Table 2. Summary of the included studies.
| Sample | Treatment intervention | Control intervention | Add-on strategya | Results | Side-effects | |
|---|---|---|---|---|---|---|
| Alcohol-dependence | ||||||
| Rampes et al. 1997 UK[21] | 59 randomized and 27, 26 completed at Wks 8, 24. | 1. Specific auricular electroacupuncture group Acupoints: Lung, Shenmen, Sympathetic; 2. Nonspecific auricular electroacupuncture group Acupoints: Elbow, Internal secretion; Manipulation: 100Hz frequency, 30 min/session, Weekly, 24 Wks | Individual alcohol counsellor/group therapy, 6 Wks | Conventional treatment | Alcohol craving: Significant within-group effect—TG1 & TG2 (8Wk) | Drowsiness; transient bleeding on needle removal; pain |
| TG1: n = 23, 4 F, age 38y; TG2: n = 20, 3 F, age 40y; CG: n = 16, 6 F, age 42y; | ||||||
| Inclusion: alcohol withdrawal (DSM-III-R); 18–65 years; no previous acupuncture use | ||||||
| Sapir-Weise et al. 1999 Sweden[20] | 72 randomized and 72, 59, 51 completed at Wk 10, Mos 3, 6. | Auricular acupuncture group Acupoints: Lung, Shenmen, Sympathetic; Manipulation: nurses administered. 45 mins/session, Weekly (2-Wk), 3 times/Wk (4-Wk), twice/Wk (4-Wk) | Non-specific acupuncture group Acupoints: 3-5mm from the real acupoints; Same manipulation | Conventional treatment | Drinking days/alcohol craving: NS | N/A |
| TG: n = 36, 11 F, age 47y; CG: n = 36, 10 F, age 45y; | ||||||
| Inclusion: alcohol withdrawal (DSM-III-R); no previous drug use | ||||||
| Bullock et al. 2002 USA[22] | 503 randomized and 356, 289, 247, 220 completed at Wk 3, Mos 3, 6, 12. | 1. Specific auricular acupuncture group Acupoints: Liver, Lung, Shenmen, Sympathetic; 2. Nonspecific auricular acupuncture group Acupoints: 5mm from the specific acupoints; 3. Symptom-based auricular acupuncture group Acupoints changed daily; Manipulation: acupuncturists administered. No manipulation. 40 mins/session, Weekly, 3 Wks | Conventional treatment group Detoxification, inpatient treatment, etc., 3 Wks | Conventional treatment | Alcohol withdrawal symptoms: Significant between-group effect—TG3>TG1 (12-Mo F/U) | N/A |
| TG1: n = 132, 65 F, age 39y; TG2: n = 133, 66 F, age 38y; TG3: n = 104, 52 F, age 38y; CG: n = 134, 67 F, age 38 y; | ||||||
| Inclusion: alcohol≥3 days/Wk; 18–66 years; on-site≥14 days; blood platelet>22,000; no medications for alcohol abuse | ||||||
| Karst et al. 2002 Germany[19] | 34 completed. | Auricular-body acupuncture group Auricular acupoints: Kidney, Liver, Lung, Shenmen, Sympathetic; Body acupoints: DU20, Extra1, LI4; Manipulation: 30 mins/session, daily, 10 sessions | Sham group Same acupoints/manipulation; Needles without tips | Carbamazepine | Alcohol withdrawal symptoms: Significant within-group effect—TG | N/A |
| TG: n = 17, 2 F, age 46y; CG: n = 17, 2 F, age 41y; | ||||||
| Inclusion: alcohol withdrawal (ICD-10); >18 years; no previous acupuncture use; no addiction to drugs | ||||||
| Trumpler et al. 2003 Switzerland[18] | 48 randomized and completed. | 1. Laser auricular acupuncture group 2. Needle auricular acupuncture group Acupoints: prescribed individually; Manipulation: acupuncturists administered, daily, 6 days. 830nm infrared laser stimulation, 1 min per acupoint; no manipulation of the needle acupuncture, <40 mins/session | Sham laser group Same acupoints; No activated laser beam | Clomethiazole; benzodiazepines if necessary; maintain other drugs before study | Alcohol withdrawal symptoms: NS | Convulsion (TG) |
| TG1: n = 17, 7 F, age 43y; TG2: n = 15, 5 F, age 45y; CG: n = 16, 8 F, age 49y; | ||||||
| Inclusion: alcohol withdrawal (DSM-IV); 18–65 years; no addiction to other drugs | ||||||
| Kunz et al. 2007 Germany[17] | 109 randomized and 74 completed. | Auricular acupuncture group Acupoints: Kidney, Liver, Lung, Shenmen, Sympathetic; Manipulation: psychiatrists/nurses administered. Needle stimulation, 45 mins/session, daily at 12:15PM, 5 days | Aromatherapy group 45 mins/session, daily at 12:15PM, 5 days | Carbamazepine or oxcarbazepine; benzodiazepines | Alcohol withdrawal symptoms/alcohol craving: NS | Pain, mild bleeding (TG); agitation, sneezing, sore throat (CG) |
| TG: n = 55, 10 F, age 48y; CG: n = 54, 10 F, age 44y; | ||||||
| Inclusion: alcohol withdrawal (ICD-10); alcohol≥10 days; 18–65 years; no addiction to other drugs | ||||||
| Lee et al. 2015 Korea[16] | 20 randomized and completed. | Body acupuncture group Acupoint: KI9; Manipulation: oriental medical doctors administered. 15 mins/session, twice/Wk, 4 Wks | Sham group Same acupoints/manipulation; Needles without tips | N/A | Alcohol craving: NS | N/A |
| TG: n = 10, age 43y; CG: n = 10, age 45y; | ||||||
| Inclusion: alcohol withdrawal (DSM-IV); male; no addiction to other drugs | ||||||
| Smoking-dependence | ||||||
