In the western world an increasing number of patients, especially those with chronic diseases, are using complementary and alternative medicine.
Chinese textbooks describe a condition called Damp-Hot diarrhoea, which shares similar clinical symptoms with irritable bowel diarrhoea.
For the treatment of this disorder, Traditional Chinese Medicine (TCM) recommends acupuncture tailored to a detailed clinical diagnosis, including history, appearance of the tongue and quality of the pulse.
The study which was done by Department of Medicine I, Friedrich-Alexander, University of Erlangen-Nuremberg, Germany, was conducted on patients with ulcerative colitis (UC) at the university hospital.
The diagnosis had to be confirmed by endoscopic biopsy performed no more than two years previously of patients between 18 and 65 years of age with a disease duration between one and 20 years.
Patients were asked to continue the same dosage of their regular medicine four weeks before study entry and throughout the treatment period.
The primary outcome measure was the change from baseline after five weeks of acupuncture treatment.
As secondary outcome measures, quality of life and general well-being. Both outcome parameters were assessed before the first acupuncture, after the fifth, after the tenth (last) acupuncture and after 16 weeks of follow-up.
During the first visit, patients were informed about the study procedures and that two different forms of acupuncture would be applied.
Patients who met the inclusion criteria and gave informed consent were diagnosed according to the principles of TCM based on a structured interview that included details of sleep, appetite, sweating, psychological state and further symptoms.
Furthermore, the appearance of the tongue (colour, form, fur) and the quality of the radial pulse were considered for the final TCM diagnosis.
Patients of both groups—TCM acupuncture and sham acupuncture—received 10 acupuncture sessions of 30 minutes each over a time period of five weeks (two sessions per week).
Acupuncture needles were inserted at specific points and moxibustion was given. Thirty patients were chosen.
Fifteen received TCM acupuncture and 15 received sham acupuncture. In the patient group receiving traditional acupuncture, a significant decrease in mean CAI (colitis activity index) after treatment was observed, which remained stable in the follow-up period. The TCM acupuncture was significantly superior at the end of the treatment period.
After 16 weeks of follow-up, the CAI score in the TCM, but not in the control group, was still significantly lower than at the beginning of the treatment.
However, the statistical comparison between both groups at the end of the follow-up period did not reveal any significant difference regarding changes from baseline.
Quality of life and subjective well-being also increased in both groups. No significant difference could be observed between TCM and the control group after treatment, though a trend favouring TCM acupuncture could be seen for quality of life.
Both groups expressed comparable confidence in acupuncture at the beginning of treatment, during acupuncture and at the end of acupuncture and no adverse effects during acupuncture treatments were observed.
This study indicates that acupuncture improves disease activity, quality of life and general wellbeing of patients with ulcerative colitis.
The TCM acupuncture was significantly superior to sham acupuncture only with regard to disease activity.
Furthermore, this study indicates that chronic stress, adverse life events or depression can cause a worsening of disease in patients with ulcerative colitis.
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi.
This treatment is now being made available in India.