Combination of acupuncture and relaxation response for treating GI side effects associated with antiretroviral therapies

Objectives: We examined the dose response of the combination of acupuncture and the relaxation response (RR) for treating gastrointestinal (GI) side effects, such as nausea, vomiting, and bowel upsets related to use of antiretroviral therapies (ART). Methods: We conducted a randomized controlled trial on HIV/AIDS patients who were on ART and had GI symptoms. Enrolled patients listened to CDs while receiving acupuncture treatment. We used a 2x2 design with 2 types of acupuncture point stimulation (true acupuncture point stimulation vs. sham) and 2 types of self-care CDs (RR vs. health education). Treatments 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). Results: We enrolled 130 subjects and randomized them into 4 study groups, 32 in acupuncture+RR (AR), 33 in acupuncture+health education, 31 in sham acupuncture+RR, and 34 in sham acupuncture+health education. Most of the GI symptoms improved as numbers of treatment increased (dose response effect) for all 4 groups. The AR groups had greater dose response effects (adjusting for baseline ratings) for diarrhea/loose stool symptoms (regression slope=-0.14, p=0.01) compared to the other three groups, which did not show significant differences among them. The AR group also showed borderline significantly greater dose response effect on nausea symptom than the other 3 groups combined (regression slope=-0.12, p=0.10). Conclusion: Our small trial provided promising pilot data demonstrating the potential positive effect of combining acupuncture and RR for treating two of the most common GI side effects associated with ART.