| He et al. 1997 Norway[23,24] | 46 randomized (age 39y) and 44, 38, 33 completed at Wk 3, Mo 8, Year 5. | ① Body electroacupuncture, ② auricular acupuncture, ③ auricular acupressure group Acupoints: ① LU6, LU7; ② Lung, Mouth, Shenmen; ③ Endocrine, Hunger, Lung, Mouth, Shenmen, Trachea; Manipulation: acupuncturists administered, 3 Wks. ① 3Hz frequency, 20 mins, twice/Wk; ② needle stimulation, 20 mins, twice/Wk; ③ Vaccariae seeds acupressure 100 repeats/time, 4 times/day | Non-specific acupuncture group Acupoints: ① LI10, SJ8; ② Knees, Lumbar vertebra, Neck; ③ Buttock, Knees, Lumbar vertebra, Neck, Shoulder, Shoulder joint; Same manipulation | N/A | Daily cigarette consumption, desire to smoke: Significant within-group effect—TG (8-Mo/5-year F/U), CG (8-Mo F/U); Significant between-group effect—TG>CG (8-Mo F/U); | N/A |
| TG: n = 26, 18 F, age 38y; CG: n = 20, 10 F, age 40y; | Cotinine concentrations: Significant within-group effect—TG; | |||||
| Inclusion: smoking≥5 years and 10–30 cigarettes/day last year; heathy; no co-intervention for smoking | Smoking cessation rate: Significant between-group effect—TG>CG | |||||
| Waite & Clough 1998 UK[25] | 79 randomized and 78 completed at Wk 2, Mos 2, 4, 6. | Auricular electroacupuncture plus acupressure group Acupoints: Lung; Manipulation: general practitioners administered, 2 Wks. 4Hz frequency, 20 mins/session; Chinese cow herb seed acupressure when feeling craving | Sham group Same acupoints/manipulation; Superficially placed needles | N/A | Smoking cessation rate: Significant between-group effect—TG>CG (6-Mo F/U) | Soreness, itch, pain of ears (TG); soreness, itch of ears (TG & CG) |
| TG: n = 40, 18 F, age 24-67y; CG: n = 38, 16 F, age 23-69y; | ||||||
| Inclusion: ≥10 cigarettes/day; >18 years; no previous acupuncture use | ||||||
| White et al. 1998 UK[26] | 76 randomized and 52 completed at Wk 2, Mo 9. | Auricular electroacupuncture group Acupoints: Lung; Manipulation: acupuncturists administered. 100Hz frequency increase to above the threshold of sensation, 20 mins/session, 2 Wks | Sham group Superficially placed needles on location not acupoints | N/A | Smoking cessation rate: NS | N/A |
| TG: n = 38, 21 F, age 41y; CG: n = 38, 18 F, age 43y; | ||||||
| Inclusion: ≥15 cigarettes/day; >21 years; no previous acupuncture use | ||||||
| Georgiou et al. 1998 UK[27] | 265 randomized and 216, 175, 63 completed at Wk 1, Mos 1, 3 (age 43y). | Auricular electroacupuncture group Acupoints: SJ17, SJ18; Manipulation: maximum 1-hour stimulation either 10Hz continuous frequency or 7-14Hz modulated frequency, 1 Wk | Non-specific acupuncture group Acupoints: SI15; Manipulation: stimulation machines disconnected from the electrodes | N/A | Smoking cessation rate/withdrawal symptoms/craving: NS | N/A |
| TG: n = 108; CG: n = 108; | ||||||
| Inclusion: >10 cigarettes/day last year; >18 years; no co-intervention for smoking | ||||||
| Cai et al. 2000 Singapore[29] | 330 randomized and 268 (68 F), 208 completed at 6-session, Mo 3. | Laser auricular acupuncture group Acupoints: Lung, Mouth, Shenmen, Sympathetic; Manipulation: 6328A wavelength, 1mm diameter, 4 mins/session, 6 sessions | Sham group Same acupoints/manipulation; No laser ray | N/A | Daily cigarette consumption/Smoking cessation rate: NS | Headache, giddy, nausea, vomiting (TG: 20; CG: 21) |
| TG: n = 128; CG: n = 140; | ||||||
| Inclusion: smoking≥3 Mos and ≥5 cigarettes/day; 12–18 years | ||||||
| Bier et al. 2002 USA[31] | 141 randomized (71 F, age 46y) and 108, 48 completed at Mos 1, 18. | 1. Auricular-body acupuncture plus education group 2. Auricular-body acupuncture group Auricular acupoints: Kidney, Liver, Lung, Shenmen, Sympathetic; Body acupoints: LI4; Manipulation: acupuncturists administered. No needle stimulation. 30 mins/session, 4 Wks;Educational program: behavioral training, social support, relapse prevention techniques, 5 Wks | Sham acupuncture plus education group Acupoints: 5mm from the real acupoints; Same manipulation/education | N/A | Daily cigarette consumption, Smoking cessation rate: Significant between-group effect—TG1>CG>TG2 (after treatment) | Minor bleeding on needle removal (both TGs) |
| TG1: n = 45; TG2: n = 38; CG: n = 58; | ||||||
| Inclusion: quitting smoking without success≥1; >18 years; no addiction to other drugs | ||||||
| White et al. 2007 UK[28] | 24 randomized and 19, 7 completed at Wks 1, 6. | Auricular acupressure group 1 Acupoints: Lung, Shenmen; Auricular acupressure group 2 Acupoints: Lung; Manipulation: researchers administered. Beads pressed when feeling craving, 6 Wks | No intervention group | NRT, group behavioral therapy | Withdrawal symptom: NS | N/A |
| TG1: n = 6, 2 F, age 51y; TG2: n = 6, 5 F, age 40y; CG: n = 7, 7 F, age 44y; | ||||||
| Inclusion: ≥10 cigarettes/day; >18 years; no co-intervention for smoking | ||||||
| Wu et al. 2007 Taiwan[33] | 118 randomized and completed at Wk 8, Mo 6. | Auricular acupuncture group Acupoints: Lung, Mouth, Shenmen, Sympathetic; Manipulation: acupuncturists administered. 8 Wks | Non-specific acupuncture group Acupoints: Elbow, Eye, Knee, Shoulder; Same manipulation | N/A | Withdrawal symptom: Significant within-group effect—TG (after treatment); | Tenderness sensation (n = 50), dizziness (n = 4), minor bleeding (n = 2), nausea sensation (n = 2) |
| TG: n = 59, 11 F, age 54y; CG: n = 59, 7 F, age 53y; | Daily cigarette consumption: Significant within-group effect—TG & CG (after treatment) | |||||
| Inclusion: smoking>1 year and ≥10 cigarettes/day; ≥18 years; no addiction to other drugs | ||||||
