Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis

Irene X. Y. Wu; Charlene H. L. Wong; Robin S. T. Ho; William K. W. Cheung; Alexander C. Ford; Justin C. Y. Wu; Arthur D. P. Mak; Holger Cramer; Vincent C. H. Chung

doi:10.1177/1756284818820438

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Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis

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Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis

Irene X. Y. Wu, Charlene H. L. Wong, Robin S. T. Ho, William K. W. Cheung, Alexander C. Ford, Justin C. Y. Wu, Arthur D. P. Mak, Holger Cramer and Vincent C. H. Chung

Therapeutic advances in gastroenterology, Vol.12, pp.1-34

01/2019

DOI: https://doi.org/10.1177/1756284818820438

PMCID: PMC6348567

PMID: 30719074

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Abstract

Gastroenterology & Hepatology

Life Sciences & Biomedicine

Science & Technology

acupuncture

acupuncture points

acupuncture therapy

irritable bowel syndrome

network meta-analysis

systematic review

Background: An overview of systematic reviews (SRs) and a network meta-analysis (NMA) were conducted to evaluate the comparative effectiveness of acupuncture and related therapies used either alone, or as an add-on to other irritable bowel syndrome (IBS) treatments. Methods: A total of eight international and Chinese databases were searched for SRs of randomized controlled trials (RCTs). The methodological quality of SRs was appraised using the AMSTAR instrument. From the included SRs, data from RCTs were extracted for the random-effect pairwise meta-analyses. An NMA was used to evaluate the comparative effectiveness of different treatment options. The risk of bias among included RCTs was assessed using the Cochrane risk of bias tool. Results: From 15 SRs of mediocre quality, 27 eligible RCTs (n = 2141) were included but none performed proper blinding. Results from pairwise meta-analysis showed that both needle acupuncture and electroacupuncture were superior in improving global IBS symptoms when compared with pinaverium bromide. NMA results showed needle acupuncture plus Geshanxiaoyao formula had the highest probability of being the best option for improving global IBS symptoms among 14 included treatment options, but a slight inconsistency exists. Conclusion: The risk of bias and NMA inconsistency among included trials limited the trustworthiness of the conclusion. Patients who did not respond well to first-line conventional therapies or antidepressants may consider acupuncture as an alternative. Future trials should investigate the potential of (1) acupuncture as an add-on to antidepressants and (2) the combined effect of Chinese herbs and acupuncture, which is the norm of routine Chinese medicine practice.

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Title: Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis
Creators: Irene X. Y. Wu - Central South University
Charlene H. L. Wong - Chinese University of Hong Kong
Robin S. T. Ho - Chinese University of Hong Kong
William K. W. Cheung - Chinese University of Hong Kong
Alexander C. Ford - St James's University Hospital
Justin C. Y. Wu - Chinese University of Hong Kong
Arthur D. P. Mak - Chinese University of Hong Kong
Holger Cramer - University of Duisburg-Essen
Vincent C. H. Chung - Chinese University of Hong Kong
Publication Details: Therapeutic advances in gastroenterology, Vol.12, pp.1-34
Publisher: Sage
Number of pages: 34
Grant note: 202045003 / High-level Talents Introduction Plan of Central South University, Changsha, China
Identifiers: 991013036328802368
Copyright: © The Author(s), 2019. Article reuse guidelines:sagepub.com/journalspermissions Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis

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