou "G10 da&s 1average '."/ da&s2 in control grou . Cure 1disa earance of s&m toms3 free movement of the lower back3 and no recurrence in " &ears2 immediatel& after 1 session of treatment in4 /2.': of the test grou )2.-: of the control grou . #!

"pine pain' acute 1see also 8ow back ain> (ciatica2 (antiesteban3 1-/' )4) ,andomi5ed controlled 12852 trial "prain Ciao3 1--1 1682 1limb2

%lectric acu uncture

(elected h&sical thera &

2004100

,andomi5ed controlled trial

Acu uncture

.h&siothera &

Cin3 1--1 1692 1lumbar2

"'*4)0

!rou com arison

9and acu uncture

;edication 1analgesic2

Fheng3 1--+ 1702 1lumbar2

1004)0

,andomi5ed grou com arison

9and acu uncture

Bod& acu uncture

AcupunctureD review and anal sis o$ controlled clinical trials

"tiff neck 6u3 1--+ 12862

1004"2

!rou com arison

Acu uncture at &ao1h4n

;edication 1ibu rofen 0." g3 " times er da&2

Cure was observed in4 /0=100 1/0:2 in the test grou after the first session3 10 after the second3 and ' after the third> * did not res ond in " da&s 12="2 1"/:2 in the control grou on the first da&3 * on the second3 and 2 on the third> 12 did not res ond in " da&s.

Condition$"tud#
"troke Chen et al.3 1--0 1892 1ischaemic22 Fou et al.3 1--0 12872 1ischaemic2 Bai et al.3 1--" 1882 1ischaemic2

%o.
20 er grou

Design
,andomi5ed controlled trial ,andomi5ed controlled trial ,andomi5ed controlled trial

&est group
Acu uncture

Control Group
;edication 1mannitol3 de<trose3 citicoline2 ;edication 1vin ocetine2 ;edication Beniol 1a Chinese medicine containing linoleic acid3 inositol L other vitamins23 tro<erutin3 nimodi ine2 .h&siothera &

Results
A better thera eutic effect 1as assessed b& %%!7 ma and somatosensor&7evoked otential2 was observed in the test grou . A better thera eutic effect was observed in the test grou . A better neurological outcome was observed in the test grou .

"24"1 '0 er grou

Acu uncture Acu uncture

9u et al.3 1--" 1942 1ischaemic2 Cin et al.3 1--" 1992 1hemi legia after stroke2 8iang3 1--" 11002 1seBuelae of stroke2 Cohansson et al.3 1--" 1952 1seBuelae of stroke2 Fhang et al.31--' 11022 1stroke with a hasia2

"04"0

,andomi5ed controlled trial ,andomi5ed grou com arison ,andomi5ed controlled trial ,andomi5ed controlled trial ,andomi5ed controlled trial

.h&siothera & lus acu uncture Aem oral acu uncture

A better neurological outcome was observed for h&siothera & lus acu uncture than for h&siothera & alone. (ignificantl& better results were obtained in the test grou . (ignificantl& better results were obtained in the test grou . A more ra id and more com lete recover& was observed in the test grou . A more ra id and more com lete recover& observed in the test grou .

10/4100

Araditional bod& acu uncture

)04)0 "/4'0

Aem oral acu uncture Acu uncture lus h&siothera & and occu ational thera & (cal electric acu uncture

Araditional bod& acu uncture .h&siothera & and occu ational thera & $o treatment

22422

#4

8% &ummar table o$ controlled clinical trials

8iao3 1--+ 1912 1hemi legia after stroke2

10/410+

!rou com arison

Acu uncture at sh>us n&, 18I102 and f"t< 1(A"22

,outine medication lus h& erbaric o<&genation

;arked im rovement after 20 da&s of treatment was observed in4 **.+: of the test grou 2-.0: of the control grou .

Condition$"tud#
Ciang et al.3 1--+ 1902 1s ontaneous limb ain after stroke2

%o.
"04"0

Design
,andomi5ed controlled trial

&est group
%lectric acu uncture

Control Group
Conventional 6estern medication 1carbama5e ine2

Results
After "0 da&s of treatment3 the two grou s showed similar amelioration of ain. %ffective rates were4 -0: in the test grou /*.+: in the control grou . Dunctional recover& was observed in4 +).*: of the scal acu uncture grou > total effective rate -/.+: )1./: of the bod& acu uncture grou > total effective rate -2./: 1*.+: control grou > total effective rate /0:. Ahe test grou im roved significantl& more than the control grou during the treatment eriod of * weeks3 and even more during the following &ear3 according to motor7assessment scale3 A#83 $ottingham health rofile and social situation. Ahere were no differences between the grou s in res ect of changes in the neurological score and the Barthel and (unnaas activities of dail& living inde< scores after " and 12 months. Clinical functional recover& was significantl& better in the test grou . .atients in the test grou had a shorter hos ital sta& for rehabilitation and better neurological and functional outcomes than those in the control grou 3 with a significant difference in scores for self7care and locomotion. #6

8iu et al.3 1--+ 1922 1m&od&namia after stroke2

+/4)*4"0

!rou com arison

(cal or bod& acu uncture

;edication

Ojendahl et al.3 1--+ 1972 1subacute stroke2

21420

,andomi5ed controlled trial

,ehabilitation rogramme lus acu uncture

,ehabilitation rogramme

!osman79edstrom et al.3 1--/ 1962 1acute stroke2 (i et al.3 1--/ 1932 1acute ischaemic stroke2 6ong et al.3 1--- 1982 1hemi legia after stroke2

10'

,andomi5ed controlled trial

Conventional rehabilitation lus dee acu uncture %lectric acu uncture lus medication %lectric acu uncture lus rehabilitation

Conventional rehabilitation lus su erficial acu uncture or conventional rehabilitation alone ;edication

'2

,andomi5ed controlled trial ,andomi5ed controlled trial

)-4)-

,ehabilitation

AcupunctureD review and anal sis o$ controlled clinical trials

&emporomandi ular -oint d#sfunction 1see also Dacial ain3 including craniomandibular disorders2 ,austia et al.3 1-/* 2)42) ,andomi5ed controlled Acu uncture (tandard stomatognathic 12882 trial treatment

Both treatments resulted in a significant reduction in s&m toms and signs. Acu uncture seems to be useful as a com lementar& treatment3 es eciall& in cases with evidence of h&siological or neuromuscular disturbances.

Condition$"tud#
&ennis el ow Brattberg3 1-/" 1422

%o.
"'42*

Design
!rou com arison

&est group
Acu uncture

Control Group
(teroid injection

Results
Im rovement was observed at follow7u in4 *1./: of the test grou "0./: of the control grou . (hort7term im rovement was significantl& greater in the test grou . .ain relief of at least )0: after 1 treatment was re orted b&4 1- of the test grou > average duration of analgesia after 1 treatment3 20.2 h * of the control grou > average duration of analgesia after 1 treatment3 1.' h. After " weeks of treatment3 cure was observed in4 +0=10/ 1*'./:2 in the test grou 2'=*' 1"+.):2 in the control grou . After * weeks of treatment cure was observed in4 / 122.-:2 in the test grou > 10 12/.*:2 markedl& im roved 2 1).+:2 in the control grou > * 11+.1:2 markedl& im roved. Ahere was no statisticall& significant difference between the two grou s. %arlier relief of fever and sore throat was observed in the test grou .

9aker et al.3 1--0 1432 ;olsberger et al.3 1--' 1442

''4"/ 2'42'

,andomi5ed grou com arison .lacebo7controlled3 single7blind trial with inde endent evaluation

Classical acu uncture Acu uncture

(u erficial acu uncture .lacebo 1acu uncture. avoiding enetration of the skin2

&iet0e s#ndrome Eang3 1--+ 12462

10/4*'

!rou com arison

Acu uncture 1manual2 lus cu ing

,outine medication 1oral indometacin and local injection of rednisolone or rocaine2 lus h&siothera & ,outine medication3 including anisodamine

&innitus Cin et al.3 1--/ 12202 1subjective2

")4")

,andomi5ed controlled trial

Bod& acu uncture

Kilholm et al.3 1--/ 12212 1severe2 &onsillitis' acute Chen3 1-/+ 11172 &ourette s#ndrome #8

)'

,andomi5ed controlled crossover trial !rou com arison

Bod& acu uncture

.lacebo

2204)0

Acu uncture

Antibiotics 1 enicillin3 etc.2

8% &ummar table o$ controlled clinical trials

Aian et al.3 1--* 12172

*/41+

,andomi5ed controlled trial

Bod& acu uncture lus auricular acu ressure

Conventional 6estern medication 1halo eridol2

Cure was observed in4 "0.-: of the test grou > effective rate at *7 month follow7u 3 '*=)+ 1/-.+:2 11./: of the control grou > effective rate at *7month follow7u 3 )=1" 1*-.+:2 in the control grou .

