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Acupuntura

No contexto terapêutico, acupuntura é um recurso originário da MTC que envolve a estimulação de pontos específicos no corpo utilizando agulhas filiformes ou outros meios, como a pressão do dedo (acupressão), o laser (laseracupuntura) e a estimulação elétrica (eletroacupuntura). Sua aplicação pode ser realizada de diferentes maneiras, variando quanto a escolha e número de pontos, o local (proximal ou distal a região acometida) e o método de agulhamento, a técnica de manipulação da agulha, a duração do estímulo, a frequência e o número de atendimentos de acordo com o referencial teórico adotado. Dentre os referenciais teóricos que embasam o diagnóstico e a escolha dos pontos para tratamento, os mais comuns são o da Acupuntura Tradicional (chinesa, japonesa, francesa) e o da Acupuntura Ocidental (neurofisiológica ou contemporânea).
No contexto do trabalho, a acupuntura é considerada como profissão de nível técnico (CBO 322105) pelo Ministério do Trabalho e como especialidade por alguns conselhos de profissões regulamentadas da área da saúde, como a de Fisioterapeuta Acupunturista (CBO 223650) pelo COFFITO, sendo reconhecida pela Organização Mundial da Saúde (OMS) e Ministério da Saúde do Brasil como uma prática multiprofissional. Por não ser uma profissão regulamentada, o art. 5º da Constituição Federal garante o livre exercício da acupuntura em todo território nacional.
Acupuntura também é reconhecida como Patrimônio Cultural Intangível da Humanidade pela UNESCO (Link).
Para saber mais sobre a história da Acupuntura no Brasil e no mundo “clique aqui“.

MeSH Term: Acupuncture.
Unitermos: dry needling, intramuscular stimulation, laser acupuncture, low-level laser therapy applied at acupuncture points, electroacupuncture, electro-acupuncture, transcutaneous electrical acupoint stimulation, acu-TENS, percutaneous electrical nerve stimulation, periosteal stimulation therapy.

Score 10/10 na escala PEDro

  • Quah-Smith JI et al. Laser acupuncture for mild to moderate depression in a primary care setting–a randomised controlled trial. Acupunct Med. 2005 Sep; 23(3): 103-11. <https://www.ncbi.nlm.nih.gov/pubmed/16259308>. [30 participantes, 2 grupos]

