Zhang Gezhi, Zhang Tao, Cao Zeng, Tao Zijing, Wan Tianhao, Yao Mengxi, Su Xiaolan, Wei Wei
Department of Gastroenterology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Beijing Key Laboratory of Functional Gastrointestinal Disorders Diagnosis and Treatment of Traditional Chinese Medicine, Beijing, China.
Front Neurosci. 2022 Jul 15;16:918701. doi: 10.3389/fnins.2022.918701. eCollection 2022.
Irritable 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.
This 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).
Literature 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.
Ten 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.
Acupuncture 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.
[https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022320331].
肠易激综合征（IBS）是一种常见的肠-脑互动障碍性疾病，治疗颇具挑战性。根据循证医学研究，针灸可能是一种有前景的疗法，也是IBS的辅助治疗手段。然而，基于高质量相关临床试验的针灸作用机制研究仍属空白。
本研究旨在评估当前临床证据的结果和质量，并总结针灸治疗腹泻型肠易激综合征（IBS-D）的相关病理生理机制及治疗效果。
系统检索四个数据库，即PubMed、Cochrane图书馆、EMBASE和Web of Science，以获取符合条件的随机对照试验（RCT），这些试验包含针灸治疗IBS-D患者的机制研究。两名独立评审员使用RevMan 5.4.1软件完成数据提取和质量评估。
本综述纳入了10项涉及19项机制研究的试验。据报道，针灸可改善IBS-D症状和生活质量，对调节脑-肠肽、大脑活动、神经内分泌功能、心理状态以及胃肠道炎症和肠道超敏反应具有积极作用。
针灸对IBS-D患者的病理生理改变具有潜在影响，如调节脑-肠肽、改变大脑连通性和活动、促进神经内分泌功能和精神状态以及减轻肠道炎症和超敏反应，但仍需要进一步开展高质量研究。
