Noneffectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome

Abstract

Background and Aim Comorbid generalized anxiety disorder and irritable bowel syndrome are common and therapeutically challenging. We aimed to assess the effectiveness of electroacupuncture in relieving anxiety and bowel symptoms in Chinese adults with this form of comorbidity. Methods In a single‐blind randomized sham‐controlled trial, subjects with comorbid generalized anxiety disorder and irritable bowel syndrome were randomly assigned to receive 10 weekly sessions of electroacupuncture or sham electroacupuncture. Patients were assessed at baseline, immediately after intervention and at 6‐week follow‐up. Primary outcome was anxiety (7‐item Patient Health Questionnaire section for anxiety). Secondary outcomes included bowel symptoms (bowel symptoms questionnaire), depressive symptoms (9‐item Patient Health Questionnaire), somatic symptoms (15‐item Patient Health Questionnaire), and health‐related quality of life (EuroQol‐5 Dimensions). Results Eighty subjects, 40 in each arm, were randomized. All but two in the sham group completed 10 weekly sessions. There was no significant difference in the proportion of patients experiencing significant (≥ 50%) reduction of anxiety symptoms between the two groups immediately after intervention (32.4% vs 21.6%, P = 0.06) and at 6‐week follow‐up (25.7% in electroacupuncture vs 27% in sham, P = 0.65). Anxiety, depressive symptom, and bowel symptom severity did not differ significantly between electroacupuncture and sham groups. Conclusions Findings failed to support the effectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome. Further studies are needed to identify effective acupuncture treatment protocols for such comorbidity.

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

“…8 trials (16–18, 25–29) adopted sham acupuncture as the control group, among which the acupuncture total times ranged from 2 [25] to 28 [16], retention time ranged around 20–30 minutes per time, with a least acupuncture duration of 3 weeks [17, 26] and a most of 10 weeks [27]. The immediate efficacy (right at finishing treatments) of acupuncture treatments were recorded in 5 studies [16–18, 26, 28], 1 study examined acupuncture efficacy at 3 weeks post treatment [27], while 2 studies observed the efficacy at both the end of treatment and follow-up [25, 29].…”

“…Coming to the Chinese research [16], a fixed formula using acupuncture of daily 30 minutes' retention over 4 weeks equaling 28 sessions was compared with sham control, nonacupoints, 2 cm bilateral, perpendicular needling with no manipulation for the same course. Otherwise, the acupuncture parameters in the 5 RCTs [25–29] with negative results about the biological effects of acupuncture were not adequate in formula design. 3 studies [25, 27, 29] punctured for once a week or even once biweekly, totaling for 10 sessions or 2 times in total.…”

“…Otherwise, the acupuncture parameters in the 5 RCTs [25–29] with negative results about the biological effects of acupuncture were not adequate in formula design. 3 studies [25, 27, 29] punctured for once a week or even once biweekly, totaling for 10 sessions or 2 times in total. Other 2 researches [26, 28] used basically enough acupuncture stimulations, relatively being twice weekly for 10 sessions over 5 weeks and twice weekly for 6 times over 3 weeks.…”

“…(1) At the End of Treatment . 4 trials [25, 26, 28, 29] assessed this kind of item. Meta-analysis results indicated that no difference was found between groups (351 persons, SMD (95% CI): −0.10(−0.31, 0.11), Supplementary , P =0.035).…”

“…(2) Follow-Ups . Pooled data of 3 studies [25, 27, 29] showed the negative results (216 persons, SMD (95% CI):−0.07 (−0.34, 0.20), Supplementary , P =0.62).…”