# Effects of Acupuncture Treatment Alone and in Combination With Japanese Kampo Medicines on Reduced Dietary Intake During Hospitalization: A Single-Center Case Series

## TL;DR

This study found that acupuncture, alone or with Japanese Kampo medicines, improved dietary intake in hospitalized patients, potentially reducing malnutrition risks.

## Contribution

The study demonstrates that acupuncture combined with Kampo medicines can effectively improve reduced dietary intake in hospitalized patients.

## Key findings

- Dietary intake increased significantly after acupuncture treatment alone or in combination with Kampo medicines.
- No significant adverse events were observed with the interventions.
- Rikkunshito (TJ-43) was the most commonly used Kampo medicine alongside acupuncture.

## Abstract

Background: Malnutrition leads to various consequences, including prolonged hospital stays and an increased risk of readmission. Insufficient dietary intake often necessitates interventions such as parenteral or enteral nutrition, further extending the duration of hospitalization. Studies suggest that acupuncture may enhance appetite; however, its direct impact on dietary intake remains unclear. In this study, we aimed to evaluate the effects of acupuncture alone and in combination with Japanese Kampo medicines on reduced dietary intake and related blood parameters to clarify this relationship.

Methods: This single-center, retrospective observational study was conducted at the Japanese Red Cross Kumamoto Hospital, an acute care facility in Japan, and included all hospitalized patients who received acupuncture treatment for reduced dietary intake from February 1, 2020, to January 31, 2023. Reduced dietary intake was defined as an average intake of less than 50% during the seven days prior to the initiation of acupuncture treatment. The treatment sessions lasted 20-30 minutes, with interventions performed once daily, five times per week (Monday to Friday, excluding Japanese holidays). Japanese Kampo medicines were prescribed by attending physicians in the course of routine medical care. The rate of daily change in dietary intake percentage from seven days before to seven days after acupuncture treatment, changes in blood parameters (total lymphocyte count, hemoglobin, albumin, and prealbumin levels), and treatment safety were evaluated. The change in dietary intake percentage before and after acupuncture treatment was analyzed using a paired t-test.

Results: Of 80 patients who received acupuncture during the study period, 64 were ultimately included in the analysis. Of these, 21 (33%) were male patients and 43 (67%) were female patients, with a mean age of 75.0 ± 12.7 years. The daily dietary intake rate increased from -1.08% before acupuncture to 1.93% after treatment. Similar trends were observed for individual meals, with breakfast intake rising from -1.46% to 2.09%, lunch from -1.67% to 1.53%, and dinner from -0.70% to 2.22%. The cause of reduced dietary intake was not clearly identified. Rikkunshito (TJ-43) was the most commonly co-administered Japanese Kampo medicine (31.7%). The most frequently used acupoints included ST36 (54 patients), SP6 (35 patients), CV12 (33 patients), SP9 (29 patients), SP3 (26 patients), and KI3 (20 patients). No significant adverse events were observed.

Conclusions: Dietary intake significantly improved following acupuncture treatment alone and in combination with Japanese Kampo medicines. These findings suggest that the observed improvements in dietary intake may be attributable to these interventions rather than to natural recovery. There were limitations to the study methods, and future studies with prospective, high-quality research designs will be necessary.