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. The n= figure tells you how many people were participants in the study.
Resources:
British Acupuncture Council Factsheet Directory of Evidence A-Z
British Acupuncture Council Research Digest
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.
The British Acupuncture Council have produced an evidence-based factsheet on PMS and acupuncture research, including details of the research studies done, and you can also find and read the original research from this resource.
PMS is a common gynaecological condition affecting 30-40% of women, usually in the luteal phase of their menstrual cycle and causing mood and physical symptoms which can affect their daily lives at that for those days of their cycle (Pang et al, 2018).
Research and Resources on PMS and Acupuncture, overview:
A scholarly search of the available research papers on the terms “acupuncture” + “PMS” yields over 4,250 papers, and narrowing this to “RCT” OR “randomised controlled trial”, gives over 630 results; of which just under a quarter (24%) 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.
Mechanisms of Action Research
Brain scans are a good way of seeing what happens when we insert acupuncture needles, demonstrating to us which areas of the brain “light up” to certain stimuli. Functional MRI (fMRI) brain scans were used on women with PMS undergoing acupuncture at a classically indicated acupoint (SP6) in a study by Pang et al (2018; n=23). Becuase previous fMRI studies of PMS patients had shown abnormal neural activity in a specific brain area (the Default Mode Network – DMN), the researchers focussed on this area in the scan, and any effect elicited in this area (and others) from the use of electroacupuncture at SP6 point (as compared to a nearby “sham” point control). Regional Homogeneity (ReHo) is the measure used in functional MRI to examine level of activity in a brain area. This study’s brain scans showed ReHo values in the area of interest (DMN) were lowered by acupuncture at SP6. The researchers concluded therefore that the abnormal brain activity associated with PMS was being modulated by the use of electroacupuncture at SP6.
The same research team have carried out further research more recently with fMRI to further examine these effects (Pang et al, 2021; n=23), using the SP6 point and electroacupuncture again in a PMS group.
Systematic Reviews on PMS and Acupuncture
A 2018 Cochrane Systematic Review acupuncture and acupressure for PMS (Armour et al, 2018), included 5 trials (n=277), and noting the fact that the trials were small and in some cases of low quality, drew the conclusion that “limited evidence available suggests that acupuncture and acupressure may improve both physical and psychological symptoms of PMS when compared to a sham control”. They stated that more studies of a higher methodological quality were warranted going forward.
Zhang et al, 2019 (systematic review of 15 studies; N=11-3), looked at the timing of acupuncture intervention in PMS as well as the most frequently used points (Spleen 6; Liver 3 and Ren 4). They concluded positive trend in the use of acupuncture in this area, and that timing of the treatment within the menstrual cycle did not make a statistically significant difference. Their finding was tentative due to the small sizes of many of the studies as well as some of the methodology in some studies being of low quality, overall they stated that “large-scale, case-control studies with rigorous designs are required to provide more accurate evidence.”
As mentioned above, 24% of the RCT’s ever carried out into acupuncture and PMS, have been done in the years since 2017. A further systematic review seems due for this area in the light of ongoing research in the interim.
Regarding Your Individual Condition and Symptoms:
Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response. We are able to tell you what experience we have had in our decades of experience in practise, of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, and how this could relate to your own individual situation. For this, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.
Resources:
British Acupuncture Council evidence based factsheet about PMS including specific research, trials and mechanisms of action for acupuncture in this condition.
Our own page on gynaecological issues
References:
Armour, M., Ee, C.C., Hao, J., Wilson, T.M., Yao, S.S. and Smith, C.A., 2018. Acupuncture and acupressure for premenstrual syndrome. Cochrane Database of Systematic Reviews, (8).
Pang, Y., Liu, H., Duan, G., Liao, H., Liu, Y., Feng, Z., Tao, J., Zou, Z., Du, G., Wan, R. and Liu, P., 2018. Altered brain regional homogeneity following electro-acupuncture stimulation at sanyinjiao (SP6) in women with premenstrual syndrome. Frontiers in human neuroscience, 12, p.104.
Pang, Y., Liao, H., Duan, G., Feng, Z., Liu, H., Zou, Z., Tao, J., Li, J., He, H., Gao, C. and Liu, P., 2021. Regulated aberrant amygdala functional connectivity in premenstrual syndrome via electro-acupuncture stimulation at sanyinjiao acupoint（ SP6）. Gynecological Endocrinology, 37(4), pp.315-319.
