Electroacupuncture for patients with diarrhea-predominant irritable bowel syndrome or functional diarrhea: A randomized controlled trial.
Diarrhea-predominant irritable bowel syndrome (IBS-D) and functional diarrhea (FD) are highly prevalent, and the effectiveness of acupuncture for managing IBS-D and FD is still unknown.The aim of this study was to compare the effectiveness of electroacupuncture with loperamide.It was a prospective, randomized, parallel group controlled trial.A total of 448 participants were randomly assigned to He electroacupuncture group (n = 113), Shu-Mu electroacupuncture group (n = 111), He-Shu-Mu electroacupuncture group (n = 112), or loperamide group (n = 112). Participants in the 3 acupuncture groups received 16 sessions of electroacupuncture during a 4-week treatment phase, whereas participants in the loperamide group received oral loperamide 2 mg thrice daily. The primary outcome was the change from baseline in stool frequency at the end of the 4-weeks treatment. The secondary outcomes were the Bristol scale, the MOS 36-item short form health survey (SF-36), the weekly average number of days with normal defecations and the proportion of adverse events.Stool frequency was significantly reduced at the end of the 4-week treatment in the 4 groups (mean change from baseline, 5.35 times/week). No significant difference was found between the 3 electroacupuncture groups and the loperamide group in the primary outcome (He vs. loperamide group [mean difference 0.6, 95% CI, -1.2 to 2.4]; Shu-Mu vs. loperamide group [0.4, 95% CI, -1.4 to 2.3]; He-Shu-Mu vs. loperamide group [0.0, 95% CI, -1.8 to 1.8]). Both electroacupuncture and loperamide significantly improved the mean score of Bristol scale and increased the weekly average number of days with normal defecations and the mean scores of SF-36; they were equivalent in these outcomes. However, the participants in electroacupuncture groups did not report fewer adverse events than those in the loperamide group. Similar results were found in a subgroup analysis of separating patients with IBS-D and FD patients.Electroacupuncture is equivalent to loperamide for reducing stool frequency in IBS-D and FD patients. Further studies on cost effectiveness of acupuncture are warranted.
Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Guang'anmen Hospital, China Academy of Chinese Medical Sciences Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Changchun University of Traditional Chinese Medicine, Changchun, Jilin Shanxi University of Traditional Chinese Medicine, Xianyang, Shanxi Shandong University of Traditional Chinese Medicine, Jinan, Shandong Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China.
Hui
H
Zheng
Ying
Y
Li
Wei
W
Zhang
Fang
F
Zeng
Si-Yuan
SY
Zhou
Hua-Bin
HB
Zheng
Wen-Zeng
WZ
Zhu
Xiang-Hong
XH
Jing
Pei-Jing
PJ
Rong
Chun-Zhi
CZ
Tang
Fu-Chun
FC
Wang
Zhi-Bin
ZB
Liu
Shi-Jun
SJ
Wang
Mei-Qi
MQ
Zhou
Zhi-Shun
ZS
Liu
Bing
B
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D003672:Defecation / Q000502:physiology*; D003967:Diarrhea / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015671:Electroacupuncture / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult