Safety Of Acupuncture For Patients Research Articles

Acupuncture for patients with mild to moderate Alzheimer\u2019s disease: a randomized controlled trial

BackgroundAlzheimer’s disease (AD) is the most common cause of dementia. However, none of medical treatment can stop or reverse the underlying neurodegenerative of AD at present. Acupuncture has attracted more and more attention in recent years due to its efficacy and very few side effects. Lately, a systematic review has thought that the evidence on the effectiveness of acupuncture in improving the cognitive function of AD patients was not powerful enough. Therefore, the aim of this study is to explore the efficacy and safety of acupuncture in patients with mild to moderate AD.MethodsThis was a randomized, controlled, parallel-group, exploratory study with 4-week baseline (T0), 12-week treatment phase (T1) and 12-week follow-up period (T2). Patients with mild to moderate AD meeting the included criteria were randomly allocated into either acupuncture or donepezil hydrochloride groups. The acupuncture group(AG) was given acupuncture treatment three times per week and the donepezil hydrochloride group(DG) group was administered donepezil hydrochloride once daily (5 mg/day for the first 4 weeks and 10 mg/day thereafter). Primary efficacy was measured using Alzheimer’s disease Assessment Scale-Cognitive (ADAS-cog) and Clinician’s Interview-Based Impression of Change-Plus (CIBIC-Plus). The second outcomes were measured with 23-Item Alzheimer’s disease Cooperative Study Activities of Daily Living Scales (ADAS-ADL23) and Neuropsychiatric Index (NPI).ResultsOf 87 participants enrolled in the study, 79 patients finished their treatment and follow-up processes. The ADAS-cog scores for AG group showed obvious decreases at T2 and ∆(T2-T0)when compared with DG group, and significant between-group differences were detected (all p < 0.05). The mean CIBIC-Plus values for the AG group at T1 and T2 were much lower than that for the DG group, and there were significant differences between the two groups (푃<0.05). There were no significant between-group differences in the scores of ADAS-ADL23 and NPI during the study period. Treatment discontinuations due to adverse events were 0 (0%) and 4 (9.09%) for the AG and DG groups, respectively.ConclusionsAcupuncture is safe, well tolerated and effective in improving the cognitive function, global clinical status of AD.Trial RegistrationChiCTR-IOR-17010465 (Retroactively registered on 18 JAN 2017).

Acupuncture for recovery after surgery in patients undergoing colorectal cancer resection: a systematic review and meta-analysis.

To assess the efficacy/effectiveness and safety of acupuncture in patients recovering from colorectal cancer resection. We systematically searched four English language databases (Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and AMED (Allied and Complementary Medicine Database)) and one Chinese database (CAJ, China Academic Journals). Randomised trials of acupuncture compared with usual/routine care, sham interventions or active comparators in patients undergoing colorectal cancer resection were eligible for inclusion. Postoperative symptoms and quality of life (QoL) were the primary outcomes for the review. Of 1225 screened hits, seven randomised trials with 540 participants were included. High or uncertain risk of bias and significant heterogeneity were observed. All outcomes were measured before discharge, and no trial explicitly reported post-discharge outcomes. The response to acupuncture in terms of postoperative symptoms was inconsistent across trials. QoL was not measured in the included studies. For certain outcomes reflecting physiological recovery, favourable effects of acupuncture were observed compared with sham acupuncture, namely time to first flatus (n=207, three studies; mean difference (MD) -7.48 h, 95% CI -14.58 to -0.39 h, I(2)=0%) and time to first defaecation (n=149, two studies; MD -18.04 h, 95% CI -31.90 to -4.19 h, I(2)=0%). Two studies reported there were no acupuncture-related adverse events, whereas the remaining studies did not consider adverse events. We found low-to moderate-quality evidence for the efficacy and safety of acupuncture for recovery after surgery in colorectal cancer patients. Future trials with adequate allocation concealment, blinding of outcome assessors, and measurement of post-discharge outcomes including QoL or functional recovery are warranted. CRD42014015537.

