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More detail on neurotransmitters in acupuncture for pain is in our blog.
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
Resources:
Resources:
Evidence Based Acupuncture Factsheet on Pain
BAcC Diabetes Evidence-Based Factsheet, also covers Diabetic Neuropathy
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
Animal Studies
Qi et al. (2014; n=60) investigated the effect of acupuncture on spastic cerebral palsy rats. The study found that acupuncture reduced the serum levels of inflammatory cytokines, which are molecules that promote inflammation. Acupuncture also improved the blood viscosity and erythrocyte electrophoresis indexes of the rats, which reflect the shape and flow of red blood cells. In addition, acupuncture decreased the muscular tension and increased the active range of motion of the paralytic extremity of the rats. The authors concluded that acupuncture may have a beneficial effect on spastic cerebral palsy by inhibiting the inflammatory response and relieving muscle spasms.
References:
Qi, Y.C., Xiao, X.J., Duan, R.S., Yue, Y.H., Zhang, X.L., Li, J.T. and Li, Y.Z., 2014. Effect of acupuncture on inflammatory cytokines expression of spastic cerebral palsy rats. Asian Pacific journal of tropical medicine, 7(6), pp.492-495.
Helen For Hyperemesis Gravidarum (Morning Sickness), see the relevant section of our pregnancy page: There is also an interesting video from the British Acupuncture Council with a patient regarding hyperemesis gravidarum (severe morning sickness) and her use of acupuncture, showing a treatment and discussion with her acupuncturist: you can see it here
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
Research and Resources on Nausea, Vomiting and Acupuncture:
A scholarly search of the available research papers on the terms “acupuncture” + “nausea” yields over 36,300 papers, and narrowing this to “RCT” to identify Randomised Controlled Trials, gives over 5,930 results; of which 39% have been carried out since 2017 (Google Scholar). This suggests that acupuncture is being used traditionally and currently in this area, leading to a body of research being carried out, the pace of which has increased in recent years, indicating increased recognition that it is worthy of scientific appraisal regarding its potential role.
Interpreting the research:
When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms. The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment). In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.
The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control). Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.
The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.
Post Operative Nausea and Vomiting (PONV)
In the hospital setting, acupuncture reduced postoperative nausea and vomiting (PONV) in children, particularly during the first 4 hours after surgery and was most effective when performed before anaesthesia (Veiga-Gil at al, 2017, systematic review of 16 RCT’s, n=1773).
Sun et al’s (2008) systematic review of 15 RCT’s (n=1166) in the British Journal of Anaesthesia examined post-operative pain but also found lower incidence of opioid side effects including post-operative nausea and vomiting (PONV) in acupuncture groups. They stated that further large and well-designed studies are needed to further examine this area including the most effective points and timings to use.
Fu et al (2020a) looked specifically at nausea and vomiting post abdominal surgery in a systematic review (20 studies, n=2862), finding positive results for acupuncture intervention groups, nausea being easier to control than was vomiting.
A further systematic review in this area is due soon, looking at comparing non-invasive and invasive acupuncture in the prevention of postoperative nausea and vomiting (protocol: Fu et al, 2020b), it will be good to have the more resent research included in this where methodology and quality allow, given this is an area of greatly increased research since 2017.
Chemotherapy and Radiotherapy Related Nausea and Vomiting
Five forthcoming systematic reviews are currently awaited from Ma et al, (protocol: 2020); Huang et al (protocol: 2020); Shi et al (protocol: 2020); Hu et al, (protocol, 2019); and Hou et al, (protocol: 2021) regarding acupuncture in chemotherapy-induced vomiting and nausea.
It will be of interest to see what these five systematics review add to the literature and evidence, given the large increase in RCT’s in this area since 2017. (Of 1,860 RCT’s for this, 638 were published since 2017 [search term “acupuncture” + “nausea” + “chemotherapy” +”RCT” on scholarly resource].
Further, a systematic review protocol has been published to investigate acupuncture in radiotherapy-induced nausea and vomiting (protocol: Shu et al, 2019).
Electro Acupuncture
EA is a safe and effective form of therapy, which studies and systematic reviews, have shown may benefit patients for the symptoms of a wide range of conditions, in particular nausea prevention: post chemotherapy (Zhang et al, 2014); post surgery nausea (Ho et al, 1990); in hyperemesis gravidarum (severe “morning sickness” of pregnancy) (Ezzo et al, 2006);
Resources:
British Acupuncture Council evidence based factsheet about Nausea and Vomiting including specific research, trials and mechanisms of action for acupuncture in this condition.
