title: Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial.
abstract: BACKGROUND
  Acupuncture is used by patients as a treatment for irritable bowel syndrome (IBS) but the evidence on effectiveness is limited. The purpose of the study was to evaluate the effectiveness of acupuncture for irritable bowel syndrome in primary care when provided as an adjunct to usual care.
  
  
  METHODS
  
  
  
  METHODS
  A two-arm pragmatic randomised controlled trial.
  
  
  METHODS
  Primary care in the United Kingdom.
  
  
  METHODS
  233 patients had irritable bowel syndrome with average duration of 13 years and score of at least 100 on the IBS Symptom Severity Score (SSS).
  
  
  METHODS
  116 patients were offered 10 weekly individualised acupuncture sessions plus usual care, 117 patients continued with usual care alone.
  
  
  METHODS
  Primary outcome was the IBS SSS at three months, with outcome data collected every three months to 12 months.
  
  
  RESULTS
  There was a statistically significant difference between groups at three months favouring acupuncture with a reduction in IBS Symptom Severity Score of -27.43 (95% CI: -48.66 to -6.21, p=0.012). The number needed to treat for successful treatment (≥50 point reduction in the IBS SSS) was six (95% CI: 3 to 17), based on 49% success in the acupuncture group vs. 31% in the control group, a difference between groups of 18% (95% CI: 6% to 31%). This benefit largely persisted at 6, 9 and 12 months.
  
  
  CONCLUSIONS
  Acupuncture for irritable bowel syndrome provided an additional benefit over usual care alone. The magnitude of the effect was sustained over the longer term. Acupuncture should be considered as a treatment option to be offered in primary care alongside other evidenced based treatments.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN08827905.
authors.affiliation: Department of Health Sciences, University of York, York, UK. hugh.macpherson@york.ac.uk
authors.forename: Hugh
authors.initials: H
authors.lastname: MacPherson
authors.forename: Helen
authors.initials: H
authors.lastname: Tilbrook
authors.forename: J Martin
authors.initials: JM
authors.lastname: Bland
authors.forename: Karen
authors.initials: K
authors.lastname: Bloor
authors.forename: Sally
authors.initials: S
authors.lastname: Brabyn
authors.forename: Helen
authors.initials: H
authors.lastname: Cox
authors.forename: Arthur Ricky
authors.initials: AR
authors.lastname: Kang'ombe
authors.forename: Mei-See
authors.initials: MS
authors.lastname: Man
authors.forename: Tracy
authors.initials: T
authors.lastname: Stuardi
authors.forename: David
authors.initials: D
authors.lastname: Torgerson
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
authors.forename: Peter
authors.initials: P
authors.lastname: Whorwell
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016896:Treatment Outcome