Acupuncture therapy for sudden sensorineural hearing loss: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
Acupuncture has commonly been used in China, either alone or in combination with Western medicine, to treat sudden sensorineural hearing loss (SSHL). The purpose of this systematic review is to assess the efficacy and safety of acupuncture therapy for patients with SSHL.


METHODS
We searched PubMed, the Cochrane Library, Embase, China National Knowledge Internet (CNKI), Database for Chinese Technical Periodicals (VIP), and Chinese Biomedical literature service system (SinoMed) to collect randomized controlled trials of acupuncture for SSHL published before July 2014. A meta-analysis was conducted according to the Cochrane systematic review method using RevMan 5.2 software. The evidence level for each outcome was assessed using the GRADE methodology.


RESULTS
Twelve trials involving 863 patients were included. A meta-analysis showed that the effect of manual acupuncture combined with Western medicine comprehensive treatment (WMCT) was better than WMCT alone (RR 1.33, 95%CI 1.19-1.49) and the same as the effect of electroacupuncture combined with WMCT (RR 1.33, 95%CI 1.19-1.50). One study showed a better effect of electroacupuncture than of WMCT (RR 1.34, 95%CI 1.24-1.45). For mean changes in hearing over all frequencies, the meta-analysis showed a better effect with the combination of acupuncture and WMCT than with WMCT alone (MD 10.85, 95%CI 6.84-14.86). However, the evidence levels for these interventions were low or very low due to a high risk of bias and small sample sizes in the included studies.


CONCLUSIONS
There was not sufficient evidence showing that acupuncture therapy alone was beneficial for treating SSHL. However, interventions combining acupuncture with WMCT had more efficacious results in the treatment of SSHL than WMCT alone. Electroacupuncture alone might be a viable alternative treatment besides WMCT for SSHL. However, given that there were fewer eligible RCTs and limitations in the included trials, such as methodological drawbacks and small sample sizes, large-scale RCTs are required to confirm the current findings regarding acupuncture therapy for SSHL.
Department of Pain Management, Subei People's Hospital of Jiangsu Province & Clinical Medical School, Yang Zhou University, Yangzhou 225001, P.R. China; The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China.
Xin-chang
XC
Zhang
Department of Critical Care Medicine, Nanjing Zhong-da Hospital, School of Medicine, Southeast University, Nanjing 210009, P.R. China.
Xiu-ping
XP
Xu
The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China.
Wen-tao
WT
Xu
The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China.
Wen-zhen
WZ
Hou
The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China.
Ying-ying
YY
Cheng
Department of Pain Management, Subei People's Hospital of Jiangsu Province & Clinical Medical School, Yang Zhou University, Yangzhou 225001, P.R. China.
Chang-xi
CX
Li
The Second School Medical College, Nanjing University of Chinese Medicine, Nanjing 210029, P.R. China; The Second Chinese Medicine Hospital of Jiangsu Province, Nanjing 210017, P.R. China.
Guang-xia
GX
Ni
D015670:Acupuncture Therapy; D001301:Audiometry, Pure-Tone; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome