Acupuncture helps recover menstrual cycles in women with PCOS

Acupuncture is useful treatment to use for menstrual problems and I recommend it with herbs and supplements when treating PCOS. Here is a meta-analysis of several studies that concludes acupuncture does help treat PCOS.



A systematic review and meta-analysis was carried out to assess the clinical effectiveness of acupuncture in treating polycystic ovarian syndrome (PCOS).


RCTs that compared either acupuncture with no/sham (placebo) acupuncture or a certain therapy with acupuncture added in the treatment of PCOS were included in the review. Measures of treatment effectiveness were the pooled odds ratios (OR) for women with PCOS having acupuncture compared with women in the control group for the recovery of menstrual cycles, standardized mean difference (SMD) for body mass index (BMI), fasting insulin (FINS), fasting plasma glucose (FPG), luteinizing hormone (LH), follicle stimulating hormone (FSH), and the ratio of LH/FSH.


A total of nine RCTs (531 women) met criteria for inclusion into the systematic review. Using the random effects model, pooling of the effect estimates from all RCTs showed recovery of menstrual cycles (OR = 0.20, 95% CI: 0.09–0.41, P < 0.01), BMI (SMD = −0.63, 95% CI: −1.04 to −0.21, P = 0.04), and LH (SMD = −0.39, 95% CI: −0.65 to −0.12, P < 0.01) which favored the acupuncture group. No significant differences were observed for FINS, FPG, FSH and the ratio of LH/FSH between acupuncture and control groups (P > 0.05).


Acupuncture appears to significantly improve the recovery of the menstrual cycles and decrease the levels of BMI and LH in women with PCOS. However, the findings should be interpreted with caution due to the limited methodological quality of included RCTs.

Acupuncture shows effectiveness in Dermatology

Objectives: Acupuncture is a form of Traditional Chinese Medicine that has been used to treat a broad range of medical conditions, including dermatologic disorders. This systematic review aims to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions.

Methods: A systematic search of MEDLINE, EMBASE, and the Cochrane Central Register was performed. Studies were limited to clinical trials, controlled studies, case reports, comparative studies, and systematic reviews published in the English language. Studies involving moxibustion, electroacupuncture, or blood-letting were excluded.

Results: Twenty-four studies met inclusion criteria. Among these, 16 were randomized controlled trials, 6 were prospective observational studies, and 2 were case reports. Acupuncture was used to treat atopic dermatitis, urticaria, pruritus, acne, chloasma, neurodermatitis, dermatitis herpetiformis, hyperhidrosis, human papillomavirus wart, breast inflammation, and facial elasticity. In 17 of 24 studies, acupuncture showed statistically significant improvements in outcome measurements compared with placebo acupuncture, alternative treatment options, and no intervention.

Conclusions: Acupuncture improves outcome measures in the treatment of dermatitis, chloasma, pruritus, urticaria, hyperhidrosis, and facial elasticity. Future studies should ideally be double-blinded and standardize the control intervention.

Comments: Acupuncture has many applications for skin diseases and skin anti-ageing. Facial cosmetic acupuncture is used to temporarily reduce wrinkles and improve skin elasticity. Acupuncture is also used for relieving skin rashes such as atopic dermatitis and acne. However these days it is not always practical for patients to come 1 to 2 times a week for acupuncture, which is often the ideal treatment plan to improve the condition. This is why  I will recommend a herbal formulation that will work on multiple internal factors between acupuncture treatments.


SOURCE: Ma, Chelsea, and Raja K. Sivamani. “Acupuncture as a Treatment Modality in Dermatology: A Systematic Review.” The Journal of Alternative and Complementary Medicine 21.9 (2015): 520-529.

Acupuncture shows beneficial effect for insomnia

The exact physiological or biochemical mechanisms by which acupuncture might improve sleep are not completely understood. However, many studies have demonstrated that acupuncture can cause multiple biological responses (Ulett 1998). A review article has summarised how the nervous system, neurotransmitters and endogenous substances could respond to needling stimulation and electroacupuncture, thereby mediating pain relief and other therapeutics (Ma 2004). Acupuncture causes stimulation of the opiodergic neurons in rats resulting in increased concentrations of beta-endorphin which might have a sleep promoting effect (Cheng 2009). Acupuncture is also found to increase melatonin secretion, which is associated with improvement in sleep (Spence 2004). Stimulation of certain acupoints is found to increase nitric oxide in the brain and the blood, which is associated with sleep improvement clinically (Li 2003). Acupuncture can also cause up-regulation of an important inhibitory neurotransmitter, gamma-aminobutyric acid (GABA) that may promote sleep (Fu 2009). Acupuncture also results in modulation of the autonomic nervous system, affecting both sympathetic and parasympathetic activities, which may be associated with its sleep-promoting effect (Huang 2011).

Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials

Background: Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication.

Methods: We included randomized controlled trials on acupuncture for insomnia. We searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. All searches ended in December 2008. Two authors extracted data and assessed the trials’ quality independently. RevMan 5.0.17 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).

Results: Forty-six (46) randomized trials involving 3811 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed a beneficial effect of acupuncture compared with no treatment (MD −3.28, 95% CI −6.10 to −0.46, p = 0.02; 4 trials) and real acupressure compared with sham acupressure (MD −2.94, 95% CI −5.77 to −0.11, p = 0.04; 2 trials) on total scores of Pittsburgh Sleep Quality Index. Acupuncture was superior to medications regarding the number of patients with total sleep duration increased for >3 hours (RR 1.53, 95% CI 1.24–1.88, p < 0.0001). However, there was no difference between acupuncture and medications in average sleep duration (MD −0.06, 95% CI −0.30–0.18,p = 0.63). Acupuncture plus medications showed better effect than medications alone on total sleep duration (MD 1.09, 95% CI 0.56–1.61, p < 0.0001). Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates (RR 1.67, 95% CI 1.12–2.50, p = 0.01). There were no serious adverse effects with related to acupuncture treatment in the included trials.

Conclusions: Acupuncture appears to be effective in treatment of insomnia. However, further large, rigorous designed trials are warranted.

Acupuncture for Xerostomia in Patients with Cancer: An Update

Background: Xerostomia (dry mouth) is a common side-effect of cancer treatment following radiotherapy, especially in patients with head-and-neck (HN) cancer. Objective: The purpose of this review was to evaluate evidence related to acupuncture for xerostomia in patients with HN cancer.

Materials and Methods: Embase, Medline, Cochrane (all databases), PubMed, and Scopus were searched from inception through December 2014 for studies published in English that were randomized controlled trials (RCTs) evaluating acupuncture to treat and/or prevent xerostomia in patients with cancer. A usual-care and/or placebo comparison group was required for inclusion. Risk of bias (ROB) was rated as low, high, or unclear according to Cochrane criteria. Outcomes and treatment parameters were summarized.

Results: Of 184 articles identified, 136 duplicates were omitted, leaving 48 publications that were screened. Thirty-nine studies were excluded because they were not prospective RCTs of acupuncture in patients with cancer, and three studies did not involve needle insertion into acupuncture points. Six studies met all inclusion criteria. Four investigated acupuncture to treat xerostomia, and two investigated acupuncture to prevent xerostomia. Of the six included trials, four reported significant between-group differences in favor of real acupuncture, and two reported significant within-group differences only. No studies were rated as low ROB, either because of low statistical power or a lack of blinding.

Conclusions: Acupuncture may be a helpful adjunct to cancer care for treatment and/or prevention of xerostomia in patients with HN cancer, but studies to date have been limited by small sample size and/or lack of blinding. Large phase III trials are currently underway.


The Acupuncture points used and the number of sessions  varied considerably in studies. Some studies combined common acupuncture points with ear points. The retention period was fairly consistent across studies with minimum 20 minutes and maximum 30 minutes. Some studies had 3 sessions a week during radiotherapy and others only 1. There are promising results across these studies that prove acupuncture can help increase salivary flow rate and relieving symptoms of dry mouth as well as improving QoL for patients. However the results are inconsistent due to differences in trial design and measurements used. Never the less the review  is a positive outcome for acupuncture as a beneficial adjunct treatment for dry mouth.

Chinese Herbs help relieve IBS

Objective: Irritable bowel syndrome (IBS) is a common problem, but treatment is unsatisfactory.

