Comparison of Electroacupuncture and Mild-Warm Moxibustion on Brain-Gut Function in Patients with Constipation-Predominant Irritable Bowel Syndrome: A Randomized Controlled Trial

Zhao, Ji; Jin, Lu; Yin, Xiao jun; Wu, Lu; Bao, Chun; Chen, Xing kui; Chen, Yue hua; Tang, Wei; Jin, Xiao Ming; Wu, Huan; Shi, Yin

doi:10.1007/s11655-018-2838-0

Cited by 33 publications

(58 citation statements)

References 28 publications

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“…As is well-known, visceral hypersensitivity has been deemed as an important neurological evidence underlying the pathogenesis of abdominal pain in IBS, and visceral pain is associated with a dysregulation of the brain-gut axis[ 75 , 76 ]. Some clinical investigations have confirmed the efficacy of acupuncture in the regulation of the abnormal brain activities and improving visceral hypersensitivity in IBS sufferers[ 77 , 78 ]. Moreover, numerous animal studies have also suggested that acupuncture could significantly reduce the peripheral blood flow of rats with 5-hydroxytryptamine positive reactant content and improve visceral hypersensitivity[ 79 - 81 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Dai

et al. 2020

WJG

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BACKGROUND Although nonpharmacological interventions (NPI) for irritable bowel syndrome (IBS) have been applied clinically, their relative efficacy and safety are poorly understood. AIM To compare and rank different NPI in the treatment of IBS. METHODS Five electronic databases were searched from their inception to January 12, 2020. Data of included publications were analyzed using network meta-analysis (NMA). Quality of endpoints were assessed by tools of the Cochrane Handbook and the GRADEpro software. Pooled relative risk or standardized mean difference with their corresponding 95% confidence intervals were used for statistical analysis. Surface under the cumulative ranking curve (SUCRA) probability value was conducted to rank the examined interventions. Sensitivity analysis was performed to verify the robustness of results and test the source of heterogeneity. RESULTS Forty randomized controlled trials with 4196 participants were included in this NMA. Compared with routine pharmacotherapies and placebo, acupuncture and cognitive behavioral therapy (CBT) had better efficacy in relieving IBS symptoms. Based on the SUCRA values, acupuncture ranked first in improving overall clinical efficacy and avoiding adverse effects. CBT ranked first in lowering the scores of IBS symptom severity scale, self-rating anxiety scale and self-rating depression scale. CONCLUSION This study confirmed the efficacy and safety of NPI for improving IBS symptoms, which to some extent recommended several interventions for clinical practice.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Dai

et al. 2020

WJG

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“…Many studies have demonstrated the e cacy of moxibustion in treating IBS-D, but It still remains unclear how moxibustion alleviates IBS-D [29]. Our previous studies indicate that moxibustion could affect intestinal microbes [30,31], visceral hypersensitivity [31,32], the brain-gut axis [14,16], gastrointestinal function [33]. Other studies showed the moxibustion or acupuncture have bene t effect for IBS-D by regulating the neuroendocrine system [34], the immune system [35], and other factors.…”

Section: Discussionmentioning

confidence: 99%

“…Acupuncture and moxibustion are the effective treatment for IBS [12,14], and there are several meta-analyses suggested bene ts of acupuncture and moxibustion in terms of symptom control and quality of life improvements in patients with IBS [13,15]. In our previous studies, we compared the e cacy of electroacupuncture with mild moxibustion for treating IBS-C and IBS-D, respectively, and showed that electroacupuncture resulted in symptoms improvement, modulating on brain-gut function in patients with IBS-C [14] and IBS-D [16]. However, these trials focused on the effect of electroacupuncture VS mild moxibustion on IBS, not mild moxibustion VS placebo Participants Participants were recruited from Shanghai Research Institute of Acupuncture and Meridian between May 2017 and December 2019 through hospital-based Wechat, print advertisements, and posters at the outpatient unit.…”

Section: Introductionmentioning

confidence: 99%

Mild Moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A Randomized Controlled Trial

