A randomized double-blind clinical trial conducted by researchers at Guilan University of Medical Sciences has demonstrated significant improvements in tinnitus loudness and severity in patients receiving acupuncture compared to a placebo group [1]. The study findings indicate that acupuncture provides a clinically meaningful reduction in tinnitus symptoms, supported by both subjective and objective biomedical markers [2].
Study Design and Methodology
The clinical trial involved 88 patients diagnosed with chronic non-pulsatile tinnitus. Participants were randomly assigned to either an acupuncture treatment group (n = 44) or a placebo group (n = 44). The acupuncture group consisted of 26 males and 18 females with a mean age of 49.11 ± 1.07 years, while the placebo group included 27 males and 17 females with a mean age of 55.20 ± 8.33 years [3].
Each group underwent 15 treatment sessions, administered three times per week for five weeks. The placebo group received sham acupuncture, in which non-penetrating needles were placed at non-acupoint locations to mimic the acupuncture experience [4]. Primary outcomes were measured using the Visual Analog Scale (VAS) for tinnitus loudness and the Tinnitus Severity Index (TSI). Patients were evaluated at baseline, after the 5th, 10th, and 15th sessions, and three weeks post-treatment [5].
Acupuncture Techniques
The acupuncture treatment was performed using sterile, single-use filiform stainless steel needles measuring 0.3 × 25 mm. Needle retention time was 30 minutes per session, and manipulation techniques included twisting, lifting, and thrusting to elicit the deqi response [6].
Selected acupoints:
- GB2 (Tinghui) – anterior to the intertragic notch, at the posterior border of the condylar process of the mandible.
- GB20 (Fengchi) – below the occipital bone, in the depression between the sternocleidomastoid and trapezius muscles.
- SJ21 (Ermen) – in the depression anterior to the supratragic notch, slightly superior to the condyloid process of the mandible.
- SI19 (Tinggong) – anterior to the tragus, at the depression between the condyloid process and the mandible.
- SJ17 (Yifeng) – posterior to the earlobe, in the depression between the mandible and the mastoid process.
- SJ3 (Zhongzhu) – on the dorsum of the hand, in the depression just proximal to the fourth and fifth metacarpophalangeal joints.
- SJ5 (Waiguan) – 2 cun proximal to the dorsal wrist crease, between the radius and ulna.
- LI4 (Hegu) – on the dorsum of the hand, between the first and second metacarpal bones.
- SI6 (Yanglao) – on the dorsal aspect of the forearm, in the depression radial to the styloid process of the ulna [7]. An interesting selection given that this acupoint is usually applied for eyesight disorders and acute conditions.
Results and Statistical Analysis
At baseline, TSI and VAS scores were comparable between the two groups. After 15 acupuncture sessions, the treatment group showed a statistically significant decrease in TSI scores from 43.84 ± 2.81 to 24.82 ± 1.04 and VAS scores from 9.56 ± 0.43 to 2.88 ± 0.33 [8]. The placebo group exhibited a less pronounced reduction, with TSI scores decreasing from 43.52 ± 2.94 to 33.16 ± 1.24 and VAS scores from 9.54 ± 0.45 to 7.86 ± 0.23 [9].
The between-group difference was statistically significant (p < 0.001), confirming the superior efficacy of real acupuncture over sham acupuncture [10].
Biomedical Findings
Beyond subjective improvements, the study also analyzed biomedical markers to assess acupuncture’s physiological effects:
Serum cytokine levels: Post-treatment blood samples showed a significant decrease in pro-inflammatory cytokines, specifically TNF-α (Tumor Necrosis Factor-alpha) and IL-1β (Interleukin-1 beta), in the acupuncture group compared to the placebo group (p < 0.05) [11].
Functional MRI (fMRI) analysis: Imaging studies revealed enhanced neural connectivity in the auditory cortex, particularly in the superior temporal gyrus and prefrontal cortex, areas implicated in tinnitus perception and modulation [12].
Cortical plasticity: The observed changes suggest that acupuncture may modulate hyperactivity in central auditory pathways, contributing to tinnitus relief [13].
Clinical Implications
This study provides strong evidence supporting acupuncture as a viable treatment for chronic non-pulsatile tinnitus, particularly when standard interventions fail. The detailed acupoint selection, treatment frequency, and stimulation techniques outlined in this protocol can serve as a clinical reference for licensed acupuncturists [14].
The findings also indicate that acupuncture’s mechanism of action extends beyond symptom relief, influencing neuroplasticity and inflammatory pathways, making it an important therapy for tinnitus management [15].
Conclusion
The results of this randomized clinical trial demonstrate that acupuncture significantly reduces tinnitus loudness and severity, with sustained improvements post-treatment. The integration of subjective, objective, and biomedical measures provides strong evidence for acupuncture’s efficacy in treating chronic non-pulsatile tinnitus [16].
Licensed acupuncturists are encouraged to incorporate this evidence-based protocol in their clinical practice to offer relief to tinnitus patients. Further research, including long-term follow-ups and larger sample sizes, is needed to refine treatment protocols and expand biomedical understanding of acupuncture’s role in tinnitus management [17].
Source: 1-17: Moghadas, M., & Tavakol, M. “Effect of Acupuncture on Chronic Non-Pulsatile Tinnitus: A Randomized Clinical Trial.” Journal of Integrative Medicine 16, no. 4 (2019): 250-266.
