Insights & Discussion
Acupuncture combined with moxibustion showed the best outcomes in terms of efficacy and quality of life improvement for adults with irritable bowel syndrome complicated with diarrhea.
The study was conducted by searching major databases, including PubMed, The Cochrane Library, Embase, and database from China, for randomized controlled trials. These trials explored the effects of acupuncture and moxibustion on individuals suffering from irritable bowel syndrome complicated with diarrhea. The selected studies underwent a rigorous bias assessment and their data were analyzed using Stata 16.0 statistical software.
The analysis encompassed 21 studies overall, considering 1626 patients undergoing 8 different therapeutic measures. The study found that treatments such as acupuncture, warming needle moxibustion, and a combination of acupuncture with sandwiched or heat-sensitive moxibustion revealed significantly improved outcomes when compared to the drug pinaverium bromide. On the other hand, pinaverium bromide demonstrated the lowest efficacy and effect on quality of life. The most frequently used acupuncture points were GV20, GV29, ST 25, ST37, ST36, SP6, LR3, and CV12.
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Acupuncture and moxibustion therapies have shown effectiveness in treating ulcerative colitis according to the summarised-findings of various systematic reviews and meta-analyses.
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Methodology: This evaluative study used an extensive and systematic methods to search data from seven different databases. The selected data were further refined by using different screening and evaluation frameworks like AMSTAR-2, PRISMA, ROBIS, and GRADE systems. These were used to determine the methodological quality, reporting quality, risk of bias, and the quality of evidence in the selected studies.
Discussion of results: After critical evaluation, the study found ten relevant reviews and analyses that showed potential for acupuncture and moxibustion therapies being effective in ulcerative colitis treatment. However, many the identified studies were reported to have several problems in their overall design and quality of outcomes. The researchers therefore stress caution when interpreting these results due to the lack of high-quality evidence in the existing studies.
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The systematic review included 25 RCTs assessing the efficacy and safety of acupuncture combined with moxibustion in treating PCOS, and all of them contributed data to the meta-analysis. Evidence of an association between acupuncture and moxibustion therapy and greater increases in the pregnancy rate and ovulation rate and greater reductions in the miscarriage rate and ovarian volume was found. Additionally, patients receiving acupuncture and moxibustion also exhibited greater improvements in some sex hormones (LH level, LH/FSH ratio and total testosterone level) and indicators related to metabolic disorders (fasting insulin level and BMI). Nevertheless, acupoint stimulation therapy had no significant effect on the levels of FSH, DHEAS, or oestradiol.
In this systematic review, the pregnancy rate among patients who received acupuncture combined with moxibustion reached 50.9%. This value represents a substantial increase compared to that of patients who did not receive acupuncture (27.5%), with an RR of 1.81 and a 4.9% additional increase compared with patients receiving acupuncture + active drugs in the PCOSAct trial (46.0%).
Traditional Chinese medicine therapies, like acupuncture and moxibustion, effectively alleviate irritable bowel syndrome with diarrhea symptoms, and reduce recurrence rates.
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Adhering to the guidelines for systematic reviews, multiple databases including PubMed and Cochrane Library, and several Chinese databases were thoroughly searched. The focus was randomized controlled trials that compared traditional Chinese external therapies with western medicine for irritable bowel syndrome with diarrhea up until the end of 2021. Two authors were independently responsible for screening, data extraction and study assessment. Study quality assessment involved both the Jadad scale and Cochrane Collaborative's risk of bias tool. Meta-analysis was performed on the data collated using Review Manager software.
The gathered data revealed that of the twenty-one studies examined, including a total of 1,862 subjects, acupuncture and moxibustion were the most prevalent external therapies. The results of the meta-analysis indicated that in comparison to the control group, the experimental group demonstrated marked improvement. Notably, the experimental group had superior clinical effectiveness rates, better clinical cure rates, and reduced recurrence. Additionally, there was significant improvement in irritable bowel syndrome related quality of life within the experimental group. Despite these promising results, the publication bias of the included studies was noted as a potential limitation.
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