Acupuncture is more effective than proton pump inhibitors and antibiotics for the treatment of chronic atrophic gastritis (stomach mucosa inflammation causing gastric cell loss and pathological growth of fibrous tissues), according to Dezhou Third People's Hospital researchers. In another independent investigation, acupuncture improved the effectiveness of drugs for the eradication of Helicobacter pylori (H. pylori) in patients with chronic atrophic gastritis. H. pylori is a bacterium that causes inflammation, ulcers, and other gastrointestinal issues. Let’s take a look at how results were achieved.
Dezhou Third People's Hospital researchers compared the therapeutic effects of acupuncture with pharmaceutical medications. Two groups were compared. Patients receiving proton pump inhibitors and antibiotics (omeprazole, amoxicillin, metronidazole) had a 75.00% total effective rate. Omeprazole is a proton pump inhibitor that treats excessive stomach acid. Amoxicillin and metronidazole are antibiotics used to treatment infections by H. pylori. The group of patients receiving acupuncture had a 91.67% total effective rate. Acupuncture outperformed the drug group by 16.67%. [1]
A total of 120 patients participated in the study. They were diagnosed with chronic atrophic gastritis between November 2017 and June 2018. Participants were randomly divided into two groups (drug control, acupuncture treatment), with 60 patients in each group. Both groups had no significant difference in all relevant demographics at the beginning of the investigation after randomization.
The treatment group had 25 males and 35 females, mean age 48.1 years, mean weight 64.1 kg, and average course of disease 4.9 years. The control group had 22 males and 38 females, mean age 47.6 years, mean weight 63.9 kg, and average course of disease 5.1 years. The control group was given omeprazole, amoxicillin, metronidazole, and Vitamin B. The treatment group received acupuncture. The treatment was conducted once daily, for a total of 2 months. Acupoints for the treatment group were selected based on basic differential diagnostic patterns. For spleen and stomach deficiency, the following acupoints were used:
- BL20 (Pishu)
- BL21 (Weishu)
- CV12 (Zhongwan)
- CV6 (Qihai)
- CV4 (Guanyuan)
- PC6 (Neiguan)
- SP10 (Xuehai)
- ST36 (Zusanli)
- SP4 (Gongsun)
For Qihai, Guanyuan, Zusanli, and Neiguan, the Ping Bu Ping Xie (mild tonifying and attenuating) manipulation technique was applied. For Zhongwan and Xuehai, the bu (tonifying) technique was used along with moxibustion. The total treatment time was 25–30 minutes for acupuncture per session and 15 minutes for moxibustion. For liver depression transforming into fire, the following acupoints were used:
- LV3 (Taichong)
- PC6 (Neiguan)
- GB41 (Zulinqi)
- ST36 (Zusanli)
- ST44 (Neiting)
- LV2 (Xingjian)
The acupoints were applied with the Xie (attenuating) technique. The needles were retained for 25–30 minutes. For blood stasis blocking the channels, the following acupoints were used:
- SP10 (Xuehai)
- ST34 (Liangqiu)
- PC6 (Neiguan)
- ST36 (Zusanli)
- SP6 (Sanyinjiao)
- BL20 (Pishu)
- BL18 (Ganshu)
For Neiguan, Zusanli, and Sanyinjiao, the mild tonifying and attenuating manipulation technique was applied. For Pishu and Ganshu, the three edge needle method was administered. Other acupoints were applied with the attenuating technique. The needle retention time was 25–30 minutes. For liver depression and spleen deficiency, the following acupoints were used:
- LV3 (Taichong)
- SP4 (Gongsun)
- PC6 (Neiguan)
- ST36 (Zusanli)
- BL20 (Pishu)
- CV12 (Zhongwan)
- CV6 (Qihai)
All acupoints except Taichong were applied with the tonifying technique. The Taichong point was applied with the attenuating technique. The needle retention time was 25–30 minutes. The acupuncture group had better outcomes for patients with chronic atrophic gastritis. In addition, 2 months after completion of treatments, the acupuncture group reported only 2 cases of adverse reactions (3.3% adverse reaction rate) and the drug therapy group reported 12 cases (20.0% adverse reaction rate).
Han et al. had similar results in their independent investigation, published in the Shanghai Journal of Acupuncture and Moxibustion. The researchers conducted a study comparing the effects of drug monotherapy with Wei San Zhen (gastric three needles) combined with drug therapy. Based on the data, the researchers conclude that acupuncture plus PPI-based drug therapy is significantly more effective than using only PPI-based drug therapy. [2]
Results were determined by symptom scores (bloating, stomachache, heartburn, etc.), serum levels of IL-7 and IL-10, H. pylori eradication rate, and the total effective rate. IL-7 and IL-10 are cytokines that have anti-inflammatory properties. Inhibited IL-10 levels and elevated IL-7 levels have been reported in gastritis patients with H. pylori infections. [3]
After treatment, the scores of clinical symptoms improved in both groups, and the scores in the acupuncture treatment group were significantly better than those in the drug control group. The serum IL-10 level increased significantly after treatment in both groups, and the treatment group had significantly better scores than the control group. The level of serum IL-17 decreased significantly after treatment in the two groups, The treatment group had significantly better scores than the control group
The H. pylori eradication and total effective rates in the treatment group were significantly higher than those in the control group. Both groups received administration of clarithromycin (500 mg, twice per day), amoxicillin (1 g, twice per day), and omeprazole (20 mg, twice per day), for 14 days. The treatment group received the addition of gastric three needles to the following acupoints:
- CV12 (Zhongwan)
- PC6 (Neiguan)
- ST36 (Zusanli)
Total needle retention time was 30 minutes, during which needle manipulation techniques were applied once. For Neiguan, the attenuating technique was applied. For Zhongwan and Zusanli, the mild tonifying and attenuating technique was used. Wei San Zhen acupuncture combined with PPI-based drugs produced a positive patient outcome rate of 92.5%. The PPI drugs produced a 76.1% positive patient outcome rate for the treatment of H. pylori-positive gastritis. The combination therapy produced superior patient outcomes.
References:
[1] Zhu FB. Efficacy of acupuncture on Chronic Atrophic Gastritis, inflammatory factor, and the quality of life [J]. Clinical Journal of Chinese Medicine, 2019, 11(29):42-44.
[2] Han XJ, Du JH, Bi LB, Sharen GW, Huge JL. Observation of the Efficacy of Wei San Zhen plus PPI-based Triple Therapy for Helicobacter Pylori Positive Chronic Atrophic Gastritis [J/OL]. Shanghai Journal of Acupuncture and Moxibustion, 2020(01):11-14[2020-03-07].
[3] Yan HY, Wang HJ, Zhang XL. Detection and significance of Th17 / Treg in peripheral blood of children with Helicobacter pylori infection-related gastritis [J]. Journal of Medical Research, 2017, 46(8):142-144.
