Randomized Trial of Acupuncture to Lower Blood Pressure A Systematic Evaluation of the Impact of STRICTA and CONSORT Recommendations on Quality of Reporting for Acupuncture Trials Acupuncture for irritable bowel syndrome: a blinded placebo-controlled trial. Acupuncture for hot flashes: a randomized, sham-controlled clinical study Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Effect of acupuncture on pain management in patients before and after lumbar disc protrusion surgery--a randomized control study. A Randomized Clinical Trial of Acupuncture Compared with Sham Acupuncture in Fibromyalgia Acupuncture in treatment of stable asthma. Dry Needling of Muscle Motor Points for Chronic Low-Back Pain: A Randomized Clinical Trial With Long-Term Follow-Up Acupuncture for Overactive Bladder: A Randomized Controlled Trial Acupuncture and knee osteoarthritis: a three-armed randomized trial. Acupuncture in chronic epicondylitis: a randomized controlled trial. The placebo response and effect of time in a trial of acupuncture to treat nausea and vomiting in early pregnancy. Acupuncture Treatment for Irritable Bowel Syndrome
Background — Arterial hypertension is a prime cause of morbidity and mortality in the general population . Pharmacological treatment has limitations result ing from drug side effects , costs , and patient compliance . Thus , we investigated whether traditional Chinese medicine acupuncture is able to lower blood pressure . Methods and Results — We r and omized 160 out patients ( age , 58±8 years ; 78 men ) with uncomplicated arterial hypertension in a single-blind fashion to a 6-week course of active acupuncture or sham acupuncture ( 22 sessions of 30 minutes ' duration ) . Seventy-eight percent were receiving antihypertensive medication , which remained unchanged . Primary outcome parameters were mean 24-hour ambulatory blood pressure levels after the treatment course and 3 and 6 months later . One hundred forty patients finished the treatment course ( 72 with active treatment , 68 with sham treatment ) . There was a significant ( P<0.001 ) difference in posttreatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment . For the primary outcome , the difference between treatment groups amounted to 6.4 mm Hg ( 95 % CI , 3.5 to 9.2 ) and 3.7 mm Hg ( 95 % CI , 1.6 to 5.8 ) for 24-hour systolic and diastolic blood pressures , respectively . In the active acupuncture  group , mean 24-hour ambulatory systolic and diastolic blood pressures decreased significantly after treatment by 5.4 mm Hg ( 95 % CI , 3.2 to 7.6 ) and 3.0 mm Hg ( 95 % CI , 1.5 to 4.6 ) , respectively . At 3 and 6 months , mean systolic and diastolic blood pressures returned to pretreatment levels in the active treatment group . Conclusions — Acupuncture according to traditional Chinese medicine , but not sham acupuncture , after 6 weeks of treatment significantly lowered mean 24-hour ambulatory blood pressures ; the effect disappeared after cessation of acupuncture treatment Background We investigated whether there had been an improvement in quality of reporting for r and omised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements . We conducted a before- and -after study , comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations . Methodology and Principal Findings Ninety peer review ed journal articles reporting the results of acupuncture trials were selected at r and om from a wider sample frame of 266 papers . Papers published in three distinct time periods ( 1994–1995 , 1999–2000 and 2004–2005 ) were compared . Assessment criteria were developed directly from CONSORT and STRICTA checklists . Papers were independently assessed for quality of reporting by two assessors , one of whom was blind to information which could have introduced systematic bias ( e.g. date of publication ) . We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured . We did not , however , find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations . Conclusions and Significance The results of this study suggest that general st and ards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996 , but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations . Wider targeting and revision of the guidelines is recommended AIM Irritable bowel syndrome ( IBS ) is a common disorder and many patients fail to find adequate relief from conventional therapies for their symptoms . This study tests the cl aim that acupuncture is effective for a majority of these patients . METHODS A prospect i ve , blinded , sham acupuncture-controlled trial of traditional Chinese acupuncture was performed at a single postgraduate teaching hospital in Europe . Sixty patients with well-established IBS were recruited . The blinded comparator was sham acupuncture administered by the second of two acupuncturists who alone was aware of the r and omization , and who otherwise followed the prescription of the first . The primary end-point was a defined fall in the symptom score at 13 wk ( by intention to treat ) . The prior expectation was a 30 % placebo response , and a response rate of 70 % from acupuncture , for which the study was adequately powered . RESULTS Patients in treated and sham groups improved significantly during the study -mean improvement in scores being equal ( minus 1.9 ) and significant for both ( P<0.05 ; one-tailed t test ) . There was