Table 1.
Summary of Included Studies
| Author (year) | Country | Symptoms | Study design | Sample size | Period (weeks) | Protocol | Significant result | Included in meta-analysis | AEs |
|---|---|---|---|---|---|---|---|---|---|
| Pain | |||||||||
| Hershman (2018) | United States | Joint pain | VA vs. SA vs. WL | 110/59/27 | 6 | SS | Yes (VAa vs. SA); yes (VAa vs. WL) | Yes | No serious AE. Grade 1 AE (n = 61) and grade 2 AE (n = 16) were reported in VA group. Grade 1 AE (n = 22) and grade 2 AE (n = 10) were reported in SA group. |
| Mao (2014) | United States | Joint pain | VA (EA) vs. SA vs. WL | 22/22/23 | 8 | SS | Yes (EAa vs. WL); yes (SAa vs. WL) | Yes | No serious AE. The EA group had more AEs reported than the SA group (16 vs. 4). A major category of AEs reported in the EA group was related to the de qi sensation (n = 6) |
| Bao (2013) | United States | Joint pain | VA vs. SA | 23/24 | 8 | ST | No (VA vs. SA) | No | Not reported. |
| Oh (2013) | Australia | Joint pain | VA (EA) vs. SA | 15/14 | 6 | ST | No (EA vs. SA) | No | No serious AE. Only minor bruising on acupuncture points (n = 5). |
| Crew (2010) | United States | Joint pain | VA vs. SA | 20/18 | 6 | SS | Yes (VAa vs. SA) | Yes | No serious AE. Only 3 participants thought that acupuncture was moderately painful (TA, n_2; SA, n_1). |
| Hot flashes | |||||||||
| Lesi (2016) | Italy | Hot flashes | VA vs. UC | 85/105 | 12 | I | Yes (VAa vs. UC) | Yes | No serious AE. Twelve patients in the acupuncture arm experienced mild AEs (muscle pain, headache, and one menstrual bleed). |
| Mao (2015) | United States | Hot flashes | VA (EA) vs. SA vs. PP vs. gabapentin | 30/32/30/28 | 8 | SS | Yes (SAa vs. PP); yes (EAa vs. PP); no (gabapentin vs. PP) | Yes | No serious AE. Five mild AE (4 bruising, 1 increased pain) in VA group, 1 in SA group. |
| Bao (2014) | United States | Hot flashes; sleep; depression | VA vs. SA | 23/24 | 8 | ST | No (Hot flashes, sleep, mood: VA vs. SA) | No | Not reported. |
| Bokmand (2013) | Denmark | Hot flashes; sleep disturbance | VA vs. SA vs. UC | 60/62/34 | 5 | ST | Yes (Hot flashes, sleep: VAa vs. SA); yes (Hot flashes, sleep: VAa vs. UC); no (Hot flashes, sleep: SA vs. UC) | No | Not reported. |
| Liljegren (2012) | Sweden | Hot flashes | VA vs. SA | 42/42 | 5 | ST | No (VA vs. SA) | Yes | No serious AE. Two minor events, a slight bleeding and a bruise at the needle site were reported in the sham group. |
| Walker (2010) | United States | Hot flashes; depression | VA vs. venlafaxine | 25/25 | 12 | ST | No (Hot flashes, mood: VA vs. venlafaxine) | No | Not reported. |
| Hervik (2009) | Norway | Hot flashes | VA vs. SA | 30/29 | 10 | ST | Yes (VAa vs. SA) | Yes | Not reported. |
| Frisk (2008) | Sweden | Hot flashes | VA (EA) vs. HT | 23/18 | 12 | ST | Yes (EA vs. HTa) | Yes | No serious AE. |
| Deng (2007) | United States | Hot flashes | VA vs. SA | 42/30 | 4 | ST | No (VA vs. SA) | Yes | Only very minor adverse effects, such as slight bleeding or bruising at the needle site, were reported, and none required further medical intervention. A total of 14 grade 1 AEs (of about 560 acupuncture sessions) were recorded by 12 participants as definitely, probably, or likely due to a study intervention. |
