Acupuncture versus sham non-acupoint acupuncture for irritable bowel syndrome: a systematic review and meta-analysis.

Abstract

Irritable bowel syndrome (IBS) is a recurrent abdominal disease globally, with limited efficacious therapeutics. Acupuncture is increasingly gaining attention on IBS with inconsistent evidence. Therefore, this study aims to evaluate the specific effect of acupuncture versus sham non-acupoint controls on IBS. International and Chinese databases were searched to identify eligible randomized controlled trials (RCTs). Primary outcomes included response rate, overall symptom severity, and quality of life (QOL). Data for dichotomous and continuous variables were extracted and pooled using risk ratios (RR), and standardized mean differences (SMD) or mean difference (MD) and 95% CIs. Twelve RCTs encompassing 1105 participants were included for systematic review and 11 RCTs for meta-analysis. Acupuncture demonstrated a significantly higher response rate for IBS compared to sham control (RR [95% CIs]: 1.61 [1.25, 2.07], I²=77%, 1004 participants). Acupuncture significantly improved the total symptom severity at the end of treatment as compared to sham acupuncture (SMD [95%CIs]: 0.79 [0.30, 1.28], I² = 86%) and at follow-up (SMD [95%CIs]: 0.70 [0.22, 1.18], I² = 83%). The significance was also noted for QOL at the end of treatment (SMD [95%CIs]: 0.36 [0.01, 0.71]). However, sensitivity analysis only confirmed the robustness regarding the response rate and symptom severity at the end of treatment. We discovered acupuncture significantly improved IBS patients' response rate and overall symptom at the end of treatment, as compared to sham non-acupoint acupuncture. Due to the significant heterogeneity and low certainty of evidence, our work merits more confirmation by large-scale and high-quality trials.