| BackgroundDiarrhea-predominant Irritable Syndrome (IBS-D), one of the most common clinical gastrointestinal diseases, has a long course and high recurrence rate. Since the later decades of last century, the number of IBS-D patients has increased greatly. This syndrome has affected the quality of their lives negatively. Considerably, researchers have paid attention to the Traditional Chinese medicine and treatments focusing on IBS-D in these years. There are also many research papers about the acupuncture and moxibustion therapies and acupoint-usage rules of IBS-D. But a systematic analysis of these contents hasn’t been done, especially the collection, selection, and analysis of the research results relevant to the acupuncture and moxibustion therapies and acupoint-usage rules of IBS-D. Also, there is no any clinical research based on the above literature research.ObjectivesThe purpose of this research is, firstly, to review the ancient medical literature of the acupuncture and moxibustion therapies of diarrhea and abdominal pain. Then, the modern medical literature on the acupuncture and moxibustion therapies of IBS-D will be searched and selected based on a group of particular criteria. At the same time, the rules of these therapies and acupoint-usage will be analyzed. Finally, a clinical research will be implemented with a treatment plan based on the previous literature studies.MethodsBesides the introduction, conclusion, reference, appendix, and acknowledgements, there are other four parts of studies in this paper, including the literature review of modern relevant researches, the literature analysis of ancient traditional Chinese medicine related to IBS-D, the analysis of literature on modern clinical reports, and a clinical research based on the literature research.The literature review of modern relevant researches will be based on the articles of IBS-D researches’analysis and review in online database, SinoMed(CBM). The blank of this research area will be concluded. According to the results of the review, the following studies will be launched.The Encyclopedia of Traditional Chinese Medicine will be used as the database of ancient literature research, using key words related to diarrhea and abdominal pain. The searching results will be analyzed. Also, the studies of ancient literature searched from online databases, published in recent years, will be analyzed. The rules of ancient acupuncture and moxibustion therapies and acupoint-usage of diarrhea and abdominal pain will be concluded base on the above studies.Online databases, such as SinoMed(CBM) and PubMed, with some other Chinese and English online databases, will be used to search the modern clinical reports of IBS-D with the acupuncture and moxibustion treatment plans, published from 1985 to 2015. Key words in both Chinese and English will be utilized. A host of criteria will be used for screening. At last, the rules of modern acupuncture and moxibustion therapies and acupoint-usage will be concluded based on the analysis.The study of IBS-D treatment plans is designed as a parallel randomized controlled conical trial, using the severity of the symptoms as the main index and the TCM syndromes as the other index, to compare the clinical effects of auricular point compression, electro acupuncture and warmed needle acupuncture.ResultsAccording to the literature reviews and analysis published since 1985, there is no research focus on the acupuncture and moxibustion treatments and rules of acupoint usage based on both ancient literature and modern clinical studies, together with a clinical study designed on the basis of literature researches in order to testify the results of the literature studies.Most of the ancient literature describe that diarrhea is caused by improper eating and working habits, some environmental elements including unpleasant weather, and the effect of negative emotions. These causes will influence the operation of spleen and stomach. As the result, diarrhea happens. Abdominal pain is caused by elements similar to diarrhea. The malfunction of spleen is also a reason of the pain. With the combined effect of all these elements, the movement of Qi will be blocked, and the meridians will be lack of nutrition. Finally, abdominal pain occurs. The TCM syndromes relevant to IBS-D are liver’s qi stasis, the weakness of spleen and stomach, insufficient yang of spleen and kidney, disorder of qi, and the phlegm and stagnant blood. With the accurate TCM syndrome differentiation, the treatments often start with the spleen, stomach or kidney from the angles of deficiency, excess, dampness, phlegm, and qi, etc. The methods include harmonization, diaphoresis, emesis, and purgation. Most of the herbal medicines are tonic or interior-warming ones, or can eliminate dampness. The herbal formulations can warm the interior cold and remove the dampness, warm the middle and cure diarrhea, support the spleen and restrict the kidney, relieve diarrhea with astringents, warm the kidney and relieve diarrhea, support the spleen and qi. The therapies of acupuncture and moxibustion will be selected based on the distinguishing of TCM syndromes. The methods include acupuncture, moxibustion, acupoint patches, and indirect moxibustion. The choose of acupoints follows the rules of nearby points selection, distal end points selection, acupoint collocation, and the usage of specific acupoints.More than half of the selected modern studies have no research funding. Most of them are published in the professional acupuncture journals. Most of the research accomplished in Guangdong, Hebei, Shandong, Zhejiang and Jiangsu province. Clear standards of diagnosis and recovery are provided in most of the studies. TCM syndromes usually include liver stagnation and spleen deficiency, yang insufficiency of spleen and kidney, weakness of spleen and stomach, and spleen deficiency and dampness stagnation. There are various and special treatments, such as auricular point patches, eye-acupuncture, scalp acupuncture, electro acupuncture, fire needling, and warm needling, etc. Besides, there are also combined therapies, such as acupuncture with herbal medicine, acupuncture with cupping or other external treatments. The range of acupoints selection is wide. Acupoints in common use are Tianshu, Zusanli, Zhongwan, Pishu, Shenque, Taichong, Shangjuxu, Guanyuan, Dachangshu, Sanyinjiao, etc. When choosing the acupoints, the following factors must be considered, such as the syndrome differentiation of viscera or meridian, the collocation of acupoints, the usage of specific acupoints. The stomach meridian of foot yangming, the spleen meridian of foot taiyin, ren meridian, bladder meridian of foot taiyang, and liver meridian of foot jueyin are often used.The clinical research is based on the previous analysis of ancient and modern studies. In this research, auricular point patches, electro acupuncture and warm needling are used separately for three groups of IBS-D patients (Liver stagnation and spleen deficiency). The acupoint selection rule of He-mu combination is utilized in the groups of electro acupuncture and warm needling. The result shows that all three treatments are effective, and can improve clinical symptoms. At the same time, the TCM syndrome scoring is also improved. Among the treatments, the curative effect of warm needling is better than the other two. Electro acupuncture is better than auricular point patches.Cone I us i onWith the development of modern science, the acupuncture and moxibustion treatments of IBS-D are more various than the ancients ones. Although the method of acupoint selection still follows the rules discussed in ancient literature, such as the meridian and viscera syndrome differentiation, and the therapeutic principles of acupuncture and moxibustion described in Huangdi Nei Jing. The clinical research based on the literature studies proved that the three commonly used treatments and methods of choosing acupoints are effective. Among them, warm needling is the best choice. Therefore, a conclusion may be drawn that the clinical research can prove the result of literature studies. Nowadays, as a common disease, IBS-D brings troubles to patients’daily lives. In the future, researchers should explore deeper in order to find out more useful information in the ancient literature. Also, researchers can choose to prove and improve the useful treatments and usage of acupoints relevant to IBS-D in clinical and lab studies. The highly cost effective and valid acupuncture and moxibustion therapies can help patients to have a better living quality, lower medical expenses, while making the treatments of IBS-D a standardized procedure. |
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