| Nedstrand (2006) | Sweden | Hot flashes; depression | VA (EA) vs. applied relaxation | 19/19 | 12 | ST | No (hot flashes, mood: EA vs. applied relaxation) | Yes | Not reported. |
| Fatigue | |||||||||
| Mao (2014) | United States | Fatigue; sleep; depression | VA (EA) vs. SA vs. WL | 22/22/23 | 8 | SS | Yes (fatigue, depression, anxiety: EAa vs. WL); no (fatigue, sleep, anxiety: SA vs. WL) | Yes | Not reported. |
| Deng (2013) | United States | Fatigue; depression | VA vs. SA | 47/50 | 6 | ST | No (fatigue, depression: VA vs. SA) | Yes | A total of 11 serious AEs occurred during the study period, including bronchospasm (1), low blood counts (1), renal failure (2), secondary malignancy (1), nausea (1), vomiting (2), small bowel obstruction (1), dyspnea (1), and back pain (1). None of these events was deemed related to the study interventions because of the timing and characteristics of the symptoms, as well as the apparent alternative explanations for them. |
| Smith (2013) | Australia | Fatigue | VA vs. SA vs. WL | 10/10/10 | 6 | SS | No (VA vs. SA); yes (VAa vs. WL) | Yes | Not reported. |
| Molassiotis (2012) | United Kingdom | Fatigue; depression | VA vs. UC | 227/75 | 6 | SS | Yes (fatigue, depression: VAa vs. UC) | Yes | Not reported. |
| Sleep disturbance [also see Mao (2014); Bao (2014); Bokmand (2013)] | |||||||||
| Garland (2017) | United States | Sleep disturbance | VA (EA) vs. gabapentin | 30/28 | 8 | SS | Yes (EAa vs. gabapentin) | Yes | Not reported. |
| Frisk (2012) | Sweden | Sleep disturbance | VA (EA) vs. HT | 26/18 | 12 | ST | No (EA vs. HT) | Yes | No AE. |
| Depression [also see Mao (2014); Deng (2013); Bao (2013); Nedstrand (2006)] | |||||||||
| Neuropathy | |||||||||
| Lu (2020) | United States | Neuropathy | VA+EA vs. UC | 20/20 | 8 | ST | Yes (VA+EAa vs. UC) | Yes | No serious AE. 2 AEs in VA group (pruritis, joint pain) |
| Greenlee (2016) | United States | Neuropathy | VA (EA) vs. SA | 31/32 | 6 | ST | No (EA vs. SA) | Yes | No serious AE. 1 AE in VA group (grade 1 acupuncture needle site reaction with discomfort, minor swelling, and bruising after acupuncture needle withdrawal) |
| Lymphedema | |||||||||
| Bao (2018) | United States | Lymphedema | VA vs. WL | 36/37 | 6 | ST | No (VA vs. WL) | Yes | No serious AE. Grade 1 treatment-related AEs such as bruising (45), hematoma (2), pain (2), skin infection (1) were reported in patients who received at least one acupuncture (n = 77). |
| Yao (2016) | China | Lymphedema | VA+WA vs. diosmin | 15/15 | 4 | ST | Yes (VA+WAa vs. diosmin) | Yes | No serious AE. |
| Smith (2014) | Australia | Lymphedema | VA vs. UC | 9/8 | 8 | ST | No (VA vs. UC) | No | No serious AE. |
a
Has more favor for effect.
AE, adverse event; EA, electroacupuncture; HT, hormone replacement therapy; I, individualized acupuncture protocol; PP, placebo pills; SA, sham acupuncture; SS, semistandardized acupuncture protocol; ST, standardized acupuncture protocol; UC, usual care; VA, verum acupuncture; WA, warm acupuncture; WL, waitlist control.