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Published in: BMC Complementary Medicine and Therapies 1/2013

Open Access 01-12-2013 | Research article

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

Authors: Mingxing Yang, Xiumin Li, Suhuan Liu, Zhipeng Li, Mei Xue, Dehong Gao, Xuejun Li, Shuyu Yang

Published in: BMC Complementary Medicine and Therapies | Issue 1/2013

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Abstract

Background

Acupuncture 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).

Methods

We 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.

Results

We 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.

Conclusions

The 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.
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Literature
1.
go back to reference Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M: Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001, 161 (16): 1989-1996. 10.1001/archinte.161.16.1989.CrossRefPubMed Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M: Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001, 161 (16): 1989-1996. 10.1001/archinte.161.16.1989.CrossRefPubMed
2.
go back to reference Maleki D, Locke GR, Camilleri M, Zinsmeister AR, Yawn BP, Leibson C, Melton LJ: Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000, 160 (18): 2808-2816. 10.1001/archinte.160.18.2808.CrossRefPubMed Maleki D, Locke GR, Camilleri M, Zinsmeister AR, Yawn BP, Leibson C, Melton LJ: Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000, 160 (18): 2808-2816. 10.1001/archinte.160.18.2808.CrossRefPubMed
3.
go back to reference Yang WY, Lu JM, Weng JP, Jia WP, Xiao JZ, Shan ZY, Liu J, Tian HM, Ji QH, L.N. J: Prevalence of diabetes among men and women in China. N Engl J Med. 2010, 362 (12): 1090-1101. 10.1056/NEJMoa0908292.CrossRefPubMed Yang WY, Lu JM, Weng JP, Jia WP, Xiao JZ, Shan ZY, Liu J, Tian HM, Ji QH, L.N. J: Prevalence of diabetes among men and women in China. N Engl J Med. 2010, 362 (12): 1090-1101. 10.1056/NEJMoa0908292.CrossRefPubMed
4.
go back to reference Takahashi T: Acupuncture for functional gastrointestinal disorders. J Gastroenterol. 2006, 41 (5): 408-417. 10.1007/s00535-006-1773-6.CrossRefPubMed Takahashi T: Acupuncture for functional gastrointestinal disorders. J Gastroenterol. 2006, 41 (5): 408-417. 10.1007/s00535-006-1773-6.CrossRefPubMed
5.
go back to reference Chang CS, Ko CW, Wu CY, Chen GH: Effect of electrical stimulation on acupuncture points in diabetic patients with gastric dysrhythmia: a pilot study. Digestion. 2001, 64 (3): 184-190. 10.1159/000048860.CrossRefPubMed Chang CS, Ko CW, Wu CY, Chen GH: Effect of electrical stimulation on acupuncture points in diabetic patients with gastric dysrhythmia: a pilot study. Digestion. 2001, 64 (3): 184-190. 10.1159/000048860.CrossRefPubMed
6.
go back to reference Chen J, Song GQ, Yin J, Koothan T, Chen JD: Electroacupuncture improves impaired gastric motility and slow waves induced by rectal distension in dogs. Am J Physiol Gastrointest Liver Physiol. 2008, 295 (3): G614-620. 10.1152/ajpgi.90322.2008.CrossRefPubMed Chen J, Song GQ, Yin J, Koothan T, Chen JD: Electroacupuncture improves impaired gastric motility and slow waves induced by rectal distension in dogs. Am J Physiol Gastrointest Liver Physiol. 2008, 295 (3): G614-620. 10.1152/ajpgi.90322.2008.CrossRefPubMed
7.
go back to reference Tatewaki M, Harris M, Uemura K, Ueno T, Hoshino E, Shiotani A, Pappas TN, Takahashi T: Dual effects of acupuncture on gastric motility in conscious rats. Am J Physiol Regul Integr Comp Physiol. 2003, 285 (4): R862-872.CrossRefPubMed Tatewaki M, Harris M, Uemura K, Ueno T, Hoshino E, Shiotani A, Pappas TN, Takahashi T: Dual effects of acupuncture on gastric motility in conscious rats. Am J Physiol Regul Integr Comp Physiol. 2003, 285 (4): R862-872.CrossRefPubMed
9.