| Yeh et al. 2009 Taiwan[34] | 79 randomized and 59 completed. | Auricular electroacupuncture plus acupressure group Acupoints: Endocrine, Lung, Mouth, Shenmen, Stomach, Tim mee; Manipulation: <60Hz frequency, 20 mins/session, Weekly; Vaccariae seeds acupressure 1 min/time, 3–5 times/day; 6 Wks | Sham group 5mm from the real acupoints; Same manipulation | N/A | Daily cigarette consumption: Significant within-group effect—TG & CG | N/A |
| TG: n = 30, age 28y; CG: n = 29, age 27y; | ||||||
| Inclusion: smoking>1y and >1 cigarette/day; serum cotinine concentration >100ng/ml; no co-intervention for smoking | ||||||
| Chae et al. 2010 Korea[35] | 29 completed. | Body acupuncture group Acupoint: HT7; Manipulation: needle stimulation 30 seconds and withdrawn 20 minutes, 2 days | Non-specific acupuncture group Acupoint: LI10; Manipulation: blunted needle via a device, 2 days | N/A | Withdrawal symptoms: Significant between-group effect—TG>CG | None |
| TG: n = 15; CG: n = 14; | ||||||
| Inclusion: >10 cigarettes/day; >18 years; male; no co-intervention for smoking; no addiction to other drugs | ||||||
| Wing et al. 2010 Hong Kong[36] | 70 randomized and 51 completed at Wk 3, Mo 3. | Auricular acupressure group Auricular acupoints: Brain, Lung, Mouth, Shenmen; Manipulation: beads pressed when feeling craving, ≥3 times/day, 3 Wks | Non-specific acupuncture group Acupoints: non-specific non-meridian points; Same manipulation | N/A | Daily cigarette consumption: Significant within-group effect—TG (after treatment, 3-Mo F/U), CG (after treatment) | Skin allergy (n = 3) |
| TG: n = 38, 12 F, age 47y; CG: n = 32, 9 F, age 46y; | ||||||
| Inclusion: daily cigarette smoking; ≥18 years; no co-intervention for smoking | ||||||
| Lambert et al. 2011 Singapore[30] | 58 randomized and 55 completed. | 10mA body TEAS group Acupoints: LI4, PC6, PC8, TE5; Manipulation: 1 sessions on Day 1, 3 sessions on Day 2 while abstaining from smoking, 26 hours | 1. i5mA TEAS group (intermittent: 3min on and 7min off) 2. Sham TEAS group (no electrical stimulation) Same acupoints/manipulation | N/A | Desire to smoke: Significant between-group effect—TG>both CGs if FTND≥5 | Coughing, giddiness, finger/hand numbness (TG: 9; CG2: 3); runny nose (CG1: 3) |
| TG: n = 21, 6 female, age 25y; CG1: n = 20, 7 female, age 24y; CG2: n = 17, 2 female, age 26y; | ||||||
| Inclusion: smoking>1-year and ≥15 cigarettes/day; FTND score≥4; no NRT within 3-Mo | ||||||
| Fritz et al. 2013 USA[32] | 125 randomized and 105 completed. | Auricular TEAS group Acupoints: Lung, Nicotine, Palate, Shenmen, Zero; Manipulation: acupuncturists administered. 80Hz frequency, 20 mins/session, Weekly, 5 Wks | Sham group Same acupoints/manipulation; No electrical stimulation | 1-hour ‘stop-smoking’ class | Daily cigarette consumption, withdrawal symptoms: NS | 15 reported (no detail) |
| TG: n = 64, 16 F, age 56y; CG: n = 61, 14 F, age 55y; | ||||||
| Inclusion: ≥10 cigarettes/day; PHQ-9<20; urine cotinine≥200mg/ml; >19 years; no co-intervention for smoking | ||||||
| Zhang et al. 2013 Australia[37] | 43 randomized and 19, 12 completed at Wk 8, Mo 3. | Specific auricular acupressure group Acupoints: Hunger, Liver, Lung, Mouth, Shenmen; Manipulation: acupuncturists administered. Beads pressed ≥3 times/day when feeling craving, 8 Wks | Nonspecific acupressure group Acupoints: Clavicle, Helix 2, Occiput, Shoulder, Tooth; Same manipulation | N/A | Daily cigarette consumption, withdrawal symptoms, Smoking cessation rate: NS | Discomfort on ears (TG: 1; CG: 4); Headache, dizziness (CG: 1) |
| TG: n = 20; 12 F, age 50y; CG: n = 23; 13 F, age 50y; | ||||||
| Inclusion: smoking>1-year and >10 cigarettes/day; >18 years; no co-intervention for smoking; no auricular acupuncture last year | ||||||
| Baccetti et al. 2015 Italy[38] | 477 randomized and 472, 447, 445 at Wk 5, Mo 6, Year 1. | 1. Body acupuncture, auricular acupressure plus psychological support group 2. Body acupuncture, auricular acupressure group Acupoints: Pharmacopuncture: 1% lidocaine solution injected into LI20, auricular Zero; Plum-blossom needle: C7 to T5, 0.5, 1.5 and 3Cun from the vertebral spinous processes; Auricular acupressure: Shenmen; Manipulation: medical doctors administered, 5 Wks. Plum-blossom needle 3 times/session. Vaccaria seeds acupressure≥8 times/day when feeling craving, 30 min/session. Group 1 started after the 3rd psychological meeting, group 2 started immediately; Psychological support group: 1.5 hours/time, 9 times/5 Wks | Sham body acupuncture, auricular acupressure plus psychological support group Acupoints: Pharmacopuncture: 0.2cc lidocaine solution pricked below LI20 and Zero; Plum-blossom needle: C7 to T5, 2, 4 and 6 Cun from the vertebral spinous processes; Auricular acupressure: 0.5 cm from Shenmen; Manipulation: needles without tips for plum-blossom treatment | N/A | Smoking cessation rate: NS | Minor bleeding |
| TG1: n = 159, 102 F, age 51y; TG2: n = 162, 103 F, age 50y; CG: n = 156, 100 F, age 48y; | ||||||
| Inclusion: smoking ≥1-year and ≥10 cigarettes/day; >18 years; Italian speaker; no co-intervention for smoking | ||||||
