Universidade Federal do Ceará
Grupo de Atenção Integral e Pesquisa em Acupuntura e Medicina Tradicional Chinesa – GAIPA UFC

*Métodos de agulhamento, combinações de terapias e perfil de pacientes que a acupuntura não foi efetiva

Atenção, antes de generalizar o resultado de um estudo é importante avaliar a sua qualidade metodológica (risco de viés e confiança na estimativa do efeito) e a adequação dos protocolos de intervenção do tratamento verdadeiro e do controle (placebo ou sham), bem como o perfil da população e desfechos que o estudo se aplica. Parâmetros como a experiência do profissional e as características da intervenção (como tipo e dose do tratamento, escolha dos pontos, tipo de agulha, técnica de agulhamento, tipo de estimulação, número e frequência de atendimento) podem influenciar o tamanho de efeito da terapia. A realização de novos estudos com alteração destes parâmetros pode modificar os resultados.

Score 10/10 na escala PEDro

• Glazov G et al. Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial. Acupunct Med. 2014 Apr; 32(2): 116–123. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995277/>. [144 participantes, 3 grupos].

Score 9/10 na escala PEDro

• Ee C et al. Acupuncture for Menopausal Hot Flashes: A Randomized Trial. Ann Intern Med. 2016 Feb 2;164(3):146-54. <https://pubmed.ncbi.nlm.nih.gov/26784863/>. [327 participantes, 2 grupos]
• Pach D et al. Standardized Versus Individualized Acupuncture for Chronic Low Back Pain: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2013;2013:125937. <https://pubmed.ncbi.nlm.nih.gov/24288556/>. [150 participantes, 2 grupos].
• White P et al. Practice, Practitioner, or Placebo? A Multifactorial, Mixed-Methods Randomized Controlled Trial of Acupuncture. Pain. 2012 Feb;153(2):455-62. <https://pubmed.ncbi.nlm.nih.gov/22169359/>. [221 participantes, 3 grupos].
• Glazov G et al. Laser acupuncture for chronic non-specific low back pain: a controlled clinical trial. Acupunct Med. 2009 Sep;27(3):94-100. <https://pubmed.ncbi.nlm.nih.gov/19734378/>. [100 participantes, 2 grupos]
• Donnellan CP, Shanley J. Comparison of the Effect of Two Types of Acupuncture on Quality of Life in Secondary Progressive Multiple Sclerosis: A Preliminary Single-Blind Randomized Controlled Trial. Clin Rehabil. 2008 Mar;22(3):195-205. <https://pubmed.ncbi.nlm.nih.gov/18285429/>. [14 participantes, 2 grupos].
• Foster NE et al. Acupuncture as an Adjunct to Exercise Based Physiotherapy for Osteoarthritis of the Knee: Randomised Controlled Trial. BMJ. 2007 Sep 1;335(7617):436. <https://pubmed.ncbi.nlm.nih.gov/17699546/>. [352 participantes, 3 grupos].
• Scharf HP et al. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med. 2006 Jul 4;145(1):12-20. <https://pubmed.ncbi.nlm.nih.gov/16818924/>. [1007 participantes, 3 grupos].
• Brinkhaus B et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med. 2006 Feb 27;166(4):450-7. <https://pubmed.ncbi.nlm.nih.gov/16505266/>. [298 participantes, 3 grupos].
• Shlay JC et al. Acupuncture and Amitriptyline for Pain Due to HIV-related Peripheral Neuropathy: A Randomized Controlled Trial. Terry Beirn Community Programs for Clinical Research on AIDS. JAMA. 1998 Nov 11;280(18):1590-5. <https://pubmed.ncbi.nlm.nih.gov/9820261/>. [250 participantes, 4 grupos].

