Acupuncture for hiccups: Case reports and literature review

Rationale: Persistent hiccups following a stroke are a common complication that can adversely affect the patient’s condition and rehabilitation. Certain refractory cases fail to respond adequately to pharmacological treatment. We report 2 cases of successful treatment of persistent hiccups with acupuncture and a medical electromagnetic device (trade name, TDP, an abbreviation of the Chinese phrase “Te-ding Dian-ci-bo Pu”). Patient concerns: The first patient was a 94-year-old male who had experienced continuous hiccups for 7 days. His comorbidities included Alzheimer disease, cardiac arrhythmia following pacemaker implantation, chronic kidney disease, glaucoma, and recent COVID-19 infection complicated by pneumonia. The second patient was a 70-year-old male who had experienced hiccups for 10 days. He had a history of cerebellar and brainstem infarction, hypertension, and hypopharyngeal carcinoma. Diagnoses: Both patients were diagnosed with persistent hiccups. Interventions: Both patients received combined treatment with acupuncture and TDP. Outcomes: Following treatment, hiccups were alleviated to different degrees, and no recurrence was observed at follow-up. Lessons: Neuroexcitatory imbalance and thoracoabdominal pressure asymmetry are considered underlying causes of persistent hiccups. Acupuncture combined with TDP may modulate periumbilical arteriovenous networks and abdominal pressure, thereby relieving hiccups. This case series suggests a novel, easily implemented, well-tolerated therapeutic option for the management of persistent hiccups.