Abstract
BackgroundThe results of many clinical trials and experimental studies regarding acupoint specificity are contradictory. This review aims to investigate whether a difference in efficacy exists between ordinary acupuncture on specific acupoints and sham acupuncture controls on non-acupoints or on irrelevant acupoints.MethodsDatabases including Medline, Embase, AMED and Chinese Biomedical Database were searched to identify randomized controlled trials published between 1998 and 2009 that compared traditional body acupuncture on acupoints with sham acupuncture controls on irrelevant acupoints or non-acupoints with the same needling depth. The Cochrane Collaboration's tool for assessing risk of bias was employed to address the quality of the included trials.ResultsTwelve acupuncture clinical trials with sham acupuncture controls were identified and included in the review. The conditions treated varied. Half of the included trials had positive results on the primary outcomes and demonstrated acupoint specificity. However, among those six trials (total sample size: 985) with low risk of bias, five trials (sample size: 940) showed no statistically significant difference between proper and sham acupuncture treatments.ConclusionThis review did not demonstrate the existence of acupoint specificity. Further clinical trials with larger sample sizes, optimal acupuncture treatment protocols and appropriate sham acupuncture controls are required to resolve this important issue.
Highlights
The results of many clinical trials and experimental studies regarding acupoint specificity are contradictory
There have been many clinical trials and experimental studies on the specificity of acupoints [3,9,10] but systematic reviews are not available to show any clear picture of the current evidence
There are different definitions of sham acupuncture controls [14], in this article, sham acupuncture is considered as needling at sites away from conventional acupoints with the same needling depth and stimulation procedures as those of conventional acupuncture
Summary
The results of many clinical trials and experimental studies regarding acupoint specificity are contradictory. There have been many clinical trials and experimental studies on the specificity of acupoints [3,9,10] but systematic reviews are not available to show any clear picture of the current evidence. The three most commonly used controlled needling methods are sham acupuncture (on points away from treatment acupoints), minimal acupuncture (superficial needling) and placebo acupuncture (noninvasive needling). To examine whether an efficacy difference between traditional acupuncture on specific acupoints and sham acupuncture controls at sites away from conventional acupoints, we conducted a systematic review of randomized controlled trials using sham acupuncture controls published between 1998 and 2009. There are different definitions of sham acupuncture controls [14], in this article, sham acupuncture is considered as needling at sites away from conventional acupoints with the same needling depth and stimulation procedures as those of conventional acupuncture
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