For angina relief, acupuncture bests sham or no acupuncture

  • Zhao L & al.
  • JAMA Intern Med
  • 29 Jul 2019

  • International Clinical Digest
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Takeaway

  • For attack reduction in chronic stable angina, acupuncture bested sham treatment or no acupuncture as adjunctive therapy in this randomized trial.

Why this matters

  • Many patients turn to alternative therapies, and randomized controlled trials of such interventions are needed.

Key results

  • Reductions in attack frequency (magnitude of reduction; 95% CIs):
    • Acupuncture targeting the “disease-affected meridian” vs targeting the unaffected meridian: 4.07 (2.43-5.71; P<.001>
    • Acupuncture targeting the “disease-affected meridian” vs sham: 5.18 (3.54-6.81; P<.001>
    • Acupuncture targeting the “disease-affected meridian” vs waitlist: 5.63 (3.99-7.27; P<.001>
  • Visual analogue scale scores also decreased more in the “disease-affected meridian” group.
  • But groups did not differ at 16 weeks for rescue medication use, anxiety and depression scale scores, or QoL ratings.
  • 16 patients reported adverse events related to acupuncture, including subcutaneous hemorrhage, tingling where needle was inserted.

Study design

  • 398 patients (ages 35-80 years) at 5 centers in China were randomly allocated to 12 sessions of “disease-affected meridian” acupuncture, "unaffected meridian" acupuncture, sham acupuncture, or waitlist groups.
  • All had chronic stable angina, with attacks at least twice weekly.
  • Outcome: change in attack frequency.
  • Funding: Chinese government grants.

Limitations

  • Acupuncture not individualized.
  • Small study, short duration.

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