Clinical Studies Of Acupuncture Research Articles

An Overview of Systematic Reviews and Meta-Analyses of Clinical Studies of Acupuncture for Cancer Pain.

Systematic reviews (SRs) and meta-analyses (MAs) for the use of acupuncture for cancer pain have been increasing, but the evidence has not been systematically and comprehensively assessed. We aimed to perform an overview of the evidence quality of SRs/MAs of acupuncture for improving cancer pain. 8 databases were systematically searched to identify SRs/MAs of acupuncture for improving cancer pain. The A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grades of Recommendations, Assessment, Development, and Evaluation (GRADE), respectively, were applied by 2 independent reviewers to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality. A total of 14 SRs/MAs were included in the present study. By AMSTAR-2, two reviews were rated as having high methodological quality, while 12 were given a critically low rating. All SRs/MAs in Phase 1, Domain 1, and Domain 4, according to ROBIS, were at low risk. Furthermore, 4 reviews in Domain 2, twelve reviews in Domain 3, and ten SRs/MAs in Phase 3, were rated as having low risk of bias. With reporting quality, some reporting flaws were identified in the topic of protocol and registration, additional analyses, and search strategy. According to GRADE, the level of evidence quality was "critically low" to "moderate," and risk of bias was the most common downgraded factor. Acupuncture may be beneficial in improving cancer pain. However, due to the identified limitations and inconsistent findings, we recommend further rigorous, and more standardized SRs/MAs to provide strong evidence for definitive conclusions.

Nitric Oxide on Pathophysiology of SARS-CoV 19: Toward Possible Role of Acupuncture Treatment

The ongoing outbreak of COVID-19 has quickly become a daunting challenge to global health. In the absence of satisfied therapy, effective treatment interventions are urgently needed. Previous studies have demonstrated that acupuncture is effective at relieving common symptoms of COVID-19 including breathlessness, nausea, insomnia, leukopenia, fatigue, vomiting, and abdominal pain. Experiments have shown that nitric oxide (NO) inhibits the replication cycle of severe acute respiratory syndrome (SARS) coronavirus with similar structures of COVID-19. Increase in level of NO by using NO gas inhalation has been shown to restore lung function by reducing airway resistance and improving virus-induced lung infections in SARS patients. Recent case report showed that a medical acupuncturist with symptoms consistent with severe COVID pneumonia achieved full recovery by self-administered medical acupuncture and cupping therapy at home. Clinical features and pathophysiology demonstrated that NO deficiency and endothelial dysfunction contribute to the development of COVID-19. Several studies from different groups consistently demonstrated that acupuncture increases NO synthase expression and induces an elevation of NO production and release in plasma and the local skin regions in both animals and humans. It is suggested that exogenous NO supplies or interventions that induce increasing levels of NO can play an important role in protective effects against inflammation and acute lung injury. This article reviews the rationale for mechanisms of NO induction induced by acupuncture in the possible treatment of COVID-19 and highlights its potential for contributing to better clinical outcomes and improving future clinical studies of acupuncture on treatment of COVID-19.

Treatment of insulin resistance by acupuncture: a review of human and animal studies.

Numerous experimental studies have demonstrated that acupuncture can correct various metabolic disorders such as hyperglycaemia, overweight, hyperphagia, hyperlipidaemia, inflammation, altered activity of the sympathetic nervous system, and insulin signalling defects, all of which contribute to the development of insulin resistance. To review human and animal studies investigating acupuncture as a treatment for insulin resistance, and to evaluate its potential to increase insulin sensitivity. PubMed was searched for relevant articles published between January 2008 and October 2015. Search terms used were 'acupuncture', 'insulin resistance', 'insulin sensitivity', and 'blood glucose'. Additional secondary sources of information included reference lists from retrieved papers and pertinent papers identified by hand searches of relevant journals not found in the database. In total, 31 articles were included in this review and comprised studies of the following insulin resistant conditions: obesity (n=9); diabetes mellitus (n=12); polycystic ovarian syndrome (n=7); skeletal muscle atrophy (n=1); ischaemic heart disease (n=1); and fatty liver disease (n=1). Of these articles, seven were human trials and 24 animal experiments. Collectively, the studies suggest that electroacupuncture (EA) at low intensity and low frequency can reduce insulin resistance and increase insulin sensitivity in a range of different insulin-resistant conditions. EA, used alone or in combination with other therapies, such as Chinese herbs or diet-exercise interventions, has the potential to be an effective treatment for insulin resistance. Additional controlled clinical studies of acupuncture are needed in subjects with diabetes mellitus, ischaemic heart disease, muscle atrophy, and fatty liver disease.

