Evidence base

Overseas member and recovering scientist Lisa Sherman selects top abstracts of the season from the Journal of Chinese Medicine's news section to keep you up to date with the latest in acupuncture research

Lisa Sherman

Overseas Member: North Carolina

RESEARCH

Acupuncture improves chronic pain in urban primary care settings

Both individual and group acupuncture therapy delivered in primary care settings can reduce pain and improve physical function in people with chronic musculoskeletal conditions, American researchers have found. Their randomised comparative effectiveness non-inferiority trial enrolled 779 adults who were receiving primary care at an inner city health centre for pain due to osteoarthritis, or chronic neck or back pain. Participants received weekly acupuncture treatment in either group or individual settings for 12 weeks, in addition to usual care. The intervention followed a ‘responsive manualisation’ protocol – a pragmatic approach allowing for individualised treatment from a consensus-built array of options. The treatment manual consisted of a common set of acupuncture points with optional points and techniques (tuina, guasha, auricular acupressure) according to the nature of each individual’s condition. Participants were also given general lifestyle recommendations. The results showed a clinically significant improvement in pain interference in both arms for a substantial proportion of participants at 12 weeks (37.5 per cent in individual arm and 30.3 per cent in group had greater than 30 per cent improvement in pain interference). Pain severity also showed clinically meaningful improvement in over 30 per cent of participants in both arms, and global physical health improved in roughly 60 per cent. Non-inferiority of group compared with individual acupuncture was not demonstrated for either pain interference or severity at 12 weeks; individual treatment was consistently slightly better than group. Opiate use also declined in the individual arm, but not in the group arm, when comparing the 12 weeks preintervention to the period 4-16 weeks post-intervention. Acupuncturists saw on average 1.9 patients per hour in group sessions compared with 1.4 per hour in individual sessions (a 35 per cent increase) suggesting a possible cost advantage to the group model. Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care-a Randomized Trial. J Gen Intern Med. 2020 Apr;35(4):1227-37

Acupuncture reduces postprandial distress

Chinese researchers have found that acupuncture reduces symptoms of postprandial distress syndrome (PDS) compared with sham acupuncture. A total of 278 participants with PDS received either acupuncture or sham acupuncture three times a week for four weeks. Patients in the acupuncture group received acupuncture at DU 20 bai hui, REN 12 zhong wan, ST 25 tian shu, REN 6 qi hai, P 6 nei guan, REN 17 dan zhong, ST 36 zu san li and SP 4 gong sun. Superficial penetration at nonacupoints was performed in the sham acupuncture group. The results showed that acupuncture resulted in a 31.4 per cent higher treatment response rate and a 10.5 per cent higher symptom elimination rate for all three cardinal symptoms (postprandial fullness, upper abdominal bloating and early satiation) compared with sham acupuncture. Patients in the acupuncture group also reported improvements in dyspepsia symptoms and quality of life. These effects persisted through 12-week follow-up. Effect of Acupuncture for Postprandial Distress Syndrome. Ann Intern Med. 2020 May 12

Breast cancer survivors report benefit from acupuncture

The majority of breast cancer survivors report a symptomatic benefit from acupuncture, American researchers have found. Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified and received a survey of acupuncture-related questions. Acupuncture use was reported by 415 women of whom 241 returned surveys. A total of 193 participants (82.1 per cent) reported a symptomatic benefit from acupuncture, and 57 (24.1 per cent of participants) reported a ‘substantial benefit’ or ‘totally resolved my symptoms’ (corresponding to 4 and 5 on a 5-point Likert scale). Mean symptom severity decreased by at least 1 point on the 5-point scale for each symptom. The percentage of patients who reported an improvement in symptoms ranged from 56 per cent for lymphedema to 79 per cent for headache. The majority of patients reported time to benefit as ‘immediate’ (34 per cent) or ‘after a few treatments’ (40.4 per cent). Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study. Support Care Cancer. 2020 Apr 6

Acupuncture best non-hormonal treatment for breast cancer hot flushes

A network meta-analysis comparing non-hormonal treatments suggested that acupuncture was the most effective in improving hot flushes for breast cancer survivors. Chinese authors analysed data from 16 RCTs involving 2,349 participants. Acupuncture was significantly more effective in reducing hot flush scores than no treatment/waitlist. Acupuncture was also ranked the optimal non-hormonal therapy for both hot flush frequency and hot flush score. Nonhormonal Hot Flash Management for Breast Cancer Survivors: A Systematic Review and Network Meta-Analysis. Evid Based Complement Alternat Med. 2020 Apr 28;2020:4243175

With thanks to the Journal of Chinese Medicine