| Hypertension | ||||||
| Macklin et al. 2006 USA[39] | 192 randomized and 188 completed at Wk 10, Mo 12. | 1. Individualized auricular-body acupuncture group Acupoints: prescribed individually; 2. Standardized auricular-body acupuncture at preselected points group Body acupoints: GB20, LI11, LR3, SP6, ST36; Auricular acupoints: Heart, Jiangyagou; Manipulation: acupuncturists administered. Neutral needle stimulation, 30 mins/session, Twice/Wk, 10 Wks | Sham group Body acupoints: 5 which are not acupoints; Auricular acupoints: Darwin’s tubercle, Ear lobe; Manipulation: no manipulation, 10 Wks | No antihypertensive medications | SBP, DBP: NS | Hypertensive urgencies (TG2: 2); congestive heart failure (CG: 1) |
| TG1: n = 64, 30 F, age 57y; TG2: n = 64, 35 F, age 56y; CG: n = 64, 35 F, age 53y; | ||||||
| Inclusion: stable BP: 140/90-179/109mmHg after 8–31 days suspension of antihypertensive medications; ≥18 years; no acupuncture within 6-Mo | ||||||
| Flachskampf et al. 2007 Germany[48] | 160 randomized and 140, 140, 135, 133 completed at Day 3, Wk 6, Mos 3, 6. | Body acupuncture group Acupoints: prescribed individually; Manipulation: acupuncturists administered. 20 mins/session, 22 sessions/6 Wks | Non-specific acupuncture group Acupoints: GB31, GB32, GB34, SI7, etc.; Same manipulation | Maintain antihypertensive medication before study | SBP, DBP: Significant within-group effect—TG (after treatment); Significant between-group effect—TG>CG (after treatment, 3-day F/U) | Pain, atrial fibrillation (TG); pain (CG) |
| TG: n = 72, 33 F, age 59y; CG: n = 68, 40 F, age 58y; | ||||||
| Inclusion: stable BP: 140/90-220/115mmHg; 45–75 years | ||||||
| Yin et al. 2007 Korea[44] | 41 randomized and 30 completed. | Body acupuncture plus exercise group Acupoints: (1) BL25, LI11, ST36 for tonification of the large intestine meridian; (2) BL13, LU9, SP3 for the lung meridian; (3) KI2, KI7, RN4 for the kidney meridian; (4) DU14, GB20, LI1 for the bladder meridian; Manipulation: physicians administered. Needle stimulation until Deqi. 17 sessions, 8 Wks; Exercise: breathing exercise 10 mins/day, walking 30 mins/day, 8 Wks | Sham acupuncture plus exercise group Same acupoints; Manipulation: until Deqi, withdrawn immediately | Maintain antihypertensive medication before study | SBP, DBP: Significant within-group effect—TG; Significant between-group effect—TG>CG (4th-8th Wk) | Bleeding on needle removal (TG: 8) |
| TG: n = 15, 11 F; CG: n = 15, 10 F; | ||||||
| Inclusion: SBP: 120-179mmHg or DBP: 80-99mmHg; SBP: 140-179mmHg or DBP: 90-99mmHg with antihypertensive medications | ||||||
| Zhang et al. 2008 USA[41] | 47 randomized and 45 completed (14 F, age 25y). | Laser body acupuncture group Acupoints: LI4, LI11; Manipulation: 40 infrared laser, 10kHz frequency, 8 mins/session, twice/Wk, 12 sessions | Sham group Same acupoints/manipulation; No activated laser beam | N/A | SBP, DBP: Significant within-group effect—TG | N/A |
| TG: n = 23; CG: n = 22; | ||||||
| Inclusion: SBP: 125-160mmHg and/or DBP: 81-110mmHg; no previous laser therapy use | ||||||
| Zhang et al. 2009 USA[42] | 27 randomized and completed (age 25y). | Body electroacupuncture group Acupoints: LI4, LI11; Manipulation: 100Hz frequency, 15 mins/acupoint/session, Twice/Wk, 5 Wks | Sham group Same acupoints/manipulation; No electric stimulation | Maintain diet, exercise, antihypertensive medications | SBP: Significant within-group effect—TG | N/A |
| TG: n = 13; 5 F; CG: n = 14; 5 F; | ||||||
| Inclusion: SBP: 120-165mmHg; DBP: 80-110mmHg; no co-intervention for hypertension | ||||||
| Kim et al. 2012 Korea[40] | 33 randomized and 28 completed. | Body acupuncture group Acupoints: PC6, ST36; Manipulation: Korean medicine practitioners administered. Needle stimulation until Deqi. 20 mins/session, twice/Wk, 8 Wks | Sham group Acupoints: 1cm from PC6, ST36; Manipulation: no manipulation | No antihypertensive medications during the treatment | Nighttime DBP: Significant within-group effect—TG; Significant between-group effect—TG>CG | Slight injection-site pain, small bleeding (TG) |
| TG: n = 12; CG: n = 16; | ||||||
| Inclusion: SBP: 140-159mmHg or DBP: 90-99mmHg; 18–70 years; no previous antihypertensive medication use | ||||||
| Chen et al. 2013 China[46] | 32 randomized and 30 completed (16 F, age 57y). | Body acupuncture group Acupoints: DU20, DU23, EX-HN1, LI4, LI11, LR3, PC6, SP6, ST9, ST36; Manipulation: acupuncturists administered. Needle stimulation until Deqi. 30 mins/session, 5 days | No intervention group | Maintain antihypertensive medications before study | SBP, DBP: NS | N/A |
| TG: n = 15; CG: n = 15; | ||||||
| Inclusion: SBP≥140mmHg and DBP≥90mmHg without medication; 30–75 years; no acupuncture last year | ||||||
| Sriloy et al. 2015 India[49] | 46 randomized and 38 completed. | Auricular-body acupuncture group Body acupoints: DU20, HT7, LR3, ST36; Auricular acupoint: Shenmen; Manipulation: naturopaths administered. Needle stimulation until Deqi. 20 mins/session | Slow breathing group | N/A | DBP: Significant within-group effect—TG; | N/A |
| TG: n = 19, 4 F, age 48y; CG: n = 19, 6 F, age 50y; | SBP: Significant within-group effect—CG | |||||
