Acupuncture Consensus Statement
A comprehensive bibliography on acupuncture was prepared in 1997 to support the National Institutes of Health Consensus Development Conference on Acupuncture. This bibliography includes 2,302 citations on acupuncture from January 1970 through September 1997. It was prepared by the staffs at the National Institute on Drug Abuse and the National Library of Medicine. The full bibliography can be accessed online at http://odp.od.nih.gov/consensus/cons/107/107_intro.htm

Therefore, the majority of studies included here were done after 1997. Please refer to the full bibliography noted above for a comprehensive listing of earlier studies.

Allergic Rhinitis
Brinkhaus B, Hummelsberger J, Kohnen R, et al. “Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial.” Allergy. 59(9):953-60, 2004.
Fifty two patients with typical symtpoms of seasonal allergies were randomly assigned to either an active treatment group of acupuncture and Chinese herbal medicine or a control group of placebo acupuncture and a non-specific Chinese herbal formula. All patients received acupuncture treatment once a week and Chinese herbal forumula three times daily for six weeks. Compared with patients in the control group, patients in the active treatment group showed a significant after-treatment improvement on three out of four measurement scales. The results of this study suggested that traditional Chinese therapy may be an effective and safe treatment option for patients with seasonal allergic rhinitis.

Ng DK, Chow PY, Ming SP, et al. “A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis.” Pediatrics. 114(5):1242-7, 2004.
Eighty five children with persistent allergic rhinitis were randomized to receive either active acupuncture or sham acupuncture for 8 weeks. Acupuncture was performed twice per week for both groups. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving active acupuncture, during both the treatment and follow-up periods. This study showed that active acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. No serious adverse effect was identified. A large-scale study is required to confirm the safety of acupuncture for children.

Angina Pectoris
Ballegaard S. “Acupuncture and the cardiovascular system: a scientific challenge”. Acupuncture Medicine. 16(1):2-9, 1998.
A randomized controlled trial of 49 patients with angina pectoris received acupuncture. Cardiological, neurophysiological and psychological observations were made. Needling was found to improve the working capacity of the heart and was found to activate cardiovascular autoregulatory mechanisms in 24 healthy persons. A controlled trial group of 69 patients with severe angina pectoris were followed for 2 years after treatment. The incidence of cardiac death or myocardial infarction was 7% compared to 15-20% for the control group. Surgery was postponed in 61% of patients due to improvement, and the annual number of in-hospital days was reduced by 90%.

Back Pain, Chronic
Haake M, Muller H, Schade-Brittinger C, et al. German Acupuncture Trials (GERAC) for Chronic Low Back Pain: Randomized, Multicenter, Blinded, Parallel-Group Trial With 3 Groups. Archives of Internal Medicine. 167(17):1892-1898, 2007.
In this randomized controlled trial of 1162 chronic low back pain patients aged 18 to 86 years, patients had ten 30-minute sessions of acupuncture, sham acupuncture consisting of superficial needling at nonacupuncture points, or conventional therapy, a combination of drugs, physical therapy, and exercise. At 6 months, response rate was 47.6% in the acupuncture group, 44.2% in the sham acupuncture group, and 27.4% in the conventional therapy group. Low back pain improved after acupuncture treatment for at least 6 months. Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy.

Brinkhaus B, Witt CM, Jena S, et al. “Acupuncture in patients with chronic low back pain: a randomized controlled trial.” Archives of Internal Medicine. 166(4):450-7, 2006 Feb.
In this randomized controlled trial, three groups totaling 298 patients received either acupuncture, minimal acupuncture (superficial needling at nonacupuncture points) or a waiting list control. Between baseline and week 8, pain intensity decreased in all groups. Acupuncture was more effective in improving pain than no acupuncture treatment in patients with chronic low back pain; there were no significant differences between acupuncture and minimal acupuncture.

Sator-katzenschlager, SM, Scharbert G, Kozek-Langenecker SA, et al. “The short- and long-term benefit in chronic low back pain through adjunvant electrical versus manual auricular acupuncture.” Anesthesia & Analgesia. 98(5):1359-64, 2004
In this randomized double-blind controlled study, auricular electroacupuncture (EA) was compared to conventional manual auricular acupuncture (CO) to test its ability to relieve pain in chronic low back pain patients. Sixty one patients received either electroacupuncture or manual acupuncture for one treatment weekly over 6 weeks, with the needles withdrawn after 48 hours of insertion. Pain relief was significantly better in the EA group during the study and the 3-month follow up period as compared with the CO group as was psychological well-being, activity, and sleep. In addition the use of analgesic rescue medication was less and more patients returned to full-time work in the electroacupuncture group. Neuropathic pain in particular improved in patients treated with EA.

