A randomized controlled study involving over 300 participants diagnosed with chronic spontaneous urticaria (CSU), or hives, suggested that acupuncture might provide some relief from symptoms. However, the clinical significance of these results remains uncertain. The study was recently published in the journal Annals of Internal Medicine.
CSU is the most common form of chronic hives and is characterized by recurrent itching, skin lesions, or swelling lasting more than 6 weeks in the absence of specific triggering factors. More than 90 percent of patients with CSU require urgent medical treatment to relieve itching; therefore, the management of itching is one of the main goals in the treatment of CSU.
Acupuncture’s Effects on CSU
Researchers from Chengdu University of Traditional Chinese Medicine randomly assigned 330 persons diagnosed with CSU to receive either 4 weeks of acupuncture, 4 weeks of sham acupuncture, or a waitlist (control) and then followed the patients for 4 weeks after treatment to investigate whether acupuncture leads to improvement of CSU synptoms. Changes in symptoms were measured using the Weekly Urticaria Activity Score (UAS7).
Patients in the acupuncture group reported improved UAS7, more than sham acupuncture or waitlist control. However, the differences between intervention and control did not meet the minimal clinical difference (MCID) threshold, so the clinical significance of the observed reductions in itch severity scores is uncertain. The rate of adverse events was highest in the acupuncture group, but events were mild and transient.
Editorial Insights and Broader Implications
An accompanying editorial by Mike Cummings of the British Medical Acupuncture Society highlights that these trial results are interesting because they describe the efficacy of acupuncture in a condition that is not characterized by pain.
While the clinical significance of the findings was not clear, the author suggests that clinicians should stay open to the potential for adjunctive use of acupuncture to influence outcomes, even in more serious medical conditions. The editorial suggests that acupuncture is often overlooked as a therapy because it lacks the commercial backing of other modern interventions.
References: “Efficacy of Acupuncture for Chronic Spontaneous Urticaria” by Hui Zheng, Xian-Jun Xiao, Yun-Zhou Shi, Lei-Xiao Zhang, Wei Cao, Qian-Hua Zheng, Feng Zhong, Ping-Sheng Hao, Ying Huang, Ming-Ling Chen, Wei Zhang, Si-Yuan Zhou, Yan-Jun Wang, Chuan Wang, Li Zhou, Xiao-Qin Chen, Zuo-Qin Yang, Zi-Hao Zou, Ling Zhao, Fan-Rong Liang and Ying Li, 14 November 2023, Annals of Internal Medicine.
DOI: 10.7326/M23-1043
“Acupuncture for Chronic Spontaneous Urticaria” by Mike Cummings, 14 November 2023, Annals of Internal Medicine.
DOI: 10.7326/M23-2713