title: Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome.
abstract: OBJECTIVE
  To identify an appropriate therapeutic regimen for using aconite cake-separated moxibustion to treat diarrhea-predominant irritable bowel syndrome (D-IBS).
  
  
  METHODS
  A factorial design was employed to examine the two factors of moxibustion frequency and number of cones. The two tested frequencies were three or six moxibustion sessions per week, and the two tested doses were one or two cones per treatment. A total of 166 D-IBS patients were randomly divided into four treatment groups, which included each combination of the examined frequencies and doses. The bilateral Tianshu acupoints (ST25) and the Qihai acupoint (RN6) were selected for aconite cake-separated moxibustion. Each patient received two courses of treatment, and each course had a duration of 2 wk. For each group, the scores on the Birmingham irritable bowel syndrome (IBS) symptom questionnaire, the IBS Quality of Life scale, the Self-Rating Depression Scale (SDS), the Self-Rating Anxiety Scale (SAS), the Hamilton Depression (HAMD) scale, and the Hamilton Anxiety (HAMA) scale were determined before treatment, after the first course of treatment, and after the second course of treatment.
  
  
  RESULTS
  The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all 4 aconite cake-separated moxibustion groups were significantly lower after the first and second courses of treatment than before treatment (P < 0.001 for all). The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all four aconite cake-separated moxibustion groups were significantly lower after the second course of treatment than after the first course of treatment (P < 0.001 for all). Between-group comparisons after the second course of treatment revealed that the symptom scores for group 1 (1 cone, 3 treatments/wk) and group 3 (2 cones, 3 treatments/wk) were significantly lower than that for group 2 (1 cone, 6 treatments/wk) (5.55 ± 5.05 vs 10.45 ± 6.61, P < 0.001; 5.65 ± 4.00 vs 10.45 ± 6.61, P < 0.001). Regarding the two levels of the two examined factors for aconite cake-separated moxibustion, after the first course of treatment, the changes in HAMA scores were significantly different for the two tested moxibustion frequencies (P = 0.011), with greater changes for the "6 treatments/wk" groups than for the "3 treatments/wk" groups; in addition, there were interaction effects between the number of cones and moxibustion frequency (P = 0.028). After the second course of treatment, changes in symptom scores for the 2 tested moxibustion frequencies were significantly different (P = 0.002), with greater changes for the "3 treatments/wk" groups than for the "6 treatments/wk" groups.
  
  
  CONCLUSIONS
  An aconite cake-separated moxibustion treatment regimen of 3 treatments/wk and 1 cone/treatment appears to produce better therapeutic effects for D-IBS compared with the other tested regimens.
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Ji-Meng
authors.initials: JM
authors.lastname: Zhao
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Lu-Yi
authors.initials: LY
authors.lastname: Wu
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Hui-Rong
authors.initials: HR
authors.lastname: Liu
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Hong-Yi
authors.initials: HY
authors.lastname: Hu
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Jia-Ying
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Ren-Jia
authors.initials: RJ
authors.lastname: Huang
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Shan-Ping
authors.initials: SP
authors.lastname: Tao
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Ci-Li
authors.initials: CL
authors.lastname: Zhou
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Li
authors.initials: L
authors.lastname: Qi
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Xiao-Peng
authors.initials: XP
authors.lastname: Ma
authors.affiliation: Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors.forename: Huan-Gan
authors.initials: HG
authors.lastname: Wu
mesh_terms: D002681:China; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009071:Moxibustion; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aconite cake-separated moxibustion; Clinical research; Diarrhea-predominant irritable bowel syndrome; Factorial design; Moxibustion quantity