Effect of Acupuncture in Patients With Irritable Bowel Syndrome: A Randomized Controlled Trial

Abstract

Objective: To evaluate the effect and safety of acupuncture for the treatment of irritable bowel syndrome (IBS) through comparisons with those of polyethylene glycol (PEG) 4000 and pinaverium bromide. Patients and Methods: This multicenter randomized controlled trial was conducted at 7 hospitals in China and enrolled participants who met the Rome III diagnostic criteria for IBS between May 3, 2015, and June 29, 2018. Participants were first stratified into constipation-predominant or diarrheapredominant IBS group. Participants in each group were randomly assigned in a 2:1 ratio to receive acupuncture (18 sessions) or PEG 4000 (20 g/d, for IBS-C)/pinaverium bromide (150 mg/d, for IBS-D) over a 6-week period, followed by a 12-week follow-up. The primary outcome was change in total IBS-Symptom Severity Score from baseline to week 6. Results: Of 531 patients with IBS who were randomized, 519 (344 in the acupuncture group and 175 in the PEG 4000/ pinaverium bromide group) were included in the full analysis set. From baseline to 6 weeks, the total IBS-Symptom Severity Score decreased by 123.51 (95% CI, 116.61 to 130.42) in the acupuncture group and 94.73 (95% CI, 85.03 to 104.43) in the PEG 4000/pinaverium bromide group. The between-group difference was 28.78 (95% CI, 16.84 to 40.72; P<.001). No participant experienced severe adverse effects. Conclusion: Acupuncture may be more effective than PEG 4000 or pinaverium bromide for the treatment of IBS, with effects lasting up to 12 weeks.

Uncovering the pathophysiology of irritable bowel syndrome by exploring the gut-brain axis: a narrative review

“…This large study of 531 patients compared acupuncture to PEG 4000/pinaverium bromide, and found that acupuncture alleviated IBS symptoms, as assessed using the IBS severity scoring system (96), and improved patients' quality-oflife over the 6-week treatment period and the 12-week follow-up period. Importantly, the patients did not experience any adverse effects (97). Therefore, acupuncture appears to provide great benefits and might be a potential treatment for IBS in the future.…”

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

“…Two SRs indicated that acupuncture produced a preferable therapeutic effect in improving IBS patients' quality of life compared with sham acupuncture or western medicine [35,36]. Of note, a latest published high-quality study including 531 patients found that acupuncture showed more effective results in reducing IBS symptoms and improving quality of life compared with pharmacologic therapies [19]. In addition, these effects could last up to 3 months, which is also in line with our consensus statement that relief of IBS symptoms can be maintained for 1 to 6 months after one course of acupuncture treatment.…”

“…In spite of its common application in clinic, previous research evidences on acupuncture for IBS are still relatively scarce and in con ict. On the one hand, a previous Cochrane systematic review (SR) composed of 17 randomized clinical trials (RCTs) indicated that acupuncture exerted more bene cial effects than pharmacological interventions [18], which was validated again in the latest published study [19]. On the other hand, the sham acupuncture-controlled trials suggested that acupuncture achieved favourable e cacy but did not show therapeutic advantage over sham acupuncture [20,21].…”

Irritable bowel syndrome in China: a review on the epidemiology, diagnosis, and management

“…Recently, two well-designed RCTs reported the effect of acupuncture on IBS. The multicenter RCT conducted by Pei et al , [ 38 ] which enrolled 531 cases of IBS-C and -D patients, compared the effect of acupuncture and PEG 4000/pinaverium on the IBS-SSS. The result showed that acupuncture was more effective than PEG 4000 or pinaverium bromide for the treatment of IBS, with effects lasting up to 12 weeks.…”