Acupuncture - a national heritage of China to the world: international clinical research advances from the past decade

Abstract

Acupuncture originated in China and is an important component of traditional Chinese medicine. The elucidation of its anesthetic mechanisms, the medical needs of Western societies, as well as the proven therapeutic effects of this technique have made it the most widely used medical practice in the world. The concept of evidence-based medicine has been introduced in acupuncture research for technical improvement and the production of high-quality clinical evidence. Upon reviewing the acupuncture clinical research over the past 10 years, we found the gradually increasing range of diseases that it benefits, from pain management to neoplasms and genitourinary, digestive, and mental disorders. Acupuncture is included in a number of international guidelines for clinical practice. However, high-quality clinical evidence to support the efficacy and effectiveness of acupuncture is lacking as a result of multiple exceptional clinical trials conducted by Western researchers that have yielded antagonistic results. Future clinical research should focus on exploring objective evaluation methods for studying the therapeutic effects of acupuncture.

Keywords

Acupuncture / Clinical research / Review

Conflict of interest statement

Baoyan Liu and Yi Guo are editorial board members of this journal. None of the other authors declare any conflicts of interest.

Author contributions

Baoyan Liu and Yi Guo conceived and designed the study. Bo Chen provided general guidance for the analysis and interpretation of the data. Lixin Tian designed the search strategy. Bo Chen and Lixin Tian drafted and revised the manuscript. All authors have read and approved the final manuscript.

Acknowledgments

We would like to thank Yong Chen, Xiyou Hu, and Yawen Tao for their support in literature retrieval.

References

[1] World Health Organization. WHO Traditional Medicine Strategy: 2014-2023. Available from: Accessed 23 April, 2021.

[2] National Administration of Traditional Chinese Medicine. “Acupuncture and Moxibustion of Traditional Chinese Medicine” Were Included in the UNESCO Representative List of Intangible Cultural Heritage of Humanity. Available from: Accessed 15 March, 2021.

[3] Xinhua Daily Telegraph. President Xi Jinping Presented a Bronze Acupuncture Statue to the World Health Organization. Available from: Accessed 23 April, 2021.

[4] Wang X, Liu B, Yang Y. The Overview of World Acupuncture Policies and Legislation. Beijing: China Press of Traditional Chinese Medicine; 2020. 5-6.

[5] Xinhuanet. In the United States, 44 States Have Legislated Acupuncture, and the Number of Licensed Acupuncturists Has Been Over 40,000. Available from: Accessed 10 March, 2021.

[6] National Center for Complementary and Alternative Medicine. Acupuncture: In Depth. Available from: Accessed 5 April, 2021.

[7] MacPherson H, Vickers A, Bland JM, et al. Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants for Applied Research 2017;5(3):1-342.

[8] Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, et al. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain 2016;157(9):1905-1917.

[9] Tu JF, Yang JW, Shi GX, et al. Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: a randomized controlled trial. Arthritis Rheumatol 2021;73(3):448-458.

[10] Zhao L, Chen J, Li Y, et al. The Long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial. JAMA Intern Med 2017;177(4):508-515.

[11] Cohen MM, Smit V, Andrianopoulos N, et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Med J Aust 2017;206(11):494-499.

[12] Oates A, Benedict KA, Sun K, et al. Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial. Pain 2017;158(1):103-109.

[13] Benson S, Hagen S, Hoffmann O, et al. Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer. Pain 2019;160(7):1562-1571.

[14] Hershman DL, Unger JM, Greenlee H, et al. Effect of acupuncture vs sham acupuncture or waitlist control on joint pain related to aromatase inhibitors among women with early-stage breast cancer: a randomized clinical trial. JAMA 2018;320(2):167-176.

[15] Zhao L, Li D, Zheng H, et al. Acupuncture as adjunctive therapy for chronic stable angina: a randomized clinical trial. JAMA Intern Med 2019;179(10):1388-1397.

[16] Xie J, Chen LH, Ning ZY, et al. Effect of transcutaneous electrical acupoint stimulation combined with palonosetron on chemotherapy-induced nausea and vomiting: a single-blind, randomized, controlled trial. Chin J Cancer 2017;36(1):6.

[17] Bao T, Seidman AD, Piulson L, et al. A phase IIA trial of acupuncture to reduce chemotherapy-induced peripheral neuropathy severity during neoadjuvant or adjuvant weekly paclitaxel chemotherapy in breast cancer patients. Eur J Cancer 2018;101:12-19.

