Acupoint-catgut embedment combined with medication does not decrease interleukin-6 levels serum in patients with gastroesophageal reflux disease: a randomized controlled clinical trial
DOI:
https://doi.org/10.13181/mji.v28i3.1850Keywords:
acupuncture therapy, GERD, interleukin-6Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a pathological condition caused by the reflux of stomach contents into the esophagus. GERD is a multifactorial disorder with an increase in prevalence worldwide. Interleukin-6 (IL-6) is a proinflammatory cytokine that is commonly found in the esophageal mucosa of GERD patients and associated with esophageal motor disorders. Acupoint-catgut embedment has long been known as adjunctive therapy for GERD. This study was aimed to establish the effect of acupoint-catgut embedment combined with medication on the IL-6 serum levels of patients with GERD.
METHODS This single-blind randomized controlled trial involved 40 GERD patients from the Gastroenterology Outpatient Clinic of Cipto Mangunkusumo Hospital that were randomly allocated to either catgut-embedding therapy plus medication or sham acupuncture with medication. Catgut-embedding therapy was given two times at CV12 (Zhongwan), ST36 (Zusanli), and BL21 (Weishu) every 15 days. Serum levels of IL-6 were measured by enzyme-linked immunosorbent assay as research output.
RESULTS There were no significant differences in the baseline levels of proinflammatory (IL-6) mediators between the groups. After 1-month treatment, the median levels of IL-6 were statistically insignificant decreased in catgut-embedding therapy plus medication versus sham acupuncture with medication (0.15 versus -0.16 pg/ml, respectively; p = 0.14).
CONCLUSIONS The results suggest that catgut-embedding therapy has not been proven to statistically influence the levels of IL-6 in patients with GERD.
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References
Dinamithra NP, Nawarathne NM. Diagnosis and management of gastro-oesophageal reflux disease. The Sri Lanka Journal of Surgery. 2015;33(1):14-9. https://doi.org/10.4038/sljs.v33i1.8124
Tack J, Becher A, Mulligan C, Johnson DA. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther. 2012;35(11):1257-66. https://doi.org/10.1111/j.1365-2036.2012.05086.x
Leow AH, Lim YY, Liew WC, Goh KL. Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population-20-year experience over three time periods. Aliment Pharmacol Ther. 2016;43(7):1-7. https://doi.org/10.1111/apt.13550
Indonesian Society of Gastroenterology. National consensus on the management of gastroesophageal reflux disease in Indonesia. Acta Med Indones. 2014;46(3):263-71.
Rieder F, Biancani P, Harnett K, Yerian L, Falk GW. Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis, and carcinogenesis. Am J Physiol Gastrointest Liver Physiol. 2010;298(5):G571-81. https://doi.org/10.1152/ajpgi.00454.2009
Altomare A, Guarino MP, Cocca S, Emerenziani S, Cicala M. Gastroesophageal reflux disease: update on inflammation and symptom perception. World J Gastroenterol. 2013;19(39):6523-8. https://doi.org/10.3748/wjg.v19.i39.6523
Scheller J, Chalaris A, Schmidt-Arras D, Rose-John S. The pro-and anti-inflammatory properties of cytokine interleukin-6. Biochim Biophys Acta. 2011;1813(5):878-88. https://doi.org/10.1016/j.bbamcr.2011.01.034
Dickman R, Schiff E, Holland A, Wright C, Sarela SR, Han B, et al. Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose and refractory heartburn. Aliment Pharmacol Ther. 2007;26(10):1333-44. https://doi.org/10.1111/j.1365-2036.2007.03520.x
Zhang CX, Qing YM, Guo BR. Clinical study on treatment of gastroesophageal reflux by acupuncture. Chin J Integr Medicine. 2010;16(4):298-303. https://doi.org/10.1007/s11655-010-0516-y
Yin J, Chen JD. Gastrointestinal motility disorders and acupuncture. Auton Neurosci. 2010;157(1-2):31-7. https://doi.org/10.1016/j.autneu.2010.03.007
Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther. 2007;6(3):251-7. https://doi.org/10.1177/1534735407305892
Kang SG, Zhang ML, Duan XD, Zhang XP, Zhang X, Xu XK, et al. Exploration to the disease spectrum of acupoint catgut-embedding therapy. World J Acupunct Moxibustion. 2012;22(1):53-8. https://doi.org/10.1016/S1003-5257(12)60012-9
Zhang C, Guo L, Guo X, Guo X, Li G. Clinical curative effect of electroacupuncture combined with zhizhukuanzhong capsules for treating gastroesophageal reflux disease. J Tradit Chin Med. 2012;32(3):364-71. https://doi.org/10.1016/S0254-6272(13)60039-4
Baginda IS, Srilestari A, Abdurrohim K, Abdullah M. Pengaruh terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap gejala dan kualitas hidup penderita gastroesophageal reflux disease [thesis]. Jakarta (Indonesia): Universitas Indonesia; 2016. Indonesian.
Savarino V, Di Mario F, Scarpignato C. Proton pump inhibitors in GORD: an overview of their pharmacology, efficacy and safety. Pharmacol Res. 2009;59(3):135-53. https://doi.org/10.1016/j.phrs.2008.09.016
Hashioka S, Klegeris A, McGeer PL. Proton pump inhibitors exert anti-inflammatory effects and decrease human microglial and monocytic THP-1 cell neurotoxicity. Exp Neurol. 2009;217(1):177-83. https://doi.org/10.1016/j.expneurol.2009.02.002
Ghebremariam YT, LePendu P, Lee JC, Erlanson DA, Slaviero A, Shah NH, et al. Unexpected effect of proton pump inhibitors: elevation of the cardiovascular risk factor asymmetric dimethylarginine. Circulation. 2013;128(8):845-53. https://doi.org/10.1161/CIRCULATIONAHA.113.003602
Kedika RR, Souza RF, Spechler SJ. Potential anti-inflammatory effects of proton pump inhibitors: a review and discussion of the clinical implications. Dig Dis Sci. 2009;54(11):2312-7. https://doi.org/10.1007/s10620-009-0951-9
Rose-John S. IL-6 trans-signaling via the soluble IL-6 receptor: importance for the pro-inflammatory activities of IL-6. Int J Biol Sci. 2012;8(9):1237-47. https://doi.org/10.7150/ijbs.4989
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