Global review of acupuncture and moxibustion in CINV/RINV guidelines' status and future focus

A large number of patients undergoing chemotherapy and radiotherapy worldwide are severely afflicted by nausea and vomiting annually. Conventional drug treatments often bring numerous side effects. Meanwhile, acupuncture and moxibustion as an adjunctive therapy has drawn increasing attention, yet guidelines' recommendations vary. This heterogeneity and the absence of detailed acupuncture and moxibustion regimens pose a challenge for clinical practice.

In a new study published in the World Journal of Acupuncture - Moxibustion, a team of researchers from the Institute of Acupuncture and Moxibustion (IAM), China Academy of Chinese Medical Sciences (CACMS), conducted a review of 56 guidelines and expert consensus documents. The scope included recommendations on acupuncture and moxibustion for CINV and RINV.

"Our findings stress the importance of developing acupuncture specific clinical practice guidelines that provide potential acupuncture and moxibustion regimens to improve patient care,” explains Dr Wei-juan Gang, Director of the Center for Evidence-based Acupuncture and Moxibustion at IAM, CACMS.”

The study's findings not only shed light on the existing gaps in CINV and RINV management, but also suggest that the current approach to integrating acupuncture and moxibustion into treatment plans lacks the rigor required for widespread clinical adoption.

“The review's assessment of guideline quality, employing the Scientific, Transparent, and Applicable Rankings (STAR) tool, found the majority to be of medium quality, with none rated as high quality,” adds Gang. “This indicates improvement in the development process of future guidelines is needed.”

One of the surprising findings was the inconsistency in the quality of evidence supporting the recommendations, with many guidelines failing to provide a robust evidence base for their suggestions.

“Our findings call for a renewed focus on the development of acupuncture specific guidelines, emphasizing the importance of personalized antiemetic programs and the integration of acupuncture and moxibusiton with Western practices,” says Gang. “They also underscore the necessity for more research to elucidate the mechanisms of action of acupuncture and moxibustion in managing CINV and RINV.”

The researchers hope that new guidelines are founded on solid evidence and transparent methods, ultimately leading to improved patient outcomes and a better understanding of the role of acupuncture and moxibustion in modern medicine.

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Contact author: Wei-juan GANG, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China, gangweijuan@126.com