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Are acupunctures, simulation of points on body with the use of needle or laser, effective for treating asthma, as compared to sham acupunctures?
Date of Publication of the systematic review: 2004
Design
Systematic review of 12 randomized controlled trials (RCTs).
Participants
350 adults or children with asthma (mean age: 39 to 43 years, age range: 5 to 73 years, male%: 46.9%). Diagnosis criteria varied between trials.
Intervention
Acupuncture was constructed at acupuncture points or other defined points (needle or laser, treatment duration >1week).
Comparator
Comparison 1: Needle acupuncture versus sham needle acupuncture;
Comparison 2: Laser acupuncture versus sham laser acupuncture;
Comparison 3: Needle acupuncture versus sham laser acupuncture.
Sham acupuncture was constructed as an active stimulation of non-acupuncture points or whether it involved non-stimulation of any points (needle or laser, no treatment duration specified).
No anti-asthma drugs used as baseline.
Comparison 2: Laser acupuncture versus sham laser acupuncture;
Comparison 3: Needle acupuncture versus sham laser acupuncture.
Sham acupuncture was constructed as an active stimulation of non-acupuncture points or whether it involved non-stimulation of any points (needle or laser, no treatment duration specified).
No anti-asthma drugs used as baseline.
Major Outcomes
Outcome 1: Morning peak expiratory flow rate (PEFR) after treatment;
Outcome 2: Forced expiratory volume in 1 second (FEV1) after treatment;
Outcome 3: Quality of life at follow-up (2 weeks after treatment).
Outcome 2: Forced expiratory volume in 1 second (FEV1) after treatment;
Outcome 3: Quality of life at follow-up (2 weeks after treatment).
Settings
The included trials were conducted in UK, Danmark, Sri Lanka, Germany, New Zealand and Israel. The reviewers did not state whether the trials were conducted in inpatient or outpatient settings.
Comparison Needle acupuncture versus sham needle acupuncture
Main Results
Compared to sham needle acupuncture, needle acupuncture did not show significant improvement on morning PEFR after treatment (standardized mean difference (SMD): 0.38, 95% CI: -0.58 to 1.34), FEV1 after treatment (pooled SMD: 0.12, 95% CI: -0.31 to 0.55) and quality of life at follow-up (mean difference (MD): -11, 95% CI: -32.11 to 10.11).
| Outcomes (units) | No. of studies (Total no. of participants) | Mean/ No. of participants | Heterogeneity test (I2) | SMD/MD (95% CI) | Overall quality of evidence* | |
| Intervention | Comparator | |||||
| 1 (L/min) | 1 (17) | 360/ 8 | 320/ 9 | Not applicable as there is only 1 study. | SMD: 0.38 (-0.58 to 1.34) | Moderate |
| 2 (L/s) | 2 (84) | 34.1/ 42 | 32.8/ 42 | 0.0% | Pooled SMD: 0.12 (-0.31 to 0.55) | Moderate |
| 3 (NA) | 1 (46) | 147/ 23 | 158/ 23 | Not applicable as there is only 1 study. | MD: -11 (-32.11 to 10.11) | Low |
Comparison Laser acupuncture versus sham laser acupuncture
Main Results
Compared to sham laser acupuncture, laser acupuncture did not show significant improvement on morning PEFR after treatment (mean difference (MD): -3.0, 95% CI: -7.19 to 1.19) and FEV1 after treatment (standardized mean difference (SMD): -0.48, 95% CI: -1.11 to 0.15).
| Outcomes (units) | No. of studies (Total no. of participants) | Mean/ No. of participants | Heterogeneity test (I2) | SMD/MD (95% CI) | Overall quality of evidence* | |
| Intervention | Comparator | |||||
| 1 (L/min) | 1 (64) | 105/ 32 | 108/ 32 | Not applicable as there is only 1 study. | MD: -3.0 (-7.19 to 1.19) | Moderate |
| 2 (L/s) | 1 (40) | 103.23/ 20 | 110.99/ 20 | Not applicable as there is only 1 study. | SMD: -0.48 (-1.11 to 0.15) | Moderate |
Comparison Needle acupuncture versus sham laser acupuncture
Main Results
Compared to sham laser acupuncture, needle acupuncture did not show significant improvement on morning PEFR after treatment (mean difference (MD): -31.78, 95%CI: -123.6 to 60.1).
| Outcomes (units) | No. of studies (Total no. of participants) | Mean/ No. of participants | Heterogeneity test (I2) | MD (95% CI) | Overall quality of evidence* | |
| Intervention | Comparator | |||||
| 1 (L/min) | 1 (24) | 357.5/ 10 | 389.3/ 14 | Not applicable as there is only 1 study. | -31.78 (-123.6 to 60.1) | Moderate |
Comparison Needle acupuncture versus sham needle acupuncture
Main Results
Compared to sham needle acupuncture, needle acupuncture did not show significant improvement on morning PEFR after treatment (standardized mean difference (SMD): 0.38, 95% CI: -0.58 to 1.34), FEV1 after treatment (pooled SMD: 0.12, 95% CI: -0.31 to 0.55) and quality of life at follow-up (mean difference (MD): -11, 95% CI: -32.11 to 10.11).
Comparison 1: Needle acupuncture versus sham needle acupuncture in patients with asthma
| Outcomes (units) | 1 (L/min) | 2 (L/s) | 3 (NA) | |
|---|---|---|---|---|
| No. of studies (Total no. of participants) | 1 (17) | 2 (84) | 1 (46) | |
| Mean/ No. of participants | Intervention | 360/ 8 | 34.1/ 42 | 147/ 23 |
| Comparator | 320/ 9 | 32.8/ 42 | 158/ 23 | |
| SMD/MD (95% CI) | SMD: 0.38 (-0.58 to 1.34) | Pooled SMD: 0.12 (-0.31 to 0.55) | MD: -11 (-32.11 to 10.11) | |
| Overall quality of evidence* | Moderate | Moderate | Low | |
Keys: SMD = standardized mean difference; MD = mean difference; CI = confidence interval.
Comparison Laser acupuncture versus sham laser acupuncture
Main Results
Compared to sham laser acupuncture, laser acupuncture did not show significant improvement on morning PEFR after treatment (mean difference (MD): -3.0, 95% CI: -7.19 to 1.19) and FEV1 after treatment (standardized mean difference (SMD): -0.48, 95% CI: -1.11 to 0.15).
Comparison 2: Laser acupuncture versus sham laser acupuncture in patients with asthma
| Outcomes (units) | 1 (L/min) | 2 (L/s) | |
|---|---|---|---|
| No. of studies (Total no. of participants) | 1 (64) | 1 (40) | |
| Mean/ No. of participants | Intervention | 105/ 32 | 103.23/ 20 |
| Comparator | 108/ 32 | 110.99/ 20 | |
| SMD/MD (95% CI) | MD: -3.0 (-7.19 to 1.19) | SMD: -0.48 (-1.11 to 0.15) | |
| Overall quality of evidence* | Moderate | Moderate | |
Keys: SMD = standardized mean difference; MD = mean difference; CI = confidence interval.
Comparison Needle acupuncture versus sham laser acupuncture
Main Results
Compared to sham laser acupuncture, needle acupuncture did not show significant improvement on morning PEFR after treatment (mean difference (MD): -31.78, 95%CI: -123.6 to 60.1).
Comparison 3: Needle acupuncture versus sham laser acupuncture in patients with asthma
| Outcomes (units) | 1 (L/min) | |
|---|---|---|
| No. of studies (Total no. of participants) | 1 (24) | |
| Mean/ No. of participants | Intervention | 357.5/ 10 |
| Comparator | 389.3/ 14 | |
| MD (95% CI) | -31.78 (-123.6 to 60.1) | |
| Overall quality of evidence* | Moderate | |
Keys: SMD = standardized mean difference; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to sham needle acupuncture, needle acupuncture has similar effect on morning PEFR after treatment and FEV1 after treatment. Compared to sham needle acupuncture, needle acupuncture has similar effect on quality of life at follow-up. For outcomes 1 and 2 in this comparison, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For outcome 3 in this comparison, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Compared to sham laser acupuncture, laser acupuncture has similar effect on morning PEFR after treatment and FEV1 after treatment. For all outcomes in this comparison, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Compared to sham laser acupuncture, needle acupuncture has similar effect on morning PEFR after treatment. The overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported by the reviewer.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/10796465The synopsis is based on the following article:
McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. Acupuncture for chronic asthma. Cochrane Database Syst Rev 2004(1):CD000008.
McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. Acupuncture for chronic asthma. Cochrane Database Syst Rev 2004(1):CD000008.
* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.
Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.
Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.
