Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Faculty of Medicine, University of Toronto, Toronto, Canada.
Sci Rep. 2017 Jun 13;7(1):3369. doi: 10.1038/s41598-017-03272-0.
Acupuncture is increasingly used worldwide. It is becoming more accepted by both patients and healthcare providers. However, the current understanding of its adverse events (AEs) is fragmented. We conducted this overview to collect all systematic reviews (SRs) on the AEs of acupuncture and related therapies. MEDLINE and EMBASE were searched from inception to December 2015. Methodological quality of included reviews was assessed with a validated instrument. Evidence was narratively reported. Seventeen SRs covering various types of acupuncture were included. Methodological quality of the reviews was overall mediocre. Four major categories of AEs were identified, which are organ or tissue injuries (13 reviews, median: 36 cases, median deaths: 4), infections (11 reviews, median: 17 cases, median deaths: 0.5), local AEs or reactions (12 reviews, median: 8.5 cases, no deaths were reported), and other complications such as dizziness or syncope (11 reviews, median: 21 cases, no deaths were reported). Minor and serious AEs can occur during the use of acupuncture and related modalities, contrary to the common impression that acupuncture is harmless. Serious AEs are rare, but need significant attention as mortality can be associated with them. Referrals should consider acupuncturists' training credibility, and patient safety should be a core part of acupuncture education.
针刺在全球范围内的应用日益广泛。患者和医疗保健提供者对其接受程度也越来越高。然而，目前人们对其不良事件（AE）的认识还比较零散。我们进行了本次综述，以收集所有关于针刺及相关疗法不良事件的系统评价（SR）。从建库到 2015 年 12 月，我们检索了 MEDLINE 和 EMBASE。使用经过验证的工具评估纳入综述的方法学质量。证据以叙述方式报告。共纳入 17 项涵盖各种类型针刺的 SR。综述的方法学质量总体一般。确定了 4 大类 AE，分别是器官或组织损伤（13 项综述，中位数：36 例，中位数死亡：4 例）、感染（11 项综述，中位数：17 例，中位数死亡：0.5 例）、局部 AE 或反应（12 项综述，中位数：8.5 例，无死亡报告）和其他并发症，如头晕或晕厥（11 项综述，中位数：21 例，无死亡报告）。与人们普遍认为针刺无害的观念相反，针刺和相关疗法的使用过程中可能会出现轻微和严重的 AE。严重 AE 虽罕见，但仍需高度重视，因为其可能与死亡相关。在进行针刺治疗时，应考虑针灸师的培训可信度，患者安全应成为针刺教育的核心部分。
