Efficacy of acupuncture in children with asthma: a systematic review

Chi Feng Liu, Li Wei Chien, Chi Feng Liu, Li Wei Chien

Abstract

Background: We performed a systematic review of the efficacy of various types of acupuncture in the treatment of asthma in children.

Methods: We searched the MEDLINE, Embase, and Cochrane Library databases up to October 20, 2014. Randomized controlled trials (RCTs) of children and adolescents (<18 years of age) with asthma were included. Data extraction was applied, and methodologic quality was assessed.

Results: A total of 32 articles were assessed for eligibility, and seven studies comprising 410 patients were included in the systematic review. Two RCTs showed significant improvement in peak expiratory flow (PEF) variability for acupuncture (traditional and laser) vs. control, with one showing significant improvement in asthma-specific anxiety level, but no significant differences in other lung function parameters or quality of life. Another RCT reported significant benefits of laser acupuncture on lung function parameters but did not describe or report statistical analyses. One crossover RCT showed significant improvements in response to both acupuncture and placebo acupuncture, with better improvements with acupuncture compared to placebo acupuncture (forced exhaled volume in 1 s [FEV1], PEF). Two additional crossover RCTs showed no significant differences between single sessions of laser acupuncture and placebo acupuncture on baseline, postacupuncture, and postinduced bronchoconstriction values (% predicted FEV1, maximum expiratory flow). A recent study showed a significant effect of acupuncture paired with acupressure on medication use and symptoms in preschool-age children. Methodologic and reporting variability remains an issue. However, the results suggest that acupuncture may have a beneficial effect on PEF or PEF variability in children with asthma.

Conclusions: The efficacy of acupuncture on other outcome measures is unclear. Large-scale RCTs are needed to further assess the efficacy of acupuncture in the treatment of asthma in children.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection

References

    1. Kudo M, Ishigatsubo Y, Aoki I. Pathology of asthma. Front Microbiol. 2013;4:263. doi: 10.3389/fmicb.2013.00263.
    1. Bousquet J, Clark TJ, Hurd S, Khaltaev N, Lenfant C, O’byrne P, et al. GINA guidelines on asthma and beyond. Allergy. 2007;62:102–12.
    1. Lai CK, Beasley R, Crane J, Foliaki S, Shah J, Weiland S. International Study of Asthma and Allergies in Childhood Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) Thorax. 2009;64:476–83. doi: 10.1136/thx.2008.106609.
    1. Ding G, Ji R, Bao Y. Risk and protective factors for the development of childhood asthma. Paediatr Respir Rev. 2014;pii:S1526–0542(14)00082-7.
    1. Hakimeh D, Tripodi S. Recent advances on diagnosis and management of childhood asthma and food allergies. Ital J Pediatr. 2013;39:80. doi: 10.1186/1824-7288-39-80.
    1. Cates CJ, Jaeschke R, Schmidt S, Ferrer M. Regular treatment with formoterol and inhaled steroids for chronic asthma: serious adverse events. Cochrane Database Syst Rev. 2013;6
    1. Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: effects on growth. Cochrane Database Syst Rev. 2014;7
    1. Pfab F, Schalock PC, Napadow V, Athanasiadis GI, Huss-Marp J, Ring J. Acupuncture for allergic disease therapy–the current state of evidence. Expert Rev Clin Immunol. 2014;10:831–41. doi: 10.1586/1744666X.2014.924855.
    1. Reinhold T, Brinkhaus B, Willich SN, Witt C. Acupuncture in patients suffering from allergic asthma: is it worth additional costs? J Altern Complement Med. 2014;20:169–77. doi: 10.1089/acm.2012.0719.
    1. McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. Acupuncture for chronic asthma. Cochrane Database Syst Rev. 2004;2004(1):CD000008.
    1. Linde K, Jobst K, Panton J. Acupuncture for chronic asthma. Cochrane Database Syst Rev. 2000;2
    1. Martin J, Donaldson AN, Villarroel R, Parmar MK, Ernst E, Higginson IJ. Efficacy of acupuncture in asthma: systematic review and meta-analysis of published data from 11 randomised controlled trials. Eur Respir J. 2002;20:846–52. doi: 10.1183/09031936.02.00078702.
    1. Zhang J, Li X, Xu J, Ernst E. Laser acupuncture for the treatment of asthma in children: a systematic review of randomized controlled trials. J Asthma. 2012;49:773–7. doi: 10.3109/02770903.2012.691194.
    1. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions, version 5.1.0 [updated March 2011] Chichester, West Sussex, UK: The Cochrane Collaboration; 2011.
    1. Karlson G, Bennicke P. Acupuncture in asthmatic children: a prospective, randomized, controlled clinical trial of efficacy. Altern Ther Health Med. 2013;19:13–9.
    1. Scheewe S, Vogt L, Minakawa S, Eichmann D, Welle S, Stachow R, et al. Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study. Complement Ther Med. 2011;19:239–46. doi: 10.1016/j.ctim.2011.07.002.
    1. Nedeljković M, Ljustina-Pribić R, Savić K. Innovative approach to laser acupuncture therapy of acute obstruction in asthmatic children. Med Pregl. 2008;61:123–30. doi: 10.2298/MPNS0804123N.
    1. Stockert K, Schneider B, Porenta G, Rath R, Nissel H, Eichler I. Laser acupuncture and probiotics in school age children with asthma: a randomized, placebo-controlled pilot study of therapy guided by principles of Traditional Chinese Medicine. Pediatr Allergy Immunol. 2007;18:160–6. doi: 10.1111/j.1399-3038.2006.00493.x.
    1. Gruber W, Eber E, Malle-Scheid D, Pfleger A, Weinhandl E, Dorfer L, et al. Laser acupuncture in children and adolescents with exercise induced asthma. Thorax. 2002;57:222–5. doi: 10.1136/thorax.57.3.222.
    1. Fung KP, Chow OK, So SY. Attenuation of exercise-induced asthma by acupuncture. Lancet. 1986;2:1419–22.
    1. Chow OK, So SY, Lam WK, Yu DY, Yeung CY. Effect of acupuncture on exercise-induced asthma. Lung. 1983;161:321–6. doi: 10.1007/BF02713881.
    1. McDonald JL, Cripps AW, Smith PK, Smith CA, Xue CC, Golianu B. The anti-inflammatory effects of acupuncture and their relevance to allergic rhinitis: a narrative review and proposed model. Evid Based Complement Alternat Med. 2013;2013:591796. doi: 10.1155/2013/591796.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa