Efficacy of acupuncture as a treatment for tinnitus: a systematic review.

BACKGROUND Tinnitus is a prevalent condition for which patients may seek treatment with acupuncture since no conventional treatment has been shown to be effective. OBJECTIVE To summarize and critically review all randomized controlled trials on the efficacy of acupuncture as a treatment for tinnitus. DATA SOURCES Four independent computerized literature searches (MEDLINE, Cochrane Controlled Trials Register, Embase, and CISCOM) were conducted in December 1998 using the key words acupuncture and tinnitus. STUDY SELECTION All randomized controlled trials that compared any form of acupuncture with any control intervention in the treatment of tinnitus were included. DATA EXTRACTION Data were extracted by 2 authors independently. The methodological quality of the included randomized controlled trials was assessed using the Jadad score. DATA SYNTHESIS Six randomized controlled trials were included in the review, 4 of which used crossover design. Four studies used manual acupuncture and 2 used electroacupuncture. Five of 6 studies used inconsistent acupoints. Three studies scored 3 points or more on the Jadad scale. MAIN OUTCOME MEASURES Outcome measurements were visual analog scale scores for loudness, annoyance, and awareness of tinnitus; subjective severity scale scores for tinnitus; or Nottingham Health Profile scores. RESULTS Two unblinded studies showed a positive result, whereas 4 blinded studies showed no significant effect of acupuncture. CONCLUSION Acupuncture has not been demonstrated to be efficacious as a treatment for tinnitus on the evidence of rigorous randomized controlled trials.