A Clinical Randomized Controlled Trial of Acupuncture Treatment of Gastroparesis Using Different Acupoints

Gastroparesis is a medical condition characterized by delayed gastric emptying without mechanical obstruction, causing symptoms such as loss of appetite, sensation of a full stomach after meals, nausea, vomiting, and abdominal distension. This condition affects mainly women and has limited conventional treatment options, with medications that frequently produce significant side effects and only temporary relief. Faced with this therapeutic limitation, acupuncture emerges as a promising alternative, but questions remain about which combination of acupuncture points would maximize treatment efficacy.

The primary objective of this study was to investigate which combination of acupuncture points would be most effective in the treatment of gastroparesis, specifically comparing the effects of different point selection strategies. The researchers conducted a randomized controlled clinical trial at three medical centers in China, involving 99 patients diagnosed with gastroparesis. Participants were randomly divided into three groups: Group A received acupuncture at Zhongwan and Zusanli (combination of local point and distal point), Group B was treated with Neiguan and Zusanli (combination of distal point and distal point), and Group C received treatment at a sham point (non-acupoint) along with Zusanli, serving as the control. The treatment consisted of daily 30-minute sessions for five days, with two-day intervals between cycles, totaling three complete treatment cycles.

Results demonstrated that all groups showed significant improvement in symptoms after treatment, but Group A showed the best results. Gastroparesis Cardinal Symptom Index scores decreased significantly in all groups after treatment and during the four-week follow-up period, with the most pronounced reduction in Group A, followed by Group B and lastly Group C. Specifically, efficacy rates after treatment were 48.48% for Group A, 30.30% for Group B, and only 12.12% for Group C. During the follow-up period, these rates increased to 93.94%, 90.91%, and 78.79%, respectively.

Symptoms such as early satiety, gastric distension, and postprandial fullness showed more significant improvement in Groups A and B compared with Group C. All groups showed improvement in gastric emptying, demonstrated by a significant reduction in the number of barium markers remaining in the stomach, with no statistically significant differences between groups.

The clinical implications of this study are relevant for both patients and health professionals. For patients with gastroparesis, the results indicate that acupuncture is an effective and safe therapeutic option, offering significant symptom relief without the common side effects of conventional medications. The combination of Zhongwan (located in the upper abdomen) with Zusanli (located on the leg) proved to be the most effective, suggesting that point selection based on anatomical location is a crucial factor for optimizing results. For practitioners, the study provides robust scientific evidence on the importance of adequate acupuncture point selection, demonstrating that the combination of a local point (close to the affected organ) with a distal point produces better results than other combinations.

This may guide more standardized and effective treatment protocols.

The study has some important limitations that should be considered. Due to the nature of acupuncture, it was not possible to keep patients completely blinded to treatment, which may have influenced the subjective perception of symptoms. In addition, the four-week follow-up period, although it showed maintenance of benefits, may be insufficient to evaluate long-term effects. The sample size, although adequate to detect significant differences, could be larger to increase statistical robustness.

Despite these limitations, the study contributes significantly to the field of acupuncture by scientifically demonstrating that point selection based on anatomical location is fundamental to maximize therapeutic efficacy, establishing a solid basis for future protocols for the treatment of gastroparesis with acupuncture.