Acupuncture for chronic neck pain: a protocol for an updated systematic review.

BackgroundThis study aims to investigate the efficacy and safety of acupuncture for patients with chronic neck pain.MethodsThe MEDLINE, EMBASE, CENTRAL, CINAHL, and the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, VIP Information, and Wanfang Data databases will be searched from their inception to present. Randomised controlled trials (RCTs) of acupuncture (assessed as the sole treatment or as an adjunct treatment) for chronic neck pain will be included. The primary outcome is chronic neck pain measured by the visual analogue scale (VAS), McGill Pain Questionnaire, or short-form McGill Pain Questionnaire. The secondary outcomes will include the functional recovery, health-related quality of life, psychological improvements related to the reduction of pain, and adverse events. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third author. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials of Acupuncture checklist will be used to assess completeness of reporting.DiscussionThe results of this systematic review will provide the latest evidence of the efficacy of acupuncture in treating chronic neck pain, which will benefit both practitioners and policymakers.Systematic review registrationPROSPERO CRD42015017178Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0257-x) contains supplementary material, which is available to authorized users.

Acupuncture for chronic knee pain: a protocol for an updated systematic review

IntroductionThe aim of this study is to evaluate the efficacy and safety of acupuncture for patients with chronic knee pain.Methods and analysisMEDLINE, EMBASE, CENTERAL, CINAHL and four Chinese medical databases...

Acupuncture for urinary incontinence after stroke: a protocol for systematic review

IntroductionThe aim of this study, which will include randomised controlled trials (RCTs), is to assess the efficacy and safety of acupuncture for patients with stroke and urinary incontinence.Methods and analysisRCTs...

The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review.

Background. Acupuncture might have effectiveness in relieving the symptoms of chronic urticaria. There are currently no systematic reviews of acupuncture for chronic urticaria published in English. Objective. We conducted a systematic review to assess the effectiveness and safety of acupuncture for chronic urticaria. Methods. A systematic review and meta-analysis of randomized, controlled trials were performed. The primary outcome was global symptom improvement. Results. We included 6 studies with 406 participants. Three trials showed significant difference between acupuncture and drugs in global symptom improvement (relative risk 1.37; 95% CI 1.11–1.70; P = 0.003). As an adjuvant to medication, acupuncture was also beneficial for global symptom improvement (relative risk 1.77; 95% CI 1.41–2.22; P < 0.01). There were no severe adverse events related to acupuncture. Limitations. Some methodological limitations were observed. The overall risk of bias in the 6 included trials was high and all included RCTs were conducted in China and published in Chinese. Besides, the lack of proper control groups and the use of different rating methods and cut-offs in the included trials also made the evidence of this review limited. Conclusions. Acupuncture might be effective and safe for chronic urticaria in relieving symptoms, based on a low level of evidence. To draw a reliable conclusion, more high quality trials are needed in the future. This trial is registered with PROSPERO CRD42015015702.

Treating attention deficit hyperactivity disorder with acupuncture: A randomized controlled trial

IntroductionAttention deficit hyperactivity disorder (ADHD) is the most common childhood behavioral problem. The purpose of this study was to evaluate the effectiveness and safety of acupuncture in patients with ADHD. MethodsThe study was randomized, waitlist-controlled, and unblinded. A total of 93 participants with ADHD were enrolled. The acupuncture group received acupuncture treatment twice per week for 6 weeks. The waitlist group did not receive acupuncture during the first six weeks, and then underwent acupuncture treatment during the next six weeks. The primary outcome measure was the ADHD-rating scale. The computerized neurocognitive function tests (CNTs) was conducted as an objective measurement. ResultsThe results of the primary analyses were equivocal. Additional analyses were conducted after data were stratified according to ADHD medication. The acupuncture group not taking ADHD medications demonstrated significantly better performance in the CNTs compared to the waitlist group: the backward digit span test (p=0.026), backward visual span test (p=0.044), correct hit/omission error of auditory continuous performance test (CPT) (p=0.021), standard deviation of response time of visual CPT (p=0.048). The clinical global impression-severity score decreased significantly in the acupuncture group after treatment compared to that in the waitlist group (p=0.000). There was no statistically significant difference between both groups taking ADHD medications, except for verbal learning test in which waitlist group experienced a higher increase than acupuncture group. No adverse effect was reported. ConclusionsAcupuncture positively influences cognitive function in patients who are not on ADHD medication.

