Summary
Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients’ psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient’s anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics, 2005, 23(5):461–476
Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology, 2006, 130(5): 1480–1491
Sun SX, Dibonaventura M, Purayidathil FW, et al. Impact of chronic constipation on health-related quality of life, work productivity, and healthcare resource use: an analysis of the national health and wellness survey. Dig Dis Sci, 2011, 56(9):2688–2695
Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol, 2004, 99(4):750–759
Riezzo G, Orlando A, D’Attoma B, et al. Randomised clinical trial: efficacy of Lactobacillus paracasei-enriched artichokes in the treatment of patients with functional constipation-a double-blind, controlled, crossover study. Aliment Pharmacol Ther, 2012, 35(4):441–450
Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut, 2011, 60(2):209–218
Dong Z, Sun Y, Lu P, et al. Electroacupuncture and lumbar transplant of GDNF-secreting fibroblasts synergistically attenuate hyperalgesia after sciatic nerve constriction. Am J Chin Med, 2013, 41(3):459–472
Napadow V, Makris N, Liu J, et al. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp, 2005, 24(3):193–205
Li M, Peng J, Song Y, et al. Electro-acupuncture combined with transcranial magnetic stimulation improves learning and memory function of rats with cerebral infarction by inhibiting neuron cell apoptosis. J Huazhong Univ Sci Technolog Med Sci, 2012, 32(5):746–749
Zeng Q, Li M, Ouyang X, et al. Effect of electroacupuncture on reperfusion ventricular arrhythmia in rat. J Huazhong Univ Sci Technolog Med Sci, 2006, 26(3):269–271
Zhao L, Shi J, Sun N, et al. Effect of electroacupuncture on TRPM7 mRNA expression after cerebral ischemia/reperfusion in rats via TrkA pathway. J Huazhong Univ Sci Technolog Med Sci, 2005, 25(3):247–250
Ouyang H, Chen JD. Review article: therapeutic roles of acupuncture in functional gastrointestinal disorders. Aliment Pharmacol Ther, 2004, 20(8):831–841
Broide E, Pintov S, Portnoy S, et al. Effectiveness of acupuncture for treatment of childhood constipation. Dig Dis Sci, 2001, 46(6):1270–1275
Chesterton LS, Foster NE, Wright CC, et al. Effects of TENS frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects. Pain, 2003, 106(1–2):73–80
Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption: a meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain, 2003, 7(2):181–188
Olsén MF, Elden H, Janson ED, et al. A comparison of high-versus low-intensity, high-frequency transcutaneous electric nerve stimulation for painful postpartum uterine contractions. Acta Obstet Gynecol Scand, 2007, 86(3):310–314
Barlas P, Ting SL, Chesterton LS, et al. Effects of intensity of electroacupuncture upon experimental pain in healthy human volunteers: A randomized, double-blind, placebo-controlled study. Pain, 2006, 122(1–2):81–89
Li Y, Zheng H, Zeng F, et al. Use acupuncture to treat functional constipation: study protocol for a randomized controlled trial. Trials, 2012, 13:104–111
Baxter GS, Craig DA, Clarke DE. 5-Hydroxytryptamine4 receptors mediate relaxation of the rat oesophageal tunica muscularis mucosae. Naunyn Schmiedebergs Arch Pharmacol, 1991, 343(5):439–446
Mader R, Kocher T, Haier J, et al. Investigation of serotonin type 4 receptor expression in human and non-human primate gastrointestinal samples. Eur J Gastroenterol Hepatol, 2006, 18(9):945–950
McLean PG, Coupar IM. Stimulation of cyclic AMP formation in the circular smooth muscle of human colon by activation of 5-HT4-like receptors. Br J Pharmacol, 1996, 117(2):238–239
Sakurai-Yamashita Y, Yamashita K, Yoshimura M, et al. Differential localization of 5-hydroxytryptamine3 and 5-hydroxytryptamine4 receptors in the human rectum. Life Sci, 2000, 66(1):31–34
Sun Y, Li XY, Yao LY, et al. Investigation of attention via the counting Stroop task in patients with functional constipation. Chin Med J, 2012, 125(3):486–490
Merkel IS, Locher J, Burgio K, et al. Physiologic and psychologic characteristics of an elderly population with chronic constipation. Am J Gastroenterol, 1993, 88(11): 1854–1859
Gue M, Junien JL, Bueno L. Conditioned emotional response in rats enhances colonic motility through the central release of corticotropin-releasing factor. Gastroenterology, 1991, 100(4):964–970
