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Normalization Effect of Both ST36 and CV11, 12, 13 Meridian Points on the Abnormal Gastric Myoelectrical Activity in Two Cases of Functional Dyspeptic Patients

족삼리와 상완, 중완, 하완혈의 침 자극으로 기능성 소화불량증 환자의 위 평활근 전기적 활성 장애를 정상화시켰던 증례 2례

  • Yoon, Sang-Hyub (Dept. of Gastroenterology, College of Korean Medicine, Kyung-Hee University)
  • 윤상협 (경희대학교 한의과대학 비계내과학교실)
  • Received : 2021.08.09
  • Accepted : 2021.10.08
  • Published : 2021.09.30

Abstract

Objectives: The aim of this study was to introduce the normalization effects of stimulation of both ST36 and CV11, 12, 13 meridian points on the abnormal gastric myoelectrical activity in two cases of functional dyspeptic patients with gastric dysmotility. Methods: Gastric myoelectrical activity was recorded by electrogastrography every two weeks until their gastric myoelectrical activity finally reached the normality. Dominant frequency of gastric slow waves in the fasting and postprandial periods and a dominant power ratio were obtained on each occasion. Patients were treated three times each day: 9 am, 1 pm, and 7 pm. The first treatment consisted of manual and immersion stimulation on all used meridian points for 20 min. In the second and third treatments, electrical stimulation of both ST36 was added. It was conducted for 20 min at a strength intensity of 1.2 times the pain threshold at a frequency of 3 Hz. Results: Stimulation of the above meridian points normalized abnormal gastric myoelectrical activity. The time taken to return from abnormal gastric myoelectrical activity to normal was 16-19 weeks. Conclusion: Stimulation of both ST36 and CV11, 12, 13 meridian points normalized the abnormal gastric myoelectrical activity in the functional dyspepsia of gastric dysmotility.

