어깨 수술을 시행한 환자에 대한 침 치료의 안전성 평가: 체계적 문헌고찰

다국어 초록 (Multilingual Abstract)

Objectives: The aim of this study was to collect and systematically analyze information on potential adverse events associated with acupuncture treatment in patients undergoing postoperative rehabilitation after shoulder surgery, thereby providing clear evidence of its safety.
Methods: For a systematic review, we searched for studies that administered acupuncture to patients undergoing postoperative rehabilitation after shoulder surgery and reported whether adverse events occurred. Data were searched from October 2025 to November 2025, using online 8 databases: PubMed, Embase, Cochrane library, CNKI, KMBASE, KoreaMed, KISS, and OASIS.
Results: As a result of research, a total of 15 studies were included in this review. Regarding study design, 7 were RCTs, 2 were non-RCTs, and 6 were observational studies.
In terms of interventions, manual acupuncture or electroacupuncture was used in 9 studies. 4 studies applied dry needling for myofascial trigger points. One study each investigated acupotomy, auricular acupuncture, and bee venom acupuncture.
8 of the 15 studies reported the occurrence of adverse events. Among these, a total of 114 events were classified as “possible” or higher according to the WHO–UMC causality categories, indicating that a causal relationship with acupuncture could not be excluded. Of the 114 events, 108 were local pain and subcutaneous bleeding/bruising, 4 were palpitations, and 2 were drowsiness. All 114 adverse events were graded as mild or moderate according to the CTCAE classification.
Based on studies in which incidence could be calculated, the total number of acupuncture sessions was 6,365, yielding an overall adverse event incidence of 1.8%. In subgroup analyses by needling location, incidence was 4.5% in the proximal needling group, 0.3% in the distal needling group, and 1.2% in the combined proximal–distal group. In subgroup analyses by timing of acupuncture initiation, incidence was 0.3% during the acute phase and 14% during the subacute phase, while no adverse events were reported in the chronic phase.
With respect to reporting quality, 10 studies were rated as high quality because they clearly defined adverse events, specified the observation period, and reported event types and the number of events by group in sufficient detail. The remaining five studies provided insufficient information on these items and were therefore rated as low quality.
Overall, the findings of this systematic review indicate that adverse events associated with acupuncture during postoperative rehabilitation after shoulder surgery have mostly been mild events, with virtually no serious adverse events reported.

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅲ
• 그림목차 ⅳ
• Ⅰ. 서 론 1
• Ⅱ. 연구 방법 2
• 1. 자료 선정 및 배제 기준 2
• 1) 연구 대상 2
• 2) 중재 유형 2
• 3) 연구 유형 2
• 2. 배제 기준 3
• 3. 자료 검색 4
• 4. 문헌 선택 5
• 5. 자료 추출 6
• 1) 일반적인 특성 6
• 2) 중재 요법의 특성 6
• 3) 이상 반응의 특성 6
• 6. 주요 결과 지표 7
• 1) 1차 결과 7
• (1) 침 치료와 관련된 이상 반응 발생 빈도 7
• 2) 2차 결과 8
• (1) 이상 반응의 중증도 평가 8
• (2) 침 치료와 이상 반응의 인과성 분석 8
• (3) 이상 반응 증상의 유형 9
• (4) 이상 반응 보고의 질 평가 9
• Ⅲ. 결 과 10
• 1. 연구 선택 10
• 2. 자료 분석 12
• 1) 문헌 정보 12
• 2) 중재 요법의 특성 14
• 3) 이상 반응의 특성 17
• 4) 주요 결과 분석 21
• (1) 침 치료와 관련된 이상 반응 발생 빈도 21
• (2) 이상 반응 보고 수준 23
• (3) 이상 반응의 중증도 및 중대한 이상 반응 23
• (4) 인과성 평가 24
• Ⅳ. 고 찰 25
• Ⅴ. 결 론 29
• 참 고 문 헌 31
• 영 문 초 록 37
• 부 록 39