Although Chinese herbal medicines have been tried, there are limited data to support their usage. The authors set out to systematically review the effectiveness of the Chinese herbal medicine TongXieYaoFang (TXYF) and TXYF with different Chinese herbal additions (TXYF-A) in the management of IBS in order to make evidence-based recommendations.


Methods: The authors searched the literature to identify randomized trials of TXYF or TXYF-A for patients with IBS by using MEDLINE,® EMBASE, the Cochrane Controlled Trials Register (CCTR), the Cochrane Complementary Medicine Fields Specialized Register from 1966 to 2004, the CMB Disc database from January 1978 to December 1988, and the Full Text Chinese Journal database from January 1994 to December 2004. Standard forms regarding study design, treatment course, outcome measures, and adverse events were used to abstract data. Studies were assigned a quality score based on published methodology. Relative risk (RR) and 95% confidence interval (CI) were analysed.

Results: Twelve studies (_ 1125) that met the criteria for review were identified. There was heterogeneity in the studies with regard to herbal formulas, control medicine, treatment course, and outcome measurement. The quality of all studies was low. The pooled analyses of effectiveness for the near-term (immediately after finishing the treatment course), short-term (3 months after finishing the treatment course), and long-term (6 months or more after finishing the treatment course) effectiveness showed that the effect of TXYF-A was better than that of conventional medicine in four, two, and six studies, respectively. The RRs were 1.34 (95% CI 1.16–1.54, _ 0.05), 1.39 (95% CI 1.17–1.64, _ 0.05), and 1.34 (95% CI 1.12–1.61, _ 0.05), respectively. Overall, combining all data from the 12 studies, the effectiveness of TXYF-As was higher than that in control groups, with statistical significance and RR of 1.35 (95% CI 1.21–1.50, _ 0.05).

Conclusions: There is evidence to indicate the potential usefulness of TXYF-A for IBS patients. The results were limited by the poor quality and heterogeneity of these studies. Further studies with carefully designed, randomized double-blinded placebo-controlled trials will be needed to confirm the effectiveness of TXYF or TXYF-A for IBS.

Medical Condition

The Characteristics  of Irritable Bowel Syndrome (IBS) are abdominal pain , which often occurs before needing to evacuate the bowels, alternating diarrhea and constipation. In IBS suffers Inflammation has been present in the small intestine and colon tract and it is now proven stress does worsen symptoms. It is believer that  20% of population  have IBS! Despite this surprising statistic  there is no cure or no medication that provides continuous relief from the pain and gut disharmony.  In TCM there are hundreds of formulas designed to treat condition involving the lower digestive tract. This review looked at twelve clinical studies of an ancient formula called TongXieYaoFang.

More about Treatment and Study

TongXieYaoFang is commonly used for treating IBS. It contains Bai Zhu (Atractlyodis Macrocephalae) , Bai Shao (Radix paeoniae alba), Chen Pi (percarpium citri reticulatae) , Fang Feng (radix saposhnikoviae).

However all of the studies included in the analysis modified this base formula adding additional herbs. This means there is no consistent formula across the studies.

In this study it says the main pattern associated with IBS is liver insulting spleen. In TCM each pattern has a list of key symptoms.  Once a practitioner determines the  main pattern, or patterns, a suitable formula can be chosen. The practitioner  can then add other herbs to tackle other symptoms providing these additional herb  are not contraindicated to any herbs in the base formula.

This approach is a challenge for clinical trials because when you do systemic analysis you have no consistency across trials,which will never satisfy the current medical trial standards that define high quality trials.

Source: Effectiveness of the Chinese Herbal Formula TongXieYaoFang for Irritable Bowel Syndrome: A Systematic Review


Can Acupuncture improve IVF outcomes?

In Vitro Fertilisation  and Acupuncture

Statistically you have a 25% chance of falling pregnant and staying pregnant with first cycle of IVF. It’s no wonder that women and couples turn to acupuncture to try to increase chances of conception and full-term pregnancy. Women and men can receive acupuncture prior to IVF. On the day of embryonic transfer the women may have acupuncture within an hour after the procedure. A woman may continue having acupuncture through the first trimester and until the risk of miscarriage is very low.

Outcome measures:

This meta-anlaysis of several studies from six countries has a varied treatment scope. This study chose to look at six outcomes.

Clinical pregnancy, biochemical pregnancy, on-going pregnancy, live birth, implantation rate, and miscarriage.

