Department of Acupuncture-Moxibustion, The Affiliated Hospital of Jiangxi University of TCM, Nanchang, Jiangxi Province 330009, China.
Acupuncture and Moxibustion Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300000, China.
Pain Res Manag. 2019 Nov 11;2019:2871505. doi: 10.1155/2019/2871505. eCollection 2019.
BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and altered defecation habits. We here attempted to determine the effect of acupuncture on IBS. METHODS: Randomized controlled trials (RCTs) published in CNKI, VIP, Wanfang, PubMed, Cochrane Library, EMBASE, Web of science, and ClinicalTrials.gov till July 17, 2019 were searched. Outcomes were total efficacy rates, overall IBS symptom scores, or global quality of life scores. Standardized mean difference (SMD) with 95% confidence intervals (CI) and risk ratio (RR) with 95% CI were calculated for meta-analysis. RESULTS: We included 41 RCTs involving 3440 participants for analysis. 8 RCTs compared acupuncture with sham acupuncture, among which 3 trials confirmed the biological effects of acupuncture, especially in treating abdominal pain, discomfort, and stool frequency. No significant difference was found when acupuncture was compared with sham acupuncture, in terms of effects on IBS symptoms and quality of life (SMD = 0.18, 95% CI -0.26∼0.63, =0.42; SMD = -0.10, 95% CI -0.31∼0.11, =0.35), but the pooled efficacy rate data showed a better outcome for true acupuncture (RR = 1.22, 95% CI 1.01∼1.47, =0.04), which was not supported by sensitivity analysis. Acupuncture was more effective relative to western medicine in alleviating IBS symptoms (RR = 1.17, 95% CI 1.12∼1.23, = 0%, < 0.00001), whose effect might last 3 months. Besides, acupuncture as an adjunct to western medicine, Chinese medications, or tuina was superior over the single latter treatment (RR = 1.68, 95% CI 1.18 to 2.40, =0.004; 1.19, 1.03 to 1.36, =0.02; 1.36, 1.08 to 1.72, =0.009, respectively), with high heterogeneities. CONCLUSIONS: Relative to sham controls, acupuncture showed no superiority for treating IBS, while the advantage over western medicine was significant. Acupuncture could be used as an adjunct in clinical settings to improve efficacy. Future high-quality and large-sample-size studies with adequate quantity-effect design need to be conducted.
背景：肠易激综合征（IBS）是一种反复发作腹痛和排便习惯改变的功能性胃肠道疾病。我们在此尝试确定针灸对 IBS 的影响。
方法：检索中国知网（CNKI）、维普（VIP）、万方、PubMed、Cochrane 图书馆、EMBASE、Web of Science 和 ClinicalTrials.gov 截至 2019 年 7 月 17 日发表的随机对照试验（RCT）。结局指标为总有效率、IBS 症状总评分或总体生活质量评分。采用标准化均数差（SMD）及其 95%置信区间（CI）和风险比（RR）及其 95%CI 进行荟萃分析。
结果：我们纳入了 41 项 RCT 共 3440 名参与者进行分析。8 项 RCT 比较了针灸与假针灸，其中 3 项试验证实了针灸的生物学效应，尤其是在治疗腹痛、不适和排便频率方面。针灸与假针灸相比，在 IBS 症状和生活质量方面的效果无显著差异（SMD=0.18，95%CI-0.26∼0.63，=0.42；SMD=-0.10，95%CI-0.31∼0.11，=0.35），但汇总的疗效数据显示真针灸的疗效更好（RR=1.22，95%CI 1.01∼1.47，=0.04），该结果未通过敏感性分析得到支持。与西药相比，针灸在缓解 IBS 症状方面更为有效（RR=1.17，95%CI 1.12∼1.23，=0%，<0.00001），其疗效可能持续 3 个月。此外，针灸作为西药、中药或推拿的辅助治疗手段优于单一的后两种治疗方法（RR=1.68，95%CI 1.18 至 2.40，=0.004；1.19，1.03 至 1.36，=0.02；1.36，1.08 至 1.72，=0.009），但存在高度异质性。
结论：与假对照相比，针灸治疗 IBS 无优势，而与西药相比则有显著优势。针灸可在临床环境中作为辅助手段来提高疗效。需要开展更多高质量、大样本量且具有充分量效设计的研究。
Cochrane Database Syst Rev. 2012-5-16
Am J Gastroenterol. 2012-4-10
Cochrane Database Syst Rev. 2006-10-18
Zhen Ci Yan Jiu. 2022-9-25
Zhongguo Zhen Jiu. 2017-8-12
Cochrane Database Syst Rev. 2005-4-18
Pain Res Manag. 2021-12-15
Anesth Pain Med. 2021-3-17
Evid Based Complement Alternat Med. 2021-4-1
J Gastroenterol Hepatol. 2019-4-10
Evid Based Complement Alternat Med. 2019-2-3
Zhongguo Zhen Jiu. 2017-12-12
World J Gastroenterol. 2017-6-7
Neurogastroenterol Motil. 2017-7
Ann Intern Med. 2016-9-13
Evid Based Complement Alternat Med. 2016
Zotero 插件