Condition$"tud#
Cin3 1--/ 12162

%o.
"04"0

Design
,andomi5ed controlled trial

&est group
Bod& acu uncture lus auricular acu ressure

Control Group
Conventional 6estern medication 1halo eridol2

Results
After 1 month of treatment3 clinical cure with no recurrence at *7month follow7u in4 "0.0: of test grou > overall effective rate -".': *.+: of control grou > overall effective rate +*.+:. After " months of treatment3 clinical cure was observed in4 1"=2' 1)':2 in test grou > im rovement in 10 "=11 12+:2 in the control grou > im rovement in '. Ahe difference was significant.

<lcerative colitis' chronic 6u et al.3 1--) 11342 2'411

!rou com arison

;o<ibustion with herbal artition

(ulfasala5ine

;a et al.3 1--+ 12892

After "0 da&s of treatment3 cure 1assessed both clinicall& and endosco icall&2 was observed in4 +*.+: of the test grou )*.+: of the control grou . <rinar# tract pro lems' see Demale urethral s&ndrome> $euro athic bladder in s inal cord injur&> ,ecurrent lower urinar& tract infection> ,enal colic> Urolithiasis <rolithiasis Fhang et al.3 1--2 172 12*411/ !rou com arison Acu uncture Dluid infusion lus herbal Cure 1elimination of s&m toms and signs and no medication2 residual stones revealed b& ?7ra& or ultrasound e<amination2 was observed in4 -0.'/: of the test grou "".0): of the control grou . =ascular dementia 8ai3 1--+ 12902 "04"0 ,andomi5ed controlled ;anual lus electric Aniracetam Im rovement after * weeks of treatment was trial acu uncture observed in4 2* 1/*.+:2 of the test grou 1- 1*".":2 of the control grou .

*04"0

,andomi5ed controlled trial

Bod& acu uncture lus mo<ibustion.

(ulfasala5ine lus metronida5ole

#9

AcupunctureD review and anal sis o$ controlled clinical trials

8iu et al.3 1--/ 12912

*04*04 "04"0

,andomi5ed controlled trial

112 (cal electric acu uncture

122 $imodi ine3 1"2 %lectric acu uncture lus medication 1nimodi ine23 or 1'2 $o treatment

Assessment b& various neuro s&chological scales showed that effects of test L control rocedures were com arable. After / weeks of treatment3 assessment 1of memor&3 intelligence and abilit& to take care of oneself2 showed im rovement in4 */.": of grou 112 +1.*: of grou 122 +".": of grou 1"2 2".": of grou 1'2.

Condition$"tud#
Ciang et al.3 1--/ 12922

%o.
""4""

Design
,andomi5ed controlled trial

&est group
%lectric acu uncture

Control Group
#ih&droergoto<ine

Results
,esults were su erior in the test grou 3 as assessed b& the 9asegawa dementia scale and functional activities Buestionnaire3 increase in su ero<ide dismutase and decreases in li id ero<ide and nitric o<ide. %ffective rates were4 )-=+2 1/1.-:2 in the test grou 1-='2 1').2:2 in the control grou . After + da&s of treatment3 cure was observed in4 -/.*: of the test grou 10: of the control grou .

=iral encephalitis in children' late stage 6ang3 1--/ 12932 +24'2

!rou com arison

(cal electric and manual acu uncture lus routine medication as for control grou Acu uncture at b (i* 1%?7U%-2

,outine medication 1including antiviral and anti7inflammator& agents3 and nutrients for brain tissue2 Chloram henicol intravenous dri

>hooping cough )pertussis* Eao et al.3 1--* 1872 1')4)0

,andomi5ed controlled trial

##

3e$erences

#:

AcupunctureD review and anal sis o$ controlled clinical trials

References
!% 4% L ;"!& 6T ! a(, On the evaluation o$ the clinical e$$ect o$ acupuncture% Pain, !";6, +3D!!!!4:% Po/ ran> B, Acupuncture analgesia $or chronic painD brie$ surve o$ clinical trials% InD ?omeranz -, &tux 1, eds% 4cienti5ic bases o5 ac&p&nct&re% -erlinCHeidelberg, &pringer) Jerlag, !";"D !":!""% R"c&ard$on P5 ! a(, Acupuncture $or the treatment o$ paina review o$ evaluation research% Pain, !";#, -1D!987% ?an SC ! a(, ?reliminar clinical stud o$ acupuncture in rheumatoid arthritis% 6o&rnal o5 7he&matology, !":8, +D!4#!4"% Ruc&k"n IN ! a(, PAuriculo)electropuncture in rheumatoid arthritis <a double)blind stud =%Q Terape8tiches9ii %r9hi8, !";:, 29<!4=D4#67 Pin 3ussianQ% Sun L@ ! a(, PObservation o$ the e$$ect o$ acupuncture and moxibustion on rheumatoid arthritis in 868 cases%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<!=D"!! Pin ChineseQ% *&ang WR ! a(, PClinical observation o$ acupuncture in treating kidne and ureter stones%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<6=D9# Pin ChineseQ% L" AR, PAnal sis on the e$$ect o$ acupuncture treatment in !6;6 adults with bacillar d senter %Q :hinese %c&p&nct&re and ;o<ib&stion, !""7, +:<8=D!!6!!8 Pin ChineseQ% @"u ?L ! a(, PA clinical stud on acupuncture treatment o$ acute bacillar d senter %Q InD (hang +T, ed% P7esearches on ac&p&nct&re-mo<ib&stion and ac&p&nct&re-anaesthesia %Q -ei.ing, &cience ?ress, !";#D 9#:9:4 Pin ChineseQ% Yu S* ! a(, Clinical observation o$ !#4 cases o$ acute bacillar d senter treated b acupuncture% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""4, -<6=D!6!8% *&ang )P, P3esearches on the mechanism o$ acupuncture and moxibustion%Q Anhui, Anhui &cience and Technolog ?ress, !";6 Pin Chinese%Q S!uB 68 Po/ ran> B, %c&p&nct&rete<tboo9 and atlas% -erlinD &pringer)Jerlag, !";:D !;!"% L ;"!& 6T ! a(, On the evaluation o$ the clinical e$$ects o$ acupunctureD a problem reassessed and a $ramework $or $uture research% 6o&rnal o5 %lternati8e and :omplementary ;edicine, !""#, -<!=D:""7% S& n SC, PImmediate analgesic e$$ect o$ acupuncture at binao <5I !8= $or pain due to subcon.unctival in.ection%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<4=D:!:4 Pin ChineseQ% L CA ! a(, The e$$ect o$ acupuncture on the incidence o$ postextubation lar ngospasm in children% %naesthesia, !"";, 2.<"=D"!:H"47% @"u L, PAcupuncture treatment o$ severe leg pain in #7 cases o$ thromboangitis obliterans%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<!!=D#::#:; Pin ChineseQ% A&on n E ! a(, Acupuncture and ph siotherap in the treatment o$ m ogenic headache patientsD pain relie$ and 0,1 activit % %d8ances in Pain 7esearch and Therapy, 1";6, 2D9:!9:#% C& n )S ! a(, PObservation o$ penetrating acupuncture treatment o$ migraine in 89 cases%Q 4han<i 6o&rnal o5 Traditional :hinese ;edicine , !"":, +.<#=D6466 Pin ChineseQ% Do rrDPro$k 5 ! a(, PA muscle and vascular oriented relaxation program $or the treatment o$ chronic migraine patients% A randomized clinical control groups stud on the e$$ectiveness o$ a biobehavioural treatment programQ% >eitschri5t 5?r Psychosomatische ;edi.in &nd Psychoanalyse, !";9, 6!<6=D48:4## Pin 1ermanQ%

6% 8% 9% #%

:% ;% "%

!7% !!% !4% !6%

!8%

!9% !#% !:%

!;% !"%

#;

