Acupuncture for schizophrenia

  • Review
  • Intervention




Acupuncture, with many categories such as traditional acupuncture, electroacupuncture, laser acupuncture, and acupoint injection, has been shown to be relatively safe with few adverse effects. It is accessible and inexpensive, at least in China, and is likely to be widely used there for psychotic symptoms.


To review the effects of acupuncture, alone or in combination treatments compared with placebo (or no treatment) or any other treatments for people with schizophrenia or related psychoses.

Search methods

We searched Cochrane Schizophrenia Group’s Trials Register (February 2012), which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and clinical trials registries. We also inspected references of identified studies and contacted relevant authors for additional information.

Selection criteria

We included all relevant randomised controlled trials involving people with schizophrenia-like illnesses, comparing acupuncture added to standard dose antipsychotics with standard dose antipsychotics alone, acupuncture added to low dose antipsychotics with standard dose antipsychotics, acupuncture with antipsychotics, acupuncture added to Traditional Chinese Medicine (TCM) drug with TCM drug, acupuncture with TCM drug, electric acupuncture convulsive therapy with electroconvulsive therapy.

Data collection and analysis

We reliably extracted data from all included studies, discussed any disagreement, documented decisions and contacted authors of studies when necessary. We analysed binary outcomes using a standard estimation of risk ratio (RR) and its 95% confidence interval (CI). For continuous data, we calculated mean differences with 95% CI. For homogeneous data we used fixed-effect model. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE.

Main results

After an update search in 2012 the review now includes 30 studies testing different forms of acupuncture across six different comparisons. All studies were at moderate risk of bias.

When acupuncture plus standard antipsychotic treatment was compared with standard antipsychotic treatment alone, people were at less risk of being 'not improved' (n = 244, 3 RCTs, medium-term RR 0.40 CI 0.28 to 0.57, very low quality evidence). Mental state findings were mostly consistent with this finding as was time in hospital (n = 120, 1 RCT, days MD -16.00 CI -19.54 to -12.46, moderate quality evidence). If anything, adverse effects were less for the acupuncture group (e.g. central nervous system, insomnia, short-term, n = 202, 3 RCTs, RR 0.30 CI 0.11 to 0.83, low quality evidence).

When acupuncture was added to low dose antipsychotics and this was compared with standard dose antipsychotic drugs, relapse was less in the experimental group (n = 170, 1 RCT, long-term RR 0.57 CI 0.37 to 0.89, very low quality evidence) but there was no difference for the outcome of 'not improved'. Again, mental state findings were mostly consistent with the latter. Incidences of extrapyramidal symptoms - akathisia, were less for those in the acupuncture added to low dose antipsychotics group (n = 180, 1 RCT, short-term RR 0.03 CI 0.00 to 0.49, low quality evidence) - as dry mouth, blurred vision and tachycardia.

When acupuncture was compared with antipsychotic drugs of known efficacy in standard doses, there were equivocal data for outcomes such as 'not improved' using different global state criteria. Traditional acupuncture added to TCM drug had benefit over use of TCM drug alone (n = 360, 2 RCTs, RR no clinically important change 0.11 CI 0.02 to 0.59, low quality evidence), but when traditional acupuncture was compared with TCM drug directly there was no significant difference in the short-term. However, we found that participants given electroacupuncture were significantly less likely to experience a worsening in global state (n = 88, 1 RCT, short-term RR 0.52 CI 0.34 to 0.80, low quality evidence).

In the one study that compared electric acupuncture convulsive therapy with electroconvulsive therapy there were significantly different rates of spinal fracture between the groups (n = 68, 1 RCT, short-term RR 0.33 CI 0.14 to 0.81, low quality evidence). Attrition in all studies was minimal. No studies reported death, engagement with services, satisfaction with treatment, quality of life, or economic outcomes.

Authors' conclusions

Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects. Better designed large studies are needed to fully and fairly test the effects of acupuncture for people with schizophrenia.








