Traditional Chinese Medicine

Ying Cao et al. (2025) · QJM : monthly journal of the Association of Physicians

This randomized trial with 84 emergency department patients explored whether acupuncture started right away, before a diagnosis is confirmed, eases the pain of suspected renal colic, the sudden, severe cramping pain in the back or abdomen that usually comes from a kidney or urinary stone. Imaging to confirm a stone takes time while patients are in extreme pain, and the authors note that the usual painkillers have drawbacks: anti-inflammatory drugs can raise heart risk with higher doses and longer use, and opioids cause side effects including nausea, drowsiness and dependence concerns. Acupuncture, a traditional Chinese medicine technique that places thin needles at specific body points, had already been reported by this group to reduce pain in confirmed cases. Adults aged 18 to 80 with one-sided colicky pain and tenderness over the kidney area, and pain of at least 4 on a 0 to 10 scale, were treated at a Beijing hospital emergency department. Half received needles in the back of both hands at Yaotongdian, a point the authors use for lumbar pain, with the needles lifted and rotated until a soreness or heaviness sensation appeared and then left in for 30 minutes. The other half had very shallow needling with tiny short needles at spots that are not acupuncture points, with no manipulation. Ten minutes after needling, 64.3% of the acupuncture group (27 of 42) had at least halved their pain, versus 16.7% of the sham group (7 of 42), a 47.6 percentage point gap (P < 0.01, so chance is very unlikely to explain it). By 30 minutes the figures were 85.7% versus 31.0%. Average pain scores at 10 minutes were 3.38 versus 6.00. Fewer acupuncture patients needed an analgesic injection by 30 minutes (33.3% vs 59.5%; P = 0.03) and satisfaction scores were higher (4.69 vs 3.69). Patients, outcome assessors and statisticians did not know the group, and patients guessed their group at similar rates, so the blinding held. Surgery and return visits did not differ between groups, and each group had one adverse event (bleeding with acupuncture; nausea and vomiting with sham). The authors suggest that early acupuncture is a safe option for pain relief while a diagnosis is awaited and that it did not appear to interfere with later care. The authors also note that a single acupuncture point may give limited improvement in critically ill patients. They state plainly that the study was done at one center with experienced acupuncturists, included only 3 acupuncture-group patients who turned out not to have a urinary stone, and did not analyze results by stone size. They call for multicenter confirmation.

Jian-Feng Tu et al. (2022) · JAMA network open

This randomized trial with 80 emergency department patients explored whether adding acupuncture to a standard painkiller injection brings faster relief from renal colic, the severe cramping flank pain that occurs when a kidney stone blocks or moves through the urinary tract. Renal colic is described by the authors as one of the worst types of pain, and the guideline first-choice drugs, nonsteroidal anti-inflammatory medicines such as diclofenac, take time to work: in an earlier study, 37.5% of patients still had moderate or severe pain 15 minutes after an injection. Acupuncture, a traditional Chinese medicine technique that inserts thin needles at specific body points, had shown quick pain reduction in other settings. Adults aged 18 to 75 with stone-related renal colic and pain of at least 4 out of 10 on a visual analog scale (a line on which patients mark their pain) were treated at a Beijing hospital emergency department in 2020. Everyone received a 50 mg diclofenac injection into the muscle. Half then had 30 minutes of needling at Yaotongdian, a point on the back of each hand, with the needles twisted and lifted until a soreness or heaviness sensation (called De qi) appeared. The other half had shallow needle pricks at forearm spots that are not acupuncture points. Ten minutes after needling, 77.5% of the acupuncture group (31 of 40) had at least halved their pain score, compared with 10.0% of the sham group (4 of 40), a gap of 67.5 percentage points (P < .001, so chance is very unlikely to explain it). Average pain fell to 3.0 versus 5.9 out of 10. Acupuncture also led at 0, 5, 15, 20 and 30 minutes (97.5% vs 80.0% at 30 minutes; P = .03). Patients, assessors and the statistician did not know the group, and patients guessed their group about equally often in both arms (P = .48). The advantage faded as the injection took effect: by 45 and 60 minutes both groups had about 92% to 98% responding (P = .62), and only 1 patient needed stronger rescue medication. No adverse events were recorded. The authors suggest acupuncture may serve as an optional add-on for faster relief, since it uses a single point and needs no individual diagnosis. They attribute the absence of a rescue-medication difference to a possible ceiling effect from the diclofenac. They note limitations plainly: one hospital, treatment given after diagnostic imaging, experienced acupuncturists who could not be blinded, and no follow-up of pain beyond 60 minutes or analysis by stone size. They plan to study acupuncture before imaging.

Dan Wang et al. (2026) · JAMA network open

This phase 3 randomized trial of 606 adults in China explored whether Guang Jing, a capsule made from the total flavonoids (plant pigment compounds with antioxidant activity) of the traditional Chinese herb Desmodium styracifolium, helps ureteral stones pass out of the body. A ureteral stone is a mineral deposit lodged in the tube that carries urine from the kidney to the bladder. Treatment that encourages passage is called medical expulsive therapy, and the authors note that alpha-blocker drugs, the guideline option, have shown mixed results in large trials. No oral medicine is currently approved for urolithiasis, and Guang Jing is already approved in China for ureteral stones. Participants were adults aged 18 to 70 with a newly diagnosed ureteral stone of 5 to 10 mm and a traditional Chinese medicine pattern called damp-heat accumulation (urethral burning, lower back pain or blood in the urine). At 34 hospitals, three of every four received 3 capsules (0.6 g) of Guang Jing three times daily for 28 days, and the rest received identical placebo capsules. Neither participants nor investigators knew who received which. Passage was confirmed by CT scan on day 28, read by blinded investigators. By day 28, 44.6% of the Guang Jing group (204 of 457) had passed their stone versus 33.8% of the placebo group (50 of 148). That is a 10.9 percentage point difference (relative risk 1.32, so passage was about one-third more likely; P = .03). At day 14 the groups did not differ significantly (29.1% vs 22.3%; P = .14), and stone movement distance was almost identical (29.5 vs 29.7 mm). Among those with 0.6 to 1.0 cm stones, passage was 37.2% vs 24.4% (a larger gap in the bigger stones), and 66.2% of Guang Jing participants with distal stones, the lower part of the ureter near the bladder, passed them. Adverse events were similar (19.3% vs 18.2%, meaning side effects were about as common with the capsule as with placebo), with no medication-related serious events. The authors describe the absolute benefit as modest, since 55.4% of the Guang Jing group did not pass a stone by day 28. The trial enrolled a fairly uniform group, mostly from southern China, and the subgroup results were exploratory. The authors state that this homogeneous population limits how far the findings generalize, and that CT slice thickness may have missed small differences in stone movement. They plan further trials in Europe and North America and call for studies to identify who benefits most and to establish how the extract works in humans.

Qiaoyun Liu et al. (2026) · Frontiers in endocrinology

This systematic review and meta-analysis of 56 randomized controlled trials (4,605 participants) examined whether herbal formulae containing Smilax glabra, known in Chinese as Tufuling, help people with acute gout. Gout is a painful inflammatory arthritis caused by uric acid crystals depositing in joints. In traditional Chinese medicine, many acute flares are classed as dampness-heat accumulation, a pattern defined by red, swollen, hot, painful joints and dark urine, and treated by clearing heat and resolving dampness. The authors also used computer-based network pharmacology to predict which plant compounds and proteins might explain the effects. All 56 trials took place in China and enrolled adults, with ages ranging from 18 to 80 years, diagnosed with gout and the dampness-heat pattern. Participants received a Tufuling-containing herbal formula, sometimes with external applications or acupuncture, either alone or added to standard drugs such as NSAIDs, colchicine, allopurinol or benzbromarone, for 14 days or less. Comparison groups received the standard drugs alone. Pain was measured on a 10-point visual analog scale, and blood uric acid, C-reactive protein and erythrocyte sedimentation rate (inflammation markers) were also tracked. Herbal formulae added to standard drugs reduced pain by 0.94 points on the 10-point scale (a modest but statistically significant gain across 17 trials), raised the chance of a treatment response by 15% (risk ratio 1.15), and lowered blood uric acid by 57 micromoles per litre. Herbal formulae alone did not beat standard drugs for pain (a 0.33-point difference, not significant) but did lower uric acid. Adverse events, mostly stomach and intestinal complaints, totalled 73 in herbal groups versus 161 in comparison groups, all mild to moderate. Certainty of evidence was rated low to moderate, and heterogeneity was very high for pain (I² = 93.2%). Network analysis predicted 49 gout-related protein targets for Tufuling, centred on PTGS2, IL1B, PPARG and TP53 (proteins governing inflammation and metabolism), and docking suggested diosgenin binds PTGS2 strongly (-11.6 kcal/mol). The authors suggest Tufuling-based formulae may be a useful adjunct in acute gout, but the evidence carries clear limits. Most trials lacked blinding and trial registration, all came from China, treatment lasted at most 14 days, a quarter of trials did not report adverse events, and only four reported follow-up. The findings do not extend to chronic gout or other traditional patterns, and the network predictions are untested hypotheses. The authors call for larger, rigorous trials with longer follow-up and laboratory validation of the predicted targets.

Bowen Xu et al. (2026) · Frontiers in endocrinology

This open-label randomized trial at Shanghai East Hospital compared two approaches to primary dysmenorrhea (menstrual cramping without an underlying pelvic disease) in 80 women aged 15 to 46: a Traditional Chinese Medicine protocol called Cai's Gynecology Cyclical Therapy, paired with a specific formula called the Stasis-Clearing and Meridian-Warming Method, versus standard ibuprofen. The TCM approach is built on a century-old idea from a Shanghai medical lineage: that treatment should change across the four phases of the menstrual cycle rather than staying the same throughout. Forty women received ibuprofen (a common anti-inflammatory pain reliever) for two days during each period, while the other forty received herbal decoctions -- different formulas depending on the cycle phase -- for three full menstrual cycles. Researchers tracked pain on a 0-to-10 visual pain scale and a symptom-severity score, and checked whether pain returned in the month after treatment ended. People collecting the follow-up data did not know which treatment each woman had received. Both treatments worked well overall (97.5% of women improved in each group), but the pattern of improvement differed. Ibuprofen relieved pain faster in the first month, as expected for a direct pain reliever. The herbal treatment started more slowly but kept improving month after month, and by the third month the two treatments were statistically equivalent on both pain and symptom scores. The most striking difference came after treatment stopped: only about 13% of the herbal-treatment group had their pain return the following month, compared to about 90% of the ibuprofen group. No side effects were reported in either group throughout the study. The researchers suggest this gap in relapse rates may reflect a real difference in how the two approaches work -- ibuprofen blocks pain-causing chemicals only while it is being taken, whereas the herbal protocol may produce a more lasting change. However, because patients and treating doctors could not be kept unaware of which treatment they were giving or receiving (an inherent challenge when comparing herbal decoctions to a standard pill), and because the study involved one hospital and a single follow-up cycle, the authors call for larger, multi-site studies with longer follow-up to confirm these findings.

Jihye Seo et al. (2020) · Medicine

This systematic review and meta-analysis pooled 14 randomized controlled trials (1,215 women, mostly from China with one from Japan) exploring whether Dangguijagyag-san (DJS) - a traditional East Asian herbal formula also called Danggui Shaoyao San - helps primary dysmenorrhea (PD), the cramping menstrual pain that occurs without an underlying pelvic disease. PD is common, estimated to affect 16-91% of women of reproductive age, and is driven by elevated uterine prostaglandins causing muscle spasm; standard NSAID and hormonal treatments carry gastrointestinal and other side-effect risks, which is part of why researchers keep examining herbal alternatives. The review followed a pre-registered protocol and searched eight medical databases through April 2019. The included trials compared DJS - most often prepared as a decoction (a boiled herbal liquid), given over roughly three menstrual cycles - against NSAIDs (5 trials), a placebo (1 trial), other herbal formulas (6 trials), or NSAIDs with moxibustion added to DJS (2 trials). The main outcome tracked was the total effective rate, a practitioner-judged measure of symptom improvement, alongside pain scores on a visual analogue scale in some trials. Pooled results favored DJS across every comparison. Against NSAIDs, DJS produced a higher effective rate (relative risk 1.16, meaning about 16% more improvement events, 95% confidence interval 1.08-1.24, with no meaningful variation between trials). Against placebo, DJS reduced pain scores and cut how often women needed rescue pain medication during their period. Against other herbal formulas, DJS again showed a higher effective rate (RR 1.24), an advantage that held up most consistently when DJS was prepared as a decoction rather than a granule or capsule. Adding moxibustion (heated-herb therapy at acupuncture points) to DJS outperformed NSAIDs alone (RR 1.47). Side effects were reported in only a handful of trials and were mostly mild digestive complaints, less frequent in the DJS groups than the NSAID groups. The review's authors rated the overall certainty of this evidence as moderate to low: most trials did not clearly describe how they randomized or concealed group assignment, could not blind participants to which herbal or drug treatment they were taking, and were often small (many under 100 participants), all conducted in East Asia. The findings do not establish how DJS performs in other populations or over longer treatment periods, and the authors call for larger, more rigorously designed trials to confirm the effect.

Aibo Li et al. (2025) · Frontiers in public health

This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly. The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire. After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups. These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.

Nor Azila Mohd Nafiah et al. (2022) · International journal of environmental research and public health