References:
Ezzo, J., Streitberger, K. and Schneider, A., 2006. Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting. Journal of Alternative & Complementary Medicine, 12(5), pp.489-495.
Fu, C., Wu, T., Shu, Q., Song, A. and Jiao, Y., 2020a. Acupuncture therapy on postoperative nausea and vomiting in abdominal operation: A Bayesian network meta analysis. Medicine, 99(23).
Fu, C.W., Shu, Q., Jiao, Y., Wu, T., Song, A.Q., Zhu, Q.C. and Zhang, W.P., 2020b. A comparison of noninvasive and invasive acupuncture in preventing postoperative nausea and vomiting: A protocol for systematic review and Bayesian network meta-analysis. Medicine, 99(31).
Ho, R.T., Jawan, B., Fung, S.T., Cheung, H.K. and Lee, J.H., 1990. Electro‐acupuncture and postoperative emesis. Anaesthesia, 45(4), pp.327-329.
Hou, X.B., Chen, D.D., Cheng, T.F., Wang, D., Dai, X.J., Wang, Y., Cui, B.X., Wang, Y.Y., Xu, H. and Chen, H.Z., 2021. Acupuncture treatment for nausea and vomiting after chemotherapy: A protocol for systematic review. Medicine: Case Reports and Study Protocols, 2(5), p.e0084.
Hu, J., Shen, Y., Zhang, G., He, J., Sun, M., Zhang, H., Hua, B. and Zheng, H., 2019. Effect of acupoint therapies on chemotherapy-induced nausea and vomiting: A systematic review protocol. Medicine, 98(37).
Huang, Y., Zhang, R., Yao, Q., Liu, J., OuYang, X., Hui, X., Wang, H., He, R. and Zhao, B., 2020. Acupuncture treatment for chemotherapy-induced nausea and vomiting: A protocol for systematic review and meta-analysis. Medicine, 99(21).
Ma, T.T., Zhang, T., Zhang, G.L., Dai, C.F., Zhang, B.R., Wang, X.M. and Wang, L.P., 2020. Prevention of chemotherapy-induced nausea and vomiting with acupuncture: a protocol for systematic review and meta-analysis. Medicine, 99(3).
Shi, Y., Xu, T., Chen, Q., Wu, J., Zhong, Y., Song, S., Chen, Y., Gao, W. and Zhao, L., 2019. Acupuncture for radiotherapy-induced nausea and vomiting: A systematic review protocol. Medicine, 98(24).
Shi, K., He, F., Tang, Y., Xiao, X., Zhang, J., Jin, Y., Wang, Y. and Zhang, Q., 2020. Acupuncture PC6 for postoperative nausea and vomiting at different times: A protocol for systematic review and meta analysis. Medicine, 99(22), p.e20452.
Sun, Y., Gan, T.J., Dubose, J.W. and Habib, A.S., 2008. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. British journal of anaesthesia, 101(2), pp.151-160.
Veiga-Gil, L., Pueyo, J. and López-Olaondo, L., 2017. Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment. Revista Española de Anestesiología y Reanimación (English Edition), 64(4), pp.223-232.
Zhang, X., Jin, H.F., Fan, Y.H., Lu, B., Meng, L.N. and Chen, J.D., 2014. Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evidence-Based Complementary and Alternative Medicine, 2014.
Helen Page still under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
Fatigue Study in RMMS
Khodaie et al’s RCT (2023: N=60) investigated acupuncture for fatigue in patients with relapsing-remitting MS (RRMS) in remission phase. They compared the effects of the drug amantadine alone, with amantadine with acupuncture, between two groups. Both groups took amantadine 100 mg every day and standard immune-modulating drugs. One group received acupuncture (10 sessions in 4 weeks) in addition, and the other group did not. Fatigue severity scale (FSS) was used, alongside MSQOL-54 questionnaire score (Quality of Life measure). Both groups had less fatigue, but the acupuncture group had more improvement after 4 weeks; the acupuncture group also had better quality of life, than did the control group. The results suggest that acupuncture with amantadine and standard care is better than amantadine and standard care alone for short-term relief of fatigue and quality of life in people with RRMS.
