Transcutaneous Electroacupuncture (TEA) Improves Dyspeptic Symptoms And Increases Vagal Activity In Patients With Functional Dyspepsia

Background: Functional dyspepsia (FD) is one of the most common gastrointestinal disorders, the causes of FD and effective treatments have remained elusive.Objective: To evaluate the therapeutic value of transcutaneous electroacupuncture (TEA) at acupoints by comparing the responses of FD patients to true TEA versus sham TEA in a double-blind and cross-over study, to explore the possible involved mechanisms.Methods: Twenty-seven patients with FD were enrolled, consisting of two parts: 1)The acute phase was composed of three randomized sessions on three separate days. The protocol of each sessions included a 30-min fasting recording and two 30-min postprandial recordings. The process was similar, only gave the patients three different treatments during the first 30-min postprandial period: TEA of GI acupoints/sham TEA treatment/TEA on non-acupoints, the EGG and ECG were recorded simultaneously during the entire 90-min period. 2) In the chronic experiment, the patients were randomly assigned to two even groups. One group was treated with TEA first for two weeks, followed with a one-week washout period and a two-week period with sham TEA. The order of the treatment and control was reversed in the other group. True TEA was performed at ST36 (Zusanli) and PC6 (Neiguan), and sham TEA at non-acupoint for 30min twice daily. The dyspepsia symptoms, electrogastrogram and electrocardiogram were recorded at baseline, end of first 2-week treatment, and beginning and end of the second 2-week treatment. Blood samples were also taken to assess NPY and Motilin levels at different points of the study. Results: 1) The dyspepsia symptoms scores were significantly improved at the end of treatment in the TEA group (P<0.01). 2) The vagal activity assessed from the spectral analysis of heart rate variability was markedly increased in the TEA group at acute and short-term treatments (P<0.05). 3) Acute and short-term TEA did not change the dominant frequency and power and normal percentage of gastric slow waves (P>0.05). 4) The plasma level of NPY not Motilin was increased after the TEA treatment.Conclusions: TEA at GI acupoints is capable of improving dyspepsia symptoms and increasing vagal activity, has no effect on gastric myoelectrical activity. These may be associated with the modulation of NPY. This study offers a potential option in the treatment of functional dyspepsia, however, further study is necessary.