Acupuncture-related therapy for chronic cough: A systematic review and meta-analysis

Background: Despite the high prevalence and socioeconomic burden of chronic cough, there has been an unmet medical need. Acupuncture may be promising for treating chronic cough with various pathophysiologies involving several neurotransmission mechanisms. We aimed to systematically compile evidence on the effect and safety of acupuncture-related therapy for chronic cough. Methods: Through a search of 11 databases, randomized controlled trials (RCTs) published until February 15, 2024 that evaluated the effect of acupuncture-related therapy at acupuncture points (including acupuncture, acupoint herbal patching, and moxibustion) for patients with chronic cough were identified and analyzed without restrictions on the cause of cough or age. When there were two or more studies that measured the same outcome measures, a meta-analysis was performed, and the certainty of evidence was evaluated based on the GRADE methodology. Results: A total of 30 RCTs with 2835 participants were included. When acupuncture-related therapy was implemented in addition to conventional treatment including medicine and lifestyle guidance according to symptoms and causes, cough severity, cough-related quality of life, and the total effective rate (TER) were significantly improved with no difference in the incidence of adverse events. Furthermore, compared with conventional treatment, acupuncture-related therapy significantly improved cough severity and the TER. The certainty of the evidence was generally moderate due to the risk of bias. The most frequently used acupuncture points in the included studies were BL13, GV14, CV17, and EX-B1. Conclusion: Acupuncture-related therapy might be an effective and safe treatment for patients with chronic cough of various causes with complex pathophysiologies. Protocol registration: PROSPERO, CRD42024518115. PROSPERO (CRD42024518115).