Acupuncture for the Treatment of Chronic Cough: A Systematic Review and Meta-Analysis

OBJECTIVES: Given the high prevalence and socioeconomic burden of chronic cough, there is a significant medical need for effective treatments. Acupuncture, leveraging various neurotransmission mechanisms, shows promise in addressing chronic cough across different pathophysiologies. The objective of this study was to systematically compile evidence on the effect and safety of acupuncture for chronic cough.

METHODS: A comprehensive search was conducted across 11 databases for randomized controlled trials (RCTs) that evaluated the effect of acupuncture. The search included studies published up to February 2024. The studies included patients with chronic cough, with no restrictions on the cause of the cough or the age of the patients. Meta-analyses were performed when two or more studies measured the same outcomes, and the certainty of evidence was assessed using the GRADE methodology.

RESULTS: A total of 30 RCTs involving 2835 participants were included in the analysis. Acupuncture, when combined with conventional treatment (medication and lifestyle guidance), significantly improved cough severity and cough-related quality of life compared to conventional treatment alone. Acupuncture combined with conventional therapy also significantly improved the total effective rate (TER) compared to conventional treatment alone. Acupuncture showed significant improvements in cough severity and TER compared to conventional treatment. There was no significant difference in the incidence of adverse events between the acupuncture and conventional treatment groups. The certainty of the evidence was generally moderate to low due to risks of bias and imprecision in the included studies.

CONCLUSIONS: Acupuncture appears to be an effective and safe treatment for chronic cough across various causes and pathophysiologies. Nonetheless, future research should focus on well-designed RCTs that use objective assessment tools to evaluate the efficacy and effectiveness of acupuncture more robustly.