Table 1.
The effectiveness of acupuncture in treating visceral pain in GI disorders
| Articles | Acupoints | Stimulation parameter | Number of participants | Disease treated | Study design | Main findings | Pain specific |
|---|---|---|---|---|---|---|---|
| (Pei et al. 2020) | GV20, GV29, LR3, ST36, SP6, ST25, and ST37 | Three times a week for 6 weeks. The needles were manipulated every 10 min, and each session lasted 30 min. |
AP (n = 344) PEG 4000/pinaverium bromide (n = 175) |
IBS-C and IBS-D | Multicenter RCT | AP treatment significantly improved total IBS-SSS scores (123.51 vs 94.73, P < 0.01), including the severity of abdominal pain (20.92 ± 25.41 vs 13.43 ± 21.48, P = 0.003) when compared with PEG 4000/pinaverium bromide group. Furthermore, AP treatment improved IBS-QOL total scores (13.35 vs 8.95, P = 0.02). | Yes |
| (Shen et al. 2022) | ST25, CV12, ST36, ST37, SP4, ST40, LR13, and SP9 | Three times a week for 8 weeks. Each session lasted 30 min, and the needles were manipulated every 10 min. |
AP (n = 33) Sham-AP (n = 32) |
IBS-D | RCT | Both groups of AP and Sham-AP had reduced IBS-SSS scores, including pain, compared with the baseline. However, there was a significant difference in the IBS-SSS score during the follow-up visit between the groups (169.70 ± 54.11 vs 204.38 ± 52.48, P < 0.05). Moreover, the BSS score also decreased after the treatment (5.00 ± 0.83 vs 5.44 ± 0.72, P < 0.05) and during follow-up (5.06 ± 0.86 vs 5.53 ± 0.84, P < 0.05) in the AP group comparing to the Sham-AP group. | Yes |
| (Rafiei et al. 2014) |
UB17, 23, 25 DU3, SP9, 15, ST25, 36, Ren12, and 4. Kid15 |
Catgut AP method |
AP (n = 20) Sham-AP (n = 20) DO (n = 20) |
IBS |
RCT Double-blinded |
AP treatment decreased abdominal pain when compared with the Sham-AP and DO group (mean score, AP: 3.07, Sham-AP: 4.6, DO: 5.08, P = 0.003). AP treatment also decreased symptoms of depression when compared with the DO group (mean score, AP: 15.9, DO: 21.9, P = 0.002). | Yes |
| (Lowe et al. 2017) | ST25, ST34, ST36, ST37, UB20 and UB23, LI4, CV6, and CV12. | Treatment was given twice weekly for 4 weeks, and the session lasted 30 min. |
AP (n = 43) Sham-AP (n = 36) |
IBS | RCT | This study didn’t observe significant differences between groups in abdominal pain score (51.0 ± 27.1 vs 38.6 ± 17.2, P = 0.70) and in McGill pain score (2.6 ± 0.4 vs 3.5 ± 0.5, P = 0.19), though both groups demonstrated reduction from the baseline. Furthermore, similar results were observed in IBS symptoms score (12.2 ± 1.2 vs 13.9 ± 1.6, P = 0.40) and QOL measures (2.2 ± 0.2 vs 1.9 ± 0.2, P = 0.28). | Yes |
| (Qi et al. 2022) | Three sessions per week, every other day for 4 weeks, each session lasting 30 min. |
SA (n = 30) NSA (n = 30) NA (n = 30) |
IBS-D | Multicenter RCT | Acupuncture in both SA and NSA groups improved abdominal pain and IBS-SSS scores, although there were no significant differences among the three groups. | Yes | |
| (Zhang et al. 2019a) | CV4, PC6, ST36, SP6, ST25, and ST37. | Three (3) sessions per week, every other day, for 4 weeks, each session lasting 30 min. |
AP (n = 31) Control (n = 30) |
IBS-D | RCT | AP treatment significantly decreased IBS-SSS scores, including abdominal pain (100.97 ± 8.55 vs 254.17 ± 11.98, P < 0.05), compared to the control group. AP treatment also improved anxiety (7.06 ± 0.50 vs 9.87 ± 0.51, P < 0.05) and depression (6.29 ± 0.42 vs 10.43 ± 0.49, P < 0.05). | Yes |
| (Meng 2019) | LR3, ST36, ST37, SP6, ST25, GV20, and GV29. | Five times a week for 4 weeks, and each session lasted for 30 min |
AP (n = 35) Control (n = 35) |
IBS-D | RCT | AP treatment decreased the total IBS-SSS score (193.71 ± 52.42 vs 245.14 ± 47.36, P < 0.05), including the degree of abdominal pain (36.00 ± 26.48 vs 48.57 ± 25.80, P < 0.05), frequency of abdominal pain (30.29 ± 27.17 vs 50.29 ± 23.45, P < 0.05), and defecation satisfaction (38.29 ± 29.25 vs 50.86 ± 22.93, P < 0.05) compared to the control group. AP treatment also decreased their depression state (51.17 ± 12.92 vs 60.69 ± 16.26, P < 0.05). | Yes |
| (Li et al. 2015) | ST36, PC6, and CV12 | Once a day for 7 days, each session lasted for 20–30 min |
AP (n = 11) Sham-AP (n = 10) |