a small numeric but non-significant difference between the response rate in patients receiving acupuncture ( 40.7 % ) and sham treatment ( 31.2 % ) . Several secondary end-points marginally favored active treatment , but an improved symptom score of any degree of magnitude occurred more often with sham therapy ( 65.6 % vs 59.2 % ) . For no criterion was statistical significance approached . CONCLUSION Traditional Chinese acupuncture is relatively ineffective in IBS in the European hospital setting , and the magnitude of any effect appears insufficient to warrant investment in acupuncture services Objective : Hot flashes are a significant problem in women going through the menopausal transition that can substantially affect quality of life . The world of estrogen therapy has been thrown into turmoil with the recent results of the Women 's Health Initiative trial report . Pursuant to a growing interest in the use of alternative therapies to alleviate menopausal symptoms and a few pilot trials that suggested that acupuncture could modestly alleviate hot flashes , a prospect i ve , r and omized , single-blind , sham-controlled clinical trial was conducted in women experiencing hot flashes . Design : Participants , after being r and omized to medical versus sham acupuncture  , received biweekly treatments for 5 weeks after a baseline assessment week . They were then followed for an additional 7 weeks . Participants completed daily hot flash question naires , which formed the basis for analysis . Results : A total of 103 participants were r and omized to medical or sham acupuncture . At week 6 the percentage of residual hot flashes was 60 % in the medical acupuncture group and 62 % in the sham acupuncture group . At week 12 , the percentage of residual hot flashes was 73 % in the medical acupuncture group and 55 % in the sham acupuncture group . Participants reported no adverse effects related to the treatments . Conclusions : The results of this study suggest that the used medical acupuncture was not any more effective for reducing hot flashes than was the chosen sham acupuncture BACKGROUND Nausea and vomiting in early pregnancy are troublesome symptoms for some women . We undertook a single blind r and omized controlled trial to determine whether acupuncture reduced nausea , dry retching , and vomiting , and improved the health status of women in pregnancy . METHODS The trial was undertaken at a maternity teaching hospital in Adelaide , Australia , where 593 women less than 14 weeks ' pregnant with symptoms of nausea or vomiting were r and omized into 4 groups : traditional acupuncture , pericardium 6 ( p6 ) acupuncture , sham acupuncture , or no acupuncture ( control ) . Treatment was administered weekly for 4 weeks . The primary outcomes were nausea , dry retching , vomiting , and health status . Comparisons were made between groups over 4 consecutive weeks . RESULTS Women receiving traditional acupuncture reported less nausea ( p < 0.01 ) throughout the trial and less dry retching ( p < 0.01 ) from the second week compared with women in the no acupuncture control group . Women who received p6 acupuncture ( p < 0.05 ) reported less nausea from the second week of the trial , and less dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture control group . Women in the sham acupuncture group ( p < 0.01 ) reported less nausea and dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture group . No differences in vomiting were found among the groups at any time . CONCLUSION Acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy . A time-related placebo effect was found for some women Management of acute and chronic low back and leg pain often includes the use of acupuncture . The effectiveness of this form of therapy is dependent upon compliance , which in turn is dependent on availability , response , treatment of proper acupoints , and the placebo effect . We hypothesized that classical acupuncture would be more effective than placebo acupuncture .  One hundred and thirty-two patients with acute and chronic low back and leg pain were examined before and after surgery for lumbar disc protrusion . Diagnosis was based on CT and MRT findings . Patients received acupuncture drug-free throughout the study period . The visual analogue scale was used to assess pain intensity before and after ( i.e. 30 min . 60 min . 2 h and 6 h ) acupuncture . Classical acupuncture result ed in a significant reduction in pain that become increasingly stronger during the 6h study period . Placebo acupuncture lead to same early pain relief that did not reach statistic significant and then declined thereafter Context A substantial number of patients use acupuncture to treat the symptoms of fibromyalgia , but previous r and omized trials of this intervention are inconclusive , in part because of control groups that did not permit adequate blinding of the patients . Contribution This study r and omly assigned 100 patients with fibromyalgia to 12 weeks of either true acupuncture treatment or one of 3 types of sham acupuncture . No differences in pain were identified between acupuncture and sham acupuncture . Caution s The study had too few patients to detect small differences between the groups . Patients could use other fibromyalgia therapies , so this study evaluates acupuncture as adjunctive treatment . The Editors