Acupuncture Continuing Education

Acupuncture and Herbs Soothe Acid Reflux


Acupuncture and herbal medicine are effective for the alleviation of GERD (gastroesophageal reflux disease, acid reflux). Independent investigations confirm that acupuncture and herbal medicine produce significant positive patient outcomes for patients with GERD. One of the clinical studies reveals an important integrative medicine finding. The combination of acupuncture and herbs with a proton pump inhibitor medication into a combined treatment protocol produces superior patient outcomes to patients receiving only drug therapy.

The first study, conducted at Huludao Fourth People’s Hospital, finds that Chinese medicine therapy (acupuncture and herbs) combined with drug therapy produces a 95% total effective rate. If acupuncture is not applied, the total effective rate sharply drops to 68%. [i] A total of 88 GERD patients were recruited for the study and were randomly assigned to the Chinese medicine group or the drug control group.

The Chinese medicine group was comprised of 29 male and 15 female patients, with a mean age of 39.24 years and a mean disease duration of 7.46 years. The drug control group was comprised of 28 male and 16 female patients with a mean age of 39.27 years and a mean disease duration of 7.44 years.


All patients were treated with pantoprazole (40 mg enteric coated tablets, 1 tablet daily, 30 minutes before food) and domperidone (10mg tablets, 1 tablet, 3 times a day). All patients were also prescribed a modified version of the herbal formula Si Ni San, which was comprised of the following herbs:

  • Bai Shao 15g
  • He Huan Hua 15g
  • Dai Zhe Shi 15g
  • Jiang Ban Xia 15g
  • Zhi Shi 15g
  • Huang Lian 10g
  • Chai Hu 10g

The herbs were administered daily, split into two doses to be taken morning and evening. Patients in the Chinese medicine group were additionally prescribed acupuncture administered at the following acupoints:

  • Dushu (BL16)
  • Xinshu (BL15)
  • Geguan (BL46)

Acupuncture treatment was provided daily with needles retained for 20 minutes each time. All treatments were administered for a total of two weeks.


Outcome measures for the study included the total effective rates and duration until relief. Symptoms monitored included gastric pain, acid reflux, bile reflux, and sensations of fullness after eating. Each symptom was rated from 0–3 based on severity, with lower scores indicative of more serious symptoms.

The total effective rates were calculated as follows. Patients with a complete resolution of symptoms and a symptom score of 0 were classified as recovered. For patients with a significant improvement in symptoms and an improvement in symptom scores of at least one point, the treatment was classified as effective. For patients with no improvement of symptoms, the treatment was classified as ineffective.

In the drug control group, there were 18 recovered, 12 effective, and 14 ineffective cases, yielding a total effective rate of 68.18%. In the Chinese medicine group, there were 30 recovered, 12 effective, and two ineffective cases, yielding a total effective rate of 95.45%. Although both groups showed improvements, outcomes were significantly greater when acupuncture was added to the treatment regimen (p<0.05).

In addition, the time taken for symptoms to resolve was measured for both groups. Gastric pain took a mean 4.24 days to resolve in the drug control group, compared with 2.51 days in the Chinese medicine group. Acid reflux took a mean 7.24 days to resolve in the drug control group, compared with 5.52 days in the Chinese medicine group. Fullness after eating took a mean 7.31 days to resolve in the drug control group, compared with 5.10 days in the acupuncture group.

Relief was experienced significantly faster in the Chinese medicine group across all areas (p<0.05). The data indicates that acupuncture greatly enhances treatment efficacy. In addition, one patient in the control group experienced nausea, while no adverse reactions were experienced in the Chinese medicine group.


Guangji Hospital
The second study was conducted at Guangji Hospital of Traditional Chinese Medicine (Beijing). [ii] This study focused on acupuncture for GERD related coughing. Outcome measures included the RDQ (Reflux Disease Questionnaire), LCQ (Leicester Cough Questionnaire), and cough symptom severity scores.

