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Patients with Systemic Sclerosis Have Unique and Persistent Alterations in Gastric Myoelectrical Activity with Acupressure to Neiguan Point PC6
DIANNE E. WOLLASTON, XIAOHONG XU, OSAMU TOKUMARU, JIANDE D.Z. CHEN, and TERRY A. McNEARNEY
ABSTRACT. Objective. To assess the effect of acupressure on gastric myoelectrical activity (GMA) in patients with systemic sclerosis (SSc) and its possible influence on SSc-associated gastrointestinal (GI) dysmotility disorders. Methods. Acupressure to Neiguan point PC6 (GI, antiemetic point) was applied while SSc patients and healthy control subjects were monitored by 4-channel surface electrogastrography (EGG) during 30-minute baseline, acupressure, and recovery intervals. Frequency of GI symptoms and modified Rodnan skin scores (mRSS) of SSc patients were recorded. Acupressure to PC10 (non-GI, sham) was also performed on SSc patients to assess the validity of PC6 as a modulator of GI gastric rhythms. Results. In the SSc patients, PC6 acupressure resulted in significant, persistent percentage mean normal wave decreases with concomitant percentage mean bradygastria and tachygastria increases during the recovery interval. Increases in percentage mean coupling seen in controls were blunted in SSc patients. In SSc patients, PC6 acupressure resulted in significant percentage normal wave and percentage bradygastria changes in the recovery interval that were not obtained with PC10 acupressure. In SSc patients, mRSS were significantly correlated to baseline GMA percentage mean normal waves and bradygastria and frequency of abdominal bloating. The frequency of symptoms for heartburn were significantly correlated with changes in GMA (dGMA, baseline vs recovery). Conclusion. In SSc patients, PC6 acupressure revealed significant, persistent, and possibly unique alterations in GMA during the recovery interval. dGMA was significantly correlated with the frequency of heartburn symptoms. Further studies will assess if acupressure to PC6 can provide a therapeutic or prognostic utility with GMA or GI symptoms in SSc patients. (J Rheumatol 2005; 32:494-501) Key Indexing Terms:
SCLERODERMA
From the Department of Internal Medicine; Preventative Medicine and Community Health; and Departments of Neuroscience, Cell Biology, and Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA. Supported by grant MO1 RR 00073 from the National Center for Research Resources, National Institutes of Health, and US Public Health Service. D.E. Wollaston, MD; X. Xu, MS; J.D.Z. Chen, PhD, Department of Internal Medicine; O. Tokumaru, MD, PhD, Preventative Medicine and Community Health; T.A. McNearney, MD, Departments of Internal Medicine, Neuroscience, and Cell Biology, and Microbiology and Immunology, University of Texas Medical Branch. Address reprint requests to Dr. T. McNearney, Division of Rheumatology — UTMB, 301 University Blvd., Galveston, TX 77555-1165. E-mail: tmcnearn@utmb.edu Submitted May 17, 2004; revision accepted October 25, 2004. |