A Review on Clinical Studies of Acupuncture and Moxibustion Therapy for Acute Herpes Zoster※

A Review on Clinical Studies of Acupuncture and Moxibustion Therapy for Acute Herpes Zoster^※

A Review on Clinical Studies of the Acupuncture and Moxibustion Therapy for Gastroesophageal Reflux Disease in China by Searching CAJ

Objectives : The purpose of this study was to review the acupuncture and moxibustion therapy for gastroesophageal reflux disease(GERD) in China. Methods : The literatures were searched using the database-China Academic Journals(CAJ)(~2015.1.). Clinical studies of acupuncture and moxibustion therapy for GERD such as randomized controlled trial(RCT), non-randomized controlled trial(NRCT), case series, or case report were included. Results : Thirty studies met our inclusion criteria: 24 RCTs, 4 NRCTs, 1 case series, 1 case report. Various kinds of treatment such as body acupuncture, abdominal acupuncture, acupuncture therapy with finger on back-shu point, electroacupuncture, acupoint injection, auricular acupuncture, and moxibustion were used in the clinical studies. The treatment groups take herbal medicines at the same time in 16 studies, and proton pump inhibitor(PPI) and histamine 2 receptor antagonist were used as a comparative treatment in the most of studies. Acupuncture or moxibustion treatments were done daily or 2~3 times a week for 5 days~18 weeks. All of studies reported higher effective rate in the acupuncture or moxibustion treatment group compared to the western medication control group. Conclusions : The results of this study could be used for the future practice and the clinical research about the acupuncture and moxibustion therapy for GERD.

Clinical Efficacy, Mechanisms, and Safety of Acupuncture and Moxibustion

Acupuncture has recently increased in popularity and is widely used all over the world. It is described as one of the “complementary and alternative medicine/therapies,” showing promising efficacy in the treatment of many conditions and resulting in fewer adverse effects compared with some conventional medical treatments. Many studies in animals and humans have demonstrated that acupuncture results in multiple biological responses. Although the endorphin hypothesis is well established, the mechanisms underlying acupuncture treatments have not been extensively studied. Basic and clinical acupuncture studies are important and timely. Although acupuncture has a relatively sound safety profile, adverse effects after acupuncture have been reported. More information is needed on safe needling depths. Moxibustion is another traditional Chinese medical intervention that involves the burning of moxa above the body surface of the acupuncture points. The clinical efficacy and mechanism of moxibustion have not been extensively studied. Moreover, safety issues related to moxibustion safety need to be investigated, including concerns of potential tissue damage and adverse physical reactions. In an attempt to summarize the current knowledge on clinical efficacy, mechanisms, and safety of acupuncture and moxibustion, this special issue contains 38 interesting publications: 14 describe the clinical effects of acupuncture; 15 describe the mechanisms of acupuncture; 3 concern the safety of acupuncture; 2 concern the clinical effects of acupressure; 2 detail clinical effects of moxibustion; and 2 describe the mechanisms of moxibustion. The investigations cover in vitro investigations, preclinical experiments, and studies in healthy volunteers and patients, as well as basic and clinical research. The above-mentioned papers investigate the role of acupuncture in the following therapeutic areas: (1) pain, (2) the respiratory system, (3) microcirculation, (4) neurodegeneration, (5) the endocrine system, (6) gastric motility, (7) itch, (8) seizures, (9) neuroprotection, (10) opioid receptors, (11) diabetes mellitus, (12) public health issues of acupuncture, (13) the effects of acupuncture on infants, (14) adverse effects of acupuncture, (15) safe needling depth, (16) psychology during acupuncture, (17) acupressure and dysmenorrhea, (18) acupressure and sleep disturbance, (19) moxibustion and hyperlipidemia, and (20) a discussion of the mechanisms and safety of moxibustion. Nowadays, modern technologies are being used to explore the effects of acupuncture and moxibustion. The results of these investigations enhance our knowledge of how acupuncture and moxibustion work and promote better insight into how best to use these tools.

