Table 1 Study design of all included studies
1st Author (year) | Design, Follow-up | Intervention, treatment duration | Details of intervention | ||
|---|---|---|---|---|---|
Treatment group | Control group | Treatment group | Control group | ||
Chen (2010) [30] | 2 parallel arms, follow-up duration not reported | Acupuncture, 1 treatment every 3 days for 15 days | Triamcinolone acetonide injection, 1 treatment every 5 days for 15 days | Local tender points, superficial, strong manual manipulation, needles retained for 1 min. | Triamcinolone acetonide 40 mg, 2% lidocaine 2 ml injected at area of pain |
Davidson (2001) [18] | 2 parallel arms, follow-up duration not reported | Acupuncture, 2–3 treatments per week for 4 weeks | Ultrasound, 2–3 treatments per week for 4 weeks | LI 4, SJ 5, LI 10, LI 11, LI 12, manual manipulation to obtain and maintain De-qi, needles retained for 20 min. | Pulsated ultrasound for 10 min. over area of lateral epicondyle |
Fink (2002) [15] | 2 parallel arms, 2 months | Acupuncture, 2 treatments per week for 5 weeks | Sham-acupuncture, 2 treatments per week for 5 weeks | 1 local tender point, LI 10, LI 11, LU 5, LI 4 and SJ 5, manual manipulation to obtain De-qi, needles retained for 25 min. | Same as treatment group, but needles placed at least 5 cm away from real acupoint, area clear of tender points |
Grua (1999) [19] | 2 parallel arms, follow-up duration not reported | Acupuncture, 1–2 treatments per week for approx. 5 weeks (total of 10 treatments) | Ultrasound, massage, 1 treatment per day for 12 days | LI 4, LI 10, LI 11, LI 12, LI 15, PC 5, PC 7, GB 20, GB 21, GB 34, ST 37, ST 38, manual manipulation needles retained for 20 min. | Pulsated ultrasound for 5 min., massage for 5 min., both at area of lateral epicondyle |
Irnich (2003) [17] | 2 parallel arms, 2 weeks | Acupuncture, 3 treatments for 10 days | Sham-acupuncture, 3 treatments for 10 days | LI 4, LI 10, SI 3, SJ 5, GB 34, intermittent manual manipulation to obtain and maintain De-qi, needles retained for 25 min. | Same as treatment group, but needles placed 1 cun away from real acupoint |
Jin (2005) [33] | 2 parallel arms, 1 month | Single scarring ginger- moxibustion | Prednisolone compound injection, 1 treatment per week for 2 weeks | Local tender points, ginger- moxibustion, 7 cones per acupoint | 2% lidocaine 1 ml, prednisolone 1 ml, Vitamin B1 50 mg, Vitamin B12 250 μg injected at area of pain |
Li (1998) [28] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment every 1 or 2 days for 2 months | Acupuncture, 1 treatment every 2 days for 2 months | Local tender points, LI 4, LI 10, LI 11, AMC, manual stimulation to obtain and maintain De-qi, needles retained for 15–20 min., moxibustion with moxa-stick until local area reddened | Same as treatment group, but only manual stimulation to obtain and maintain De-qi |
Li (2007) [22] | 2 parallel arms, follow-up duration not reported | Ginger-moxibustion, 1 treatment every 2 days for 14 days | Prednisolone injection, 1 treatment every 5–7 days for 14–21 days | SJ 10, LI 11, manual stimulation to obtain De-qi, needles not retained, ginger-moxibustion 5–7 cones per acupoint | 2% lidocaine 2 ml, prednisolone 25 mg injected at area of pain |
Liu (2008) [23] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment every 2 days for 28 days | Acupuncture, 1 treatment every 2 days for 28 days | Local tender points, LI 4, LI 10, LI 11, SJ 5, AMC, manual stimulation to obtain and maintain De-qi, needle retained for 20–30 min., indirect moxibustion, 3–5 cones per acupoint | Same as treatment group, but only manual stimulation to obtain and maintain De-qi |
Lin (2011) [21] | 2 parallel arms, 1 month | Acupuncture, 1 treatment every 2 days for 20 days | Prednisolone injection, 1 treatment every 10 days for 20 days | LI 11, 1 most tender point on lateral aspect of elbow, 3 points 0.5-1 cun distal to the most tender point, manual manipulation to obtain and maintain De-qi, needles retained for 30 min. | Prednisolone 5 ml, 2% procaine 1.5 ml injected at area of pain |
