Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting
Evidence SummariesLevel of Evidence = B
Electroacupuncture in adjunction to antiemetic medication appears to be effective for first day vomiting after chemotherapy but comparisons with modern antiemetic drugs are lacking.
A Cochrane review 1 [withdrawn from publication] included 11 studies with a total of 1247 subjects. Overall, acupuncture-point stimulation of all methods combined reduced the incidence of acute vomiting (RR = 0.82; 95% confidence interval 0.69 to 0.99), but not acute or delayed nausea severity compared to control. Stimulation with needles (manual acupuncture and electroacupuncture trials combined) reduced proportion of acute vomiting (RR = 0.74; 95% CI 0.58 to 0.94), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% CI 0.60 to 0.97), but manual acupuncture did not. Acupressure reduced mean acute nausea severity (SMD = –0.19; 95% CI –0.37 to –0.01) but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics.
Comment: The quality of evidence is downgraded by indirectness (differences in studied interventions; modern antiemetics not studied).
1. Ezzo J, Richardson MA, Vickers A et al. WITHDRAWN: Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev 2014;(11):CD002285. [PMID:25412832]
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