3e$erences
47% 4!% 44% 46% 48% 49% 4#% Do;$on DI ! a(, The e$$ects o$ acupuncture versus placebo in the treatment o$ headache% Pain, !";9, -+D6984% Aub" na 6 ! a(, Akupunktur bei ,igrRne% PAcupuncture treatment o$ migraine%Q De&tsche >eitschri5t 5?r %9&np&n9t&r, !""4, .2<#=D!87!8; Pin 1ermanQ% L"u AS ! a(, PAThree &calp 2eedlesB in the treatment o$ migraine%Q 3e@ Tradiitional :hinese ;edicine, !"":, -9<8= 494# Pin ChineseQ% Lo& L ! a(, Acupuncture versus medical treatment $or migraine and muscle tension headaches% 6o&rnal o5 3e&rology$ 3e&ros&rgery and Psychiatry, !";8, 14D66666:% Ta#o(a T ! a(, Traditional Chinese acupuncture in the treatment o$ tension)t pe headacheD a controlled stud % Pain, !""4, 17D64964"% V"nc n! CA, A controlled trial o$ the treatment o$ migraine b acupuncture% :linical 6o&rnal o5 Pain, !";", 2D6796!4% W "n$c&E!> T ! a(, (ur neuroregulativen Wirkung der Akupunktur bei Fop$schmerzpatienten% P2euroregulator action o$ acupuncture in headache patients%Q De&tsche >eitschri5t 5?r %9&np&n9t&r, !""8, .4<9=D!7#!!: Pin 1ermanQ% )u * ! a(, PTreatment o$ migraine b @i)manipulating acupuncture%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !""6, +-<6=D":!77 Pin ChineseQ% Ca" L, PObservation o$ therapeutic e$$ects o$ intractable prosopod nia treated b retaining the $ili$orm needle $or long time%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<8=D!"7 !"! Pin ChineseQ% 5an$ n PE ! a(, Acupuncture treatment o$ chronic $acial painD a controlled crossover trial% Aeadache, !";6, -.D###"% Co&an$$on A ! a(, Acupuncture $or the treatment o$ $acial muscular pain% %cta Bdontologica 4candina8ica, !""!, 19D!96!9;% L"$! T, Acupuncture in the treatment o$ patients with craniomandibular disordersD comparative, longitudinal and methodological studies% 4@edish Dental 6o&rnal, !""4, 74<&uppl% !=D!H!9"% Po&jo(a RT ! a(, 3ationale behind acupuncture treatment o$ temporomandibular .oint d s$unction% %9&p&n9t&r Theorie &nd Pra<is, !";#, +1<8=D4#6% B"rc& S ! a(, Controlled trial o$ >apanese acupuncture $or chronic m o$ascial neck painD assessment o$ speci$ic and nonspeci$ic e$$ects o$ treatment% :linical 6o&rnal o5 Pain, !"";, +1<6=D48;H499% Da#"d C ! a(, Chronic neck painD a comparison o$ acupuncture treatment and ph siotherap % Critish 6o&rnal o5 7he&matology, !"";, .4<!7=D!!!;H!!64% Coan R ! a(, The acupuncture treatment o$ neck painD a randomized controlled stud % %merican 6o&rnal o5 :hinese ;edicine, !";4, 9D64#664% Lo0 TT, Treatment o$ cervical spond losisD electro)acupuncture versus ph siotherap % ;edical 6o&rnal o5 %&stralia, !";6, -D6468% P !r" CP ! a(, A controlled stud o$ acupuncture in neck pain% Critish 6o&rnal o5 7he&matology, !";#, -2D4:!4:9% A"no$&"!a 5, P0$$ect o$ speci$ic treatment $or periarthritis o$ shoulder%Q 6o&rnal o5 the 6apanese %c&p&nct&re and ;o<ib&stion 4ociety, !":6, --<!=D464;% Pin >apaneseQ% S&ao CC, PTreatment o$ #4 cases o$ periarthritis o$ shoulder b needling at 5I 4%Q :hinese %c&p&nct&re and ;o<ib&stion, !""8, +1<9=D48:48; Pin ChineseQ% D (u> C ! a(, 0lectroacupuncture in $ibrom algiaD result o$ a controlled trial% Critish ;edical 6o&rnal, !""4, .:2D!48"!494% Aar n D ! a(, True acupuncture vs% sham acupuncture and conventional sports medicine therap $or plantar $asciitis painD a controlled, double blind stud % Dnternational 6o&rnal o5 :linical %c&p&nct&re, !""!, -<6=D48:496% Bra!!b rg 6, Acupuncture therap $or tennis elbow% Pain, !";6, +3D4;94;;% 5ak r E ! a(, Acupuncture treatment in epicond lalgiaD a comparison stud acupuncture techni@ues% :linical 6o&rnal o5 Pain, !""7, 3D44!44#% o$ two

4:% 4;%

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64% 66%

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AcupunctureD review and anal sis o$ controlled clinical trials


88% 89% 8#% 8:% 8;% 8"% 97% 9!% 94% 96% 98% ?o($b rg r A ! a(, The analgesic e$$ect o$ acupuncture in chronic tennis elbow pain% Critish 6o&rnal o5 7he&matology, !""8, ..<!4=D!!#4!!#9% Coan R ! a(, The acupuncture treatment o$ low back painD a randomized controlled treatment% %merican 6o&rnal o5 :hinese ;edicine, !";7, 7D!;!!;"% 6unn CC ! a(, 'r needling o$ muscle motor points $or chronic low)back pain% 4pine, !";7, 2<6=D4:"4"!% L &/ann TR ! a(, 0$$icac o$ electroacupuncture and T02& in the rehabilitation o$ chronic low back pain patients% Pain, !";#, -3D4::4"7% ?acDona(d ACR ! a(, &uper$icial acupuncture in the relie$ o$ chronic low back pain% %nnals o5 the 7oyal :ollege o5 4&rgeons o5 England, !";6, 32:888#% ? nd ($on 6 ! a(, Acupuncture treatment o$ low back painD a double)blind placebo) controlled trial% %merican 6o&rnal o5 ;edicine, !";6, 41D8"99% A"no$&"!a 5, PClinical trials on rein$orcing and reducing manipulations%Q 6o&rnal o5 the 6apanese %c&p&nct&re and ;o<ib&stion 4ociety, !":!, -:<6=D#!6 Pin >apaneseQ% A"no$&"!a 5, PClinical research in the use o$ paraneural acupuncture $or sciatica%Q 6o&rnal o5 the 6apanese %c&p&nct&re and ;o<ib&stion 4ociety, !";!, .:<!=D8!6 Pin >apaneseQ% L" 5Y, PControlled stud o$ !:7 cases o$ sciatica treated with acupuncture at the lower zhibian point%Q :hinese %c&p&nct&re and ;o<ib&stion, !""!, ++<9=D!:!; Pin ChineseQ% S& n 6*, PTreatment o$ !77 cases o$ sciatica b appl ing the long needle%Q :hinese %c&p&nct&re and ;o<ib&stion, !";:, 4<4=D:: Pin ChineseQ% C&r"$! n$ n BV ! a(, Acupuncture treatment o$ severe knee osteoarthrosisD a long)term stud % %cta %naesthesiologica 4candina8ica, !""4, .3D9!"49 <also iFges9ri5t 5or Gaeger, !""6, +22<8"=D877:87!! Pin 'anishQ=% Cunn"(a SYT, Acupuncture superior to piroxicam in the treatment o$ osteoarthritis% %merican 6o&rnal o5 %c&p&nct&re, !";4, +:D68!689% ?aruno A, PComparative anal sis o$ electrical acupuncture therap $or arthrosis o$ the knee%Q 6o&rnal o5 the 6apanese %c&p&nct&re and ;o<ib&stion 4ociety , !":#, -2<6=D9498 Pin >apaneseQ% Ar c>" T ! a(, A comparison o$ laser acupuncture versus placebo in radicular and pseudoradicular pain s ndromes as recorded b sub.ective responses o$ patients% %c&p&nt&re and Electrotherapy 7esearch, !";#, ++D47:4!#% B r/an B? ! a(, A randomized trial o$ acupuncture as an ad.unctive therap in osteoarthritis o$ the knee% 7he&matology, !""", .7<8=D68#H698% )"ao C ! a(, PAnal sis o$ the therapeutic e$$ect on 8! cases o$ rheumatoid arthritis treated b acupuncture and the in$luence on interleukin)4%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<#=D67#67; Pin ChineseQ% L" *W ! a(, PControlled stud o$ gout arthritis treated with blood)pricking acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<8=D!:"!;4 Pin ChineseQ% Pan 5L, PObservation o$ 6" cases o$ gout treated with plum)blossom needling plus cupping%Q >hen-i& Ginch&ang >a.hi, !"":, +.<6=D4" Pin ChineseQ% ?o TW, PObservation o$ :7 cases o$ biliar ascariasis treated b acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !";:, 4<9=D46:46; Pin ChineseQ% Wu )L ! a(, Observation o$ acupuncture treatment o$ biliar colic in !84 cases% 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""4, 7<#=D;% Yang T6 ! a(, PClinical report o$ electro)acupuncture analgesia in the treatment o$ abdominal colics%Q 6iangs& 6o&rnal o5 Traditional :hinese ;edicine , !""7, ++<!4=D6! Pin ChineseQ% L Y5 ! a(, Acupuncture in the treatment o$ renal colic% 6o&rnal o5 Frology, !""4, +14D!#!;% L" C) ! a(, PObservation o$ the therapeutic e$$ect o$ acupuncture treatment o$ renal colic%Q :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<4=D#9## Pin ChineseQ%