Using the random-effects model, pooling of the effect estimates from all of the 17 trials showed no significant difference in the clinical pregnancy outcome between the acupuncture and the control groups
(RR= 1.09, 95% confidence interval (CI) 0.94–1.26, p = 0.25). No significant differences in the biochemical pregnancy, ongoing pregnancy, implantation rate, live birth, or miscarriage outcomes were found between the acupuncture and the control groups
(biochemical pregnancy: RR = 1.01, 95% CI 0.84–1.20, p = 0.95;
ongoing pregnancy: RR = 1.20, 95% CI 0.93–1.56, p = 0.16; implantation rate: RR = 1.22, 95% CI 0.93–1.62, p = 0.16;
live birth: RR = 1.42, 95% CI 0.92–2.20, p = 0.11;
miscarriage outcomes: RR = 0.94, 95% CI 0.67–1.33, p = 0.74).

Conclusions: No significant benefits of acupuncture are found to improve the outcomes of IVF or ICSI.

More information about treatment

In this meta-analysis acupuncture was viewed as any form of acupuncture used in clinical practice. This included auricular acupuncture, laser acupuncture, electro-acupuncture and traditional acupuncture. This study chose not to conduct an analysis of outcomes for each type of acupuncture instead focusing on the IVF outcomes.

However most of the case studies report using traditional acupuncture. Some case studies had control groups with sham acupuncture or alternative treatment , for example lying down for an hour was used in one study’s control group.

Comments on study

This meta-analysis also referred to previous smaller meta-anlaysis pointing out that there were contradictory findings. For example one meta-analysis had reported acupuncture significantly improved the pregnancy rate, whilst another meta-analysis reported no significant improvement for clinical pregnancy.

This meta-analysis concludes that across all the outcomes measured in the selected seventeen trials acupuncture does not produce any significant improvement against placebo or sham.

The study recommends future large TCM theory based randomised trials are needed.

This meta-analysis highlights the challenges facing evidence based acupuncture. How do you design and complete trails that will result in conclusive evidence?

References (stats on IVF pregnancy)

Long-Term Effect of Acupuncture for Treatment of Tinnitus” A Randomized , Patient and Assessor Blind, Sham-Acupuncture-Controlled, Pilot Trial. The Journal of Alternative and Complementary Medicine , Vol 18, No 5, 2012 pp.429-439. Fan Qu, PhD,1  Jue Zhou, PhD,2  and Ru-Xiang Ren, MD –

Can Acupuncture Treat Tinnitus?

Source: Long-Term Effect of Acupuncture for Treatment of Tinnitus” A Randomized , Patient and Assessor Blind, Sham-Acupuncture-Controlled, Pilot Trial. The Journal of Alternative and Complementary Medicine , Vol 18, No 7, 2012 pp.693-699

Medical Condition

Tinnitus is a perception of noise within the person’s ears. Some patients describe it as  “beeping” or “hissing” noises, others a buzzing sound ‘like  swarm of bees”.  The severity and type of noise varies amongst sufferers. With this constant internal noise a suffers hearing can be impaired. We are yet to understand the patho-physiology of this condition and this lack of understanding is demonstrated in the fact that there is currently no drug on the market that provide a long-term relief for Tinnitus.

Outcome measures:

The subjective outcome was the score of Tinnitus Handicap Inventory (THI) and Visual

Analogue Scale (VAS) from baseline to 3 months after.

Pure Tone Average (PTA) and Speech Discrimination

(SD) from baseline to 3 months after were assessed as objective outcomes.

Results: A significant interaction between time and group in VAS ( p = 0.017) was evident, but not in THI, PTA, and SD scores. THI showed significant improvement at the end of treatment and 3 months after, compared to baseline, in real acupuncture ( p = 0.004). In SD, a significant long-term effect of real acupuncture was observed until 3 months after ( p = 0.011). However, the effect of real acupuncture in PTA was not maintained until 3 months after the end of treatment. No significant difference in the sham-acupuncture treatment group was evident. No statistical difference in any outcome was observed between real and sham acupuncture. Only in the mean percent change of VAS, real acupuncture showed statistical significance, compared with sham-acupuncture

from baseline to 3 months after ( p = 0.019).