Manheimer E, White A, Berman B, et al. “Meta-analysis: acupuncture for low back pain.” Annals of Internal Medicine. 142(8): 651-63, 2005 Apr.
Randomized controlled trials comparing needle acupuncture with sham acupuncture, other sham treatments, no additional treatment or another active treatment for patients with low back pain were included in the review. The meta-analysis showed that acupuncture is significantly more effective than sham treatment and no additional treatment for the short-term relief of chronic back pain. While acupuncture effectively relieved chronic low back pain, results for acute low back pain were sparse and inconclusive.

Cancer Pain Relief
Alimi D, Rubino C et al. “Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial.” Journal of Clinical Oncology. 21(22):4120-6, 2003 Nov 15.
This study examined the efficacy of auricular acupuncture in decreasing pain intensity in cancer patients. Ninety patients were randomly divided into three groups: one group received two courses of auricular acupuncture and two placebo groups received auricular acupuncture at placebo points. Pain intensity decreased by 36% at 2 months from baseline in the group receiving acupuncture; there was little change for patients receiving placebo (2%). The difference between groups was statistically significant. The observed reduction in pain intensity measured on the Visual Analog Scale represents a clear benefit from auricular acupuncture for these cancer patients who are in pain, despite stable analgesic treatment.

He JP, Friedrich M, Ertan AK, Muller K, Schmidt,W. “Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer.” Clinical & Experimental Obstetrics & Gynecology. 26(2):81-4, 1999.
Forty-eight patients with mammary cancer treated with acupuncture after ablation and axillary lymphadenectomy were compared with 32 patients with the same operation who did not receive acupuncture. Statistically significant differences were found in pain relief and arm movements in the group that received acupuncture on the 5th and 7th post-operative days and up to discharge.

Central Nervous System Pathway
Wu MT, Hsieh JC, Xiong J, Yang CF, et al. “Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain-preliminary experience.” Radiology. 212(1):133-41, 1999.
Magnetic resonance imaging was used to demonstrate the central nervous system pathway for acupuncture stimulation and may be used in future investigations of endogenous pain modulation circuits in the brain as they relate to acupuncture analgesic effects.

Depression
Luo H, Meng F, Jia Y, Zhao X. “Clinical research on the therapeutic effect of the electro-acupuncture treatment in patients with depression.” Psychiatry & Clinical Neurosciences. 52 Suppl: S338-40, Dec. 1998.
A multi-centered study of 241 inpatients with depressive disorder showed electro-acupuncture was as effective as anti-depressant medication (amitriptyline), had a better therapeutic effect for some aspects of depressive symptomatology, and had fewer side effects.

Manber R, Schnyer RN, Allen JJ, et al. “Acupuncture: a promising treatment for depression during pregnancy.” Journal of Affective Disorders. 83(1):89-95, 2004 Nov 15.
Sixty-one pregnant women with major depressive disorder were randomly assigned to one of three treatments delivered over 8 weeks: an active acupuncture, an active control acupuncture, and massage. Response rates at the end of the acute phase were statistically significantly higher for acupuncture(69%) than for massage(32%), with an intermediate control acupuncture response rate (47%). The acupuncture group also exhibited a significantly higher average rate of reduction in depression scores from baseline to the end of the first month of treatment than the massage group. Although generalizability is limited by the small sample size, acupuncture holds promise for the treatment of depression during pregnancy.

Roschke J, Wolf C, Muller MJ, et al. “The benefit from whole body acupuncture in major depression.” Journal of Affective Disorders. 57(1-3):73-81, 2000.
This single blind, placebo-controlled study investigated the efficacy of acupuncture added to drug treatment in major depression. Seventy patients with a major depressive episode were randomly assigned to three different treatment groups: active acupuncture, placebo acupuncture and a control group. All three groups were also treated with the antidepressant mianserin. The active acupuncture group received acupuncture at specific points considered effective in the treatment of depression. The placebo group was treated with acupuncture at non-specific locations and the control group received pharmacological treatment plus clinical management. Acupuncture was given three times a week for four weeks. Patients who received acupuncture improved slightly more than patients treated with mianserin alone and the course of their depression improved more than treatment with mianserin alone. However, no differences were detected between placebo and active acupuncture.