Keywords

References

  1. Guo Y, Wei W, Chen JD. Effects and mechanisms of acupuncture and electroacupuncture for functional dyspepsia: A systematic review. World J Gastroenterol 2020;26(19):2440-57. https://doi.org/10.3748/wjg.v26.i19.2440
  2. Wang YP, Herndon CC, Lu CL. Non-pharmacological Approach in the Management of Functional Dyspepsia. J Neurogastroenterol Motil 2020;26(1):6-15. https://doi.org/10.5056/jnm19005
  3. Masuy I, Van Oudenhove L, Tack J. Treatment options for functional dyspepsia. Aliment Pharmacol Ther 2019;49(9):1134-72 https://doi.org/10.1111/apt.15191
  4. Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. Korean J Intern Med 2016;31(3):444-56. https://doi.org/10.3904/kjim.2016.091
  5. Min YW. The Implication of Gastric Dysmotility in the Pathophysiology of Functional Dyspepsia. J Neurogastroenterol Motil 2017;23(3):323-4. https://doi.org/10.5056/jnm17072
  6. Hunt RH, Camilleri M, Crowe SE, El-Omar EM, Fox JG, Kuipers EJ, et al. The stomach in health and disease. Gut 2015;64(10):1650-68. https://doi.org/10.1136/gutjnl-2014-307595
  7. Smout AJ, van der Schee EJ, Grashuis JL. What is measured in electrogastrography? Dig Dis Sci 1980;25(3):179-87. https://doi.org/10.1007/BF01308136
  8. Lin X, Chen JZ. Abnormal gastric slow waves in patients with functional dyspepsia assessed by multichannel electrogastrography. Am J Physiol Gastrointest Liver Physiol 2001;280(6):G1370-5. https://doi.org/10.1152/ajpgi.2001.280.6.g1370
  9. Lee KJ, Kim JH, Cho SW. Dietary influence on electro-gastrography and association of alterations in gastric myoelectrical activity with symptoms in patients with functional dyspepsia. J Gastroenterol Hepatol 2006;21(1):59-64. https://doi.org/10.1111/j.1440-1746.2005.04088.x
  10. Lim HC, Lee SI, Chen JD, Park H. Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia. World J Gastroenterol 2012;18(41):5948-56. https://doi.org/10.3748/wjg.v18.i41.5948
  11. Kim JY, Lee JY, Yoon SH. Effect of Naesohwajung-tang on electrogastrography in children with functionl dyspepsia. J Korean Oriental Pediatrics 2002;16(2):199-213.
  12. Ha NY, Kim S, Ko SJ, Park JW, Kim J. A clinical study on safety and efficacy of Naesohwajung-tang on functional dyspepsia. Medicine (Baltimore) 2020;99(21):e19910. https://doi.org/10.1097/MD.0000000000019910
  13. Ryu JM, Yoon SH, Jang SY, Kim HK, Lee JS, Lee SY, et al. Effects of traditional korean medical therapy on gastric myoelectrical activity in patients with functional dyspepsia. The Journal of Internal Korean Medicine 2005;26(2):360-8.
  14. Lin X, Liang J, Ren J, Mu F, Zhang M, Chen JD. Electrical stimulation of acupuncture points enhances gastric myoelectrical activity in humans. Am J Gastroenterol 1997;92(9):1527-30.
  15. Xu F, Tan Y, Huang Z, Zhang N, Xu Y, Yin J. Ameliorating Effect of Transcutaneous Electroacupuncture on Impaired Gastric Accommodation in Patients with Postprandial Distress Syndrome-Predominant Functional Dyspepsia: A Pilot Study. Evid Based Complement Alternat Med 2015;2015:168252.
  16. Yoon SH. Postprandial Epigastric Fullness and Pyloric Valve Disturbance in Patients with Functional Dyspepsia; Analysis of Bowel Sounds and Electrogastrography. J Int Korean Med 2007;28(4):769-78.
  17. 김현제, 최용태, 임종국, 이윤호(공역). 최신침구학. 서울: 성보사; 1979, p. 190, 191, 264, 307.
  18. Lux G, Hagel J, Backer P, Backer G, Vogl R, Ruppin H, et al. Acupuncture inhibits vagal gastric acid secretion stimulated by sham feeding in healthy subjects. Gut 1994;35(8):1026-9. https://doi.org/10.1136/gut.35.8.1026
  19. Li H, He T, Xu Q, Li Z, Liu Y, Li F, et al. Acupuncture and regulation of gastrointestinal function. World J Gastroenterol 2015;21(27):8304-13. https://doi.org/10.3748/wjg.v21.i27.8304
  20. Lin X, Levanon D, Chen JD. Impaired postprandial gastric slow waves in patients with functional dyspepsia. Dig Dis Sci 1998;43(8):1678-84. https://doi.org/10.1023/A:1018806913907
  21. Lin Z, Eaker EY, Sarosiek I, McCallum RW. Gastric myoelectrical activity and gastric emptying in patients with functional dyspepsia. Am J Gastroenterol 1999;94(9):2384-9. https://doi.org/10.1016/S0002-9270(99)00418-9
  22. Yin J, Chen JD. Electrogastrography: methodology, validation and applications. J Neurogastroenterol Motil 2013;19(1):5-17. https://doi.org/10.5056/jnm.2013.19.1.5
