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Electroacupuncture for patients with diarrhea-predominant irritable bowel syndrome or functional diarrhea

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


Trial flowchart.
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Figure 2: Trial flowchart.

Mentions: After screening 495 possible candidates, we included 448 patients with IBS-D or FD. The reasons for exclusion were violation of the inclusion criteria or decline to participate. The 448 participants were randomly allocated to He (n = 113), Shu-Mu (n = 111), He-Shu-Mu (n = 112), and loperamide group (n = 112). All these participants were from 8 hospitals in 8 provinces in China (113 participants from Chengdu province, 97 from Hunan province, 68 from Beijing province, 55 from Shandong province, 48 from Shanxi province, 42 from Changchun province, 20 from Guangzhou province, 5 from Anhui province). All participants in the 3 acupuncture groups received at least 1 acupuncture treatment, whereas 2 participants in the loperamide group declined to participate after randomization. Five participants did not report primary outcome at baseline, 11 participants were lost to follow-up at week 4, and 19 participants at week 8. A total of 441 participants were included in the ITT population and 411 in the PP population. Figure 2 shows more details.


Electroacupuncture for patients with diarrhea-predominant irritable bowel syndrome or functional diarrhea
Trial flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998466&req=5

Figure 2: Trial flowchart.
Mentions: After screening 495 possible candidates, we included 448 patients with IBS-D or FD. The reasons for exclusion were violation of the inclusion criteria or decline to participate. The 448 participants were randomly allocated to He (n = 113), Shu-Mu (n = 111), He-Shu-Mu (n = 112), and loperamide group (n = 112). All these participants were from 8 hospitals in 8 provinces in China (113 participants from Chengdu province, 97 from Hunan province, 68 from Beijing province, 55 from Shandong province, 48 from Shanxi province, 42 from Changchun province, 20 from Guangzhou province, 5 from Anhui province). All participants in the 3 acupuncture groups received at least 1 acupuncture treatment, whereas 2 participants in the loperamide group declined to participate after randomization. Five participants did not report primary outcome at baseline, 11 participants were lost to follow-up at week 4, and 19 participants at week 8. A total of 441 participants were included in the ITT population and 411 in the PP population. Figure 2 shows more details.

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.