Dry Mouth
Morganstein WM. “Acupuncture in the treatment of xerostomia [dry mouth]:
Clinical report.” General Dentistry. 53(30:223-226, May-June, 2005.
This article reviews the causes and symptomatology of xerostomia (dry mouth) and approaches for treating it, including the use of acupuncture. Seven patients with xerostomia were treated once a week for four to five weeks using acupuncture, followed by two or three biweekly sessions. Eight months after treatment, all patients reported a reduction in dry mouth symptoms, as well as an increase in saliva flow and the ability to eat and apeak, and improved sleep. It is recommended that acupuncture be considered as a viable adjunct when treating xerostomia.

Fibromyalgia
Deluze C, Bosia L, Zirbs A, Chantraine A, Vischer TL. “Electroacupuncture in fibromyalgia: results of a controlled trial”. British Medical Journal. 305(6864):1249-52, 1992.
In a randomized controlled trial of 70 patients given electroacupuncture or sham acupuncture, seven out of eight outcome measures showed a significant improvement in the acupuncture group and no improvement in the sham treatment group. Differences between the groups were significant for five and of the eight outcome measures.

Assefi NP, Sherman KJ, Jacobsen C, et al. “A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia.” Annals of Internal Medicine. 143(1):10-9, 2005 Jul 5.
In this randomized, controlled clinical trial, 100 adults with fibromyalgia were given twice-weekly treatment for 12 weeks with an acupuncture program that was specifically designed to treat fibromyalgia, or 1 of 3 sham acupuncture treatments. The mean subjective pain rating among patients who received acupuncture for fibromyalgia did not differ significantly from that in the sham acupuncture group.

Headache/Migraine
Linde K, Streng A, Jurgens S, et al. “Acupuncture for patients with migraine: a randomized controlled trial.” JAMA. 293(17):2118-25, 2005 May 4.
In this randomized controlled trial involving 302 patients (88% women), mean age of 43 years, with migraine headaches, patients were treated at 18 outpatient centers with acupuncture, sham acupuncture, or waiting list control for 12 sessions per patient over 8 weeks. No difference was detected between the acupuncture and the sham acupuncture groups, but there was a difference between the acupuncture group compared with the waiting list group. The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group. Acupuncture was no more effective than sham acupuncture in reducing migraine headaches although both interventions were more effective than a waiting list control.

Melchart D, Streng A, Hoppe A, et al. “Acupuncture in patients with tension-type headache: randomized controlled trial.” BMJ. 331(7513):376-82, 2005 Aug 13.
In this randomized controlled multicenter trial, 270 patients in 28 outpatient centers (74% women, mean age 43) with episodic or chronic tension-type headache were treated with acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or waiting list control for 12 sessions over eight weeks. The number of days with a headache decreased by 7.2 days in the acupuncture group compared with 6.6 days in the minimal acupuncture group and 1.5 days in the waiting list group. The acupuncture intervention investigated in this trial was more effective than no treatment but not significantly more effective than minimal acupuncture for the treatment of tension-type headache.

Vickers AJ, Rees RW, Zollman CE, et al. “Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.” BMJ. 328(7442):744, 2004.
Researchers tested 401 patients aged 18 to 65 who had two or more migraine or tension-type headaches a month. All patients received standard care from their general practitioner, and 161 also received acupuncture (up to 12 treatments over three months). It was found that patients who received a combination of acupuncture plus medication reported fewer and less-intense headaches than those who were given medication alone. At 12 months, patients who had received acupuncture reported 22 fewer days of headaches per year, 15% less medication use, 25% fewer visits to their doctors and 15% fewer missed days at work. The researchers concluded that acupuncture leads to persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine.

Irritable Bowel Syndrome
Schneider A, Enck P, Streitberger K, et al. “Acupuncture treatment in irritable bowel syndrome.” Gut. 55(5):649-54, 2006 May.
Forty-three patients with IBS were randomly assigned to receive either acupuncture or sham acupuncture for 10 sessions. Both groups improved significantly in global quality of life, with no differences between the groups. Acupuncture in IBS was found to be primarily a placebo response. Based on the small differences found between both groups, a larger study would be necessary to prove the efficacy of acupuncture over sham acupuncture for IBS.

