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Meta-Analysis
. 2012 May 16;2012(5):CD005111.
doi: 10.1002/14651858.CD005111.pub3.

Acupuncture for treatment of irritable bowel syndrome

Eric Manheimer  1 , Ke Cheng, L Susan Wieland, Li Shih Min, Xueyong Shen, Brian M Berman, Lixing Lao
Affiliations
Meta-Analysis

Acupuncture for treatment of irritable bowel syndrome

Eric Manheimer et al. Cochrane Database Syst Rev. .

Abstract

Background: Irritable bowel syndrome (IBS) is a common, costly, and difficult to treat disorder that impairs health-related quality of life and work productivity. Evidence-based treatment guidelines have been unable to provide guidance on the effects of acupuncture for IBS because the only previous systematic review included only small, heterogeneous and methodologically unsound trials.

Objectives: The primary objectives were to assess the efficacy and safety of acupuncture for treating IBS.

Search methods: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Cumulative Index to Nursing and Allied Health, and the Chinese databases Sino-Med, CNKI, and VIP were searched through November 2011.

Selection criteria: Randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture, other active treatments, or no (specific) treatment, and RCTs that evaluated acupuncture as an adjuvant to another treatment, in adults with IBS were included.

Data collection and analysis: Two authors independently assessed the risk of bias and extracted data. We extracted data for the outcomes overall IBS symptom severity and health-related quality of life. For dichotomous data (e.g. the IBS Adequate Relief Question), we calculated a pooled relative risk (RR) and 95% confidence interval (CI) for substantial improvement in symptom severity after treatment. For continuous data (e.g. the IBS Severity Scoring System), we calculated the standardized mean difference (SMD) and 95% CI in post-treatment scores between groups.

Main results: Seventeen RCTs (1806 participants) were included. Five RCTs compared acupuncture versus sham acupuncture. The risk of bias in these studies was low. We found no evidence of an improvement with acupuncture relative to sham (placebo) acupuncture for symptom severity (SMD -0.11, 95% CI -0.35 to 0.13; 4 RCTs; 281 patients) or quality of life (SMD = -0.03, 95% CI -0.27 to 0.22; 3 RCTs; 253 patients). Sensitivity analyses based on study quality did not change the results. A GRADE analysis indicated that the overall quality of the evidence for the primary outcomes in the sham controlled trials was moderate due to sparse data. The risk of bias in the four Chinese language comparative effectiveness trials that compared acupuncture with drug treatment was high due to lack of blinding. The risk of bias in the other studies that did not use a sham control was high due to lack of blinding or inadequate methods used for randomization and allocation concealment or both. Acupuncture was significantly more effective than pharmacological therapy and no specific treatment. Eighty-four per cent of patients in the acupuncture group had improvement in symptom severity compared to 63% of patients in the pharmacological treatment group (RR 1.28, 95% CI 1.12 to 1.45; 5 studies, 449 patients). A GRADE analysis indicated that the overall quality of the evidence for this outcome was low due to a high risk of bias (no blinding) and sparse data. Sixty-three per cent of patients in the acupuncture group had improvement in symptom severity compared to 34% of patients in the no specific therapy group (RR 2.11, 95% CI 1.18 to 3.79; 2 studies, 181 patients). There was no statistically significant difference between acupuncture and Bifidobacterium (RR 1.07, 95% CI 0.90 to 1.27; 2 studies; 181 patients) or between acupuncture and psychotherapy (RR 1.05, 95% CI 0.87 to 1.26; 1 study; 100 patients). Acupuncture as an adjuvant to another Chinese medicine treatment was significantly better than the other treatment alone. Ninety-three per cent of patients in the adjuvant acupuncture group improved compared to 79% of patients who received Chinese medicine alone (RR 1.17, 95% CI 1.02 to 1.33; 4 studies; 466 patients). There was one adverse event (i.e. acupuncture syncope) associated with acupuncture in the 9 trials that reported this outcome, although relatively small sample sizes limit the usefulness of these safety data.

Authors' conclusions: Sham-controlled RCTs have found no benefits of acupuncture relative to a credible sham acupuncture control for IBS symptom severity or IBS-related quality of life. In comparative effectiveness Chinese trials, patients reported greater benefits from acupuncture than from two antispasmodic drugs (pinaverium bromide and trimebutine maleate), both of which have been shown to provide a modest benefit for IBS. Future trials may help clarify whether or not these reportedly greater benefits of acupuncture relative to pharmacological therapies are due entirely to patients' preferences for acupuncture or greater expectations of improvement on acupuncture relative to drug therapy.

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Conflict of interest statement

