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Acupuncture (PDQ®)

  • Posted: 09/23/2005
  • Updated: 08/18/2014

Table 3. Clinical Studies of Acupuncture: Nausea and Vomitinga

Reference Citation(s) Type of Study Condition Treated No. of Patients: Enrolled; Treated; Controlb Strongest Benefit Reportedc Concurrent Therapyd Level of Evidence Scoree 
[26]RCTN/V related to high-dose chemotherapy for breast cancer104; 37; 67 (sham EA or no EA)Less N/V in EA groupfYes (prochlorperazine, lorazepam, and diphenhydramine)1iiC
[24,30,31]RCTN/V from chemotherapy10; 10 EA; 10 sham EA (crossover study)Significantly less N/V than controlgYes (metoclopramide)1iiC
[27]RCTN/V from chemotherapy100 (these patients were used more than once because of nature of crossover study); 27 surface electrodes; 11 rubber electrodes; 14 crossover study; 24 transcutaneous electrical stimulation75% achieved considerable benefithYes (metoclopramide, thiethylperazine, prochlorperazine, cyclizine, lorazepam, and steroid)1iiC
[34]RCTN/V from chemotherapy16 (the same 16 patients treated twice in a crossover study); 16 ondansetron plus transcutaneous electrical stimulation; 16 cross-over treatment ondansetron onlySymptom-free patient days: 58.8%iYes (ondansetron)1iiC
[32]RCTN/V from chemotherapy53 enrolled; 38 completed; 38 acupressure; 38 crossover to acupressure at a sham point55% reduction in N/VjYes (antiemetics)1iiC
[36]RCTN/V from high-dose chemotherapy80; 41 acupuncture; 39 noninvasive placebo acupunctureNonekYes (ondansetron)1iiC
[35]RCTN/V from chemotherapy739; 233 bilateral acupressure bands and 234 transcutaneous electrical stimulation bands; 233 no bands; 39 not evaluableLess N/V in treatment groups than in controllYes (5-HT3 receptor antagonist, prochlorperazine, and/or others)1iiC
[37]RCTN/V from chemotherapy142; 48 acupuncture + vitamin B6 PC6 point injection; 46 vitamin B6; 48 acupunctureFewer emesis episodesYes (diazepam, diphenhydramine, cimetidine, and granisetron)1iiC
[41]RCTN/V from chemotherapy36; 17 acupressure; 19 controlSignificantly lower N/VYes (antiemetics)1iiC
[40]RCTN/V from radiation277; 215; 62Less nauseaYes (antiemetics)1iiC
[38]RCTN/V from moderate to highly emetogenic chemotherapy160; 96; 54Decreased delayed N/V for acupressureYes (anthracycline, cyclophosphamide, and an antiemetic)1iiC
[25]Nonrandomized controlled trialN/V from chemotherapy105; EA at P663%, complete relief, at least 8 hYes (metoclopramide; prednisolone)2C
[25]CTN/V from chemotherapy43; 38 10 Hz EA; 5 sham (crossover subset)8–10 h relief; 32 patients had complete reliefYes (antiemetics)2C
[33]CTN/V from chemotherapy18; 18 acupressure bands; 18 (crossover study—incorrect placement of acupressure bands)Effective for N/VYes (antiemetics: prochlorperazine, metoclopramide, and domperidone suppository)2C
[29]Nonconsecutive case seriesN/V from chemotherapy26; 26 acupuncture; 51 historical controls—no acupunctureMean no. of episodes and duration of N/V reducedYes (metoclopramide, dexamethasone, and diphenhydramine)3iiiC
[24]Nonconsecutive case series (pilot study)N/V from chemotherapy15; 15 EA; none12 patients—no symptoms for 8 hYes (antiemetic: metoclopramide)3iiiC
[28,30]Consecutive case studyN/V from chemotherapy40; 40 acupressure8–24 h reliefYes (not specified)3iiC
[42]Consecutive, uncontrolled case seriesN/V from chemotherapy mean no. of emesis 7–327; no controls10 patients had complete response to EA and had no vomitingYes (antiemetics: either ondansetron 8 mg or granisetron 3 mg)3iiiC

