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Human / Clinical Studies

    continued...

    In a case series involving 183 cancer patients who were treated with acupuncture for cancer-related pain, 52% were significantly helped (P value not stated).[12] Multiple treatments at intervals of 1 to 4 weeks were nearly always necessary for significant and long-term pain control.

    In another case series, 29 patients with malignant tumors who developed pain received EA treatment.[13]. All experienced various degrees of pain relief, and 25 out of 29 were able to either reduce or eliminate their analgesic requirements following multiple EA treatments.

    A third case series produced similar results.[9] After auricular EA treatment, five patients with cancer pain reported improvements.

    Although most of these studies were positive and demonstrated the effectiveness of acupuncture in cancer pain control, the findings have limited significance because of methodologic weaknesses such as small sample sizes, an absence of patient blinding to treatment in most cases, varying acupuncture treatment regimens, a lack of standard outcome measurements, and an absence of adequate randomization. Further investigations into the effects of acupuncture on cancer pain using rigorous scientific methodology are warranted.

    Table 1. Clinical Studies of Acupuncture: Cancer-related Paina

    Reference Citation(s)Type of StudyCondition TreatedNo. of Patients: Enrolled; Treated; ControlbStrongest Benefit ReportedcConcurrent Therapy Used (Yes/No/ Unknown)dLevel of Evidence Scoree
    EA = electroacupuncture; No. = number; NUR = Nourishing yin and Unblocking meridians Recipe; RCT = randomized controlled trial; TCM = traditional Chinese medicine; VAS = Visual Analog Scale.
    a Refer to text and theNCI Dictionary of Cancer Termsfor additional information and definition of terms.
    b Number of patients treated plus number of patient controls may not equal number of patients enrolled; number of patients enrolled equals number of patients initially recruited/considered by the researchers who conducted a study; number of patients treated equals number of enrolled patients who were given the treatment being studied AND for whom results were reported.
    c Strongest evidence reported that the treatment under study has activity or otherwise improves the well-being of cancer patients.
    d Concurrent therapy for symptoms treated (not cancer).
    e For information about levels of evidence analysis and an explanation of the level of evidence scores, refer toLevels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.
    fP< .05, acupuncture treatment versus conventional analgesics.
    gP< .05, combination oftraditional Chinese medicine(acupuncture and Chinese herbs) and epidural morphine versus placebo.
    hP< .0001, acupuncture versus placebo.
    iP< .00001, day 60 after start of acupuncture treatment versus day 0.
     
    [10]RCTGastric cancer pain48; 16 acupuncture and 16 acupuncture point injection of freeze-dried human transfer factor; 16 conventional analgesicsIn long-term treatment, equal or better analgesia than conventional drugsfNo1iiC
    [15]RCTCancer pain41 patients treated with NUR combined with opioid analgesics. 43 patients in the control group treated with opioids alone. All the patients enrolled were differentiated as of yin deficiency and meridian blocked syndrome type of TCM.NUR combined with opioid analgesics in cancer pain management was more effective than opioid analgesics alonegYes (combined with opioid analgesics in managing cancer pain)1iiC
    [14]RCTCancer pain90; 28 auricular acupuncture; 51 acupuncture at placebo points in ear or auricular seeds fixed at placebo points with adhesivePain intensity decreased by 36% at 2 monthshYes (analgesics and co-analgesics, includingtricyclic antidepressantsandantiepileptics)1iiC
    [11]Nonconsecutive case seriesCancer pain20; 20 auricular acupuncture; noneAverage pain intensity decreased by 43%, using VAS (0–100 mm)iYes (analgesics)3iiiC
    [12]Nonconsecutive case seriesCancer-related pain183; 183 acupuncture; none95 (52%) "significantly helped"Yes (analgesics)3iC
    [13]Nonconsecutive case seriesCancer pain29; 29 EA; nonePain reduced; injection of analgesics reduced or no longer requiredYes (analgesics)3iC
    [9]Best case seriesCancer pain5; 5 auricular EA; noneSymptoms improvedUnknown4
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