Electroacupuncture plus on-demand gastrocaine for refractory functional dyspepsia: Pragmatic randomized trial

J Gastroenterol Hepatol. 2019 Dec;34(12):2077-2085. doi: 10.1111/jgh.14737. Epub 2019 Jul 4.

Abstract

Background and aim: Treatment options for functional dyspepsia (FD) refractory to pharmacological treatments are limited but the effectiveness of electroacupuncture (EA) is uncertain. We assessed the effectiveness of EA combined with on-demand gastrocaine.

Methods: We conducted a single-center, assessor-blind, randomized parallel-group 2-arm trial on Helicobacter pylori negative FD patients of the postprandial distress syndrome subtype refractory to proton pump inhibitor, prokinetics, or H2 antagonists. Enrolled participants were block randomized in a 1:1 ratio, with concealed random sequence. The treatment and control groups both received on-demand gastrocaine for 12 weeks, but only those in treatment group were offered 20 sessions of EA over 10 weeks. The primary endpoint was the between-group difference in proportion of patients achieving adequate relief of symptoms at week 12.

Results: Of 132 participants randomly assigned to EA plus on-demand gastrocaine (n = 66) or on-demand gastrocaine alone (n = 66), 125 (94.7%) completed all follow-up at 12 weeks. The EA group had a compliance rate 97.7%. They had a significantly higher likelihood in achieving adequate symptom relief at 12 weeks, with a clinically relevant number needed to treat (NNT) value of 2.36 (95% CI: 1.74, 3.64). Among secondary outcomes, statistically and clinically significant improvements were observed among global symptom (NNT = 3.85 [95% CI: 2.63, 7.69]); postprandial fullness and early satiation (NNT = 5.00 [95% CI: 2.86, 25.00]); as well as epigastric pain, epigastric burning, and postprandial nausea (NNT = 4.17 [95% CI: 2.56, 11.11]). Adverse events were minimal and nonsignificant.

Conclusion: For refractory FD, EA provides significant, clinically relevant symptom relief when added to on-demand gastrocaine (ChiCTR-IPC-15007109).

Keywords: acupuncture; functional dyspepsia; on-demand antacid; randomized trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aluminum Hydroxide / administration & dosage
  • Aluminum Hydroxide / therapeutic use*
  • Aminobenzoates / administration & dosage
  • Aminobenzoates / therapeutic use*
  • Atropine / administration & dosage
  • Atropine / therapeutic use*
  • Combined Modality Therapy
  • Drug Administration Schedule
  • Drug Combinations
  • Dyspepsia / drug therapy*
  • Electroacupuncture / adverse effects
  • Electroacupuncture / methods*
  • Female
  • Humans
  • Magnesium Compounds / administration & dosage
  • Magnesium Compounds / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Aminobenzoates
  • Drug Combinations
  • Magnesium Compounds
  • Aluminum Hydroxide
  • Atropine
  • Gastro-caine