Table 1: Summary of randomized controlled trials and prospective clinical trials of acupuncture for posttraumatic stress disorder.

First author [ref]
(year)
country
PopulationStudy designSample
size/ , analyzed
Intervention/control group
(regime)
Treatment
session
Main outcomesIntergroup differenceComments

RCT ( )

Hollifield [18]
(2007)
U.S.A.
28 out of 84 identified childhood abuse/
Others, unknown trauma
3 arm parallel, open84/73(A) AT + AAT ( )/
(B) CBT ( )
(C) WLC ( )
24 sessions(1) PTSD scale (PSS-SR)
(2) Depression (HSCL-25)
(3) Anxiety (HSCL-25)
(4) Impairment (SDI)
(1) A versus B: = 0.36, MD, −0.26 [−0.83, 0.30]
  A versus C: = 0.001, MD, −0.98 [−1.58, −0.38]
  B versus C: = 0.004, MD, −0.85 [−1.44, −0.27]
(2) A versus B: = 0.92 MD, 0.03 [−0.53, 0.59]
  A versus C: = 0.02, MD, −0.68 [−1.27, −0.10]
  B versus C: = 0.008, MD, −0.80 [−1.38, −0.21]
(3) A versus B: = 0.39, MD, −0.25 [−0.81, 0.31]
  A versus C: = 0.003, MD, −0.91 [−1.51, −0.32]
  B versus C: = 0.008, MD, −0.79 [−1.37, −0.21]
(4) A versus B: = 0.98, MD, −0.01 [−0.57, 0.55]
   A versus C: = 0.03, MD, −0.64 [−1.22, −0.06]
  B versus C: = 0.03, MD, −0.64 [−1.22, −0.07]
The AT group had significantly better improvements in PTSD symptoms than the WLC group. But, there was no statistically significant difference between the AT group and the CBT group.
Zhang [25] (2010)ChinaEarthquake4 arm parallel, open276/256(A) EA ( )
(B) EA + moxa ( )
(C) EA + AAT ( )/
(D) Oral SSRI ( )
36 sessions(1) PTSD scale (CAPS)
(2) Depression (HAMD)
(3) Anxiety (HAMA)
(1) A versus D: = 0.43, MD, −0.13 [−0.47, 0.20]
  B versus D: = 0.88, MD, −0.03 [−0.36, 0.31]
  C versus D: = 0.55, MD, −0.10 [−0.44, 0.23]
(2) A versus D: = 0.14, MD, −0.25 [−0.59, 0.08]
  B versus D: = 0.34, MD, −0.16 [−0.50, 0.17]
  C versus D: = 0.23, MD, −0.21 [−0.54, 0.13]
(3) A versus D: = 0.34, MD, −0.16 [−0.50, 0.17]
  B versus D: = 0.64, MD, −0.08 [−0.41, 0.25]
  C versus D: = 0.54, MD, 0.11 [−0.23, 0.44]
The therapeutic effect of EA was not better than that of oral SSRI.
Zhang [26](2010)
China
Earthquake2 arm
parallel
open
92/81(A) EA + moxa ( )/
(B) Oral SSRI ( )
36 sessions(1) PTSD scale (CAPS)
(2) Depression (HAMD)
(3) Anxiety (HAMA)
(1) A versus B: < 0.00001, MD, −1.77 [−2.26, −1.29]
(2) A versus B: < 0.00001, MD, −1.96 [−2.46, −1.46]
(3) A versus B: < 0.00001, MD, −1.53 [−2.00, −1.07]
EA plus moxa was more effective than oral SSRI therapy.
Zhang [27]
(2011)
China
Earthquake2 arm
parallel
open
91/90(A) Acupoint Stimulation
+ CBT ( )/
(B) CBT ( )
3~4 sessions*(1) PTSD scale (IES-R)
(2) PTSD scale (self compiled questionnaire)
(1) A versus B: < 0.00001, MD, −1.56 [−2.08, −1.04]
(2) A versus B: = 0.01, MD, −0.59 [−1.07, −0.12]
The acupoint stimulation plus CBT showed better efficacy than CBT therapy alone.

UCT ( )

Wang [28]
(2009)
China
EarthquakeUCT69EA + AAT + moxa36 sessions(1) The number of cured/improved/non-improvedNot applicableTreatment was effective in 65 out of 69 (94.2%).
Yuan [29]
(2009)
China
EarthquakeUCT34AT20 sessions(1) The number of cured/improved/non-improvedNot applicableAT was effective in 31 out of 34 (91.2%).

Abbreviations: RCT: randomized controlled trial; UCT: uncontrolled clinical trial; AT: classical acupuncture; EA: electro-acupuncture; moxa, moxibustion; AAT: auricular acupuncture; CBT: cognitive behavioral therapy; WLC: waitlist control; SSRI: selective serotonin reuptake inhibitors; PSS-SR: posttraumatic symptom scale-self report; HSCL-25: self-rated Hopkins symptom checklist-25; SDI: Sheehan Disability Inventory; MD: mean difference; CAPS: clinician-administered PTSD scale; HAMD: Hamilton depression rating scale; HAMA: Hamilton anxiety rating scale; IES-R: Chinese version of the incident effect scale revised; *treated a time every other day for 1 week.