Acupuncture may improve abdominal pain in IBS-D
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Specific and nonspecific acupoint acupuncture improved symptoms of diarrhea among a small subset of patients with irritable bowel syndrome, according to results from a pilot study reported in JAMA Network Open.
“Available treatments target IBS symptoms rather than underlying pathophysiological mechanisms, and additional improvements in the testing methods are still necessary. All these factors have resulted in an increasing interest in complementary and alternative medicine, such as acupuncture,” Ling-Yu Qi, MM, of the International Acupuncture and Moxibustion Innovation Institute in Beijing, and colleagues wrote. “A previous study suggested that acupuncture has promising effects on IBS.”
In a multicenter, randomized clinical trial, Qi and colleagues investigated the feasibility and efficacy of acupuncture for the treatment of IBS using FDA-recommended endpoints. They analyzed treatment with specific acupoints (SA) and nonspecific acupoints (NSA) according to traditional meridian and acupoint theories.
“The acupoint is considered one of the most determining factors in the efficacy of acupuncture, and the choice of more appropriate acupoints for stimulation is meaningful for acupuncture clinical application,” Qi and colleagues added.
Researchers enrolled 90 patients (60% men; mean age, 34.5 years) with IBS-diarrhea who underwent SA, NSA or nonacupoint (NA) acupuncture therapy (n = 30 patients each). All participants received 12 30-minute sessions over 4 consecutive weeks at three sessions per week.
Studied outcomes included response rate at week 4, which researchers defined as the proportion of patients whose worst abdominal pain score was reduced by at least 30% and a decrease of at least 50% in the number of type 6 or 7 stool days.
According to study results, the composite response rate was 46.7% (95% CI, 28.8-64.6) in both the SA and NSA groups and 26.7% (95% CI, 10.9-42.5) in the NA group, with no statistically significant difference between groups. Response rates of adequate relief were 64.3% (95% CI, 44.1-80.7), 62.1% (95% CI, 42.4-78.7) and 55.2% (95% CI, 36-73) among groups, respectively.
Researchers reported mild and transient adverse events among 6.6% and 13.3% of patients in the NSA and NA groups, respectively.
“The findings of this pilot randomized clinical trial suggest that acupuncture is feasible and safe for the treatment of IBS-D,” Qi and colleagues concluded. “To accurately assess the efficacy of acupuncture for IBS-D, a larger, sufficiently powered trial with the FDA-recommended composite response rate as the primary outcome is needed.”
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