Acupuncture for chronic asthma: Cochrane systematic review
Assessed as up to date: 2008/08/06
Acupuncture has traditionally been used to treat asthma in China and is used increasingly for this purpose internationally.Objectives
The objective of this review was to assess the effects of acupuncture for the treatment of asthma or asthma-like symptoms.Search methods
We searched the Cochrane Airways Group Specialised Register (last searched August 2008), the Cochrane Complementary Medicine Field trials register, AMED, and reference lists of articles. We also contacted trialists and researchers in the field of complementary and alternative medical research.Selection criteria
Randomised and possibly randomised trials using needle acupuncture or other forms of stimulation of acupuncture. Any form of control treatment was considered (no treatment in addition to conventional asthma treatment, sham or placebo interventions, active comparator interventions). Studies were included provided outcome was assessed at one week or more.Data collection and analysis
At least two reviewers independently assessed trial quality. A reviewer experienced in acupuncture assessed the adequacy of the active and sham acupuncture used in the studies. Study authors were contacted for missing information.Main results
Twelve studies met the inclusion criteria recruiting 350 participants. Trial reporting was poor and trial quality was deemed inadequate to generalise findings. There was variation in the type of active and sham acupuncture, the outcomes measured and time-points presented. The points used in the sham arm of some studies are used for the treatment of asthma according to traditional Chinese medicine. Two studies used individualised treatment strategies and one study used a combination strategy of formula acupuncture with the addition of individualised points. No statistically significant or clinically relevant effects were found for acupuncture compared to sham acupuncture. Data from two small studies were pooled for lung function (post-treatment FEV1): Standardised Mean Difference 0.12, 95% confidence interval -0.31 to 0.55).Authors' conclusions
There is not enough evidence to make recommendations about the value of acupuncture in asthma treatment. Further research needs to consider the complexities and different types of acupuncture.
McCarney Robert W, Brinkhaus Benno, Lasserson Toby J, Linde Klaus
Acupuncture for chronic asthma
Acupuncture is a treatment originating from traditional Chinese medicine. It consists of the stimulation of defined points on the skin (mostly by insertion of needles). The objective of this review was to assess whether there is evidence from randomised controlled trials that asthma patients benefit from acupuncture. The studies included in the review were of variable quality and had inconsistent results. Future research should concentrate on establishing whether there is a non-specific component of acupuncture which benefits recipients of treatment. There should be an assessment not merely of placebo treatment, but also of 'no treatment' as well. There is insufficient evidence to make recommendations about the value of acupuncture as a treatment for asthma based on current evidence.
Implications for practice
On the basis of this review, no recommendations could be made for the practice of acupuncture.
Implications for research
There is an urgent need for information on the different ways in which acupuncture is practiced and might be evaluated in order that appropriate trials can be designed. The methodological inconsistencies and problems encountered in all the trials reported to date indicate that more pilot data should be acquired before proceeding to any large scale randomised trials. In particular, researchers should pay attention to the nature of sham/control points selected since in a number of the studies the control points selected can be used for the treatment of asthma according to Traditional Chinese Acupuncture practice. Future trials should attempt to include a no-treatment control arm, in addition to active and sham groups.
Acupuncture should also be assessed in the context of more severe asthma, in order to be able to generalise the findings of more rigorously conducted and reported clinical research.
Attention needs to be paid to the nature or style of acupuncture used (for a introduction to acupuncture see Stux 1997; Helms 1998). The available evidence does not allow objective comparison between different acupuncture types. Therefore, it is not possible to comment on claims by proponents of any technique or style that any one is better than any other.Get full text at The Cochrane Library
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