CINAHL、BIOSIS、AMED、EMBASE、PubMed、MEDLINE、PsycINFO、臨床試験レジストリを元に通常検索されたCochrane Schizophrenia Group’s Trials Register(2012年2月)を検索した。同定した研究の参考文献を調査し、追加の情報を得るために関連する著者と連絡を取った。







鍼療法+標準の抗精神病治療を標準の抗精神病治療単独と比較した場合、参加者の「改善しない」リスクはより低かった(n = 244、3件のRCT、中期RR 0.40、CI 0.28〜0.57、エビデンスの質は非常に低い)。 精神状態の所見は、入院時の所見とおおむね一致していた(n = 120、1件のRCT、日数のMD -16.00、CI -19.54〜 -12.46、エビデンスの質は中程度)。 どちらかと言えば、有害事象は鍼療法群が低かった(例:中枢神経系、不眠症、短期、n = 202、3件のRCT、RR 0.30、CI 0.11〜0.83、エビデンスの質は低い)。

鍼療法を低用量の抗精神病薬に追加し、標準用量の抗精神病薬と比較した場合、実験群の方が再発率は低かった(n = 170、 1件のRCT、長期RR 0.57、CI 0.37〜0.89、エビデンスの質は非常に低い)が、「改善しない」アウトカムに差はみられなかった。 この場合も先と同様に、精神状態の所見は、おおむね入院時の所見と一致していた。錐体外路症状(静座不能)の発生率は、低用量の抗精神病薬+鍼療法群が低かった(n = 180、1件のRCT、短期RR0.03、CI 0.00〜0.49、エビデンスの質は低い)。口渇、目のかすみ、頻脈も同様であった。

鍼療法と効果が既知である標準用量の抗精神病薬との比較では、「改善しない」などのアウトカムに異なる状態基準を用いた不明瞭なデータが存在した。TCM薬に伝統的な鍼療法を加えた治療はTCM薬単独よりも利益が認められた(n = 360、2件のRCT、RR臨床的に重要な変化は無し0.11、CI 0.02〜0.59、エビデンスの質は低い)が、伝統的な鍼療法とTCM薬を直接比較すると、短期間での有意差は認められなかった。 しかし、電気鍼を受けた参加者は、全身状態の悪化が有意に減少する傾向がみられた(n = 88、 1件のRCT、短期RR 0.52、CI 0.34〜0.80、エビデンスの質は低い)。

電気鍼によるけいれん療法と電気けいれん療法を比較した1件の研究では、脊椎骨折の発生率で群間に有意差が認められた(n = 68、1件のRCT、短期RR 0.33、CI 0.14〜0.81、エビデンスの質は低い)。 全研究における失敗率は最小であった。死亡、サービスへの積極的な取組み、治療への満足度、生活の質、経済的アウトカムに関する報告をした研究はなかった。




《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。

Plain language summary

Acupuncture for schizophrenia

Although acupuncture or Traditional Chinese Medicine has been practised for over 2000 years in China and the Far East, especially in Korea and Japan, it is a relatively new form of treament for physical and psychological conditions in the West. Acupuncture inserts needles into the skin to stimulate specific points of the body (acupoints). The aim is to achieve balance and harmony of the body.

Schizophrenia is a serious mental illness and is usually treated using antipsychotic medication. However, although effective, antipsychotic medication can cause side-effects (such as sleepiness, weight gain and even dribbling). Acupuncture has been shown to have very few negative effects on the individual and could be more socially acceptable and tolerable for people with mental health problems. Acupuncture may also be less expensive than drugs made by pharmaceutical companies, so reducing costs to individuals and health services.

This reviews looks at the effectiveness of various types of acupuncture as treatment for people with schizophrenia. An update search for studies was carried out in 2012 and found 30 studies that randomised participants who were receiving antipsychotic medication to receive additional acupuncture or standard care.

Although some of the studies did favour acupuncture when combined with antipsychotics, the information available was small scale and rated to be very low or low quality by the review authors, so not completely provable and valid. Depression was reduced when combining acupuncture with antipsychotic medication, but again this finding came from small-scale research, so cannot be clearly shown to be true. The review concludes that people with mental health problems, policy makers and health professionals need much better evidence in order to establish if there are any potential benefits to acupuncture.

This means that the question of whether acupuncture is of benefit to people, and whether it is of greater benefit than antipsychotic medication, remains unanswered. There is not enough information to establish that acupuncture is of benefit or harm to people with mental health problems.

Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness.

Laički sažetak

Akupunktura u liječenju shizofrenije

Iako se akupunktura u tradicionalnoj kineskoj medicini primjenjuje više od 2000 godina u Kini i Dalekom Istoku, posebno u Koreji i Japanu, to je na Zapadu još uvijek nov oblik liječenja fizičkih i psihičkih smetnji. Akupunktura se izvodi umetanjem igala u kožu da bi se stimulirale određene točke na tijelu. Cilj je postići ravnotežu i sklad u organizmu.

