Meta - Analysis Of Acupuncture And Moxibustion Treatment Of Irritable Bowel Syndrome

Purpose: A meta-analysis of randomized controlled trials was conducted to evaluate the safety and curative efficacy of acupuncture and moxibustion for irritable bowel syndrome under the guidance of the theory of evidence-based medicine, meanwhile, looking forward to providing reference value when makes the clinical diagnosis and treatment decision.Material and method: All the included RCT studies about the acupuncture therapy for irritable bowel syndrome were searched from the Cochrane Central Register of Controlled Trials, Pubmed, EMBASE, The Chinese Biological Medicine Database, the China National Knowledge infrastructure, Wanfang Database and VIP. In addition, in order to avoid the risk of missing other eligible trials, manual retrieval was performed from “Journal of Clinical Acupuncture and Moxibustion” and the bibliographies of the included articles. The main outcome measures chose in this study included the total effectiveness of clinical symptoms,three months follow-up recurrence rate and the improvement in scores of the quality of life.Information related to the included studies was extracted independently by project team members according to the extraction table. Once there had any difference, discussion between team members or a third party(hierophant) was needed. The cochrane collaboration’s tool for assessing risk of bias was uesd to assessment of methodological Quality of all the inclusive trails. The Revman Manager 5.3 for the Meta-analysis.Results:28 eligible trials(N=1991) were brought into our study. The results of the Meta-analysis as follows:Compared to other positive pharmacological therapies, there was no evidence of an improvement with acupuncture for the quality of life(95%CI :-0.42 to-0.04,6 trials). The three months follow-up recurrence rate was lower than other therapies(95%CI:0.35 to 0.68, 4trials). Among trials that didn’t use placebo control, there disappeared that acupuncture was more effective in improving the IBS clinical symptom than the traditional Chinese herbal (95%CI: 1.03 to 1.29, 3 trials). Or western medication(95%CI: 1.08 to 1.26, 9 trials). And the funnel plot was substantially symmetric. Also, the warm needling moxibustion or other moxibustion showed the similar curative effect when compared to western medication(95%CI : 1.11 to 1.32, 5 trials) and( 95%CI : 1.19 to 1.45, 6 trials).All in all, the test results of the combined statistics showed that there had significant difference in above the 6 merger results.Conclusion:1.The Meta analysis results showed that, compared to control groups, acupuncture had its own advantages in improving the quality of life and clinical symptoms of IBS patients, reducing the three months follow-up recurrence rate.2.There existed problems such as random sequence generation and allocation concealment,which resulted in the relatively lower assessment of methodological quality, reducing the strength of evidence that demonstrated the efficacy of experimental group was better than that of control group. Because of the controversy, The reliability of the conclusion should be treated with caution. Due to the causes above, looking forward to the future clinical trials could strictly follow the design scheme of randomized controlled trials, and so as to further validate the clinical curative effectiveness of acupuncture for IBS, high quality, multi-center,lager samples were necessary.