Conclusions: Through evaluation of subjective (THI and VAS) and objective outcomes (PTA and SD), this study demonstrates the long-term effect of real acupuncture.

More information about treatment

All Real-acupuncture points were inserted to depth of 2mm, stimulated and retained for ten minutes. Points used in real acupuncture group were:

In prone position

GV-14, 15 ,20

GB 12,20,21

Then in supine position


SI -19



Extra Point HN3

Bl-2 (bi-laterally)


The Sham-Acupuncture  group used points not at specific documented meridian points. This included inserting points around the ear but not at any meridian point. Inserting points a few CMs from ST36, SJ-5. No specific stimulation technique was used . needles inserted to depth of 3mm and retained for ten minutes.

Other treatments applied for both groups were infrared light projected to area around ear to promote blood circulation during acupuncture.

Comments on study

Comparing Sham-acupuncture to real-acupuncture challenges a lot of acupuncturists because it can often the results have  no-significant statistical difference. This study is a good example of this contradiction to real-acupuncture. However when you look at each measurement  it gets more complicated. In the case of this study the Tinnitus Health Inventory (THI) scores are reported, a subjective self-reporting questionnaire of patients health, to have significantly improved for real-acupuncture at end of the treatment and this was maintained  3 month follow-up. But the sham group did not replicate these positive results. THI looks at patients emotional, psychological and physiological responses to their condition. All other measurements are more specific and there was no significant statistical difference between these. You can read more about measurements in the paper itself.

Regarding acupuncture in general it seems that for some conditions acupuncture works very well and is completely safe. However there are still  fundamental unanswered questions about this medicine.

We really don’t know how acupuncture works and why.

Why is it that sometimes real acupuncture  is superior to sham-acupuncture and sometimes it is not?

There is no high quality studies that have tested whether treatment variables such as: needling technique, needle retention time, needle type, needle depth, needles quantity, and needling style]  provides any significant difference in patient outcomes.

How do we account for the placebo effect in clinical trials as a factor in sham and real acupuncture?

We may never be able to answer these questions, but  does this matter if we have evidence based acupuncture that proves it works or doesn’t?

TCM and Non-acute bronchial Asthma complicated with gastroesophageal reflux

A review of effectiveness and safety of TCM treatments for bronchial asthma and gastroesophageal reflux (GERD)

Study: Zhao Yu-Hao, LIU Zhao-hua, JIANG Sheng-hua, SHI Cheng-he: Systematic review of randomized controlled trials of traditional Chinese medicine treatment of non-acute bronchial asthma complicated by gastroesophageal reflux. Journal of Traditional Chinese Medicine: 32(1):12-18

Location of trials: All trials in this review were conducted in China


This review looked at  randomized, controlled trials that compared TCM treatments to western medical treatments such as anti-inflammatory drugs, bronchodialators for asthma and drugs to inhibit gastric acid production and promote gastric peristalsis. TCM trials selected included those using various herbal formulas and one trial involving a  combined treatment of acupoint injections , cupping and ginger-separated moxibustion.

Medical Condition

Gastroesophageal reflux and bronchial asthmas are often found together in patients. The theory is that regurgitated contents of the gut during reflux can irritate or damage tissues outside the esophagus such as the bronchial tissue of the lungs. It is believed this type of irritation of bronchial may cause asthma. One study revealed that 59.2 % of asthma patients had symptoms of gastroesophageal reflux.

What is gastroesophageal reflux? Also referred to as Gastrophageal reflux disease (GERD) or acid reflux is where stomach acid breaches the barrier (a sphincter type lid)  between the stomach and the esophagus. The acid damages the esophagus wall and causes that painful feeling we call heart burn. Nausea, belching, regurgitation are other symptoms associated withGERD.


Six studies were analysed – totalling 304 patients.

Outcomes Measured

  1. Asthma Scores: Reid method was reported in two studies
  2. Gastroesophageal reflux scores: used Harper method in three studies the symptoms relieved and the bulk of signs disappeared within 5 days
  3. Pulmonary function: was reported in two studies
  4. Adverse reactions: no adverse reactions were reported in any of the selected studies.