CT = controlled trial; EA = electroacupuncture; No. = number; N/V = nausea and vomiting; RCT = randomized controlled trial.
aRefer to text and the NCI Dictionary of Cancer Terms for additional information and definition of terms.
bNumber of patients treated plus number of patient controls may not equal number of patients enrolled; number of patients enrolled equals number of patients initially considered by the researcher 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; historical control subjects are not included in number of patients enrolled.
cStrongest evidence reported that the treatment under study has activity or improves the well-being of cancer patients.
dConcurrent therapy for symptoms treated (not cancer).
eFor information about levels of evidence analysis and an explanation of the level of evidence scores, refer to Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.
f P < .001, low-frequency EA at classical antiemetic acupuncture points daily versus minimal needling at control points with sham EA versus no adjunct needling.
g P < .001, EA versus sham EA.
h P < .001, surface electrodes versus rubber electrodes.
i P < .00059.
j P < .02, acupressure versus acupressure at a sham point.
k P < .05, acupuncture versus noninvasive placebo acupuncture.
l P < .05, acupressure and acustimulation wrist bands versus no treatment.

References

  1. Dundee JW, Ghaly RG, Fitzpatrick KT, et al.: Acupuncture prophylaxis of cancer chemotherapy-induced sickness. J R Soc Med 82 (5): 268-71, 1989.  [PUBMED Abstract]

  2. Dundee JW, Ghaly RG, Fitzpatrick KT, et al.: Optimising antiemesis in cancer chemotherapy. Br Med J (Clin Res Ed) 294 (6565): 179, 1987.  [PUBMED Abstract]

  3. Shen J, Wenger N, Glaspy J, et al.: Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. JAMA 284 (21): 2755-61, 2000.  [PUBMED Abstract]

  4. Dundee JW, Yang J, McMillan C: Non-invasive stimulation of the P6 (Neiguan) antiemetic acupuncture point in cancer chemotherapy. J R Soc Med 84 (4): 210-2, 1991.  [PUBMED Abstract]

  5. Dundee JW, Yang J: Prolongation of the antiemetic action of P6 acupuncture by acupressure in patients having cancer chemotherapy. J R Soc Med 83 (6): 360-2, 1990.  [PUBMED Abstract]

  6. Aglietti L, Roila F, Tonato M, et al.: A pilot study of metoclopramide, dexamethasone, diphenhydramine and acupuncture in women treated with cisplatin. Cancer Chemother Pharmacol 26 (3): 239-40, 1990.  [PUBMED Abstract]

  7. Dundee JW, McMillan CM: Clinical uses of P6 acupuncture antiemesis. Acupunct Electrother Res 15 (3-4): 211-5, 1990.  [PUBMED Abstract]

  8. Dundee JW, Ghaly RG, Fitzpatrick KT, et al.: Acupuncture to prevent cisplatin-associated vomiting. Lancet 1 (8541): 1083, 1987.  [PUBMED Abstract]

  9. Price H, Lewith G, Williams C: Acupressure as an antiemetic in cancer chemotherapy. Complementary Medical Research 5 (2): 93-4, 1991. 

  10. Stannard D: Pressure prevents nausea. Nurs Times 85 (4): 33-4, 1989 Jan 25-31.  [PUBMED Abstract]

  11. McMillan C, Dundee JW, Abram WP: Enhancement of the antiemetic action of ondansetron by transcutaneous electrical stimulation of the P6 antiemetic point, in patients having highly emetic cytotoxic drugs. Br J Cancer 64 (5): 971-2, 1991.  [PUBMED Abstract]

  12. Roscoe JA, Morrow GR, Hickok JT, et al.: The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. J Pain Symptom Manage 26 (2): 731-42, 2003.  [PUBMED Abstract]

  13. Streitberger K, Friedrich-Rust M, Bardenheuer H, et al.: Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res 9 (7): 2538-44, 2003.  [PUBMED Abstract]

  14. You Q, Yu H, Wu D, et al.: Vitamin B6 points PC6 injection during acupuncture can relieve nausea and vomiting in patients with ovarian cancer. Int J Gynecol Cancer 19 (4): 567-71, 2009.  [PUBMED Abstract]

  15. Dibble SL, Luce J, Cooper BA, et al.: Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial. Oncol Nurs Forum 34 (4): 813-20, 2007.  [PUBMED Abstract]

  16. Enblom A, Lekander M, Hammar M, et al.: Getting the grip on nonspecific treatment effects: emesis in patients randomized to acupuncture or sham compared to patients receiving standard care. PLoS One 6 (3): e14766, 2011.  [PUBMED Abstract]

  17. Molassiotis A, Helin AM, Dabbour R, et al.: The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Ther Med 15 (1): 3-12, 2007.  [PUBMED Abstract]

  18. Choo SP, Kong KH, Lim WT, et al.: Electroacupuncture for refractory acute emesis caused by chemotherapy. J Altern Complement Med 12 (10): 963-9, 2006.  [PUBMED Abstract]