Efficacy and Safety of Thread Embedding Acupuncture in Treating Gastroesophageal Reflux Disease

NCT05353933 | Completed

• 1 other identifier: 606/HDDD-DHYD
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

Gastroesophageal reflux disease is a very common disease nowadays. Proton-pump inhibitors (PPIs) are the first-line treatment for this disease. However, the effectiveness of treatment with PPIs is still limited. Acupuncture has been shown to be effective in treating this condition. Another treatment method is thread embedding acupuncture therapy, which is a method of burying threads into acupoints to create a more lasting stimulation than traditional acupuncture. This study will evaluate the efficacy and safety of the combination of thread embedding acupuncture and standard dose pantoprazole compared with standard dose pantoprazole as monotherapy in adults.

Conditions

Gastroesophageal Reflux

Outcome Measures

Primary Outcomes (2)

• Change in the Gastroesophageal reflux disease questionnaire score (GerdQ) after each week of treatment.

  According to GerdQ, patients were asked to reflect on their symptoms and use of over-the-counter medications over the preceding week. It uses a four graded Likert scale (0-3) to score giving a total GerdQ score range of 0-18. High score indicates serious disease.

  Assessments at day 0 and after every week during 4-week treatment (day 7th, day 14th, day 21st, day 28th).

• Change in the proportion of GERD typical symptoms absence after each week of treatment.

  Based on the GerdQ score, when the answers for questions 1 and 2 are zero, the disappearance of typical symptoms including heartburn and regurgitation respectively will be determined.

  Assessments at day 0 and after every week during 4-week treatment (day 7th, day 14th, day 21st, day 28th).

Secondary Outcomes (3)

• Change in the GERD symptoms frequency after every two weeks of treatment.

  Assessments day 0 and every two weeks during 4-week treatment (day 14th, day 28th).

• Change in the health related quality of life after every two weeks of treatment.

  Assessments at day 0 and every two weeks during 4-week treatment (day 14th, day 28th).

• The proportion of thread embedding acupuncture side effects.

  Up to 4 weeks.

Study Arms (2)

TEA + PPI

EXPERIMENTAL

Thread embedding acupuncture (TEA) every 2 weeks in 4 weeks (twice). Combined with oral pantoprazole 40 mg capsules (Pantostad 40 CAP) once daily for 4 weeks.

Other: Thread embedding acupuncture; Drug: Pantoprazole 40mg

PPI

ACTIVE COMPARATOR

Oral pantoprazole 40 mg capsules (Pantostad 40 CAP) once daily for 4 weeks.

Drug: Pantoprazole 40mg

Interventions

Thread embedding acupuncture OTHER

Thread embedding acupuncture (TEA) that use chromic catgut thread with 3/0 size with 1 centimeter long for each acupoint (TRUSTIGUT® (C), CPT Sutures Co., Ltd, Ho Chi Minh, Vietnam). Every 2 weeks in 4 weeks (twice), 13 acupoints will be embedded including Xiawan (CV-10), Zhongwan (CV-12), Shangwan (CV-13) and Zusanli (ST-36), Neiguan (PC-6), Geshu (BL-17), Ganshu (BL-18), Pishu (BL-20) in both sides of the body.

TEA + PPI

Pantoprazole 40mg DRUG

Oral pantoprazole 40 mg capsules (Pantostad 40 CAP, Stellapharm J.V. Co., Ltd, Binh Duong, Vietnam) thirty minutes to one hour before the first meal once daily for 4 weeks.

PPI; TEA + PPI

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male or female 18-60 years of age.
• Patients with total scores ≥ 8 on the Gastroesophageal Reflux Disease Questionnaire (GerdQ) and scores ≥ 2 for each symptom including heartburn and/or regurgitation.
• Ability to read, understand and provide informed consent.
• Currently not receiving any intervention to treat GERD.

You may not qualify if:

• Have any current symptoms related to a structural disease that has been confirmed by endoscopy (e.g., gastrointestinal cancer, eosinophilic esophagitis, candida esophagitis, peptic ulcers, Zollinger-Ellison syndrome, pyloric stenosis, etc.).
• With known inflammatory bowel disease or other serious disease (hepatic, renal, respiratory, or cardiac disease) or rare genetic diseases (such as fructose intolerance, glucose-galactose malabsorption, saccharose-isomaltose deficiency), severe concomitant diseases, or a history of alcohol or drug abuse.
• Have severe dysphagia, hematemesis, weight loss, or hematochezia.
• A history of oesophageal and/or gastrointestinal surgery.
• Current use of drugs affecting treatment and evaluation of GERD including systemic glucocorticoids, nonsteroidal anti-inflammatory, calcium channel blockers, anticholinergics, bisphosphonates, ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin, tetracycline, HIV protease inhibitors, rifampin, potassium supplements, iron, quinidine, zidovudine, anticholinergic agents, alpha-adrenergic antagonists, β2-adrenergic agonists, benzodiazepines, barbiturates, dopamine, estrogens, progesterone, narcotic analgesics, nitrates, prostaglandins, theophylline.
• Are being treated with proton-pump inhibitors within the last 14 days, H2-receptor antagonists, or prokinetics within the last 10 days, intake of alginates or antacids within the last 3 days or using any traditional medicine to treat GERD within the last 2 weeks.
• A history of hypersensitivity reaction with PPIs (including their components), catgut or acupuncture or thread embedding acupuncture treatment.
• Are pregnant or breastfeeding.
• Are taking part in any other clinical trials.

Sponsors & Collaborators

• University of Medicine and Pharmacy at Ho Chi Minh City: lead

Study Sites (1)

University of Medical Center HCMC - Branch no.3

Ho Chi Minh City, 700000, Vietnam

Location

Related Publications (30)

• Sakurai K, Suda H, Fujie S, Takeichi T, Okuda A, Murao T, Hasuda K, Hirano M, Ito K, Tsuruta K, Hattori M. Short-Term Symptomatic Relief in Gastroesophageal Reflux Disease: A Comparative Study of Esomeprazole and Vonoprazan. Dig Dis Sci. 2019 Mar;64(3):815-822. doi: 10.1007/s10620-018-5365-0. Epub 2018 Nov 10.

  PMID: 30415407 BACKGROUND

• Han G, Leem J, Lee H, Lee J. Electroacupuncture to treat gastroesophageal reflux disease: study protocol for a randomized controlled trial. Trials. 2016 May 17;17(1):246. doi: 10.1186/s13063-016-1371-8.

  PMID: 27188910 BACKGROUND

• Scholten T, Gatz G, Hole U. Once-daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD-related symptoms. Aliment Pharmacol Ther. 2003 Sep 15;18(6):587-94. doi: 10.1046/j.1365-2036.2003.01745.x.

  PMID: 12969085 BACKGROUND

• Wong BC, Kinoshita Y. Systematic review on epidemiology of gastroesophageal reflux disease in Asia. Clin Gastroenterol Hepatol. 2006 Apr;4(4):398-407. doi: 10.1016/j.cgh.2005.10.011.

  PMID: 16616342 BACKGROUND

• El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther. 2010 Sep;32(6):720-37. doi: 10.1111/j.1365-2036.2010.04406.x.

  PMID: 20662774 BACKGROUND

• El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871-80. doi: 10.1136/gutjnl-2012-304269. Epub 2013 Jul 13.

  PMID: 23853213 BACKGROUND

• Fock KM, Talley N, Goh KL, Sugano K, Katelaris P, Holtmann G, Pandolfino JE, Sharma P, Ang TL, Hongo M, Wu J, Chen M, Choi MG, Law NM, Sheu BS, Zhang J, Ho KY, Sollano J, Rani AA, Kositchaiwat C, Bhatia S. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus. Gut. 2016 Sep;65(9):1402-15. doi: 10.1136/gutjnl-2016-311715. Epub 2016 Jun 3.

  PMID: 27261337 BACKGROUND

• Zhou Y, Ma HQ, Yang ZJ, Shao HT, Yue GL, Du GZ. [Comparative study on effect of electroacupuncture at lower he-sea point of stomach and he-sea matching front-mu points for gastroparesis]. Zhongguo Zhen Jiu. 2020 Sep 12;40(9):925-7. doi: 10.13703/j.0255-2930.20191025-k0002. Chinese.

  PMID: 32959584 BACKGROUND

• Gyawali CP, Fass R. Management of Gastroesophageal Reflux Disease. Gastroenterology. 2018 Jan;154(2):302-318. doi: 10.1053/j.gastro.2017.07.049. Epub 2017 Aug 5.