This randomized controlled trial with 90 hospitalized pregnant women tested whether pressing on a specific wrist point (P6, also known as Nei Guan) could relieve hyperemesis gravidarum -- a severe, dangerous form of pregnancy sickness marked by relentless nausea and vomiting, weight loss, and dehydration, distinct from ordinary "morning sickness." P6 sits about two finger-widths above the inner wrist crease and has long been used in Traditional Chinese Medicine to settle the stomach; commercial acupressure wristbands apply steady pressure to this same point. The trial compared wristband acupressure directly against standard intravenous anti-nausea medication, rather than against a placebo. Ninety women under 16 weeks pregnant with moderate-to-severe nausea and vomiting were admitted to a Malaysian hospital and randomly assigned, 1:1, to either wear acupressure wristbands on both wrists three times a day for at least 10 minutes before meals, or receive standard intravenous anti-nausea medicine (metoclopramide) every 8 hours. Both groups received the same IV fluids. Researchers tracked nausea and vomiting severity with a validated symptom score at 8, 16, and 24 hours, and separately tracked how quickly ketones (a dehydration marker) cleared from the urine. Every enrolled woman completed the trial. The acupressure group had significantly milder nausea and vomiting than the medication-only group at every checkpoint (8, 16, and 24 hours; p=0.001-0.006) -- by 24 hours, 93% of the acupressure group had only mild symptoms left, compared to 60% on medication alone. Acupressure also cleared the dehydration marker (urine ketones) faster on average (about 22 hours versus 28 hours, p=0.02) and cut the need for rescue anti-nausea injections sharply: over a quarter of the acupressure group needed no extra medication at all, while the medication-only group received three scheduled doses regardless. No side effects were reported in either group. These results position P6 acupressure as a genuinely useful, risk-free option for easing severe pregnancy nausea and reducing how much anti-nausea medication a hospitalized patient needs. The key caveat: there was no realistic way to "fake" acupressure for comparison, so some of the benefit could reflect expectation rather than the specific pressure point itself -- and the trial was conducted at a single hospital. Still, hyperemesis gravidarum has very few rigorously tested nondrug treatments, making this a meaningful addition to the evidence.

Jing-Yu Tan et al. (2022) · BMC complementary medicine and therapies

This preliminary randomized controlled trial with 114 breast cancer patients starting their first round of chemotherapy explored whether auricular acupressure -- pressing small seeds against specific points on the outer ear -- could ease chemotherapy-induced nausea and vomiting (CINV), a side effect that standard anti-nausea drugs do not fully control. The study is grounded in the idea, borrowed from Traditional Chinese Medicine, that stimulating certain ear points can influence nausea pathways elsewhere in the body. To find out how much of any benefit was real versus expectation, researchers compared a "true" acupressure group against a look-alike "sham" version and against standard care alone. Women scheduled for chemotherapy known to cause significant nausea were split into three groups of 38: true acupressure (firm seeds pressed on seven ear points three times a day for five days), sham acupressure (soft, non-stimulating seeds at the same points and schedule), and standard antiemetic care alone. Everyone received standard anti-nausea medication regardless of group. Nausea and vomiting were tracked using the MASCC Antiemesis Tool, a validated eight-item scale, on the second and sixth days of the chemotherapy cycle, and quality of life was measured separately. Both acupressure groups did better than standard care alone for CINV occurring in the first 24 hours (acute CINV). More than half of the true acupressure group (52.6%) had no nausea or vomiting at all in that window, compared to under a quarter (23.7%) on standard care alone (a meaningful and statistically significant difference, p=0.01). Total symptom scores were also meaningfully lower with true acupressure across several measures (p-values from 0.001 to 0.004, with effect sizes edging toward "large"). The catch: the sham acupressure group did almost as well as the true group on nearly every measure, meaning much of the benefit looks like a placebo effect rather than something unique to real acupressure -- though the researchers note that a placebo effect big enough to meaningfully reduce nausea is still clinically useful. Neither approach measurably helped with nausea that showed up later (days 2-5) or with quality of life. Practically, this suggests auricular acupressure is a safe, low-cost option worth adding alongside standard anti-nausea medication for the first day of chemotherapy, with only mild, temporary ear discomfort reported by about 1 in 7 participants. The main limitation is that the study was small and not designed to definitively prove acupressure's own mechanism works beyond expectation -- a larger, more rigorously powered trial is needed to confirm whether the benefit holds up and how much is truly attributable to acupressure itself versus the ritual of treatment.

Zhiyong Long et al. (2023) · Frontiers in immunology

Whether the plant compounds often discussed for rheumatoid arthritis — turmeric, green tea, pomegranate, garlic — actually do anything is the question this meta-analysis set out to answer. This review gathered every randomized trial it could find on the question: 47 trials, nearly 3,900 people, fifteen different plant polyphenols, from Iran, China, Korea, Egypt, Japan, Brazil, India and the United States. The clearest picture came from two of them. The first is total glucosides of paeony, an extract of Chinese peony root that is a licensed prescription medicine in China. Twenty-three trials tested it — always added to standard RA drugs like methotrexate, never instead of them. Disease activity scores came down, and so did CRP, ESR and rheumatoid factor, the blood markers doctors track. The most interesting result: people taking it reported *fewer* side effects than people on the standard drugs alone. That fits how it is used clinically — it appears to soften the toll the conventional drugs take on the liver and stomach. The second is curcumin, the yellow compound in turmeric. Five trials, and the same direction: lower disease activity, lower inflammatory markers, no extra side effects. Green tea polyphenols looked promising across two trials. Saffron did not show a clear effect. Everything else — pomegranate, garlic, resveratrol, sesame, cinnamon, ginger, kudzu, cranberry, olive oil, quercetin — rests on one or two small trials apiece, which is encouraging but not yet evidence that bears weight. The honest caveat, which the authors state plainly themselves: the trials disagreed with each other a great deal, most were small, and when the researchers sliced the data by dose and duration some of the headline benefits faded. Nearly all of these were add-on studies. Nobody tested a polyphenol against methotrexate, so the evidence says nothing about replacing a prescribed medication. What it does support is turmeric and peony extract as the best-evidenced candidates, studied as additions to existing treatment rather than replacements for it.

