Table 1.
The Comparisons of the Characteristics of the Included Trials.
| Author (Year)/Trial Type | Sample Size/Control | Inclusion Criteria/Status About Lymphedema | Intervention (Primary Acupoints) | Course | Measurement Tools | Results |
|---|---|---|---|---|---|---|
| Bao et al19 (2018)/RCT | 73/wait-list | 1. Affected arm circumference >2 cm larger than the
unaffected arm in at least 1 of the 2 sites 2. The median duration of lymphedema was 2.5 years in experimental group (quartiles 1.4 and 3.4) and 2.2 years in the control group |
CV12 and CV3, and at bilateral TE14, LI15, LU5, LI4, ST36, and SP6 points | Twice weekly manual acupuncture for 6 weeks | Circumference and bioimpedance | 1. Compared lymphedematous arm versus unaffected
arm 2. No significant difference between the groups for arm circumference difference or bioimpedance difference |
| Yao et al23 (2016)/RCT | 30/diosmin 900 mg 3 times daily | 1. ≥3 cm circumference differences between the affected and
unaffected arms 2. Participants had met the clinical diagnostic criteria for between 6 months and 5 years |
30 minutes of acupuncture at 6 acupoints (Shousanli [LI.10], Quchi [LI.11], Binao [LI.14], Jianyu [LI.15], Waiguan [SJ.5], and Jianliao [SJ.14]) | Three times per week for 30 days | Arm circumference, QoL, clinical safety, and adverse events | 1. Compared lymphedematous arm versus unaffected
arm 2. BCRL improved by 51.46% in the experimental group and by 26.27% in the control group (P < .00001) |
| Jeong et al24 (2015)/pilot study | 9/nil | 1. ≥2 cm difference in a circumferential measurement of the
affected upper limb in comparison with the contralateral
limb 2. Clinical diagnosis of lymphedema for at least 6 months 3. Did not mention the duration postsurgery |
Saam acupuncture; the 5 Shu points | 3 times per week for 6 weeks | Stages of lymphedema, VAS, arm circumference, and QoL | 1. Compared lymphedematous arm versus the unaffected
arm 2. Reduction of lymphedema in VAS and circumferential measurements (P < .001) |
| Smith et al22 (2014)/a parallel randomized controlled feasibility study | 20/treatment as usual | 1. ≥10 cm segment by bioimpedance 2. Stable unilateral intransient lymphedema present for at least 6 months, no use of intensive therapy |
CV12, CV3, CV2; LI15, TE4, LU5, LI4, ST36, SP9, and SP6 | Twice weekly for 4 weeks then once weekly for 4 weeks; 8weeks | Extracellular fluid, lymphedema symptoms, well-being, and safety | 1. Compared pre- versus posttreatment 2. Acupuncture may stabilize symptoms yet no change in extracellular fluid or any patient-reported outcome measurement |
| Cassileth et al21 (2013)/pilot study | 37/nil | 1. ≥2 cm arm circumference differences between affected and
unaffected arms 2. Postsurgery 6 months to 5 years were included |
TE14, LI15, LU5, CV12, CV3, LI4, ST36, and SP6 | Twice weekly for 4 weeks | Arm circumference at 2 points | 1. Two-point circumference measurements of the affected and
unaffected arms were performed before and after each
treatment session 2. Mean reduction in arm circumference difference was 0.90 cm (95% CI = 0.72-1.07; P < .0005) |
| Cassileth et al20 (2011)/pilot study | 9/nil | 1. ≥2 cm arm circumference differences between the affected
and unaffected limbs 2. Clinical diagnosis of lymphedema for at least 6 months and no more than 5 years |
LI15, LI4, TE14, CV12, CV3, LU5, SP6, and ST36 | Twice a week for 4 weeks | Arm circumference (response was defined as at least a 30% reduction in the difference in size between the affected and unaffected arms after 4 weeks of treatment) | 1. Compared both the affected and unaffected limbs, before
and after each treatment 2. Acupuncture appears safe and may reduce lymphedema associated with breast cancer surgery |
Abbreviations: RCT, randomized controlled trial; QoL, quality of life; BCRL, breast cancer–related chronic lymphedema; VAS, Visual Analogue Scale; CI, confidence interval.