The effect of prophylactic acupuncture treatment in women with recurrent cystitis: kidney patients fare better.

OBJECTIVE To evaluate how the effect of acupuncture treatment in recurrent cystitis relates to Traditional Chinese Medicine (TCM) diagnostic categories and physiologic measurements. SETTING/LOCATION Two private acupuncture clinics in Bergen, Norway. Measurements were carried out in Haukeland University Hospital, Bergen. DESIGN AND SUBJECTS Ninety-eight (98) cystitis-prone women were randomly assigned to acupuncture treatment or no treatment. Main effect parameter was number of cystitis during 6 months observation time. Residual urine was measured with an automatic Bladder Scan 2500 (Diagnostic Ultrasound Corporation, Bothell, WA) at baseline, 2, 4 and 6 months. RESULTS Twenty-two (22) patients had Spleen yang/qi xu (Sp), 18 Kidney yang/qi xu (Kid), and 18 Liver qi stagnation (Liv). Of the Kid group, 78% were free of cystitis (irrespective of bacteriuria) during the observation period compared to 45% in the Sp group, 44% in the Liv group (p < or = 0.05, Kid versus Sp and Liv), and 17% in the nontreated group (p < or = 0.01, versus all treated patients). One sixth as many episodes of acute cystitis occurred in the Kid group compared to the nontreated group (incidence rate ratio [IRR] = 0.15, 95% confidence interval [CI] 0.05-0.42, p < or = 0.001). Similarly, we found IRR = 0.49 (0.25-0.83) in the Sp group and IRR = 0.42 (0.21-0.80) in the Liv group. Subanalyzing for cystitis with detected bacteriuria yielded comparable results. Kid patients significantly reduced their residual urine from baseline to 6 months (36.4 mL versus 12.9 mL, p < or = 0.05). The reduction was less and nonsignificant in Sp and Liv groups (31.5 mL versus 22.2 mL, 36.4 mL versus 16.7 mL, respectively). Residual urine remained unchanged among nontreated patients. CONCLUSION Our findings show a better acupuncture treatment effect on Kidney yang/qi xu than on other TCM syndromes found in women with recurrent cystitis. This has practical implications, and highlights the need for considering different TCM diagnostic categories in acupuncture research.