Fibromyalgia is a condition of unknown cause that is characterized by chronic , diffuse pain and tenderness to palpation at specific musculoskeletal sites ( 1 ) . It is the second most common rheumatologic condition after osteoarthritis , afflicting 2 % to 4 % of the U.S. population ( 2 ) . Most r and omized , controlled trials of allopathic interventions have not demonstrated sustained benefit , and use of complementary and alternative medicine for fibromyalgia is common ( 3 ) . For example , 60 % to 90 % of patients with fibromyalgia report using 1 or more complementary or alternative treatments ( 4 , 5 ) , and 22 % of these patients have tried acupuncture ( 6 ) . Despite skepticism in western cultures , the literature suggests that acupuncture may alleviate chronic pain ( 7 ) . R and omized , controlled trials of acupuncture face many method ologic challenges , including the identification of appropriate treatment and control groups , blinding of study participants , and the inability to blind practitioners ( 8) . Needle placement and the extent to which needle insertion and stimulation is necessary are also controversial ( 7 - 9 ) . In the only rigorous r and omized , controlled trial of acupuncture for fibromyalgia , 7 of 8 outcome measures significantly improved after 3 weeks of treatment with electroacupuncture ( 10 ) . However , because blinding was not assessed and electroacupuncture involves perceptible current , these promising results could reflect a lack of blinding to treatment condition . Moreover , the study followed patients only during treatment . Because fibromyalgia is a chronic condition , longer-term outcomes should be examined . To address these method ologic problems , we performed a r and omized , controlled trial of acupuncture to treat fibromyalgia that included 3 sham acupuncture treatments to account for the effects of needle insertion and placement . The adequacy of participant blinding was carefully evaluated . We sought to determine whether directed acupuncture that is design ed to treat fibromyalgia relieves pain better than does sham acupuncture in adults with fibromyalgia . On the basis of the scant literature and our clinical experience , we hypothesized a priori that directed acupuncture would result in the greatest clinical improvement . Methods Participants Participants were recruited from the greater Seattle , Washington , metropolitan area between January 2001 and September 2002 . Recruitment strategies included dissemination of information on the study through newspapers , television , advertisements , signs posted at university-affiliated hospitals , and letters to local fibromyalgia support groups and health care providers with large caseloads of patients with fibromyalgia . Potential participants were told that they had an equal chance of being assigned to 1 of 4 acupuncture interventions , none of which have been proven but 1 of which was believed to have the most potential to improve the symptoms of fibromyalgia . The institutional review boards at the participating institutions approved the study , and participants provided written informed consent . Eligible participants were English-speaking adults 18 years of age or older in whom fibromyalgia was diagnosed by a physician and who had a prer and omization global pain score of 4 or greater on a visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Participants agreed to undergo r and omization and kept use of any fibromyalgia-related pharmacologic and nonpharmacologic therapies constant throughout the study . At the baseline evaluation before r and omization , a research coordinator trained in tender-point examination confirmed the diagnosis of fibromyalgia by using the 1990 criteria of the American College of Rheumatology ( 1 ) . Participants were excluded if they reported other pain-related medical conditions or potential contraindications to acupuncture treatment ( such as bleeding disorders or severe needle phobia ) , were pregnant or breastfeeding , used narcotics ( which could blunt the effects of acupuncture ) , were involved in litigation related to fibromyalgia ( which might reduce their incentive for improvement ) , or had previously received acupuncture ( to maximize blinding ) . R and omization Procedure A research coordinator screened and enrolled participants at an academic research center . After participants completed a baseline evaluation , another research coordinator who was uninvolved with data collection r and omly assigned them to 1 of 4 treatment groups by using a computer-generated , blocked r and om-allocation sequence with a block size of 4 . This research coordinator informed the acupuncture clinic of the treatment assignment . Intervention Eight U.S.