Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and altered defecation habits. We here attempted to determine the eﬀect of acupuncture on IBS.
Methods.: Randomized controlled trials (RCTs) published in CNKI, VIP, Wanfang, PubMed, Cochrane Library, EMBASE, Web of science, and ClinicalTrials.gov till July 17, 2019 were
searched. Outcomes were total eﬃcacy rates, overall IBS symptom scores, or global quality of life scores. Stan- dardized mean diﬀerence (SMD) with 95% conﬁdence intervals (CI) and risk ratio (RR) with 95% CI were calculated for meta- analysis.
Results: We included 41 RCTs involving 3440 participants for analysis. 8 RCTs compared acupuncture with sham acupuncture, among which 3 trials conﬁrmed the biological eﬀects of acupuncture, especially in treating abdominal pain, discomfort, and stool frequency. No signiﬁcant diﬀerence was found when acupuncture was compared with sham acupuncture, in terms of eﬀects on IBS symptoms and quality of life (SMD 0.18, 95% CI 0.26∼0.63, P 0.42; SMD 0.10, 95% CI 0.31∼0.11, P 0.35), but the pooled eﬃcacy rate data showed a better outcome for true acupuncture (RR 1.22, 95% CI 1.01∼1.47, P 0.04), which was not supported by sensitivity analysis. Acupuncture was more eﬀective relative to western medicine in alleviating IBS symptoms (RR 1.17, 95% CI 1.12∼1.23, I2 0%, P 0.00001), whose eﬀect might last 3 months. Besides, acupuncture as an adjunct to western medicine, Chinese medications, or tuina was superior over the single latter treatment (RR 1.68, 95% CI 1.18 to 2.40, P 0.004; 1.19, 1.03 to 1.36, P 0.02; 1.36, 1.08 to 1.72, P 0.009, respectively), with high heterogeneities.
Conclusions: Relative to sham controls, acupuncture showed no superiority for treating IBS, while the advantage over western medicine was be used as an adjunct in clinical settings to improve eﬃcacy. Future high-quality and large-sample-size studies with adequate quantity-eﬀect design need to be conducted.