Acupuncture is rapidly becoming part of mainstream medicine in the West and in the United States. A national survey shows that more Americans are using the modality now than they were a decade ago. Federal research funding has increased, and an extensive body of acupuncture research has been published, much of it with important clinical implications. Recent clinical trial and systematic review results clearly show acupuncture to be more beneficial than conventional standard care for many pain conditions, and basic scientific research has advanced our knowledge of acupuncture's mechanisms of action in a number of pathological conditions. While the current research is not without its problems and difficulties, the acupuncture research community has matured and is facing its challenges by developing better research methodologies, applying new technologies, and engaging in more creative and innovative translational research. This review discusses developments in the field.
BarnesPM, Powell-GrinerE, McFannK, NahinRL. Complementary and alternative medicine use among adults: United States, 2002. Adv Data., 2004; 343:1–19.
3.
BarnesPM, BloomB, NahinRL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report., 2008; 12:1–23.
4.
NahinRL, BarnesPM, StussmanBJ, BloomB. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report., 2009; 18:1–14.
5.
BermanBM, LaoL, LangenbergP, LeeWL, GilpinAM, HochbergMC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med., 2004; 141,12:901–910.
6.
LaoL, HuangY, FengC, BermanBM, TanM. Evaluating Traditional Chinese Medicine using modern clinical trial design and statistical methodology: application to a randomized controlled acupuncture trial. Stat Med., 2011February23e-pub ahead of print.
7.
CherkinDC, ShermanKJ, AvinsAL, ErroJHet al.A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med., 2009; 169,9:858–866.
8.
BrinkhausB, WittCM, JenaS, LindeKet al.Interventions and physician characteristics in a randomized multicenter trial of acupuncture in patients with low-back pain. J Altern Complement Med., 2006; 12,7:649–657.
9.
WittC, BrinkhausB, JenaS, LindeK, StrengA, WagenpfeilS, HummelsbergerJ, WaltherHU, MelchartD, WillichSN. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet., 2005; 366,9480:136–143.
10.
LindeK, StrengA, JurgensS, HoppeAet al.Acupuncture for patients with migraine: a randomized controlled trial. JAMA., 2005; 293,17:2118–2125.
11.
MelchartD, StrengA, HoppeA, BrinkhausBet al.The acupuncture randomised trial (ART) for tension-type headache—details of the treatment. Acupunct Med., 2005; 23,4:157–165.
12.
DienerHC, KronfeldK, BoewingG, LungenhausenM, MaierC, MolsbergerA, TegenthoffM, TrampischHJ, ZenzM, MeinertR. GERAC Migraine Study Group. Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial. Lancet Neurol., 2006; 5:310–316.
13.
ScharfHP, MansmannU, StreitbergerK, WitteS, KrämerJ, MaierC, TrampischHJ, VictorN. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med., 2006; 145:12–20.
14.
MengX, XuS, LaoL. Clinical acupuncture research in the West. Front Med., 2011; 5:134–140.
15.
MolsbergerAF, SchneiderT, GotthardtH, DrabikA. German Randomized Acupuncture Trial for chronic shoulder pain (GRASP)—a pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Pain., 2010; 151,1:146–154.
MadsenMV, GøtzschePC, HróbjartssonA. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ, 2009; 338:a3115.
18.
EzzoJ, BermanB, HadhazyVA, JadadAR, LaoL, SinghBB. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain., 2000; 86,3:217–225.
SmithLA, OldmanAD, McQuayHJ, MooreRA. Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain. Pain., 2000; 86,1–2:119–132.
21.
RubinsteinSM, van MiddelkoopM, KuijpersT, OsteloRet al.A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain. Eur Spine J., 2010; 19,8:1213–1228.
22.
ManheimerE, WhiteA, BermanB, ForysK, ErnstE. Meta-analysis: acupuncture for low back pain. Ann Intern Med., 2005; 142,8:651–663.
23.