Anti-Inflammatory and Immune Effects of Acupuncture
Wang et al (2023) reviewed evidence from animal and human studies regarding the immunomodulatory mechanism of acupuncture, regarding its effects on different components of the immune system, such as mast cells, macrophages, neutrophils, natural killer cells, astrocytes, microglia, CD4+ and CD8+ T cells, and cytokines. They detailed the neuroanatomical mechanisms of acupuncture in immunomodulation, such as the vagal-adrenal pathway, the cholinergic anti-inflammatory pathway, the spinal sympathetic pathway, the brain-gut axis, and the hypothalamus-pituitary-adrenal axis. They concluded that studies to support the role of acupuncture in regulating inflammation, infection, allergy, pain, and tissue repair.
Electroacupuncture (EA) has been shown in a rat model (Li et al, 2008) to have anti-inflammatory benefits by modulating the hypothalamic-pituitary-adrenal (HPA) axis, (HPA axis regulates the stress response and immune function). Specifically, Li et al outlined that EA sets off a cascade in the brain (via corticotropin-releasing hormone, and adrenocorticotropic hormone) to produce cortisol, which reduces inflammation and oedema.
References:
Khodaie, F., Naser Moghadasi, A., Kazemi, A.H. and Zhao, B., 2023. Effectiveness of acupuncture for fatigue in patients with relapsing-remitting multiple sclerosis: a randomized controlled trial. Acupuncture in Medicine, p.09645284221150824.
Li, A., Lao, L., Wang, Y., Xin, J., Ren, K., Berman, B.M., Tan, M. and Zhang, R., 2008. Electroacupuncture activates corticotrophin-releasing hormone-containing neurons in the paraventricular nucleus of the hypothalammus to alleviate edema in a rat model of inflammation. BMC Complementary and Alternative Medicine, 8(1), pp.1-8.
Wang, M., Liu, W., Ge, J. and Liu, S., 2023. The immunomodulatory mechanisms for acupuncture practice. Frontiers in Immunology, 14.
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
References:
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
References:
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
References:
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
References:
Helen Page under construction
Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
References:
Helen Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
CKD
A systematic review (Melo et al, 2020) examined acupuncture’s effect in CKD over 9 RCT’s, finding positive effects on improving quality of life, fatigue, and sleep in patients with chronic kidney disease, but not on the clinical variables of the disease, such as serum creatinine and glomerular filtration rate.
According to Lui et al’s (2022) narrative overview of preclinical studies and clinical trials published in Frontiers in Nephrology, acupuncture has been shown to improve symptoms and delay the progress of chronic kidney disease (CKD). The review suggests that acupuncture may be effective in reducing albuminuria, improving glomerular filtration rate, relieving symptoms, and improving the quality of life of patients with CKD.
Specifically, in diabetic patients with CKD, a prospective RCT (Wang et al, 2014; n=59) found that auricular (ear) acupuncture may have positive effects on improving the quality of life in these patients. The auricular acupressure group had significantly higher SF-36 (Short Form-36 Health Survey) scores and lower PSQI (Pittsburgh Sleep Quality Index) scores compared to the control group, indicating improvements in quality of life and sleep quality.
A preliminary small study (Yu et al, 2017; n=53) found acupuncture at points LI4, St36, and Kid3 for 12 weeks reduced creatinine levels and increased eGFR levels in patients with CKD.
Possible mechanisms of action of acupuncture in CKD include, per Lui et al, 2022, include “oxidative stress inhibition, reducing inflammatory effects, improving haemodynamics, maintaining podocyte structure, and increasing energy metabolism” [sic], leading the researchers to conclude that acupuncture could potentially present a safe, inexpensive treatment modality toward CKD, to improve patient symptoms and slow the progress of renal dysfunction.
Fatigue in End Stage Renal Disease (ESRD)
Hadadian et al (2016) found positive effects from Transcutaneous Electrical Acupoint Stimulation (TEAS) on fatigue among ESRD patients receiving haemodialysis treatment.
Shariati et al’s RCT (2012; n=48) found acupressure beneficial for end-stage renal disease patients on haemodialysis, with Ht7, Li4 and SP6 points used, significant differences in the PSQI (Pittsburgh Sleep Quality Index) and other sleep measures of duration, and daytime function were seen between the acupressure group and the control group after intervention.