Menopausal Symptoms
Zaborowska E, Brynhildsen J, et al. “Effects of acupuncture, applied relaxation, estrogens and placebo on hot flushes in postmenopausal women: an analysis of two prospective, parallel, randomized studies.”
Climacteric.10(1): 38-45, 2007.
102 postmenopausal women experiencing climacteric symptoms (e.g., hot flashes)received either oral estradiol therapy (17 beta-estradiol 2 mg),applied relaxation (60 minutes, once/week, electroacupuncture, or superficial needle insertion. Results found that subjects in all intervention groups experienced a significant reduction in hot flashes, as compared to the placebo group. After 12 weeks, subjects who received acupuncture (both electroacupuncture and superficial needle insertion experienced a similar reduction in hot flashes as subjects who received estrogen. Subjects in the applied relaxation intervention group also experienced a reduction in hot flashes, though not as significant as in the acupuncture and estrogen groups. Six months after the treatments ceased, subjects in the acupuncture and applied relaxation groups were found to have an even greater decrease in hot flashes. Acupuncture and applied relaxation should be further evaluated to develop alternative methods for women with menopausal complaints.

Nausea and Vomiting, Post-Operative
al-Sadi M, Newman B, Julious SA. “Acupuncture in the prevention of postoperative nausea and vomiting.” Anaesthesia. 52(7):658-61, 1997.
A double blind, randomized controlled trial of intra-operative acupuncture vs. placebo was performed in 81 patients undergoing same day gynecological laparoscopic surgery. The use of acupuncture reduced the incidence of postoperative nausea or vomiting in hospital from 65% to 35% compared with placebo and after discharge from 69% to 31% compared with placebo.

Streitberger K, Diefenbacher M, Bauer A, et al. “Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer
blind trial.” Anaesthesia. 59(2):142-9, 2004.
Female patients (n = 220) scheduled for gynaecological or breast surgery were randomly assigned to two groups receiving either acupuncture (n = 109) or placebo acupuncture (n = 111). The incidence of Post-operative nausea and vomiting and/or anti-nausea medcation use within 24 hour after surgery was the main outcome measure. This showed no statistically significant difference between groups (43.7% acupuncture, 50.9% placebo). The secondary outcome, vomiting, was significantly reduced by acupuncture from 39.6% to 24.8%.

Neck Pain
White P, Lewith G, Prescott P, et al. “Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial.” Annals of Internal Medicine. 141(12):911-9, 2004 Dec 21.
In this randomized trial, 124 patients 18 to 80 years of age who had chronic mechanical neck pain received 8 treatments over 4 weeks with acupuncture or with mock transcutaneous electrical stimulation of acupuncture points. Both groups improved statistically from baseline, and acupuncture and placebo had similar credibility. Acupuncture reduced neck pain and produced a statistically, but not clinically, significant effect (12%) compared with placebo. The beneficial effects of acupuncture for pain may be due to both nonspecific and specific effects.

David J, Modi S, Muko AA, Robertshaw C. “Acupuncture or physiotherapy for neck pain? Similar success rates.” British Journal of Rheumatology. 37(10):1118-22, 1998.
Seventy adult patients were assigned to receive either acupuncture or physiotherapy. Outcome measures were collected at the start of treatment, at 6 weeks and at 6 months. Both treatment groups improved in all criteria, with acupuncture being slightly more effective in patients who had higher baseline pain scores. No untreated control group was included in the study for comparison.

Osteoarthritis
Berman BM, Lao L, Langengerg P, et al. “Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial.” Annals of Internal Medicine 141(12):901-910, 2004
In this study of 570 patients with osteoarthritis of the knee, patients received either true acupuncture, sham acupuncture or education.
Patients in the true acupuncture group showed greater improvement in function than the sham acupuncture group at 8 weeks but not in the pain score or global assessment. At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in function, pain and global assessment. Acupuncture seems to provide improvement in function and pain relief as an adjunctuve therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.

Berman BM, Singh BB, Lao L, Langenberg P, Li H, Hadhazy V, Bareta J, Hochberg M. “A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee.” Rheumatology. 38(4):346-54, Apr 1999.
Seventy-three patients with symptomatic osteoarthritis of the knee were randomly assigned to acupuncture or standard care in order to investigate its effectiveness as an adjunctive therapy to standard care for the relief of osteoarthritic pain and dysfunction. Patients receiving acupuncture improved on both measurement indices compared to those receiving standard treatment alone. Significant differences were seen at 4 and 8 weeks. No adverse effects were reported.

Linde K, Weidenhammer W, Streng A, et al. “Acupuncture for osteoarthritic pain: an observational study in routine care.” Rheumatology. 45(2):222-7, 2006
In this observational study in routine care, 278 patients had primary osteoarthritis of the hip or knee, 239 had another type of osteoarthritis and 149 had more than one affected joint. Statistically significant and clinically relevant improvements were seen in all subgroups both after acupuncture treatment as well as 6 months later.