FurlanAD, van TulderM, CherkinD, TsukayamaH, LaoL, KoesB, BermanB. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the Cochrane Collaboration. Spine (Phila Pa 1976)., 2005; 30,8:944–963.
ManheimerE, LindeK, LaoL, BouterLM, BermanBM. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med., 2007; 146,12:868–877.
26.
WhiteA, FosterNE, CummingsM, BarlasP. Acupuncture treatment for chronic knee pain: a systematic review. Rheumatology (Oxford)., 2007; 46,3:384–390.
27.
KwonYD, PittlerMH, ErnstE. Acupuncture for peripheral joint osteoarthritis: a systematic review and meta-analysis. Rheumatology (Oxford)., 2006; 45,11:1331–1337.
28.
CaoH, LiuJ, LewithGT. Traditional Chinese Medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials. J Altern Complement Med., 2010; 16,4:397–409.
29.
LanghorstJ, KloseP, MusialF, IrnichD, HäuserW. Efficacy of acupuncture in fibromyalgia syndrome—a systematic review with a meta-analysis of controlled clinical trials. Rheumatology (Oxford)., 2010; 49,4:778–788.
TrinhKV, PhillipsSD, HoE, DamsmaK. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology (Oxford)., 2004; 43,9:1085–1090.
33.
ErnstE, PittlerMH. The effectiveness of acupuncture in treating acute dental pain: a systematic review. Br Dent J., 1998; 184,9:443–447.
ChoSH, LeeH, ErnstE. Acupuncture for pain relief in labour: a systematic review and meta-analysis. BJOG., 2010; 117,8:907–920.
37.
YuXM, ZhuGM, ChenYL, FangM, ChenYN. Systematic assessment of acupuncture for treatment of herpes zoster in domestic clinical studies [in Chinese]Zhongguo Zhen Jiu., 2007; 27,7:536–540.
38.
La ToucheR, GoddardG, De-la-HozJL, WangKet al.Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain., 2010; 26,6:541–550.
39.
ManberR, SchnyerRN, LyellD, ChambersASet al.Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol., 2010; 115,3:511–520.
40.
LeeA, FanLT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev., 2009; 2:CD003281.
41.
EzzoJM, RichardsonMA, VickersA, AllenCet al.Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev., 2006; 2:CD002285.
42.
HelmreichRJ, ShiaoSY, DuneLS. Meta-analysis of acustimulation effects on nausea and vomiting in pregnant women. Explore (NY)., 2006; 2,5:412–421.
43.
ShiaoSY, DibbleSL. Metaanalyses of acustimulation effects on nausea and vomiting across different patient populations: a brief overview of existing evidence. Explore (NY)., 2006; 2,3:200–201.
44.
DuneLS, ShiaoSY. Metaanalysis of acustimulation effects on postoperative nausea and vomiting in children. Explore (NY)., 2006; 2,4:314–320.
45.
LimB, ManheimerE, LaoL, ZieaE, WisniewskiJ, LiuJ, BermanB. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev., 2006; 4:CD005111.
MartinJ, DonaldsonAN, VillarroelR, ParmarMK, ErnstE, HigginsonIJ. Efficacy of acupuncture in asthma: systematic review and meta-analysis of published data from 11 randomised controlled trials. Eur Respir J, 2002; 4:20,846–852.
48.
KleijnenJ, ter RietG, KnipschildP. Acupuncture and asthma: a review of controlled trials. Thorax., 1991; 46,11:799–802.
SzeFK, WongE, OrKK, LauJ, WooJ. Does acupuncture improve motor recovery after stroke? A meta-analysis of randomized controlled trials. Stroke., 2002; 33,11:2604–2619.
WhiteA, MoodyR. The effects of auricular acupuncture on smoking cessation may not depend on the point chosen—an exploratory meta-analysis. Acupunct Med., 2006; 24,4:149–156.
Ter RietG, KleijnenJ, KnipschildP. A meta-analysis of studies into the effect of acupuncture on addiction. Br J Gen Pract., 1990; 40,338:379–382.
59.
