Acupuncture alleviates irritable bowel syndrome symptoms and reduces IBS (irritable bowel syndrome) recurrences. Pu’er People’s Hospital (Yunnan, China) researchers conclude that warm needle acupuncture is clinically effective against type-D (diarrhea predominant) IBS. A six-month follow-up after completion of acupuncture treatments confirms lasting improvements.

The study compared warm needle acupuncture with pharmaceutical intervention for the treatment of IBS-D. The acupuncture group experienced significantly greater relief, with a total effective rate of 97.96%, compared with 83.67% in the drug control group. Patients that received acupuncture had a greatly reduced recurrence rate in the six months following treatment, with just 6.12% experiencing recurrence of symptoms compared with 24.49% in the drug control group. [1] The results indicate that acupuncture is clinically more effective for the reduction of symptoms and prevention of relapses.

 

Baseline
A total of 98 patients with IBS-D were recruited for the study and were assigned to the acupuncture group or the drug control group. In addition to meeting the diagnostic criteria for the condition, patients were required to be ages 18–60 years and give voluntary consent to participate in the study. Exclusion criteria were as follows: concurrent serious organic disease, pathological changes to the intestinal mucosa, impaired communication due to psychiatric disorders, pregnancy, or an inability to cooperate with treatment.

The drug control group was comprised of 29 male and 20 female patients, ages 21–49 years (mean age 33.53 years), with a disease duration of 1–4 years (mean duration 2.23 years). The acupuncture group was comprised of 28 male and 21 female patients, ages 22–48 years (mean age 33.25 years), with a disease duration of 1–4 years (mean duration 2.25 years). There were no statistically significant differences in baseline characteristics between the two groups (p>0.05).

 

Treatment Protocols
Patients assigned to the control group were treated with the drugs flupentixol/melitracen (0.5/10 mg) and bacillus licheniformis (0.25 g). Flupentixol/melitracen is a preparation used to treat anxiety, depression, migraines, and IBS. The drugs were administered once daily, before bedtime. Bacillus licheniformis (a soil-based probiotic) was administered three times a day, 30 minutes before meals. Both medications were taken for four consecutive weeks. Patients assigned to the acupuncture group received treatment at the following acupoints:

  • Zusanli (ST36) – unilateral
  • Shangjuxu (ST37) – unilateral
  • Xiajuxu (ST39) – unilateral
  • Tianshu (ST25) – bilateral
  • Guanyuan (CV4)

Following standard disinfection, single-use 0.25 × 25 mm needles were selected and inserted into the acupoints. The needles were manipulated using a balanced reinforcing-reducing technique, which was comprised of lifting-thrusting and twisting-rotating. A 25 mm piece of moxa roll was attached to the handles of the needles at Tianshu and Guanyuan, ignited, and allowed to burn until exhausted. Needles at the remaining acupoints were manipulated at five-minute intervals. One course consisted of five days of treatment, and a total of four courses were administered. Each course was separated by a two-day break.

 

Results
Outcome measures for the study included symptom scores and the total effective rates for each group. In addition, patients were followed up after six months to assess the recurrence rates for each group. Symptom scores were used to assess issues including frequency of bowel movements, loose bowel movements, and mucus in the stools. Symptoms were scored out of 10, with higher scores indicative of severe symptoms.

Mean pre-treatment symptom scores were 7.76 in the drug control group and 7.65 in the acupuncture group. Following treatment, both groups saw improvements in symptoms but improvements were significantly greater in the acupuncture group (p<0.05).

The total effective rates were calculated according to the degree of improvements. Patients experiencing a complete resolution of symptoms, had 1–2 bowel movements daily, and well-formed stools, were classified as cured. In those experiencing significant improvements in symptoms and whose bowel movements were basically normal, the treatment was classified as markedly effective. In patients experiencing some improvement in symptoms, whose bowel movement frequency was reduced, but still suffered from occasional mucus in the stools, the treatment was classified as effective. In patients that did not experience any improvements, the treatment was classified as ineffective. The cured, markedly effective, and effective cases were added together to calculate the total effective rate for each group.

In the control group, there were 20 cured, 10 markedly effective, 11 effective, and 8 ineffective cases, giving a total effective rate of 41 (83.67%). In the acupuncture group, there were 30 cured, 10 markedly effective, 8 effective, and 1 ineffective cases, giving a total effective rate of 48 (97.96%). The total effective rate was significantly higher in the acupuncture group (p<0.05).

Patients were assessed for recurrence of symptoms at the six-month follow-up appointment. In the control group, 24.49% of patients experienced a recurrence of symptoms compared with just 6.12% in the acupuncture group. The difference in recurrence rates between the two groups was considered statistically significant (p<0.05).

The results of this study suggest that warm needle acupuncture provides an effective treatment for IBS-D and is worthy of clinical consideration. Not only does it have the potential to relieve symptoms in the short-term, but it may also help to reduce the risk of recurrence within a six-month period. The results of this study indicate that additional funding for further research is warranted, including longer follow-up periods and larger sample sizes.

 

Reference:
1. Wang Xiaojiang (2018) “Therapeutic Effect of warm needle acupuncture on Diarrhea-Type Irritable Bowel Syndrome” China and Foreign Medical Treatment Vol.29 pp.173-174, 177.

 

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