Score 9/10 na escala PEDro

  • Huang CH et al. Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial. J Integr Med. 2022 Jul;20(4):321-328. <https://pubmed.ncbi.nlm.nih.gov/35459599/>. [82 participantes, 5 grupos]
  • Zeng D et al. Placebo response varies between different types of sham acupuncture: A randomized double-blind trial in neck pain patients. Eur J Pain. 2022 May;26(5):1006-1020.. <https://pubmed.ncbi.nlm.nih.gov/35129852/>. [175 participantes, 5 grupos]
  • Chen L et al. Optimized acupuncture treatment (acupuncture and intradermal needling) for cervical spondylosis-related neck pain: a multicenter randomized controlled trial. Pain. 2021 Mar 1;162(3):728-739. <https://pubmed.ncbi.nlm.nih.gov/32947547/>. [857 participantes, 3 grupos]
  • Sun Y et al. Efficacy of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized Trial. Ann Intern Med. 2021 Oct;174(10):1357-1366. <https://pubmed.ncbi.nlm.nih.gov/34399062/>. [440 participantes, 2 grupos]
  • Tu JF et al. Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis: A randomized controlled trial. Arthritis Rheumatol. 2021 Mar;73(3):448-458. <https://pubmed.ncbi.nlm.nih.gov/33174383/>. [442 participantes, 3 grupos]
  • Zhang ZJ et al. Assessor- and participant-blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke. Psychiatry Clin Neurosci. 2020 Mar; 74(3): 183-190. <https://www.ncbi.nlm.nih.gov/pubmed/31747095>. [91 participantes, 2 grupos]
  • Qin Z et al. Acupuncture versus noninsertive sham acupuncture in ageing patients with degenerative lumbar spinal stenosis: a randomized controlled trial. Am J Med. 2020 Apr;133(4):500-507.e20. <https://pubmed.ncbi.nlm.nih.gov/31525334/>. [80 participantes, 2 grupos]
  • Zhao L et al. Acupuncture as Adjunctive Therapy for Chronic Stable Angina: A Randomized Clinical Trial. JAMA Intern Med. 2019 Jul 29. <https://www.ncbi.nlm.nih.gov/pubmed/31355870?fbclid=IwAR1LnbBiFLbc-9gVNubvf1lUkFlC-cFCA92kYs9lvm3VGC1XBeb6Mw4UXjY>. [404 participantes, 4 grupos]
  • Ho LF et al. Efficacy of abdominal acupuncture for neck pain: A randomized controlled trial. PLoS One. 2017 Jul 17; 12(7): e0181360. <https://www.ncbi.nlm.nih.gov/pubmed/28715459>. [154 participantes, 2 grupos]
  • Mao JJ et al. Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial. Cancer. 2014 Dec 1;120(23):3744-51. <https://pubmed.ncbi.nlm.nih.gov/25077452/>. [67 participantes, 3 grupos]
  • Choi SM et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013 Mar; 68(3): 365-74. <https://www.ncbi.nlm.nih.gov/pubmed/23253122>. [238 participantes, 3 grupos]
  • Hauer K et al. Stimulation of acupoint ST-34 acutely improves gait performance in geriatric patients during rehabilitation: A randomized controlled trial. Arch Phys Med Rehabil. 2011 Jan; 92(1): 7-14. <https://www.ncbi.nlm.nih.gov/pubmed/21187200>. [60 participantes, 2 grupos]
  • Rogha M et al. The effects of acupuncture on the inner ear originated tinnitus. J Res Med Sci. 2011 Sep;16(9):1217-23. <https://pubmed.ncbi.nlm.nih.gov/22973392/>. [63 participantes, 2 grupos]
  • Gottschling S et al. Laser acupuncture in children with headache: a double-blind, randomized, bicenter, placebo-controlled trial. Pain. 2008 Jul 15;137(2):405-412. <https://pubmed.ncbi.nlm.nih.gov/18022318/>. [48 participantes, 2 grupos]
  • Witt C et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. 2005 Jul 9-15; 366(9480): 136-43. <https://www.ncbi.nlm.nih.gov/pubmed/16005336>. [300 participantes, 3 grupos]
  • Vas J et al. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial. BMJ. 2004 Nov 20; 329(7476): 1216. <https://www.ncbi.nlm.nih.gov/pubmed/15494348>. [97 participantes, 2 grupos]

