Systematic Review Of Clinical Trials Of Acupuncture Therapies For Irritable Bowel Syndrome

BackgroundIrritable bowel syndrome (IBS) is the most common functional bowel disease with high prevalence and recurrence, which seriously affect the quality of life of the patients. The etiology and pathogenesis of IBS is still unclear and there is no ideal treatment so far. Acupuncture therapy is important part of Chinese medicine with unique effects in the treatment of functional disease, but there is still no strict evidence-based medical evidence for effectiveness of acupuncture therapy in IBS.ObjectiveThe purpose of this work was to assess the evidence for effectiveness of acupuncture therapy in IBS.MethodsStrict inclusion and exclusion criteria were formulated. A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture therapy for IBS was performed according to International Cochrane Collaboration.Data SourceTrials were collected from Cochrane Library, PubMed Database, CBM Database, CNKI Database,Wanfang Database and VIP Database.Data AnalysisStatistic analysis was managed by Revman 5.0.24 version provided by Cochrane organization. According to the type of outcome index, classification variables were assessed by relative risk (RR), continuous variables were assessed by weighted mean difference (WMD) or standardized mean difference (SMD), and the 95% confidence interval (CI) was reported. Results33 RCTs and 2 QRCTs, totally 2907 cases were included, with 2 trials of high methodological quality. Most trials were of low methodological quality. 7 trials adopted blinding method,5 trials used "sham" acupuncture for controlled intervention. Data analysis indicated that moxibustion, combined acupuncture and moxibustion, catgut embedding treatment, combined electro-acupuncture and auricular point-pressing, combined point application and drug treatments of IBS were superior to drug. The most frequently used acupoints were Tianshu (ST 25), Zusanli (ST 36), Zhongwan (CV 12), Shenque (CV 8), Dachangshu (BL 25), Shangjuxu (ST 37), Guanyuan (CV 4), Sanyinjiao (SP 6) and Taichong (LR 3). The most frequently used auricular points were Dachang (CO 7) large intestine, Jiaogan (AH 6a) sympathesis, Pi (CO 13) spleen, Shen (CO 10) kidney and Fei (CO 14) lung.ConclusionCurrent evidence indicated that acupuncture therapy was statistically effective for IBS. Moxibustion, combined acupuncture and moxibustion, catgut embedding treatment, combined electro-acupuncture and auricular point-pressing, combined point application and drug treatments may be valuable in treating IBS. Because of limited trials and low methodological quality, the above conclusions were not fully convinced. There is an urgent need for strictly designed, randomized, controlled trials with large sample, high methodological quality to assess the effectiveness of acupuncture therapy.