Published online May 21, 2020. doi: 10.3748/wjg.v26.i19.2440
Peer-review started: December 16, 2019
First decision: February 24, 2020
Revised: April 16, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: May 21, 2020
Functional dyspepsia (FD) is one of the most common functional gastrointestinal disorders in the clinic. Due to the multifactorial pathophysiology of this disease, however, current clinical approaches remain unsatisfactory with limited efficacy or side effects. Acupuncture along with electroacupuncture (EA) has been applied in treating FD with seemingly promising therapeutic effects.
Numerous clinical trials were performed to investigate the effects as well as the underlying mechanisms of acupuncture in treating FD. Still, there is a lack of a bibliometric analyses that evaluated the results and qualities of existing clinical evidence.
A better understanding of therapeutic mechanisms of acupuncture will help to improve the clinical efficacy of this treatment as well as provide new insights into the medical practice for treating FD. Hence, the aim of this systematic review was to evaluate pathophysiological mechanisms involved in the ameliorating effect of acupuncture/EA in patients with FD.
According to the methodology of evidence-based medicine, a systematic search of the literature was performed to identify randomized controlled trials in which the mechanism researches of acupuncture or EA were applied in FD patients.
Eight studies were included in this review with a total of 17 items of detecting techniques for mechanistic research. Positive effects of acupuncture and EA were observed in regulating gastric motility, gastric accommodation, mental status, gastrointestinal hormones, and central and autonomic functions while improving dyspeptic symptoms and QOL.
This is the first time that a systematic review focused on the underlying mechanisms of acupuncture including manual acupuncture, EA, and transcutaneous electrical acustimulation has been conducted to elaborate the current research status in the clinical trials of FD.
Under the limitations of included articles, high-quality studies with well-planned designs and multi-regional investigations are necessary to provide more convincing and credible evidence. Also, mechanistic studies on acupuncture in FD should focus on revealing the interactions of gut-brain axis.