Acupuncture Treatment of Digestive Disorders
Epigastric pain is a common symptom in diseases of the stomach, including peptic ulcer, acute and chronic gastritis, and gastric spasm. Acupuncture provides satisfactory relief of epigastric pain-significantly better than injections of anisodamine or morphine plus atropine, as shown in randomized controlled trials (128, 129). For gastrointestinal spasm, acupuncture is also superior to injections of atropine (130), and for gastrokinetic disturbances, the effectiveness of acupuncture is comparable with that of conventional medicine (domperidone) (131).
Another common symptom of digestive disorders is nausea and vomiting. This can be due to a disordered function of the stomach, but it is more often a symptom or sign of generalized disorders. Morning sickness, postoperative vomiting, and nausea and vomiting related to chemotherapy are frequently encountered clinically. In all these conditions, acupuncture at point nèiguan (PC6) seems to have a specific antiemetic effect. A recent systematic review of trials using acupuncture for antiemesis showed that 11 of 12 randomized placebo-controlled trials, involving nearly 2000 patients, supported this effect. The reviewed papers showed consistent results across different investigators, different groups of patients, and different forms of acupuncture stimulation (132).
Irritable colon syndrome and chronic ulcerative colitis are often difficult to treat with conventional medication. For these diseases, acupuncture may serve as a complementary or alternative therapeutic measure (133, 134).
Because of its analgesic effect, acupuncture can be used in endoscopic examinations, e.g. in colonoscopy. It has been reported that the effect of acupuncture to relieve pain and discomfort during the examination is comparable with that of scopolamine or pethidine with fewer side-effects (135, 136).
There has been extensive research on the effect of acupuncture on the digestive system, with extensive data showing its influence on the physiology of the gastrointestinal tract, including acid secretion, motility, neurohormonal changes and changes in sensory thresholds. Many of the neuroanatomic pathways of these effects have been identified in animal models (137).
Acupuncture shows good analgesic and antispasmodic effects on the biliary tract and, as indicated previously, can be recommended for treatment of biliary colic (62-64). It also has a cholagogic action, which has been demonstrated in experimental studies. In the treatment of biliary colic due to gallstones, acupuncture is not only effective for relieving the colicky pain, but is also useful for expelling the stones. Satisfactory results were reported when electric acupuncture was used in combination with oral administration of magnesium sulfate (138). Acupuncture treatment is also worth trying for chronic cholecystitis, even if there is acute exacerbation (139).
126. Batra YK et al. Acupuncture in corticosteroid-dependent asthmatics. American Journal of Acupuncture, 1986, 14(3):261-264.
127. Jobst K et al. Controlled trial of acupuncture for disabling breathlessness. Lancet, 1986, 2:1416-1419.
128. Xu PC et al. Clinical observation of treatment of acute epigastralgia by puncturing liangqiu and weishu acupoints. International Journal of Clinical Acupuncture, 1991, 2(2):127-130.
129. Yu YM. [Therapeutic effect and mechanism of needling ST36 in the treatment of epigastric pain.] Shanghai Journal of Acupuncture and Moxibustion, 1997, 16(3):10-11 [in Chinese].
130. Shi XL et al. [Acupuncture treatment of gastrointestinal spasm.] Chinese Acupuncture and Moxibustion, 1995, 15(4):192 [in Chinese].
131. Zhang AL et al. Clinical effect of acupuncture in the treatment of gastrokinetic disturbance. World Journal of Acupuncture-Moxibustion, 1996, 6(1):3-8.
132. Vickers AJ. Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. Journal of the Royal Society of Medicine, 1996, 89(6): 303-311.
133. Wu HG et al. Preliminary study on therapeutic effects and immunologic mechanisms of herbal-moxibustion treatment of irritable bowel syndrome. Chinese Acupuncture and Moxibustion, 1996, 16(2):43-45 [in Chinese].
134. Wu HG et al. [Therapeutic effect of herbal partition-moxibustion for chronic diarrhoea and its immunological mechanism.] Journal of Traditional Chinese Medicine, 1995, 36(1):25-27 [in Chinese].
135. Wang HH et al. A study in the effectiveness of acupuncture analgesia for colonoscopic examination compared with conventional premedication. American Journal of Acupuncture, 1992, 20:217-221.
136. Wang HH et al. A clinical study on physiological response in electroacupuncture analgesia and meperidine analgesia for colonoscopy. American Journal of Chinese Medicine, 1997, 25(1):13-20.
137. Diehl DL. Acupuncture for gastrointestinal and hepatobiliary disorders. Journal of Alternative and Complementary Medicine, 1999, 5(1):27-45.
138. Zhao SD et al. {Electro-acupuncture and magnesium sulphate in treatment of cholelithiasis-clinical observations on 522 cases and preliminary consideration of features.] Chinese Medical Journal, 1979, 59(12):716 [in Chinese].
139. Gong CM et al. [Clinical study on regulatory action of combination of body acupuncture with auricular acupuncture on gallbladder motor function.] Chinese Acupuncture and Moxibustion, 1996, 16(1):1-3 [in Chinese].
PUBLICATIONS
Zhang CX, et al. Department of Gastroenterology, First Hospital Affiliated to Xinxiang Medical College, Henan 453100, China. [email protected] OBJECTIVE: To explore the clinical efficacy and safety of acupuncture in treating gastroesophageal reflux (GER). METHODS: Sixty patients with confirmed diagnosis of GER were randomly assigned to two groups. The 30 patients in the treatment group were treated with acupuncture at acupoints Zhongwan (CV 12), bilateral Zusanli (ST36), Sanyinjiao (SP6), and Neiguan (PC6), once a day, for 1 week as a therapeutic course, with interval of 2-3 days between courses; the 30 patients in the control group were administered orally with omeprazole 20 mg twice a day and 20 mg mosapride thrice a day. The treatment in both group lasted 6 weeks. Patients’ symptoms and times of reflux attacking were recorded, the 24-h intraesophageal acid/bile reflux were monitored, and the endoscopic feature of esophageal mucous membrane was graded and scored at three time points, i.e., pre-treatment (T0), immediately after ending the treatment course (T1) and 4 weeks after it (T2). Besides, the adverse reactions were also observed. RESULTS: Compared with those detected at T0, 24-h intraesophageal pH and bile reflux, endoscopic grading score and symptom score were all decreased significantly at T1 in both groups similarly (P<0.01), showing insignificant difference between groups (P>0.05). These indices were reversed at T2 to high level in the control group (P<0.05), but the reversion did not occur in the treatment group (P>0.05). No serious adverse reaction was found during the therapeutic period. CONCLUSION: Acupuncture can effectively inhibit the intraesophageal acid and bile reflux in GER patients to alleviate patients’ symptoms with good safety and is well accepted by patients. Chin J Integr Med. 2010 Aug;16(4):298-303. Source: PubMed |
