Acupuncture and the relaxation response for treating gastrointestinal symptoms in HIV patients on highly active antiretroviral therapy

I bring this study to your attention for a few reasons. It underscores the efficacy of acupuncture for gastrointestinal problems in general by addressing a serious and pernicious problem in HIV patients. The gut is highly innervated, and for that reason is actually easier to affect with acupuncture than one might think. The other interesting part of this study is that they combined the relaxation response with acupuncture to see if there was any difference and it turns out that they had a synergistic effect. The biofeedback device I use in my clinic to monitor Heart Rate Variability (HRV), a measure of the relaxation response, is designed to be used as a device for patients to learn to relax. I use it as a simple monitor, to see what happens during treatment. This makes me think I should go ahead and use it as intended, with patient participation. Who knows how much better my results would be? (For info on my practice, please click here.)

Acupuncture and the relaxation response for treating gastrointestinal symptoms in HIV patients on highly active antiretroviral therapy.
Chang BH, Sommers E.
Acupunct Med. 2011 Jun 24. [Epub ahead of print]

1VA Boston Health Care System, Boston, Massachusetts, USA.
Abstract
OBJECTIVES:

To examine the effect of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) symptoms in HIV patients who are using highly active antiretroviral therapy (HAART).
METHODS:

The authors conducted a 4-arm 2×2 double-blind randomised controlled trial in an acupuncture clinic in the USA. Sham acupuncture and health education were used as the control conditions of real acupuncture and RR elicitation, respectively. Enrolled patients were randomised to real acupuncture+RR (AR), sham acupuncture+RR (SR), real acupuncture+health education (AE) or sham acupuncture+health education (SE) study arm. Participants listened to CDs with RR-eliciting instructions or health education while receiving acupuncture intervention. Interventions were provided twice weekly for 4 weeks and once weekly for another 4 weeks. Participants used daily diaries to record GI symptom severity ratings (0-10). The authors estimated the intervention effect as the changes in symptom rating per intervention session increase using a mixed-effects regression model.
RESULTS:

A total of 130 people with HIV/AIDS who were on HAART and had persistent GI symptoms were enrolled and 115 started the study intervention. The AR group had greater intervention effects for loose stools symptoms than the other three groups (ß=-0.149, -0.151 and -0.144, p value=0.013, 0.013 and 0.018 comparing AR to AE, SR and SE, respectively). The AR group also had significant intervention effects on reducing nausea symptoms when the intervention was given twice per week (ß=-0.218, p=0.001).
CONCLUSIONS:

Our trial provided preliminary data demonstrating the potential synergistic effects of acupuncture and RR for treating GI symptoms in HIV patients on HAART.