Meta-analysis of acupuncture for relieving non-organic dyspeptic symptoms suggestive of diabetic gastroparesis

Abstract

BackgroundAcupuncture is widely used to treat diabetic patients with dyspeptic symptoms suggestive of gastroparesis in China. We conducted this systematic review of randomized controlled trials (RCTs) to evaluate the efficacy of acupuncture for diabetic gastroparesis (DGP).MethodsWe searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and four Chinese databases including China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals, Chinese Biomedical Literature Database (CBM) and WanFang Data up to January 2013 without language restriction. Eligible RCTs were designed to examine the efficacy of acupuncture in improving dyspeptic symptoms and gastric emptying in DGP. Risk of bias, study design and outcomes were extracted from trials. Relative risk (RR) was calculated for dichotomous data. Mean difference (MD) and standardized mean difference (SMD) were selected for continuous data to pool the overall effect.ResultsWe searched 744 studies, among which 14 RCTs were considered eligible. Overall, acupuncture treatment had a higher response rate than controls (RR, 1.20 [95% confidence interval (CI), 1.12 to 1.29], P < 0.00001), and significantly improved dyspeptic symptoms compared with the control group. There was no difference in solid gastric emptying between acupuncture and control. Acupuncture improved single dyspeptic symptom such as nausea and vomiting, loss of appetite and stomach fullness. However, most studies were in unclear and high risk of bias and with small sample size (median = 62). The majority of the RCTs reported positive effect of acupuncture in improving dyspeptic symptoms.ConclusionsThe results suggested that acupuncture might be effective to improve dyspeptic symptoms in DGP, while a definite conclusion about whether acupuncture was effective for DGP could not be drawn due to the low quality of trials and possibility of publication bias. Further large-scale, high-quality randomized clinical trials are needed to validate this claim and translate this result to clinical practice.

Diabetic gastroparesis: current challenges and future prospects

“… 34 In a meta-analysis of low-quality randomized trials, acupuncture treatment had a higher response for the improvement of dyspeptic symptoms than controls (RR 1.20, CI: 1.12–1.29; p <0.00001). 35 These data should be regarded with caution due to the possibility of publication bias. Our research group has evaluated the effect of transcutaneous acupuncture (TEA) in the treatment of nausea in patients with GP.…”

Acupuncture and related techniques for type 2 diabetes mellitus

“…A few systematic reviews discussed the topic of acupuncture for T2DM previously. [43–45] However, the targets of these reviews are substantially different from ours, one of which only included herbal acupuncture, [43] one only included manual acupuncture, [44] and the other one only focused on diabetic gastroparesis. [45] Except for the 1st one, all reviews did not assess the outcomes related to the hypoglycemic effects (e.g., FBG, HbA1c, and FINS).…”

Responses of Autonomic Nervous System and Gastrointestinal Function to Acupuncture at Abdominal Anterior Cutaneous Nerve : A Pilot Study

“…하는 신경을 이용하여 자율신경과 위장관 기능의 조절 에 접근한 것은 보고된 바 없다 4,5,11,20) .그러나 하부흉추 [33][34][35] . 말초 혈류의 증가는 자율신경의 조절 에 따라 교감신경의 억제효과가 일어나거나 축삭반사 에 따라 혈관확장중재자가 분비되어 혈류 변화가 일어 났을 때 유발된다 29,33,36) .…”