Fang Xue, Wang XiaoYan, Zheng WenJun, Yin Ying, Ge XiaoBin
Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, Shandong Province, China.
College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong Province, China.
Int J Behav Med. 2025 Jan 27. doi: 10.1007/s12529-025-10348-z.
BACKGROUND: Irritable bowel syndrome (IBS) has been effectively treated with acupuncture, but the significance of quality of life, depression, and anxiety in the assessment of IBS patients has received little consideration. This study examined the impact of acupuncture on depression, anxiety, and quality of life in IBS patients. METHOD: PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), EMBASE, China Science and Technology Journal Database (VIP), Chinese Biological Medical (CBM, SinoMed) Database, and the Wan Fang Database were among the electronic databases from which relevant randomized controlled trials (RCTs) were systematically retrieved between their inception and July 2023. The outcomes included adverse events, total response rate, anxiety, and symptoms of depression, as well as quality of life. In this study, the heterogeneity, publication bias, standardized mean difference (SMD), and risk ratios (RR) with 95% confidence intervals (CI) were estimated. RESULTS: In this study, 29 RCTs including 3114 participants for analysis (treatment group, 1730; control group, 1384) were included. Compared to other therapies, acupuncture significantly improved the quality of life (SMD = 0.61, 95% CI = [0.26, 0.96], P < 0.001) and alleviated anxiety (SMD = - 0.72, 95% CI = [- 1.76, 0.32], P = 0.18) and depression (SMD = - 0.74, 95% CI = [- 1.18, - 0.3], P < 0.001) in IBS patients. A statistically significant improvement was recorded in their quality of life, and they also displayed fewer symptoms of depression. The total response rate (RR = 1.18, 95% CI = [1.12, 1.25], P < 0.001) indicated that acupuncture significantly affected IBS treatment in comparison to other methods. Subgroup analysis of primary outcome indicators revealed that acupuncture demonstrated better results regardless of the duration of intervention and was more effective than Western medicine or sham acupuncture. In addition to the total response rate (I = 0%), the other three outcome indicators showed significant heterogeneity (I > 50%). No publication bias was noted in RR (P < 0.05); however, a significant publication bias was observed in quality of life (P > 0.05). CONCLUSION: Acupuncture can enhance the quality of life and relieve anxiety and depression in patients with IBS with apparent safety; however, a large number of high-quality RCTs are still needed.
背景：针刺已被有效用于治疗肠易激综合征（IBS），但生活质量、抑郁和焦虑在IBS患者评估中的意义却很少受到关注。本研究探讨了针刺对IBS患者抑郁、焦虑和生活质量的影响。 方法：系统检索了PubMed、Cochrane图书馆、中国知网（CNKI）、EMBASE、中国科技期刊数据库（VIP）、中国生物医学文献数据库（CBM，SinoMed）和万方数据库等电子数据库，纳入从建库至2023年7月期间发表的相关随机对照试验（RCT）。结局指标包括不良事件、总有效率、焦虑、抑郁症状以及生活质量。本研究估计了异质性、发表偏倚、标准化均数差（SMD）和95%置信区间（CI）的风险比（RR）。 结果：本研究纳入了29项RCT，共3114名参与者进行分析（治疗组1730名；对照组1384名）。与其他疗法相比，针刺显著改善了IBS患者的生活质量（SMD = 0.61，95% CI = [0.26, 0.96]，P < 0.001），并缓解了焦虑（SMD = -0.72，95% CI = [-1.76, 0.32]，P = 0.18）和抑郁（SMD = -0.74，95% CI = [-1.18, -0.3]，P < 0.001）。患者的生活质量有统计学意义的改善，抑郁症状也较少。总有效率（RR = 1.18，95% CI = [1.12, 1.25]，P < 0.001）表明，与其他方法相比，针刺对IBS治疗有显著影响。主要结局指标的亚组分析显示，无论干预持续时间如何，针刺均显示出更好的效果，且比西药或假针刺更有效。除总有效率（I = 0%）外，其他三个结局指标均显示出显著的异质性（I > 50%）。RR未发现发表偏倚（P < 0.05）；然而，生活质量方面观察到显著的发表偏倚（P > 0.05）。 结论：针刺可提高IBS患者的生活质量，缓解焦虑和抑郁，且安全性明显；然而，仍需要大量高质量的RCT。
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