BowerWF, DiaoM, TangJL, YeungCK. Acupuncture for nocturnal enuresis in children: a systematic review and exploration of rationale. Neurourol Urodyn., 2005; 24,3:267–272.
60.
CaoH, PanX, LiH, LiuJ. Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. J Altern Complement Med., 2009; 15,11:1171–1186.
61.
HuangW, KutnerN, BliwiseDL. A systematic review of the effects of acupuncture in treating insomnia. Sleep Med Rev., 2009; 13,1:73–104.
62.
ManheimerE, ZhangG, UdoffL, HaramatiA, LangenbergP, BermanBM, BouterLM. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ., 2008; 336,7643:545–549.
63.
El-ToukhyT, SunkaraSK, KhairyM, DyerR, KhalafY, CoomarasamyA. A systematic review and meta-analysis of acupuncture in in vitro fertilisation. BJOG., 2008; 115,10:1203–1213.
HanJS. Acupuncture analgesia: areas of consensus and controversy. Pain., 2011; 1523,suppl:S41–S48.
66.
CarlssonC. Acupuncture mechanisms for clinically relevant long-term effects—reconsideration and a hypothesis. Acupunct Med., 2002; 20,2–3:82–99.
67.
ZhangRX, LaoL, WangL, LiuB, WangX, RenK, BermanBM. Involvement of opioid receptors in electroacupuncture-produced anti-hyperalgesia in rats with peripheral inflammation. Brain Res., 2004; 1020:12–17.
68.
LaoL, ZhangRX, ZhangG, WangX, BermanBM, RenK. A parametric study of electroacupuncture on persistent hyperalgesia and Fos protein expression in rats. Brain Res., 2004; 1020:18–29.
69.
ZhangR-X, LaoL, WangX, FanAet al.Electroacupuncture attenuates inflammation in a rat model. J Altern Complement Med., 2005; 11,1:135–142.
70.
LiA, ZhangR-X, WangY, ZhangHet al.Corticosterone mediates electroacupuncture-produced anti-edema in a rat model of inflammation. BMC Complement Altern Med., 2007; 7:27.
71.
LiA, LaoL, WangY, XinJet al.Electroacupuncture activates corticotrophin-releasing hormone-containing neurons in the paraventricular nucleus of the hypothalammus to alleviate edema in a rat model of inflammation. BMC Complement Altern Med, 2008; 8:20.
72.
LiA, WangY, XinJ, LaoL, RenK, BermanBM, ZhangRX. Electroacupuncture suppresses hyperalgesia and spinal Fos expression by activating the descending inhibitory system. Brain Res., 2007; 1186:171–179.
73.
GoldmanN, ChenM, FujitaT, XuQet al.Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci., 2010; 13,7:883–888.
74.
DhondRP, KettnerN, NapadowV. Neuroimaging acupuncture effects in the human brain. J Altern Complement Med., 2007; 13,6:603–616.
75.
NapadowV, LiuJ, LiM, KettnerNet al.Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture. Hum Brain Mapp., 2007; 28,3:159–171.
76.
AsgharAU, GreenG, LythgoeMF, LewithG, MacPhersonH. Acupuncture needling sensation: the neural correlates of deqi using fMRI. Brain Res., 2010; 1315:111–118.
77.
LangevinHM, ChurchillDL, CipollaMJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J., 2001; 15,12:2275–2282.
78.
LangevinHM, HammerschlagR, LaoL, NapadowV, SchnyerRN, ShermanKJ. Controversies in acupuncture research: selection of controls and outcome measures in acupuncture clinical trials. J Altern Complement Med., 2006; 12,10:943–953.
79.
BingZ, VillanuevaL, Le BarsD. Acupuncture and diffuse noxious inhibitory controls: naloxone-reversible depression of activities of trigeminal convergent neurons. Neuroscience., 1990; 37,3:809–818.
80.
LangevinHM, WaynePM, MacphersonH, SchnyerRet al.Paradoxes in acupuncture research: strategies for moving forward. Evid Based Complement Alternat Med., 2011; 2011:180805.
