San Francisco Acupuncture for Bowel DiseaseMore like this please. As readers of the blog may know, I heartily endorse studies that compare dose responses when it comes to acupuncture instead of comparisons to sham.  This study, though not an acupuncture study, compares dosing of TENS to gastric motility and in happy convergence to HRV.  In sum, short dosages of TENS were not effective, but two doses per day (30 min) for 2 weeks were decidedly effective and correlated with autonomic activity.

Clin Exp Rheumatol. 2013 Feb 7.

[Epub ahead of print] Prolonged treatment with transcutaneous electrical nerve stimulation (TENS) modulates neuro-gastric motility and plasma levels of vasoactive intestinal peptide (VIP), motilin and interleukin-6 (IL-6) in systemic sclerosis.
McNearney TA, Sallam HS, Hunnicutt SE, Doshi D, Chen JD.

Departments of Internal Medicine, Neuroscience and Cell Biology and Microbiology and Immunology, University of Texas Medical Branch, Galveston, USA.

We assessed the effects of transcutaneous electrical nerve stimulation (TENS) on neurogastric functioning in scleroderma patients.

Seventeen SSc patients underwent 30 min TENS treatment >10Hz at GI acupuncture points PC6 and ST36, once (acute TENS) and then after two weeks of TENS sessions for 30 min twice daily (prolonged TENS). Data collected at Visits 1 and 2 included gastric myoelectrical activity (GMA) by surface electrogastrography (EGG), heart rate variability (HRV) by surface electrocardiography (EKG), GI specific symptoms and health related SF-36 questionnaires. Plasma VIP, motilin and IL-6 levels were determined. Statistical analyses were performed by Student’s t-test, Spearman Rank and p-values <0.05 were considered significant.

1. Only after prolonged TENS, the percentages of normal slow waves and average slow wave coupling (especially channels 1, 2 reflecting gastric pacemaker and corpus regions) were significantly increased; 2. the percentage of normal slow waves was significantly correlated to sympathovagal balance; 3. Mean plasma VIP and motilin levels were significantly decreased after acute TENS, (vs. baseline), generally maintained in the prolonged TENS intervals. Compared to baseline, mean plasma IL-6 levels were significantly increased after acute TENS, but significantly decreased after prolonged TENS. 4. After prolonged TENS, the frequency of awakening due to abdominal pain and abdominal bloating were significantly and modestly decreased, respectively.

In SSc patients, two weeks of daily TENS improved patient GMA scores, lowered plasma VIP, motilin and IL-6 levels and improved association between GMA and sympathovagal balance. This supports the therapeutic potential of prolonged TENS to enhance gastric myoelectrical functioning in SSc.