Acupuncture was found effective for treating Parkinson’s Disease induced constipation in a recent clinical study conducted at the Wuhan City Hospital of Traditional Chinese Medicine. Researchers determined that acupuncture markedly relieves non-motor symptoms. Also, acupuncture significantly improved patients’ quality of life scores without the side effects associated with laxatives or gastrointestinal agent ingestion. [1]
The duration of this study was from January 2018 to January 2019 and the sample consisted of 66 patients with constipation due to Parkinson’s Disease. The age range of the 66 patients was from 45 to 70 years. Inclusion criteria were based on Diagnostic Criteria for Parkinson's Disease of China (2016 Edition) and Roman III Diagnostic Criteria for Functional Gastroenterology.
Patients were randomly divided into an observation group and an acupuncture group, with each group consisting of 33 patients. For the observation group, the 18 males and 15 females had a mean age of 64.82 ±12.23 and a disease duration of 3.76 ±1.76 years. For the acupuncture group, the 17 males and 16 females had a mean age of 64.41 ±11.89 and a disease duration of 3.79 ±1.86 years. No statistical differentiation was observed between the two groups prior to beginning the treatment aspect of the investigation.
Both groups received treatment for a 20-day period. Before and after the treatment, three parameters were used to record and assess the patients’ condition: Cleveland Constipation Score (CSS), Constipation Patients Quality of Life Scale (PAC-QOL), and Parkinson’s Patients Quality of Life Questionnaire (PDQ39).
For the observation group, Madopar (levodopa plus benserazide) was prescribed to the patients, in doses according to the disease severity. For the acupuncture group, Madopar plus regular acupuncture treatment (including warm needle acupuncture) was administered. A supine position was taken and 0.25 × 40 mm sterile filiform acupuncture needles were inserted bilaterally into the following two points:
- ST37 (Shangjuxu)
- ST36 (Zusanli)
After obtaining a deqi sensation, a Ping Bu Ping Xie (mild tonifying and attenuating) manipulation technique was employed along with manual stimulation to the acupoints at 10 minute intervals. The needles were retained for a total of 30 minutes. Additionally, warm needle acupuncture was applied to the following:
- ST25 (Tianshu)
- CV6 (Qihai)
After a deqi sensation was achieved, moxa was attached to the end of the needles and then maintained for 30 minutes. The results of the study indicates that patients experienced a significant change in both CSS and PAC-QOL scores. The group receiving acupuncture plus medications had significantly better scores after treatment than the drug monotherapy group.
In this study, Tianshu was used as the chief acupoint because it is a main channel acupuncture point used for the treatment of intestinal motility issues. Based on TCM (traditional Chinese Medicine) principles, Tianshu serves to separate the essence from the waste of food, regulate the qi, and eliminate accumulation food retention.
Qihai, located along the Conception Vessel (任脉), is another important point in regulating digestion, as it can complement Tianshu and activate the qi in the lower abdominal area. In addition, a previous study in 2010 determined the efficacy of Tianshu for treating Slow Transit Constipation (STC). [2] The study involved 120 patients and lasted from August 2008 to October 2009. In this study, patients receiving electroacupuncture treatment experienced marked improvement in all observation parameters. The control group solely received daily doses of of lactulose for a 20-day course. The electroacupuncture group was given treatment at Tianshu (bilateral). Needles were connected to an electroacupuncture device, at 2/15 Hz for 30 minutes per session. During treatment, the goal was for patients to sense subtle soreness or stimulation of the abdominal area. The data indicates that the electroacupuncture group had better outcomes for pain relief and improving restoration of defecation frequency.
Both studies indicate that acupuncture is an effective treatment for the alleviation of constipation. Tianshu (ST25) stands out as an important acupuncture point for the restoration of gastrointestinal motility. Based on the evidence, additional studies are warranted to confirm the results.
References:
1. Jiang Lei, Ke Jinsheng, Jin Jing, Clinical observation of treating Parkinson Disease-induced constipation, Neural Injury And Functional Reconstruction，December 2020, Vol.15, No.12.
2. Duan Jin-xiu,Peng Wei-na , Liu Zhi-shun , Yang De-li, Guo Jun, Cai Heng-jing, Clinical Observation on the Treatment of Slow Transit Constipation by Deeply Inserting Tianshu Acupoint, Shanghai Acupuncture Magazine, 2010, 29.
