Acupuncture On Specific Acupoints For Functional Dyspepsia: A Multi-center, Large-sample, Randomized Controlled Trial

Objective:To explore the rule of acupoints selection for functional dyspepsia (FD) by data mining methods and to investigate the therapeutic efficacy of acupuncture on specific acupoints for FD by comparing non-specific acupoints with non-acupoints so as to preliminarily clarify the hypothesis of "acupoint has specificity in efficacy, which is closely related to the gathering of meridian qi"Method:Multi-center, central-randomanization controlled trial was designed.474 patients meeting the inclusion criteria were randomly allocated to receive one of specific-point acupuncture treatments (Treatment Group A:ST34, ST36, ST40, ST42; Treatment Group B:UB21, REN12) or non-specific-point acupuncture (Group C:ST32, ST33, ST35, ST38) or non-acupoint puncture (Group D) treatment. The HAN's acupoint nerve stimulaor was used. The study consisted of a treatment period of 4 weeks (five sessions continuously per week, an interval two days between two courses), and a follow-up period of 12 weeks. Dyspepsic symptoms and the disease-specific quality of life (Nepean Dyspepsia Index,DNI) were evaluated to determine patients'therapeutic efficacy.Results:1. Each group had significant therapeutic effect in relieving three main symptoms as postprandial fullness, early satiation and pigastric pain. In the life quality improvement, A and B group significantly raised the quality of life in all subscales of NDI. Clinically differences were not deteted in four sunscales of life quality in D group at four assessment time. As for C group, clinically differences were not deteted in subscale of interference at four assessment time, in sunscale of eating/drinking in 2-week,4-week after treatment and in subscale of sleep in 2-week after treatment.2. The changes in the score of NDI and Dyspeptic Symptom Score of postprandial fullness and early satiation were significant different between A and D groups in 2-week, 4-week after treatment as well as 4-week and 12-week follow-up period (P<0.05). The differences between A and D groups in 2-week,4-week after treatment as well as 1 month follow-up period were also significant in the change of Dyspeptic Symptom Score of pigastric pain. 3. The changes in the score of NDI subscales of interference, konwledge/control and eating/drinking were significantly different between A and C groups in 2-week,4-week after treatment as well as 4-week and 12-week follow-up period (P<0.05). The differences between A and C groups in 4-week after treatment as well as 4-week and 12-week follow-up period were also significant in the change of Dyspeptic Symptom Score of postprandial fullness. There was significant difference between A and C group in the change of NDI subscale of sleep at the end of treatment.4. Except for significant difference between A and B group in the change of NDI subscale of interference at the end of treatment and the subscales of eating/drinking in 2-week after treatment, no significant differences were detected between the two groups in the other NDI subscales and at other assessment time. There were not significant differences between A and B group in the changes of Dyspeptic Symptom Score of early satiation and pigastric pain.in 2-week after treatment,4-week and 12-week follow-up as well as postprandial fullness in 2-week after treatment(P>0.05).5. There was significant difference between A and other three groups in the overall efficacy at the end of treatment (P<0.05).Conclusion:1. Puncturing at specific acupoint on the stomach meridian and the combination of Back-shu and front-mu point of stomach have significant effect in improving quality of life on FD patients and relieving three main symptoms as postprandial fullness, early satiation and pigastric pain.2. Puncturing at specific acupoint shows better effect in improving dyspepsia-related quality of life in four subscales of NDI, relieving postprandial fullness and early satiation in 2-week,4-week after treatment as well as 4-week and 12-week follow-up,and relieving pigastric pain in 2-week,4-week after treatment as well as 12-week follow-up than non-acupoint. The effect of puncturing at specific acupoint is also superior to non-specific acupoint in improving dyspepsia-related quality of life in three subscales of NDI (interference, konwledge/control and eating/drinking), relieving postprandial fullness in 2-week,4-week after treatment as well as 4-week and 12-week follow-up,and improving dyspepsia-related quality of life in subscale of sleep at the end of treatment. 3. The effect of puncturing at specific acupoint is superior to non-acupoint and non-specific acupoint, which provides the hypothesis of "acupoint has specificity in efficacy, which is closely related to the gathering of meridian qi" with primilary evidence.