| Inclusion: diagnosed hypertension≥3 years; 35–60 years; no previous acupuncture use | ||||||
| Li et al. 2015 USA[43] | 65 randomized and 64, 20 completed at Wk 8, Mo 3. | Body electroacupuncture group Acupoints: PC5, PC6, ST36, ST37; Manipulation: 2-5Hz frequency, 30 mins/session, Weekly, 8 Wks | Non-specific acupuncture group Acupoints: LI6, LI7, GB37, GB39; Same manipulation | N/A | SBP: Significant between-group effect—TG>CG (after treatment, 1-Mo F/U); | None |
| TG: n = 33, 17 F, age 58y; CG: n = 32, 18 F, age 54y; | DBP: NS | |||||
| Inclusion: SBP/DBP≥140-180/90–99mmHg; no antihypertensive medications within 3-day before enrolment | ||||||
| Liu et al. 2015 Korea[45] | 30 randomized and 26 completed at Wks 8, 12. | Body acupuncture group Acupoints: LI11, LR3, PC6, SP4, ST36; Manipulation: needle stimulation until Deqi. 20 mins/session, twice/Wk, 8 Wks | No intervention group | N/A | SBP: Significant within-group effect—TG (after treatment, 4Wk F/U); | None |
| TG: n = 15, 12 F, age 49y; CG: n = 15, 11 F, age 53y; | DBP: Significant within-group effect—TG (after treatment); | |||||
| Inclusion: SBP: 120–159 mmHg or DBP: 80–99 mmHg; 20–65 years; no co-intervention for hypertension; no acupuncture within 6-Mo | SBP, DBP: Significant between-group effect—TG> CG (after treatment, 4Wk F/U) | |||||
| Lin et al. 2016 Taiwan[50] | 80 randomized and completed. | Body acupressure group Acupoints: LR3; Manipulation: press 5 seconds and release 1 second, 30 times | Sham group Acupoints: 1inch from LR3; Same manipulation | N/A | SBP, DBP: Significant within-group effect—TG; Significant between-group effect—TG>CG (immediately, 15-/30-min after acupressure) | N/A |
| TG: n = 40, 20 F, age 59y; CG: n = 40, 20 F, age 63y; | ||||||
| Inclusion: SBP: 150-180mmHg; 40–75 years; no antihypertensive medication within 2h before enrolment | ||||||
| Zhan et al. 2016 China[47] | 174 patients randomized and completed. | 1. Laser body acupuncture plus musical group 2. Laser body acupuncture group Acupoints: LI11, LR3 for liver fire hyperactivity syndrome; KI3, SP6 for yin-deficiency and yang-hyperactivity syndrome; ST36, ST40 for excessive phlegm-dampness syndrome; KI3, RN4 for yin-yang deficiency syndrome; Manipulation: 30 mins/session, daily; 30 days. Group 1: listening to music while laser stimulation (650nm wavelength, 0.5cm diameter). Group 2: needle stimulation until Deqi | Starch tablets 25 mg/tablet, 1 tablet/time, 3 times/day before meal, 30 days | N/A | SBP, DBP: Significant within-group effect—TG1 & TG2; Significant between-group effect—TG1>CG; TG2>CG | N/A |
| TG1: n = 58, 33 F, age 50y; TG2: n = 58, 31 F, age 50y; CG: n = 58, 34 F, age 50y; | ||||||
| Inclusion: SBP: 140-159mmHg and/or DBP: 90-99mmHg; 25–69 years; BMI: 18–30 kg/m2; no previous antihypertensive drugs (or stopped ≥2 Wks) | ||||||
| Obesity | ||||||
| Richards & Marley 1998 Australia[51] | 60 randomized and 50 completed. | Auricular acupuncture group Acupoints: Shenmen, Stomach; Manipulation: acuSlim device. 15–20 mins/session, twice/daily, 4 Wks | Sham group Acupoints: thumb (no acupoints); Same manipulation | Maintain diet | Weight loss ≥2kg, suppression of appetite: Significant between-group effect—TG>CG | N/A |
| TG: n = 28, age 44y; CG: n = 32, age 43y; | ||||||
| Inclusion: BW<120kg; >18 years; stable BW≥3 Mos; no co-intervention for obesity | ||||||
| Mazzoni et al. 1999 Italy[52] | 40 randomized and 22 completed. | Auricular-body acupuncture moxibustion group Acupoints: Sessions 1–3, Moxibustion: BL14, BL15, BL20; body acupoints: DU20, HT9, RN14, RN17, SP1; auricular acupoints: Hunger, Stomach; Sessions 4–8, body acupoints: BL10, BL60, LR13, RN12, RN15, SP7, ST36; auricular acupoints: Hunger, Stomach; Sessions 9–12, body acupoints: DU20, RN14, SJ10, ST40, ST44; auricular acupoints: Shenmen; Manipulation: acupuncturist administered. Weekly, 12 Wks | Sham group Body acupoints: 3mm from the real acupoints; Manipulation: superficial insertion (3-5mm), 12 Wks | No medications for obesity; restricted saturated fats and snacks; daily abdominal self-massage 30–45 minutes | BMI, suppression of appetite: NS | N/A |
| TG: n = 20, 16 F, age 37y; CG: n = 20, 17 F, age 40y; | ||||||
| Inclusion: BMI>30kg/m2; 18–60 years; no other disorders or treatments determining weigh gain | ||||||
| Wei & Liu 2004 China[53] | 195 randomized and completed (187 F, age 36y). | Auricular-body acupuncture group Body acupuncture: Acupoints: LI4, LI11, ST36, ST37, ST44 for excess-heat in stomach and intestines syndrome (syndrome 1); RN6, RN12, SP6, SP9, ST36, ST40 for damp retention due to spleen deficiency syndrome (syndrome 2); BL23, KI6, RN4, SJ6 for kidney qi insufficiency syndrome (syndrome 3); BL18, GB43, LR3, LR8 for liver qi stagnation syndrome (syndrome 4); Auricular acupuncture: Acupoints: Endocrine, Hunger, Lung, Shenmen (syndrome 1); Endocrine, Lung, Spleen, Stomach (syndrome 2); Endocrine, Kidney, Lung, Triple energizers (syndrome 3); Endocrine, Liver, Shenmen (syndrome 4); Manipulation: 30 mins/session, every two-day, 12 sessions | 1. Body acupuncture group Same with the body acupuncture treatment; 2. Auricular acupuncture group Same with the auricular acupuncture treatment; Same manipulation | N/A | Weight loss≥3kg: Significant between-group effect—TG>CG1; TG>CG2 | N/A |
| TG: n = 76; CG1: n = 64; CG2: n = 55; | ||||||
| Inclusion: BMI>25kg/m2 (F)/26kg/m2 (M); no co-intervention for obesity | ||||||
| Hsu et al. 2005 Taiwan[54] | 72 randomized and 63 completed. | Body electroacupuncture group Acupoints: KI14, RN6, RN9, SP6, ST26, ST28, ST40; Manipulation: 42Hz frequency to maximal tolerable intensity. Needle stimulation until Deqi. 40 mins/session, twice/Wk, 6 Wks | 1. Sit-up exercises group 10 times/day, 6 Wks 2. No intervention group | Maintain diet | BW, BMI, WC: Significant between-group effect—TG>CG1; TG>CG2 | Mild ecchymosis (n = 3); abdominal discomfort (n = 1) |
| TG: n = 22, age 40y; CG1: n = 20, age 41y; CG2: n = 21, age 41y; | ||||||
| Inclusion: WC>90cm; female; BMI>30kg/m2; 16–65 years; no co-intervention for obesity within 3-Mo and the study | ||||||
| Elder et al. 2007 USA[55] | 92 randomized and 73 completed. | 1. Qigong group Shaking (5 minutes), Movements (18 minutes), harvest the energy method (5 minutes), 24 Wks; 2. Body Tapas acupressure technique group Acupoints: BL1, EX-HN3, GB21; Manipulation: acupuncturists administered. 1 min/session, daily, 24 Wks | Self-directed support Written materials and maintenance support groups, 24 Wks | N/A | Weight loss of 2.8kg: Significant between-group effect—TG2>TG1 | None |
| TG1: n = 31, 26 F, age 48y; TG2: n = 30, 27 F, age 48y; CG: n = 31, 26 F, age 46y; | ||||||
| Inclusion: BMI: 25–35 kg/m2 (F)/25–40 kg/m2 (M); weight change<10 pounds within 6-Mo; 18–80 years; no co-intervention for obesity within 6-Mo; no previous complementary medicine use; no other disorders determining weigh gain; alcohol<21 drinks/Wk | ||||||
| Hsieh 2007 Taiwan[56] | 70 randomized and 55 completed. | Auricular acupressure group Acupoints: Endocrine, Mouth, Shenmen, Small intestine, Stomach; Manipulation: Japanese magnetic pearl acupressure. 10 mins/session, Weekly, 8 Wks | Sham group Same acupoints; Acupressure tape only | Education on low-calorie diet; maintain physical activity | BMI: Significant within-group effect—TG | N/A |
| TG: n = 27, 24 F; CG: n = 28, 26 F; | ||||||
| Inclusion: BMI≥23kg/m2; 18–20 years; Asian ethics | ||||||
| Yeh & Yeh 2008 Taiwan[57] | 38 randomized and completed. | Auricular acupressure group Acupoints: Endocrine, Mouth, Shenmen, Small intestine, Stomach; Manipulation: beads acupressure before meals, 15 mins/session, Weekly, 9 Wks | No intervention group | Maintain diet, physical activity | WC, HC: Normal weigh participants Significant within-group effect—TG & CG; Obese participants: NS | None |
| TG: n = 19, 16 F, age 33y; CG: n = 19, 16 F, age 33y; | ||||||
| Inclusion: BMI≥27 kg/m2 (obese)/<27 kg/m2 (normal weight); 22–50 years; no acupuncture for obesity within 1-Mo | ||||||
| Nourshahi et al. 2009 Iran[58] | 27 randomized and completed. | 1. Exercise plus low-calorie diet group 3 sessions/Wk, 8 Wks; 2. Auricular-body acupuncture, exercise plus low-calorie diet group Auricular acupoints: Hunger, Shenmen; Body acupoint: ST40; Manipulation: acupuncturists administered. 8 Wks. Body acupuncture 20 mins/session; Lentil seeds auricular acupressure 10 times/30 mins before meals and whenever feeling hungry | No intervention group | N/A | BMI, fat mass: Significant between-group effect—TG1>CG; TG2>CG | N/A |
| TG1: age 42y; TG2: age 40y; CG: age 37y; | ||||||
| Inclusion: fat mass>30%; female | ||||||
| Hsu et al. 2009 Taiwan[59] | 60 randomized and 45 completed. | Auricular acupuncture group Acupoints: Endocrine, Hunger, Shenmen, Stomach; Manipulation: acupuncturists administered. Twice/Wks, 6 Wks | Sham group Same acupoints/manipulation; Needles without tips | Maintain diet | BW, BMI, WC: NS | Minor inflammation (TG: 1); tenderness (TG: 7; CG: 2) |
| TG: n = 23, age 40y; CG: n = 22, age 39y; | ||||||
| Inclusion: BMI >27kg/m2; female; 16–65 years; no co-intervention for obesity within 3-Mo and the study | ||||||
| Hsieh et al. 2010, 2011, 2012 Taiwan[60,61,65] | 84 randomized and 68 completed. | 1. Auricular acupressure (Japanese magnetic pearl) group 2. Auricular acupressure (Vaccaria seeds) group Auricular acupoints: Endocrine, Mouth, Shenmen, Small intestine, Stomach; Manipulation: 10 mins/session/Wk, 8 Wks | Sham group Same acupoints/manipulation; Acupressure tape only | Education on low-calorie diet; maintain physical activity | BMI: Significant within-group effect—TG1 & TG2; | N/A |
| TG1: n = 27, 24 F; TG2: n = 29, 26 F; CG: n = 28, 26 F; | BW, WC: Significant within-group effect—TG1, TG2, & CG; Significant between-group effect—TG2>TG1; | |||||
| Inclusion: WC≥80cm (F)/90cm (M); BMI>23kg/m2; 18–20 years | Waist-to-hip ratio: Significant within-group effect—TG1 & TG2 | |||||
| Rerksuppaphol & Rerksuppaphol 2011 Thailand[62] | 45 randomized and completed. | Body TEAS group Acupoints: RN4, RN6, RN10, RN12, SP15, ST25, ST28; Manipulation: acupuncturists administered. Electrodes with 40Hz frequency, 30 mins/session, twice/Wk, 8 Wks | Body electroacupuncture group Same acupoints; Manipulation: disposable needles with 40Hz frequency, 30 mins/session, twice/Wk, 8 Wks | Maintain diet, exercise, medication for obesity | Weight loss, BMI: Significant within-group effect—TG | None |