[18] Bao T, Patil S, Chen C, et al. Effect of acupuncture vs sham procedure on chemotherapy-induced peripheral neuropathy symptoms: a randomized clinical trial. JAMA Netw Open 2020;3(3):e200681.

[19] Lu W, Wayne PM, Davis RB, et al. Acupuncture for chemoradiation therapy-related dysphagia in head and neck cancer: a pilot randomized sham-controlled trial. Oncologist 2016;21(12):1522-1529.

[20] Garcia MK, Meng Z, Rosenthal DI, et al. Effect of true and sham acupuncture on radiation-induced xerostomia among patients with head and neck cancer: a randomized clinical trial. JAMA Netw Open 2019;2(12):e1916910.

[21] Lesi G, Razzini G, Musti MA, et al. Acupuncture as an integrative approach for the treatment of hot flashes in women with breast cancer: a prospective multicenter randomized controlled trial (AcCliMaT). J Clin Oncol 2016;34(15):1795-1802.

[22] Minchom A, Punwani R, Filshie J, et al. A randomised study comparing the effectiveness of acupuncture or morphine versus the combination for the relief of dyspnoea in patients with advanced non-small cell lung cancer and mesothelioma. Eur J Cancer 2016;61:102-110.

[23] Mao H, Mao JJ, Guo M, et al. Effects of infrared laser moxibustion on cancer-related fatigue: a randomized, double-blind, placebo-controlled trial. Cancer 2016;122(23):3667-3672.

[24] Liu Z, Liu Y, Xu H, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial. JAMA 2017;317(24):2493-2501.

[25] Liu Q, Liu J, Ren C, et al. Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry. Int J Nanomedicine 2017;12:1663-1671.

[26] Yang JW, Wang LQ, Zou X, et al. Effect of acupuncture for postprandial distress syndrome: a randomized clinical trial. Ann Intern Med 2020;172(12):777-785.

[27] Liu Z, Yan S, Wu J, et al. Acupuncture for chronic severe functional constipation: a randomized trial. Ann Intern Med 2016;165(11):761-769.

[28] Hinman RS, McCrory P, Pirotta M, et al. Acupuncture for chronic knee pain: a randomized clinical trial. JAMA 2014;312(13):1313-1322.

[29] Wu XK, Stener-Victorin E, Kuang HY, et al. Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial. JAMA 2017;317(24):2502-2514.

[30] Smith CA, de Lacey S, Chapman M, et al. Effect of acupuncture vs sham acupuncture on live births among women undergoing in vitro fertilization: a randomized clinical trial. JAMA 2018;319(19):1990-1998.

[31] Wechsler ME, Kelley JM, Boyd IO, et al. Active albuterol or placebo, sham acupuncture, or no intervention in asthma. N Engl J Med 2011;365(2):119-126.

[32] Xu S, Yu L, Luo X, et al. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ 2020;368:m697.

[33] Witt C, Brinkhaus B, Jena S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet 2005;366(9480):136-143.

[34] Teixeira LJ, Soares BG, Vieira VP, et al. Physical therapy for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2011;(12):CD006283.

[35] Zhu X, Hamilton KD, Mcnicol ED. Acupuncture for pain in endometriosis. Cochrane Database Syst Rev 2011;(9):CD007864.

[36] Huang T, Shu X, Huang YS, et al. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database Syst Rev 2011;(12):CD005230.

[37] Coyle ME, Smith CA, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database Syst Rev 2012;(2):CD003928.

[38] Kim TH, Lee MS, Kim KH, et al. Acupuncture for treating acute ankle sprains in adults. Cochrane Database Syst Rev 2014;(6):CD009065.

[39] Deare JC, Zhen Z, Xue CC, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev 2013;(5):CD007070.

[40] Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev 2016;4:CD007587.

[41] Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev 2016;(6):CD001218.

[42] Franco JV, Turk T, Jung JH, et al. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev 2018;5:CD012551.

[43] Lee A, Chan SK, Fan LT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2015;(11):CD003281.

[44] Dodin S, Blanchet C, Marc I, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev 2013;(7):CD007410.

[45] Moretto EN, Wee B, Wiffen PJ, et al. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst Rev 2013;(1):CD008768.

[46] Cheuk DK, Wong V. Acupuncture for epilepsy. Cochrane Database Syst Rev 2014;(4):CD005062.

[47] Jin L, Wu JS, Chen GB, et al. Unforgettable ups and downs of acupuncture anesthesia in China. World Neurosurg 2017;102:623-631.

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Acupuncture and Herbal Medicine