Researchers find acupuncture more effective than the drug mosapride for the treatment of abdominal pain and discomfort due to indigestion. This is significant in that mosapride has been proven effective for the relief of digestion related disorders, including GERD (gastroesophageal reflux disease), gastritis, and functional dyspepsia. Specifically, acupuncture outperformed mosapride for the treatment of functional dyspepsia (abdominal discomfort or pain with no known organic cause identifiable with endoscopy). The results were confirmed by electrogastrogram and other instruments.
Researchers find an ancient acupuncture point combination more effective than mosapride for the treatment of functional dyspepsia. The combination of Gongsun (SP4) and Neiguan (PC6) produces significant improvements for patients with functional dyspepsia without producing adverse effects. The data was published in the report entitled Observations on the Efficacy of Electroacupuncture at Points Gongsun and Neiguan in Treating Functional Dyspepsia.
The combination of Gongsun and Neiguan “significantly relieved clinical symptoms such as abdominal distention and discomfort after eating, early satiety, upper abdominal pain, and upper abdominal burning sensation.” The researchers note that “acupuncture outperformed drugs in regulating EGG dominant frequency as well as slow wave frequency.” They add, “compared with the drug group, the acupuncture group showed a significant difference in FDDQL scores.” Let’s take a closer look at the results.
A total of 62 patients with functional dyspepsia were treated and evaluated in this study. They were diagnosed with functional dyspepsia between January 2014 and January 2015. They were randomly divided into a treatment group and a control group, with 32 patients in the treatment group and 30 patients in the control group. The treatment group underwent electroacupuncture therapy, while the control group received drug therapy.
The statistical breakdown was as follows. The treatment group was comprised of 15 males and 17 females. The average age in the treatment group was 41 years (±16). The average course of disease was 3.91 years (±2.17). The control group was comprised of 14 males and 16 females. The average age in the control group was 44 years (±15). The average course of disease in the control group was 4.01 years (±1.62). There were no significant statistical differences in terms of age, gender, and course of disease relevant to patient outcome measures.
Inclusion criteria were as follows. According to the Rome III diagnostic standard for functional dyspepsia, patients participating in the study met at least one of the following criteria for at least six months:
- Abdominal distention and discomfort after eating
- Early satiety
- Upper abdominal pain
- Upper abdominal burning sensation
In addition, organic causes of indigestion were disallowed and were sorted using physical or biochemical examinations. Gastrointestinal motor function tests showing dysfunction of esophageal and gastrointestinal motility were allowed. Exclusion criteria were applied. This assured that patients participating in the study suffered from functional dyspepsia and not dyspepsia secondary to a separate, known etiology. Patients who had the following conditions did not participate in the study:
- Severe primary and concomitant cardiovascular, liver, kidney, digestive, or hematopoietic diseases
- Progressive malignant tumors or other severe consumptive diseases
- Pregnant or lactating
- Unable to follow instructions from researchers due to ambiguous consciousness or psychosis
- Takes other medications for gastrointestinal disorders within a month
Let’s take a look at the acupuncture point prescription. The acupoints selected for the treatment group were the following:
- SP4 (Gongsun)
- PC6 (Neiguan)
According to TCM (Traditional Chinese Medicine) principles, Neiguan is a Luo-connecting acupoint on the pericardium meridian. Gongsun is a Luo-connecting acupoint on the spleen meridian. Both acupoints belong to the Ba Mai Jiao Hui Xue (meeting points of the twelve meridians and eight extraordinary meridians). The combination of these two acupoints is used for disorders of the stomach, heart, and chest. SP4 is the confluent point of the Penetrating (Chong) vessel and PC6 is the confluent point of the Yin Linking (Yinwei) vessel. Together, they are paired confluent points in the eight extra meridian system, specifically indicated for heart, chest, and stomach disorders.
The efficacy of both acupoints in treating stomach disorders is verified by modern research. Peng et al. found that needling Neiguan improves gastric motility, stimulates motilin (a hormone that increases motility of the gut) secretion, and reduces visceral hypersensitivity. Chen et al. found that needling Gongsun inhibits gastric acid secretion. Yuan et al. found that the combination of both acupoints significantly reduces anxiety and depression caused by functional dyspepsia and regulates the gastric emptying rate. Lin et al. proved that Neiguan combined with Gongsun has a bidirectional regulatory effect for stomach disorders.
The acupuncture point prescription was administered with both manual and electroacupuncture techniques. Patients were instructed to rest in a supine position. Upon disinfection of the acupoint sites, a 0.30 mm × 40 mm filiform acupuncture needle was inserted into the acupoints, to a maximum depth of 25—40 mm. A mild tonifying and attenuating manipulation technique was conducted to achieve a deqi sensation. Next, electroacupuncture was applied to the acupoints. A disperse-dense wave of 2—100 Hz (0.1—1.0 mA) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. Electroacupuncture was applied once per day, 30 minutes per acupuncture session, for a total of 30 days. For the control group, patients received 5 mg of mosapride citrate tablets, 30 minutes before meals. Tablets were orally administered three times per day, for a total of 30 days.
Patients were evaluated before and after the treatment course. Both subjective and objective instruments were used to measure patient outcomes. First, the improvement of the aforementioned symptoms was recorded using a clinical scoring system. Second, the health related quality of life of all the participants was assessed based on a functional digestive disorders quality of life questionnaire (FDDQL). The FDDQL for the assessment of life quality for patients with functional dyspepsia is an agreed upon standard by international consensus. Third, an electrogastrogram (EGG) was conducted to measure the electrical activity of the stomach (including EGG dominant frequency and slow wave frequency). The results indicate that acupuncture is both safe and effective for the treatment of functional dyspepsia.
References:
1. HONG Feng. Observations on the Efficacy of Electroacupuncture at Points Gongsun and Neiguan in Treating Functional Dyspepsia[J]. Shanghai Journal of Acupuncture and Moxibustion, 2016.
2. Peng SF et al. Electroacupuncture Improves Gastric Motility, Autonomic Nerve Activity and Psychological Sate in Patients with Functional Dyspepsia [J]. World Chinese Journal of Digestology, 2008, 16(36):4105—4109.
3. Chen M et al. Progress in acupuncture for treatment of postoperative nausea and vomiting in foreign countries [J]. Chinese Journal of Clinical Rehabilitation, 2006, 10(47):112—114.
4. Yuan XX et al. Clinical Observation on Acupuncture at Gongsun and Neiguan Points for Functional Dyspepsia Patients with Psychological Factors [J]. Journal of Clinical Acupuncture and Moxibustion, 2015(4):52—55.
5. Curran, Monique P., and Dean M. Robinson. "Mosapride." Drugs 68, no. 7 (2008): 981-991.
