Evidence on acupuncture therapies is underused in clinical practice and health policy
Nenggui Xu and colleagues call for more effective evidence dissemination of and research into promising acupuncture therapies
13 Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
Many doctors and patients worldwide now use acupuncture, a technique of traditional Chinese medicine that originated 2000 years ago.1 While traditional Chinese medicin e theory attributes the effect of acupuncture to the stimulation at specific body regions (acupoints) on the meridian channels (that is, paths through which the vital energy known as “qi” flows) to modulate body physiology, modern science has increasingly provided evidence on the biology of the effect of acupuncture.2 This evidence shows that acupuncture works to stimulate reflexes that activate peripheral nerves, transmit sensory information from the spinal cord to the brain, then activate peripheral autonomic pathways, and eventually modulate physiology.345
Along with research into the underlying biology and increasingly wide clinical use of acupuncture, clinical research on acupuncture has also grown.6 Since 1975, more than 10 000 randomised controlled trials on acupuncture have been published.78 Given the rapid increase in the literature on acupuncture, evidence based practice and policy making require systematic reviews of the available randomised controlled trials.
In this analysis, we assess the number and quality of systematic reviews of acupuncture, explore the possible underuse of proven beneficial acupuncture therapies in clinical practice and health policy, identify the promising and under-researched areas, and propose strategies to implement effective acupuncture treatments and establish funding opportunities and research agendas for acupuncture therapies.
We identified 2471 systematic reviews of acupuncture therapies in the Web of Science between 2000 and 2020, with the number of systematic reviews increasing annually (fig 1). Published systematic reviews of randomised trials (1578, 63.9%) and observational studies (893, 36.1%) mainly focused on the following therapeutic areas: musculoskeletal and connective tissue diseases (865, 35.0%), …