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1) Standard treatment comes first

If H. pylori infection is confirmed, completing the prescribed eradication regimen and follow-up testing is essential. Acupuncture should be viewed as an add-on, not a replacement for medical therapy.

若已確認幽門桿菌感染，完成醫師開立的根除療程並接受追蹤檢測是必要的。 針灸應被視為輔助治療，而非取代標準醫療。

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2) Where acupuncture may help

Symptom relief – clinical trials suggest acupuncture may ease upper-abdominal pain, bloating, early satiety, nausea, or acid reflux during H. pylori treatment.
Improve gastric motility – electro-acupuncture at points such as ST36 and PC6 has been reported to increase antral contractions and accelerate gastric emptying.
Reduce drug side-effects – some studies note lower rates of nausea, diarrhea, metallic taste, or abdominal discomfort during triple or quadruple therapy.
Stress modulation – acupuncture may down-regulate sympathetic activity, improve sleep or anxiety, and indirectly support digestive recovery.

• 緩解上腹痛、腹脹、飽脹感、反酸或噁心。
• 透過電針刺激足三里、內關等穴位，促進胃動力與胃排空。
• 減少三合一／四合一療程中常見的噁心、腹瀉、口苦金屬味或副胃痛。
• 調節自律神經、降低壓力，改善睡眠與焦慮，間接支持消化功能。

Commonly used points (examples): ST36 足三里、CV12 中脘、PC6 內關、SP4 中封、LR3 太衝、ST25 天樞

Suggested frequency: 1–2 times per week, 4–6 weeks per course, adjusted according to symptoms.
建議頻率： 每週 1–2 次，4–6 週為一個療程，並依症狀狀況調整。

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3) Where acupuncture cannot help

• Eradication itself – acupuncture has no antibacterial action; cure depends on antibiotics.
• Drug-resistant strains – resistance requires physician-guided regimen changes.
• Alarm features – black stools, rapid weight loss, dysphagia, persistent vomiting require urgent GI evaluation.
• Poor adherence – irregular medication use or lack of re-testing directly reduces success rates.

• 針灸本身沒有抗菌作用，無法單獨根除幽門桿菌，根除仍需依賴抗生素。
• 若幽門桿菌出現抗藥性，需由醫師調整藥物療程，針灸無法解決耐藥問題。
• 出現黑便、體重快速下降、吞嚥困難或持續性嘔吐，屬警訊症狀，應立即就醫。
• 未規律服藥或未完成療程後檢測，將直接影響根除成功率，針灸亦無法補救。

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4) Safety & precautions

• Choose licensed practitioners and ensure single-use sterile needles.
• Avoid acupuncture immediately after heavy meals or prolonged fasting.
• Consult a physician if taking anticoagulants (e.g., warfarin, DOACs) or during pregnancy.
• Report persistent pain, bruising, dizziness, or unusual symptoms promptly.

• 請選擇合格執業的針灸師，並確保使用一次性無菌針具。
• 避免在過量進食後或長時間空腹狀態下立即接受針灸。
• 服用抗凝血藥物（如 warfarin、DOACs）或懷孕期間，應先諮詢醫師。
• 若出現持續疼痛、瘀青、頭暈或其他異常反應，應立即告知治療師並就醫。

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5) Integrative care roadmap

1. Confirm infection (urea breath test, stool antigen, or endoscopic biopsy).
   確認是否感染幽門桿菌（如尿素呼氣測試、糞便抗原檢測，或胃鏡切片檢查）。
2. Complete standard eradication regimen based on local resistance patterns.
   依據當地抗藥性情況，完成醫師建議的標準幽門桿菌根除療程。
3. Add supportive acupuncture 1–2×/week and monitor symptoms.
   視需要加入每週 1–2 次的輔助針灸治療，並持續追蹤症狀變化。
4. Lifestyle support: stop smoking/betel nut, limit NSAIDs, alcohol, and spicy foods; eat small frequent meals.
   生活型態調整：戒菸與檳榔，減少非類固醇止痛藥（NSAIDs）、酒精與辛辣食物， 並採取少量多餐的飲食方式。
5. Re-test ≥4 weeks post-therapy; if negative, consider tapering acupuncture.
   於療程結束後至少 4 週再次檢測幽門桿菌； 若結果為陰性，可評估逐步減少或結束針灸治療。

The integrative care pathway is as follows: confirm infection → complete standard eradication therapy → add supportive acupuncture with symptom monitoring → implement lifestyle modifications → re-test at least 4 weeks after therapy and adjust care as needed.

整合式照護流程建議為： 確認感染 → 完成標準根除療程 → 輔助針灸與症狀追蹤 → 生活型態調整 → 療程後至少 4 週重新檢測，再視情況調整。

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6) Evidence snapshot

A 2020 meta-analysis (n = 1,244, 18 RCTs) reported improved dyspepsia relief and fewer gastrointestinal adverse events when acupuncture was added to standard therapy, while eradication rates were not significantly different. Methodological quality varied; higher-quality trials are still needed.

2020 年綜合分析顯示，在標準治療中加用針灸可改善消化不適並減少腸胃副作用， 但對幽門桿菌根除率未見顯著差異；研究品質不一，仍需更多高品質隨機對照試驗。

Reference highlights:
1. Zhang Y et al., Evid-Based Complement Alternat Med, 2020.
2. Malfertheiner P et al., Maastricht VI / Florence Consensus, Gut, 2022.
3. Chen X et al., Neurogastroenterol Motil, 2019.

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