Efficacy of transcutaneous electrical acupoint stimulation combined with diazepam for acute alcohol withdrawal syndrome: A double-blind randomized sham-controlled trial

Abstract

Objective To compare the efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with diazepam against diazepam alone for treatment of acute alcohol withdrawal syndrome (AWS). Methods In this double-blind randomized sham-controlled trial, men with acute AWS were randomly allocated to either a group treated with TEAS combined with diazepam (n = 57) or a control group treated with sham TEAS combined with diazepam (n = 60). Treatment was performed at four acupoints twice a day for 14 days. The Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar), visual analogue scale (VAS), Pittsburgh Sleep Quality Index (PSQI) and modified Epworth Sleepiness Scale (mESS) were used to evaluate treatment efficacy. Results All scores improved significantly in both groups during the trial. CIWA-Ar scores were lower in the TEAS group than in the control group from day 3 until the end of observation. VAS and mESS scores were also lower in the TEAS group than in the control group on day 7. VAS and PSQI scores were lower in the TEAS group on day 14. Conclusion Combining diazepam with TEAS may result in milder AWS symptoms than diazepam alone, improve sleep quality and reduce sleepiness.

Acupoint stimulation for alcohol use disorder: A systematic review and meta-analysis

“…There are 14 [20][21][22][23][24][25][26][27][28][30][31][32]34,35] included trials that use craving for alcohol as the outcome, measured using scores on a visual analogue scale, obsessive compulsive drinking scale, Pennsylvania alcohol craving scale or self-made evaluation scale. Three [20,21,28] choose clinical institute withdrawal assessment for alcohol scale as AWS assessment. Eight literatures [23][24][25]27,29,30,33,35] assess anxiety by Hamilton rating scale for anxiety or statetrait anxiety inventory, and 7 [22][23][24][25]32,33,35] report depression with Hamilton rating scale for depression or beck depression inventory.…”

“…Most studies emphasized randomization and published expected outcomes. Randomization was performed in 16 studies, but only 8 studies [20,21,[23][24][25]28,34,35] reported the details of random sequence generation while the others lacked evidence. Only 3 studies [24,25,35] reported the information of allocation concealment, which were assessed as low risk of bias.…”

“…Blinding of participants and acupuncturists was not possible by design in 7 studies [20,22,27,28,32,35] comparing acupoint stimulation plus drug or psychotherapy versus drug or psychotherapy, and 1 study [34] comparing acupoint stimulation versus drug; accordingly, these trials were considered to be at high risk of performance bias. There were 8 studies [21,[23][24][25][26]29,31,33] reported blindness, among which 2 [21,25] were double-blind and 5 [23,24,26,29,31] were single-blind, which we believe could be rated as low risk, and 1 [33] was rated as unclear. And only 2 [21,25] do the blinding of outcome assessment, as the researcher who was blind to the type of acupoint stimulation given responded for assessments.…”

“…There were 8 studies [21,[23][24][25][26]29,31,33] reported blindness, among which 2 [21,25] were double-blind and 5 [23,24,26,29,31] were single-blind, which we believe could be rated as low risk, and 1 [33] was rated as unclear. And only 2 [21,25] do the blinding of outcome assessment, as the researcher who was blind to the type of acupoint stimulation given responded for assessments. There were 4 [21,[23][24][25]29,31,33,34] included studies that were assessed as having high risks cause because they did not report complete outcome datas.…”

“…Sixteen studies (from China, Germany, USA and Sweden) with a total of 1097 participants were included in this summary. All studies [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were designed as RCTs. One of them [11] is muti-center clinical trial.…”