Methodological quality was low in all six RCTs. Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group (RR: 1.43, 95% CI: 1.10 to 1.87 vs RR: 1.51, 95% CI: 1.09 to 2.08). One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group (MD: -1.10, 95% CI: -2.04 to -0.16). Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group (RR: -3.70, 95% CI: -4.30 to 3.10 vs RR: -5.30, 95% CI: -6.32 to -4.28). One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group (P<0.05). No differences were seen in the various indexes between groups in the other RCTs. No adverse reactions, dropout rates, or follow-up rates were reported in any of the RCT

More About one Treatment

One study used these herbs to treat asthma (dosage not available in review paper)

Sha Shen (Radix Glehniae seu Adenophorae),Ban Xia (Rhizoma Pinelliae), Bai Zhu (Rhizoma Atractylodi Macrocephalae), Wu Zhu Yu (Fructus Evodiae), Huang Lian (Rhizoma Polygonati) , Zhi Shi (Fructus Aurantii Immaturus), Zhi Gan Cao (Radix Glycyrrhizae Preparata).

Commanality of herbs across the six studies were:

Ban Xia – 5/6 studies

Gan Cao – 4/6 studies

Zhi Shi – 3/6

Huang Lian/Whu Zhu Yu/Xuan fu hua/Wu Zei Gu – 2/6

Cochrane Quality 

Methodological quality was rated low in all studies selected for this review.

The quality of the selected trials was criticised for being of low quality due, what seems to be a set of common characteristics of TCM trials conducted in CHINA including inconsistent interventions (different formulas), difficulties extracted bigger numbers of trials , lack of detail around the trial methodologies  and measures that would only lead the reviewers to conclude the trials may be subject to bias.  In this case there were no details of drop-outs and follow-ups. In thew review  the authors make many more specific comments regarding trial quality.



This review demonstrates that at a collective level of the selected studies, and based on the information available to the reviewers, that TCM treatments for bronchial asthma and gastroesophageal reflux could be just as effective as common western medication and in one study a TCM combined with western medicine was significantly better that  using western medicine alone to treat asthma.

However in the limitations section of this paper , the authors  caution readers to jump to conclusions that TCM is definitely equally curative or better than pharma treatments. This is a small review and not a meta-analysis.



Zhao Yu-Hao, LIU Zhao-hua, JIANG Sheng-hua, SHI Cheng-he: Systematic review of randomized controlled trials of traditional Chinese medicine treatment of non-acute bronchial asthma complicated by gastroesophageal reflux. Journal of Traditional Chinese Medicine: 32(1):12-18


Acupuncture and Headache

A systematic review of Acupuncture for the management of Chronic Headaches

Study: Conducted by Department of Anethesiology, Duke University Medical centre.


This was  a review of efficacy of acupuncture to treat chronic headaches. The review involved looking at clinical trials that used true acupuncture over a course  ranging from 6 to 12 weeks and one more treatment sessions a week. The majority of the selected trials used sham acupuncture in the control group. A few trials compared true acupuncture with other treatments including physiotherapy, massage and relaxation and commonly used medication.

Medical Condition

Chronic headaches including migraines and tension-type headaches.


Thirty one trials consisting of 3916 patients met the inclusion criteria. The review only chose trials where participants were randomised for acupuncture or control receiving sham acupuncture , medication or other non pharmacological treatments.

17 trials were for treatment of migraine

10 trials were for treatment of tension type headaches

4 trials were for mixed headaches

Outcomes Measured

Headache intensity and frequency of headache, and health related QoL questionnaires were the primary information to determine efficacy of acupuncture treatments. These measurements were reviewed in a defined follow-up early period of close to 8 weeks and no more than 3 months and also  a late follow-up period of  close to  6 months but longer than 3 months. The treatment response rate was based on a  minimum improvement of 33% in headache frequency or headache index.


Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: -8.54 mm, 95% CI: -15.52, -1.57), headache frequency (standard mean difference: -0.70, 95% CI: -1.38, -0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17).


Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.

Cochrane Quality and Risk Rating (if available)

The quality of the selected studies was not rated. However quality was independently assessed  by two independent reviewers who based their assessment on a criteria for selecting quality of controlled trials. See paper for more details.


The paper did not discuss point locations or provide any analysis of commonality of points used across the selected trials.


Sun and Gan (2008) Acupuncture of the management of Chronic Headache: A systematic Review. Journal of Anesthesia and Analgesia. 2008, Vol 107 (6) International Anesthesia Research Society