Different acupuncture and moxibustion therapies in the treatment of IBS-D with anxiety and depression: A network meta-analysis

Yi Hou; Xiaoli Chang; Ningning Liu; Zhen Wang; Zhengwen Wang; Shaozong Chen

doi:10.1097/MD.0000000000037982

Different acupuncture and moxibustion therapies in the treatment of IBS-D with anxiety and depression: A network meta-analysis

Medicine (Baltimore). 2024 Apr 26;103(17):e37982. doi: 10.1097/MD.0000000000037982.

Authors

Yi Hou¹, Xiaoli Chang², Ningning Liu³, Zhen Wang², Zhengwen Wang², Shaozong Chen²

Affiliations

¹ School of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
² Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
³ Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China.

Abstract

Background: Currently, a variety of Western medical interventions are available for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) with comorbid anxiety and depression. However, the attendant negative effects also emerge, putting pressure on healthcare resources and socio-economic structures. In recent years, the benefits of acupuncture (ACU) and moxibustion in the treatment of IBS-D with anxiety and depression have gradually emerged. However, there are many types of ACU-moxibustion-related treatments, and the aim of this study is to examine the effectiveness of different ACU-moxibustion therapies in the treatment of anxiety and depression in IBS-D patients.

Methods: Searched and identified randomized controlled trials (RCTS) of ACU for the treatment of anxiety and depression in patients with irritable bowel syndrome (IBS). The search spanned from the establishment of the database until September 1, 2023. Revman 5.4 and Stata 15.0 software were used for network meta-analysis (NMA), and the included interventions were ranked by the area under the cumulative ranking curve.

Results: A total of 26 articles involving 8 interventions were included. In terms of improving HAMA score, MOX was superior to EA, combined therapies, CH, WM and placebo; In terms of improving HAMD score, MOX was superior to ACU, EA, combined therapies, WM and placebo; In terms of improving the SAS score, The combined therapies were superior to EA, CH and WM; In terms of improving SDS scores, The combined therapies were superior to EA, CH and WM; In terms of improving IBS-SSS score, The combined therapies were superior to WM; In terms of reducing recurrence rates, CH was superior to combined therapies; In terms of improving total effective rates, MOX was superior to EA, CH, WM and placebo; MOX, combined therapies, ACU and EA ranked higher in SUCRA of different outcome indicators.

Conclusion: MOX, combined therapies, ACU and EA have certain curative effect on anxiety and depression in patients with IBS-D, and their safety is high. ACU and MOX combined with other therapies also have significant advantages in the treatment effect.

Publication types

Meta-Analysis

MeSH terms

Acupuncture Therapy* / methods
Anxiety* / etiology
Anxiety* / therapy
Depression* / etiology
Depression* / therapy
Humans
Irritable Bowel Syndrome* / complications
Irritable Bowel Syndrome* / psychology
Irritable Bowel Syndrome* / therapy
Moxibustion* / methods
Network Meta-Analysis*
Randomized Controlled Trials as Topic
Treatment Outcome