99% 9#%

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#7% #!% #4% #6% #8%

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:7

3e$erences
#:% S&u )8 ! a(, PObservation o$ acupuncture treatment o$ abdominal pain in acute gastroenteritis%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<!!=D#96#98 Pin ChineseQ% C"ao Y, Acupuncture analgesia in treating sprain o$ limbs% %c&p&nct&re 7esearch, !""!, ++<68=D496498% C"n CL, PClinical observation o$ 68# cases o$ acute lumbar sprain treated with hand) acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""!, ++<6=D67 Pin ChineseQ% *& ng L?, PHand acupuncture treatment o$ !77 cases o$ acute lumbar sprain%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<8=D47!474 Pin ChineseQ% C& n L ! a(, The e$$ect o$ location o$ transcutaneous electrical nerve stimulation o$ postoperative opioid analgesic re@uirementD acupoint versus nonacupoint stimulation% %nesthesia and %nalgesia, !"";, 74<9=D!!4"H!!68% C&r"$! n$ n PA ! a(, 0lectroacupuncture and postoperative pain% Critish 6o&rnal o5 %naesthesia, !";", 3-D49;4#4% Lao L ! a(, 0valuation o$ acupuncture $or pain control a$ter oral surger D a placebo) controlled trial% %rchi8es o5 Btolaryngology$ Aead and 3ec9 4&rgery, !""", +-2<9=D9#:H 9:4% LE D ! a(, PObservation o$ the analgesic e$$ect o$ acupuncture $or pain a$ter anal surger %Q 4hanghai 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""6, +-<4=D:4 Pin ChineseQ% T$"bu("ak VN ! a(, PAcupuncture analgesia and analgesic transcutaneous electroneurostimulation in the earl postoperative period%Q %neste.iologiia i 7eanimatologiia, !""9, <4=D"6": Pin 3ussianQ% Wang @ ! a(, PAcupuncture treatment o$ post)tonsillectom pain in 66 cases%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine , !""7, +:<8=D488489 Pin ChineseQ% Lao L) ! a(, 0$$icac o$ Chinese acupuncture on postoperative oral surger pain% Bral 4&rgery$ Bral ;edicine$ Bral Pathology$ Bral 7adiology and Endodontics , !""9, 49<8=D84684;% Sung YF ! a(, Comparison o$ the e$$ects o$ acupuncture and codeine on postoperative dental pain% %nesthesia and %nalgesia, !"::, 23D8:68:;% *& ng C ! a(, P?revention and treatment o$ pain caused b pulp devitalisation with arsenical%Q 6o&rnal o5 the >he-iang :ollege o5 Traditional :hinese ;edicine , !""7, +1<#=D# Pin ChineseQ% Sukandar SD ! a(, PAnalgesic e$$ect o$ acupuncture in acute periodontitis apicalis%Q :ermin D&nia Hedo9teran, !""9, <!79=D9!7 Pin IndonesianQ Ro$! d P, The use o$ acupuncture in dentistr D a s stematic review% %c&p&nct&re-;edicine, !"";, +3<!=D86H8;% *&ang YF ! a(, PClinical observation o$ acupuncture painless labour in !97 cases%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<8=D!;4!;6 Pin ChineseQ% @"an )*, PAchievements in scienti$ic studies on acupuncture)moxibustion and acupuncture)anaesthesia in China%Q InD (hang +T, ed% P 7esearches on ac&p&nct&remo<ib&stion and ac&p&nct&re-anaesthesia%Q -ei.ing, &cience ?ress, !";#D ! !6 Pin ChineseQ% )u B@ ! a(, P0xperimental studies on acupuncture treatment o$ acute bacillar d senter the role o$ humoral immune mechanism%Q InD (hang +T, ed% P 7esearches on ac&p&nct&re-mo<ib&stion and ac&p&nct&re-anaesthesia% Q-ei.ing, &cience ?ress, !";#D 9:69:; Pin ChineseQ% Wang )Y ! a(, Acupuncture and moxibustion in the treatment o$ as mptomatic hepatitis - virus carriers b strengthening the bod resistance to eliminate pathogenic $actorsD a clinical experimental stud % Dnternational 6o&rnal o5 :linical %c&p&nct&re , !""!, -<4=D!!: !49% Song )6 ! a(, The e$$ect o$ moxibustion on the kidne $unction o$ the patients with epidemic haemorrhagic $ever% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""4, -<!=D!: !"%
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AcupunctureD review and anal sis o$ controlled clinical trials


;:% ;;% ;"% Yao 55 ! a(, PClinical stud on treatment o$ pertussis with acupuncture at baxie <0+D0"=%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<!!=D#78 Pin ChineseQ% Ba" )Y ! a(, PA comparative stud o$ acupuncture and Western medicine in the treatment o$ strokeQ% :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<!=D!8 Pin ChineseQ% C& n D* ! a(, P0valuation o$ therapeutic e$$ects o$ acupuncture in treating ischaemic cerebrovascular disease%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine , !""7, +:<"=D94#94; Pin ChineseQ% C"ang *Y ! a(, PClinical stud on needling .ia.i <0+-4= in the treatment o$ thalamic spontaneous pain induced b stroke%Q 6o&rnal o5 Traditional :hinese ;edicine, !"":, .7<!7=D9""#7! Pin ChineseQ% L"ao S5, PTreatment o$ stroke with talon needling at 5I!7 and &T64%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<;=D8:"8;7 Pin ChineseQ% L"u YC ! a(, 2eedling scalp points in treating cerebrovascular diseasesD a report o$ :; cases% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<6=D46!H468% S" @? ! a(, 0$$ects o$ electroacupuncture on acute cerebral in$arction% %c&p&nct&re and Electro-Therape&tics 7esearch, !"";, -.<4=D!!:H!48% 5u 55 ! a(, A randomized controlled trial on the treatment $or acute partial ischemic stroke with acupuncture% 3e&roepidemiology, !""6, +-D!7#!!6% Co&an$$on A ! a(% Can sensor stimulation improve the $unctional outcome in stroke patientsS 3e&rology, !""6, 1.D4!;"4!"4% 6o$/anD5 d$!ro/ 6 ! a(, 0$$ects o$ acupuncture treatment on dail li$e activities and @ualit o$ li$eD a controlled, prospective, and randomized stud o$ acute stroke patients% 4tro9e, !"";, -9<!7=D4!77H4!7;% Aj nda&( A ! a(, A one ear $ollow)up stud on the e$$ects o$ acupuncture in the treatment o$ stroke patients in the subacute stageD a randomized, controlled stud % :linical 7ehabilitation, !"":, ++<6=D!"4H477% Wong A? ! a(, Clinical trial o$ electrical acupuncture on hemiplegic stroke patients% %merican 6o&rnal o5 Physical ;edicine and 7ehabilitation, !""", 47<4=D!!:H!44% C"n R ! a(, PClinical observation o$ temporal needling in the treatment o$ postapoplectic se@uelae%Q :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<!=D!!!4% Pin ChineseQ% L"ang RA, Clinical observation and experimental studies on the treatment o$ se@uelae o$ stroke b needling temporal points% Dnternational 6o&rnal o5 :linical %c&p&nct&re , !""6, 1<!=D!"4#% )u B, P0$$ect o$ acupuncture on the convalescence o$ meningioma removal%Q >hongg&o >hongyiyao Iin<i >a.hi P2ews 5etters o$ Chinese ,edicineQ, !"";, 2<6=D8: Pin ChineseQ% *&ang L5 ! a(, A control stud o$ scalp acupuncture in treating aphasia a$ter acute cerebrovascular disease% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""8, 1<!=D4746% L ;"!& 6T ! a(, Acupuncture compared with placebo in post)herpetic pain% Pain, !";6, +4D6#!6#;% Sukandar SD ! a(, PCuring e$$ect o$ acupuncture in post)herpetic neuralgia%Q ;a-alah Hedo9teran Dndonesia P6o&rnal o5 the Dndonesian ;edical %ssociationQ, !""9, 12<;=D 89# 8#! Pin IndonesianQ% L"n L, Through puncture compared with traditional acupuncture in treating $acial paral sis% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<!=D:6H:9% You FY ! a(, PObservation o$ the e$$ect o$ picking)out <blood)letting= acupuncture in the treatment o$ -ellTs pals %Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion , !""6, +-<4=D:8 Pin ChineseQ% L"u )R, PObservation o$ therapeutic e$$ects o$ ## cases o$ $acial spasm treated with wrist) ankle acupuncture and bod )acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<8=D!"4 Pin ChineseQ% Fro$! EA?, Acupuncture $or the comatose patient% %merican 6o&rnal o5 %c&p&nct&re, !":#, 1<!=D898;% Luo *P ! a(, PClinical observation o$ ear)acupressure treatment o$ insomnia%Q Aeilong-iang 6o&rnal o5 Traditional :hinese ;edicine, !""6, <!=D898; Pin ChineseQ%

