Table 2.
The actions and mechanisms of acupoint stimulation in chemotherapy-induced gastrointestinal toxicity.
| Clinical trials | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ref. | Randomized type of clinical trial | Jadad score /NOS Stars | Clinical condition | Intervention | Comparison | Acupoints | Acupoint stimulation parameters | Outcomes | ||||
| Zhang (36) | Yes, RCT | Jadad, 1 | Cancer patients | TEAS (n = 38) | Sham TEAS (n = 34) | Bilateral: PC6, PC5 | 0.3 ms, 20 Hz, 10 mA, on-time of 0.1 s and off-time of 0.4 ms, 1 h, 2 times/day, 3 days | Vomiting times↓, nausea score↓, plasma levels of 5-HT and dopamine↓ | ||||
| Li (39) | No, single-blind sham RCT | Jadad, 4 | Lung, breast, gynecologic cancer patients | Acupuncture and EA (n = 68) | Sham acupuncture (n = 66) | CV12, CV6; bilateral: LR13, ST25, PC6, ST36 | Acupuncture at CV12, CV6, LR13, ST25, PC6: 10–35 mm, deqi, 30 min, 5 days Electroacupuncture at ST36: 2/100 Hz, 30 min, 5 days | CTCAE score↓, SNAQ score↑ | ||||
| Varejão (40) | Yes, RCT | Jadad, 1 | Solid tumor patients | LA (n = 8) | Sham acupuncture (n = 10) | CV10, CV12; bilateral: PC6, LI4, SP6, ST36, BL20 | 660 nm, 30 mw, 3 joules, 1 min/point, 6 min, 5 days | Scale of the national cancer institute intensity of nausea↓ | ||||
| Kulthida (41) | Yes, RCT | Jadad, 4 | Gynecologic cancer patients | Acupuncture (n = 35) | Ondansetron (n = 35) | Bilateral: PC6 | deqi, 30 min, 3 weeks | Complete response rate of delayed emetic control↑, constipation and insomnia↓, cute emetic control↑, FACT-GQOL↑ | ||||
| Liu (42) | Yes, RCT | Jadad, 3 | Gynecologic cancer patients | Acupuncture and moxibustion (n = 30) | Tropisetron hydrochloride and dexamethasone (n = 30) | CV8; bilateral: point 1 | Acupuncture: 23 mm, 30 min Ginger moxibustion: ginger diameter, 5 cm, thickness, 0.5 cm, mugwort 3 cm long; 1–2 times/day, 5 min, 5 days | Vomiting times↓, nausea score↓, constipation index↓, cost↓ | ||||
| Zhu (43) | Yes, RCT | Jadad, 5 | Liver cancer patients | TEAS (n = 37) | Sham TEAS (n = 37) | Bilateral: ST36, PC6 | 1 h, 2 times/week, 3 weeks; ST36: 2 s- ON, 3 s- OFF, 25 Hz, 0.5 ms, 2–10 mA; PC6: 0.25 s- ON, 0.25 s- OFF, 100 Hz, 0.5 ms, 2–10 mA | Nausea score↓, bloating scores↓, anorexia score↓ | ||||
| Xie (37) | Yes, RCT | Jadad, 4 | Liver cancer patients | Active acupuncture (n = 72) | Placebo acupuncture (n = 70) | Bilateral: LI4, PC6, ST36 | 4Hz, 10mA, 30 min, 2 times/day, 6 days | VAS of anorexia score↓ | ||||
| Zhou (44) | Yes, RCT | Jadad, 1 | Gastric cancer patients | Acupuncture (n = 28) | Control (n = 28) | Bilateral: ST36, ST37, ST25, SP6, PC6 | 30 min, 2 weeks | Duration of nausea↓, abdominal pain↓ | ||||
| Genç (45) | Yes, RCT | Jadad, 1 | Breast cancer patients | Acupressure and antiemetic drugs (n = 32) | Antiemetic drugs (n = 32) | Bilateral: PC6 | 5 days | Index of nausea, vomiting and retching↓, beck anxiety inventory↓, mean scores for the distress↓ | ||||
| Basic researches | ||||||||||||
| Ref. | Model | Chemotherapeutic agents | Intervention | Acupoints | Acupoint stimulation parameters | Effect indicators | Mechanism indicators | |||||
| Baek (46) | CIA rats | Cisplatin, 6 mg/kg, a single i.p. | EA | CV12 | 16 mA, 10 Hz; 32 mA, 100 Hz;10 min | Body weight↑, food intake↑ | (Plasma) 5-HT↑, 5-HIAA↑, DA↑, NE↑, (hypothalamus) NPY↑ | |||||
| Kang (47) | CIA rats | Cisplatin, 6 mg/kg, a single i.p. | EA | CV12 | 10 Hz, low intensity (without muscle contractions) | Body weight↑, food intake↑ | (Stomach) ghrelin mRNA↑, (hypothalamus) BDNF↑ | |||||
↑, upregulated by intervention; ↓, downregulated by intervention.
RCT, randomized controlled trial; TEAS, transcutaneous electrical acupoint stimulation; PC6, Neiguan; PC5, Jianshi; 5-HT, 5-hydroxytryptamine; EA, electroacupuncture; CV12, Zhongwan; CV6, Qihai; LR13, Zhangmen; ST25, Tianshu; ST36, Zusanli; CTCAE, common terminology criteria for adverse events; SNAQ, simplified nutritional appetite questionnaire; LA, laser acupuncture; CV10, Xiawan; LI4, Hegu; SP6, Sanyinjiao; BL20, Pishu; FACT-GQOL, functional assessment of cancer therapy-general questionnaire version; CV8, Shenque; VAS, visual analogue scale; ST37, Shangjuxu; CIA, chemotherapy-induced anorexia; 5-HIAA, 5-hydroxyindoleacetic acid; DA, dopamine; NE, norepinephrine; NPY, neuropeptide Y; BDNF, brain-derived neurotrophic factor.