Effects of acupuncture treatment for irritable bowel syndrome: a systematic review and meta-analysis

Objective: To evaluate the effectiveness and safety of acupuncture treatment for irritable bowel syndrome (IBS). Method: Seven databases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), Wanfang Database, and Chinese Biomedical Literature Database (Sinomed) were searched to identify relevant randomized controlled trials (RCTs). The data were extracted and assessed independently. The risk of bias was assessed using the Cochrane risk of bias assessment tool. Review Manager Software (V5.3) was used for data synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to grade the quality of evidence. This trial is registered with CRD42016037769. Results: Seventeen RCTs with 1032 participants were included with poor methodological quality. We found acupuncture plus drug showed superior effects to sham acupuncture plus drug on symptom severity (n=120, RR=1.29, CI=1.11-1.50, P=0.001). One trial showed no statistically significant difference between acupuncture plus drug and drug alone on symptom severity (n=48, RR=1.28, CI=1.00-1.63, P=0.05). Twelve RCTs showed that acupuncture was superior to drug therapy on symptom severity (n=705, RR=1.20, CI=1.09-1.32, P=0.0002). One RCT on IBS-SSS failed to show statistically significant difference between acupuncture and drug (n=73, SMD=-0.45, CI=-0.91-0.02). Two RCTs on global symptom score didn’t show statistically significant difference between acupuncture and drug (n=100, SMD=-2.41, CI=-4.07-0.75). Five RCTs on quality of life showed that acupuncture showed superior effects to control condition on quality of life (n=288, SMD=0.51, CI=0.17-0.86, P=0.04). Conclusion: For the included studies with poor methodological quality, no firm conclusion can be drawn regarding the effects of acupuncture for IBS.