Yan-Kun Chen et al. (2023) · Frontiers in endocrinology

This literature review asks two connected questions: what actually drives obesity and type 2 diabetes at a biological level, and whether Traditional Chinese Medicine has anything to offer in managing them. The two conditions are closely linked — the review notes that type 2 diabetes accounts for roughly 90% of all diabetes cases and is strongly tied to excess weight. There is a practical bind behind the question, too: several standard diabetes drugs, including insulin and sulfonylureas, make weight loss harder rather than easier. The authors searched PubMed, Scopus and Web of Science for work published between 2019 and 2023, covering molecular, cellular and clinical studies of how obesity, diabetes and TCM interact. It is important to be clear about what kind of review this is: a narrative overview rather than a systematic one. There is no count of included trials, no pooled statistics and no formal assessment of study quality, so it maps a field rather than measuring an effect. On mechanism, the review draws a useful distinction between visceral fat — stored around the liver, pancreas and kidneys, hormonally active, and the type that drives insulin resistance — and subcutaneous fat sitting under the skin. This is why apple-shaped fat distribution carries more metabolic risk than pear-shaped. The scale of the problem is stark: the World Health Organization counted 1.9 billion overweight adults in 2016, 650 million of them with obesity, and 38.2 million children under five overweight or obese in 2019. The TCM proposal is that acupuncture, herbal remedies and dietary therapy act on inflammation, oxidative stress, insulin resistance and the balance of gut bacteria. What this review does not provide is evidence of how well any of that works. No effect sizes, no confidence intervals, no trial results for any specific TCM intervention appear. The authors themselves conclude only that TCM may be promising and that well-designed studies are still needed to confirm both efficacy and safety. Read it as a map of plausible mechanisms and an argument for research, not as grounds for choosing a treatment.

Shuang Liang et al. (2024) · BMJ open

This systematic review and meta-analysis pooled 8 randomized controlled trials with 463 participants (229 receiving acupuncture, 234 receiving a comparator) to test acupuncture for atopic dermatitis — also called atopic eczema — a chronic, relapsing inflammatory skin condition marked by itch (pruritus), dryness and rash. The most frequently needled points were LI11 (Quchi), ST36 (Zusanli) and SP10 (Xuehai), acupoints from Traditional Chinese Medicine's meridian system traditionally used to clear heat, calm itch and support immune balance; here they were tested against blank controls, sham (non-penetrating) acupuncture, or standard medicines like antihistamines and topical steroids. Across the eight trials — two from Germany, two from South Korea and four from China — treatment took two main forms: manual acupuncture (5 trials, mostly needling LI11, ST36 and SP10 for 15-30 minutes, one to seven times weekly over 10 days to 5 weeks) and fire acupuncture, where a heated needle is briefly inserted (3 trials, mainly paired with standard medicine). Two trials added retained press-tack needles at LI11 and the ear point Shenmen. Severity was tracked with the SCORAD index (combining physician and patient ratings) and the EASI (physician-only); itch with a 0-100 visual analogue scale (VAS); and quality of life with the DLQI questionnaire. Acupuncture significantly lowered SCORAD scores compared with control (MD=-10.61, 95% CI -17.77 to -3.45, p=0.004 — a drop large enough to clear the 8.7-point threshold doctors consider clinically noticeable). It cut itch scores even more clearly (VAS MD=-14.71, 95% CI -18.20 to -11.22, p<0.00001 — also above its meaningful-change threshold) and improved DLQI quality-of-life scores (MD=-2.37, p<0.0001), though that change fell short of the threshold considered clinically important. The EASI score, which relies only on a physician's rating rather than patient-reported itch and sleep, showed no significant group difference (p=0.08), and neither did blood IgE levels (p=0.07). Compared specifically with sham (fake-point) acupuncture rather than no treatment, real acupuncture still won out on SCORAD (p<0.00001) — evidence the effect is not just expectation or attention. Only mild, short-lived side effects were reported (bruising, limb numbness, mild stomach upset), and no serious harms occurred in any of the five trials that tracked safety. In atopic dermatitis, these results suggest acupuncture — especially manual or fire acupuncture at LI11, ST36 and SP10 — may help as an add-on to standard treatment, with itch relief the most consistent benefit and a good safety record. The review authors caution that only 8 small trials (463 people total) were available, most had weaknesses like unclear allocation concealment or blinding, and results varied a great deal between studies. Larger, more rigorously blinded multicentre trials are needed before acupuncture earns a stronger recommendation than a promising adjunct therapy.