Shizofrenija je ozbiljan psihički poremećaj i obično se liječi antipsihoticima. Međutim, iako su učinkoviti, antipsihotici mogu uzrokovati nuspojave (pospanost, debljanje, pa čak i nevoljno curenje urina ili sline). Akupunktura ima malo nuspojava, te bi mogla biti društveno prihvatljivija i podnošljivija za ljude koji boluju od psihičkih poremećaja. Također, akupunktura može biti jeftinija od mnogih lijekova koje proizvode farmaceutske tvrtke, što je dobro za smanjenje troškova pojedinca i zdravstvenih centara.

Ovaj Cochrane sustavni pregled literature istražuje učinkovitost različitih vrsta akupunktura koje bi se koristile u liječenju shizofrenije. Godine 2012. nađeno je 30 studija koje su nasumično rasporedile pacijente koji su primali antipsihotike u skupine koje su primale standardnu skrb ili akupunkturu.

Iako neke od studija pokazuju da je učinak bolji kad se akupunkturu kombinira s antipsihoticima, dostupne informacije su bile jako oskudne i autori sustavnog pregleda su ih ocijenili kao slabe ili veoma slabe kvalitete, zbog čega ti rezultati nisu vjerodostojni. Razina depresije je ublažena kada se akupunktura kombinirala s antipsihoticima, ali nije moguće dokazati istinitost te tvrdnje zbog malog uzorka u istraživanju. Zaključak je da ljudi s psihičkim problemima, donosioci odluka i zdravstveni djelatnici trebaju mnogo bolje dokaze da bi mogli utvrditi je li akupunktura djelotvorna za shizofreniju.

Pitanje je li akupunktura korisnija od liječenja antipsihoticima ostaje neodgovoreno. Nema dovoljno dokaza da bi tvrdili da je akupunktura štetna ili korisna u liječenju ljudi s psihičkim problemima.

Sažetak napisao: Benjamin Gray, istraživač udruge Rethink Mental Illness.

Bilješke prijevoda

Hrvatski Cochrane
Prevela: Paula Morović
Ovaj sažetak preveden je u okviru volonterskog projekta prevođenja Cochrane sažetaka. Uključite se u projekt i pomozite nam u prevođenju brojnih preostalih Cochrane sažetaka koji su još uvijek dostupni samo na engleskom jeziku. Kontakt:








Benjamin Gray、Service User、Service User Expert、 Rethink Mental Illness.


《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。

쉬운 말 요약

조현병의 침 치료

침 및 전통 중의학은 2000년 넘게 중국 및 한국, 일본 등의 동북아시아에서 활용되어 왔지만, 서구에서는 신체적/정신적 질환에 대한 비교적 새로운 치료 방식에 속한다. 침 치료는 바늘과 같은 호침을 피부로 자입하여 경혈을 자극함으로써 몸의 균형과 조화를 얻는 것을 목적으로 한다.

조현병은 중대한 정신 질환이며 대체로 항정신병 약물로 치료한다. 하지만 항정신병 약물은 그 효과에도 불구하고 졸림, 체중 증가, 소변 지림 등의 부작용을 유발할 수 있다. 침 치료는 환자에게 거의 부작용을 나타내지 않는 것으로 알려져 있으며, 정신건강 상의 문제로 치료가 필요한 사람들에게 보다 사회적으로 수용 가능하고 받아들이기 나은 방법이 될 수 있다. 침 치료는 또한 제약회사의 약물보다 덜 비쌀 수 있어, 환자 개인의 의료비 및 보건 서비스 측면의 비용을 줄일 수도 있다.

이 리뷰는 조현병 환자에 대한 다양한 유형의 침 치료 효과를 평가하고자 한다. 리뷰를 위한 가장 최근의 검색은 2012년에 이루어졌으며, 항정신병 약물 투여를 받고 있는 환자들을 대상으로 부가적인 침 치료를 하거나 표준 치료 (standard care) 를 하는 군으로 배정한 무작위 대조 연구 30건이 있음을 확인했다.

