Acupuncture & GI Tract

Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial

BMC Gastroenterology 2012, 12:150    doi:10.1186/1471-230X-12-150

Hugh MacPherson1*, Helen Tilbrook1, J Martin Bland1, Karen Bloor1, Sally Brabyn1, Helen Cox1, Arthur Ricky Kang’ombe1, Mei-See Man1, Tracy Stuardi1, David Torgerson1, Ian Watt1 and Peter Whorwell2

* Corresponding author: Hugh MacPherson hugh.macpherson@york.ac.uk

Author Affiliations

1 Department of Health Sciences, University of York, York, UK

2 Wythenshawe Hospital, Manchester, UK

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Received: 3 May 2012
Accepted: 19 September 2012
Published: 24 October 2012

© 2012 MacPherson et al.; licensee BioMed Central Ltd.

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-230X/12/150

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Acupuncture is used by patients as a treatment for irritable bowel syndrome (IBS) but the evidence on effectiveness is limited.  The purpose of the study was to evaluate the effectiveness of acupuncture for irritable bowel syndrome in primary care when provided as an adjunct to usual care.

Methods

Design: A two-arm pragmatic randomised controlled trial.

Setting: Primary care in the United Kingdom.

Patients: 233 patients had irritable bowel syndrome with average duration of 13 years and score of at least 100 on the IBS Symptom Severity Score (SSS).

Interventions: 116 patients were offered 10 weekly individualised acupuncture sessions plus usual care, 117 patients continued with usual care alone.

Measurements: Primary outcome was the IBS SSS at three months, with outcome data collected every three months to 12 months.

Results

There was a statistically significant difference between groups at three months favouring acupuncture with a reduction in IBS Symptom Severity Score of −27.43 (95% CI: –48.66 to −6.21, p = 0.012). The number needed to treat for successful treatment (≥50 point reduction in the IBS SSS) was six (95% CI: 3 to 17), based on 49% success in the acupuncture group vs. 31% in the control group, a difference between groups of 18% (95% CI: 6% to 31%). This benefit largely persisted at 6, 9 and 12 months.

Conclusions

Acupuncture for irritable bowel syndrome provided an additional benefit over usual care alone. The magnitude of the effect was sustained over the longer term. Acupuncture should be considered as a treatment option to be offered in primary care alongside other evidenced based treatments.

Click below to read the entire study.
Acupuncture for Irritable Bowel Syndrome_Primary Care Based Pragmatic Randomised Controlled Trial

Trial Registration

Current Controlled Trials ISRCTN08827905

Keywords:

Acupuncture; Irritable bowel syndrome; Randomised controlled trial; Primary care

Stimulation of gastric slow waves with manual acupuncture at acupuncture points ST36 and PC6–a randomized single blind controlled trial

2012 May;24(5):438-45, e211-2. doi: 10.1111/j.1365-2982.2012.01877.x. Epub 2012 Feb 6.

Stimulation of gastric slow waves with manual acupuncture at acupuncture points ST36 and PC6–a randomized single blind controlled trial.

1Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany. claudia.witt@charite.de

Abstract

BACKGROUND:

To investigate the effects of stimulated and non-stimulated manual acupuncture at ST36 and PC6 on gastric myoelectrical activity and autonomic function.

METHODS:

A total of 65 healthy volunteers were randomly assigned to a 1: 1: 2 ratio to receive either 15 min of verum acupuncture (VA) with stimulation followed by 15 min of VA without stimulation (nsVA), or 15 min of nsVA followed by 15 min of VA with stimulation (sVA), or 30 min of sham acupuncture (SA). Measures of autonomic function included electrogastrogram, electrocardiogram, impedance cardiography and assessment of blood pressure, breathing frequency, and electrodermal activity. Outcome parameters were compared between VA and SA, and between sVA and nsVA. The percentage of regular gastric slow waves (normogastria) was defined as the primary outcome.

KEY RESULTS:

The percentage of normogastria was not significantly different between VA and SA. Differences in secondary outcomes such as power spectrum of gastric slow waves and heart rate variability parameters were pronounced in the comparison of sVA and nsVA. During sVA, the percentage of normogastria was lower (P = 0.005), the percentage of bradygastria was higher (P = 0.003) and power ratio was higher (P < 0.001), systolic blood pressure was lower (P = 0.039) and RMSSD was higher (P < 0.001) as compared with nsVA.

CONCLUSIONS & INFERENCES:

Our study suggests that manual stimulation of acupuncture needles at ST36 and PC6 affects gastric myoelectrical as well as cardiac activities in healthy volunteers. The effect of stimulation in acupuncture deserves further investigation.

© 2012 Blackwell Publishing Ltd.

PMID: 22309404  [PubMed – indexed for MEDLINE]

Electroacupuncture & Partial Bowel Obstruction

Therapeutic Effect and Mechanism of Electroacupuncture at Zusanli on Plasticity of Interstitial Cells of Cajal

BMC Complement Altern Med.2014 Jun 7;14(1):186. [Epub ahead of print]

Source: PubMed

Peng MF, et al.

BACKGROUND: Electroacupuncture (EA) is one of the techniques of acupuncture and is believed to be an effective alternative and complementary treatment in many disorders. The aims of this study were to investigate the effects and mechanisms of EA at acupoint Zusanli (ST36) on the plasticity of interstitial cells of Cajal (ICCs) in partial bowel obstruction. METHODS: A Sprague Dawley rat model of partial bowel obstruction was established and EA was conducted at Zusanli (ST36) and Yinglingquan (SP9) in test and control groups, respectively. Experiments were performed to study the effects and mechanisms of EA at Zusanli on intestinal myoelectric activity, distribution and alteration of ICCs, expression of inflammatory mediators, and c-Kit expression. RESULTS: 1) EA at Zusanli somewhat improved slow wave amplitude and frequency in the partial obstruction rats. 2) EA at Zusanli significantly stimulated the recovery of ICC networks and numbers. 3) the pro-inflammatory mediator TNF-alpha and NO activity were significantly reduced after EA at Zusanli, However, no significant changes were observed in the anti-inflammatory mediator IL-10 activity. 4) EA at Zusanli re-expressed c-Kit protein. However, EA at the control acupoint, SP9, significantly improved slow wave frequency and amplitude, but had no effect on ICC or inflammatory mediators. CONCLUSIONS: We concluded that EA at Zusanli might have a therapeutic effect on ICC plasticity, and that this effect might be mediated via a decrease in pro-inflammatory mediators and through the c-Kit signaling pathway, but that the relationship between EA at different acupoints and myoelectric activity needs further study.

BMC Complement Altern Med.2014 Jun 7;14(1):186. [Epub ahead of print]

Source: PubMed