title: Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial.
abstract: BACKGROUND
  Whether subgroups of functional dyspepsia (FD) should be treated with different approaches is controversially discussed in research. As our previous study has demonstrated the effect of acupuncture in FD treatment, we now further analyze the therapeutic effect of acupuncture in the treatment of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).
  
  
  METHODS
  A retrospective analysis was conducted in 465 eligible PDS patients and 241 EPS patients. 4 acupuncture groups (group A: specific acupoints along the stomach meridian; group B: non-specific acupoints along the stomach meridian; group C: alarm and transport acupoints; group D: specific acupoints along the gallbladder meridian) were compared with a non-acupoint sham acupuncture group and an itopride group. The patients were treated in 5 consecutive sessions per week for 4 weeks and were followed-up for 12 weeks afterwards. Primary outcome of the study was defined as response rate and symptom improvement as measured by the Symptom Index of Dyspepsia, while secondary outcome was designated as improvement in quality of life (QoL) as determined by the Nepean Dyspepsia Index.
  
  
  RESULTS
  Symptoms of dyspepsia and QoL were improved from baseline in all groups. In EPS patients, no statistically significant differences could be observed in response rate (p = 0.239) and symptoms improvement (p = 0.344 for epigastric pain; p = 0.465 for epigastric burning). In contrast, PDS patients of the acupuncture group A showed higher response rate (53.2% vs. 19.7%, p<0.001; 53.2% vs. 35.1%, p = 0.025) and score change in postprandial fullness (1.01 vs. 0.27, p<0.001; 1.01 vs. 0.57, p<0.001), early satiation (0.81 vs. 0.21, p<0.001; 0.81 vs. 0.39, p=0.001), and QoL (14.5 vs. 4.33, p<0.001; 14.5 vs. 8.5, p<0.001) compared to the sham acupuncture and itopride group.
  
  
  CONCLUSIONS
  FD patients with PDS responded better to the acupuncture therapies, especially at the specific acupoints along the stomach meridian. The positive therapeutic effect of acupuncture on PDS was correlated with the improvement in postprandial fullness.
  
  
  BACKGROUND
  ClinicalTrial.gov NCT00599677.
authors.affiliation: Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Ma
authors.forename: Fang
authors.initials: F
authors.lastname: Zeng
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.forename: Chieh-Mei
authors.initials: CM
authors.lastname: Wang
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Tian
authors.forename: Shuyuan
authors.initials: S
authors.lastname: Yu
authors.forename: Ling
authors.initials: L
authors.lastname: Zhao
authors.forename: Xi
authors.initials: X
authors.lastname: Wu
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.forename: Dejun
authors.initials: D
authors.lastname: Wang
authors.forename: Fanrong
authors.initials: F
authors.lastname: Liang
mesh_terms: D015670:Acupuncture Therapy / Q000592:standards*; D004415:Dyspepsia / Q000145:classification / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome