Acupuncture (PDQ®): Complementary and alternative medicine - Health Professional Information [NCI]-General Information

Acupuncture (PDQ®): Complementary and alternative medicine - Health Professional Information [NCI] - General Information

Acupuncture (PDQ®): Complementary and alternative medicine - Health Professional Information [NCI] Guide

• Overview
• General Information
• History
• Laboratory / Animal / Preclinical Studies
• Human / Clinical Studies
• Adverse Effects
• Summary of the Evidence for Acupuncture Treatment of Cancer-related Symptoms
• Changes to This Summary (10 / 07 / 2014)
• About This PDQ Summary

These actions by the FDA and NIH have resulted in the establishment of a number of active programs of research into the mechanisms and efficacy of acupuncture, much of which is, or is potentially, relevant to cancer management. To date, the most extensively investigated aspect of these mechanisms has been the effect of acupuncture on pain management. The NIH Consensus Panel concluded that "acupuncture can cause multiple biological responses," local and distal, "mediated mainly by sensory neurons...within the central nervous system." Acupuncture "may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects," including "alterations in peptides, hormones and neurotransmitters and the regulation of blood flow."[19] Recent studies show the effect of acupuncture on chronic inflammatory pain.[21,22] Evidence suggests that acupuncture operates through the autonomic nervous system to balance the sympathetic and parasympathetic systems and suggests that the anti-inflammatory effects of acupuncture are mediated by its electrophysiologic effects on neurotransmitters, cytokines, and neuropeptides.[1,22,23,24,25,26,27,28,29,30,31] Many studies provide evidence that opioid peptides are released during acupuncture and that acupuncture analgesia is mediated by the endogenous opioid system.[32,33]

Laboratory and animal cancer studies exploring the mechanisms of acupuncture have focused mainly on the activation and modulation of the immune system. Acupuncture treatment points are located by using standard anatomic landmarks and comparative anatomy. EA is the most commonly used treatment intervention; a few studies have used moxibustion.[34] These studies show that acupuncture may boost animal immune function by enhancing NK cell and lymphocyte activity.[34,35,36] According to one animal study, acupuncture may be a useful adjuvant for suppressing chemotherapy-induced emesis.[37]

Although several studies published in China examined the effect of acupuncture on the human immune system,[8,29,32,38,39,40,41] most cancer-related human clinical studies of acupuncture evaluated its effect on patient quality of life. These investigations mainly focused on cancer symptoms or cancer treatment-related symptoms, predominantly cancer pain [10,23,42,43,44,45,46] and chemotherapy-induced N/V.[25,27,47,48,49,50,51,52,53,54,55] Studies have also been done on the effect of acupuncture on radiation -induced xerostomia (dry mouth), proctitis, dysphonia, weight loss, cough, thoracodynia, hemoptysis, fever, esophageal obstruction, poor appetite, night sweats, hot flashes in women and men,[56] dizziness, fatigue, anxiety, and depression in cancer patients.[8,9,10,57,58,59,60] The evidence from most of these clinical studies is inconclusive, despite their positive results; either poor research design or incompletely described methodologic procedures limit their value. There is controversy about the most appropriate control for acupuncture, which also limits the interpretability of the results of clinical trials.[61] The positive results of the studies on chemotherapy-induced N/V, which benefit from scientifically sound research designs, are the most convincing.

References:

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