Randomized Clinical Trials of Constitutional Acupuncture: A Systematic Review
1Korea Institute of Oriental Medicine, Daejeon and 2Department of Oriental Rehabilitation Medicine, School of Oriental Medicine, Pusan National University, Busan, Korea
The aim of this systematic review is to compile and critically evaluate the evidence from randomized clinical trials (RCTs) for the effectiveness of acupuncture using constitutional medicine compared to standard acupuncture. Ten databases were searched through to December 2008 without language restrictions. We also hand-searched nine Korean journals of oriental medicine. We included prospective RCTs of any form of acupuncture with or without electrical stimulation. The included trials had to investigate constitutional medicine. There were no restrictions on population characteristics. Forty-one relevant studies were identified, and three RCTs were included. The methodological quality of the trials was variable. One RCT found Sasang constitutional acupuncture to be superior to standard acupuncture in terms of the Unified PD Rating Scale and freezing gate in Parkinson's disease (PD). Another two RCTs reported favorable effects of eight constitutional acupuncture on pain reduction in patients with herniated nucleus pulposi and knee osteoarthritis. Meta-analysis demonstrated positive results for eight constitutional acupuncture compared to standard acupuncture on pain reduction (weighted mean difference: 10 cm VAS, 1.69, 95% CI 0.85–2.54, P < 0.0001; heterogeneity:
2 = 0.00,
2 = 0.00, P = 0.96, I2 = 0%). Our results provide suggestive evidence for the effectiveness of constitutional acupuncture in treating pain conditions compared to standard acupuncture. However, the total number of RCTs and the total sample size included in our analysis were too small to draw definite conclusions. Future RCTs should assess larger patient samples with longer treatment periods and appropriate controls.
Keywords: acupuncture – clinical trial – constitutional medicine – systematic review
For reprints and all correspondence: Myeong Soo Lee, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea. Tel: +82-42-868-9266; Fax: +82-42-863-9464; E-mail: drmslee{at}gmail.com; mslee{at}kiom.re.kr
Received March 12, 2009; accepted June 18, 2009