Wrist-Ankle Acupuncture for the Treatment of Pain Symptoms: A Systematic Review and Meta-Analysis

Table 1

Randomized controlled trials of wrist-ankle acupuncture for the treatment of pain with Jadad score ≥3.

(a)

Number	1st author  (year)	Country	Disease category	Design  (treatment group versus control group)	Sample size (treatment/control)	Adverse events
1 [11]	Zhou et al.  2006	China	Root pain in lumbar disc prolapse	3-parallel-arm  (WAA versus BA; WM)	310 (162 + 76 + 72)	Not mentioned
2 [12]	Chan et al. 2010	China	Acute lumbago	2-parallel-arm   (WAA versus SA)	60 (30 + 30)	WAA: 3 cases of subcutaneous hemorrhage  SA: 1 case of punctured skin but not bleeding
3 [13]	Deeks et al.  2011	China	Chronic neck pain	2-parallel-arm  (WAA + neck exercise versus SA + neck exercise)	49 (22 + 27)	Report: both AA and SA were safe and there were no adverse events
4 [14]	Su et al.  2010	China	Herpes zoster	2-parallel-arm  (WAA + PB + QC versus WM)	78 (40 + 38)	Not mentioned
5 [15]	Wang   2012	China	Postherpetic neuralgia	2-parallel-arm  (WAA versus BA)	60 (30 + 30)	Not mentioned
6 [16]	Xu   2012	China	Pain after knee arthroplasty	2-parallel-arm  (WAA + AP versus WM)	80 (40 + 40)	Treatment group: 1 case of dizziness; 1 case of nausea Control group: 7 cases of nausea; 6 cases of dizziness; 13 cases of stomach problem
7 [17]	Hu   2004	China	Middle-late liver cancer pain	2-parallel-arm  (WAA versus WM)	86 (36 + 50)	WAA: 1 case of nausea and vomiting; 2 cases of dizziness (total: 3)   WM: 5 cases of nausea and vomiting; 5 cases of dizziness; 6 cases of constipation; 3 cases of drowsiness (total: 12)

(b)

Followup	Measurement points	Outcome	Treatment course
2 days	After 0.5 h, 1 h, 24 h, and 48 h of treatment	Effective rate: 19.14% in WAA, 1.32% in BA, and 2.78% in WM	Only 1 time
No	Before 3 min of treatment and after 5, 10, 15, and 30 min of treatment	VAS: 35.30 ± 10.89 in WAA; 46.73 ± 9.26 in SA	Only 1 time
One-month	Immediately after treatment; 1 month after treatment	40% in WAA group reported a reduction of NRS ≥ 50% and 12.5% in SA group; 70% in WAA reported a reduction of NRS ≥ 30% and 12.5% in SA. NRS: 3.61 ± 1.98 in WAA; 5.35 ± 2.15 in SA	2 times/per week and a total of 4 weeks in both groups
No	After 1st, 2nd, and 3rd of treatment	Effective rate: 97.5% in WAA; 78.9% in WM	1 time/per day, 3 days as a course, and a total of 3 courses in both groups
No	After the last treatment	Total effective rate: 96.7% in WAA and 93.3% in WM; cure rate: 63.3% in WAA and 40% in WM	1 time/per day, 5 days as a course, a total of 3 courses; relaxation 2 days between courses
No	After treatment	VAS: 1.04 ± 0.54 in WAA and 2.08 ± 0.76 in WM; effective rate: 95% in WAA and 77.50% in WM	1 time/per day, 10 days as a course, and a total of 3 courses
10	After the last treatment	Effective rate: 86.1% in WAA and 92% in WM	1 time/per day; totally 10 days

Note: WAA: wrist-ankle acupuncture; WM: western medication; SA: sham acupuncture; NRS: numerical rating scale; VAS: visual analogue scale; BA: body acupuncture; QC: quick cupping; AP: auricular-plaster; PB: puncture bleeding.