Comparison between the Effects of Acupuncture Relative to Other Controls on Irritable Bowel Syndrome: A Meta-Analysis

Haizhen Zheng; Rixin Chen; Xiaofeng Zhao; Guanhui Li; Yi Liang; Hao Zhang; Zhenhai Chi

doi:10.1155/2019/2871505

Comparison between the Effects of Acupuncture Relative to Other Controls on Irritable Bowel Syndrome: A Meta-Analysis

Pain Res Manag. 2019 Nov 11:2019:2871505. doi: 10.1155/2019/2871505. eCollection 2019.

Authors

Haizhen Zheng¹, Rixin Chen¹, Xiaofeng Zhao², Guanhui Li³, Yi Liang³, Hao Zhang³, Zhenhai Chi¹

Affiliations

¹ Department of Acupuncture-Moxibustion, The Affiliated Hospital of Jiangxi University of TCM, Nanchang, Jiangxi Province 330009, China.
² Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300000, China.
³ Tianjin University of Traditional Chinese Medicine, Tianjin 300000, China.

Abstract

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and altered defecation habits. We here attempted to determine the effect of acupuncture on IBS.

Methods: Randomized controlled trials (RCTs) published in CNKI, VIP, Wanfang, PubMed, Cochrane Library, EMBASE, Web of science, and ClinicalTrials.gov till July 17, 2019 were searched. Outcomes were total efficacy rates, overall IBS symptom scores, or global quality of life scores. Standardized mean difference (SMD) with 95% confidence intervals (CI) and risk ratio (RR) with 95% CI were calculated for meta-analysis.

Results: We included 41 RCTs involving 3440 participants for analysis. 8 RCTs compared acupuncture with sham acupuncture, among which 3 trials confirmed the biological effects of acupuncture, especially in treating abdominal pain, discomfort, and stool frequency. No significant difference was found when acupuncture was compared with sham acupuncture, in terms of effects on IBS symptoms and quality of life (SMD = 0.18, 95% CI -0.26∼0.63, P=0.42; SMD = -0.10, 95% CI -0.31∼0.11, P=0.35), but the pooled efficacy rate data showed a better outcome for true acupuncture (RR = 1.22, 95% CI 1.01∼1.47, P=0.04), which was not supported by sensitivity analysis. Acupuncture was more effective relative to western medicine in alleviating IBS symptoms (RR = 1.17, 95% CI 1.12∼1.23, I ² = 0%, P < 0.00001), whose effect might last 3 months. Besides, acupuncture as an adjunct to western medicine, Chinese medications, or tuina was superior over the single latter treatment (RR = 1.68, 95% CI 1.18 to 2.40, P=0.004; 1.19, 1.03 to 1.36, P=0.02; 1.36, 1.08 to 1.72, P=0.009, respectively), with high heterogeneities.

Conclusions: Relative to sham controls, acupuncture showed no superiority for treating IBS, while the advantage over western medicine was significant. Acupuncture could be used as an adjunct in clinical settings to improve efficacy. Future high-quality and large-sample-size studies with adequate quantity-effect design need to be conducted.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review

MeSH terms

Acupuncture Therapy / methods*
Female
Humans
Irritable Bowel Syndrome / therapy*
Quality of Life
Randomized Controlled Trials as Topic