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Moxibustion for ulcerative colitis: a systematic review and meta-analysis.

Lee DH, Kim JI, Lee MS, Choi TY, Choi SM, Ernst E - BMC Gastroenterol (2010)

Bottom Line: Acupuncture-type treatments are among the most popular options.In total, five RCTs were included.All were of low methodological quality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon, Korea.

ABSTRACT

Background: Complementary and alternative medicine (CAM) is increasingly used for treatment of inflammatory bowel disease (IBD). Acupuncture-type treatments are among the most popular options. Several studies have reported that moxibustion is effective in ulcerative colitis (UC). The objective of this review was to assess the clinical evidence for or against moxibustion as a treatment for UC.

Methods: We searched the literature using 18 databases from their inception to February 10, 2010, without language restrictions. We included randomized clinical trials (RCTs), in which human patients with UC were treated with moxibustion. Studies were included if they were placebo-controlled or controlled against a drug therapy or no treatment group. The methodological quality of all RCTs was assessed using the Cochrane risk of bias.

Results: In total, five RCTs were included. All were of low methodological quality. They compared the effects of moxibustion with conventional drug therapy. Three tested moxibustion against sulfasalazine and two against sulfasalazine plus other drugs. A meta-analysis of five RCTs showed favorable effects of moxibustion on the response rate compared to conventional drug therapy (n = 407; risk ratio = 1.24, 95% CI = 1.11 to 1.38; P < 0.0001; heterogeneity: I2 = 16%).

Conclusions: Current evidence is insufficient to show that moxibustion is an effective treatment of UC. Most of included trials had high risk of bias. More rigorous studies seem warranted.

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Forest plot of moxibustion for ulcerative colitis compared to conventional drug. Moxa: moxibustion.
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Figure 2: Forest plot of moxibustion for ulcerative colitis compared to conventional drug. Moxa: moxibustion.

Mentions: The meta-analysis of the five RCTs [16-20] suggested favorable effects of moxibustion on the RR compared with conventional drug therapy (n = 407; RR = 1.24, 95% CI = 1.11 to 1.38; P < 0.0001; heterogeneity: I2 = 16%, Figure 2). A subgroup analysis [16-18] also demonstrated beneficial effects of moxibustion compared to sulfasalazine alone (n = 281; RR = 1.23, 95% CI = 1.04 to 1.46; P = 0.01; heterogeneity: I2 = 39%). A further analysis [19,20] showed favorable effects of moxibustion compared to sulfasalazine plus metronidazole or prednisone (n = 126; RR = 1.33, 95% CI = 1.11 to 1.59; P = 0.002; heterogeneity: I2 = 0%).


Moxibustion for ulcerative colitis: a systematic review and meta-analysis.

Lee DH, Kim JI, Lee MS, Choi TY, Choi SM, Ernst E - BMC Gastroenterol (2010)

Forest plot of moxibustion for ulcerative colitis compared to conventional drug. Moxa: moxibustion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864201&req=5

Figure 2: Forest plot of moxibustion for ulcerative colitis compared to conventional drug. Moxa: moxibustion.
Mentions: The meta-analysis of the five RCTs [16-20] suggested favorable effects of moxibustion on the RR compared with conventional drug therapy (n = 407; RR = 1.24, 95% CI = 1.11 to 1.38; P < 0.0001; heterogeneity: I2 = 16%, Figure 2). A subgroup analysis [16-18] also demonstrated beneficial effects of moxibustion compared to sulfasalazine alone (n = 281; RR = 1.23, 95% CI = 1.04 to 1.46; P = 0.01; heterogeneity: I2 = 39%). A further analysis [19,20] showed favorable effects of moxibustion compared to sulfasalazine plus metronidazole or prednisone (n = 126; RR = 1.33, 95% CI = 1.11 to 1.59; P = 0.002; heterogeneity: I2 = 0%).

Bottom Line: Acupuncture-type treatments are among the most popular options.In total, five RCTs were included.All were of low methodological quality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon, Korea.

ABSTRACT

Background: Complementary and alternative medicine (CAM) is increasingly used for treatment of inflammatory bowel disease (IBD). Acupuncture-type treatments are among the most popular options. Several studies have reported that moxibustion is effective in ulcerative colitis (UC). The objective of this review was to assess the clinical evidence for or against moxibustion as a treatment for UC.

Methods: We searched the literature using 18 databases from their inception to February 10, 2010, without language restrictions. We included randomized clinical trials (RCTs), in which human patients with UC were treated with moxibustion. Studies were included if they were placebo-controlled or controlled against a drug therapy or no treatment group. The methodological quality of all RCTs was assessed using the Cochrane risk of bias.

Results: In total, five RCTs were included. All were of low methodological quality. They compared the effects of moxibustion with conventional drug therapy. Three tested moxibustion against sulfasalazine and two against sulfasalazine plus other drugs. A meta-analysis of five RCTs showed favorable effects of moxibustion on the response rate compared to conventional drug therapy (n = 407; risk ratio = 1.24, 95% CI = 1.11 to 1.38; P < 0.0001; heterogeneity: I2 = 16%).

Conclusions: Current evidence is insufficient to show that moxibustion is an effective treatment of UC. Most of included trials had high risk of bias. More rigorous studies seem warranted.

Show MeSH
Related in: MedlinePlus