The Safety of Acupuncture in Patients with Cancer Therapy–Related Thrombocytopenia

Background: Acceptance of acupuncture as an efficacious integrative modality for oncology-related side-effect management is rapidly expanding. It is imperative that guidelines regarding safe treatment supported by clinical experience are established. Oncology patients frequently experience thrombocytopenia as a side-effect of chemotherapy or radiation. However, safety data for acupuncture in adult patients with cancer who are thrombocytopenic is lacking.Materials and Methods: The medical records of 684 patients who received acupuncture treatments in an established acupuncture program at a private cancer treatment hospital were reviewed for adverse events occurring within the context of thrombocytopenia.Results: Of 2135 visits eligible for evaluation, 98 individual acupuncture visits occurred in patients with platelet counts <100,000/μL, including nine visits in which platelet counts were <50,000/μL. No adverse events of increased bruising or bleeding were noted. Medications and nutritional supplements or botanicals that may influence coagulation were also tabulated, with no apparent adverse events in this patient population.Conclusions: Discrepancies in the literature highlight the need to create cohesive safety guidelines backed by clinical research, specifically for groups at higher risk for adverse events. The preliminary evidence put forth in this study lays the foundation that supports the notion that acupuncture can be used safely with a high-need oncology population within an integrated model of care. In this descriptive retrospective case series of adult oncology patients with thrombocytopenia, no adverse events of increased bruising or bleeding were documented. Prospective trials are needed to confirm these initial observations.

The effectiveness and safety of acupuncture for patients with Alzheimer disease: a systematic review and meta-analysis of randomized controlled trials.

The use of acupuncture for treating Alzheimer disease (AD) has been increasing in frequency over recent years. As more studies are conducted on the use of acupuncture for treating AD, it is necessary to re-assess the effectiveness and safety of this practice.The objective of this study was to assess the effectiveness and safety of acupuncture for treating AD.Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, Embase, PsycINFO, Chinese Biomedicine Literature (CBM), Chinese Medical Current Content (CMCC) and China National Knowledge Infrastructure (CNKI) were searched from their inception to June 2014.Randomized controlled trials (RCTs) with AD treated by acupuncture or by acupuncture combined with 1 kind of drugs were included.Two authors extracted data independently. The continuous data were expressed as mean differences (MD) with 95% confidence intervals (CIs). Weighted MD (WMD) was used instead of standardized MD (SMD) when the same scales were used. Adverse reactions related to acupuncture were also investigated.Ten randomized controlled trials with a total of 585 participants were included in the meta-analysis. The combined results of 6 trials showed that acupuncture was better than drugs at improving scores on the Mini Mental State Examination (MMSE) scale (MD 1.05, 95% CI 0.16–1.93). Evidence from the pooled results of 3 trials showed that acupuncture plus donepezil was more effective than donepezil alone at improving the MMSE scale score (MD 2.37, 95% CI 1.53–3.21). Out of 141 clinical trials, 2 trials reported the incidence of adverse reactions related to acupuncture. Seven out of 3416 patients had adverse reactions related to acupuncture during or after treatment; the reactions were described as tolerable and not severe.Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating AD in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients’ ability to carry out their daily lives. Moreover, acupuncture is safe for treating people with AD.Protocol registration: PROSPERO CRD42014009619.Protocol published in BMJ-open.

Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis

Objective. This systematic review aimed to assess current evidence from randomized controlled trials (RCTs) on the effects of acupuncture for patients with primary ovarian insufficiency (POI). Methods. We searched twelve databases to identify relevant studies published before July 2014. The outcomes were serum follicle-stimulating hormone (FSH) levels and resumption of menstruation. Two reviewers independently assessed the risk of bias using the Cochrane's tool, extracted the results, and evaluated the overall level of the evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results. Eight RCTs were selected. Acupuncture significantly lowered serum FSH levels and more women receiving acupuncture reported resumption of menses. However, the results should be interpreted with caution due to a small number of participants, high risk of bias for blinding, and likely publication bias. The level of evidence for FSH level and resumption of menses were assessed as “low” using GRADE. Conclusion. The current evidence on acupuncture for POI is insufficient to draw a firm conclusion due to scarcity of studies with a low risk of bias and likely publication bias. Further rigorously designed and conducted studies are needed to confirm the effectiveness and safety of acupuncture in patients with POI.

Safety of acupuncture treatments for patients taking warfarin or antiplatelet medications: Retrospective chart review study

IntroductionAnticoagulant and antiplatelet therapy are widely used as preventive measures and treatment for cardiovascular and cerebrovascular diseases. Bleeding is a significant complication of anticoagulant and antiplatelet medications. With the growing use of acupuncture and the potential concomitant use of such medications, studies on the safety of acupuncture are necessary. The objective of this study was to evaluate the safety of acupuncture for patients taking warfarin or antiplatelet medications by comparing the rate of side effects for patients who did not take either of these medications. MethodologyThe medical records were searched to identify patients who had received acupuncture treatments at the Department of Korean Internal Medicine of Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong between November 2010 and April 2012. Prescribed medications were identified from medical records and each patient was allocated to one of three groups based on the medication they were taking. Group A were taking warfarin, group B were taking antiplatelet medications but not warfarin, group C took neither warfarin nor antiplatelet medications and acted as a control group. Potential side effects that could be attributed to of acupuncture were identified. ResultsA total of 242 patients and 4891 acupuncture treatments were identified. No patients experienced serious adverse events such as extensive bleeding. The occurrence rate of microbleeding (bleeding which stopped within 30s) was 4.8% for group A, 0.9% for group B and 3.0% for group C. ConclusionAcupuncture treatment appears safe even for patients taking warfarin or antiplatelet medications. Large-scale, well-designed studies are needed to confirm these results.This article belongs to the Special Issue: ‘IG000019’.

Efficacy and safety of acupuncture for chronic dizziness: study protocol for a randomized controlled trial

BackgroundDizziness is one of the most challenging symptoms in medicine. No medication for dizziness in current use has well-established curative or prophylactic value or is suitable for long-term palliative use. Unconventional remedies, such as acupuncture, should be considered and scientifically evaluated. However, there has been relatively little evidence in randomized controlled clinical trials on acupuncture to treat chronic dizziness. The aim of our study is to evaluate the efficacy and safety of acupuncture in patients with dizziness.Methods/DesignThis trial is a randomized, single-blind, controlled study. A total of 80 participants will be randomly assigned to two treatment groups receiving acupuncture and sham acupuncture treatment, respectively, for 4 weeks. The primary outcome measures are the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS). Treatment will be conducted over a period of 4 weeks, at a frequency of two sessions per week. The assessment is at baseline (before treatment initiation), 4 weeks after the first acupuncture session, and 8 weeks after the first acupuncture session.DiscussionThe results from this study will provide clinical evidence on the efficacy and safety of acupuncture in patients with chronic dizziness.Trial registrationInternational Standard Randomized Controlled Trial Number Register: ISRCTN52695239

Acupuncture for Whiplash-associated disorder: A randomized, waiting-list controlled, pilot trial

