Quick answer
Acupuncture evidence has a credibility problem: small trials, unblinded designs, and outcomes chosen by believers. Guang'anmen Hospital's acupuncture department took the opposite route over fifteen years. First a sham-controlled trial in 1,075 patients across 15 hospitals, published in Annals of Internal Medicine in 2016. Then a non-inferiority trial against the drug prucalopride in 560 patients across 14 hospitals, published in the American Journal of Gastroenterology in 2020. The department's director Yang Tao presented the two studies publicly in February 2026 [1][2][5].
Key takeaways
- Sham-controlled trial: 1,075 patients, 15 hospitals, electroacupuncture at Tianshu, Fujie and Shangjuxu for 8 weeks [4][6].
- Effect persisted 12 weeks after treatment ended — 20 weeks in total from baseline [2][6].
- Non-inferiority trial: 560 patients, 14 hospitals, electroacupuncture 28 sessions over 8 weeks versus prucalopride 2 mg daily for 32 weeks [2][5].
- Primary endpoint (weeks 3–8, ≥3 complete spontaneous bowel movements per week): 36.2% versus 37.8% — non-inferior [5][6].
- Post-treatment effect lasted 24 weeks after acupuncture stopped [2][5].
Why the sham-controlled trial came first
Before comparing a therapy to a drug, you have to know it does something. The 2016 trial did that: patients with severe chronic constipation, defined as two or fewer complete spontaneous bowel movements per week, were randomised to electroacupuncture at three real points or to shallow needling at non-points beside them, for eight weeks. The real-point group had more complete spontaneous bowel movements, and the difference outlasted the treatment period [4][6].
The non-inferiority design then answered the practical question a patient asks: is this worth eight weeks of visits instead of a daily tablet? Non-inferiority against an active drug is a meaningful claim — and the persistence of effect after stopping, which prucalopride does not show, is arguably the more interesting finding [2][5].
How to read the numbers honestly
A 36.2% versus 37.8% response rate means both treatments helped roughly a third of patients to the trial's threshold. That is a modest absolute effect for either modality, and it defines the population: severe, refractory constipation where simpler measures have failed [5].
Non-inferiority means the acupuncture was not shown to be worse, within a pre-specified margin — not that it was better. Sham acupuncture is an imperfect control: patients can often tell whether a needle is inserted deeply, and the practitioner cannot be blinded at all, so expectation effects are only partly controlled. Both trials were conducted by committed academic groups with rigorous methods, but independent replication outside China remains limited. The 28 visits over eight weeks are a real burden compared with a tablet [3][6].
The condition in context: chronic constipation
Constipation affects a large share of adults, and refractory cases have few satisfactory options.
| Region | What the data shows | Source |
|---|---|---|
| Burden | Hundreds of millions of people worldwide are affected [6]. | Chinese medicine news [6] |
| Current treatment | Laxatives and prokinetics give immediate relief but risk dependence with long-term use [6]. | Chinese medicine news [6] |
| Department record | Guang'anmen's acupuncture team has published in JAMA, Annals of Internal Medicine and AJG across urinary incontinence, constipation and pelvic pain [7]. | Beijing health commission [7] |
Because refractory constipation is chronic and treatment options are limited, a non-drug option with a durable post-treatment effect fills a real gap [2][5].
Why it matters
| For the patient | What the report suggests | Source |
|---|---|---|
| Evidence quality | Two large multicentre randomised trials in high-impact journals [1][3]. | [1][3] |
| Durability | Effect persisted 12–24 weeks after stopping [2][5]. | [2][5] |
| Caution | Non-inferiority, not superiority; imperfect blinding [5][6]. | [5][6] |
Availability and limits
- This is an editorial summary of published trials and hospital reporting, not a treatment recommendation [1][2].
- Non-inferiority to prucalopride does not establish superiority [5].
- Sham acupuncture controls expectation imperfectly [6].
- Eight weeks of 28 sessions is a substantial time commitment [2].
- Alarm features such as bleeding or weight loss require investigation before any therapy [8].
What to ask before booking
| Question | Why it matters |
|---|---|
| Have organic causes been excluded first? | Alarm features need investigation, not acupuncture [8]. |
| Which acupuncture protocol would I receive? | The trials used specific points and electrical parameters [4]. |
| Which department handles foreign patients, and in what language? | Guang'anmen is a working hospital we do not book; confirm international-department coordination and language support. |
| How many sessions, and what happens if there is no response? | The trial schedule was 28 sessions over 8 weeks [2]. |
Questions patients ask
What is the evidence for acupuncture in constipation?
Two large multicentre randomised trials from Guang'anmen: 1,075 patients sham-controlled (Annals of Internal Medicine, 2016) and 560 patients non-inferiority versus prucalopride (American Journal of Gastroenterology, 2020) [1][2][5].
Did acupuncture beat the drug?
No — it was non-inferior: 36.2% versus 37.8% reached the primary threshold. The advantage claimed is durability after stopping [5][6].
How is it given?
Electroacupuncture at Tianshu, Fujie and Shangjuxu, 28 sessions over 8 weeks in the non-inferiority trial [2][4].
Is it safe?
The trials reported it as safe; the main burden is time and the need to exclude organic disease first [6][8].
Is this relevant to international patients?
It is useful context for China's acupuncture research. Guang'anmen is a working hospital we do not book — contact its international department directly [1].