Review Article

Central and Peripheral Mechanism of Acupuncture Analgesia on Visceral Pain: A Systematic Review

Table 2

Overview of visceral pain studies on humans.

Author
(year)
Participants group:n(f)/
mean age
Acupuncture groupsControl groupsOutcomesResults
Acupunctureacupoints
number, duration
Control acupoints
number, duration

(1) Thomas et al. (1995) [17]Primary dysmenorrhea
Acu: 17(17)/30.4
Con: 12(12)/27.8
(a) MA
(b) EA (2Hz)
(c) EA (100Hz)
(d) Periosteal stimulation
(e) acu-TENS (2Hz)
(f) acu-TENS (100Hz)
(a), (b), (c), (d): BL32, CV4, SP6, 9
(e), (f): Spinous processes Thoracic 10-Lumbar 1
2, 20min
(g) Sham TENS (ns)Spinous processes Thoracic 10-Lumbar 1
2, 20min
(1) Blood loss
(2) Vomiting
(3) Work hours lost
(4) Tablet intake
(5) Subjective assessment
(6) Total pain
Within group
(4), (5), (6) (a), (c), (d) improved
(5), (6) (b) improved
(4), (5), (6) (e) improved
(2) Kotani et al. (2001) [19](1) Upper abdominal surgery
(A) 50(21)/52
(C) 48(18)/55
(2) Lower abdominal surgery
(B) 39(12)/55
(D) 38(13)/55
(A) Patient 1 +MA
(B) Patient 2 +MA
(A) BL18, 19, 20, 21, 22, 23, 24
(B) BL20, 21, 22, 23, 24, 25, 26
1, 4 days
(C) Patient 1+sham MA (ni)
(D) Patient 2+sham MA (ni)
(C) BL18, 19, 20, 21, 22, 23, 24
(D) BL20, 21, 22, 23, 24, 25, 26
1, 4 days
(1) Incisional, visceral pain
(2) Drowsiness
(3) Pruritus
(4) Nausea/Vomiting
(5) Adequacy of pain treatment
(6) Morphine intake
(7) Adrenal hormone
Within group
(1) (A), (C) improved
(6) (A), (B), (C), (D) decreased
Between groups
(1), (4), (6), (7) (epinephrine, cortisol) (A)<(C), (B)<(D)
(3) Xing et al. (2004) [16]IBS
+rectal distention
7(6)/44
(a) acu-TENS (5Hz, 250ms)(a) ST36, PC6
1, -
(b) TENS (5Hz, 250ms)(b) non-acupoint
1, -
(1) Rectal tone
(2) Rectal compliance
(3) Rectal perception of gas, pain, desire to defecate
Within group
(1) (A), (B) decreased
(3) (A) decreased
Between groups
(3) (A)<(B)
(4) Chu et al. (2012) [15]IBS
+rectal distention
(A) 15(7)/42.3
(B) 15(8)/44.2
(A) EA (10Hz, 0.5ms, 60v)(A) ST36, 37, SP6
2, 30min
(B) Sham EA (ns)(B) ST36, 37, SP6
2, 30min
(1) fMRI-rectal distention
(2) fMRI-A or B +rectal distention
(3) fMRI-rectal distention after (2)
(4) fMRI-A or B
(5) Rectal sensation
Within group
(1) (A), (B): ACC, pgCC, PFC, TH, INS, cerebellum, Temp
(A): (1)<(2) pgCC, ACC, PFC, SC, INS, Temp
(1)<(3) PFC, SC, Temp
(3)<(2) ACC, PFC, TH, INS, Temp
(B): (2)>(1) ACC, PFC, SC
(3)>(1) PFC, Temp, cerebellum
(2)>(3) Temp
(3)>(2) PFC
Between groups
(A)>(B): (2)>(1) in TH, INS
Correlation between (5) and brain activation in hypothalamus, TH, INS
(5) Leung et al. (2013) [20]Healthy
+rectal distention
(A) 20(12)/53.4
(B) 20(12)/53.9
(A) acu-TENS (2Hz, 0.2ms)(A) LI4, PC6, ST36
1, 45min
(B) Sham TENS (ns)(B) LI4, PC6, ST36
1, 45min
(1) Tolerance to rectal sensation
(2) Rectal distention pressure
(3) Beta-endorphin
Between groups
(1), (2), (3) (B)<(A)
(6) Juel et al. (2016) [21]Healthy
+rectal distention
15(8)/27.6
(a) MA(a) CV4, 6, 7, 9, 10, 12, ST25, 26, 37, LI4 +non-acupoints
1, 30min
(b) Sham MA (ni)(b) ST37, LI4
1, 30min
(1) Rectal distention volume
(2) Rectal pain
(3) EEG
Within groups
(1) (A), (B) increased
(7) Juel et al. (2017) [18]Chronic pancreatitis
15(7)/61.8
(a) MA(a) CV4, 6, 9, 10, 12, ST25, ST36, SP6, 8, 9, 15+non-acupoints
1, -
(b) Sham MA (ni)(b) CV4, 6, 9, 10, 12, ST25, ST36, SP6, 8, 9, 15+non-acupoints
1, -
(1) Reduced pain score
(2) EEG
Between groups
(1) (B)<(A)

Group written in lowercase letters (e.g., (a), (b), and (c)): different treatments in the same population, unless stated otherwise; Group written in capital letters (e.g., (A), (B), and (C)): different treatments in different population
Acu: acupuncture group; ACC: anterior cingulate cortex; BL: Bladder Meridian; Con: control group; CV: Conception Vessel Meridian; EA: electro-acupuncture; EEG: electroencephalography; f: female; fMRI: functional magnetic resonance imaging; IBS: irritable bowel syndrome; INS: insula; LI: Large Intestine Meridian; MA: manual acupuncture; n: number; ni: not inserted; ns: not stimulated; PC: Pericardium Meridian; PFC: prefrontal cortex; pgCC: perigenual cingulate cortex; SC: somatosensory cortex; SP: Spleen Meridian; ST: Stomach Meridian; Temp: temporal lobes; TH: thalamus; (acu-)TENS: Transcutaneous electrical nerve stimulation (on acupoints); min: minutes; ms: milliseconds; v: volts.