  23. Long QL, Fang DC, Shi HT, Luo YH. Gastro-electric dysrhythm and lack of gastric interstitial cells of cajal. World J Gastroenterol 2004;10(8): 1227-30. https://doi.org/10.3748/wjg.v10.i8.1227
  24. Wang TH, Angeli TR, Ishida S, Du P, Gharibans A, Paskaranandavadivel N, et al. The influence of interstitial cells of Cajal loss and aging on slow wave conduction velocity in the human stomach. Physiol Rep 2021;8(24):e14659.
  25. Sanders KM, Ordog T, Koh SD, Torihashi S, Ward SM. Development and plasticity of interstitial cells of Cajal. Neurogastroenterol Motil 1999; 11(5):311-38. https://doi.org/10.1046/j.1365-2982.1999.00164.x
  26. Pasternak A, Szura M, Gil K, Matyja A. Interstitial cells of Cajal: systematic review. Folia Morphol (Warsz) 2016;75(3):281-6. https://doi.org/10.5603/FM.a2016.0002
  27. Peng MF, Li K, Wang C, Zhu XY, Yang Z, Zhang GH, et al. Therapeutic effect and mechanism of electroacupuncture at Zusanli on plasticity of interstitial cells of Cajal: a study of rat ileum. BMC Complement Altern Med 2014;14:186. https://doi.org/10.1186/1472-6882-14-186
  28. Zhang CC, Lin YP, Peng Y, Yue ZH, Chen HJ, Yang JW, et al. Effects of Electroacupuncture on Ultrastructure of Interstitial Cells of Cajal and Stem Cell Factor-kit Signal Pathway of Gastric Antrum in Diabetic Gastroparesis Rats. Zhen Ci Yan Jiu 2017;42(6):482-8.
  29. Liu M, Zhang S, Gai Y, Xie M, Qi Q. Changes in the Interstitial Cells of Cajal and Immunity in Chronic Psychological Stress Rats and Therapeutic Effects of Acupuncture at the Zusanli Point (ST36). Evid Based Complement Alternat Med 2016;2016:1935372.
  30. Deng JJ, Lai MY, Tan X, Yuan Q. Acupuncture protects the interstitial cells of Cajal by regulating miR-222 in a rat model of post-operative ileus. Acupunct Med 2019;37(2):125-32. https://doi.org/10.1177/0964528419829755
  31. Zhang G, Xie S, Hu W, Liu Y, Liu M, Liu M, et al. Effects of Electroacupuncture on Interstitial Cells of Cajal (ICC) Ultrastructure and Connexin 43 Protein Expression in the Gastrointestinal Tract of Functional Dyspepsia (FD) Rats. Med Sci Monit 2016;22:2021-7. https://doi.org/10.12659/msm.899023
  32. Wang JJ, Ming Q, Liu XD, Huang YX, Chen LW, Qiu JY, et al. Electro-acupuncture of Foot YangMing regulates gastric activity possibly through mediation of the dorsal vagal complex. Am J Chin Med 2007;35(3):455-64. https://doi.org/10.1142/S0192415X07004977
  33. Lu CL, Montgomery P, Zou X, Orr WC, Chen JD. Gastric myoelectrical activity in patients with cervical spinal cord injury. Am J Gastroenterol 1998;93(12):2391-6. https://doi.org/10.1016/S0002-9270(98)00574-7
  34. Yu Z, Cao X, Xia Y, Ren B, Feng H, Wang Y, et al. Electroacupuncture Stimulation at CV12 Inhibits Gastric Motility via TRPV1 Receptor. Evid Based Complement Alternat Med 2013;2013:294789.
  35. Chen JZ, Lu MJ, Han X, Xu B, Yu Z. Influence of electroacupuncture of "Zhongwan" (CV12) and "Zusanli" (ST36) in different combinations of stimulating strength and sequence on intragastric pressure in normal rats. Zhen Ci Yan Jiu 2019;44(2):125-30.
  36. Borrelli O, Salvia G, Mancini V, Santoro L, Tagliente F, Romeo EF, et al. Evolution of gastric electrical features and gastric emptying in children with Duchenne and Becker muscular dystrophy. Am J Gastroenterol 2005;100(3):695-702. https://doi.org/10.1111/j.1572-0241.2005.41303.x
  37. Yoon SH. Familial Gastric Dysmotility in Monozygotic Twins with Functional Dyspepsia and Their Mothers and the Effect of Korean Traditional Medicine on Symptoms and Gastric Dysmotility in Twins. Korean J Orient Int Med 2018;39(4):772-83. https://doi.org/10.22246/jikm.2018.39.4.772
  38. Usai-Satta P, Bellini M, Morelli O, Geri F, Lai M, Bassotti G. Gastroparesis: New insights into an old disease. World J Gastroenterol 2020;26(19):2333-48. https://doi.org/10.3748/wjg.v26.i19.2333
  39. Friesen CA, Lin Z, Hyman PE, Andre L, Welchert E, Schurman JV, et al. Electrogastrography in pediatric functional dyspepsia: relationship to gastric emptying and symptom severity. J Pediatr Gastroenterol Nutr 2006;42(3):265-9. https://doi.org/10.1097/01.mpg.0000189367.99416.5e
  40. Gharibans AA, Coleman TP, Mousa H, Kunkel DC. Spatial Patterns From High-Resolution Electrogastrography Correlate With Severity of Symptoms in Patients With Functional Dyspepsia and Gastroparesis. Clin Gastroenterol Hepatol 2019;17(13):2668-77. https://doi.org/10.1016/j.cgh.2019.04.039