Standardizing and Optimizing Acupuncture Therapy for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Abstract

Background: Acupuncture has been regarded as a potential physical approach for irritable bowel syndrome (IBS). However, there is still no adequate conclusive evidence on its efficacy and optimal therapeutic strategy of acupuncture for IBS. The purpose of this expert consensus study was to put forward some viable recommendations for clinical acupuncture practitioners in treating IBS.Methods: A panel composed of 74 acupuncturists, was convened to participate in a 2-round clinical issue investigation. Subsequently, systematic reviews on acupuncture for IBS were screened using 3 databases. An initial consensus voting list was generated from the results of clinical issue investigation and literature review. Finally, a multi-round Delphi vote was conducted to develop an expert consensus on these specific issues. 30 authoritative experts were required to respond with agreement, neutrality, or disagreement for the items on the consensus voting list. Consensus achievement was identified as the level of agreement on a given item > 80%.Results: Following a 2-round Delphi vote, there were 19 items achieving consensus; of which 5 items (26.32%) achieved complete consensus, and more than 80% expert agreement was reached for the other 14 items. These items can be roughly categorized into 3 major domains of acupuncture for IBS: (1) therapeutic effects, (2) therapeutic principles and protocols, (3) possible adverse events.Conclusions: Without any ready-made guidelines, this preliminary expert consensus could be helpful for acupuncturists in daily clinical practice and patients with IBS to acquire appropriate and standardized acupuncture treatment. In addition, it also points out the clinical issues which need to be further explored in future studies.