"7%

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:4

3e$erences
!!7% !!!% !!4% !!6% !!8% !!9% !!#% *&ang )F, P0ar acupressure in the treatment o$ insomniaQ% :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<#=D4":4"; Pin ChineseQ% C&ar" P ! a(, Acupuncture therap in allergic rhinitis% %merican 6o&rnal o5 %c&p&nct&re, !";;, +3<4=D!86!8:% 5uang Y@, PTherapeutic e$$ect o$ acupuncture treatment in !4; cases o$ ha $ever%Q :hinese %c&p&nct&re and ;o<ib&stion, !""7, +:<#=D4"#4": Pin ChineseQ% C"n R ! a(, PClinical observation o$ !77 cases with allergic rhinitis treated b acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !";", 9<8=D!;9!;# Pin ChineseQ% L"u D), PAcupuncture at bi@iu in the treatment o$ allergic rhinitis%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<#=D4"6 Pin ChineseQ% Yu CL ! a(, P0$$ect o$ acupuncture treatment in 467 cases o$ allergic rhinitis%Q :hinese %c&p&nct&re and ;o<ib&stion, !""8, +1<9=D48!484 Pin ChineseQ% W"(("a/$on L ! a(, Ha $ever treatment in general practiceD a randomised controlled trial comparing standardised Western acupuncture with sham acupuncture% %c&p&nct&re;edicine, !""#, +1<!=D#H!7% C& n R5, PAcupuncture treatment o$ 447 cases o$ acute tonsillitis%Q :hinese %c&p&nct&re and ;o<ib&stion, !";:, 4<6=D98 Pin ChineseQ% 6un$b rg r ?, Acupuncture in the treatment o$ sore throat s mptomatolog % %merican 6o&rnal o5 :hinese ;edicine, !":6, +D66:687% Fung AP ! a(, Attenuation o$ exercise)induced asthma b acupuncture% Gancet, !";#, -D!8!"!844% 5 Y* ! a(, PClinical observation o$ CO 4 laser acupuncture in the treatment o$ bronchial asthma%Q :hinese %c&p&nct&re and ;o<ib&stion, !""8, +1<!=D!6!# Pin ChineseQ% Ta$&k"n DP ! a(, Comparison o$ real and simulated acupuncture and isoproterenol in methacholine)induced asthma% %nnals o5 %llergy, !"::, 6"D6:"6;:% )" CP ! a(, Observation o$ the speci$icit o$ points in electro)acupuncture treatment o$ asthma% :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<4=D;8;# Pin ChineseQ% Yu DC ! a(, 0$$ect o$ acupuncture on bronchial asthma% :linical 4cience and ;olec&lar ;edicine, !":#, 2+D97697"% Co$&" Y?, Acupuncture in bronchial asthma% 6o&rnal o5 the %ssociation o5 Physicians o5 Dndia, !""4, 1:<9=D64:66!% Tandon ?A ! a(, Comparison o$ real and placebo acupuncture in histamine)induced asthmaD a double)blind crossover stud % :hest, !";", "#D!74!79% Ba!ra YA ! a(, Acupuncture in corticosteroid)dependent asthmatics% %merican 6o&rnal o5 %c&p&nct&re, !";#, +1<6=D4#!4#8% Cob$! A ! a(, Controlled trial o$ acupuncture $or disabling breathlessness% Gancet, !";#, -D!8!#!8!"% )u PC ! a(, Clinical observation o$ treatment o$ acute epigastralgia b puncturing liang@iu and weishu acupoints% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !""!, -<4=D!4:!67% Yu Y?, PTherapeutic e$$ect and mechanism o$ needling &T6# in the treatment o$ epigastric pain%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"":, +3<6=D!7!! Pin ChineseQ% S&" )L ! a(, PAcupuncture treatment o$ gastrointestinal spasm%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<8=D!"4 Pin ChineseQ% *&ang AL ! a(, Clinical e$$ect o$ acupuncture in the treatment o$ gastrokinetic disturbance% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""#, 3<!=D6;% V"ck r$ AC, Can acupuncture have speci$ic e$$ects on healthS A s stematic review o$ acupuncture antiemesis trials% 6o&rnal o5 the 7oyal 4ociety o5 ;edicine, !""#, 79<#=D 676 6!!% Wu 56 ! a(, ?reliminar stud on therapeutic e$$ects and immunologic mechanisms o$ herbal)moxibustion treatment o$ irritable bowel s ndrome% :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<4=D8689 Pin ChineseQ%

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!66%

:6

AcupunctureD review and anal sis o$ controlled clinical trials


!68% Wu 56 ! a(, PTherapeutic e$$ect o$ herbal partition)moxibustion $or chronic diarrhoea and its immunological mechanism%Q 6o&rnal o5 Traditional :hinese ;edicine, !""9, .3<!=D49 4: Pin ChineseQ% Wang 55 ! a(, A stud in the e$$ectiveness o$ acupuncture analgesia $or colonoscopic examination compared with conventional premedication% %merican 6o&rnal o5 %c&p&nct&re, !""4, -:D4!:44!% Wang 55 ! a(, A clinical stud on ph siological response in electroacupuncture analgesia and meperidine analgesia $or colonoscop % %merican 6o&rnal o5 :hinese ;edicine, !"":, -2<!=D!6H47% D" &( DL, Acupuncture $or gastrointestinal and hepatobiliar disorders% 6o&rnal o5 %lternati8e and :omplementary ;edicine, !""", 2<!=D4:H89% *&ao SD ! a(, U0lectro)acupuncture and magnesium sulphate in treatment o$ cholelithiasis clinical observations on 944 cases and preliminar consideration o$ $eatures%Q :hinese ;edical 6o&rnal, !":", 29<!4=D:!# Pin ChineseQ% 6ong C? ! a(, PClinical stud on regulator action o$ combination o$ bod acupuncture with auricular acupuncture on gallbladder motor $unction%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<!=D!6 Pin ChineseQ% C& n B ! a(, PClinical observation o$ moxibustion treatment o$ leukopenia caused b chemotherap %Q G&o Ji G&n Tan P*orum o$ Traditional Chinese ,edicineQ, !""7, 2<#=D4: 4; Pin ChineseQ% C& n 5L ! a(, PObservation o$ the treatment o$ chemotherap )induced leucoc topenia with acupuncture and moxibustion%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine, !""!, ++<#=D697694 Pin ChineseQ% Wang ), P0$$ect o$ moxibustion in the treatment o$ chemotherap )induced leukopenia%Q P:hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<!=D!6!8 Pin ChineseQ% Y"n *F ! a(, PTherapeutic e$$ect o$ acupuncture in the treatment o$ leucopenia induced b benzene%Q 6iangs& 6o&rnal o5 Traditional :hinese ;edicine , !""7, ++<"=878879 Pin ChineseQ% Y"n *F ! a(, Clinical approach to treatment o$ benzene)induced leucopenia with acupuncture% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""4, -<6=D!9!;% 5 LY ! a(, PObservation o$ therapeutic e$$ect on 67 cases o$ puerperal retention o$ urine treated b acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !";6, .<9=D!"# Pin ChineseQ Pan )W ! a(, PApplication o$ acupuncture therap in traumatic urinar retention%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<!!=D9"#9": Pin ChineseQ% A0d"n S ! a(, Acupuncture and h pnotic suggestions in the treatment o$ non)organic male sexual d s$unction% 4candina8ian 6o&rnal o5 Frology and 3ephrology , !"":, .+<6=D4:!H 4:8% S&u" 5D, PAcupuncture treatment o$ de$ective e.aculation%Q :hinese %c&p&nct&re and ;o<ib&stion, !";#, 3<!=D!" Pin ChineseQ% Luo YN ! a(, Clinical research on treatment o$ chronic prostatitis with acupuncture% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""8, 1<6=D:!8% Wang SY ! a(, PThe e$$ect o$ acupuncture in lowering the urethral pressure o$ $emale urethral s ndrome patients%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"":, +3<4=D8# Pin ChineseQ% *& ng 5T ! a(, PAcupuncture treatment o$ $emale urethral s ndrome%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<!4=D:!":4! Pin ChineseQ% Aun A ! a(, Acupuncture in the proph laxis o$ recurrent lower urinar tract in$ection in adult women% 4candina8ian 6o&rnal o5 Primary Aealth :are, !"";, +3<!=D6:H6"% 5 (/$ C?, Acupuncture $or the management o$ primar d smenorrhea% Bbstetrics and Gynecology, !";:, 39D9!9#% S&" )L ! a(, PAcupuncture at &? # in the treatment o$ primar d smenorrhoea%Q :hinese %c&p&nct&re and ;o<ib&stion, !""8, +1<9=D48!484 Pin ChineseQ%

