Acupuncture for infantile colic: a blinding-validated, randomized controlled multicentre trial in general practice

Holgeir Skjeie, Trygve Skonnord, Arne Fetveit, Mette Brekke, Holgeir Skjeie, Trygve Skonnord, Arne Fetveit, Mette Brekke

Abstract

Objective: Infantile colic is a painful condition in the first months of infancy. Acupuncture is used in Scandinavia as a treatment for infantile colic. A randomized controlled trial was carried out with the aim of testing the hypothesis that acupuncture treatment has a clinically relevant effect for this condition.

Design: A prospective, blinding-validated, randomized controlled multicentre trial in general practice. Research assistants and parents were blinded.

Setting: 13 GPs' offices in Southern Norway.

Intervention: Three days of bilateral needling of the acupuncture point ST36, with no treatment as control.

Subjects: 113 patients were recruited; 23 patients were excluded, and 90 randomized; 79 diaries and 84 interviews were analysed.

Main outcome measures: Difference in changes in crying time during the trial period between the intervention and control group.

Results: The blinding validation questions showed a random distribution with p = 0.41 and 0.60, indicating true blinding. We found no statistically significant difference in crying time reduction between acupuncture and control group at any of the measured intervals, nor in the main analysis of differences in changes over time (p = 0.26). There was a tendency in favour of the acupuncture group, with a non-significant total baseline-corrected mean of 13 minutes (95% CI -24 to + 51) difference in crying time between the groups. This was not considered clinically relevant, according to protocol.

Conclusion: This trial of acupuncture treatment for infantile colic showed no statistically significant or clinically relevant effect. With the current evidence, the authors suggest that acupuncture for infantile colic should be restricted to clinical trials.

Trial registration: ClinicalTrials.gov NCT00907621.

Figures

Figure 1.
Figure 1.
Trial flow chart: The ST36 infantile colic acupuncture trial.
Figure 2.
Figure 2.
Plot diagram of changes in crying time: The ST36 infantile colic acupuncture trial.

References

    1. Wessel MA, Cobb JC, Jackson EB, Harris GS, Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954;14:421–35.
    1. Management of infantile colic. BMJ. 2013;347:f4102.
    1. Savino F. Focus on infantile colic. Acta Paediatr [Review] 2007;96:1259–64.
    1. Gupta SK. Update on infantile colic and management options. Curr Opin Investig Drugs [Review] 2007;8:921–6.
    1. Lucassen P. Colic in infants. Clin Evid (Online) 2010;2010
    1. Ernst E. Chiropractic spinal manipulation for infant colic: A systematic review of randomised clinical trials. Inr J Clin Pract [Review] 2009;63:1351–3.
    1. Savino F, Tarasco V. New treatments for infant colic. Curr Opin Pediatr [Review] 2010;22:791–7.
    1. Szajewska H, Gyrczuk E, Horvath A. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: A randomized, double-blind, placebo-controlled trial. J Pediatrics. 2013;162:257–62.
    1. Hanssen B, Grimsgaard S, Launso L, Fonnebo V, Falkenberg T, Rasmussen NK. Use of complementary and alternative medicine in the Scandinavian countries. Scand J Prim Health Care. 2005;23:57–62.
    1. Reinthal M, Lund I, Ullman D, Lundeberg T. Gastrointestinal symptoms of infantile colic and their change after light needling of acupuncture: A case series study of 913 infants. Chin Med. 2011;6:28.
    1. Ernst E. Prevalence of complementary/alternative medicine for children: A systematic review. Eur J Pediatrics [Review] 1999;158:7–11.
    1. Gilmour J, Harrison C, Cohen MH, Vohra S. Pediatric use of complementary and alternative medicine: Legal, ethical, and clinical issues in decision-making. Pediatrics [Research Support, Non-U.S. Govt] 2011;128((Suppl 4)):S149–54.
    1. Kaptchuk TJ. Acupuncture: Theory, efficacy, and practice. Ann Intern Med. 2002;136:374–83.
    1. White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004;22:122–33.
    1. Adams D, Cheng F, Jou H, Aung S, Yasui Y, Vohra S. The safety of pediatric acupuncture: a systematic review. Pediatrics [Research Support, Non-U.S. Govt Review] 2011;128:e1575–87.
    1. Reinthal M, Andersson S, Gustafsson M, Plos K, Lund I, Lundeberg T, et al. Effects of minimal acupuncture in children with infantile colic: A prospective, quasi-randomised single blind controlled trial. Acupunct Med. 2008;26:171–82.
    1. Landgren K, Kvorning N, Hallstrom I. Acupuncture reduces crying in infants with infantile colic: A randomised, controlled, blind clinical study. Acupunct Med [Randomized Controlled Trial Research Support, Non-U.S. Govt] 2010;28:174–9.
    1. Shanghai CoTM. Acupuncture: A comprehensive text. Seattle, WA: Eastland Press; 1988.
    1. Deadman P, Al-Khafaji M, Baker K. Journal of Chinese Medicine. 2008. A manual of acupuncture. 3rd ed.
    1. Takahashi T. Acupuncture for functional gastrointestinal disorders. J Gastroenterology [Research Support, N.I.H., Extramural Review] 2006;41:408–17.
    1. Skjeie H, Skonnord T, Fetveit A, Brekke M. A pilot study of ST36 acupuncture for infantile colic. Acupunct Med. 2011;29:103–7.
    1. Madsen MV, Gotzsche PC, Hrobjartsson A. Acupuncture treatment for pain: Systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009;338:a3115.
    1. Vickers AJ, Cronin AM, Maschino AC, Lewith G, Macpherson H, Foster NE, et al. Acupuncture for chronic pain: Individual patient data meta-analysis. Arch Intern Med. 2012;10:1–10.
    1. Scott J, Barlow T. Acupuncture in the treatment of children. Seattle, WA: Eastland Press; 1999.
    1. Loo M. Pediatric acupuncture. Edinburgh: Churchill Livingstone, Elsevier; 2002.
    1. Birch S. Shonishin: Japanese pediatric acupuncture. Stuttgart and New York: Thieme Publishing Group; 2011.
    1. Raith W, Urlesberger B, Schmolzer GM. Efficacy and safety of acupuncture in preterm and term infants. Evid Based Complement Alternat Med. 2013;2013:739414.
    1. Jindal V, Ge A, Mansky PJ. Safety and efficacy of acupuncture in children: A review of the evidence. J Pediatric Hematology/Oncology. 2008;30:431–42.
    1. Markestad T. [Physicians and alternative treatment]. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke. 2012;132:2409–10.
    1. Linde K, Niemann K, Schneider A, Meissner K. How large are the nonspecific effects of acupuncture? A meta-analysis of randomized controlled trials. BMC Med. 2010;8:75.

Source: PubMed

3
订阅