Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review

Table 2 Characteristics of included studies of acupuncture vs sham, medication or no treatment in treating functional dyspepsia

Ref.	Study design	Partial inclusion (details)	Participants	Interventions (acupoints)	Main results (scales)	Mechanism research
Liu et al[26], 2008	Cross-over	Yes (chronic stage included)	n: 27 (F 18); Age (mean): 40.3 ± 4.5; groups (n): Verum A (27), Sham A (27); Diagnosis: Rome II	EXP: TEA (PC6, ST36); CONT: Sham TEA (2 non-acupoints); duration and frequency: 30 min, twice per day, for 2 wk	Decreased dyspepsia symptom scores by 55% in TEA group (dP < 0.01) (symptom scores without identified source)	Gastric motility (myoelectrical activity); neuroactivity (autonomic function); GI hormones
Zeng et al[27], 2012	Parallel	No	n: 64 (F 39); Age (mean, 95%CI): Verum A (23.97, 22.90-25.04), sham A (23.83, 22.67-25.00); groups (n): Verum A (34), sham A (30); diagnosis (subtype): Rome III (PDS)	EXP: EA (ST34, ST36, ST40, ST42); CONT: Sham EA (4 non-acupoints); duration and frequency: 30 min, once per day, 20 sessions in 4 wk	Decreased symptom score in EA greater than sham EA (gP < 0.05) (SID); clinically improved QOL in EA not in sham EA (NDI for QOL)	Brain function
Ji et al[28], 2014	Cross-over	No	n: 28; age (mean): 44.1 ± 9.4; Groups (n): Verum A (28), sham A (28); diagnosis (subtype): Rome III (PDS)	EXP: TEA (PC6, ST36); CONT: Sham TEA (2 non-acupoints); duration and frequency: 2 h, thrice per day, for 2 wk	Improved dyspeptic symptoms in TEA (cP < 0.05) not in sham TEA (GCSI); improved 4 domains of QOL in TEA (cP < 0.05) not in sham TEA (SF-36)	Gastric motility (myoelectrical activity and gastric emptying); gastric accommodation; mental status
Jin et al[29], 2015	Parallel	Yes (serum gastrin concentration and gastric slow wave excluded)	n: 56 (F 35); age (mean): Verum A (49.29 ± 10.32), sham A (48.25 ± 11.40); groups (n): Verum A (28), sham A (28); diagnosis: Rome III	EXP: MA (ST36, KI3 ± GB4, PC6, HT7); CONT: Sham MA (non-acupoints); duration and frequency: 20-60 min in EXP/20 min in CONT, once every other d, for 4 wk	Improved dyspeptic symptoms in MA and better than sham MA (iP < 0.05) (NDI); improved QOL in MA and greater than sham MA (iP < 0.05) (SF-36)	Mental status
Xu et al[30], 2015	Cross-over	Yes (TEA and sham TEA sessions included)	n: 8; age (mean): Not mentioned; groups (n): Verum A (8), sham A (8); diagnosis (subtype): Rome III (PDS)	EXP: TEA (PC6, ST36); CONT: Sham TEA (2 non-acupoints); Duration and frequency: 30 min, for 1 session	Improved dyspeptic symptoms in TEA and greater than sham TEA (cP < 0.05) (GCSI)	Gastric motility (myoelectrical activity); gastric accommodation; neuroactivity (autonomic function)
Zhang et al[31], 2015	Parallel	Yes (EA and control groups included)	n: 319 (F 157); age (mean): EA (42.6 ± 11.9); CONT (41.8 ± 12.2); groups (n): EA (159), CONT (160); diagnosis: Rome III	EXP: EA (ST36, CV12, PC6, LR3, SP4); CONT: Oral pantoprazole, amitriptylines and mosapride; duration and frequency: 15 min, twice per day, 5-d per wk in EXP; pantoprazole 20 mg with amitriptylines 5 mg, twice per day, and mosapride 5 mg, thrice per day in CONT; for 4 wk	Decreased symptom scores in EA and greater than CONT (aP < 0.05) (symptom scores without identified source); increased QOL scores in EA and better than CONT (aP < 0.05) (SF-36)	GI hormones; gastric motility (myoelectrical activity and gastric emptying)
Ko et al[32], 2016	Cross-over	Yes (from baseline to the first 4-wk included)	n: 76 (F 53); age (mean): MA (49.4 ± 12.1); CONT (49.1 ± 14.5); groups (n): MA (37), CONT (39); diagnosis: Rome III	EXP: MA (LI4, ST36, LR3, SP4, CV12 ± GB21, SI14, PC6, EX-HN5, ST34); CONT: No treatment; duration and frequency: 15 min, twice weekly, for 4 wk	Significantly higher PR in MA than CONT (eP < 0.001); lower symptom scores in MA than CONT (aP < 0.05) (NDI); improved QOL in MA (eP < 0.001) not in CONT (FD-QOL scale)	Mental status
Qiang et al[33], 2018	Parallel	No	n: 64 (F 38); age (mean): EA (42.6 ± 11.9); CONT (41.8 ± 12.2); groups (n): EA (32), CONT (32); diagnosis: Rome III	EXP: EA (ST36, SP6, SP4, PC6); CONT: Oral mosapride; duration and frequency: 30 min, once per day in EXP; 5 mg, thrice per day in CONT; for 30 d	Decreased symptom score in EA and greater than CONT (aP < 0.05) (LDQ); increased QOL scores in EA and better than CONT (aP < 0.05) (FD-QOL scale)	GI hormones

^aP < 0.05, ^bP < 0.01,

^eP < 0.001 vs control group;

^cP < 0.05,

^dP < 0.01, ^fP < 0.001 vs sham TEA;

^gP < 0.05 vs sham EA;

ⁱP < 0.05 vs sham MA. A: Acupuncture; CONT: Control group; EA: Electroacupuncture; EXP: Experimental group; F: Female; FD-QOL: Functional dyspepsia-related quality of life; GCSI: Gastroparesis cardinal symptom index; GI: Gastrointestinal; LDQ: Leeds dyspepsia questionnaire; MA: Manual acupuncture; NDI: Nepean dyspepsia index; PDS: Postprandial distress syndrome; PR: Proportion of responders; QOL: Quality of life; SF-36: Short form 36 health survey questionnaires; SID: Symptom index of dyspepsia; TEA: Transcutaneous electrical acustimulation; CI: Confidence interval.