Abstract
BackgroundComplementary therapies are widespread but controversial. We aim to provide
a comprehensive collection and a summary of systematic reviews of clinical trials in three
major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is
dealing with acupuncture. Potentially relevant reviews were searched through the register of
the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and
bibliographies of articles and books. To be included articles had to review prospective clinical
trials of acupuncture; had to describe review methods explicitly; had to be published; and had
to focus on treatment effects. Information on conditions, interventions, methods, results and
conclusions was extracted using a pretested form and summarized descriptively. ResultsFrom a total of 48 potentially relevant reviews 39 met the inclusion criteria. 22 were on various pain syndromes or rheumatic diseases. Other topics addressed by more than one review were addiction, nausea, asthma and tinnitus. Almost unanimously the reviews state that acupuncture trials include too few patients. Often included trials are heterogeneous regarding patients, interventions and outcome measures, are considered to have insufficient quality and contradictory results. Convincing evidence is available only for postoperative nausea, for which acupuncture appears to be of benefit, and smoking cessation, where acupuncture is no more effective than sham acupuncture. ConclusionsA large number of systematic reviews on acupuncture exists. What is most obvious from these reviews is the need for (the funding of) well-designed, larger clinical trials.