Liuting Zeng et al. (2022) · Frontiers in immunology

This systematic review and meta-analysis pooled 31 randomized controlled trials (34 study records, roughly 1,583 participants) exploring curcumin and Curcuma longa (turmeric) extract across 10 autoimmune diseases — conditions where the immune system mistakenly attacks the body's own tissue. Autoimmune disease covers more than 120 named conditions; this review focused on ankylosing spondylitis, Behçet's disease, Crohn's disease, multiple sclerosis, oral lichen planus, psoriasis, rheumatoid arthritis, systemic lupus erythematosus, Takayasu arteritis, and ulcerative colitis. Curcumin is the main active compound in turmeric, long used in Chinese medicine, and is studied here for its ability to regulate immune cells and reduce inflammation. Researchers searched English and Chinese databases plus the Cochrane Library and ClinicalTrials.gov through February 2022, screening 2,991 records down to 31 RCTs that tested curcumin or Curcuma longa extract against placebo or usual care. Trial count per disease varied widely: 9 RCTs for ulcerative colitis and 6 for oral lichen planus, but only 1 each for ankylosing spondylitis, Behçet's disease, and Takayasu arteritis. Doses ranged from 60 mg to 6,000 mg daily, taken orally, or in some trials applied as a gel, mouthwash, or enema, for 2 to 96 weeks. Disease activity was tracked with condition-specific scales (PASI for psoriasis, DAS28 for rheumatoid arthritis, EDSS for multiple sclerosis, and others) alongside blood markers like ESR and CRP. Where enough trials existed to combine statistically, curcumin performed well. In psoriasis, it roughly tripled the rate of major skin-clearance (PASI75: RR=3.01, p=0.008—meaning patients getting curcumin were about three times as likely to see substantial improvement). In ulcerative colitis, it raised clinical remission more than twofold (RR=2.28, p=0.0005) and lowered inflammatory markers ESR and CRP. In rheumatoid arthritis, it reduced the DAS28 disease-activity score (WMD=-1.10, p=0.0002—a clinically noticeable drop in joint disease activity), though results varied considerably between the five trials. Oral lichen planus, despite being studied in six trials, did not show a significant benefit on its pooled lesion-severity score (p=0.17). None of the pooled analyses found more side effects with curcumin than with placebo. The other six diseases each had just one or two small trials reporting improvement, too few to combine or confirm. These findings support curcumin as a reasonably safe adjunct for psoriasis, ulcerative colitis, and rheumatoid arthritis specifically, where the evidence is strongest and most consistent; for the seven other diseases, results are preliminary and should not yet guide treatment decisions. Curcumin's poor absorption from the gut remains a practical obstacle to reliable dosing. The authors call for larger, multi-center trials, especially for the thinly studied conditions, before broader clinical recommendations can be made.

Min He et al. (2022) · European journal of medical research

This systematic review and meta-analysis combined 30 randomised controlled trials with 4,413 participants to test whether acupuncture helps allergic rhinitis — the sneezing, congestion and runny nose caused by an allergic reaction in the lining of the nose. What sets it apart is that the authors then stress-tested their own findings using trial sequential analysis, a method that asks whether enough participants have been studied for a pooled result to be trusted rather than treated as a chance finding. Trials came mostly from China (22 of 30), with others from Germany, Australia, South Korea and Sweden, ranging from 24 to 981 participants and lasting between two and twelve weeks. Three needling approaches were used: standard needle acupuncture, electroacupuncture, and warm needling, in which mugwort is burned on the needle to heat it. Acupuncture was compared against no treatment, against sham needling at non-acupuncture points, and against antihistamines including cetirizine and loratadine. Symptoms were scored with the Total Nasal Symptom Score and quality of life with the Rhinoconjunctivitis Quality of Life Questionnaire. Against no treatment, acupuncture improved both nasal symptoms and quality of life in adults. Against sham needling it also came out ahead, improving nasal symptoms (mean difference -0.60, 95% CI -1.16 to -0.04, from 489 participants) and quality of life (mean difference -8.47, 95% CI -14.91 to -2.03, from 248 participants) — both statistically significant, since neither confidence interval crosses zero. Against cetirizine or loratadine no clear difference appeared, suggesting acupuncture performs about as well as standard antihistamines. But the trial sequential analysis failed to confirm any of these results, meaning the pooled evidence has not yet accumulated enough participants to be considered reliable. Effects in children and adolescents could not be determined at all. The honest summary is a promising signal that has not yet been confirmed. Performance and attrition bias were serious in most of the included trials, and the authors' own robustness check contradicted their own positive findings. For an adult who would rather not take daily antihistamines, acupuncture is a defensible option on current evidence; it is not yet a demonstrated one. Larger and better-conducted trials, especially in children, are what would settle the question.