Score 8/10 na escala PEDro

  • Usichenko TI et al. Effectiveness of Acupuncture for Pain Control After Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2022 Feb 1;5(2):e220517. <https://pubmed.ncbi.nlm.nih.gov/35226080/>. [120 participantes, 2 grupos]
  • Meyer-Hamme G et al. Electrophysiologically verified effects of acupuncture on diabetic peripheral neuropathy in type 2 diabetes: The randomized, partially double-blinded, controlled ACUDIN trial. J Diabetes. 2021 Jun;13(6):469-481. <https://pubmed.ncbi.nlm.nih.gov/33150711/>. [180 participantes, 3 grupos]
  • Uygur E et al. The use of dry needling vs. corticosteroid injection to treat lateral epicondylitis: a prospective, randomized, controlled study. J Shoulder Elbow Surg. 2021 Jan;30(1):134-139. <https://pubmed.ncbi.nlm.nih.gov/32950674/>. [108 participantes, 2 grupos]
  • Dunning J et al. Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial. Spine J. 2021 Feb;21(2):284-295. <https://pubmed.ncbi.nlm.nih.gov/33065273/>. [142 participantes, 2 grupos]
  • Dunning J et al. Spinal Manipulation and Electrical Dry Needling in Patients With Subacromial Pain Syndrome: A Multicenter Randomized Clinical Trial. J Orthop Sports Phys Ther. 2021 Feb;51(2):72-81. <https://pubmed.ncbi.nlm.nih.gov/32857944/>. [145 participantes, 2 grupos]
  • Xu S et al. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ. 2020 Mar 25; 368: m697. <https://www.ncbi.nlm.nih.gov/pubmed/32213509>. [150 participantes, 3 grupos]
  • Li QW et al. Efficacy of acupuncture in the prevention and treatment of chemotherapy-induced nausea and vomiting in patients with advanced cancer: a multi-center, single-blind, randomized, sham-controlled clinical research. Chin Med. 2020 Jun 3;15:57. <https://pubmed.ncbi.nlm.nih.gov/32514290/>. [134 participantes, 2 grupos]
  • Gadau M et al. A multi-center international study of acupuncture for lateral elbow pain – Results of a randomized controlled trial. Eur J Pain. 2020 Sep;24(8):1458-1470. <https://pubmed.ncbi.nlm.nih.gov/32301166/>. [96 participantes, 2 grupos]
  • Valiente-Castrillo P et al. Effects of pain neuroscience education and dry needling for the management of patients with chronic myofascial neck pain: a randomized clinical trial. Acupunct Med. 2020 May 5;964528420920300. <https://pubmed.ncbi.nlm.nih.gov/32370545/>. [60 participantes, 3 grupos].
  • Shi G-X et al. Effect of Electro-Acupuncture (EA) and Manual Acupuncture (MA) on Markers of Inflammation in Knee Osteoarthritis. J Pain Res. 2020 Aug 26;13:2171-2179. <https://pubmed.ncbi.nlm.nih.gov/32904642/>. [60 participantes, 2 grupos]
  • Martín-Collares C et al. Benefits of Adding Gluteal Dry Needling to a Four-Week Physical Exercise Program in a Chronic Low Back Pain Population. A Randomized Clinical Trial. Pain Med. 2020 Nov 1;21(11):2948-2957. <https://pubmed.ncbi.nlm.nih.gov/33580803/>. [46 participantes, 2 grupos]
  • Dunning J et al. Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial. Clin J Pain. 2018 Dec; 34(12): 1149-1158. <https://www.ncbi.nlm.nih.gov/pubmed/29864043>. [242 participantes, 2 grupos]
  • Shi GX et al. Motion style acupuncture therapy for shoulder pain: a randomized controlled trial. J Pain Res. 2018 Sep 25;11:2039-2050. <https://www.ncbi.nlm.nih.gov/pubmed/30310308>. [164 participantes, 4 grupos]
  • Vas J et al. Acupuncture for fibromyalgia in primary care: a randomised controlled trial. Acupunct Med. 2016 Aug;34(4):257-66. <https://pubmed.ncbi.nlm.nih.gov/26879181/>. [164 participantes, 2 grupos]
  • Xue CC et al. Acupuncture for seasonal allergic rhinitis: a randomized controlled trial. Ann Allergy Asthma Immunol. 2015 Oct;115(4):317-324.e1. <https://pubmed.ncbi.nlm.nih.gov/26073163/>. [175 participantes, 2 grupos]
  • Brinkhaus B et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med. 2013 Feb 19;158(4):225-34. <https://pubmed.ncbi.nlm.nih.gov/23420231/>. [422 participantes, 3 grupos]
  • Shin JS et al. Effects of motion style acupuncture treatment in acute low back pain patients with severe disability: a multicenter, randomized, controlled, comparative effectiveness trial. Pain. 2013 Jul; 154(7): 1030-7. <https://www.ncbi.nlm.nih.gov/pubmed/23639822>. [58 participantes, 2 grupos]
  • Karner M et al. Objectifying specific and nonspecific effects of acupuncture: a double-blinded randomised trial in osteoarthritis of the knee. Evid Based Complement Alternat Med. 2013;2013:427265. <https://pubmed.ncbi.nlm.nih.gov/23365608/>. [125 participantes, 3 grupos]
  • Vas J et al. Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial. Rheumatology (Oxford). 2008 Jun; 47(6): 887-93. <https://www.ncbi.nlm.nih.gov/pubmed/18403402>. [425 participantes, 2 grupos]
  • Williamson L et al. Severe knee osteoarthritis: a randomized controlled trial of acupuncture, physiotherapy (supervised exercise) and standard management for patients awaiting knee replacement. Rheumatology (Oxford). 2007 Sep; 46(9): 1445-9. <https://www.ncbi.nlm.nih.gov/pubmed/17604311>. [181 participantes, 3 grupos]
  • Elden H et al. Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ. 2005 Apr 2; 330(7494): 761. <https://www.ncbi.nlm.nih.gov/pubmed/15778231>. [386 participantes, 3 grupos]
  • Johansson KM et al. Effects of acupuncture versus ultrasound in patients with impingement syndrome: randomized clinical trial. Phys Ther. 2005 Jun; 85(6): 490-501. <https://www.ncbi.nlm.nih.gov/pubmed/15921471>. [85 participantes, 2 grupos]
  • Ng DK et al. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics. 2004 Nov;114(5):1242-7. <https://pubmed.ncbi.nlm.nih.gov/15520102/>. [72 participantes, 2 grupos]
  • Brinkhaus B et al. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy. 2004 Sep;59(9):953-60. <https://pubmed.ncbi.nlm.nih.gov/15291903/>. [59 participantes, 2 grupos]
  • Molsberger et al. Does acupuncture improve the orthopedic management of chronic low back pain–a randomized, blinded, controlled trial with 3 months follow up. Pain. 2002 Oct;99(3):579-87. <https://pubmed.ncbi.nlm.nih.gov/12406534/>. [186 participantes, 3 grupos]