Witt C, Brinkhaus B, Jena S, et al. “Acupuncture in patients with osteoarthritis of the knee: a randomized trial.” Lancet. 366(9480):136-43, 2005 Jul 9-15.
In this randomized trial, 294 patients with chronic osteoarthritis of the knee were assigned to acupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or a waiting list control in 28 outpatient centers for 12 sessions. After 8 weeks of treatment, pain and joint function improved more with acupuncture than with minimal acupuncture or no acupuncture. However, this benefit decreased over time.

Pain Control, Post-Operative
Lao L, Bergman S, Hamilton GR, Langenberg P, Berman B. “Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial.” Archives of Otolaryngology -- Head and Neck Surgery. 125 (5):567-572, May 1999.
Thirty-nine patients were randomly assigned to receive either real acupuncture or placebo acupuncture immediately after oral surgery. Patients in the acupuncture group were pain free nearly twice as long as those in the placebo group. When post-operative pain occurred, the acupuncture group required only about two-thirds the amount of medication as the placebo group for pain control.

Polycystic Ovary Syndrome
Stener-Victoria E, Waldenstrom U, Tagnfors, U, et al. “Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.” Acta Obstetrica et Gynecologica Scandinavica. 79(3):180-8, 2000.
In this longitudinal, prospective study, twenty-four women between the ages of 24 and 40 years with polycystic ovary syndrome and oligo/amenorrhea received 10-14 treatments of electroacupuncture(EA) over a three-month period. The study period began 3 months before the first EA treatment and ran until three months after the last EA treatment. The menstrual and ovulation patterns were confirmed by recording vaginal bleeding, daily measuring of basal body temperature and blood samples. Repeated EA treatments induced regular ovulation in 38% of the women. This group of women had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. The findings suggest that for this selected group EA may offer an alternative to pharmacological ovulation induction.

Pregnancy — Assisted Reproduction
Paulus WE, Zhang M, Strehler E, Danasouri IE, Sterzik K. “Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproductive therapy”. Fertility and Sterility. 77(4):721-724, 2002.
In a prospective randomized clinical study with 160 patients undergoing assisted reproductive therapy, the effects of acupuncture on pregnancy rate were evaluated. Patients who were undergoing assisted reproduction therapy (ART) were divided into two groups: embryo transfer with acupuncture (80 women) and a control group of embryo transfer without acupuncture (80 women). Acupuncture was performed 25 minutes before and after embryo transfer. The results showed that clinical pregnancies were documented in 42.5% of patients in the treatment group compared with 26.3% in the control group. Acupuncture appears to be a useful tool for improving pregnancy rate after ART.

Rotator Cuff Tendonitis
Kleinhenz J, Streitberger K, Windeler J, Gussbacher A, Mavridis G, Martin E. “Randomized clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendonitis”. Pain. 83(2):235-41, Nov.1999.
This four-week randomized single blind clinical trial of 52 patients showed acupuncture to be more effective than placebo needling in treating chronic shoulder pain in athletes.

Stroke
Johansson K, Lindgren I, Widner H, Wiklund I, Johansson BB. “Can sensory stimulation improve the functional outcome in stroke patients?” Neurology. 43(11):2189-92, Nov. 1993.
Seventy eight patients with severe hemiparesis of the left or right side within 10 days of stroke onset were randomized to a control group receiving daily physiotherapy and occupational therapy or the same therapies plus acupuncture twice a week for 10 weeks. Patients given acupuncture recovered faster and to a greater extent than the control group, with a significant difference for balance, mobility, quality of life, and days spent at hospital/nursing homes.

Park J, White AR, James MA, et al. “Acupuncture for subacute stroke rehabilitation: a sham-controlled, subject- and assessor-blind, randomized trial.” Archives of Internal Medicine. 165(17):2026-31, 2005.
In this randomized subject and assessor-blind trial, 116 patients with a recent (greater than 4 weeks) episode of stroke were randomized to receive 12 sessions of either real or sham acupuncture during the span of 2 weeks. Acupuncture was not superior to sham treatment for recovery of activities of daily living and health-related quality of life after stroke, although there may be a limited effect on leg function in more severely affected patients.

Wong AM, Su TY, Tang FT, Cheng PT, Liaw MY. “Clinical trial of electrical acupuncture on hemiplegic stroke patients.” American Journal of Physical Medicine & Rehabilitation. 78 (2): 117-22, 1999.
In a study of 128 patients with post-stroke hemiplegia, patients treated with electrical acupuncture had a shorter hospital stay for rehabilitation and better neurological results, with a significant difference in self-care and locomotion scores.

Content last modified on Sep 25, 2007