-trained and licensed acupuncturists with a median of 10 years of experience ( range , 4 to 18 years ) provided study treatments in their private offices . One investigator trained the acupuncturists in the study procedures to increase their comfort with delivering all 4 treatments and monitored compliance with the protocol throughout the study . Participants were assigned an acupuncturist according to geographic convenience and schedule availability , and every effort was made to have them treated by the same acupuncturist for the entire 12 weeks . The primary acupuncturist was defined as the practitioner from whom a participant received the most treatments . In all groups , participants were asked to attend treatment sessions twice weekly for 12 weeks ( 24 treatments ) . We considered participants who attended 80 % or more ( 19 of 24 ) of acupuncture appointments to have completed a full course of treatment . Outcome measures were collected at regularly scheduled time points from participants who discontinued treatment . Participants received directed acupuncture design ed to treat fibromyalgia according to the practice of Traditional Chinese Medicine or 1 of 3 sham acupuncture treatments . One sham intervention , a control for acupoint specificity , involved acupuncture typically used to treat irregular menses or early menses due to Blood Heat ( an unrelated condition ) according to Traditional Chinese Medicine . Another sham intervention , which was also a control for acupoint specificity , used body locations not recognized as true acupoints or meridians for needling ( sham needling ) . The third sham treatment , a control for needle insertion , consisted of noninsertive simulated acupuncture at the same acupoints used in directed acupuncture ( simulated acupuncture ) . This technique , in which a toothpick in a needle guide-tube is used to mimic needle insertion and withdrawal , has been shown to be indistinguishable from true acupuncture in acupuncture-nave patients with back pain ( 9 ) . Simulated acupuncture more closely duplicates the needle insertion experience than do techniques using placebo needles that require placing adhesive or plastic foam on the skin ( 11 , 12 ) . Acupoints and sham points ( Appendix Figure ) were chosen by a study acupuncturist with 15 years of experience in treating fibromyalgia and were approved by 3 other senior acupuncturists . In all groups that underwent needle insertion , needles were retained at st and ard depths ( 13 ) for 30 minutes at each acupoint . Disposable Chinese , Japanese , or Korean needles ( 34 to 40 gauge ) were used , depending on the practitioner 's preference . In the simulated acupuncture group , participants remained on the table for 30 minutes after simulated insertion and then underwent simulated needle withdrawal . Efforts were made to imitate the sounds of opening needle packs and needle disposal . Acupuncturists were not blinded to the treatments they delivered . To maximize participant blinding , we included only acupuncture-nave persons who could not compare their treatment with previous experiences with acupuncture , limited contact among study participants , restricted conversation between acupuncturists and participants , and blindfolded participants during treatment . All research personnel who collected or analyzed data were unaware of treatment group . At the end of 12 weeks , we collected data to assess the adequacy of blinding . Outcome Measures Demographic measures collected at the baseline evaluation included age , sex , race , education , marital status , and duration of pain and diagnosis of fibromyalgia . Participants also listed the types of therapies they had previously tried for their pain . We grouped this information into manual therapies ( physical , ergonometric , chiropractic , or massage therapy ) , mental health therapies ( psychotherapy or cognitive behavioral therapy ) , dietary changes , or other therapies ( nerve blocks , hypnosis , or biofeedback ) . Outcome measures were collected at baseline ; after 1 , 4 , 8 , and 12 weeks of acupuncture treatment ; and 3 and 6 months after completion of treatment ( weeks 24 and 36 ) . The primary outcome was subjective pain , as measured by a st and ard 10-cm visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Other outcomes measured by using a visual analogue scale were intensity of fatigue ( 0 = none , 10 = worst ever ) , sleep quality ( 0 = worst ever , 10 = best ever ) , and overall well-being ( 0 = worst ever , 10 = best ever ) . We assessed physical and mental functioning by using the Medical Outcomes Study 36-item Short-Form Health Survey ( 14 ) , which has high reliability and validity in many patient groups , including Previous studies of acupuncture in asthma have reported conflicting results , some cl aim ing benefit for some patients . We conducted a r and omized , double-blind ( patient and evaluator ) study in 23 non-smoking asthmatics ( 10 M ; 13 F ) aged 43 + /- 15 years with forced expiratory volume in 1 s ( FEV1 ) 59 + /- 16 % pred . After initial assessment ( respiratory function tests and Asthma Quality Life Question naire ) patients were r and omized to receive either ' real ' or ' sham ' acupuncture . The measurements were repeated within 1 h and after 2 weeks . Patients were recording peak expiratory flow rate ( PEFR ) throughout the period of the study . After 2 weeks patients who received ' real ' treatment on the first visit received ' sham ' treatment and vice versa . The measurements were again repeated within 1 h and after 2 weeks . There was no improvement in any aspects of respiratory function measured after either form of acupuncture . Despite this there was a significant improvement in AQLQ and parallel reduction in the usage of bronchodilators . We concluded that in some patients acupuncture could be useful in improving quality of life and reducing the need for using bronchodilators either by having a placebo effect or that the