!69%

!6#%

!6:% !6;%

!6"%

!87%

!8!%

!84% !86%

!88% !89%

!8#% !8:%

!8;% !8"% !97%

!9!% !94% !96% !98%

:8

3e$erences
!99% !9#% L" C ! a(, PTreatment o$ !7; cases o$ premenstrual tension b head)acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<6=D48948# Pin ChineseQ% Yu C ! a(, P3elationship o$ hand temperature and blood )endorphin immunoreactive substance with electroacupuncture induction o$ ovulation%Q %c&p&nct&re 7esearch, !";#, ++<4=D;#H"7 Pin ChineseQ% C& n BY, Acupuncture normalized d s$unction o$ h pothalamic)pituitar )ovarian axis% %c&p&nct&re and Electro-Therape&tics 7esearch$ !"":, --D":H!7;% C" P ! a(, PClinical stud on acupuncture treatment o$ in$ertilit due to in$lammator obstruction o$ $allopian tube%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<"=D8#"8:7 Pin ChineseQ% L"n PC ! a(, PObservation o$ the e$$ect o$ acupuncture and ox tocin intravenous per$usion $or expediting labour%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<#=D4;!4;6 Pin ChineseQ% ?a W* ! a(, PClinical observation o$ the in$luence o$ puncturing di$$erent points on the whole stage o$ labour%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<6=D!67!6! Pin ChineseQ% Yu )* ! a(, PObservation o$ hastening o$ parturition and induction o$ labour with acupuncture%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine , !";!, +<!=D!4!9 Pin ChineseQ% Dund CW ! a(, ?C # acupressure reduces morning sickness% 6o&rnal o5 the 7oyal 4ociety o5 ;edicine, !";;, 7+<;=D89#89:% Fan YC, Observation o$ the therapeutic e$$ect o$ moxibustion $or treatment o$ pregnant vomiting% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""9, 2<8=D6!66% Card"n" F ! a(, ,oxibustion $or correction o$ breech presentationD a randomized controlled trial% 6o&rnal o5 the %merican ;edical %ssociation, !"";, -7:<!;=D!9;7H!9;8% L" 6R ! a(, PCorrection o$ abnormal $oetal position b moxibustion in :8 cases%Q 6o&rnal o5 .%c&p&nct&re-;o<ib&stion, !""7, .:<6=D!! Pin ChineseQ% L" @, Clinical observation o$ correcting malposition o$ $etus b electro)acupuncture% 6o&rnal o5 Traditional :hinese ;edicine, !""#, +3<8=D4#7H4#4% @"n 6F ! a(, PCorrection o$ abnormal $oetal position b ear point pressure a report o$ 8!6 cases%Q :hina 6o&rnal o5 Traditional :hinese ;edicine , !";", .:<#=D697H694 Pin ChineseQ% 5u )C ! a(, PThe in$luence o$ acupuncture on blood prolactin level in women with de$icient lactation%Q 4hanghai 6o&rnal o5 Traditional :hinese ;edicine , !"9;, <!4=D99:H 99; Pin ChineseQ% C&andra A ! a(, PThe in$luences o$ acupuncture on breast $eeding production%Q :ermin D&nia Hedo9teran, !""9, <!79=D666: Pin IndonesianQ% 6uo CS, PClinical observation o$ !97 cases o$ primar h potension treated b vaccaria seeds pressed on ear points%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<#=D4"94"# Pin ChineseQ% Yu L ! a(, PTreatment o$ !;7 cases o$ h potension with 147 needling%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"";, +4<8=D; Pin ChineseQ% Dan Y, PAssessment o$ acupuncture treatment o$ h pertension b ambulator blood pressure monitoring%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine , !"";, +7<!=D4#H4: Pin ChineseQ% Iur n # AP ! a(, P/se o$ various non)pharmacological methods in the treatment o$ patients in the earl stages o$ arterial h pertension%Q Terape8tiches9ii %r9hi8, !";;, 3:<!=D!46!4# Pin 3ussianQ% Wu C) ! a(, &calp acupuncture in treating h pertension in the elderl % Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<6=D4;!H4;8% Yu P ! a(, Clinical stud on auricular pressure treatment o$ primar h pertension% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !""!, -<!=D6:87% *&ou R) ! a(, PThe h potensive e$$ect o$ ear acupressure an anal sis o$ 4:8 cases%Q :hina 6o&rnal o5 Traditional :hinese ;edicine, !""7, .:<4=D""!77 Pin ChineseQ
:9

!9:% !9;%

!9"%

!#7%

!#!%

!#4% !#6% !#8% !#9% !##% !#:%

!#;%

!#"% !:7%

!:!% !:4%

!:6%

!:8% !:9% !:#%

AcupunctureD review and anal sis o$ controlled clinical trials


!::% Ca" @C ! a(, PThe regulator e$$ects o$ acupuncture on blood pressure and serum nitrogen monoxide levels in patients with h pertension%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<!=D"H!! Pin ChineseQ% *&ou Y?, PObservation o$ the therapeutic e$$ect o$ 67 cases o$ cardiac neurosis treated with acupuncture at ren ing%Q :hinese %c&p&nct&re and ;o<ib&stion, !""4, +-<4=D6764 Pin ChineseQ% Ba(( gaard S, Acupuncture and the cardiovascular s stemD a scienti$ic challenge% %c&p&nct&re-;edicine, !"";, +3<!=D4H"% Ba(( gaard S ! a(, Acupuncture in severe, stable angina pectorisD a randomized trial% %cta ;edica 4candina8ica, !";#, --:<8=D67:6!6% Ba(( gaard S ! a(, 0$$ects o$ acupuncture in moderate, stable angina pectorisD a controlled stud % 6o&rnal o5 Dnternal ;edicine, !""7, --4<!=D4967% Da" CY ! a(, PClinical observation o$ ear acupuncture at point heart in the treatment o$ coronar heart disease%Q 6o&rnal o5 Traditional :hinese ;edicine, !""9, .3<!!=D##8##9 Pin ChineseQ% C& ng BA, PClinical observation o$ ear acupressure treatment in 97 cases o$ angina pectoris%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<4=D:8:9 Pin ChineseQ% ?ao )R ! a(, 0$$ects o$ acupuncture on angina pectoris, 0C1 and blood lipids o$ patients with coronar heart disease% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""6, .<8=D!9!"% *&ou )@ ! a(, PIn$luence o$ acupuncture on the calibre o$ coronar arter in coronar heart disease%Q 6o&rnal o5 the A&nan :ollege o5 Traditional :hinese ;edicine , !""7, +:<6=D!##H!#: Pin ChineseQ% )u S? ! a(, 0$$ects o$ acupuncture on the le$t ventricular diastolic $unction in patients with coronar heart disease% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""4, -<4=D!7% 5o F? ! a(, 0$$ect o$ acupuncture at nei)kuan on le$t ventricular $unction in patients with coronar arter disease% %merican 6o&rnal o5 :hinese ;edicine, !""", -4<4=D!8"H!9#% 5u NA ! a(, PAcupuncture at neiguan causes haemorrheological improvement in patients with coronar heart disease%Q >hong Ii Ji 6iehe 4hiyong Ginch&ang 6i-i& K:linical Emergency by Dntegrated :hinese and =estern ;edicine Q, !"":, 1<9=D47#H47: Pin ChineseQ% 5ou DF ! a(, PClinical observation o$ therapeutic e$$ect o$ baihui <1J47=) intang <0+ H26= electro)acupuncture in 67 cases o$ post)apoplectic depression%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<;=D864866 Pin ChineseQ% L" CD ! a(, Treating post)stroke depression with AantidepressiveB acupuncture therap D A clinical stud o$ 4! cases% Dnternational 6o&rnal o5 :linical %c&p&nct&re , !""8, 2<8=D6;" 6"6% Luo 5C ! a(, 0lectro)acupuncture vs amitript line in the treatment o$ depressive states% 6o&rnal o5 Traditional :hinese ;edicine, !";9, 2<!=D6H;% Luo 5C ! a(, PClinical observation o$ electro)acupuncture on !66 patients with depression in comparison with tric clic am tript line%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine, !";;, 7<4=D::;7 Pin ChineseQ% Yang ), Clinical observation o$ needling extrameridian points in treating mental depression% 6o&rnal o5 Traditional :hinese ;edicine, !""8, +1D!8!;% *&ang B ! a(, A control stud o$ clinical therapeutic e$$ects o$ laser)acupuncture on depressive neurosis% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""#, 3<4=D!4!:% C"a YA ! a(, PTreatment o$ schizophrenia with helium)neon laser irradiation at acupoints%Q :hinese %c&p&nct&re and ;o<ib&stion, !";#, 3<!=D!"H4! Pin ChineseQ% @u YT ! a(, PObservation o$ !!! cases o$ competition stress s ndrome treated with auriculo)pressure therap %Q :hinese %c&p&nct&re and ;o<ib&stion, !";#, 3<4=D9: Pin ChineseQ% W n 5L ! a(, Treatment o$ drug addiction b acupuncture and electrical stimulation% %sian 6o&rnal o5 ;edicine, !""6, 9D!6;!8!% Cu(("!on RD ! a(, Overview o$ substance abuse acupuncture treatment research% 6o&rnal o5 %lternati8e and :omplementary ;edicine, !""#, -<!=D!8"!9"%

