Randomised Clinical Trial: An Assessment of Acupuncture on Specific Meridian or Specific Acupoint vs. Sham Acupuncture for Treating Functional Dyspepsia

T. T. Ma; S.Y. Yu; Y. Li; F. R. Liang; X. P.Tian; H. Zheng; J.Yan; G. J. Sun; X. R.Chang; L. Zhao; X.Wu; F. Zeng

Disclosures

Aliment Pharmacol Ther. 2012;35(5):552-561. 

In This Article

Abstract and Introduction

Abstract

Background Functional dyspepsia (FD) is a common disease without an established optimal treatment.
Aim To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints.
Methods A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients' response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index.
Results All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups.
Conclusions Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture

Introduction

Functional dyspepsia (FD) is a common gastrointestinal disorder that is defined as epigastric pain or burning, postprandial fullness or early satiation in the absence of underlying organic disease, according to the Rome III criteria.[1] Globally, the prevalence of FD has been reported to vary between 11% and 29.2%;[2] and it reaches 45% in the outpatient department.[3] Although FD is not a life-threatening disease, patients with FD have a poor quality-of-life (QoL), which imposes an economic burden on society.

The classic pharmacologic treatments for FD include antacids, prokinetics, antidepressants and anxiolytics, but the benefit of these agents still remains unclear,[4–6] and patients do not gain sufficient benefit in improved QoL from the above treatments.[7] As the pharmacologic treatments for FD remain unsatisfactory, alternative therapies, including acupuncture, are attractive to both patients and practitioners.

Acupuncture for treating FD has been practiced in China for thousands of years, and is increasingly accepted worldwide.[6] However, previous evidence is minimal. As a meta-analysis on acupuncture for FD[8] indicated, because of the poor quality of the trials, the efficacy of acupuncture for FD has not been verified. Based on traditional meridian and acupoint theories, the efficacy of acupuncture is mostly determined by acupoint. There is a specific effect of acupoint compared with non-acupoint, and the specific effect may differ from acupoints on different meridians or of different types. Due to the heterogeneity of results from previous randomised controlled trials,[9,10] this theory is not completely supported.

The aim of our study was as follows: (i) to determine the efficacy of acupuncture for patients with FD compared with itopride and its safety; (ii) to investigate the specific effect of acupoint compared with that of the non-acupoint; and (iii) to explore whether there is acupoint specificity by comparing different acupoints or not.

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