Acupuncture for treatment of irritable bowel syndrome

摘要: Background Irritable bowel syndrome (IBS) is a common, costly, and difficult to treat disorder that impairs health-related quality of life work productivity. Evidence-based treatment guidelines have been unable provide guidance on the effects acupuncture for IBS because only previous systematic review included small, heterogeneous methodologically unsound trials. Objectives The primary objectives were assess efficacy safety treating IBS. Search methods MEDLINE, Cochrane Central Register Controlled Trials, EMBASE, Cumulative Index Nursing Allied Health, Chinese databases Sino-Med, CNKI, VIP searched through November 2011. Selection criteria Randomized controlled trials (RCTs) compared with sham acupuncture, other active treatments, or no (specific) treatment, RCTs evaluated as an adjuvant another in adults included. Data collection analysis Two authors independently assessed risk bias extracted data. We data outcomes overall symptom severity life. For dichotomous (e.g. Adequate Relief Question), we calculated pooled relative (RR) 95% confidence interval (CI) substantial improvement after treatment. continuous Severity Scoring System), standardized mean difference (SMD) CI post-treatment scores between groups. Main results Seventeen (1806 participants) Five versus acupuncture. these studies was low. found evidence (placebo) (SMD -0.11, -0.35 0.13; 4 RCTs; 281 patients) = -0.03, -0.27 0.22; 3 253 patients). Sensitivity analyses based study did not change results. A GRADE indicated moderate due sparse four language comparative effectiveness drug high lack blinding. use control blinding inadequate used randomization allocation concealment both. Acupuncture significantly more effective than pharmacological therapy specific Eighty-four per cent patients group had 63% (RR 1.28, 1.12 1.45; 5 studies, 449 this outcome low (no blinding) Sixty-three 34% 2.11, 1.18 3.79; 2 181 There statistically significant Bifidobacterium 1.07, 0.90 1.27; studies; psychotherapy 1.05, 0.87 1.26; 1 study; 100 medicine better alone. Ninety-three improved 79% who received alone 1.17, 1.02 1.33; 466 one adverse event (i.e. syncope) associated 9 reported outcome, although relatively small sample sizes limit usefulness Authors' conclusions Sham-controlled benefits credible IBS-related In trials, greater from two antispasmodic drugs (pinaverium bromide trimebutine maleate), both which shown modest benefit Future may help clarify whether reportedly therapies are entirely patients' preferences expectations therapy.