Positive Health Online

Abstract

MEDICI and co-workers, Department of Internal Medicine, University Hospital Zurich, Switzerland, media@bluewin.ch, have conducted a long-term randomized study of real versus sham acupuncture in patients with bronchial asthma.

Background

Acupuncture is traditionally used in China for the treatment of asthma. There is still a dearth of high quality studies showing its effectiveness or otherwise.

Methodology

In this randomized partially blinded study, 66 patients with mild to moderate chronic asthma were divided into three groups: real acupuncture (23 patients), sham acupuncture (23 patients), and no treatment (20 patients). After 2 weeks of run-in, two acupuncture periods of 4 weeks each were followed by a 6 months observation period. The primary outcome measure was peak expiratory flow (PEF). Secondary outcomes were forced expiratory volume in one second (FEV1), airway responsiveness, symptoms of asthma, use of drugs, and wellbeing of patients. In addition the effect of the treatment on eosinophils and eosinophil cationic protein in blood and sputum was assessed.

Results

PEF variability decreased in all groups. In a subgroup of patients, PEF variability decreased significantly compared to controls with both real and sham needling. Most of the other variables did not differ from those obtained in controls. Eosinophils decreased in all groups, and there was possibly a small effect of real compared to sham acupuncture on eosinophilic inflammation at 10 months.

Conclusion

Any effects seen in this study were small and possibly clinically not relevant. These data do not support the use of acupuncture for the treatment of chronic asthma.

References

Medici TC, Grebski E, Wu J, Hinz G, Wuethrich B. Acupuncture and bronchial asthma: a long-term randomized study of the effects of real versus sham acupuncture compared to controls in patients with bronchial asthma. The Journal of Alternative and Complementary Medicine 8 (6): 737-750, Dec 2002.

Comment

As with most research, the devil is in the detail. In this instance, there were decreases in peak expiratory flow (PEF) variability in all groups, including a significant PEF decrease in a subgroup of patients in both the real and sham acupuncture groups compared with the controls. Hence, there was a therapeutic effect from acupuncture in some patients. Due to relatively small numbers and probably diverse clinical parameters of patients, definitive interpretation is difficult, and hence further research is needed before pronouncing that acupuncture is not useful in the treatment of chronic asthma.