The Effect of Short-term Bed-rest on Radial Pulse in Healthy Subjects

The objective of this study is to investigate the effects of short-term bed rest on the radial pulse in healthy subjects. Twenty-one healthy volunteers participated in this study. Their radial pulse was measured at different measuring positions using a multi-step tonometry system. The participants took 30 minutes of bed rest and their radial pulse was measured before and after the bed rest. The effects of bed rest on the radial pulse were analyzed. The pulse area, the amplitudes of h4 and h5, the pulse period, and the diastolic pulse proportion increased with short-term bed rest, whereas the proportions of systolic and hightension pulse and the fundamental frequency of the pulse wave decreased with short-term bed rest. All the changes were in the same direction in both male and female participants at all measuring positions; however, some parameters changed more in women than in men, and some changed more at the distal position than at the proximal position. In shortly, Short-term bed rest induces significant changes in the radial pulse of healthy subjects. The results of this study could be used as a control reference for clinical acupuncture studies with participants lying on a bed for acupuncture treatment.

LASER PROJECTION SYSTEM TO LOCALIZE ACUPOINTS ON FACE USING 3D HEAD MODEL

Clinical studies of acupuncture and moxibustion often are disapproved by international academic circles due to research methods and randomized controlled trials (RCT). Accurately localizing acupoints is a key issue in traditional Chinese medicine (TCM) therapy research. The objective of this study was to systematically propose an effective method to localize the acupoints on the head accurately and to track the points automatically with the movement of the body within a defined range using a laser projection system that comprises laser pointers, a control system, charge-coupled device (CCD) cameras, and a computer. A 3D head model, on which all acupoints were clearly marked and the coordinates of the points were extracted, was constructed previously using point clouds by a 3D scanner based on structured light. Then, a uniform coordinate system was established, in which correlations of model, CCD and body were described. Under signals from the point of the model, the beam emitted from each laser pointer was individually guided towards the head, pointing at the corresponding site on the head. The spot was captured by CCD to identify the localization of the acupoint. To test the validity of the proposed technique, the experiments were carried out. The experimental results show that the central points of the spots can be nearly in coincidence with the points localized directly in an experienced TCM expert, and the errors are within 3.1 mm. The results indicate also that the localization accuracy and the repeatability of acupoints are high disregarding the movement of the head. The work lays a research foundation for RCT in clinical studies of acupuncture and moxibustion.

Neurobiological Mechanisms of Acupuncture

Acupuncture, an age-old healing art, has been accepted to effectively treat various diseases, particularly chronic pain and neurodegenerative diseases. Since its public acceptance and good efficacy, increasing attention has been now paid to exploring the physiological and biochemical mechanisms underlying acupuncture, particularly the brain mechanisms. Basic and clinical acupuncture studies on neurobiological mechanisms of acupuncture are crucial for the development of acupuncture. This issue compiles 32 exciting papers, most of which are very novel and excellent investigations in this field. The neural mechanism underlying acupuncture analgesia was addressed in four articles. J. Wang et al. established a postincisional pain model of rats and investigated electroacupuncture effect on the brain oscillations involving postoperative pain. B.-S. Lim et al., using interesting bee venom acupuncture, explored whether it can relieve oxaliplatin-induced cold allodynia and which endogenous analgesic system is implicated. The paper by Yumi Maeda et al. aimed to evaluate this linkage between brain response to acupuncture and subsequent analgesia in chronic pain patients with carpal tunnel syndrome. Since many articles aimed to assess the effect of electroacupuncture induced analgesia, W. Kim et al. systemically conducted a review to assess the efficacy and clarify its mechanism on neuropathic pain. In addition, as a great challenge in acupuncture analgesia and treatment evaluations, D. Zhu et al. outlined the advantages and disadvantages of kinds of acupuncture controls and highlighted how the differences among placebo devices can be used to isolate distinct components of acupuncture treatment. Five papers deal with potential neural mechanism underlying acupuncture treatments on the stroke, hypertension, and mild cognitive impairments. The paper by L. Liu and R.T.F. Cheung aimed to investigate whether the combination of melatonin and electroacupuncture therapies could be beneficial against transient focal cerebral ischemia in a rat model of transient middle cerebral artery occlusion. W. Qin et al. accompanied by L. Liu and R.T.F. Cheung's paper explored the importance of anti-inflammatory acupuncture treatment for the focal cerebral ischemia/reperfusion by inhibiting the NF-κB signaling pathway. Another two papers mainly focused on the acupuncture modulation of neural mechanism for hypertension regulation with long-term as well as short-term treatments. The paper by G.-H. Tian et al. addressed the long-term electroacupuncture on cerebral microvessels and neurons in CA1 region of hippocampus in spontaneously hypertensive rats. H. Chen et al. aimed to explore the hypothalamus-anchored resting brain network underlying primary hypertension patients after short-term acupuncture treatments. Moreover, for mild cognitive impairments, S. Chen et al. have pointed out that acupuncture at KI3 at different cognitive states and with varying needling depths may induce distinct reorganizations of effective connectivity of brain networks. The neuroendocrine system involving acupuncture has been addressed by the following three papers. Z. Yu et al. has suggested that TRPV1 receptor is partially involved in the electroacupuncture-mediated modulation of gastric motility. The paper by C.-C. Kuo et al. explored the mechanism of electroacupuncture (EAc) induced antinociception involved opioid receptors and the serotonergic system. Q.-Q. Li et al. conducted a systemic review about the central mechanism of acupuncture in modulating various autonomic responses. Moreover, other papers focused on the relatively acupoint specificity from wide aspects. One of the studies by L. Li et al. suggested that both the size and function of the acupoints comply with the functionality of the internal organs; thus the sensitive degree of acupoints changed according to malfunction of internal organs. C.-Y. Chen et al. implied that somatoparasympathetic neuronal connection (groin-spinal dorsal horn-NTS/DMX-uterus) and a somatosympathetic neuronal connection (groin-spinal dorsal horn-NTS-PVN-uterus) could be the prerequisites to the neuronal basis of the somatovisceral reflex and also the neuronal mechanism of acupuncture. Z. Wang et al. advanced that the modulatory effects of different needling sensations induced by relatively different acupoints contribute to acupuncture modulations of limbic-paralimbic-neocortical network. Although the acupoints were spatially adjacent, there was also relatively functional specificity inflected by brain networks. By gathering these papers, we hope to enrich our readers and researchers with respect to the underlying neurological mechanism of acupuncture, and we look forward to an increasing number of both clinical trials and experimental studies to further promote the development of understanding the neurological mechanism involving acupuncture. Lijun Bai Richard E. Harris Jian Kong Lixing Lao Vitaly Napadow Baixiao Zhao

