Potential Mechanisms of Acupuncture for Functional Dyspepsia Based on Pathophysiology.

Na-Na Yang,Cun-Zhi Liu,Yue-Jie Li,Yu Wang,Lu-Lu Lin,Xin-Tong Su,Ling-Yu Qi,Jing-Wen Yang,Chun-Xia Tan

doi:10.3389/fnins.2021.781215

Na-Na Yang, Cun-Zhi Liu + Show 7 more

Open Access

https://doi.org/10.3389/fnins.2021.781215

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Abstract

Functional dyspepsia (FD), a common disorder of gastrointestinal function, originated from the gastroduodenum. Although the therapeutic effect of acupuncture has been investigated by various high-quality randomized controlled trials, the potential mechanisms showed obvious heterogeneity. This review summarized the potential mechanisms of acupuncture on FD in order to guide for future laboratory and clinical studies. Here, we argued that the primary cause of FD was gastroduodenal low-grade inflammation and acid exposure, which impaired mucosal integrity, caused brain-gut axis dysfunction, and impaired brain network connectivity, all of which generated various symptom patterns. Overall the clinical studies indicated that acupuncture was a promising treatment to alleviate symptoms in FD patients, whose efficacy was influenced by acupoints and individual variance. Mechanistically, studies with animal models of FD and patients have shown that acupuncture, a non-invasive strategy for nerve stimulation, may have the potential to control intestinal inflammation and suppress acid-secretion via different somatic autonomic reflex pathways, regulate the brain-gut axis through intestinal microbiota, and has the potential to ameliorate FD-symptoms. The cumulative evidence demonstrated that acupuncture is a promising treatment to alleviate symptoms of FD patients.

Highlights

Functional dyspepsia (FD), a chronic functional gastrointestinal disorder (FGID), is characterized by upper abdominal symptoms without any organic, systemic, or metabolic diseases (Vanheel and Farré, 2013)
We argued that the primary cause of FD was gastroduodenal low-grade inflammation and acid exposure, which impaired mucosal integrity, caused brain-gut axis dysfunction, and impaired brain network connectivity, all of which generated various symptom patterns
Overall the clinical studies indicated that acupuncture was a promising treatment to alleviate symptoms in FD patients, whose efficacy was influenced by acupoints and individual variance

Summary

Introduction

Functional dyspepsia (FD), a chronic functional gastrointestinal disorder (FGID), is characterized by upper abdominal symptoms without any organic, systemic, or metabolic diseases (Vanheel and Farré, 2013). The prevalence of FD worldwide has reached 15–20% in 2015 and was markedly increased by 1% annually per year, the bulk of FD patients did not seek medical advice (Tack and Talley, 2013). Acupuncture, in use for the past 3,000 years, is a valuable therapy to improve gastrointestinal symptoms (Zhang et al, 2014). Acupuncture improved gastrointestinal dysmotility (Yang et al, 2021) and suppressed visceral pain and acid secretion (Song G. et al, 2019), all of which implied that acupuncture may be conducive for patients with FGID. Concomitant with the increasing use of acupuncture, related mechanisms have been increasingly accumulated and gradually performed. It’s time to summarize the efficacy and potential mechanisms of acupuncture on FD to guide future laboratory and clinical studies

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Conclusion