Acupuncture for functional gastrointestinal disorders

Department of Surgery, Duke University Medical Center, Durham, NC 27705, USA.
Journal of Gastroenterology (Impact Factor: 4.02). 06/2006; 41(5):408-17. DOI: 10.1007/s00535-006-1773-6
Source: PubMed

ABSTRACT Functional gastrointestinal (GI) symptoms are common in the general population. Especially, motor dysfunction of the GI tract and visceral hypersensitivity are important. Acupuncture has been used to treat GI symptoms in China for thousands of years. It is conceivable that acupuncture may be effective in patients with functional GI disorders because it has been shown to alter acid secretion, GI motility, and visceral pain. Acupuncture at the lower limbs (ST-36) causes muscle contractions via the somatoparasympathetic pathway, while at the upper abdomen (CV-12) it causes muscle relaxation via the somatosympathetic pathway. In some patients with gastroesophageal reflux disease (GERD) and functional dyspepsia (FD), peristalsis and gastric motility are impaired. The stimulatory effects of acupuncture at ST-36 on GI motility may be beneficial to patients with GERD or FD, as well as to those with constipation-predominant irritable bowel syndrome (IBS), who show delayed colonic transit. In contrast, the inhibitory effects of acupuncture at CV-12 on GI motility may be beneficial to patients with diarrhea-predominant IBS, because enhanced colonic motility and accelerated colonic transit are reported in such patients. Acupuncture at CV-12 may inhibit gastric acid secretion via the somatosympathetic pathway. Thus, acupuncture may be beneficial to GERD patients. The antiemetic effects of acupuncture at PC-6 (wrist) may be beneficial to patients with FD, whereas the antinociceptive effects of acupuncture at PC-6 and ST-36 may be beneficial to patients with visceral hypersensitivity. In the future, it is expected that acupuncture will be used in the treatment of patients with functional GI disorders.

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    • "Thus, treatment in TCM including acupuncture should aim to facilitate qi and blood circulation in meridians related to these organs and thus normalizes patient's status of health. With the guidance of these diagnostic and therapeutic principles, therapeutic effectiveness of acupuncture for abdominal pain, abdominal distension, bloating, nausea, and others was well documented in various TCM classics and has been reported in research studies [15] [16] [17] [18] [19] [20]. Besides normalization of qi and blood in the affected meridians, modern understandings of these results also lie in pathophysiological research studies, in which researchers found that acupuncture in patients with FD could accelerate solid gastric emptying [17], increase plasma level of neuropeptide Y but not motilin [18], and induce deactivation of the brainstem, anterior cingulate cortex (ACC), insula, thalamus, and hypothalamus in the human body [21]. "
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    ABSTRACT: In order to investigate the therapeutic potential of acupuncture on patients with functional dyspepsia (FD), patients were randomized to receive acupuncture at classic acupoints with manipulations (treatment group) versus acupuncture at nonacupoints without manipulation (control group) once every other day, three times a week, for one month and were followed up for three months. The primary outcomes included dyspeptic symptoms, quality of life, and mental status. The secondary outcomes included the fasting serum gastrin concentration, and frequency and propagation velocity of gastric slow waves. Sixty patients with FD were included, among whom, four dropped out. After one month's treatment, patients with FD showed significant improvements in primary (in both groups) and secondary (in the eight patients of the treatment group) outcomes as compared with baseline (P = 0.0078 to <0.0001); treatment group has better outcomes in all primary outcome measures (P < 0.0001 except for SDS (P = 0.0005)). Improvements on dyspeptic symptoms persist during follow-up (better in the treatment group). Acupuncture with manual manipulation had better effects on improving dyspeptic symptoms, mental status, and quality of life in patients with FD. These effects may be related to the increased frequency and propagation speed of gastric slow waves and serum gastrin secretion.
    Evidence-based Complementary and Alternative Medicine 01/2015; 2015:904926. DOI:10.1155/2015/904926 · 1.88 Impact Factor
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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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    • "However, acupressure is a noninvasive technique that uses fingers to rub, knead, nail pinch, and press instead of using needle insertion at the different acupressure points on the body. Acupressure involves stimulating surface acupoints to stimulate the energy, or Qi, of the body to achieve comfort and relief (Chang, Liu, Li, Chen, & Chou, 2006; Takahashi, 2006). A study by Chen et al. (2003) demonstrated that acupressure at ST-36, PC-6, and SP-6 (Sanyinjiao) applied after surgery increased GI motility in patients who underwent hysterectomy. "
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    ABSTRACT: Purpose/Objectives: To evaluate the effectiveness of ST-36 (Zusanli) acupressure on recovery of postoperative gastrointestinal function in patients with colorectal cancer. Design: A longitudinal, randomized, controlled trial design. Setting: An urban medical center in Taiwan. Sample: 60 patients with colorectal cancer who had undergone abdominal surgery. Methods: Patients were randomly assigned to two groups, the ST-36 acupressure group (n = 30) and a sham acupressure group (n = 30). Patients in the ST-36 group received an acupressure procedure in a three-minute cycle performed three times per day during the five days after surgery. Patients in the control group received routine postoperative care and sham acupressure. Generalized estimating equations (GEEs) were used to gauge longitudinal effects of the two groups of patients. Main Research Variables: Frequency of bowel sounds, the time to first flatus passage, first liquid intake, solid intake, and defecation. Findings: Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group. Other main variables, including the first time to solid intake and defecation, did not show significant difference between the two groups. The GEE method revealed that all patients had increasing bowel sounds over time, and the experimental group had greater improvement of bowel motility than the control group within the period of 2-3 days postoperatively. Conclusions: ST-36 acupressure was able to shorten the time to first flatus passage, oral liquid intake, and improve gastrointestinal function in patients after abdominal surgery. Implications for Nursing: ST-36 acupressure can be integrated into postoperative adjunct nursing care to assist patients' postoperative gastrointestinal function. Knowledge Translation: Few studies have explored the effectiveness of acupressure techniques on promoting bowel sounds. Evidence from this study suggests stimulation of the ST-36 acupressure point can increase bowel sound frequency for patients with colorectal cancer in the first three days after surgery. Application of this technique may improve a patient's comfort after surgery.
    Oncology Nursing Forum 03/2013; 40(2):E61-8. DOI:10.1188/13.ONF.E61-E68 · 1.91 Impact Factor
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