Neuromodulation in treatment of hypertension by acupuncture: A neurophysiological prospective

Hypertension is a major public health problem affecting over one billion individuals worldwide. This disease is the result of complex interactions between genetic and life-style factors and the central nervous system. Sympathetic hyperactivity has been postulated to be present in most forms of hypertension. Pharmaceutical therapy for hypertension has not been perfected, often requires a multidrug regimen, and is associated with adverse side effects. Acupuncture, a form of somatic afferent nerve stimulation has been used to treat a host of cardiovascular diseases such as hypertension. It has long been established that the two major contributors to systemic hypertension are the intrarenal reninangiotensin system and chronic activation of the sympathetic nervous system. A number of important studies on the baroreflex response and its response to acupuncture are discussed. The inhibitory effects of acupuncture on the rostral ventrolateral medulla (rVLM) reduces sympathetic nerve activity and blood pressure suggesting overactivity of the angiotensin system in this nucleus may play a role in the maintenance of hypertension. Our experimental studies have shown that electroacupuncture stimulation activates neurons in the arcuate nucleus, ventro-lateral gray, and nucleus raphe to inhibit the neural activity in the rVLM in a model of visceral reflex stimulation-induced hypertension. The significant role of spinal cord opioids and nociceptin are also reviewed. Although clinical studies of acupuncture to date have met some success, they are rarely scientifically robust and do not feature randomization and long-term follow up. Based on a great deal of basic scientific evidence, large trials are desperately needed to study the effects of acupuncture on the hyperensive man.

Do we really understand what constitutes an acupuncture point?

Do we really understand what constitutes an acupuncture point?

La fascia y los mecanismos de la acupuntura

In light of the recent results consistently produced by meta-analyses of clinical acupuncture studies, acupuncturists have been challenged to re-evaluate the principles of acupuncture practice. This paper reconsiders acupuncture, positing that the fascia is the mechanism of action of acupuncture therapy. Acupuncture is defined behaviorally, and recent research findings related to the form and function of the fascia are applied to explain the mechanism of action of acupuncture therapy. Acupuncture is then viewed from a historical perspective, and fundamental principles of acupuncture therapy are reconsidered in terms of the fascia model. A conception of acupuncture emerges that is linked to a renewed understanding of ancient acupuncture principles and is characterized by a return to diagnosis and treatment rooted in skilled palpation.

