Clinical Study Of Warm Acupuncture In The Treatment Of Irritable Bowel Syndrome With Diarrhea

Objective:The objective of this study was to observe the clinical efficacy of warm acupuncture in the treatment of Irritable Bowel Syndrome with Diarrhea(IBS-D),and exploratorily demonstrated that warm acupuncture has better efficacy and more obvious advantages than acupuncture alone.Methods:This trial began in January 2020 and was discontinued in February 2022.All the cases came from the Gastroenterology Specialist Clinic of the Department of Acupuncture and Moxibustion of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,colonoscopic return visit patients and university students,and after 2 weeks of screening,a total of 60 cases of IBS-D patients who met the diagnostic criteria of traditional Chinese and Western medicine and voluntarily followed the doctor’s instructions and signed informed consent were treated.This trial used a simple randomized method to divide patients into treatment groups and control groups,with 30 cases in each group.The control group adopted the simple acupuncture method,taking the main acupuncture points in the middle,ST25,RN4,RN12,ST36,ST37 and the corresponding dialectical matching points,the treatment group adopted warm acupuncture treatment,and on the basis of the control group,the main points were given 1 small moxa stick.During the 6-week treatment period,each group was treated 3 times a week for the first 3 weeks and twice a week for the next 3 weeks,for a total of 15 treatments,and followed up for 4 weeks.The clinical efficacy of the treatment in the 2 groups was observed,the scale was evaluated,and adverse events were recorded.The primary outcome measures of the study were the effective response rate after 6weeks of treatment,and the secondary outcome measures were the IBS Quality of Life(IBS-QOL)specific to irritable bowel syndrome and the Patient Health Questionnaire Depression Scale(PHQ-9).The frequency of defecation and the degree of abdominal pain in patients during the entire trial period were recorded by the patient himself by filling in the defecation diary card online,and the relevant scale was completed by the evaluator through online or offline questions and answers.SPSS26.0 was used to statistically analyze the index score,reflect the clinical efficacy of warm acupuncture intervention in IBS-D patients,and evaluate its safety.Results:1.Basic situation: the treatment group completed 29 cases,1 patient failed to complete treatment due to the impact of the epidemic,the control group completed 28 cases,1 patient withdrew from the trial due to needle intolerance,and 1 patient withdrew from the trial due to the impact of the epidemic.There was no statistical difference between the baseline of the basic data and scale evaluation indicators of the two patient groups,which was comparable(P>0.05).2.Comparison of primary outcome indicators: after 6 weeks of treatment,the thin stool response rate,abdominal pain response rate and total response rate of patients in the treatment group were significantly higher than those in the control group,the thin stool response rate was 82.8%,the abdominal pain response rate was 82.8%,the total response rate was 69.0%,the control group’s thin stool response rate was 50.0%,the abdominal pain response rate was64.3%,the total response rate was 35.7%,the dilute stool response rate and the total response rate of the two groups were statistically different(P<0.05),and there was no statistical difference in abdominal pain response rate(P>0.05)。3.Comparison of secondary outcome measures:IBS-QOL:(1)Intra-group comparison: At different time points,there were statistical differences in the scores of each dimension and total scores in the treatment group compared with baseline(P<0.05),and there were significant statistical differences except for sexual behavior(P<0.001);Compared with the baseline at different time points in the control group,except for the statistical difference between sexual behavior and autologous intention(P>0.05),the remaining scores were significantly improved with statistical differences(P<0.05),and there was a significant statistical difference in the total score after treatment and eating avoidance after follow-up(P<0.001);There was no statistical difference between treatment and follow-up(P>0.05);(2)Comparison between groups: there was a statistical difference in IBS-QOL sexual behavior after treatment(P<0.05),no statistical difference in other dimensions(P > 0.05),and no statistical difference in the comparison of various dimensions between groups at follow-up(P>0.05).PHQ-9:(1)Intra-group comparison: The two groups had statistical differences in the comparison of PHQ-9 at various time points with baseline(P < 0.05),and there was a significant statistical difference in the treatment group(P<0.001),but there was no statistical difference between the treatment and follow-up comparison(P>0.05);(2)between the two groups: there was no statistical difference after follow-up(P>0.05).4.Adverse reaction event records and safety evaluation: no serious adverse events occurred in the study cases.One patient in the control group had acupuncture sequelae during treatment and could not tolerate shedding treatment,and 2 patients continued treatment with subcutaneous bleeding after acupuncture;1 patient in the treatment group completed treatment with subcutaneous bleeding after acupuncture,and 1 patient suffered local scalds on the skin due to moxibustion ash falling during warm acupuncture,and no other discomfort was completed after treatment.The safety evaluation of the two groups was comparable,and there was no statistical difference(P>0.05).Conclusion:1.Warm acupuncture and acupuncture treatment IBS-D can improve the abdominal pain and loose stool symptoms of patients,among which the effect of warm acupuncture to improve the number of days of thin stool in patients is better than that of the acupuncture group,and the efficacy of improving abdominal pain symptoms is comparable to that of the acupuncture group.2.Both warm acupuncture and acupuncture can improve the quality of life of patients,alleviate depression and the effect can be extended to 4 weeks after the end of treatment,but there is no significant difference in efficacy between the two,and further verification is needed.3.The safety of warm acupuncture and acupuncture treatment IBS-D is comparable,and the effect of improving the symptoms of loose stool is better,which can be further promoted in clinical practice.