Molsberger (1994) [16] | 2 parallel arms, 3 days | Acupuncture, 1 treatment only | Sham-acupuncture, 1 treatment only | Ipsilateral GB 34, manual manipulation to obtain and maintain De-qi, needles retained for 5 min. | BL13 non-needle sham acupuncture, stimulation with a pencil-like probe at beginning and after 5 min. |
Shen (1999) [20] | 3 parallel arms, follow-up duration not reported | Electro-acupuncture, 1 treatment per day for 10 days | Control 1: AMC, 1 treatment per day for 10 days | Local tender points, manual manipulation to obtain De-qi followed by electric stimulation for 30 min., heat lamp for 30 min. | Control 1: Same as treatment group but AMC, needle retainment for 30 min., indirect moxibustion (moxa stick) |
Control 2: Prednisolone, 1 treatment per week for 3 weeks | Control 2: Prednisolone 20 mg injected at area of pain | ||||
Wang (2007) [24] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment per day for 10 days | Acupuncture, 1 treatment per day for 10 days | LI 10, LI 11, SJ 10, PC 6, REN 12, ST 36, SP 6, points chosen based on TCM pattern diagnosis, AMC, De-qi obtained, duration of needle retainment not reported, indirect moxibustion 3 cones per acupoint | Same as treatment group, but only manual stimulation to obtain De-qi, no additional stimulation during treatment, duration of needle retainment not reported |
Wang (2008) [25] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment every 3 days for 30 days | Acupuncture, 1 treatment every 3 days for 30 days | 5 local tender points, LI 4, AMC, even manual stimulation technique to obtain and maintain De-qi, needles retained for 30 min., indirect moxibustion, 2–3 cones per acupoint | LI 4, LI 10, LI11, LI 12, manual stimulation every 10 min., needles retained for 30 min. |
Wu (2003) [26] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment every 2 days for 14 days | Acupuncture, 1 treatment every 2 days for 14 days | Local tender points, LI 4, LI 10, LI 11, SJ 5, manual manipulation for 1 min. to obtain and maintain De-qi, needles retained for 30 min., indirect moxibustion 3–5 cones per acupoint | 1 local tender point was selected, De-qi obtained, needles retained for 30 min. |
Xu (2010) [29] | 2 parallel arms, follow-up duration not reported | Single scarring ginger-moxibustion | Prednisolone injection, 1 treatment every 5 days for 15 days | Local tender points, ginger- moxibustion, duration not reported | Prednisolone 25 mg, 2% procaine 2 ml injected at area of pain |
Zha (2004) [31] | 2 parallel arms, follow-up duration not reported | Acupuncture, 1 treatment every 2 days for 14 days | Hydrocortisone acetate injection, 1 treatment per week for two weeks | Local tender points, manual manipulation, duration of needle retainment not reported | 2% lidocaine 5 ml, hydrocortisone-acetate 125 mg (1 ml) injected at area of pain. |
Zhang (2007) [32] | 2 parallel arms, follow-up duration not reported | Acupuncture, 1 treatment every 2 days for 20 days | Meloxicam tablets oral intake, 1 treatment every 2 days for 20 days | 1 local tender point and 2 points at 2 cm apart from the tender point, manual manipulation to obtain and maintain De-qi, duration of needle retainment not reported | Meloxicam tablets 7.5 mg/ day |
Zhao (2003) [27] | 2 parallel arms, follow-up duration not reported | AMC, 1 treatment per day for 10 days | Acupuncture, 1 treatment per day for 10 days | Local tender points, manual manipulation to obtain and maintain De-qi, duration of needle retainment not reported, indirect moxibustion (moxa stick) until local area reddened | Acupuncture at local tender points, manual stimulation, duration of needle retainment not reported |