Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2020; 26(19): 2440-2457
Published online May 21, 2020. doi: 10.3748/wjg.v26.i19.2440
Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review
Yu Guo, Wei Wei, Jiande DZ Chen
Yu Guo, Wei Wei, Department of Gastroenterology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
Yu Guo, Jiande DZ Chen, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, United States
Jiande DZ Chen, Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI 48109, United States
Author contributions: Guo Y, Wei W, and Chen JDZ designed the review protocol; Guo Y conducted the literature research; Guo Y and Wei W contributed to data extraction and quality assessment; Guo Y drafted the manuscript; Chen JDZ contributed to the critical revision of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81703923 and No. 81820108033.
Conflict-of-interest statement: No potential conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 checklist and the manuscript was prepared and revised according to the PRISMA 2009 checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jiande DZ Chen, MD, PhD, Professor, Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, 1515 E Medical Center Dr, Ann Arbor, MI 48109, United States.
Received: December 16, 2019
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
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.