!:;%

!:"% !;7% !;!% !;4%

!;6% !;8% !;9%

!;#% !;:% !;;%

!;"%

!"7%

!"!% !"4%

!"6% !"8% !"9% !"#%

!":% !";%

:#

3e$erences
!""% 477% 47!% 474% 476% Bu((ock ?L ! a(, Auricular acupuncture in the treatment o$ cocaine abuseD a stud o$ e$$icac and dosing% 6o&rnal o5 4&bstance %b&se Treatment, !""", +3<!=D6!H6;% Ca" * ! a(, PAcupuncture treatment in the late stage o$ addiction abstinence%Q 6iangs& 6o&rnal o5 Traditional :hinese ;edicine, !"";, +9<!4=D69 Pin ChineseQ% ?argo("n A ! a(, Acupuncture $or the treatment o$ cocaine dependence in methadone) maintained patients% %merican 6o&rnal o5 %ddiction, !""6, -<6=D!"847!% Wa$&burn A? ! a(, Acupuncture heroin detoxi$icationD a single)blind clinical trial% 6o&rnal o5 4&bstance %b&se Treatment, !""6, +:D68969!% C(a# ( F ! a(, PA stud o$ various smoking cessation programs based on close to !777 volunteers recruited $rom the general populationD !)month results%Q 7e8&e Epidemiologi2&e de 4ant* P&bli2&e, !""7, .7<4=D!66!6; Pin *renchQ% Fang YA, PClinical stud on giving up smoking with acupuncture%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !";6, -<4=D676! Pin ChineseQ% 5 D ! a(, 0$$ects o$ acupuncture on smoking cessation or reduction $or motivated smokers% Pre8enti8e ;edicine, !"":, -3<4=D47;H4!8% Wa"! NR ! a(, A single)blind, placebo)controlled trial o$ a simple acupuncture treatment in the cessation o$ smoking% Critish 6o&rnal o55 General Practice , !"";, 17<866=D!8;:H !8"7% W&"! AR ! a(, 3andomized trial o$ acupuncture $or nicotine withdrawal s mptoms% %rchi8es o5 Dnternal ;edicine, !"";, +27<47=D449!H4499% W&"! AR ! a(, P&moking cessation with acupunctureS A Vbest evidence s nthesisKQ% Lorschende Homplimentarmedi.in, !"":, 1<4=D!74H!79 Pin 1ermanQ% Bu((ock ?L ! a(, Controlled trial o$ acupuncture $or severe recidivist alcoholism% Gancet, !""7, ..2D474!% Bu((ock ?L ! a(, Acupuncture treatment o$ alcoholic recidivismD a pilot stud % %merican 6o&rnal o5 %c&p&nct&re, !";:, +2<8=D6!6H647% Bu((ock ?L ! a(, Controlled trial o$ acupuncture $or severe recidivist alcoholism% Gancet, !";", !D!869!86"% T&or r 5 ! a(, Acupuncture a$ter alcohol consumptionD a sham controlled assessment% %c&p&nct&re-;edicine, !""#, !8<4=D#6H#:% L" Y@ ! a(, &wi$t needling o$ zusanli and chang@iang in treating in$antile diarrhea% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<4=D!;:H!;"% Yang *W, PTreatment o$ !77 cases o$ in$antile diarrhoea b acupuncture%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"";, +4<#=D!!% Pin ChineseQ% 5 C) ! a(, PTherapeutic e$$ect o$ acupuncture at 5I 8 in the treatment o$ in$antile convulsion due to high $ever%Q >hong Ii Ji 6iehe 4hiyong Ginch&ang 6i-i& PClinical 0mergenc b Integrated Chinese and Western ,edicineQ, !"":, 1<;=D6#76#! Pin ChineseQ% C"n ?*, PAcupuncture plus auricular acupressure treatment o$ 67 cases o$ 1illes de la TouretteTs s ndrome%Q G&angming Traditional :hinese ;edicine, !"";, 47<9=D4648 Pin ChineseQ% T"an LD ! a(, PObservation o$ therapeutic e$$ects o$ #; cases o$ 1illes de la TouretteTs s ndrome in children treated with acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<"=D8;68;8 Pin ChineseQ% Wang C5 ! a(, PClinical stud on acupuncture treatment o$ sudden dea$ness%Q %c&p&nct&re 7esearch, !"";, -.<!=D9: Pin ChineseQ% *&ang *F ! a(, PClinical stud on acupuncture treatment o$ acute attack o$ ,LniMreTs s ndrome%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !";6, -<8=D4; Pin ChineseQ% C"n )@ ! a(, PClinical observation o$ 69 cases o$ sub.ective tinnitus treated with acupuncture%Q >he-iang 6o&rnal o5 Traditional :hinese ;edicine$ !"";, ..<6=D!!; Pin ChineseQ% V"(&o(/ OC ! a(, 0$$ect o$ traditional Chinese acupuncture on severe tinnitusD a double) blind, placebo)controlled clinical investigation with open therapeutic control% Critish 6o&rnal o5 %&diology, !"";, .-<6=D!":H478%
::

478% 479% 47#%

47:% 47;% 47"% 4!7% 4!!% 4!4% 4!6% 4!8% 4!9%

4!#%

4!:%

4!;% 4!"% 447%

44!%

AcupunctureD review and anal sis o$ controlled clinical trials


444% 446% 448% ? k&a/ r A ! a(, 0xperience with unexplained otalgia% Pain, !";:, <&uppl%=D6#!% Lang B) ! a(, PClinical observation o$ the therapeutic e$$ect o$ ear acupuncture in treating simple epistaxis%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<4=D:#:: Pin ChineseQ% Luan Y5 ! a(, PClinical observation o$ #7 cases o$ chloasma treated with auricular acupuncture and acupressure%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<"=D8;9 8;# Pin ChineseQ% C& n B* ! a(, Comparative observation o$ the curative e$$ects o$ herpes zoster treated b t pe >I He)2e laser and pol inosinic acid% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !""8, 1<4=D4"6!% Lund rb rg T ! a(, 0$$ect o$ acupuncture on experimentall induced itch% Critish 6o&rnal o5 Dermatology, !";:, +4D::!:::% 5uang BS ! a(, PTreatment o$ #7 cases o$ neurodermatitis with three)step seven)star needling therap %Q 6o&rnal o5 G&iyang :hinese ;edical :ollege , !"";, -:<4=D69H6# Pin ChineseQ% L" 5@ ! a(, PAcupuncture treatment in 84 cases o$ acne vulgaris%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<6=D!## Pin ChineseQ% Wang C ! a(, PAuriculo)acupuncture treatment o$ 64 cases o$ $acial acne vulgaris%Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"":, +3<6=D49 Pin ChineseQ% Dang W ! a(, PClinical stud on acupuncture treatment o$ pain caused b stomach cancer%Q 6o&rnal o5 Traditional :hinese ;edicine, !""9, .3<9=D4::4;7 Pin ChineseQ% Dan Y ! a(, PClinical stud on analgesic e$$ect o$ acupuncture on carcinomatous pain%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<!=D!:!; Pin ChineseQ% C& n 6P ! a(, PObservation o$ therapeutic e$$ects o$ acupuncture in 88 cases with gastrointestinal reaction induced b radiotherap and chemotherap %Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<:=D69"6#7 Pin ChineseQ% Dund CW ! a(, Acupuncture to prevent cisplatin)associated vomiting% Gancet, !";:, +D!7;6% L" 5 ! a(, Clinical stud on acupuncture treatment o$ side reactions o$ radiotherap and chemotherap $or malignant tumour% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !"";, 7<4=D;!4% L"u A ! a(, PClinical research on attenuating chemotherapeutic toxicit b acupoint stimulation therap %Q 4hanghai 6o&rnal o5 %c&p&nct&re and ;o<ib&stion, !"";, +4<#=D;" Pin ChineseQ% Wang S* ! a(, PClinical stud on acupuncture control o$ gastrointestinal reactions to chemotherap %Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<!=D!:!; Pin ChineseQ% )"a Y@ ! a(, PAcupuncture treatment o$ reactions due to radiotherap in patients with malignant tumour%Q :hinese %c&p&nct&re and ;o<ib&stion, !";8, 1<#=D#; Pin ChineseQ% R"c&ard$ D ! a(, &timulation o$ auricular acupuncture points in weight loss% %&stralian Lamily Physician, !"";, -4<&4=D&:6H::% Wang 5, Clinical anal sis on treatment o$ 87 cases o$ h perlipemia with point)in.ection o$ radix salviae miltiorrhizae in.ection% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !"";, 7<8=D4744% Aang SY ! a(, PClinical investigation o$ the treatment o$ diabetes mellitus with timing acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""9, +2<!=D#; Pin ChineseQ% La!" % R, The e$$ect o$ san in ciao point on h pergl cemia o$ non)insulin)dependent diabetes mellitus% :ermin D&mia Hedo9teran, !";:, <88=D4746 Pin IndonesianQ% )"ong D* ! a(, PObservation o$ the therapeutic e$$ect o$ acupuncture in the treatment o$ drug)induced sialorrhea%Q :hinese %c&p&nct&re and ;o<ib&stion, !""6, +.<6=D!6:!6; Pin ChineseQ% L"$! T ! a(, The e$$ect o$ acupuncture in the treatment o$ patients with primar &.OgrenKs s ndromeD a controlled stud % %cta Bdontologica 4candina8ica, !"";, 23<4=D"9H""% A''"a& R ! a(, Treatment o$ primar 3a naudKs s ndrome with traditional Chinese acupuncture% 6o&rnal o5 Dnternal ;edicine, !"":, -1+<4=D!!"H!48%