  PMID: 28827081 BACKGROUND

• Gyawali CP, Kahrilas PJ, Savarino E, Zerbib F, Mion F, Smout AJPM, Vaezi M, Sifrim D, Fox MR, Vela MF, Tutuian R, Tack J, Bredenoord AJ, Pandolfino J, Roman S. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018 Jul;67(7):1351-1362. doi: 10.1136/gutjnl-2017-314722. Epub 2018 Feb 3.

  PMID: 29437910 BACKGROUND

• Jones R, Junghard O, Dent J, Vakil N, Halling K, Wernersson B, Lind T. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther. 2009 Nov 15;30(10):1030-8. doi: 10.1111/j.1365-2036.2009.04142.x. Epub 2009 Sep 8.

  PMID: 19737151 BACKGROUND

• Gao L, Chen B, Zhang Q, Zhao T, Li B, Sha T, Zou J, Guo Y, Pan X, Guo Y. Acupuncture with different acupoint combinations for chemotherapy-induced nausea and vomiting: study protocol for a randomized controlled trial. BMC Complement Altern Med. 2016 Nov 8;16(1):441. doi: 10.1186/s12906-016-1425-1.

  PMID: 27821107 BACKGROUND

• Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. JAMA. 2000 Dec 6;284(21):2755-61. doi: 10.1001/jama.284.21.2755.

  PMID: 11105182 BACKGROUND

• Ho CE, Goh YL, Zhao XX, Yu CY, Zhang C. GERD: An Alternative Perspective. Psychosomatics. 2016 Mar-Apr;57(2):142-51. doi: 10.1016/j.psym.2015.10.007. Epub 2015 Oct 26.

  PMID: 26895729 BACKGROUND

• Hunt R, Armstrong D, Katelaris P, Afihene M, Bane A, Bhatia S, Chen MH, Choi MG, Melo AC, Fock KM, Ford A, Hongo M, Khan A, Lazebnik L, Lindberg G, Lizarzabal M, Myint T, Moraes-Filho JP, Salis G, Lin JT, Vaidya R, Abdo A, LeMair A; Review Team:. World Gastroenterology Organisation Global Guidelines: GERD Global Perspective on Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2017 Jul;51(6):467-478. doi: 10.1097/MCG.0000000000000854. No abstract available.

  PMID: 28591069 BACKGROUND

• Huo J, Zhao J, Yuan Y, Wang J. [Research status of the effect mechanism on catgut-point embedding therapy]. Zhongguo Zhen Jiu. 2017 Nov 12;37(11):1251-4. doi: 10.13703/j.0255-2930.2017.11.031. Chinese.

  PMID: 29354967 BACKGROUND

• Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28; quiz 329. doi: 10.1038/ajg.2012.444. Epub 2013 Feb 19. No abstract available.

  PMID: 23419381 BACKGROUND

• Quach DT, Pham QTT, Tran TLT, Vu NTH, Le QD, Nguyen DTN, Dang NLB, Le HM, Le NQ. Clinical characteristics and risk factors of gastroesophageal reflux disease in Vietnamese patients with upper gastrointestinal symptoms undergoing esophagogastroduodenoscopy. JGH Open. 2021 Mar 26;5(5):580-584. doi: 10.1002/jgh3.12536. eCollection 2021 May.

  PMID: 34013058 BACKGROUND

• Shuai X, Xie P, Liu J, Xiang Y, Li J, Lan Y. Different effects of electroacupuncture on esophageal motility and serum hormones in cats with esophagitis. Dis Esophagus. 2008;21(2):170-5. doi: 10.1111/j.1442-2050.2007.00757.x.

  PMID: 18269654 BACKGROUND

• Sun QH, Li TT, Huang MT, Wang MY, Xiao X, Bai XH. [Acupoint selection rules in treating gastroesophageal reflux disease with acupuncture in China based on data mining]. Zhongguo Zhen Jiu. 2020 Dec 12;40(12):1374-8. doi: 10.13703/j.0255-2930.20191107-0003. Chinese.

  PMID: 33415885 BACKGROUND

• Wang C, Zhou DF, Shuai XW, Liu JX, Xie PY. Effects and mechanisms of electroacupuncture at PC6 on frequency of transient lower esophageal sphincter relaxation in cats. World J Gastroenterol. 2007 Sep 28;13(36):4873-80. doi: 10.3748/wjg.v13.i36.4873.

