Electroacupuncture effects on diabetic patients with gastroparesis.
Aim Of This Study
This pilot study was conducted to determine the effect of electroacupuncture (EA) on solid gastric emptying time; serum gastrin, motilin and pancreatic polypeptide (PP); fasting and postprandial blood glucose; and gastroparesis symptoms in patients with type 2 diabetes.
Nineteen type 2 diabetic patients (16 males, 3 females) with a mean age of 57 years completed this study. All participants had experienced symptoms suggestive of gastroparesis for longer than three months. Nine participants were allocated to the EA group and ten to the sham EA group.
Participants in the EA group received two 30-minute electroacupuncture treatments per week for two weeks for a total of four treatments. Needles were inserted at the ST 36 acupoint in both feet and the LI 4 acupoint in both hands. Once a de qi sensation was felt, the needles were connected to an electrode which was connected to a battery-powered pulse generator. They were then electrically stimulated for 30 minutes.
The sham EA group had needles inserted at non-acupuncture points 2 cm away from the true acupoints in the hands and feet. These needles did not penetrate any further than the subcutaneous layers of the skin. The same electrical stimulation was applied as the EA group.
The Gastroparesis Cardinal Symptom Index (GCSI) was used to measure symptom severity. This questionnaire comprises of three subscales: post-prandial fullness and early satiety, nausea and vomiting, and bloating. It was completed prior to study commencement, immediately after intervention and two weeks after intervention.
Scintigraphy was used to time the half-emptying of a solid meal of two eggs and two slices of white bread--a meal that was consumed by all participants following overnight fasting. Scintigraphy is a diagnostic test in which a two-dimensional picture of internal body tissue is produced through the detection of an intravenously injected radioactive chemical.
The test showed dynamic gastric movement for 100 minutes at 5 minute intervals. It was performed prior to study commencement and after intervention.
Blood samples were taken before ingestion of the solid meal and at one and two hours after ingestion to measure fasting and postprandial blood glucose levels. Further blood samples were taken before study commencement and after intervention to measure serum levels of gastrin, motilin and PP.
Total GCSI scores significantly improved both immediately after and two weeks after intervention in the EA group. However, the nausea/vomiting subscale remained unchanged after two weeks compared to before intervention. No changes were evident in the sham EA group at both times.
Gastric half-emptying times decreased in the EA group from a mean of 143.8 minutes to 98.9 minutes. No change occurred in gastric half-emptying in the sham EA group.
Fasting and postprandial blood glucose levels did not indicate any differences in either group prior to ingestion or after ingestion. Serum levels of gastrin, motilin and PP also remained the same at all times in both groups.
The researchers concluded that the study:
Revealed that short-term EA at the Zusanli [ST 36] and Hegu [LI 4] points effectively alleviates dyspeptic symptoms and accelerates solid-phase gastric emptying in patients with diabetic gastroparesis. Sustained improvement in dyspeptic symptoms was observed at the two-week follow-up after EA treatment. EA may have a future as a therapeutic option in the treatment of gastroparesis.
Limitations Of This Study
The study was limited by the fact only the GCSI scores for gastroparesis were measured for longer term effects (i.e. two weeks after intervention). All other outcome measures should also have been tested in the longer term for electroacupuncture efficacy.
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|Publication:||Journal of the Australian Traditional-Medicine Society|
|Date:||Mar 1, 2010|
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