YuJuan Zhang et al. (2020) · Current rheumatology reports

This review examined five years of research — 16 review articles and 11 randomized controlled trials published between 2016 and 2020 — to answer a question millions of people ask: does acupuncture actually work for chronic musculoskeletal pain? That umbrella covers osteoarthritis, rheumatoid arthritis, fibromyalgia, and chronic low back pain, which together form the leading cause of disability worldwide. About three million American adults already use acupuncture yearly, most of them for these very conditions. The reviewers, writing in Current Rheumatology Reports, held studies to clear standards: randomized trials with at least 20 adults, pain as a measured primary outcome, and a genuine control group — sham needling, waiting list, active therapy, or routine care. They excluded dry needling and moxibustion so the conclusions would apply specifically to classical acupuncture at standard points. The answer turned out to be condition-specific, and refreshingly honest. Knee osteoarthritis and chronic low back pain earned the strongest support: short-term pain relief is real, and the authors call acupuncture a safe and reasonable referral option for both — a stance Medicare has since echoed by covering acupuncture for chronic low back pain. Fibromyalgia sits in the middle: acupuncture may help, but the evidence is thinner. Hip osteoarthritis and rheumatoid arthritis land on the other side: the available evidence does not support acupuncture for either, a negative finding stated without hedging. Safety was favorable across the board. For joint or back pain, this review is essentially a map of where the evidence for acupuncture stands. It is a narrative synthesis rather than a statistical meta-analysis, so it pools no numbers of its own, and its authors close with the field''s standing caveat: the short-term benefits reported across these trials still need confirmation in larger, more rigorous studies, especially for the conditions in the middle ground.

Shabei Xu et al. (2020) · BMJ (Clinical research ed.)

This randomized controlled trial with 150 participants, published in The BMJ, tackled the biggest criticism of acupuncture research head-on: that acupuncture only beats "sham" needling when the sham is badly designed. Seven hospitals in China enrolled adults with episodic migraine without aura who had never received acupuncture before, so nobody could tell true needling from fake by experience. Participants were randomized to twenty sessions of manual acupuncture (real needles at true points, with the classical rotation and lift-thrust manipulation), twenty sessions of non-penetrating sham (blunt needles at non-acupuncture points that never break the skin), or usual care alone, all over eight weeks. Blinding was formally tested and held — 79% of the real-acupuncture group and 75% of the sham group believed they had received penetrating needles, a statistical dead heat (P=0.891). Migraine days and attacks were counted in four-week blocks through week 20. Real acupuncture pulled ahead of sham, and the gap grew after treatment ended. By weeks 17–20, manual acupuncture had cut 3.9 migraine days per four weeks versus 2.2 for sham (adjusted difference −2.1 days, 95% CI −2.9 to −1.2, P<0.001 — meaning roughly two extra migraine-free days a month attributable to true needling), and attacks dropped by 2.3 versus 1.6 (P<0.001). Both needle groups beat usual care alone, which is itself informative: part of acupuncture's benefit comes from the ritual and attention of treatment, and part — the two extra migraine-free days — from the needling itself. No severe adverse events were reported, and 147 of 150 participants completed the analysis. For the millions of people with migraine who cannot tolerate preventive drugs — or prefer not to start them — this trial provides unusually clean evidence that manual acupuncture has a real, specific preventive effect beyond placebo. The benefit emerged gradually, months into follow-up, suggesting patience matters. The trial ran in a single country and followed patients only to week 20, so durability beyond five months remains an open question.

He Chen et al. (2024) · Current pain and headache reports

Does acupuncture keep helping knee osteoarthritis after the needles stop? A 2024 systematic review and meta-analysis in Current Pain and Headache Reports pooled 10 randomized controlled trials with 3,221 participants to answer exactly that, and found benefits lasting roughly 3 to 6 months after the final session. The durability depended on the comparison. Against sham acupuncture, real acupuncture kept function measurably better for 4.5 months after treatment ended, and overall pain stayed lower through 4.5 months as well. Against usual care, both pain relief and functional improvement remained large enough to matter clinically for 5 months. One trial comparing dry needling with the anti-inflammatory drug diclofenac found relief persisting 6 months after treatment ended. Not every comparison favored acupuncture. When it was added on top of exercise-based physical therapy, it added nothing measurable for up to 11 months — exercise appears to occupy much of the same therapeutic ground. And two no-treatment-controlled trials disagreed, one showing 3 months of persistence and the other showing benefits only at end of treatment. Safety was consistently good across trials, with no significant excess of adverse events. For the estimated one in five adults over 40 living with knee osteoarthritis, the practical takeaway is that a 4-to-12-week course of acupuncture (typically 1–3 sessions weekly) can deliver relief that outlasts treatment by months — something NSAIDs and steroid injections generally cannot claim. It works best as its own treatment or alongside routine care, not stacked on structured exercise therapy, and results should be weighed knowing each individual comparison rested on relatively few trials.