  PMID: 17828819 BACKGROUND

• Wang XL, Lin GH, Xu N, Zeng JC, Xu DH, Wang SX. [Analysis of adverse reactions of acupoint catgut embedding therapy]. Zhongguo Zhen Jiu. 2020 Feb 12;40(2):193-6. doi: 10.13703/j.0255-2930.20190316-k00034. Chinese.

  PMID: 32100507 BACKGROUND

• Weijenborg PW, Cremonini F, Smout AJ, Bredenoord AJ. PPI therapy is equally effective in well-defined non-erosive reflux disease and in reflux esophagitis: a meta-analysis. Neurogastroenterol Motil. 2012 Aug;24(8):747-57, e350. doi: 10.1111/j.1365-2982.2012.01888.x. Epub 2012 Feb 6.

  PMID: 22309489 BACKGROUND

• Yang J, Wang C. [Electroacupuncture at "Zusanli"(ST 36) can inhibit frequencies of transient lower esophageal sphincter relaxation induced by gastric distention in cats]. Zhen Ci Yan Jiu. 2011 Dec;36(6):423-7. Chinese.

  PMID: 22379788 BACKGROUND

• Zachariah RA, Goo T, Lee RH. Mechanism and Pathophysiology of Gastroesophageal Reflux Disease. Gastrointest Endosc Clin N Am. 2020 Apr;30(2):209-226. doi: 10.1016/j.giec.2019.12.001. Epub 2020 Feb 5.

  PMID: 32146942 BACKGROUND

• Zhang XP, Jia CS, Wang JL, Shi J, Zhang X, Li XF, Xu XK, Qin L, Zhang ML, Kang SG, Duan XD. [Acupoint catgut-embedding therapy: superiorities and principles of application]. Zhongguo Zhen Jiu. 2012 Oct;32(10):947-51. Chinese.

  PMID: 23259283 BACKGROUND

• Zhu J, Guo Y, Liu S, Su X, Li Y, Yang Y, Hou L, Wang G, Zhang J, Chen JJ, Wang Q, Wei R, Wei W. Acupuncture for the treatment of gastro-oesophageal reflux disease: a systematic review and meta-analysis. Acupunct Med. 2017 Oct;35(5):316-323. doi: 10.1136/acupmed-2016-011205. Epub 2017 Jul 8.

  PMID: 28689187 BACKGROUND

• Zou D, Chen WH, Iwakiri K, Rigda R, Tippett M, Holloway RH. Inhibition of transient lower esophageal sphincter relaxations by electrical acupoint stimulation. Am J Physiol Gastrointest Liver Physiol. 2005 Aug;289(2):G197-201. doi: 10.1152/ajpgi.00023.2005. Epub 2005 Apr 14.

  PMID: 15831714 BACKGROUND

• Luo Z, Hu X, Chen C, Zhu L, Zhang W, Shen Y, He J. Effect of Catgut Embedment in Du Meridian Acupoint on Mental and Psychological Conditions of Patients with Gastroesophageal Reflux Disease. Evid Based Complement Alternat Med. 2020 Sep 22;2020:5415813. doi: 10.1155/2020/5415813. eCollection 2020.

  PMID: 33029166 RESULT

• Trinh DT, Tran AH, Bui MP, Vuong NL. Thread-embedding acupuncture may improve symptom resolution in patients with gastroesophageal reflux disease: A randomized controlled trial. Integr Med Res. 2023 Sep;12(3):100971. doi: 10.1016/j.imr.2023.100971. Epub 2023 Jul 7.

  PMID: 37637187 DERIVED

MeSH Terms

Conditions

Gastroesophageal Reflux

Interventions

Pantoprazole

Condition Hierarchy (Ancestors)

Esophageal Motility Disorders; Deglutition Disorders; Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

2-Pyridinylmethylsulfinylbenzimidazoles; Sulfoxides; Sulfur Compounds; Organic Chemicals; Pyridines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Benzimidazoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: The investigator who examine GERD-related symptoms and outcome assessor will be blinded. However, the investigator who examine the side effects of thread embedding acupuncture will not be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 16, 2022
• First Posted: April 29, 2022
• Study Start: May 4, 2022
• Primary Completion: July 20, 2022
• Study Completion: July 20, 2022
• Last Updated: July 28, 2022

Record last verified: 2022-07

Locations

VN (1)