Wang¹,

Xu²,

Shi³

et al. 2021

Preprint

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Objective To evaluate the effects of mild moxibustion (MM) for the treatment of irritable bowel syndrome with diarrhea (IBS-D) through comparisons with those of placebo moxibustion. Patients and Methods: This was a single-site, randomized controlled trial was conducted at Shanghai Research Institute of Acupuncture and Meridian in China and enrolled 76 participants who met the Rome IV diagnostic criteria for IBS-D between May 2017 and December 2019. 76 participants were randomized to either mild moxibustion (MM) or placebo moxibustion group (PM) in a 1:1 ratio. 18 sessions of MM or PM were implemented over the course of 6 weeks (3 times per week). The primary outcome was adequate relief after 6 weeks of treatment. Results Of 76 patients with IBS-D who were randomized (38 in the MM group and 38 in the PM group) were included in the intention-to-treat (ITT) analysis set. After treatment at week 6, the response rate was significantly higher in the MM group than the PM group (81.58% vs. 36.84%,) with an estimated difference of 44.74 (95% CI, 23.46 to 66.02, P < 0.001). No participant reported severe adverse effects. Conclusion The findings suggest that mild moxibustion may be more effective than placebo moxibustion for the treatment of IBS-D, with effects lasting up to 12 weeks. Trial Registration: ChiCTR, ChiCTR2100046852. Registered 29 May 2021 - Retrospectively registered, URL: http://www.chictr.org.cn/showproj.aspx?proj=127000

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“…The mechanism of moxibustion analgesia has not been adequately explained thus far. Some studies only support the effect of moxibustion in relieving functional visceral pain but cannot ensure its effect for other forms of pain 36,48,49. Zhu et al found that the analgesic effect that moxibustion produced for functional visceral pain should be associated with the regulation of the prefrontal cortex (PFC) and anterior cingulate cortex (ACC), indicating a central regulation mechanism of moxibustion analgesia 50.…”

Section: Discussionmentioning

confidence: 99%

<p>Moxibustion Eases Chronic Inflammatory Visceral Pain In Rats Via MAPK Signaling Pathway In The Spinal Cord</p>

Huang

Zhang

et al. 2019

JPR

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PurposeThe purpose of this study was to explore the central analgesia mechanism of moxibustion for chronic inflammatory visceral pain (CIVP).MethodsA CIVP rat model was established by 2,4,6-trinitrobenzene sulfonic acid (TNBS) plus 50% ethanol via enema. The analgesic effect of moxibustion was evaluated using the abdominal withdrawal reflex (AWR), mechanical withdrawal threshold (MWT), and thermal withdrawal latency (TWL). The expression profile of phosphorylated proteins of the mitogen-activated protein kinase (MAPK) signaling pathway in the spinal cord was assayed by protein microarray. The differentially expressed proteins were examined by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) for functional clusters and corresponding signaling pathways.ResultsMoxibustion exerted a significant analgesic effect for CIVP rats, mainly presenting as a decrease in the AWR score (all P<0.01) under different levels of distending pressure and an increase in MWT and TWL thresholds (all P<0.05). Compared with the normal group, 76 proteins were upregulated while 15 were downregulated, and MAPK signaling pathway was activated in the model group. Compared with the model group, there were 53 downregulated and 38 upregulated proteins in the moxibustion group, and MAPK signaling pathway was inhibited. Fold change (FC)>1.3 or <0.77 was taken as the screening standard to define the differentially expressed proteins. Fifteen differentially expressed proteins upregulated in the model group were downregulated in the moxibustion group. GO analysis showed that the differentially expressed proteins mainly controlled cellular metabolism regulation, transportation, and stress reactions. KEGG analysis revealed that these differentially expressed proteins were mostly involved in the ERK, JNK, and p38 pathways, and the ERK pathway was predominant.ConclusionMoxibustion mitigates CIVP in rats and inhibits the phosphorylation of proteins in the spinal MAPK signaling pathway. The analgesic effect of moxibustion may be associated with the regulation of the spinal MAPK signaling pathway.

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Comparison of Electroacupuncture and Mild-Warm Moxibustion on Brain-Gut Function in Patients with Constipation-Predominant Irritable Bowel Syndrome: A Randomized Controlled Trial

Abstract: Both EA and Mox could signifificantly improve some of the most intrusive symptoms of C-IBS patients, and EA was more effective than Mox. The therapeutic effect of these two therapies might through modulating of the brain-gut axis function. (Registration No. ChiCTRTRC-11001349).

Cited by 33 publications

References 28 publications

Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults

Mild Moxibustion for Irritable Bowel Syndrome with Diarrhea (IBS-D): A Randomized Controlled Trial

<p>Moxibustion Eases Chronic Inflammatory Visceral Pain In Rats Via MAPK Signaling Pathway In The Spinal Cord</p>

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