IntroductionWhiplash-associated disorder (WAD) is a general after-effect of motor vehicle collisions or sporting accidents. Acupuncture is a common intervention for pain conditions such as musculoskeletal disease. We conducted a pilot trial to determine the efficacy and safety of acupuncture for patients with WAD. MethodologyForty participants were randomly allocated to an acupuncture group or a waiting-list group. The acupuncture group received acupuncture treatment three times per week for 2 weeks.Symptoms were evaluated before random allocation and after 2 weeks. The primary outcome measure was pain intensity. Secondary outcome measures were the SF-36, cervical range of motion (ROM), Self-Rating Depression Scale (SDS), and the Cornell Medical Index (CMI). ResultsThe results demonstrated that the change in visual analogue scale (VAS) in the acupuncture group was −1.85 [−2.67 to −1.02], compared to −0.40 in the waiting-list group [95% CI: −1.18 to 0.38] (p=0.001). VAS significantly improved from 4.59 [3.67–5.48] at baseline to 2.74 [2.08–3.37] at the endpoint (p<0.001) in the acupuncture group. No significant changes in secondary outcomes such as SF-36, Cervical ROM, SDS and CMI within either group were observed, and the scores from baseline revealed no significant differences between the groups. There were no reports of serious adverse events related to acupuncture treatment. ConclusionsAcupuncture treatment was associated with a significant alleviation of pain. This pilot study provided preliminary data on the efficacy and safety of acupuncture treatment for WAD. A full-scale randomized controlled trial is required to provide firm evidence of the effectiveness of this intervention.

Acupuncture for attention deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neuro-psychiatric problem, affecting 7-9% of children. Pharmacological interventions are widely used with behavioral treatments in ADHD. Still, the origin of ADHD is unclear, limiting pharmacological effectiveness and making adverse effects common. The use of complementary and alternative medicine (CAM) has increased, especially for developmental and behavioral disorders, such as ADHD. CAM is used by 60-65% of parents of children with ADHD to relieve ADHD-associated symptoms and to avoid the side effects of conventional medication. Acupuncture has been widely used to treat patients with ADHD, but the available evidence of its effectiveness is insufficient. Our aim was to evaluate the effectiveness and safety of acupuncture in patients (both and each treatment naive and conventional therapy children) with ADHD (any subtype) compared to the waitlist control.Methods/DesignThis study is a waitlist controlled open trial. We used a computer generated randomization scheme. This randomised, controlled trial had two parallel arms (acupuncture, and waitlist group). Each arm consisted of 40 participants. The acupuncture group received acupuncture treatment two times per week for a total of 12 sessions over 6 weeks. Post-treatment follow-up was performed 3 weeks later to complement the 12 acupuncture sessions. Participants in the waitlist group did not receive acupuncture treatments during the first six weeks but were only required to be assessed. After 6 weeks, the same treatments given to the acupuncture group were provided to the waitlist group. The primary outcome of this trial included differences in Korean version of ADHD-Rating Scale (K-ADHD-RS) before randomization, 3 weeks and 6 weeks after randomization, and 3 weeks after completing the treatment.DiscussionSubjective measurements, like K-ADHD-RS, are commonly used in ADHD. Although these measurements have adequate reliability and validity, lack of objective assessment in ADHD may lead to some disputes, like parental placebo effects. More objective measurements, like Computerized Neurocognitive function Test (CNT) in this study, are needed in ADHD trials. Furthermore, this trial will provide evidence for the effectiveness of acupuncture as a treatment for ADHD.Trial RegistrationClinical Research Information Service (CRiS) KCT0000019

Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol.

ObjectiveIncomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy.Method/DesignThis study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI) from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales.Trial registrationCurrent Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010

The safety of acupuncture in children and adolescents with cancer therapy-related thrombocytopenia

Acupuncture is frequently used to manage the side effects associated with cancer therapy. In acupuncture practice, the presence of thrombocytopenia is a relative contraindication to acupuncture use among patients with cancer. However, the safety of acupuncture in patients with cancer treatment-related thrombocytopenia has not been previously investigated. Medical records of 32 patients receiving acupuncture at an academic medical center with an established acupuncture program during treatment for cancer or during stem cell transplantation were reviewed. Of 237 acupuncture sessions, 20%, 8%, and 19% of the sessions were administered to patients with severe, moderate, and mild thrombocytopenia, respectively. No bleeding side effects were observed. This retrospective case series provides descriptive data on the safety of acupuncture using Japanese J-type Seirin needles, with mild manual stimulation administered at 0.5-cun depth in patients with cancer with and without thrombocytopenia. Prospective trials are needed to confirm these initial observations.