| TG: n = 23, age 34y; CG: n = 22, age 33y; | ||||||
| Inclusion: BMI>23kg/m2; WC>80cm; female; >15 years; no co-intervention for obesity | ||||||
| Rerksuppaphol 2012 Thailand[63] | 40 randomized and 29 completed. | Body TEAS plus auricular acupressure group Body acupoints: RN4, RN6, RN10, RN12, SP15, ST25, ST28; Auricular acupoints: Shenmen, Hungry, Stomach; Manipulation: acupuncturists administered. Electrodes with 40Hz frequency, 30 mins/session, twice/Wk, 8 Wks | Auricular acupressure group Same acupoints; Manipulation: magnetic pellets acupressure. Self-stimulation, 10 times/session, 3 sessions/day before meals, 8 Wks | Maintain diet, exercise | BW, BMI, WC, waist-to-hip ratio: Significant within-group effect—TG; | N/A |
| TG: n = 20, age 41y; CG: n = 20, age 32y; | BW, BMI: Significant between-group effect—TG>CG | |||||
| Inclusion: BMI>23kg/m2; female; >15 years; no other medications for obesity | ||||||
| Lien et al. 2012 Taiwan[64] | 90 randomized and 71 completed. | 1. Auricular acupuncture group 2. Auricular acupressure group Acupoints: Endocrine, Hunger, Shenmen, Stomach; Manipulation: acupuncturists administered. Beads acupressure 3 sessions/Wk, 4 Wks | Sham acupuncture group Same acupoints/manipulation; Needles without tips | Maintain diet, lifestyle | BW, BMI, WC: Significant within-group effect—TG1 & TG2 | Dizziness (TG1: 1). |
| TG1: n = 24, age 39y; TG2: n = 24, age 42y; CG: n = 23, age 41y; | ||||||
| Inclusion: BMI≥27kg/m2; female; 16–60 years; no co-intervention for obesity within 2-Mo; no previous auricular acupuncture | ||||||
| Darbandi et al. 2012 Iran[66] | 90 randomized and 86, 84 completed at Wk 6, Mo 2. | Auricular acupressure group Acupoints: Centre of ear, Hunger, Mouth, Sanjiao, Shenmen, Stomach; Manipulation: acupuncturists administered. Vaccaria seed acupressure before meals, 6 Wks | Non-specific acupressure group Acupoints: Hip, Nose, Oesophagus, Spleen; Manipulation: plasters without seeds, 6 Wks | Low-calorie diet | BW, BMI: Significant within-group effect—TG & CG (after treatment) | None |
| TG: n = 43, 37 F, age 38y; CG: n = 43, 37 F, age 38y; | ||||||
| Inclusion: BMI: 25-45kg/m2; 18–55 years; no co-intervention for obesity; no medications for obesity within 3-Mo | ||||||
| Abdi et al. 2012 Iran[67] | 196 randomized and 161 completed at Wks 6, 12. | Body acupuncture group Acupoints: GB28, RN4, RN9, RN12, SP6, ST25. For excess syndromes, LI11, ST40 added; For deficiency syndromes, RN6, SP9 added; Manipulation: acupuncturists administered. Needle stimulation until Deqi. GB28, ST25 applied with electricity at 30-40Hz frequency. 20 mins/session, twice/Wk, 6 Wks | Sham group Acupoints: on the RN meridian, 0.3cm from the real acupoints; Manipulation: superficial needling. Disconnected electric lines | Low-calorie diet | BW, BMI, HC: Significant within-group effect—TG & CG (after treatment, 6Wk F/U); | None |
| TG: n = 79, age 37y; CG: n = 82, age 37y; | WC: Significant within-group effect—TG (after treatment, 6Wk F/U), CG (after treatment) | |||||
| Inclusion: same with Darbandi et al. 2012 | ||||||
| He et al. 2012 China[68] | 60 randomized and completed (age 34y). | Auricular acupressure plus exercise group Acupoints: Endocrine, Hunger, Large intestine, Shenmen, Spleen, Stomach; Manipulation: vaccariae seed acupressure, 10 seconds/time, 3 times/day, 4 Wks | Exercise group Heart rates at 120–150 beats/min, 1 hour/day, 4 Wks | Low-calorie diet; no food after 8PM | BW, BMI, WC: Significant within-group effect—TG & CG; | N/A |
| TG: n = 30; CG: n = 30; | BW: Significant between-group effect—TG>CG | |||||
| Inclusion: BMI≥25kg/m2; WC≥80cm; female; 18–60 years; no medical/drug use for obesity within 2-Mo | ||||||
| Guo et al. 2014 China[69] | 64 randomized and 61 completed (32 F, age 37y). | Body electroacupuncture plus diet group Acupoints: RN4, RN12, SP6, SP9, ST25, ST36, ST40; Manipulation: 1400kcal/diet. 2Hz frequency stimulation, 30 mins/session, daily, 45 days | Diet group 1400kcal/diet. 45 days | N/A | BW: Significant within-group effect—TG & CG | N/A |
| TG: n = 32; CG: n = 32; | ||||||
| Inclusion: BMI ≥28kg/m2 (obese); >18 years | ||||||
| Wu et al. 2014 China[70] | 72 randomized and 65 completed. | Body acupuncture group Acupoints: SP4, SP6, SP8, SP9, SP10, SP14, SP15; Manipulation: acupuncture at 9-11AM. Needle stimulation until Deqi. 30 mins/session, daily, 30 days | Sham group Same acupoints; Manipulation: acupuncture at any time beyond 9-11AM | N/A | BW, BMI, WC, HC: Significant within-group effect—TG & CG | N/A |
| TG: n = 36, age 28y; CG: n = 36, age 28y; | ||||||
| Inclusion: BMI≥25kg/m2; 18–65 years; WC≥80cm (F)/90cm (M); TCM syndrome of spleen deficiency and exuberant dampness; no drug within 6-Mo; no co-intervention for obesity | ||||||
| Kim et al. 2014 Korea[71] | 58 randomized and 49 completed. | Auricular acupressure group Acupoints: Endocrine, Mouth, Shenmen, Small intestine, Stomach; Manipulation: salba seeds acupressure 30 minutes before meals, 5 sec/point, 10 times/point, 3 times/day, 1 Mo | No information | N/A | BW, BMI: Significant within-group effect—TG & CG; Significant between-group effect—TG>CG | N/A |
