Modulation of Inflammatory and Neuroendocrine Biomarkers by PC6 Acupressure in Hyperemesis Gravidarum: A Randomized Double-Blind Controlled Trial

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Abstract Background: PC6 acupressure is clinically effective against hyperemesis gravidarum (HG), but its biomolecular mechanism remains unclear. This study aimed to determine whether PC6 acupressure reduces inflammatory and neuroendocrine biomarkers and symptom severity in hospitalized HG patients compared to a sham intervention. Materials and Methods: A parallel-group, double-blind, randomized sham-controlled superiority trial was conducted at three hospitals in Denpasar. Thirty women with HG (8–14 weeks gestation) were randomized to PC6 acupressure ( n = 15) or sham acupressure ( n = 15). The primary outcome was the change in the pregnancy-unique quantification of emesis (PUQE) score at 48 h. Secondary outcomes included changes in serum interleukin-1 Beta (IL-1β), IL-6, human chorionic gonadotropin (hCG), and dopamine levels at 24–48 h, measured using enzyme-linked immunosorbent assay. Results: Twenty-seven participants completed the study (PC6: n = 14; sham: n = 13). PC6 acupressure significantly reduced PUQE scores compared to sham at 48 h (mean difference: −1.38; 95% confidence interval: −2.95 to −0.19; P = 0.026; Cohen’s d = 0.62). Significant reductions in IL-1β, IL-6, and hCG and an attenuation of the dopamine rise were also observed in the PC6 group at both time points. Pathway analysis suggested dopamine ( β = 0.63 at 24 h) and IL-6 ( β = 0.58 at 48 h) had strong direct effects on symptom improvement. Conclusion: In this exploratory trial, PC6 acupressure was associated with improvements in HG symptoms and reductions in inflammatory and neuroendocrine biomarker levels. These findings suggest that PC6 acupressure may alleviate HG symptoms, potentially through modulation of inflammatory and neuroendocrine pathways. Larger confirmatory trials are needed to validate these results.

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