Lynn L DeBar et al. (2025) · JAMA network open

This randomized trial with 800 participants asked a question no large study had answered: does acupuncture help adults 65 and older with chronic low back pain? Acupuncture — the Traditional Chinese Medicine practice of inserting fine needles at specific points — is already guideline-recommended for back pain in general adults, but older adults face the highest risks from pain medications and had never had a dedicated large trial. The results were designed to inform Medicare coverage. Participants (average age 74, and 41% over 75) were randomized to three groups: standard acupuncture (8–15 sessions over 12 weeks), enhanced acupuncture (the same plus 4–6 maintenance sessions), or usual medical care alone. Real-world community acupuncturists — more than 50 of them — tailored needling to each patient, and disability was measured with the Roland-Morris questionnaire, a standard count of daily activities limited by back pain. At six months, both acupuncture groups functioned meaningfully better than usual care. The share of people achieving at least 30% improvement — the accepted bar for a clinically meaningful change — was 43.8% with enhanced acupuncture and 39.1% with standard, versus 29.4% with usual care alone (a relative 49% and 33% higher chance of meaningful improvement). Benefits held at twelve months. Pain intensity and anxiety also improved, and maintenance sessions added a modest edge on pain. Safety was excellent: serious adverse events were rare, equal across groups, and less than 1% were possibly related to acupuncture. For older adults weighing pain options, this is the strongest evidence yet: acupuncture delivered by community practitioners produced lasting improvement with almost no risk — in a population where the usual alternatives (opioids, NSAIDs, gabapentinoids) carry their highest dangers. The authors suggest it may deserve first-line status for this age group.

Jun J Mao et al. (2021) · JAMA oncology

This randomized clinical trial with 360 cancer survivors asked a practical question: for people who finished cancer treatment but still live with chronic musculoskeletal pain, does acupuncture work better than usual care — and which kind of acupuncture is better? The PEACE trial, run across six sites in New York and New Jersey and published in JAMA Oncology, compared electroacupuncture (electrical stimulation through needles placed in the body) with auricular acupuncture (needles placed at standardized points on the ear). Participants — mean age 62, about 70% women — had a prior cancer diagnosis, no current disease, and pain of at least three months. They were randomized to ten weekly sessions of electroacupuncture (145 people), ear acupuncture (143), or usual care (72), with pain scored on the Brief Pain Inventory, a 0-to-10 scale. Electroacupuncture points were tailored to where each person hurt, while ear acupuncture used the same standardized points for everyone — a deliberately pragmatic design reflecting how each style is really practiced. Nearly everyone (94.4%) completed the twelve-week assessment, unusually high retention for a pain trial in this population. Both acupuncture styles delivered real relief. Electroacupuncture reduced pain by 1.9 points more than usual care (97.5% CI 1.4–2.4, p<0.001 — roughly a one-third drop from the average starting pain of 5.2), and auricular acupuncture by 1.6 points more (97.5% CI 1.0–2.1, p<0.001). But ear acupuncture failed to prove itself as good as electroacupuncture, and it was harder to tolerate: 10.5% of ear-acupuncture patients stopped because of side effects — mostly ear discomfort — versus just 0.7% with electroacupuncture. For cancer survivors seeking alternatives to long-term pain medication, this trial makes electroacupuncture the stronger evidence-backed choice, with ear acupuncture as a workable fallback when body needling isn't practical. The design was pragmatic and the analysis blinded, though there was no sham-needle arm, so expectation effects can't be fully separated — and follow-up ended at 24 weeks, leaving durability an open question.

Jinglan Mu et al. (2020) · The Cochrane database of systematic reviews

Does acupuncture help chronic low back pain? A Cochrane systematic review — the reference standard for evidence synthesis in medicine — pooled 33 randomized controlled trials with 8,270 adults whose low back pain had lasted more than three months without an identifiable cause, and the answer depends entirely on what acupuncture is compared against. The trials, conducted across Europe, Asia, and the Americas, compared real acupuncture with three alternatives: sham needling (needles placed superficially or away from true acupuncture points), no treatment at all, and usual medical care such as medication and physiotherapy. Pain was measured on 0–100 scales, function with validated back-specific questionnaires like the Hannover Functional Ability Questionnaire, and the review graded how trustworthy each pooled result was using the GRADE framework. Against no treatment, acupuncture delivered a 20-point pain reduction (95% CI 16–25 — well past the roughly 15 points patients can actually feel) along with clear functional improvement. Against usual care, pain improved by about 10 points and physical quality of life rose measurably (4.2 points on the SF-12), though mental well-being did not change. Against sham needling, however, the advantage shrank to 9 points — a real but sub-clinical difference — and back function did not separate at all. Side effects were minor and no more frequent than with sham: needle-site pain, bruising, occasional bleeding, with no serious harms attributed to treatment. For the many people living with chronic low back pain, this review supports acupuncture as genuinely better than doing nothing and a reasonable, safe addition to routine care — while being honest that much of the measured benefit may ride on components shared with sham treatment, such as expectation, focused attention, and the treatment ritual itself. Trial quality was mixed, seven German studies contributed two-thirds of all participants, and the authors conclude the choice should ultimately weigh availability, cost, and personal preference.