Neuroendocrinological effects of acupuncture for irritable bowel syndrome.
Aim Of This Study
This study was conducted to assess whether acupuncture had any effects on the neuroendocrinic and autonomic nervous system which might benefit people suffering from irritable bowel syndrome (IBS).
Seventeen participants fulfilled the inclusion criteria and completed all the required tests. These participants were randomised into two groups. Eight participants formed the acupuncture group (AC) and nine participants were in the sham acupuncture group (SAC).
Participants in the AC group received two weekly acupuncture treatments over five weeks for a total of 10 treatments. Eight acupuncture points were chosen to calm the liver, strengthen the spleen and stomach, remove stomach stagnation, and calm the mind. Those in the SAC group also received 10 treatments over two weeks. Blunted telescopic placebo needles were inserted at points 2 cm away from the adjacent points used for the AC group.
Two questionnaires were used immediately before intervention, at the end of the 10 treatment weeks and three months after completion of the study. The Functional Digestive Diseases Quality of Life Questionnaire (FDDQL) was used to assess the impact of IBS on quality of life (QoL) and the SF-36 was used to measure health-related QoL that is unrelated to any specific disease.
Samples of salivary cortisol were taken the day immediately before intervention and within three days after the final treatment. Participants had to either chew on cotton wool or place it under their tongues for 30-45 seconds. Four samples were taken at 7 am, 12 noon, 5 pm and 10 pm.
A tilt table test was used to assess autonomic function immediately before the first treatment and immediately after the last treatment. The test began with the participants relaxing for 10 minutes on the tilt table in the supine position. After five minutes, blood pressure and heart rate were measured.
This was followed by two tests to evaluate cardiovagal function (i.e. how heart rate responds to deep breathing). In the first test, participants spent three minutes of controlled breathing to the timing of a metronome and in the second test, participants blew into a mouthpiece attached to a blood pressure metre for 15 seconds. Once the above tests were completed, participants were tilted on the table at 75[degrees] for 10 minutes to measure orthostatic stress (unusually low blood pressure due to being upright).
Both groups experienced equal improvements in QoL but only the pain subscale in the SF-36 showed a significant improvement. The AC group showed significantly lower cortisol levels from pre-treatment to post-treatment measurements. The SAC also lowered their cortisol levels but to a much lesser extent.
After the autonomic function tests, participants in the AC group showed a significant decrease in heart rate response-an indication of increased parasympathetic tone. This effect was not evident in the SAC group. Further analysis revealed that there was a significant relationship between the decrease in heart rate and improvement in pain-related QoL.
The researchers concluded that:
in patients with IBS, unspecific (placebo) effects accompanying acupuncture ... play a major role ... However, this does not imply that there is no specific physiological effect of acupuncture treatment as we found an acupuncture-specific increased parasympathetic tone accompanied by an increase of pain-related QoL.
Limitations Of This Study
Although this study started out with 43 enrolled participants, the sample size was reduced to 17 due to incomplete data and other confounding variables. The researchers conceded that a larger sample size is needed to confirm the preliminary findings in this study.
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|Publication:||Journal of the Australian Traditional-Medicine Society|
|Date:||Mar 1, 2010|
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