Score 8/10 na escala PEDro

• Haugmark T et al. Effects of a mindfulness-based and acceptance-based group programme followed by physical activity for patients with fibromyalgia: a randomised controlled trial. BMJ Open. 2021 Jun 29;11(6):e046943. <https://pubmed.ncbi.nlm.nih.gov/34187823/>. [170 participantes, 2 grupos]
• Kong J-T et al. Effect of electroacupuncture versus 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]
• Jan AL et al. Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain. Emerg Med Australas. 2020 Sep 23. <https://pubmed.ncbi.nlm.nih.gov/32969169/>. [90 participantes, 3 grupos]
• Noll E et al. Efficacy of acupressure on quality of recovery after surgery: randomised controlled trial. Eur J Anaesthesiol. 2019 Aug;36(8):557-565. <https://pubmed.ncbi.nlm.nih.gov/30985537/>. [163 participantes, 3 grupos]
• Vas J et al. Acupuncture in patients with acute low back pain: a multicentre randomised controlled clinical trial. Pain. 2012 Sep;153(9):1883-1889. <https://pubmed.ncbi.nlm.nih.gov/22770838/>. [275 participantes, 4 grupos]
• Suarez-Almazor ME et al. A randomized controlled trial of acupuncture for osteoarthritis of the knee: effects of patient-provider communication. Arthritis Care Res (Hoboken). 2010 Sep;62(9):1229-36. <https://pubmed.ncbi.nlm.nih.gov/20506122/>. [560 participantes, 5 grupos]
• Haake M et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007 Sep 24;167(17):1892-8. <https://pubmed.ncbi.nlm.nih.gov/17893311/>. [1162 participantes, 3 grupos]
• Sze FK et al. Does acupuncture have additional value to standard poststroke motor rehabilitation? Stroke. 2002 Jan;33(1):186-94. <https://pubmed.ncbi.nlm.nih.gov/11779909/>. [106 participantes, 2 grupos]
• White AR et al. Randomized trial of acupuncture for nicotine withdrawal symptoms. Arch Intern Med. 1998 Nov 9;158(20):2251-5. <https://pubmed.ncbi.nlm.nih.gov/9818805/>. [76 participantes, 2 grupos]

Score 7/10 na escala PEDro

• Korelo RIG et al. Effects of Auriculotherapy on treatment of women with premenstrual syndrome symptoms: A randomized, placebo-controlled clinical trial. Complement Ther Med. 2022 Jun;66:102816. <https://pubmed.ncbi.nlm.nih.gov/35167949/>. [111 participantes, 3 grupos]
• Cherkin DC et al. A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain. Arch Intern Med. 2009 May 11;169(9):858-66. <https://pubmed.ncbi.nlm.nih.gov/19433697/>. [638 participantes, 4 grupos].
• Hinman RS et al. Acupuncture for Chronic Knee Pain: A Randomized Clinical Trial. JAMA. 2014 Oct 1;312(13):1313-22. <https://pubmed.ncbi.nlm.nih.gov/25268438/>. [282 participantes, 4 grupos].
• M L Bullock et al. Auricular acupuncture in the treatment of cocaine abuse. A study of efficacy and dosing. J Subst Abuse Treat. 1999 Jan;16(1):31-8. <https://pubmed.ncbi.nlm.nih.gov/9888119/>. [236 participantes, 3 grupos]
• Lewis J, Sim J, Barlas P. Acupuncture and electro-acupuncture for people diagnosed with subacromial pain syndrome: A multicentre randomized trial. Eur J Pain. 2017 Jul;21(6):1007-1019. <https://pubmed.ncbi.nlm.nih.gov/28106306/>. [227 participantes, 3 grupos]

Score 6/10 na escala PEDro

• Margolin A et al. Acupuncture for the treatment of cocaine addiction: a randomized controlled trial. JAMA. 2002 Jan 2;287(1):55-63. <https://pubmed.ncbi.nlm.nih.gov/11754709/>. [620 participantes, 3 grupos]
• Tan JY, Molassiotis A, Suen LKP, Liu J, Wang T, Huang HR. Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC Complement Med Ther. 2022 Mar 24;22(1):87. <https://pubmed.ncbi.nlm.nih.gov/35331208/>. [114 participantes, 3 grupos]

Aguardando avaliação

• de Oliveira Rodrigues DM et al. Efficacy and Safety of Auricular Acupuncture for Depression: A Randomized Clinical Trial. JAMA Netw Open. 2023 Nov 1;6(11):e2345138. <https://pubmed.ncbi.nlm.nih.gov/38032640/>. [74 participantes, 2 grupos]
• Epstein AS et al. Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer: The IMPACT Randomized Clinical Trial. JAMA Netw Open. 2023 Nov 1;6(11):e2342482. <https://pubmed.ncbi.nlm.nih.gov/37962891/>. [298 participantes, 2 grupos]

Imagem mostrando o “paradoxo da eficácia“, que é quando o efeito inespecífico de uma intervenção sham ou palcebo é superior ao efeito total de um tratamento padrão.