GP | Single-blind, crossover trial | Although both groups had reduced GSCI and GVAS scores from the baseline, the AP group showed significant differences in both GSCI (− 8.0 ± 3.4 vs − 2.4 ± 3.7, P < 0.01) and GVAS (− 58.1 ± 31.2 vs − 12.9 ± 29.9, P < 0.01) scores when compared with the sham group. | Yes |
| (Jin et al. 2015) | ST36, KI3, GB4, PC6, and HT7 | Three sessions per week, every other day, for 4 weeks |
Treatment (n = 30) Control (n = 30) |
FD | RCT | DSS scores, including epigastric pain, were reduced in both groups; however, the treatment group exhibited more effect than the control group (0.48 ± 1.03 vs 6.32 ± 3.41, P < 0.0001). AP treatment has better outcomes for improving mental status [(SDS score (45.60 ± 8.75 vs 54.00 ± 10.80, P < 0.0001)) and SAS score (42.30 ± 6.22 vs 52.20 ± 7.98, P < 0.0001))] and QOL [SF-36 score (70.0 ± 12.54 vs 56.00 ± 13.42, P < 0.0001)]. | Yes |
| (Lee et al. 2022) | Saam acupuncture | Three sessions per week for 4 weeks, and each session lasted 20 min. |
Saam-AP (n = 12) Usual care (n = 12) |
FD | RCT | There was no difference in GIS after the treatment between both groups. However, Saam-AP had a significant reduction in GIS scores at 8-week [(6.30 (3.03, 9.57) vs 9.40 (5.64, 13.16), P = 0.0339] and 12-week [(4.70 (1.26, 8.14) vs 10.80 (5.22, 16.38), P = 0.0113] follow-ups compared to the usual care group. Only Saam-AP group significantly reduced epigastric pain scores at 8-week [(2.10 (1.24, 2.96) vs 0.70 (0.11, 1.29), P = 0.0205] and 12-week follow-ups [[(2.10 (1.24, 2.96) vs 0.60 (0.10, 1.10), P = 0.0091] when compared to the baseline. | Yes |
| (Xuefen et al. 2020) |
Group-A: CV12, ST36 Group-B: PC6, ST36 Group-C: non-acupoints, ST36 |
Five sessions per week for 3 weeks, and each session lasted 30 minutes. |
Group-A (n = 33) Group-B (n = 33) Group -C (n = 33) |
GP | RCT | All groups demonstrated a significant reduction in GCSI scores. However, Group-A had better outcomes than all groups. | No |
| (Ko et al. 2016) | LI4, ST36, LR3, SP4, CV12, GB21, SI14, PC6, EX-HN5, and ST34 | Twice weekly for 4 weeks |
AT (n = 37) Control (n = 39) |
FD | RCT | Acupuncture treatment significantly reduced the total NDI score (57.1 ± 30.2 43.4 ± 33.1, P = 0.03) compared to the control group. Moreover, AP treatment significantly reduced upper abdominal pain (4.3 ± 3.6 vs 3.2 ± 3.6, P < 0.05) and discomfort in the upper abdomen (6.8 ± 3.4 4.7 ± 3.8, P < 0.05) from the baseline; however, there was a significant difference between groups in discomfort in the upper abdomen (6.4 ± 3.2 4.7 ± 3.8, P = 0.01). | Yes |
| (Park et al. 2009) | CV12, LI4, LR3, ST36, PC6, and SP4. |
Three times per week for 2 weeks After insertion, needles were rotated 90° for 3 times and retained for 15 min. |
AP (n = 38) Sham-AP (n = 38) |
FD | RCT | In both cases, NDI scores, including abdominal pain, reduced from the baseline (from 59.59 ± 22.03 to 25.44 ± 17.96, P < 0.001 in the AP group, and from 55.71 ± 22.94 to 26.38 ± 15.69, P < 0.001 in the Sham-AP group). However, no significant differences were observed in the average NDI scores between groups (34.15 ± 24.74 vs 29.32 ± 20.76, P = 0.387). | Yes |
Abbreviations: AP Acupuncture, Sham-AP Sham acupuncture, AT Actual treatment, NDI The Nepean dyspepsia index, GV20 Baihui, GV29 Yintang, LR3 Taichong, ST36 Zusanli, SP6 Sanyinjiao, ST25 Tianshu, ST37 Shangjuxu, CV12 Zhongwan, SP4 Gongsun, ST40 Fenglong, LR13 Zhangmen, SP9 Yinlingquan, PC6 Neiguan, BL25 Dachangshu, LI11 Quchi, GB40 Qiuxu, GB37 Guangming, GB34 Yanglingquan, GB36 Waiqiu, ST33 Yinshi, ST35 Dubi, ST32 Futu, ST34 Liangqiu, ST42 Chongyang, ST38 Tiaokou, BL21 Weishu, KI3 Yuan, ST2 Neiting, SP4 Gongsun, SP9 Yinlingquan, Ren4 Guanyuan, Ren12 Zhongwan, Kid15 Zhongzhu, EX-HN5 Taiyang, HT7 Shenmen, DU3 Yaoyangguan LI-EA Low intensity EA, HI-EA High intensity EA, IBS-C Irritable bowel syndrome with constipation, IBS-D Irritable bowel syndrome with diarrhea, FD Functional dyspepsia, GP Gastroparesis, RCT Randomized controlled trial, SA Specific acupoints, NSA Non-specific acupoints, NA Non-acupoints, IBS-SSS Irritable Bowel Syndrome Severity Scoring System, IBS-QOL Irritable bowel syndrome quality of life, GCSI Gastroparesis cardinal symptom index