exact site of needle puncture on the chest is unimportant Fifty-six male patients who had chronic low-back pain of at least 12 weeks ' duration ( average duration , 28.6 weeks ) and who had failed to respond to traditional medical or surgical therapy were entered into a r and omized clinical trial to compare the relative efficacies of the Clinic 's st and ard therapy regimen with and without dry needling at muscle motor points . Before entering the trial , all patients had undergone without improvement eight weeks of the Clinic 's st and ard therapy regimen of physiotherapy , remedial exercises , and occupational therapy . The 29 study subjects and 27 control patients then continued with this regimen , but the study subjects also received needling at muscle motor points once or twice a week ( average number of treatments , 7.9 ) . All patients were assessed at the time of discharge , 12 weeks after discharge , and at the time of writing ( average , 27.3 weeks ) . The group that had been treated with needling was found to be clearly and significantly better than the control group ( P > 0.005 , N = 53 ) with regard to status at discharge , status at 12 weeks ' follow-up , and status at final follow-up . At final followup , 18 of the 29 study subjects had returned to their original or equivalent jobs and 10 had returned to lighter employment . In the control group , only four had returned to their original work and 14 to lighter employment ; nine were still disabled . The results seem to justify the procedure in chronic low-back patients in whom myofascial pain ( the majority ) rather than skeletal irritation is the dominant disabling feature Objective : To compare acupuncture treatment for overactive bladder with urge incontinence with a placebo acupuncture treatment . Methods : Eighty-five women enrolled in this r and omized , placebo-controlled trial . Women were r and omly assigned to either receive an acupuncture treatment expected to improve their bladder symptoms , or a placebo acupuncture treatment design ed to promote relaxation . They underwent cystometric testing , completed a 3-day voiding diary , and completed the urinary distress inventory and incontinence impact question naire , vali date d quality -of-life inventories , before and after 4 weekly acupuncture treatments . The primary endpoint was number of incontinent episodes over 3 days . Secondary endpoints included voiding frequency and urgency , cystometric bladder capacity , maximum voided volume , and the urinary distress inventory and incontinence impact question naire symptom scores . Results : Seventy-four women completed all aspects of the study . Women in both treatment and placebo groups had significant decreases in number of incontinent episodes ( 59 % for treatment , 40 % for placebo ) without a significant difference in the change between the groups . Women in the treatment group had a 14 % reduction in urinary frequency ( P = .013 ) , a 30 % reduction in the proportion of voids associated with urgency ( P = .016 ) , and a 13 % increase in both maximum voided volume and maximum cystometric capacity ( P = .01 ) . Both groups also had an improvement in the urinary distress inventory and incontinence impact question naire scores ( 54 % decrease for treatment , 30 % decrease for placebo , P < .001 for the difference in change between the groups ) . Conclusion : Women who received 4 weekly bladder-specific acupuncture treatments had significant improvements in bladder capacity , urgency , frequency , and quality -of-life scores as compared with women who received placebo acupuncture treatments . Level of Evidence : BACKGROUND Despite the popularity of acupuncture , evidence of its efficacy for reducing pain remains equivocal . OBJECTIVE To assess the efficacy and safety of traditional Chinese acupuncture ( TCA ) compared with sham acupuncture ( needling at defined nonacupuncture points ) and conservative therapy in patients with chronic pain due to osteoarthritis of the knee . DESIGN R and omized , controlled trial . SETTING 315 primary care practice s staffed by 320 practitioners with at least 2 years ' experience in acupuncture . PATIENTS 1007 patients who had had chronic pain for at least 6 months due to osteoarthritis of the knee ( American College of Rheumatology [ ACR ] criteria and Kellgren-Lawrence score of 2 or 3 ) . INTERVENTIONS Up to 6 physiotherapy sessions and as-needed anti-inflammatory drugs plus 10 sessions of TCA , 10 sessions of sham acupuncture , or 10 physician visits within 6 weeks . Patients could request up to 5 additional sessions or visits if the initial treatment was viewed as being partially successful . MEASUREMENTS Success rate , as defined by at least 36 % improvement in Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) score at 26 weeks . Additional end points were WOMAC score and global patient assessment . RESULTS Success rates were 53.1 % for TCA , 51.0 % for sham acupuncture , and 29.1 % for conservative therapy . Acupuncture groups had higher success rates than conservative therapy groups ( relative risk for TCA compared with conservative therapy , 1.75 [ 95 % CI , 1.43 to 2.13 ] ; relative risk for sham acupuncture compared with conservative therapy , 1.73 [ CI , 1.42 to 2.11 ] ) . There was no difference between TCA and sham acupuncture ( relative risk , 1.01 [ CI , 0.87 to 