Acupuncture to improve tolerance of diagnostic esophagogastroduodenoscopy in patients without systemic sedation: results of a single-center, double-blinded, randomized controlled trial (DRKS00000164)

A Scoping Review of Measures Utilized to Assess Patient Satisfaction with Acupuncture Treatments Within Randomized Controlled Trials

Objective

Patient satisfaction is an increasing priority for health care facilities in ensuring reimbursement for services, high-quality access to care, and transparent communication. Cumulatively, these metrics guide patient-centered care and facilitate optimal service delivery. The purpose of this scoping review was to evaluate measures of patient satisfaction with acupuncture treatments.

Materials and Methods

This scoping review was guided by the Arksey and O'Malley methodological framework. Analysis was performed based on the multidimensional hierarchical model of perceived service-quality conceptual framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was used to organize included publications and to display search processes in a flow diagram. An academic reference librarian conducted a literature search, using electronic databases that included PubMed,® Cumulative Index to Nursing and Allied Health Literature, EMBASE,® and Web of Science.

Results

A total of 384 publications were initially identified and screened; 26 met the eligibility criteria and were included in the synthesis. Discrepancies in the use of patient-satisfaction measures among studies were found in only 1 study demonstrating holistic assessment.

Conclusions

There is a need for consistent measurement of patient satisfaction with acupuncture treatments. Future studies may evaluate development of a satisfaction tool to measure patient satisfaction with acupuncture treatments comprehensively.

Acupuncture to Improve Patient Discomfort During Upper Gastrointestinal Endoscopy: Systematic Review and Meta-Analysis

Background and Aims

Severe discomfort during an upper gastrointestinal endoscopy (UGE) is often a stressful experience for patients undergoing the procedure. An increasing number of studies have shown that acupuncture may reduce discomfort during UGE. A systematic review in 2004 investigated the effect of acupuncture for gastrointestinal endoscopy, but these data have not been recently reviewed. Therefore, this study was conducted to evaluate the current evidence and provide up-to-date knowledge for clinical decision-making.

Methods

Nine databases were searched from inception to June 2021. Eligible randomized controlled trials (RCTs) were included. The outcome data were synthesized where necessary, and risks of bias of included studies were assessed using RevMan V.5.3.

Results

Twenty-three eligible RCTs with 3,349 patients were identified. It was found that acupuncture plus topical pharyngeal anesthesia with lidocaine hydrochloride (TPALH) resulted in greater improvements regarding visual analog scale (VAS) scores and the incidence of nausea and vomiting (INV) when compared with TPALH alone. These results were consistent among studies of manual acupuncture, electroacupuncture, auricular-plaster, superficial needle (SFN) and acupressure. In the meta-analysis, SFN plus TPALH showed significant improvement of VAS scores compared to sham SFN plus TPALH (MD -1.11, 95% CI -1.52 to -0.70, P < 0.00001). Most of included studies did not report any side effects in their findings, and were of medium-to-high risk of bias.

Conclusion

Acupuncture, as adjunctive therapy to TPA, may result in less patient discomfort than TPA alone. Findings from this review should be interpreted with caution due to the high heterogeneity identified. There is low-quality evidence supporting the use of acupuncture over sham. More rigorously designed RCTs are needed to inform clinical decision-making.

Systematic Review Registration

PROSPERO [CRD42014008966].

The cerebral mechanism of acupuncture for chronic insomnia with gastrointestinal disorder: protocol for a randomized controlled trial

Background

Many patients with chronic insomnia disorder (CID) have gastrointestinal (GI) symptoms. First-line insomnia medications do not treat GI problems. Acupuncture has a comprehensive regulative action on both CID and GI disorder and is receiving increasing attention. Recent studies indicate that both CID and GI diseases may cause abnormal brain activity. However, the neurological mechanism underlying the effect of acupuncture on such diseases is still unclear. The aim of this study is to explore the pathological mechanisms of CID with GI discomfort, as well as the main response characteristics of acupuncture treatment from multiple perspectives using multimodal magnetic resonance imaging (MRI).

Methods

A total of 60 participants with CID and GI disorders will be randomly divided into two groups (real acupuncture group and sham acupuncture group; ratio of 1:1). Patients will receive 20 sessions (five sessions per week) of real acupuncture treatment or sham acupuncture treatment. The primary outcome is the aggregate score on the Pittsburgh Sleep Quality Index. Secondary outcomes are scores on the Gastrointestinal Symptom Rating Scale, Self-Rating Anxiety Scale, and Self-Rating Depression Scale. Multimodal MRI scans and clinical assessments will be performed both at baseline and post-treatment. Another 30 age-, sex-, and education-matched healthy subjects will be recruited as controls and will receive MRI scans and clinical evaluations.

Discussion

This study aims to provide scientific evidence for the mechanism of acupuncture in treating CID with GI disorder using multimodal MRI imaging data on brain structure, function, and metabolism.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1800017092 (URL: http://www.chictr.org.cn/showproj.aspx?proj=27173). Registered on July 11, 2018.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05332-3.