Clinical evaluation of Soothing Gan (肝) and invigorating Pi (脾) acupuncture treatment on diarrhea-predominant irritable bowel syndrome

Sun, Jianhua; Wu, Xiaoliang; Chen, Xia; Xu, Li; Pei, Lixia; Li, Hao; Han, Guang-yan

doi:10.1007/s11655-011-0875-z

Cited by 37 publications

(53 citation statements)

References 14 publications

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“…For trials comparing acupuncture versus pharmacological therapies, restriction to the 4 trials that compared acupuncture versus evidence-based (53) antispasmodic pharmacological therapies (35,45,46,49) had similar results (RR 1.21, 95% CI 1.07 to 1.37, 249 participants, I 2 =0). For the other comparisons, there were too few trials to attempt subgroup analyses (32).…”

Section: Resultsmentioning

confidence: 98%

“…In the trials comparing acupuncture with another active treatment (33,35,40,41,45,46,48,49), no (specific) treatment (38,43), or evaluating acupuncture as an adjuvant to another treatment received by all trial participants (36,39-41,47), blinding of participants was not possible, and this likely represents the major risk of bias in these trials. In these comparative effectiveness trials, there were also risks of bias associated with the randomization procedure and the follow-up of patients (see Risk of Bias table).…”

Section: Resultsmentioning

confidence: 99%

“…The five trials (35,45,46,48,49) that compared acupuncture versus pharmacological therapies for IBS found that participants receiving acupuncture reported a greater improvement than participants receiving pharmacological therapies (see Figure 2). …”

Section: Resultsmentioning

confidence: 99%

“…Nine trials included descriptions of adverse events associated with acupuncture (33,34,36-38,41,43,45,46). For 8 of these 9 trials (33,34,36-38,41,43,46), no serious adverse events were reported, while the Shi et al trial (45) reported that 1 participant in the electro-acupuncture group withdrew because of syncope.…”

Section: Resultsmentioning

confidence: 99%

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Acupuncture for Irritable Bowel Syndrome: Systematic Review and Meta-Analysis

Manheimer

Wieland

Cheng

et al. 2012

American Journal of Gastroenterology

106

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Objective Evidence-based treatment guidelines have been unable to provide evidence-based guidance on the effects of acupuncture for irritable bowel syndrome (IBS) because the only previous systematic review included only small, heterogeneous and methodologically unsound trials. We conducted a new systematic review and meta-analysis of randomized controlled trials (RCTs) to estimate the effects of acupuncture for treating IBS. Methods MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, Cumulative Index to Nursing and Allied Health, and the Chinese databases Sino-Med, CNKI, and VIP were searched through November 2011. Eligible RCTs compared acupuncture with sham acupuncture, other active treatments, or no (specific) treatment, and evaluated acupuncture as an adjuvant to another treatment. Our outcomes were overall IBS symptom severity and health-related quality of life. Dichotomous data were pooled to provide a relative risk (RR) of substantial improvement after treatment, and continuous data were pooled to provide a standardized mean difference (SMD) in post-treatment scores between groups. Results Seventeen RCTs (N=1806) were included. We found no evidence of an improvement with acupuncture relative to sham acupuncture on symptom severity (SMD = −0.11, 95% confidence interval: −0.35 to 0.13; 4 RCTs) or quality of life (SMD = −0.03, −0.27 to 0.22; 3 RCTs). Because of the homogeneity of the results of the sham-controlled trials, results were unaffected by restriction to the 4 sham-controlled RCTs that used adequate randomization, blinding, and had few withdrawals/drop-outs. Among RCTs that did not use a placebo control, acupuncture was more effective than pharmacological therapy (RR of symptom improvement=1.28, 1.12 to 1.45; 5 RCTs) and no (specific) treatment (RR = 2.11, 1.18 to 3.79; 2 RCTs). There was no difference between acupuncture and Bifidobacterium (RR = 1.07, 0.90 to 1.27; 2 RCTs) or between acupuncture and psychotherapy (RR=1.05, 0.87 to 1.26; 1 RCT). Acupuncture as an adjuvant to another Chinese medicine treatment was statistically significantly better than the other treatment alone, in trials with a high risk of bias (RR = 1.17, 1.02 to 1.33; 4 RCTs). Conclusions Sham-controlled RCTs have found no benefits of acupuncture relative to a credible sham acupuncture control on IBS symptom severity or IBS-related quality of life. In comparative effectiveness Chinese trials, patients reported greater benefits from acupuncture than from pharmacological therapies. Future trials may help clarify whether or not these reportedly greater benefits of acupuncture relative to pharmacological therapies are due entirely to patients’ preferences for acupuncture or patients’ greater expectations of improvement on acupuncture relative to drugs.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Acupuncture for Irritable Bowel Syndrome: Systematic Review and Meta-Analysis

Manheimer

Wieland

Cheng

et al. 2012

American Journal of Gastroenterology

106

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“…Acupuncture and EA are widely used in pain relief in clinic [18, 19] and in relieving inflammation-induced hypersensitivity in rat models [8, 20]. However, in the treatment of visceral hypersensitivity, the use of acupuncture once is often not enough.…”

Section: Discussionmentioning

confidence: 99%

Acupuncture Alleviates Colorectal Hypersensitivity and Correlates with the Regulatory Mechanism of TrpV1 and p-ERK

Wang

Yang

2012

Evidence-Based Complementary and Alternative Medicine

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Here we used a mouse model of zymosan-induced colorectal hypersensitivity, a similar model of IBS in our previous work, to evaluate the effectiveness of the different number of times of acupuncture and elucidate its potential mechanism of EA treatment. Colorectal distension (CRD) tests show that intracolonic zymosan injection does, while saline injection does not, induce a typical colorectal hypersensitivity. EA treatment at classical acupoints Zusanli (ST36) and Shangjuxu (ST37) in both hind limbs for 15 min slightly attenuated and significantly blunted the hypersensitive responses after first and fifth acupunctures, respectively, to colorectal distention in zymosan treatment mice, but not in saline treatment mice. Western blot results indicated that ion channel and TrpV1 expression in colorectum as well as ERK1/2 MAPK pathway activation in peripheral and central nerve system might be involved in this process. Hence, we conclude that EA is a potential therapeutic tool in the treatment and alleviation of chronic abdominal pain, and the effectiveness of acupuncture analgesia is accumulative with increased number of times of acupuncture when compared to that of a single time of acupuncture.

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