1.17 ] ) . LIMITATIONS There was no blinding between acupuncture and traditional therapy and no monitoring of acupuncture compliance with study protocol . In general , practitioner-patient contacts were less intense in the conservative therapy group than in the TCA and sham acupuncture groups . CONCLUSIONS Compared with physiotherapy and as-needed anti-inflammatory drugs , addition of either TCA or sham acupuncture led to greater improvement in WOMAC score at 26 weeks . No statistically significant difference was observed between TCA and sham acupuncture , suggesting that the observed differences could be due to placebo effects , differences in intensity of provider contact , or a physiologic effect of needling regardless of whether it is done according to TCA principles OBJECTIVE To evaluate the clinical efficacy of acupuncture in the treatment of chronic lateral epicondylitis . METHODS In a r and omized , investigator- and patient-blinded , controlled clinical study , 23 patients were treated with real acupuncture and 22 patients received sham acupuncture .  Patients each received 10 treatments , with two treatments per week . The primary outcome variables were maximal strength , pain intensity ( verbal rating scale ) and disability scale ( Disabilities of the Arm , Shoulder and H and question naire ) . Patients were examined at baseline ( 1 week before the start of treatment ) and at follow-up 2 weeks and 2 months after the end of treatment . RESULTS There was no significant difference between the groups at baseline for any outcome parameter . Two weeks and 2 months after the end of treatment , there were significant reductions in pain intensity and improvements in the function of the arm and in maximal strength in both treatment groups . At the 2-week follow-up these differences were significantly greater for all outcome parameters in the group treated with real acupuncture . At 2 months the function of the arm was still better in this group than in the sham acupuncture group ; however , the differences in pain intensity and maximal strength between the groups were no longer significant . CONCLUSION In the treatment of chronic epicondylopathia lateralis humeri , acupuncture in which real acupuncture points were selected and stimulated was superior to non-specific acupuncture with respect to reduction in pain and improvement in the functioning of the arm . These changes are particularly marked at early follow-up OBJECTIVES The sham control is widely used in acupuncture research , and its adequacy may be assessed by exploring the ' credibility ' of the intervention . We aim ed to examine the credibility of the study intervention , to quantify the size of the placebo response and effect of time in reducing nausea in early pregnancy . DESIGN Five hundred and ninety-three women with nausea or vomiting in early pregnancy volunteered to participate in a r and omised controlled trial , conducted at the Women 's and Children 's Hospital , South Australia . OUTCOME MEASURES Women completed the Rhodes Index of Nausea and Vomiting and the Credibility Rating Scale . RESULTS The credibility of the acupuncture and sham acupuncture interventions were not different . The relative change in nausea at the end of the first week of the study was estimated to be 28 % attributed to a time effect and 7 % to the placebo response . At the end of the third week , there was a further small increase in time effect ( 32 % ) and the placebo response ( 17 % ) . CONCLUSION Sham acupuncture is a credible control and allows assessment of the size of the placebo response Background / Aim : Irritable bowel syndrome is one of the most common gastrointestinal disorders in Western society , affecting around 15 % of the population , especially young adults . The cause(s ) of irritable bowel syndrome and effective treatment(s ) have remained elusive . This study aim ed at exploring the therapeutic value of acupuncture by comparing the responses of irritable bowel syndrome sufferers to true acupuncture versus sham acupuncture in a controlled double-blind study . Methods : Twenty-five patients who fulfilled the Rome criteria ( irritable bowel syndrome symptoms persisting for more than 1 year ) comprised the final study population . They were recruited through a ‘ call for ’ bulletin sent to gastroenterologists practicing in the region of our medical center .  True acupuncture was performed at LI-4 ( colonic meridian , needle only ) and sham acupuncture at BL-60 ( urinary vesicle meridian , needle only ) . Patient assignment to one of the two groups was r and om . Results : The effect of the first true acupuncture on overall symptoms and abdominal pain was a clear and significant improvement ( p = 0.05 ) . No comparable effect was seen in the second session . Conclusions : Although the true acupuncture results were consistently better , no difference was found between the two groups in the overall statistical analysis . We could not show a therapeutic benefit of this treatment modality in irritable bowel syndrome
Background The results of many clinical trials and experimental studies regarding acupoint specificity are contradictory .
This review aims to investigate whether a difference in efficacy exists between ordinary acupuncture  on specific acupoints and sham acupuncture controls on non-acupoints or on irrelevant acupoints .