Acupuncture treatment in gastrointestinal diseases: A systematic review

Department of General Practice and Health Services Research, University Medical Hospital Heidelberg, Vossstrasse 2, Heidelberg 69120, Germany.
World Journal of Gastroenterology (Impact Factor: 2.43). 08/2007; 13(25):3417-24.
Source: PubMed

ABSTRACT The purpose of this work was to assess the evidence for effectiveness of acupuncture (AC) treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome (IBS) trials, 1 Crohn's disease and 1 colitis ulcerosa trial had a robust random controlled trial (RCT) design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life (QoL) improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Efficacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in inflammatory bowel diseases (IBD), whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefit when this harmless and obviously powerful therapy with regard to QoL is demystified by further placebo controlled trials.

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Available from: Konrad Streitberger, Aug 20, 2015
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    • "Acupuncture, an important traditional Chinese medicine (TCM) therapy, has been used to treat gastrointestinal symptoms for centuries in China. Now it has been increasingly accepted as a complementary and alternative treatment for functional gastrointestinal disorders in western countries [7] [8]. ST25 (Tianshu), an important acupoint in the stomach meridian of the Foot Yangming, is commonly used to treat intestinal illnesses, such as constipation, diarrhea, abdominal pain, and bloating [9]. "
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    ABSTRACT: Acupuncture is a commonly used therapy for treating functional diarrhea (FD), although there is limited knowledge on the mechanism. The objectives of this study were to investigate the differences in brain activities elicited by acupuncture between FD patients and healthy controls (HC) so as to explore the possible mechanism. Eighteen FD patients and eighteen HC received 10 sessions of acupuncture treatment at ST25 acupoints. Functional magnetic resonance imaging (fMRI) scans were, respectively, performed before and after acupuncture. The defecation frequency, Bristol stool form scale (SBFS), and MOS 36-item Short Healthy Survey (SF-36) were employed to evaluate the clinical efficacy. After acupuncture, the FD patients showed a significant decrease in defecation frequency and BSFS score. The regional homogeneity (ReHo) map showed a decrease in the paracentral lobule and postcentral gyrus, and an increase in the angular gyrus, insula, anterior cingulate cortex (ACC), and precuneus in the FD group. Moreover, the changes in ReHo values in the ACC were correlated with the reduction in defecation frequency. Decreasing functional connectivity among the ACC, insula, thalamus, and orbital frontal cortex only existed in the FD group. Conclusively, acupuncture alleviated defecation frequency and improved stool formation in FD patients. The efficacy might result from the regulation of the homeostasis afferent processing network.
    Evidence-based Complementary and Alternative Medicine 12/2013; 2013:975769. DOI:10.1155/2013/975769 · 1.88 Impact Factor
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    • "The evidence for any benefit from acupuncture in the treatment of IBD is equivocal. In a systematic review, Schneider et al. [29] concluded that, overall, the studies that were evaluated suggested a positive effect of acupuncture on both quality of life and clinical symptoms , but that these studies were hampered by methodological deficits. There is an ongoing debate as to whether a placebo-controlled randomized clinical trial is appropriate for and capable of capturing and evaluating whole systems of traditional health care practice, such as traditional Chinese medicine/acupuncture, as these systems encompass a complexity of components that each may exert any number of influences on the outcome of interest [30]. "
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    ABSTRACT: The use of complementary and alternative medicine (CAM) has been increasing in recent decades. Our aim was to determine the proportion of CAM use among patients with inflammatory bowel disease (IBD) in a longitudinal, population-based cohort and to identify predictive factors for CAM use. The Inflammatory Bowel South-Eastern Norway (IBSEN) study is a population-based IBD cohort that has been followed prospectively for 10 years. The ten-year follow-up was conducted from 2000 to 2004 and included a questionnaire regarding CAM, a structured interview, a review of hospital records, a clinical examination, laboratory tests, and an ileocolonoscopy. Of the 620 patients evaluated at the ten-year follow-up, 517 (84%) completed the CAM questionnaire, 353 had ulcerative colitis (UC), 164 had Crohn's disease (CD), and 50% were male. Thirty percent reported the use of CAM at some point since their IBD diagnosis, and 7.5% reported current CAM use. More CD patients than UC patients reported CAM use (38% vs. 27%, respectively; p=0.01). Younger age, female gender, and higher education level predicted CAM use in UC, whereas younger age was the only predictor of CAM use in CD. Thirty-six percent of the CAM users were mostly satisfied or very satisfied with the treatment. One third of the patients in this population-based cohort had used CAM at some point during a ten-year disease course, but only 7.5% reported current CAM use. CAM use was more common in the CD than in the UC patients. Only socio-demographic factors, such as age, gender and education, predicted CAM use.
    Journal of Crohn s and Colitis 04/2012; 6(3):345-53. DOI:10.1016/j.crohns.2011.09.007 · 3.56 Impact Factor
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    • "There are several further considerations that question the involvement of DNIC in acupuncture. Firstly, patients suffering from diseases with typically impaired DNIC (e.g., fibromyalgia [14], osteoarthritis of the hip [15], irritable bowel syndrome [16], or temporomandibular disorder [17]) still benefit from acupuncture therapy [18] [19] [20] [21]. Secondly, classic DNIC-inducing tests in humans, such as the cold pressor test, ischemic tourniquet test and thermal heat test are noninvasive but very painful, whereas acupuncture is invasive but usually not very painful. "
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    ABSTRACT: Diffuse noxious inhibitory control (DNIC) is described as one possible mechanism of acupuncture analgesia. This study investigated the analgesic effect of acupuncture without stimulation compared to nonpenetrating sham acupuncture (NPSA) and cold-pressor-induced DNIC. Forty-five subjects received each of the three interventions in a randomized order. The analgesic effect was measured using pressure algometry at the second toe before and after each of the interventions. Pressure pain detection threshold (PPDT) rose from 299 kPa (SD 112 kPa) to 364 kPa (SD 144), 353 kPa (SD 135), and 467 kPa (SD 168) after acupuncture, NPSA, and DNIC test, respectively. There was no statistically significant difference between acupuncture and NPSA at any time, but a significantly higher increase of PPDT in the DNIC test compared to acupuncture and NPSA. PPDT decreased after the DNIC test, whereas it remained stable after acupuncture and NPSA. Acupuncture needling at low pain stimulus intensity showed a small analgesic effect which did not significantly differ from placebo response and was significantly less than a DNIC-like effect of a painful noninvasive stimulus.
    Evidence-based Complementary and Alternative Medicine 01/2012; 2012(1):785613. DOI:10.1155/2012/785613 · 1.88 Impact Factor
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