비록 일부 연구에서 항정신병 약물과 침 치료 병행요법이 효과적이라 보고하긴 했지만, 연구의 규모가 작았고 연구 품질이 낮음 또는 매우 낮음으로 분류되어, 그 입증 능력 및 타당성은 제한적이었다. 침과 항정신병 약물의 병행요법 역시 우울증을 감소시켰지만, 이 또한 소규모 연구 결과에 바탕한 것이므로 분석 결과가 타당하다고 명확하게 말하긴 어렵다. 침 치료가 어떠한 잠재적 이득이라도 제시할 수 있는지 조현병 환자, 정책 입안자, 보건의료 전문가들이 판단하기 위해서는, 훨씬 더 양질의 근거가 필요하다는 것이 이 리뷰의 결론이다.

즉 침 치료가 조현병 환자들에게 도움이 되는지, 항정신병 약물보다 더 도움이 되는지 현재로서는 알 수 없다. 조현병 환자들에 대한 침 치료의 효과 또는 위해가 어떠한지 확실히 알기 위한 정보가 부족하다.

벤저민 그레이, 서비스 사용자 및 전문 사용자, 리씽크 정신 질환 (Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness).


이 리뷰는 김건형 (부산대학교 한의학전문대학원; 이 번역하였습니다. 번역 내용과 관련한 궁금점은 위 메일로 연락주시기 바랍니다.

Streszczenie prostym językiem

Akupunktura w leczeniu schizofrenii

Chociaż akupunktura czy tradycyjna medycyna chińska były praktykowane przez ponad 2000 lat w Chinach i na Dalekim Wschodzie, zwłaszcza w Korei i Japonii, to na zachodzie jest to stosunkowo nowa metoda leczenia schorzeń fizycznych i zaburzeń psychicznych. W akupunkturze igły wprowadza się do skóry w celu stymulacji konkretnych punktów na ciele (tzw. punktów akupunktury). Celem jest uzyskanie równowagi i harmonii ciała.

Schizofrenia jest poważną chorobą psychiczną i zwykle leczy się ją za pomocą leków przeciwpsychotycznych. Jednak, pomimo swojej skuteczności, leki przeciwpsychotyczne mogą powodować skutki uboczne (takie jak: senność, zwiększenie masy ciała, a nawet nadmierne ślinienie). Wykazano, że stosowanie akupunktury wiąże się z występowaniem niewielu skutków ubocznych i może być społecznie bardziej akceptowane i tolerowane u osób z zaburzeniami zdrowia psychicznego. Akupunktura może być również tańsza niż leki produkowane przez firmy farmaceutyczne, zmniejszając przez to koszty ponoszone przez pacjentów i służbę zdrowia.

Niniejszy przegląd ocenia skuteczność stosowania różnych rodzajów akupunktury u chorych na schizofrenię. Aktualizację wyszukiwania badań przeprowadzono w 2012 roku i odnaleziono 30 badań, w których pacjentów przyjmujących leki przeciwpsychotyczne przydzielono losowo do jednej z 2 grup, w których otrzymywali odpowiednio: akupunkturę albo standardowe leczenie.

Chociaż w niektórych badaniach odnotowano korzyści ze stosowania akupunktury łącznie z lekami przeciwpsychotycznymi, to dostępne dane były ograniczone, a autorzy przeglądu ocenili ich jakość na bardzo niską lub niską, uznano je zatem za niewystarczająco wiarygodne i przekonujące. Łączne stosowanie akupunktury i leku przeciwpsychotycznego wiązało się z poprawą w zakresie nasilenia objawów depresji, jednak ponownie wynik ten pochodził z małego badania, przez co nie można było wyraźnie wykazać, że był wiarygodny. Podsumowując stwierdzono, że osoby z zaburzeniami zdrowia psychicznego, decydenci oraz pracownicy służby zdrowia potrzebują danych naukowych o znacznie lepszej jakości, aby móc ustalić czy istnieją potencjalne korzyści ze stosowania akupunktury.

Oznacza to, że nadal nie znamy odpowiedzi na pytanie: czy stosowanie akupunktury jest korzystne oraz czy korzyści ze stosowania akupunktury są większe niż korzyści ze stosowania leków przeciwpsychotycznych. Nie ma wystarczających danych, aby móc ustalić czy stosowanie akupunktury jest korzystne lub szkodliwe u osób z zaburzeniami zdrowia psychicznego.

Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness.

Uwagi do tłumaczenia

Tłumaczenie:Bartłomiej Matulewicz, Redakcja: Karolina Moćko