Zhang, J., Cao, L., Wang, Y., Jin, Y., Xiao, X. and Zhang, Q., 2019. Acupuncture for Premenstrual Syndrome at Different Intervention Time: A Systemic Review and Meta-Analysis. Evidence-based complementary and alternative medicine, 2019.
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.
Acupuncture is safe for children when given by a trained acupuncturist, and with their parent present. If they are unable to tolerate needles, acupressure or moxibustion can be used on the relevant points.
Research and Resources on Acupuncture for Children:
A scholarly search of the available research papers on the terms “acupuncture” + “paediatric OE “pediatric” yields over 35,700 papers, and narrowing this to “RCT” to identify Randomised Controlled Trials, gives over 3,970 results; of which 40% 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.
The Research:
Research has looked at acupuncture in a number of areas including paediatric pain, nausea, and post-operative symptoms. Research and information on post-operative pain in an adult population is here.
In the hospital setting, acupuncture reduces 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, n=1773). More information on acupuncture, nausea and the research is here.
Azarfar et al’s (2017) systematic review of 7 trials showed promise in the area of nocturnal enuresis (bedwetting) in children, many of the studies used low level laser acupuncture in lieu of needling. The positive trend limited by the small number of trials available to the researchers at the time, warranting further large RCT trials of quality. Research and mechanisms of action on the urinary system are here.
Stadler et al’s systematic review concluded acupuncture may have a role in neonatal pain, (2019) although they also pointed out that the number and quality of trials available was low, meaning more research is warranted. More on the pain research in the adult population, and the research is here.
A systematic review has also found that acupuncture appears “safe and effective for the treatment of migraine in children” (Doll et al, 2019). More information on acupuncture research for headache and migraine is here
In the area of allergic rhinitis (hayfever), there is already some research evidence for adult populations with acupuncture (see our specific page), and a forthcoming systematic review will examine this in children (protocol: Li et al, 2021).
A systematic review has drawn tentatively positive conclusions in trends in the fields of autism spectrum disorder (Lee at al, 2018, 27 articles, n=1736); however it is of note the quality of the available studies examined was low and therefore further high quality trials are needed.
A systematic review protocol was put forward in 2021 for an examination of the efficacy and safety of acupuncture for the treatment of children with attention deficit hyperactivity disorder (Lin et al, 2021), so it will be of interest to see the forthcoming publication of this.
Regarding Your Individual Condition and Symptoms:
Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response. We are able to tell you what experience we have had in our decades of experience in practise, of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, and how this could relate to your own individual situation. For this, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.
References:
Azarfar, A., Ravanshad, Y., Aval, S.B., Khamnian, S. and Mehrad-Majd, H., 2017. A systematic review and a meta-analysis of using acupuncture for the treatment of nocturnal enuresis. Journal of Nephrology & Therapeutics, 7(2), pp.292-297.
Doll, E., Threlkeld, B., Graff, D., Clemons, R., Mittel, O., Sowell, M.K. and McDonald, M., 2019. Acupuncture in adult and pediatric headache: a narrative review. Neuropediatrics, 50(06), pp.346-352.
Lee, B., Lee, J., Cheon, J.H., Sung, H.K., Cho, S.H. and Chang, G.T., 2018. The efficacy and safety of acupuncture for the treatment of children with autism spectrum disorder: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2018.
Li, J., Liu, L., Jiao, L., Liao, K., Xu, L., Zhou, X. and Xiong, J., 2021. Clinical acupuncture therapy for children with allergic rhinitis: A protocol for systematic review and meta analysis. Medicine, 100(3).
Lin, Y., Jin, H., Huang, B., Zhao, N., Li, Z., Mao, J., Chen, C., Xu, J., Zhang, J. and Shuai, B., 2021. Efficacy and safety of acupuncture on childhood attention deficit hyperactivity disorder: A protocol for systematic review and meta-analysis. Medicine, 100(5).
Stadler, J., Raith, W., Mileder, L.P., Schmölzer, G.M. and Urlesberger, B., 2019. Invasive and non-invasive acupuncture techniques for pain management in neonates: A systematic review. Acupuncture in Medicine, 37(4), pp.201-210.
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.
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.
For Trigeminal Neuralgia, see our page on TMJ disorder and pain may be of assistance
Resources:
British Acupuncture Council evidence based factsheet about Neuralgia including specific research, trials and mechanisms of action for acupuncture in this condition.
Helen Page under construction
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