Acupuncture – RCTs

StudyStudy type and ELNo. of patientsPatient characteristicsInterventionComparisonLength of follow-upOutcome measuresEffect sizeAdditional comments
Zheng 1992485RCT
EL = 1−
60F mean age 56 years (22–75), stress UIAcupuncture, 30 sessions, every other day (n = 34)Placebo (not described) (n = 26)60 days tx; 10 pts from acupuncture grp followed up to 1 year% reporting Improvement88% vs 23%, P < 0.01
10 of 36 followed up to 1 year; 8 ‘still effective’, 2 relapsed.
Funding: none declared.
Acupoints used: Ren 6, Ren 4, St 28, UB23, UB29, UB35, UB39 if symptoms identified as owing to insufficiency of Kidney-Qi and dysfunction of urinary bladder; plus Sp6, Lu7, K3 if Insufficiency owing to Kidney-Yin and deficiency of ling and kidney-Qi. For deficiency of Kidney-Yin and decline of kidney-Yang, acupoints were: Moxibustion to Guanyuan and Qihai, and Du4.
It is unclear from the report how many women were stimulated by which acupoints.
Improvement: ‘clinical’ improvement and improvements in 1 or more of 5 urodynamic parameters.
Urodynamic parametersurethral max. pressure: +13 (cmH2O) vs no change, P < 0.01
No sig. differences between grps in changes in urethral length
Ellis 1990483
Ellis 1993484
EL = 1−
20Elderly M/F* (aged 65–96 years), with problem of night urinary frequency on long-stay hospital wards
*Two publications of this study identified; one stated 15 /20 were women, the other stated that 17 were women
Exclusions: □rethra□n□ within 1 month, UTI
Acupuncture (acupoints Sp 6, St36; needles left in situ for 20 min)Placebo (mock TENS) for 20 min2 weeks treatmentNocturnal frequency (median change for h 9 pm to 7 am)*−2 (95% CI −1.0, −3.0) vs ‘no significant change’Funding: none stated.
*2 hospitals measured this in different ways: 1 monitoring device introduced into one-way incontinence pads, connected to a visual alarm checked hourly; other hospital toileted pts in usual way.
1 pt from each grp withdrew.
Emmons 2005486SB RCT
EL = 1−
85 randomised, 74 (87%) completed all aspects of study and analysed*F median age 51 years (22–82) with symptoms of OAB and urge UI ( > 8 voids per 24 h, urgency, and urge UI at least twice in a 3 day period)
18% had prior continence surgery
Exclusions: if taking drug tx for OAB, or acupuncture for any condition; haematuria or UTI
Acupuncture (n = 44 randomised, 38 completed and analysed)Placebo acupuncture (n = 41 randomised, 36 completed and analysed)Tx given weekly for 4 weeks
Assessment at 6–8 weeks
Leakage episodes/ 3 days, mean change−59 vs −40%, P = NSFunding: in part by Oregon Health Science Foundation.
Physician who performed acupuncture not blind to randomisation code; assessment was blinded.
[EL = 1−] only completers analysed.
*3 withdrew owing to difficulty scheduling appointments; others had incomplete assessment data.
Acupuncture: needles placed bilaterally at SP6 (inner legs), BL39 (outer knee fold), BL28 (low back), CV4 (low abdomen) and rotated clockwise until patient reported a sensation of warmth and tightening. The needles retained for 20 min without further stimulation.
Placebo; same method as active tx grp but tx designed for relaxation; sites were GB31 (outer thigh), ST36 (outer legs), BL12 (upper back), and mid-line CV12 (epigastrium).
Frequency/ 3 days, mean change−14 vs −4%, P = 0.03
Urgency/ 3 days, mean change−30 vs −3%, P = 0.016
Functional bladder capacity, mean change+12 vs −2%, P = 0.01
UDI (mean score change)−57 vs −32%, P = 0.05
IIQ (mean score change)−52 vs −23%, P = 0.004
Adverse effects23% bleeding or bruising from acupuncture
25% minor discomfort on needle displacement (none had discomfort beyond the time of tx)

From: Evidence tables for included studies

Cover of Urinary Incontinence
Urinary Incontinence: The Management of Urinary Incontinence in Women.
NICE Clinical Guidelines, No. 40.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2006 Oct.
Copyright © 2006, National Collaborating Centre for Women’s and Children’s Health.

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