Score 7/10 na escala PEDro

  • Barth J et al. Effect of Briefing on Acupuncture Treatment Outcome Expectations, Pain, and Adverse Side Effects Among Patients With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021 Sep 1;4(9):e2121418. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8433606/>. [152 participantes, 4 grupos]
  • Mao JJ et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. 2021 May 1;7(5):720-727. <https://pubmed.ncbi.nlm.nih.gov/33734288/>. [360 participantes, 3 grupos]
  • Liu Z et al. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial. JAMA. 2017 Jun 27; 317(24): 2493-2501. <https://www.ncbi.nlm.nih.gov/pubmed/28655016>. [504 participantes, 2 grupos]
  • Brennan KL et al. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. J Orthop Sports Phys Ther. 2017 Apr; 47(4): 232-239. <https://www.ncbi.nlm.nih.gov/pubmed/28257614>. [43 participantes, 2 grupos]
  • Elbadawy MA. Effectiveness of Periosteal Stimulation Therapy and Home Exercise Program in the Rehabilitation of Patients With Advanced Knee Osteoarthritis. Clin J Pain. 2017 Mar; 33(3): 254-263. <https://www.ncbi.nlm.nih.gov/pubmed/27513639>. [60 participantes, 2 grupos]
  • MacPherson H et al. Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial. Ann Intern Med. 2015 Nov 3;163(9):653-62. <https://pubmed.ncbi.nlm.nih.gov/26524571/>. [517 participantes, 3 grupos]
  • Suzuki M et al. A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT). Arch Intern Med. 2012 Jun 11; 172(11): 878-86. <https://www.ncbi.nlm.nih.gov/pubmed/22905352>. [68 participantes, 2 grupos]
  • Johansson K et al. Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care – a randomized clinical trial. Fam Pract. 2011 Aug; 28(4): 355-65. <https://www.ncbi.nlm.nih.gov/pubmed/21378086>. [123 participantes, 2 grupos]
  • Molsberger AF et al. German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) – a pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Pain. 2010 Oct;151(1):146-154. <https://pubmed.ncbi.nlm.nih.gov/20655660/>. [424 participantes, 3 grupos]
  • Vas J et al. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study. Pain. 2006 Dec 15;126(1-3):245-55. <https://pubmed.ncbi.nlm.nih.gov/16934402/>. [123 participantes, 2 grupos]
  • Thomas KJ et al. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ. 2006 Sep 23;333(7569):623. <https://pubmed.ncbi.nlm.nih.gov/16980316/>. [289 participantes, 2 grupos]
  • Thomas KJ et al. Longer term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain. Health Technol Assess. 2005 Aug;9(32):iii-iv, ix-x, 1-109. <https://pubmed.ncbi.nlm.nih.gov/16095547/>.[241 participantes, 2 grupos]
  • Guerra de Hoyos JA et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. 2004 Dec; 112(3): 289-98. <https://www.ncbi.nlm.nih.gov/pubmed/15561384>. [130 participantes, 2 grupos]

