Department of Acupuncture & Moxibustion Medicine, Korean Medicine Hospital, Pusan National University, Yangsan, South Korea.
Complement Ther Med. 2013 Feb;21(1):65-72. doi: 10.1016/j.ctim.2012.12.004. Epub 2012 Dec 29.
Patients with non-emergent and non-life threatening conditions often present to the emergency department (ED), which hinders the efficient utilisation of healthcare resources. Acupuncture has frequently been used for such common conditions, although not in the ED context. This study aimed to evaluate the current evidence for acupuncture treatment in the ED and to inform future randomised controlled trials (RCTs) for acupuncture in ED settings.
Four English databases (MEDLINE, EMBASE, CENTRAL and AMED) were systematically searched to identify studies that tested the effects of acupuncture in ED settings using the search terms of "acupuncture" and "emergency". Data extraction and the risk of bias assessments were performed by two independent reviewers.
Of the 102 screened studies, two RCTs and two uncontrolled observational studies were deemed eligible. Sample sizes ranged from 42 to 100. The conditions treated included various musculoskeletal and non-musculoskeletal symptoms and showed substantial clinical heterogeneity. Acupuncture was delivered in conjunction with standard medical care with the goal of immediate pain alleviation; in one RCT, acupuncture resulted in a positive outcome, but it did not in the other. The risk of bias was generally high or unclear. Uncontrolled studies reported beneficial effects for acupuncture, although these studies were prone to bias. Two studies reported mild and transient adverse events associated with acupuncture.
The current evidence is insufficient to make any recommendations concerning the use of acupuncture in the ED. The effectiveness and safety as well as the feasibility of acupuncture should be tested in future RCTs.
非紧急和非危及生命的病症患者常到急诊部就诊，这阻碍了医疗资源的有效利用。针刺疗法常被用于治疗这些常见病症，尽管并非在急诊环境下。本研究旨在评估针刺疗法在急诊部的现有证据，并为未来在急诊部进行针刺的随机对照试验（RCT）提供信息。
系统检索了 4 个英文数据库（MEDLINE、EMBASE、CENTRAL 和 AMED），以检索在急诊部使用“针刺”和“急诊”这两个检索词测试针刺疗效的研究。两名独立的审稿人进行数据提取和偏倚风险评估。
在筛选出的 102 项研究中，有 2 项 RCT 和 2 项非对照观察性研究被认为符合条件。样本量从 42 到 100 不等。所治疗的病症包括各种肌肉骨骼和非肌肉骨骼症状，具有明显的临床异质性。针刺是在标准医疗护理的基础上进行的，目的是立即缓解疼痛；在一项 RCT 中，针刺取得了积极的结果，但在另一项 RCT 中则没有。偏倚风险普遍较高或不明确。非对照研究报告了针刺的有益效果，但这些研究容易存在偏倚。有两项研究报告了与针刺相关的轻微和短暂的不良事件。
目前的证据不足以对在急诊部使用针刺提出任何建议。未来的 RCT 应测试针刺的疗效、安全性和可行性。