go back to reference Xu S, Hou X, Zha H, Gao Z, Zhang Y, Chen JD: Electroacupuncture accelerates solid gastric emptying and improves dyspeptic symptoms in patients with functional dyspepsia. Dig Dis Sci. 2006, 51 (12): 2154-2159. 10.1007/s10620-006-9412-x.CrossRefPubMed Xu S, Hou X, Zha H, Gao Z, Zhang Y, Chen JD: Electroacupuncture accelerates solid gastric emptying and improves dyspeptic symptoms in patients with functional dyspepsia. Dig Dis Sci. 2006, 51 (12): 2154-2159. 10.1007/s10620-006-9412-x.CrossRefPubMed
10.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009, 6 (7): e1000097-10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009, 6 (7): e1000097-10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral
11.
go back to reference Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J: Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther. 2003, 18 (1): 141-150. 10.1046/j.1365-2036.2003.01612.x.CrossRefPubMed Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J: Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther. 2003, 18 (1): 141-150. 10.1046/j.1365-2036.2003.01612.x.CrossRefPubMed
12.
go back to reference Wang BE, Liang XM, Jia BQ: Controlled multi-centre clinical trials on cisapride in treatment of functional dyspepsia. Zhonghua Nei Ke Za Zhi. 1995, 34 (3): 180-184.PubMed Wang BE, Liang XM, Jia BQ: Controlled multi-centre clinical trials on cisapride in treatment of functional dyspepsia. Zhonghua Nei Ke Za Zhi. 1995, 34 (3): 180-184.PubMed
13.
go back to reference Feldman M, Smith HJ, Simon TR: Gastric emptying of solid radiopaque markers: studies in healthy subjects and diabetic patients. Gastroenterology. 1984, 87 (4): 895-902.PubMed Feldman M, Smith HJ, Simon TR: Gastric emptying of solid radiopaque markers: studies in healthy subjects and diabetic patients. Gastroenterology. 1984, 87 (4): 895-902.PubMed
15.
16.
go back to reference Sterne JA, Egger M: Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001, 54 (10): 1046-1055. 10.1016/S0895-4356(01)00377-8.CrossRefPubMed Sterne JA, Egger M: Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001, 54 (10): 1046-1055. 10.1016/S0895-4356(01)00377-8.CrossRefPubMed
18.
go back to reference Park J, Hahn S, Park JY, Park HJ, Lee H: Acupuncture for ankle sprain: systematic review and meta-analysis. BMC Complement Altern Med. 2013, 13: 55-10.1186/1472-6882-13-55.CrossRefPubMedPubMedCentral Park J, Hahn S, Park JY, Park HJ, Lee H: Acupuncture for ankle sprain: systematic review and meta-analysis. BMC Complement Altern Med. 2013, 13: 55-10.1186/1472-6882-13-55.CrossRefPubMedPubMedCentral
19.
go back to reference Chen H: Master, Thesis. Clinical observation of electro-acupuncture for gastric dysmotility of diabetic gastroparesis. 2008, Guangzhou, China: Guangzhou University of Chinese Medicine Chen H: Master, Thesis. Clinical observation of electro-acupuncture for gastric dysmotility of diabetic gastroparesis. 2008, Guangzhou, China: Guangzhou University of Chinese Medicine
20.
go back to reference Ge JY, Zheng SL, Song FJ: Acupuncture for treatment of 30 cases of diabetic gastroparesis. Jiangxi J Tradit Chin Med. 2010, 41 (2): 55-56. Ge JY, Zheng SL, Song FJ: Acupuncture for treatment of 30 cases of diabetic gastroparesis. Jiangxi J Tradit Chin Med. 2010, 41 (2): 55-56.
21.
go back to reference Han XH, Wang RQ, Zhou S: Clinical observation on 60 cases of diabetogenous gastroparesis treated with acupuncture combination with drug. Hebei J Tradit Chin Med. 2001, 23 (6): 413-414. Han XH, Wang RQ, Zhou S: Clinical observation on 60 cases of diabetogenous gastroparesis treated with acupuncture combination with drug. Hebei J Tradit Chin Med. 2001, 23 (6): 413-414.
22.
go back to reference Li YL: Clinical research on diabetic gastroparesis treated with acupuncture. Master Thesis. 2006, Harbin, China: Heilongjiang University of Chinese Medcine Li YL: Clinical research on diabetic gastroparesis treated with acupuncture. Master Thesis. 2006, Harbin, China: Heilongjiang University of Chinese Medcine
23.
go back to reference Shen L, Kong DM, Cui J: The clinical therapeutic observation on combination of acupuncture with point application for diabetic gastroparesis. J Guiyang Coll Tradit Chin Med. 2010, 32 (2): 69-71. Shen L, Kong DM, Cui J: The clinical therapeutic observation on combination of acupuncture with point application for diabetic gastroparesis. J Guiyang Coll Tradit Chin Med. 2010, 32 (2): 69-71.
24.
go back to reference Wang CP, Kao CH, Chen WK, Lo WY, Hsieh CL: A single-blinded, randomized pilot study evaluating effects of electroacupuncture in diabetic patients with symptoms suggestive of gastroparesis. J Altern Complement Med. 2008, 14 (7): 833-839. 10.1089/acm.2008.0107.CrossRefPubMed Wang CP, Kao CH, Chen WK, Lo WY, Hsieh CL: A single-blinded, randomized pilot study evaluating effects of electroacupuncture in diabetic patients with symptoms suggestive of gastroparesis. J Altern Complement Med. 2008, 14 (7): 833-839. 10.1089/acm.2008.0107.CrossRefPubMed
25.
go back to reference Wang L, Tao JP, Wu LX: The effect of acupuncture acupoints of Ren meridian on gastric emptying-time and blood glucose for diabetic gastroparesis. J Clin Acupunct Moxibustion. 2009, 25 (3): 5-7. Wang L, Tao JP, Wu LX: The effect of acupuncture acupoints of Ren meridian on gastric emptying-time and blood glucose for diabetic gastroparesis. J Clin Acupunct Moxibustion. 2009, 25 (3): 5-7.
26.
go back to reference Wang LJ: The clinical researches on diabetic gastroparesis treated with connection between back-shu and pront-mu points prescription. Master Thesis. 2007, Harbin, China: Heilongjiang University of Chinese Medicine Wang LJ: The clinical researches on diabetic gastroparesis treated with connection between back-shu and pront-mu points prescription. Master Thesis. 2007, Harbin, China: Heilongjiang University of Chinese Medicine
27.
go back to reference Wang SH, Yang LX, Wei LL, Cui X, Peng ZH: Observation of therapeutic effect of chiropractic combining with acupuncture on 35 cases with diabetic gastroparesis. J Clin Acupunct Moxibustion. 2010, 26 (7): 4-6. Wang SH, Yang LX, Wei LL, Cui X, Peng ZH: Observation of therapeutic effect of chiropractic combining with acupuncture on 35 cases with diabetic gastroparesis. J Clin Acupunct Moxibustion. 2010, 26 (7): 4-6.
28.
go back to reference Zeng HW, Cai TJ: Observation on therapeutic effect of turtle probing the cave needling method on diabetic gastroparesis. Zhongguo Zhenjiu. 2008, 28 (8): 576-578. Zeng HW, Cai TJ: Observation on therapeutic effect of turtle probing the cave needling method on diabetic gastroparesis. Zhongguo Zhenjiu. 2008, 28 (8): 576-578.
29.
go back to reference Zhang P, Liu ZF, Wang CM, Yao SZ, Zhang ZL: Observation on the therapeutic effect of needling method for harmoning spleen-stomach on diabetic gastroparesis. Zhongguo Zhenjiu. 2007, 27 (4): 258-260. Zhang P, Liu ZF, Wang CM, Yao SZ, Zhang ZL: Observation on the therapeutic effect of needling method for harmoning spleen-stomach on diabetic gastroparesis. Zhongguo Zhenjiu. 2007, 27 (4): 258-260.
30.
go back to reference Zheng SL, Ge JY: Therapeutic observation on warming acupuncture for treatment of 40 cases of diabetic gastroparesis. Chin J Tradit Med Sci Tech. 2010, 17 (3): 247-248. Zheng SL, Ge JY: Therapeutic observation on warming acupuncture for treatment of 40 cases of diabetic gastroparesis. Chin J Tradit Med Sci Tech. 2010, 17 (3): 247-248.
31.
go back to reference Zhao LF: The clinical study of electro-acupuncture combining with western medicine for diabetic gastroparesis. Master thesis. 2011, Guangzhou, China: Guangzhou University of Chinese Medicine Zhao LF: The clinical study of electro-acupuncture combining with western medicine for diabetic gastroparesis. Master thesis. 2011, Guangzhou, China: Guangzhou University of Chinese Medicine
32.
go back to reference Chen C: The clinical and experimental researches on diabetic gastroparesis treated with electroacupuncture. 2005, Guangzhou University of Chinese Medicine: Master Thesis Chen C: The clinical and experimental researches on diabetic gastroparesis treated with electroacupuncture. 2005, Guangzhou University of Chinese Medicine: Master Thesis
33.
