EVIDENCE SUMMARY: ACUPUNTURE FOR NAUSEA AND VOMITING

Treatment for nausea depends on what is causing it. In some cases, the cause of nausea or vomiting cannot be easily
avoided, such as:
● postoperative nausea and vomiting (PONV)
● chemotherapy-induced nausea and vomiting (CINV)
● pregnancy-related nausea and vomiting (PRNV)
Diet and lifestyle changes can be very helpful in reducing morning sickness.
There is good clinical evidence that acupuncture can help with Nausea a Vomiting. Some research is listed below.

Postoperative nausea and vomiting (PONV)

A systematic review and meta-analysis published in the Plos One journal in 2013 (1) found that acupuncture – of both Pc 6 and other acupuncture points, as well as the use of electo-acupuncture stimulation – was effective at significantly reducing Postoperative nausea and vomiting .They did caution that some studies were not of very high-quality design, and details of blinding were not reported in many reports.

A Cochrane review called ‘Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting’ carried out in 2015 (2), found that:
“…compared with sham treatment, PC6 acupoint stimulation significantly reduced the incidence of nausea…, vomiting…, and the need for rescue antiemetics…. As heterogeneity among trials was substantial and there were study limitations, we rated the quality of evidence as low. Using trial sequential analysis, the
required information size and boundary for benefit were reached for both primary outcomes.
PC6 acupoint stimulation was compared with six different types of antiemetic drugs (metoclopramide, cyclizine, prochlorperazine, droperidol. ondansetron and dexamethasone). There was no difference between PC6 acupoint stimulation and antiemetic drugs in the incidence of nausea… vomiting… or the need for
rescue antiemetics… We rated the quality of evidence as moderate, due to the study limitations…
Compared to antiemetic drugs, the combination of PC6 acupoint stimulation and antiemetic therapy reduced the incidence of vomiting… but not nausea… We rated the quality of evidence as very low, due to substantial heterogeneity among trials, study limitations and imprecision. Using trial sequential analysis,
none of the boundaries for benefit, harm or futility were crossed for PONV. The need for rescue antiemetic was lower in the combination PC6 acupoint stimulation and antiemetic group than the antiemetic group…”

 

Chemotherapy induced nausea and vomitin (CINV)

A systematic review carried out by a research team from the University of Western Sydney in Australia in 2013, and published in the Australian Journal of Acupuncture and Chinese Medicine (3), concluded that acupuncture has demonstrated benefit for CINV by reducing vomiting frequency and the use of rescue medication, while acupressure has decreased the frequency of nausea. They recommended more sufficiently powered trials [trials that have a high probability of detecting a true effect if it exists] be carried out, as this was a weakness that they found with the studies available up to that point.
An overview of systematic reviews published in Nature in 2015, which was carried out by a research team from China (4), concluded that acupuncture and related therapies have demonstrated favourable therapeutic effects in the management of CINV in cancer patients.

 

Pregnancy-related nausea and vomiting (PRNV)

A systematic review and meta-analysis carried out by a research team based in China, and published in the Complimentary Therapies in Medicine journal in 2024 (5), concluded that acupuncture combined with western medicine may be a more effective treatment for PRNV than western medicine alone, and that acupuncture may be as effective as western medicine. They also called for further robust large studies to be carried out.

General Overview – All 3 Types

An update of clinical and experimental studies carried out by researchers from Germany and the USA and published in the Autonomic Neuroscience journal in 2006 (6) found the following:
“For postoperative nausea and vomiting, results from 26 trials showed acupuncture-point stimulation was effective for both nausea and vomiting. For chemotherapy-induced nausea and vomiting, results of 11 trials differed according to modality with acupressure appearing effective for first-day nausea, electroacupuncture appearing effective for first-day vomiting, and noninvasive electrostimulation appearing no more effective than placebo for any outcome. For pregnancy-related nausea and vomiting, results were mixed. Experimental studies showed effects of P6-stimulation on gastric myoelectrical activity, vagal modulation and cerebellar vestibular activities in functional magnetic resonance imaging. There is good clinical evidence from more than 40 randomised controlled trials that acupuncture has some effect in preventing or attenuating nausea and vomiting. A growing number of experimental studies suggest mechanisms of action.”

Written By:
Seamus Fitzgerald

References:

1.
2. Cheong KB, Zhang JP, Huang Y, Zhang ZJ. The effectiveness of acupuncture in prevention and
treatment of postoperative nausea and vomiting–a systematic review and meta-analysis. PLoS One. 2013
Dec 13;8(12):e82474.
3. Lee A, Chan SKC, Fan LTY. Stimulation of the wrist acupuncture point PC6 for preventing
postoperative nausea and vomiting. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.:
CD003281.
4. Mckeon, Chris & Smith, Caroline & Hardy, J & Chang, Esther. (2013). Acupuncture and acupressure
for chemotherapy-induced nausea and vomiting: A systematic review. AJACM. 8. 2-27.
5. Wu, X., Chung, V., Hui, E. et al. Effectiveness of acupuncture and related therapies for palliative care
of cancer: overview of systematic reviews. Sci Rep 5, 16776 (2015).
6. Bao Jin, Yanhua Han, Yue Jiang, Jiao Zhang, Wenjuan Shen, Yuehui Zhang, Acupuncture for nausea
and vomiting during pregnancy: A systematic review and meta-analysis, Complementary Therapies in
Medicine, Volume 85, 2024, 103079, ISSN 0965-2299.
7. Konrad Streitberger, Jeanette Ezzo, Antonius Schneider, Acupuncture for nausea and vomiting: An
update of clinical and experimental studies, Autonomic Neuroscience, Volume 129, Issues 1–2, 2006, Pages
107-117, ISSN 1566-0702.