Synergistic efficacy of electroacupuncture and rabeprazole in NERD

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Created On: 15/10/2026

Non-erosive reflux disease (NERD) is a subtype of gastroesophageal reflux disease characterized by typical reflux symptoms in the absence of visible esophageal mucosal injury.

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Key take away

Electroacupuncture combined with rabeprazole improves reflux symptoms, anxiety, and depression and maintains these benefits for 3 months in patients with non-erosive reflux disease.

Background

Non-erosive reflux disease (NERD) is a subtype of gastroesophageal reflux disease characterized by typical reflux symptoms in the absence of visible esophageal mucosal injury. Although proton pump inhibitors such as rabeprazole are widely used for symptom management, some patients continue to experience persistent symptoms and associated emotional disturbances.

This randomized controlled trial explored whether electroacupuncture (EA) added to rabeprazole could yield greater clinical benefits than sham-EA combined with rabeprazole or rabeprazole treatment alone.

Method

The study enrolled 156 patients with NERD, who were randomly assigned in a 1:1:1 ratio to the following groups:

EA group: Received oral rabeprazole sodium enteric-coated capsules (20 mg once daily) combined with EA. EA was applied at positive reaction points along the governor vessel, including Dazhui (GV14) and Baihui (GV20). The stimulation parameters used were a continuous wave, a frequency of 10 Hz, and an electrical intensity ranging from 2 mA to 5 mA. Treatment sessions were administered once every 2 days (3 sessions per week) for 8 weeks.
Sham-EA group: Received oral rabeprazole sodium enteric-coated capsules (20 mg once daily) along with sham-EA. Point selection and needle insertion procedures matched those in the EA group, but no electrical stimulation was delivered.
Western medication group: Received oral rabeprazole sodium enteric-coated capsules (20 mg once daily) as monotherapy for 8 weeks.

Each group initially included 52 patients, with 2 patients dropping out from each group, leaving 50 patients per group for efficacy analysis. Treatment response was assessed via the Reflux Disease Questionnaire (RDQ), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) at baseline, after treatment, and at the 3-month follow-up. Overall clinical efficacy was also assessed.

Result

RDQ and SDS scores: Post-treatment and at the 3-month follow-up, RDQ and SDS scores dropped markedly across all three groups. The reduction was greater in the EA group compared to both the sham-EA and Western medication groups. The sham-EA group also illustrated lower RDQ and SDS scores relative to the Western medication monotherapy group.
SAS scores: All three groups exhibited remarkable reductions in SAS scores immediately post-treatment. At the 3-month follow-up, sustained SAS score reductions remained significant in both the EA and sham-EA groups. Intergroup comparisons revealed that SAS scores in the EA group were lower than those in the sham-EA and Western medication groups both post-treatment and at follow-up. Correspondingly, scores in the sham-EA group were lower than those in the Western medication monotherapy group.
Clinical response rate: Importantly, overall clinical efficacy was highest with EA + rabeprazole (Table 1):

Conclusion

EA + rabeprazole sodium enteric-coated capsules successfully mitigated esophageal reflux symptoms and comorbid psychological distress (anxiety and depression) in patients with NERD. The combination regimen offered superior short-term symptom relief and long-term therapeutic durability compared to sham EA adjunctive therapy or rabeprazole monotherapy alone.