The Programme for the Evaluation of Patient Care with Acupuncture (Pep-Ac) – a Project Sponsored by Ten German Social Health Insurance Funds

Objective The aim of the Programme for the Evaluation of Patient care with Acupuncture (PEP-Ac) was to investigate the efficacy, effectiveness and safety of acupuncture in patients with the following three indications: chronic headache, chronic low back pain and chronic osteoarthritic pain. This article provides an overview of the results of the whole programme. Methods The programme included five randomised trials, a large observational study, a survey of physicians providing acupuncture, and three systematic reviews. Results The results show that, for all three indications, acupuncture, when compared to no treatment, produces a clear benefit that lasts for at least several months. However the effects of point-specific acupuncture only offered a significant advantage over minimal acupuncture in the treatment of OA knee. Conclusions The evidence from these trials – on the one hand, a clear overall effect of acupuncture and on the other hand, the lack of evidence supporting its superiority over sham acupuncture for all indications except osteoarthritis of the knee – leaves a considerable amount of room for interpretation.

Acupuncture for Acute Stroke

Section Editors: Graeme J. Hankey MD, FRCP Acupuncture is widely used in the treatment of stroke in China and it is increasingly requested by patients in some Western countries. Experimental data indicate that acupuncture-like sensory stimulation activates multiple efferent (nerve) pathways leading to altered activity in numerous neural systems. The objectives of this study were to assess the effectiveness and safety of acupuncture in patients with acute stroke. We searched the Cochrane Stroke Group Trials Register (last searched August 2003), the Chinese Stroke Trials Register (August 2003), and the Chinese Acupuncture Trials Register (August 2003). Electronic searches were performed in the Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003), …

Acupuncture for acute stroke

Acupuncture-like sensory stimulation activates multiple efferent (nerve) pathways leading to altered activity in numerous neural systems. Acupuncture is widely accepted by Chinese people and it is increasingly requested by patients and their relatives in Western countries. To assess the effectiveness and safety of acupuncture in patients with acute stroke. We searched the Cochrane Stroke Group trials register (last searched August 2003), the Chinese Stroke Trials Register (August 2003) and the Chinese Acupuncture Trials Register (August 2003). Electronic searches were performed in the Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003), Alternative Medicine Database (1985 to 2003), CINAHL (1982 to 2003) and the Chinese Biological Medicine Database (1981 to 2003). Reference lists of systematic reviews and identified trials were handsearched. Randomised and quasi-randomised trials of acupuncture started within 30 days of stroke onset, compared with placebo/sham acupuncture or open control in patients with acute ischaemic and/or haemorrhagic stroke. Needling into skin was required for acupuncture. Two reviewers selected trials for inclusion, assessed trial quality, and extracted the data independently. Authors of trials were contacted for missing data. Fourteen trials involving 1208 patients were included. Ten trials included patients with only ischaemic stroke. When acupuncture was compared with sham acupuncture or open control, there was a borderline significant trend towards fewer patients being dead or dependent (Odds ratio (OR) 0.66, 95% confidence interval (CI) 0.43 to 0.99), and significantly fewer being dead or needing institutional care (OR 0.58, 95% CI 0.35 to 0.96) in the acupuncture group after three months or more. There was also a significant difference favouring acupuncture in the mean change of global neurological deficit score during the treatment period (standardized mean difference (SMD) 1.17, 95% CI 0.30 to 2.04). Comparison of acupuncture with sham acupuncture only showed a statistically significant difference on death or requiring institutional care (OR 0.49, 95% CI 0.25 to 0.96), but not on death or dependency (OR 0.67, 95% CI 0.40 to 1.12), or change of global neurological deficit score (SMD 0.01, 95% CI -0.55 to 0.57). Severe adverse events with acupuncture (dizziness, intolerable pain and infection of acupoints) were rare (6/386, 1.55%). Acupuncture appeared to be safe but without clear evidence of benefit. The number of patients is too small to be certain whether acupuncture is effective for treatment of acute ischaemic or haemorrhagic stroke. Larger, methodologically-sound trials are required.