Effects and Mechanisms of Acupuncture on Diarrhea-Predominant Irritable Bowel Syndrome: A Systematic Review

Abstract

BackgroundIrritable bowel syndrome (IBS) is a common disorder of gut-brain interaction with challenging treatment. According to evidence-based studies, acupuncture is likely to be a promising therapy and subservient adjunct for IBS. Mechanism study of acupuncture based on related clinical trials of high quality, nevertheless, is still vacant.AimThis study aims to assess the results and qualities of current clinical evidence and conclude the relevant pathophysiological mechanisms and therapeutic effects of acupuncture on IBS with diarrhea (IBS-D).MethodsLiterature from four databases, namely, PubMed, Cochrane Library, EMBASE, and Web of Science, was systematically searched to obtain eligible randomized controlled trials (RCTs), which contained mechanism research of acupuncture treatment in IBS-D patients. Two independent reviewers completed data extraction and quality evaluation using the RevMan 5.4.1 software.ResultsTen trials that covered 19 items related to mechanism research were included in this review. Acupuncture was reported to improve IBS-D symptoms and quality of life, with positive effects in regulating brain-gut peptides, cerebral activities, neuroendocrine functions, psychological state, and inflammatory GI and hypersensitive intestinal tracts.ConclusionAcupuncture has potential influence on pathophysiology alterations such as regulating brain-gut peptides, altering cerebral connectivity and activity, promoting neuroendocrine functions and mental state, and mitigating inflammation as well as hypersensitivity of bowels in IBS-D patients, but further studies of high quality are still necessary.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022320331].

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

“…[43] In recent years, the reports of ACU and moxibustion in the treatment of IBS-D with anxiety and depression have increased significantly, and it has been gradually accepted by patients at home and abroad due to its good therapeutic effect. [44] Although a large number of previous clinical studies have been conducted, indirect comparisons between different ACU interventions are lacking. This study used network meta-analysis to indirectly compare different interventions and calculate the best probability.…”

Efficacy of different courses of acupuncture for diarrhea irritable bowel syndrome: A protocol for systematic review and meta-analysis

“…Most IBS [ 17 ] patients with poor efficacy of conventional treatment seek acupuncture as an alternative treatment for poor efficacy of conventional treatment. Acupuncture can improve IBS-D by regulating multiple mechanisms such as brain-gut peptides, inflammation and hypersensitivity of bowels [ 20 ]. Evidence-based medical research suggests that acupuncture may be a promising treatment for IBS-D [ 18 , 19 ].…”

“…According to the comprehensive review, acupuncture therapy may relieve IBS-D symptoms by regulating brain-gut peptides, modifying cerebral connection and activity, and reducing inflammation and intestinal hypersensitivity [ 20 ].…”

Modulation of visceral pain by brain nuclei and brain circuits and the role of acupuncture: a narrative review

“…Previous research showed that following acupuncture treatment, the FC of the attention network (the temporal lobe) and the visceral pain network (such as the insula and middle cingulate gyrus) in IBS patients was weakened, the FC of the right anterior cingulate gyrus cerebellar vermis was enhanced, and that the FC of the left amygdala left posterior central gyrus was weakened. Researchers have hypothesized that acupuncture could improve the clinical symptoms of pain and anxiety by regulating the activities of FC in relevant brain regions (Zhang et al, 2022). Similarly, a previous fMRI study demonstrated brain imaging changes in D-IBS patients during rectal balloon expansion before and after moxibustion.…”