Acupuncture Treatment of a Patient with Persistent Allergic Rhinitis Complicated by Rhinosinusitis and Asthma

A pathophysiologic relationship between allergic rhinitis and rhinosinusitis and asthma has long been suggested. However, few clinical studies of acupuncture have been conducted on these comorbid conditions. A 48-year-old male suffering from persistent allergic rhinitis with comorbid chronic rhinosinusitis and asthma since the age of 18 years was studied. He complained of nasal obstruction, sneezing, cough, rhinorrhea and moderate dyspnea. He occasionally visited local ear-nose-throat clinics for his nasal symptoms, but gained only periodic symptom relief. The patient was treated with acupuncture, infrared radiation to the face and electro-acupuncture. Needles were inserted at bilateral LI20, GV23, LI4 and EX-1 sites with De-qi. Electro-acupuncture was performed simultaneously at both LI20 sites and additional traditional Korean acupuncture treatments were performed. Each session lasted for 10 min and the sessions were carried out twice a week for 5 weeks. The patient's Mini-Rhinoconjunctivitis Quality-of-Life Questionnaire score decreased from 38, at the beginning of treatment, to 23, 3 weeks after the last treatment. The Total Nasal Symptom Score was reduced from six (baseline) to five, 3 weeks after the last treatment. There was significant clinical improvement in the forced expiratory volume in 1 s—from 3.01 to 3.50 l—with discontinuation of the inhaled corticosteroid, and no asthma-related complaints were reported. Further clinical studies investigating the effectiveness of acupuncture for the patients suffering from allergic rhinitis and/or rhinosinusitis with comorbid asthma are needed.

Prof. CHEN Han-ping: A thinker in principles and practice of acupuncture-moxibustion

@@ The Thinker (Le Penseur) is known as the masterpiece of Auguste Rodin, a distinguished French sculptor, signifying the intellectual activity and creativity of human being. Having put forward a way of "viewing the Earth from the Moon" in developing preclinical and clinical studies of acupuncture, Prof. CHEN Han-ping brought about imaginations to acupuncture scholars with his ideas on the soul, principle, skills and orientations of acupuncture. He deserves the title of "the thinker in principles and practice of acupuncture"[1-3]. The academic ideas of Prof. CHEN Han-ping are now summarized as follows.

Fascia and the mechanism of acupuncture

In light of the recent results consistently produced by meta-analyses of clinical acupuncture studies, acupuncturists have been challenged to re-evaluate the principles of acupuncture practice. This paper reconsiders acupuncture, positing that the fascia is the mechanism of action of acupuncture therapy. Acupuncture is defined behaviorally, and recent research findings related to the form and function of the fascia are applied to explain the mechanism of action of acupuncture therapy. Acupuncture is then viewed from a historical perspective, and fundamental principles of acupuncture therapy are reconsidered in terms of the fascia model. A conception of acupuncture emerges that is linked to a renewed understanding of ancient acupuncture principles and is characterized by a return to diagnosis and treatment rooted in skilled palpation.

Acupuncture for treating erectile dysfunction: a systematic review

We evaluated the current evidence for the use of acupuncture to treat erectile dysfunction (ED). Systematic searches were conducted in 15 electronic databases, with no language restrictions. Hand-searches included conference proceedings and our files. All clinical studies of acupuncture as a treatment for ED were considered for inclusion, and their methodological quality was assessed using the Jadad score. Of the four studies included, one randomized controlled trial (RCT) showed beneficial effects of acupuncture compared with sham acupuncture in terms of response rate, while another RCT found no effects of acupuncture. The remaining two studies were uncontrolled clinical trials. Collectively these data showed that RCTs of acupuncture for ED are feasible but scarce. Most investigations had methodological flaws, e.g. inadequate study design, poor reporting of results, small sample size, and publication without appropriate peer review process. The evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED. Further research is required to investigate whether there are specific benefits of acupuncture for men with ED.