Chattat R, Bazzocchi G, Balloni M, et al. Illness behavior, affective disturbance and intestinal transit time in idiopathic constipation. J Psychosom Res, 1997, 42(1):95–100
Brummett BH, Kuhn CM, Boyle SH, et al. Cortisol responses to emotional stress in men: association with a functional polymorphism in the 5HTR2C gene. Biol Psychol, 2012, 89(1):94–98
Rosmond R. Role of stress in the pathogenesis of the metabolic syndrome. Psychoneuroendocrinology, 2005, 30(1): 1–10
Kim JG, Jung HS, Kim KJ, et al. Basal blood corticosterone level is correlated with susceptibility to chronic restraint stress in mice. Neurosci Lett, 2013, 555:137–142
Kumari M, Badrick E, Sacker A, et al. Identifying patterns in cortisol secretion in an older population. Findings from the Whitehall II study. Psychoneuroendocrinology, 2010, 35(7):1091–1099
Hamer M, Endrighi R, Venuraju SM, et al. Cortisol responses to mental stress and the progression of coronary artery calcification in healthy men and women. PLoS One, 2012, 7(2):e31356
Gong S, Ding J, Chang Q. The expression of VIP and SP in the cochlea of spontaneously hypertensive rats and its implication. J Huazhong Univ Sci Technolog Med Sci, 2004, 24(4):396–399
Datar P, Srivastava S, Coutinho E, et al. Substance P: structure, function, and therapeutics. Curr Top Med Chem, 2004, 4(1):75–103
De Felipe C, Herrero JF, O’Brien JA, et al. Altered nociception, analgesia and aggression in mice lacking the receptor for substance P. Nature, 1998, 392(6674):394–397
Ebner K, Singewald N. The role of substance P in stress and anxiety responses. Amino Acids, 2006, 31(3):251–272
Hutson JM, Chow CW, Hurley MR, et al. Deficiency of substance P-immunoreactive nerve fibres in children with intractable constipation: a form of intestinal neuronal dysplasia. J Paediatr Child Health, 1997, 33(3):187–189
Hutson JM, Chow CW, Borg J. Intractable constipation with a decrease in substance P-immunoreactive fibres: is it a variant of intestinal neuronal dysplasia? J Pediatr Surg, 1996, 31(4):580–583
Tomita R. Regulation of the peptidergic nerves (substance P and vasoactive intestinal peptide) in the colon of women patients with slow transit constipation: an in vitro study. Hepatogastroenterology, 2008, 55(82–83):500–507
Liu L, Shang F, Morgan MJ, et al. Cyclooxygenase-dependent alterations in substance P-mediated contractility and tachykinin NK1 receptor expression in the colonic circular muscle of patients with slow transit constipation. J Pharmacol Exp Ther, 2009, 329(1):282–289
King SK, Sutcliffe JR, Ong SY, et al. Substance P and vasoactive intestinal peptide are reduced in right transverse colon in pediatric slow-transit constipation. Neurogastroenterol Motil, 2010, 22(8):883–892
Said SI, Mutt V. Polypeptide with broad biological activity: isolation from small intestine. Science, 1970, 169(3951): 1217–1218
Said SI, Mutt V. Potent peripheral and splanchnic vasodilator peptide from normal gut. Nature, 1970, 225(5235): 863–864
Qiao Y, Fang JG, Xiao J, et al. Effect of baicalein on the expression of VIP in extravillous cytotrophoblasts infected with human cytomegalovirus in vitro. J Huazhong Univ Sci Technolog Med Sci, 2013, 33(3):406–411
Cortesini C, Cianchi F, Infantino A, et al. Nitric oxide synthase and VIP distribution in enteric nervous system in idiopathic chronic constipation. Dig Dis Sci, 1995, 40(11):2450–2455
Han B. Correlation between gastrointestinal hormones and anxiety-depressive states in irritable bowel syndrome. Ther Med, 2013, 6(3):715–720
Shen GM, Zhou MQ, Xu GS, et al. Role of vasoactive intestinal peptide and nitric oxide in the modulation of electroacupucture on gastric motility in stressed rats. World J Gastroenterol, 2006, 12(38):6156–6160
Author information
Authors and Affiliations
Corresponding author
Additional information
This project was supported by the National Basic Research Program of China (973 Program) (No. 2011CB505203).
Rights and permissions
About this article
Cite this article
Xiong, F., Wang, Y., Li, Sq. et al. Clinical study of electro-acupuncture treatment with different intensities for functional constipation patients. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 34, 775–781 (2014). https://doi.org/10.1007/s11596-014-1351-8
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-014-1351-8