| TG: n = 25, age 21y; CG: n = 24, age 21y; | ||||||
| Inclusion: BMI≥25kg/m2; female; no previous medication; no co-intervention for obesity | ||||||
| Yeo et al. 2014 Korea[72] | 91 randomized and 58 completed. | Auricular acupuncture group 1 Acupoints: Endocrine, Hunger, Shenmen, Spleen, Stomach; Auricular acupuncture group 2 Acupoint: Hunger; Manipulation: Korean medicine practitioners administered. 8 Wks | Sham group Acupoints: same with TG1; Manipulation: needles removed immediately after insertion, 8 Wks | Low-calorie diet; no extra exercise | BW, BMI: Significant between-group effect—TG1>CG; TG2>CG; | N/A |
| TG1: n = 31, 25 F, age 35y; TG2: n = 30, 25 F, age 39y; CG: n = 30, 25 F, age 43y; | WC: Significant between-group effect—TG1>CG | |||||
| Inclusion: BMI≥23kg/m2; >19 years; daily ambulatory time<2h; stable weight; no co-intervention for obesity within 6-Mo; no addiction to alcohol | ||||||
| Schukro et al. 2014 Austria[73] | 56 randomized and 45, 42 completed at Wks 6, 10. | Auricular electroacupuncture group Acupoints: Colon, Hunger, Stomach; Manipulation: 1Hz frequency. 7AM-11AM, 4 days/Wk, 6 Wks | Sham group Same acupoints/manipulation; No electric stimulation | N/A | BW, BMI: Significant between-group effect—TG>CG (after treatment, 4Wk F/U) | Skin irritations (n = 8) |
| TG: n = 28, age 54y; CG: n = 28, age 50y; | ||||||
| Inclusion: BMI>25kg/m2; female; >18 years; no previous acupuncture use | ||||||
| Darbandi et al. 2014 Iran[74] | 80 randomized and completed. | 1. Body electroacupuncture group Acupoints: same with Abdi et al 2012; Manipulation: acupuncturists administered. 30–40Hz frequency at a maximal tolerable intensity, 20 mins/session, twice/Wk, 6 Wks; 2. Auricular electroacupuncture group Acupoints: Center of ear, Hungry, Mouth, Sanjiao, Shenmen, Stomach; Manipulation: vaccaria seeds acupressure before meals, twice/Wk, 6 Wks | 1. Sham body electroacupuncture group Acupoints: 0.5cun from the real acupoints; Manipulation: superficial insertion. No electric stimulation; 2. Sham auricular electroacupuncture group Acupoints: Esophagus, Hip, Nose, Spleen; Manipulation: plasters without seeds | Low-calorie diet | BMI: Significant between-group effect—TG1>CGs1, 2; TG2>CGs1, 2; | None |
| TG1: n = 20, age 38y; TG2: n = 20, age 39y; CG1: n = 20, age 38y; CG2: n = 20, age 38y; | HC: Significant between-group effect—TG1>CGs1, 2; TG2>CGs1, 2; TG2>TG1; | |||||
| Inclusion: BMI: 30–40kg/m2; male; 18–50 years; no medications for obesity within 3-Mo | WC: Significant between-group effect—TG1>CGs1, 2; TG2>CG2; TG1>TG2 | |||||
| Yeh et al. 2015 Taiwan[75] | 134 randomized and 70 completed (35 F). | Auricular electroacupuncture & acupressure group Acupoints: Endocrine, Hunger, Shenmen, Stomach; Manipulation: researchers administered. 10 Wks. Needle stimulation until Deqi. 2-100Hz frequency, 20 mins/session, Weekly; Vaccariae seeds acupressure 1 min/point, 4 times/day | Non-specific acupuncture group Acupoints: Ankle, Clavicle, Elbow, Shoulder; Same manipulation | Nutrition counselling | BMI: Significant within-group effect—TG & CG | N/A |
| TG: n = 36, age 30y; CG: n = 34, age 33y; | ||||||
| Inclusion: BMI≥27kg/m2; WC≥80cm (F)/90cm (M); 18–50 years; no medication/surgery use for obesity within 3-Mo | ||||||
| He et al. 2015 China[76] | 56 randomized and completed. | Body acupuncture plus massage group Acupoints: LI11, RN6, RN12, SJ6, SP6, SP15, ST21, ST25, ST36; Manipulation: acupuncturists administered. Needle stimulation until Deqi. 30 mins/session, daily, 21 days; Massage: stomach Meridian, Ren Meridian, Dai Meridian (abdomen), 25 mins/session, daily, 21 days | Body acupuncture group Same acupoints/manipulation | Maintain diet; no physical training or exercise | BW, BMI: Significant within-group effect—TG & CG | N/A |
| Inclusion: BMI≥25kg/m2; female; no previous drug use | ||||||
| Jiao et al. 2015 China[77] | 48 randomized and completed. | Body electroacupuncture plus running group Acupoints: SP6, ST36; Manipulation: 50Hz frequency, 45 mins/session, daily, 6 Wks; Running: 45 mins/day, 6 Wks | Running group 45 mins/day, 6 Wks | No overeating | Fat mass: NS | N/A |
| TG: n = 24, age 35y; CG: n = 24, age 36y; | ||||||
| Inclusion: BMI>28kg/m2; male | ||||||
aAdd-on strategy of all the intervention groups.
Wk: Week; TG: treatment group; CG: Control group; F: Female; Age, mean age; Mo: Month; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders IIIR; NS, not statistically significant; N/A, not available; F/U: follow-up; ICD-10, International Statistical Classification of Diseases and Related Health Problems 10th Revision; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders 4thed; NRT, nicotine replacement therapy; FTND, Fagerstrom Test for Nicotine Dependence; TEAS, transcutaneous electric acupoint stimulation; PHQ-9, 9-item Patient Health Questionnaire; BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; BW, body weight; BMI, body mass index; WC, waist circumference; HC, hip circumference; M: male.