title: Acupuncture for functional dyspepsia.
abstract: BACKGROUND
  Functional dyspepsia (FD) has been a worldwide complaint. More effective therapies are needed with fewer adverse effects than are seen with conventional medications. Acupuncture, as a traditional therapeutic method, has been widely used for functional gastrointestinal disorders in the East. Manual acupuncture and electroacupuncture have been recognized treatments for FD, but to date, no robust evidence has been found for the effectiveness and safety of these interventions in the treatment of this condition.
  
  
  OBJECTIVE
  This review was conducted to assess the efficacy and safety of manual acupuncture and electroacupuncture in the treatment of FD.
  
  
  METHODS
  Trials meeting the inclusion criteria were identified through electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Allied and Complementary Medicine Database (AMED), Chinese Biology Medicine Disc (CBMdisc), China National Knowledge Infrastructure (CNKI), the Wanfang Database, the VIP Database, and six trial registries. Handsearching was done to screen the reference sections of potential trials and reviews.
  
  
  METHODS
  Randomized controlled trials (RCTs) were included if investigators reported efficacy and safety of manual acupuncture or electroacupuncture for patients with FD diagnosed by Rome II or Rome III criteria, compared with medications, blank control, or sham acupuncture.
  
  
  METHODS
  Data were extracted by independent review authors. Study limitations were assessed by using the tool of The Cochrane Collabration for assessing risk of bias. For dichotomous data, risk ratios (RRs) and 95% confidence intervals (95% CIs) would be applied, and for continuous data, mean differences (MDs) and 95% CIs. A fixed-effect model was applied in the meta-analysis, or a descriptive analysis was performed. The quality of evidence for the outcome measure was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods.
  
  
  RESULTS
  Seven studies were included in the review, involving 542 participants with FD (212 males and 330 females). These studies generally had an unclear risk of bias based on inadequate descriptions of allocation concealment and a high risk of bias based on lack of blinding. None of the studies reported on outcomes of the Functional Digestive Disorder Quality of Life questionnaire (FDDQL), the Satisfaction With Dyspepsia Related Health scale (SODA), the Digestive Health Status Instrument (DHSI), or effective/inefficient rate and symptom recurrence six months from completion of acupuncture treatment.Four RCTs of acupuncture versus medications (cisapride, domperidone, and itopride) were included in the review. No statistically significant difference was noted in the reduction in FD symptom scores and the frequency of FD attack by manual acupuncture, manual-electroacupuncture, or electroacupuncture compared with medications. In three trials of acupuncture versus sham acupuncture, all descriptive or quantitative analysis results implied that acupuncture could improve FD symptom scores and scores on the Neck Disability Index (NDI), the 36-Item Short Form Health Survey (SF-36), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) more or as significantly as sham acupuncture. With regard to adverse effects, acupuncture was superior to cisapride treatment (one study; all minor events), but no statistically significant difference was reported between acupuncture and sham acupuncture. No adverse effects data were reported in studies examining manual acupuncture versus domperidone, manual-electroacupuncture versus domperidone, or electroacupuncture versus itopride.Nevertheless, all evidence was of low or very low quality. The body of evidence identified cannot yet permit a robust conclusion regarding the efficacy and safety of acupuncture for FD.
  
  
  CONCLUSIONS
  It remains unknown whether manual acupuncture or electroacupuncture is more effective or safer than other treatments for patients with FD.
authors.affiliation: Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, 37 shi-er-qiao Road, Chengdu, Sichuan, China, 610075.
authors.forename: Lei
authors.initials: L
authors.lastname: Lan
authors.forename: Fang
authors.initials: F
authors.lastname: Zeng
authors.forename: Guan J
authors.initials: GJ
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Ying
authors.forename: Xi
authors.initials: X
authors.lastname: Wu
authors.forename: Mailan
authors.initials: M
authors.lastname: Liu
authors.forename: Fan-Rong
authors.initials: FR
authors.lastname: Liang
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods*; D001549:Benzamides / Q000009:adverse effects / Q000627:therapeutic use; D001593:Benzyl Compounds / Q000009:adverse effects / Q000627:therapeutic use; D020117:Cisapride / Q000009:adverse effects / Q000627:therapeutic use; D004294:Domperidone / Q000009:adverse effects / Q000627:therapeutic use; D004415:Dyspepsia / Q000628:therapy*; D015671:Electroacupuncture / Q000379:methods; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D001549:Benzamides; D001593:Benzyl Compounds; D005765:Gastrointestinal Agents; D004294:Domperidone; C102254:itopride; D020117:Cisapride