Score 6/10 na escala PEDro

  • Atalay SG et al. The Effect of Acupuncture and Physiotherapy on Patients with Knee Osteoarthritis: A Randomized Controlled Study. Pain Physician. 2021 May;24(3):E269-E278. <https://pubmed.ncbi.nlm.nih.gov/33988943/>. [105 participantes, 2 grupos]
  • McKee MD et al. Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care-a Randomized Trial. J Gen Intern Med. 2020 Apr;35(4):1227-1237. <https://www.ncbi.nlm.nih.gov/pubmed/32076985>. [779 participantes, 2 grupos]
  • Hershman DL et al. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA. 2018 Jul 10; 320(2): 167-176. <https://www.ncbi.nlm.nih.gov/pubmed/29998338>. [226 participantes, 3 grupos]
  • Al Rashoud AS et al. Efficacy of low-level laser therapy applied at acupuncture points in knee osteoarthritis: a randomised double-blind comparative trial. Physiotherapy. 2014 Sep; 100(3): 242-8. <https://www.ncbi.nlm.nih.gov/pubmed/24418801>. [49 participantes, 2 grupos]

Aguardando classificação

  • Tu JF et al. Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial. JAMA Intern Med. 2024 Oct 14. <https://pubmed.ncbi.nlm.nih.gov/39401008/>. [220 participantes, 2 grupos]
  • Zhao L et al. Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain: A Randomized Controlled Trial. Ann Intern Med. 2024 Sep 3. <https://pubmed.ncbi.nlm.nih.gov/39222507/>.  [716 participantes, 4 grupos]
  • Li B et al. Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia: A Randomized Clinical Trial. JAMA Netw Open. 2024 Jan 2;7(1):e2352580. <https://pubmed.ncbi.nlm.nih.gov/38252438/>. [252 participantes, 2 grupos]
  • Wu XK et al. Acupuncture and Doxylamine-Pyridoxine for Nausea and Vomiting in Pregnancy: A Randomized, Controlled, 2 × 2 Factorial Trial. Ann Intern Med. 2023 Jun 20.  <https://pubmed.ncbi.nlm.nih.gov/37335994/>. [352 participantes, ? grupos]
  • Hershman DL et al. Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor-Related Joint Pain: A Randomized Clinical Trial. JAMA Netw Open. 2022 Nov 1;5(11):e2241720. <https://pubmed.ncbi.nlm.nih.gov/36367721/>. [226 participantes, 3 grupos].
  • Wang Y et al. Electroacupuncture vs Sham Electroacupuncture in the Treatment of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer: A Multicenter, Randomized Clinical Trial. JAMA Surg. 2022 Nov 2. <https://pubmed.ncbi.nlm.nih.gov/36322060/>. [248 participantes, 2 grupos].
  • Fan JQ et al. Effectiveness of Acupuncture for Anxiety Among Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Netw Open. 2022 Sep 1;5(9):e2232133. <https://pubmed.ncbi.nlm.nih.gov/36129711/>. [70 participantes, 2 grupos]
  • Tu JF et al. Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis: A Randomized Clinical Trial. JAMA Netw Open. 2022 Aug 1;5(8):e2225735. <https://pubmed.ncbi.nlm.nih.gov/35943743/>. [80 participantes, 2 grupos]
  • Yin X et al. Effect of Electroacupuncture on Insomnia in Patients With Depression: A Randomized Clinical Trial. JAMA Netw Open. 2022 Jul 1;5(7):e2220563. <https://pubmed.ncbi.nlm.nih.gov/35797047/>. [270 participantes, 3 grupos]
  • Kong JT et al. Effect of Electroacupuncture vs Sham Treatment on Change in Pain Severity Among Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2022787. <https://pubmed.ncbi.nlm.nih.gov/33107921/>. [121 participantes, 2 grupos]
  • Liu Z et al. Acupuncture for Chronic Severe Functional Constipation: A Randomized Trial. Ann Intern Med. 2016 Dec 6;165(11):761-769. <https://pubmed.ncbi.nlm.nih.gov/27618593/>. [1075 participantes, 2 grupos]

Gráfico mostrando o tamanho de efeito das intervenções, com a diferença das médias na comparação Within-Group e Between-Groups.

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