Department of Chinese Medicine, An Nan Hospital, China Medical University, Tainan 709204, Taiwan.
School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan.
Am J Chin Med. 2024;52(6):1555-1587. doi: 10.1142/S0192415X24500617. Epub 2024 Oct 26.
Acupuncture is widely accepted as a therapeutic treatment by patients and healthcare providers globally. The safety record has been well established in acupuncture practice although some rare adverse events (AEs) were reported in the literature. While acupuncture-related AEs are generally defined as any undesirable event that occurs in patients during acupuncture treatment that may or may not be associated with the treatment, acupuncture-related adverse reactions (ARs) are defined as any undesirable or harmful reaction induced by trained practitioners practicing acupuncture treatment with standard doses. In this review, we clarify the relationship between AEs and ARs. Furthermore, we compile a list of acupuncture-related AEs reported in systematic reviews and meta-analysis articles. We find that serious acupuncture-related AEs are rare, with serious AEs occurring at a rate of approximately 0.04-0.08 per 10,000 treatments. The most likely serious AEs are pneumothorax, central and peripheral nerve injuries, heart injuries, abdominal organ injuries, infections, and needle breakage. Commonly reported minor AEs include bruising, hematoma, or bleeding at the needling site, as well as vasovagal reactions such as tiredness, dizziness, fainting, or residual pain at insertion points. The analysis identifies contributing factors for serious AEs being deep needle penetration, incorrect acupoint selection, and improper needle manipulation. It also addresses infections caused by contaminated needles, environmental factors, and inadequate skin disinfection. Moreover, other serious AEs, like needle breakage, are mostly due to aggressive manipulation and repeated reheating. Importantly, most acupuncture-related AEs are preventable. To avoid such AEs, acupuncturists in clinical practice should carefully select needling areas, be aware of cautions and contraindications of acupuncture, maintain safe acupuncture depth and hygiene, and strictly adhere to standard operating procedures.
针灸在全球范围内被患者和医疗保健提供者广泛接受为一种治疗方法。尽管文献中有报道一些罕见的不良事件（AE），但针灸的安全性记录已经得到很好的建立。虽然与针灸相关的 AE 通常被定义为在针灸治疗过程中发生在患者身上的任何不良事件，无论是否与治疗相关，但与针灸相关的不良反应（AR）被定义为训练有素的从业者以标准剂量进行针灸治疗时引起的任何不良或有害反应。在这篇综述中，我们澄清了 AE 和 AR 之间的关系。此外，我们编译了一份在系统评价和荟萃分析文章中报告的与针灸相关的 AE 列表。我们发现严重的与针灸相关的 AE 很少见，严重的 AE 发生率约为每 10000 次治疗 0.04-0.08 次。最有可能发生的严重 AE 是气胸、中枢和外周神经损伤、心脏损伤、腹部器官损伤、感染和针断裂。常见的轻微 AE 包括针刺部位的瘀伤、血肿或出血，以及血管迷走神经反应，如疲劳、头晕、晕厥或插入点残留疼痛。分析确定了严重 AE 的促成因素，包括深针穿透、不正确的穴位选择和不当的针操作。它还解决了由污染针引起的感染、环境因素和皮肤消毒不足等问题。此外，其他严重的 AE，如针断裂，主要是由于剧烈的操作和反复加热。重要的是，大多数与针灸相关的 AE 都是可以预防的。为了避免这些 AE，临床实践中的针灸师应仔细选择针刺部位，了解针灸的注意事项和禁忌症，保持安全的针灸深度和卫生，并严格遵守标准操作规程。
