Acupuncture increased response rate and elimination rate of all three cardinal symptoms of postprandial distress syndrome, the most common subtype of functional dyspepsia, a small study found.
To assess the efficacy of acupuncture versus sham acupuncture for postprandial distress syndrome, researchers conducted a randomized clinical trial among patients 18 to 65 years of age from five tertiary hospitals in China who met Rome IV criteria for postprandial distress syndrome and had normal results on endoscopy within one year of the study start. They were assigned to either twelve 20-minute sessions of acupuncture or sham acupuncture for four weeks.
The study's primary outcomes were response rate and elimination rate. Response rate was based on an overall treatment effect questionnaire, which asked, “How were your gastric symptoms during the past week in comparison with the baseline period?” with options of “extremely improved,” “improved,” “slightly improved,” “not changed,” “slightly aggravated,” “aggravated,” or “extremely aggravated.” Patients were considered responders if they answered “extremely improved” or “improved” and were considered nonresponders otherwise. The elimination rate was defined as the proportion of patients whose scores on the severity scale for all three cardinal symptoms (postprandial fullness, upper abdominal bloating, and early satiation) were 0 at week 4. Acupuncture was considered effective only if both primary outcomes achieved significance. Results were published May 12 by Annals of Internal Medicine.
Among 278 patients who were randomized, 228 (82%) completed outcome measurements at week 16. The estimated response rate from generalized linear mixed models at week four was 83.0% in the acupuncture group versus 51.6% in the sham acupuncture group (difference, 31.4 percentage points; 95% CI, 20.3 to 42.5 percentage points; P<0.001). Researchers noted that an expert group suggested that 10% to 15% improvement over placebo would constitute a clinically meaningful outcome.
The estimated elimination rate of all three cardinal symptoms was 27.8% in the acupuncture group versus 17.3% in the sham acupuncture group (difference, 10.5 percentage points; 95% CI, 0.08 to 20.9 percentage points; P=0.034). The efficacy of acupuncture was maintained during the 12-week post-treatment follow-up. No serious adverse events were noted.
The study authors noted that its limitations included a lack of objective outcomes and daily measurement, high dropout rate (18%), and inability to blind acupuncturists.