449%

44#% 44:%

44;% 44"% 467% 46!% 464%

466% 468%

469%

46#% 46:% 46;% 46"%

487% 48!% 484%

486% 488%

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3e$erences
489% 48#% 48:% ?a R5 ! a(, PClinical observation o$ acupuncture treatment in pol c stic ovar s ndrome%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<!!=D#74#46 Pin ChineseQ% Yang )T, PObservation o$ !7; cases o$ TietzeTs s ndrome treated with short needling plus cupping%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<:=D86986# Pin ChineseQ% Wo(k n$! "n E8 5orak F, A statistical evaluation o$ the protective e$$ect o$ acupuncture against allergen)provoked rhinitis% De&tsche >eitschri5t 5?r %9&p&n9t&r, !""6, .3<#=D!64 !6:% B" rnack" W ! a(, Acupuncture in treatment o$ stable asthma% 7espiratory ;edicine, !"";, 9-<"=D!!86H!!89% D"ng *S, PObservation o$ therapeutic e$$ect o$ !47 cases o$ bulbar paral sis treated with acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<6=D!4;!4" Pin ChineseQ% Ca" *?, PThe e$$ect o$ acupuncture and auricular acupressure on colour discrimination%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<"=D94!944 Pin ChineseQ% ?a R* ! a(, Clinical observation and stud o$ mechanisms o$ acupuncture treatment o$ coronar heart disease% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !"":, 4<!=D6;% D"ng C ! a(, Comparative observation o$ curative e$$ects o$ postoperative s mptoms o$ the closed craniocerebral in.ur treated b acupuncture% =orld 6o&rnal o5 %c&p&nct&re;o<ib&stion, !"":, 4<6=D4#4;% C(a# ( F ! a(, Helping people to stop smokingD randomized comparison o$ groups being treated with acupuncture and nicotine gum with control group% Critish ;edical 6o&rnal, !";9, -9+D!96;!96"% Luo 5 ! a(, Clinical research on the therapeutic e$$ect o$ the electroacupuncture treatment in patients with depression% Psychiatry and :linical 3e&rosciences, !"";, 2- <&uppl%=D &66;H&687% L"u *S ! a(, PClinical stud on acupuncture treatment o$ d sphagia in pseudobulbar paral sis%Q 3e@ Traditional :hinese ;edicine, !"";, .:<6=D4849% Pin ChineseQ% ?a R5 ! a(, PClinical observation o$ 9# cases o$ h po)ovarianism treated with acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<:=D6"96"# Pin ChineseQ% T"an LT ! a(, PClinical observation o$ !77 children o$ h pophrenia treated mainl with acupuncture%Q :hinese %c&p&nct&re and ;o<ib&stion, !""#, +3<#=D4"44"6 Pin ChineseQ% D A(o0$"o D8 P nacc&"on" P, ,orning sickness control in earl pregnanc b eiguan point acupressure% Bbstetrics and Gynecology, !""4 7:F9=D ;94H;98% Ba0r u!& r C8 L ;"!& 6T8 P"ck r"ng R, A double)blind cross)over stud to evaluate the e$$ectiveness o$ acupressure at pericardium # <?#= in the treatment o$ earl morning sickness <0,&=% :omplementary Therapies in ;edicine, !""8, -D:7H:#% Dund CW ! a(, Traditional Chinese acupunctureD a potentiall use$ul antiemeticS Critish ;edical 6o&rnal, !";#, -9.D6;66;8% 6&a(0 R6 ! a(, A comparison o$ manual needling with electrical stimulation and commonl used antiemetics% %naesthesia, !";:, 12D!!7;!!!7% W "g&!/an W? ! a(, Traditional Chinese acupuncture as an antiemetic% Critish ;edical 6o&rnal, !";:, -92<##!7=D!6:"H!6;7% Dund CW ! a(, Acupuncture proph laxis o$ cancer chemotherap )induced sickness% 6o&rnal o5 the 7oyal 4ociety o5 ;edicine, !";", 7-D4#;H4:!% Bar$ou/ 6 ! a(, ?ostoperative nausea is relieved b acupressure% 6o&rnal o5 the 7oyal 4ociety o5 ;edicine, !""7, 7.<4=D;#;"% 5o RT ! a(, 0lectro)acupuncture and postoperative emesis% %naesthesia, !""7, 12D64: 64"% 5o C? ! a(, 0$$ect o$ ?C # acupressure on prevention o$ nausea and vomiting a$ter epidural morphine $or post)cesarean section pain relie$% %cta %naesthesiologica 4candina8ica, !""#, 1:<6=D6:46:9% Andr> jo;$k" C ! a(, &emi)permanent acupuncture needles in the prevention o$ postoperative nausea and vomiting% %c&p&nct&re-;edicine, !""#, +1<4=D#;H:7%

48;% 48"% 497% 49!% 494%

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AcupunctureD review and anal sis o$ controlled clinical trials


4#;% ?cConag&0 P ! a(, Acupuncture in the management o$ postoperative nausea and vomiting in patients receiving morphine via a patient)controlled analgesia s stem% %c&p&nct&re-;edicine, !""#, +1<!=D4H9% Sc&;ag r AL ! a(, Acupuncture and postoperative vomiting in da )sta paediatric patients% %naesthesia and Dntensi8e :are, !""#, 48<#=D#:8H#::% L"u S) ! a(, ,agnetotherap o$ neiguan in preventing vomiting induced b cisplatin% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<!=D6"H8!% A(DSad" ? ! a(, Acupuncture in the prevention o$ postoperative nausea and vomiting% %naesthesia, !"":, 2-<:=D#9;H##!% S! "n DC ! a(, Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia $or cesarean section% %nesthesia and %nalgesia, !"":, 71<4=D684H689% Sc&(ag r A ! a(, 5aser stimulation o$ acupuncture point ?# reduces postoperative vomiting in children undergoing strabismus surger % Critish 6o&rnal o5 %naesthesia, !"";, 7<8=D94"H964% C&u YC ! a(, 0$$ect o$ -5!7 <tianzhu=, -5!! <dazhu= and 1-68 < angling@uan= acuplaster $or prevention o$ vomiting a$ter strabismus surger in children% %cta %naesthesiologica 4inica, !"";, .3<!=D!!H!#% A(ka"$$" A ! a(, 0$$ect and placebo e$$ect o$ acupressure <?#= on nausea and vomiting a$ter outpatient g naecological surger % %cta %naesthesiologica 4candina8ica, !""", 1.<6=D4:7H 4:8% S& nk/an * ! a(, Acupressure)acupuncture antiemetic proph laxis in children undergoing tonsillectom % %nesthesiology, !""", "7<9=D!6!!H!6!#% C& ng PT ! a(, A therapeutic trial o$ acupuncture in neurogenic bladder o$ spinal cord in.ured patientsEa preliminar report% 4pinal :ord, !"";, .3<:=D8:#H8;7% F (& nd( r D ! a(, ?ressure on acupoints decreases postoperative pain% :linical 6o&rnal o5 Pain, !""#, +-<8=D64#H64"% *ou ? ! a(, PObservation o$ therapeutic e$$ects o$ combined treatment o$ ginger moxibustion and acupoint)in.ection in 67 cases o$ chronic pulmonar heart disease%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<:=D6;"6"7 Pin ChineseQ% A&o A5, The impact o$ acupuncture on pain in patients with re$lex s mpathetic d stroph % Pain-:linic, !""9, 7<!=D9"H#!% Yu DF ! a(, PAcupuncture treatment in ;# cases o$ central serous retinopath %Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<9=D4:64:8 Pin ChineseQ% *&ang B ! a(, PControlled stud o$ clinical e$$ect o$ computer controlled electro) acupuncture in the treatment o$ schizophrenia%Q :hinese %c&p&nct&re and ;o<ib&stion, !""8, +1<!=D!:47 Pin ChineseQ% Yu C@ ! a(, PTreatment o$ simple obesit in children with photo)acupuncture%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine , !"";, +7<#=D68;H697 Pin ChineseQ% C& n Y ! a(, Observation o$ the time)e$$ect o$ acupuncture in improving small airwa $unction% =orld 6o&rnal o5 %c&p&nct&re-;o<ib&stion, !"":, 4<4=D4#4;% San!" $! ban AC, Comparison o$ electro)acupuncture and selected ph sical therap $or acute spine pain% %merican 6o&rnal o5 %c&p&nct&re, !";8, +-<6=D49:4#!% Wu @F, !77 cases o$ sti$$ neck treated b contralateral acupuncture% Dnternational 6o&rnal o5 :linical %c&p&nct&re, !"":, 7<8=D84:H84"% *ou )C ! a(, PComparative stud o$ cerebral in$arction with acupuncture on six acupoints o$ ang meridian and calan tablets%Q :hinese 6o&rnal o5 Dntegrated Traditional and =estern ;edicine, !""7, +:<8=D!""474 Pin ChineseQ% Rau$!"a A? ! a(, Acupuncture compared with stomatognathic treatment $or temporomandibular .oint d s$unction% 6o&rnal o5 Prosthetic Dentistry, !";#, 23<9=D#!# #46% ?a S ! a(, PObservation o$ combined acupuncture and moxibustion treatment o$ #7 cases o$ ulcerative colitis%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<9=D4:94:# Pin ChineseQ%

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3e$erences
4"7% 4"!% La" )S, PTherapeutic e$$ect o$ acupuncture in the treatment o$ senile vascular dementia%Q :hinese %c&p&nct&re and ;o<ib&stion, !"":, +4<8=D47!474 Pin ChineseQ% L"u C ! a(, PClinical stud on treatment o$ vascular dementia b electroacupuncture o$ scalp acupoints%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<8=D!":477 Pin ChineseQ% C"ang 65 ! a(, PControlled observation o$ electro)acupuncture treatment o$ vascular dementia%Q C&lletin o5 Ga&ng.ho& Traditional :hinese ;edicine Fni8ersity , !"";, +2<4=D!!7!!4 Pin ChineseQ% Wang L@, PA comparative stud on acupuncture treatment o$ viral encephalitis in children%Q :hinese %c&p&nct&re and ;o<ib&stion, !"";, +7<:=D6":6"; Pin ChineseQ%

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