Haemodialysis side effects
An RCT (Hmwe et al. 2015; n=108), examined the effects of acupressure on depression, anxiety, and general psychological distress in patients with haemodialysis, finding it could have positive effects on improving the psychological wellbeing of patients. The acupressure group had significantly lower DASS-21 (Depression, Anxiety Stress Scales) scores and GHQ-28 (General Health Questionnaire) scores compared to the control group, indicating improvements in depression, anxiety, stress, and general psychological distress.
Studies by both Sabouhi et al (2013; n=96) and Eglence et al (2013; n=118).found acupressure to reduce fatigue in haemodialysis patients.
Renal Calculi – Kidney Stones, renal colic
Acupuncture has also been used for the management of renal colic caused by urinary calculi (kidney stones), as one of the main issues involved pain management, and the mechanisms of action of acupuncture in pain are well-understood. See our page, for example on Chronic Pain.
Acupuncture at Neiguan (PC 6) and Zusanli (ST 36) points was shown in a Chinese RCT (n=240) to have a good analgesic (painkilling) effect in renal colic pain with a low incidence of adverse reactions, this was compared to two groups who each received pharmaceutical treatments.
Wu et al (2023; n=82) also found acupuncture beneficial for acute pain in patients with urinary calculi, as did Zhang et al, 2021 (n=80), in comparison with drug treatment.
A later RCT study (Tu et al, 2022, n=80) combined acupuncture with diclofenac drug treatment in the emergency department for patients with acute renal colic due to urolithiasis (stones); they concluded that acupuncture combined with diclofenac injection to be safe, providing fast, effective pain relief.
Qu et al (2022) conducted a systematic review and meta-analysis of acupuncture in renal colic caused by urinary calculi; over 15 studies they found acupuncture an effective and safe adjuvant therapy for kidney stone pain.
Later, Chen et al’s (2023) meta-analysis and trial sequence analysis examined 13 studies (n=1212) comparing conventional medicinal painkillers with acupuncture, finding acupuncture to be able to efficiently relieve renal colic with fewer adverse effects than those seen in pharmaceutical approaches. Both Que et al, and Chen et al (2022; 2023) noted some limitations in the number and quality of studies, warranting further future RCTs in this area.
Forthcoming is a study protocol for a randomized controlled trial published in Trials aims to evaluate the efficacy and safety of acupuncture as an adjunctive treatment to diclofenac for acute renal colic caused by urinary calculi (Cao et al, 2021).
During extracorporeal shock wave lithotripsy (ESWL) for kidney stones
Clinical studies by Tavakoli et al (2014); Rogenhofer et al (2004; n=90); Agah et al (2004; n=100) and Medina et al (2005; ) all found acupuncture effective on pain during ESWL.
A meta-analysis and systematic review of studies into acupuncture during ESWL (Chen et al, 2023b; n=1220), found acupuncture associated with higher pain relief and low side effect profile and supported the efficacy of acupuncture for pain relief during and after ESWL.
References:
Agah M, Falihi A. The efficacy of acupuncture in extracorporeal shock wave lithotripsy. Urol J. 2004 Summer;1(3):195-9.
Cao, Y., Tu, J.F., Shi, G.X., Wang, L.Q., Jia, L.C., Li, B., Liu, B.L., Yao, W.H., Pei, X.L., Qu, Z.C. and Liu, C.Z., 2021. Acupuncture as adjunctive therapy for acute renal colic caused by urinary calculi: study protocol for a randomized controlled trial. Trials, 22(1), pp.1-8.
Chen, H.T., Kuo, C.F., Hsu, C.C., Lai, L.C., Cheng, A.C., Sun, C.K. and Hung, K.C., 2023. Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis. Frontiers in Medicine, 9, p.1100014.
Chen, H.T., Hung, K.C., Hsu, Y.C., Kuo, J.R., Chang, Y.J., Chen, I.W. and Sun, C.K., 2023b. Efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy: a meta-analysis of randomized controlled studies. Frontiers in Medicine, 10, p.1114485.
Eglence, R., Karatas, N. and Tasci, S., 2013. The effect of acupressure on the level of fatigue in hemodialysis patients. Alternative Therapies in Health and Medicine, 19(6), p.23.
