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Meta-Analysis
. 2014 Oct 13;2014(10):CD008487.
doi: 10.1002/14651858.CD008487.pub2.

Acupuncture for functional dyspepsia

Lei Lan  1 , Fang Zeng, Guan J Liu, Li Ying, Xi Wu, Mailan Liu, Fan-Rong Liang
Affiliations
Meta-Analysis

Acupuncture for functional dyspepsia

Lei Lan et al. Cochrane Database Syst Rev. .

Abstract

Background: Functional dyspepsia (FD) has been a worldwide complaint. More effective therapies are needed with fewer adverse effects than are seen with conventional medications. Acupuncture, as a traditional therapeutic method, has been widely used for functional gastrointestinal disorders in the East. Manual acupuncture and electroacupuncture have been recognized treatments for FD, but to date, no robust evidence has been found for the effectiveness and safety of these interventions in the treatment of this condition.

Objectives: This review was conducted to assess the efficacy and safety of manual acupuncture and electroacupuncture in the treatment of FD.

Search methods: Trials meeting the inclusion criteria were identified through electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Allied and Complementary Medicine Database (AMED), Chinese Biology Medicine Disc (CBMdisc), China National Knowledge Infrastructure (CNKI), the Wanfang Database, the VIP Database, and six trial registries. Handsearching was done to screen the reference sections of potential trials and reviews.

Selection criteria: Randomized controlled trials (RCTs) were included if investigators reported efficacy and safety of manual acupuncture or electroacupuncture for patients with FD diagnosed by Rome II or Rome III criteria, compared with medications, blank control, or sham acupuncture.

Data collection and analysis: Data were extracted by independent review authors. Study limitations were assessed by using the tool of The Cochrane Collabration for assessing risk of bias. For dichotomous data, risk ratios (RRs) and 95% confidence intervals (95% CIs) would be applied, and for continuous data, mean differences (MDs) and 95% CIs. A fixed-effect model was applied in the meta-analysis, or a descriptive analysis was performed. The quality of evidence for the outcome measure was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods.

Main results: Seven studies were included in the review, involving 542 participants with FD (212 males and 330 females). These studies generally had an unclear risk of bias based on inadequate descriptions of allocation concealment and a high risk of bias based on lack of blinding. None of the studies reported on outcomes of the Functional Digestive Disorder Quality of Life questionnaire (FDDQL), the Satisfaction With Dyspepsia Related Health scale (SODA), the Digestive Health Status Instrument (DHSI), or effective/inefficient rate and symptom recurrence six months from completion of acupuncture treatment.Four RCTs of acupuncture versus medications (cisapride, domperidone, and itopride) were included in the review. No statistically significant difference was noted in the reduction in FD symptom scores and the frequency of FD attack by manual acupuncture, manual-electroacupuncture, or electroacupuncture compared with medications. In three trials of acupuncture versus sham acupuncture, all descriptive or quantitative analysis results implied that acupuncture could improve FD symptom scores and scores on the Neck Disability Index (NDI), the 36-Item Short Form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) more or as significantly as sham acupuncture. With regard to adverse effects, acupuncture was superior to cisapride treatment (one study; all minor events), but no statistically significant difference was reported between acupuncture and sham acupuncture. No adverse effects data were reported in studies examining manual acupuncture versus domperidone, manual-electroacupuncture versus domperidone, or electroacupuncture versus itopride.Nevertheless, all evidence was of low or very low quality. The body of evidence identified cannot yet permit a robust conclusion regarding the efficacy and safety of acupuncture for FD.

Authors' conclusions: It remains unknown whether manual acupuncture or electroacupuncture is more effective or safer than other treatments for patients with FD.

PubMed Disclaimer

Conflict of interest statement

Ling Ying, one author of this review, once participated in an included trial of acupuncture for FD. Therefore, Ling Ying did not take part in the data selection and analysis process.

Figures

1
1
Study flow diagram.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 Manual acupuncture compared with cisapride, Outcome 1 Symptom scores of FD.
1.2
1.2. Analysis
Comparison 1 Manual acupuncture compared with cisapride, Outcome 2 Frequency of FD symptoms.
1.3
1.3. Analysis
Comparison 1 Manual acupuncture compared with cisapride, Outcome 3 Adverse effects.
2.1
2.1. Analysis
Comparison 2 Manual acupuncture compared with domperidone, Outcome 1 Symptom scores of FD.
3.1
3.1. Analysis
Comparison 3 Manual‐electroacupuncture compared with domperidone, Outcome 1 Symptom scores of FD.
3.2
3.2. Analysis
Comparison 3 Manual‐electroacupuncture compared with domperidone, Outcome 2 Symptom scores of FD in ulceration subtype.
3.3
3.3. Analysis
Comparison 3 Manual‐electroacupuncture compared with domperidone, Outcome 3 Symptom scores of FD in regurgitation subtype.
3.4
3.4. Analysis
Comparison 3 Manual‐electroacupuncture compared with domperidone, Outcome 4 Symptom scores of FD in dyskinesia subtype.
3.5
3.5. Analysis
Comparison 3 Manual‐electroacupuncture compared with domperidone, Outcome 5 Symptom scores of FD in nonspecific subtype.
4.1
4.1. Analysis
Comparison 4 Electroacupuncture compared with itopride, Outcome 1 Symptom scores of FD.
5.1
5.1. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 1 Symptom scores of FD.
5.2
5.2. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 2 Symptom scores of FD during follow‐up period.
5.3
5.3. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 3 Nepean Dyspepsia Symptom Index.
5.4
5.4. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 4 Nepean Dyspepsia Life Quality Index.
5.5
5.5. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 5 Nepean Dyspepsia Symptom Index (at 1 month follow‐up).
5.6
5.6. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 6 Nepean Dyspepsia Life Quality Index (at 1 month follow‐up).
5.7
5.7. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 7 SF‐36.
5.8
5.8. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 8 SF‐36 (at 1 month follow‐up).
5.9
5.9. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 9 SAS.
5.10
5.10. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 10 SDS.
5.11
5.11. Analysis
Comparison 5 Acupuncture compared with sham acupuncture, Outcome 11 Adverse effects.
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Update of

References

References to studies included in this review

Chang 2010 {published and unpublished data}
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References to studies excluded from this review

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References to studies awaiting assessment

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