Applicability of Press Needles to a Double-blind Trial

Owing to a lack of a suitable needle procedure, it has been impossible to evaluate the efficacy of acupuncture in clinical studies using double-blind testing. We evaluated the applicability of a new kind of press needle (Pyonex) to a double-blind trial by comparing the press needle with a placebo (lacking the needle element). The purpose of the study consisted of 2 phases. In the phase 1, to evaluate the applicability and efficacy of the press needles, 90 participants who had never been treated using acupuncture were randomly assigned to receive either the press needle (n=45) or a placebo (n=45). The applicability was measured using a questionnaire regarding the perception of penetration, and efficacy was measured using a visual analog scale of low back pain (LBP). When the applicability and efficacy of the press needles were confirmed in phase 1, the mechanism of LBP relief by the press needles was examined in phase 2. In phase 1, intergroup comparisons showed no significant differences concerning the perception of penetration. In addition, for patients with LBP, the press needles reduced the subjective evaluation of LBP compared with the placebo (P<0.05). In phase 2, visual analog scale results indicated that LBP was reduced significantly more in the press needle group than in the local anesthesia group (P<0.05). The participants could not distinguish between the press needle and a placebo, and the data from the press needle group suggested a specific influence on patients with LBP. These findings imply that the press needle and a placebo provide an effective means of realizing a double-blind setting for clinical studies of acupuncture.

Improving the quality of reporting acupuncture interventions: describing the collaboration between STRICTA, CONSORT and the Chinese Cochrane Centre

First published in 2001, STRICTA (STandards for Reporting Interventions in Controlled Trials of Acupuncture) was designed to expand on the reporting of one item within the CONSORT (Consolidated Standards of Reporting Trials) Statement checklist, the item relating to the intervention. Two recent reviews had found that STRICTA was highly regarded in the field and that there was a need for minor revisions. To revise STRICTA within the CONSORT family of reporting guidelines. A collaborative effort involving the STRICTA Group, the CONSORT Group and the Chinese Cochrane Centre was agreed. A consultation process with 47 international experts provided detailed feedback on an initial draft of a revised checklist. These data, along with the two review studies, comprised the documentation for a consensus meeting in Freiburg, Germany in October 2008. A total of 21 participants attended the meeting, bringing their expertise as research methodologists, reporting guideline developers, acupuncturists, physicians and journal editors. At the workshop, a revised draft checklist was agreed. There was general consensus that STRICTA should continue to function as a stand-alone guideline as well as an extension to CONSORT. It was agreed that STRICTA should be sufficiently broad to cover all type of clinical studies, from case reports through uncontrolled studies to randomised controlled trials. It was also decided that explanations and examples, as with other CONSORT reporting guidelines, would provide a useful way of supporting the uptake to the new recommendations when published. The checklist will be subjected to further revision processes in order to further its impact and support wider dissemination. Journals that regularly publish acupuncture trials will be encouraged to adopt the revised STRICTA, include it in their guidelines for authors, and promote the adoption of its recommendations for clinical studies of acupuncture.

Acupuncture for the relief of cancer-related pain – a systematic review

Aims This systematic review summarises the existing evidence on acupuncture for cancer-related pain. Methods Literature searches were conducted in seven databases. All clinical studies of acupuncture, electroacupuncture and ear acupuncture in cancer patients with the main outcome measure of pain were included. Data were extracted according to pre-defined criteria by two independent reviewers and methodological quality was assessed using the Jadad scale. Results Of the seven studies included, one high quality randomised clinical trial of ear acupuncture showed statistically significant pain relief in comparison with placebo ear acupuncture. All the other studies were either non-blinded ( n = 2) or uncontrolled clinical trials ( n = 4). Most investigations suffered from methodological flaws such as inadequate study design, poor reporting of results, small sample size and overestimation of the results. Conclusions The notion that acupuncture may be an effective analgesic adjunctive method for cancer patients is not supported by the data currently available from the majority of rigorous clinical trials. Because of its widespread acceptance, appropriately powered RCTs are needed.

Acupuncture for pain in locomotive disorders. Critical analysis of clinical studies with respect to the quality of acupuncture in particular

88 clinical acupuncture studies concerning the treatment of locomotive disorders are compared. The studies are evaluated according to treatment quality and categorised into 6 categories. For the assessment of acupuncture treatment quality minimal criteria are defined: reporting the duration of one acupuncture treatment (at least 15 min.), reporting the frequency of acupuncture treatments (at least 10 sessions before cancelling the therapy), exact description of used acupuncture points. Without respect to biostatistical and therapeutical qualities, 75 of 88 studies (85.2%) showed positive results for the acupuncture treatment. None of the 16 studies, that met the minimal criteria we defined, could prove that acupuncture is non-effective. Only two of the 16 studies are controlled trials. Our results were compared with those of meta-analytical reviews, which discussed acupuncture studies solely on the basis of the biometrical aspects. In comparison to conventional orthopedic therapies, certain locomotive disorders are recommended for acupuncture therapy.