Hmwe, N.T.T., Subramanian, P., Tan, L.P. and Chong, W.K., 2015. The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: A randomized controlled trial. International journal of nursing studies, 52(2), pp.509-518.
Hadadian, F., Sohrabi, N., Farokhpayam, M., Farokhpayam, H., Towhidi, F., Fayazi, S., Soroush, A. and Abdi, A., 2016. The effects of transcutaneous electrical acupoint stimulation (TEAS) on fatigue in haemodialysis patients. Journal of Clinical and Diagnostic Research: JCDR, 10(9), p.YC01.
Ju, B.J. and Niu, L.L., 2012. Analysis of therapeutic effect of acupuncture at neiguan (PC 6) and zusanli (ST 36) on acute renal colic. Zhongguo Zhen jiu= Chinese Acupuncture & Moxibustion, 32(11), pp.975-978.
Liu, X., Wang, X., Ma, H. and Zhang, W., 2022. Mechanisms underlying acupuncture therapy in chronic kidney disease: A narrative overview of preclinical studies and clinical trials. Frontiers in Nephrology, 2, p.1006506.
Melo, G.A.A., Aguiar, L.L., Silva, R.A., Pereira, F.G.F., Silva, F.L.B.D. and Caetano, J.Á., 2020. Effects of acupuncture in patients with chronic kidney disease: a systematic review. Revista Brasileira de Enfermagem, 73, p.e20180784.
Qu, Z., Wang, T., Tu, J., Yao, W., Pei, X., Jia, L., Cao, Y. and Liu, C., 2022. Efficacy and safety of acupuncture in renal colic caused by urinary calculi in adults: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2022.
Rogenhofer S, Wimmer K, Blana A, Roessler W, Wieland WF, Filbeck T. Acupuncture for pain in extracorporeal shockwave lithotripsy. J Endourol. 2004 Sep;18(7):634-7.
Sabouhi, F., Kalani, L., Valiani, M., Mortazavi, M. and Bemanian, M., 2013. Effect of acupressure on fatigue in patients on hemodialysis. Iranian journal of nursing and midwifery research, 18(6), p.429.
Shariati, A., Jahani, S., Hooshmand, M. and Khalili, N., 2012. The effect of acupressure on sleep quality in hemodialysis patients. Complementary therapies in medicine, 20(6), pp.417-423.
Tu, J.F., Cao, Y., Wang, L.Q., Shi, G.X., Jia, L.C., Liu, B.L., Yao, W.H., Pei, X.L., Cao, Y., Li, H.W. and Yan, S.Y., 2022. Effect of adjunctive acupuncture on pain relief among emergency department patients with acute renal colic due to urolithiasis: a randomized clinical trial. JAMA Network Open, 5(8), pp.e2225735-e2225735.
Tavakoli K, Taghavi R, Barakati N, Mohammadi SH. The effect of acupuncture on pain during extracorporeal shock wave lithotripsy- a clinical trial. J Shahrekord Univ Med Sci. 2014; 16(5): 84-91.
Wang, S., Chen, Z., Fu, P., Zang, L., Wang, L., Zhai, X., Gao, F., Huang, A. and Zhang, Y., 2014. Use of auricular acupressure to improve the quality of life in diabetic patients with chronic kidney diseases: a prospective randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2014.
Wu, L.M., Liu, Q., Yin, X.H., Yang, L.P., Yuan, J., Zhang, X.Q. and Wang, Y.L., 2023. Wrist-ankle acupuncture combined with pain nursing for the treatment of urinary calculi with acute pain. World Journal of Clinical Cases, 11(18), pp.4287-4294.
Yu, J.S., Ho, C.H., Wang, H.Y., Chen, Y.H. and Hsieh, C.L., 2017. Acupuncture on renal function in patients with chronic kidney disease: a single-blinded, randomized, preliminary controlled study. The Journal of Alternative and Complementary Medicine, 23(8), pp.624-631.
Zhang, X., Liu, X., Ye, Q., Wang, X., Chen, J., Wang, Z., Zhao, P., Tao, B., Xu, G., Xu, W. and Wu, K., 2021. Acupuncture versus lornoxicam in the treatment of acute renal colic: a randomized controlled trial. Journal of Pain Research, pp.3637-3648.
Helen