A total of 60 patients with GERD related coughing were recruited and randomly assigned to the medication group or the acupuncture group. The medication group was comprised of 11 male and 19 female patients, with a mean age of 53.9 years and a mean disease duration of 9.4 years. The acupuncture group was comprised of 7 male and 23 female patients, with a mean age of 51.1 years and a mean disease duration of 4.5 years.

Diagnostic criteria included chronic coughing lasting >8 weeks with no lesions apparent on chest X-rays, coughing related to eating or accompanied by acid reflux, hiatal hernia, or heartburn with inflammatory changes visible by gastroscopy. In addition to these criteria, patients were required to be in the range of ages 20–80 years, able to cooperate with treatment, and provide voluntary informed consent to participate.

Exclusion criteria included symptoms due to pregnancy, achalasia (difficulty swallowing due to neurological or muscular disorders of the esophagus), pyloric obstruction, cardiac resection, drug induced esophagitis, immune system related esophagitis, esophageal cancer, concurrent heart, liver, kidney, pancreatic, liver, or central nervous system disorders, and suspected or confirmed malignancy. Patients with coughing due to asthma, bronchitis, post-nasal drip, etc.—were also excluded from the study.


Patients in the medication group were treated with omeprazole (20 mg enteric coated capsules, 1 tablet, twice daily). Patients in the acupuncture group were treated with acupuncture administered at acupoints located below the spinous processes of the thoracic vertebrae as follows:

  • T3: Shenzhu (GV12)
  • T4: extra acupoint
  • T5: Shendao (GV11)
  • T6: Lingtai (GV10)
  • T7: Zhiyang (GV9)
  • T8: extra acupoint
  • T9: Jinsuo (GV8)
  • T10: Zhongshu (GV7)
  • T11: Jizhong (GV6)
  • T12: extra acupoint

Needles were inserted obliquely to a depth of 15 mm. After the arrival of deqi, needles were manipulated using a balanced reinforcing-reducing method for one minute. Needles were retained for 30 minutes with manipulation repeated at 15-minute intervals. Treatment was administered every Tuesday, Thursday, and Saturday. Both groups underwent treatment for a total of eight weeks.


Outcome measures included the RDQ, LCQ, and cough symptom severity scores. The RDQ rates GERD symptoms including sternum pain, acid reflux, and loss of appetite according to severity over the prior week. Symptoms were rated on a scale of 0–5, with higher scores indicative of more severe symptoms. Both groups experienced significant relief from GERD symptoms following treatment but relief was significantly greater in the acupuncture group (p<0.05).

The LCQ measures the physical, psychological, and social impact of coughing symptoms according to their frequency over the prior two weeks. Each area is scored from 1–7, with lower scores indicative of more frequent symptoms and a greater impact on quality of life. Both groups saw improvements across all areas following treatment, but improvements were significantly greater in the acupuncture group (p<0.05).

The cough symptom severity score was used to rate cough frequency and severity on a scale of 0–3, with higher scores indicative of more severe symptoms. Both groups saw improvements in nighttime coughing and overall cough symptoms. Improvements were significantly greater in the acupuncture group (p<0.05).

The results of the aforementioned studies indicate that acupuncture provides safe and effective relief from GERD symptoms. Acupuncture monotherapy and acupuncture combined with herbal medicine and drugs demonstrates significant clinical advantages over drug monotherapy. Based on the data, acupuncture optimizes GERD treatment.


[i] Yang Ling (2018) “Analysis of the application effect of Jiawei Sini San combined acupuncture therapy in reflux esophagitis” Guide of China Medicine Vol. 16 (24) pp.178-179.
[ii] Gao Danxia, Bai Xinghua (2019) “Clinical trial of acupuncture treatment of gastroesophageal reflux cough by needling dorsal segment of the Governor Vessel” Acupuncture Research Vol.44 (2) pp.140-143.


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