go back to reference Vickers A, Goyal N, Harland R, Rees R: Do certain countries produce only positive results? A systematic review of controlled trials. Control clin trials. 1998, 19 (2): 159-166. 10.1016/S0197-2456(97)00150-5.CrossRefPubMed Vickers A, Goyal N, Harland R, Rees R: Do certain countries produce only positive results? A systematic review of controlled trials. Control clin trials. 1998, 19 (2): 159-166. 10.1016/S0197-2456(97)00150-5.CrossRefPubMed
34.
go back to reference Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L: Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013, 108 (1): 18-37. 10.1038/ajg.2012.373. quiz 38CrossRefPubMed Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L: Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013, 108 (1): 18-37. 10.1038/ajg.2012.373. quiz 38CrossRefPubMed
35.
go back to reference MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, Moher D: Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 2010, 7 (6): e1000261-10.1371/journal.pmed.1000261.CrossRefPubMedPubMedCentral MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, Moher D: Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 2010, 7 (6): e1000261-10.1371/journal.pmed.1000261.CrossRefPubMedPubMedCentral
37.
go back to reference Wu B, Liu M, Liu H, Li W, Tan S, Zhang SH, Fang Y: Meta-analysis of traditional Chinese patent medicine for ischemic stroke. Stroke. 2007, 38 (6): 1973-1979. 10.1161/STROKEAHA.106.473165.CrossRefPubMed Wu B, Liu M, Liu H, Li W, Tan S, Zhang SH, Fang Y: Meta-analysis of traditional Chinese patent medicine for ischemic stroke. Stroke. 2007, 38 (6): 1973-1979. 10.1161/STROKEAHA.106.473165.CrossRefPubMed
38.
go back to reference Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J: Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004, 13 (4): 833-844.CrossRefPubMed Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J: Gastroparesis Cardinal Symptom Index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004, 13 (4): 833-844.CrossRefPubMed
39.
40.
go back to reference Chassany O, Marquis P, Scherrer B, Read NW, Finger T, Bergmann JF, Fraitag B, Geneve J, Caulin C: Validation of a specific quality of life questionnaire for functional digestive disorders. Gut. 1999, 44 (4): 527-533. 10.1136/gut.44.4.527.CrossRefPubMedPubMedCentral Chassany O, Marquis P, Scherrer B, Read NW, Finger T, Bergmann JF, Fraitag B, Geneve J, Caulin C: Validation of a specific quality of life questionnaire for functional digestive disorders. Gut. 1999, 44 (4): 527-533. 10.1136/gut.44.4.527.CrossRefPubMedPubMedCentral
41.
go back to reference De La Loge C, Trudeau E, Marquis P, Revicki DA, Rentz AM, Stanghellini V, Talley NJ, Kahrilas P, Tack J, Dubois D: Responsiveness and interpretation of a quality of life questionnaire specific to upper gastrointestinal disorders. Clin Gastroenterol Hepatol. 2004, 2 (9): 778-786. 10.1016/S1542-3565(04)00349-0.CrossRefPubMed De La Loge C, Trudeau E, Marquis P, Revicki DA, Rentz AM, Stanghellini V, Talley NJ, Kahrilas P, Tack J, Dubois D: Responsiveness and interpretation of a quality of life questionnaire specific to upper gastrointestinal disorders. Clin Gastroenterol Hepatol. 2004, 2 (9): 778-786. 10.1016/S1542-3565(04)00349-0.CrossRefPubMed
42.
go back to reference Bian JL, Zhang CH: Conception and core of academician Shi Xuemin’s acupuncture manipulation quantitative arts. Zhongguo zhenjiu. 2003, 23 (5): 287-289. Bian JL, Zhang CH: Conception and core of academician Shi Xuemin’s acupuncture manipulation quantitative arts. Zhongguo zhenjiu. 2003, 23 (5): 287-289.
43.
go back to reference Shi XM: Stroke and Xingnao Kaiqiao acupuncture. 1998, Tianjin: Tianjin Science and Technology Press Shi XM: Stroke and Xingnao Kaiqiao acupuncture. 1998, Tianjin: Tianjin Science and Technology Press
Metadata
Title
Meta-analysis of acupuncture for relieving non-organic dyspeptic symptoms suggestive of diabetic gastroparesis
Authors
Mingxing Yang
Xiumin Li
Suhuan Liu
Zhipeng Li
Mei Xue
Dehong Gao
Xuejun Li
Shuyu Yang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2013
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-13-311

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