None known

Figures

1
1
Flow of studies through selection process.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Acupuncture versus sham acupuncture: Symptom severity
4
4
Acupuncture versus sham acupuncture: Quality of life
5
5
Acupuncture versus another active treatment, as adjuvant to another active treatment, or compared to no specific treatment: Symptom severity
1.1
1.1. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 1 Symptom severity (mean outcomes) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
1.2
1.2. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 2 Symptom severity (responders) (short‐term:up to 3 mons, closest to 8 wks).
1.3
1.3. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 3 Symptom severity (generic inverse variance) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
1.4
1.4. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 4 Quality of life (mean outcomes) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
1.5
1.5. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 5 Quality of life (responders) (short‐term:up to 3 mons, closest to 8 wks).
1.6
1.6. Analysis
Comparison 1 Acupuncture versus sham acupuncture, Outcome 6 Quality of life (mean outcomes) post‐treatment scores (long‐term: >3 mos, closest to 6 mos).
2.1
2.1. Analysis
Comparison 2 Acupuncture versus pharmacological medication, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mons, closest to 8 wks).
2.2
2.2. Analysis
Comparison 2 Acupuncture versus pharmacological medication, Outcome 2 Symptom severity (mean outcomes) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
3.1
3.1. Analysis
Comparison 3 Acupuncture versus Bifidobacterium, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mons, closest to 8 wks).
4.1
4.1. Analysis
Comparison 4 Acupuncture versus psychotherapy, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mons, closest to 8 wks).
5.1
5.1. Analysis
Comparison 5 Acupuncture plus psychotherapy versus psychotherapy alone, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mons, closest to 8 wks).
6.1
6.1. Analysis
Comparison 6 Acupuncture plus another traditional Chinese medicine (TCM) treatment versus the other TCM treatment alone, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mos, closest to 8 wks).
6.2
6.2. Analysis
Comparison 6 Acupuncture plus another traditional Chinese medicine (TCM) treatment versus the other TCM treatment alone, Outcome 2 Quality of life (mean outcomes) (short‐term: up to 3 mos, closest to 8 wks).
7.1
7.1. Analysis
Comparison 7 Acupuncture versus no specific treatment, Outcome 1 Symptom severity (responders) (short‐term: up to 3 mons, closest to 8 wks).
7.2
7.2. Analysis
Comparison 7 Acupuncture versus no specific treatment, Outcome 2 Symptom severity (mean outcomes) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
7.3
7.3. Analysis
Comparison 7 Acupuncture versus no specific treatment, Outcome 3 Quality of life (mean outcomes) post‐treatment scores (short‐term: up to 3 mos, closest to 8 wks).
7.4
7.4. Analysis
Comparison 7 Acupuncture versus no specific treatment, Outcome 4 Quality of life (responders) (short‐term: up to 3 mons, closest to 8 wks).
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

An 2010 {published data only}
    1. An G, Li N, Zhai G, Liu H, Sun J, Liang H, et al. [Evaluation of the therapeutic effect of acupuncture and moxibustion on irritable bowel syndrome]. Shanghai Journal of Acupuncture and Moxibustion 2010;29(6):354‐6.
Anastasi 2009 {published data only}
    1. Anastasi JK, McMahon DJ, Kim GH. Symptom management for irritable bowel syndrome: a pilot randomized controlled trial of acupuncture/moxibustion. Gastroenterology Nursing 2009;32(4):243‐55. [PUBMED: 19696601] - PubMed
Chen 2009 {published data only}
    1. Chen Y. [Clinical reseach on treating irritable bowel syndrome mainly by acupuncture with warmed needles at Tiansh (ST25) and Dangchangshu (BL25)]. Master's thesis of Guangzhou University of Traditional Chinese Medicine 2006.
    1. Chen Y, Lai X. Clinical observation on combined warming needle and patented Chinese medicine for irritable bowel syndrome. Journal of Acupuncture and Tuina Science 2009, (7):274‐7.
Chen 2011 {published data only}
    1. Chen Q. [Clinical study on irritable bowel syndrome of diarrhea type with Chang‐three‐needle technique]. Master's thesis of Guangzhou University of Traditional Chinese Medicine 2011.
Forbes 2005 {published data only}
    1. Forbes A, Jackson S, Walter C, Quraishi S, Jacyna M, Pitcher M. Acupuncture for irritable bowel syndrome: a blinded placebo‐controlled trial. World Journal of Gastroenterology 2005;11(26):4040‐4. [PUBMED: 15996029] - PMC - PubMed
Lembo 2009 {published data only}
    1. Lembo AJ, Conboy L, Kelley JM, Schnyer RS, McManus CA, Quilty MT, et al. A treatment trial of acupuncture in IBS patients. American Journal of Gastroenterology 2009;104(6):1489‐97. [PUBMED: 19455132] - PMC - PubMed
Li 2009 {published data only}
    1. Li W. [Treatment of warming needle moxibustion combined with spinal manipulation on irritable bowel syndrome]. China Practical Medicine 2009;4(31):212‐3.
Liu 1997 {published data only}
    1. Liu G. [Treatment of acupuncture and moxibustion plus psychotherapy for irritable bowel syndrome]. Chinese Acupuncture and Moxibustion 1997, (10):611‐2.
Liu 2010 {published data only}
    1. Liu Q, Wang Z, Zhang W, Zhang X. [Clinical observation on Geshanxiaoyao Decoction combining acupuncture effect on the life quality of patients with irritable bowel syndrome]. Journal of Zhejiang University of Traditional Chinese Medicine 2010;34(4):510‐11, 513.
    1. Wang Z, Liu Q, Zhang X, Wang Y, Su X. [Clinical observation of "Geshan Xiaoyao Decoction" plus acupuncture in treating diarrhea‐predominant irritable bowel syndrome]. Shanghai Journal of Traditional Chinese Medicine 2010;44(3):41‐3.
    1. Wang Z, Liu Q, Zhang X, Zhang W. [Geshanxiaoyao Decoction combining with acupuncture on 150 patients with diarrhea‐predominant irritable bowel syndrome]. Liaoning Journal of Traditional Chinese Medicine 2010;37(2):276‐7.
Lowe 2000 {published data only}
    1. Lowe C, Depew W, Vanner S. A placebo‐controlled, double‐blind trial of acupuncture in the treatment of irritable bowel syndrome (IBS). Gastroenterology 2000;118(4 Suppl 2):A3168.
Reynolds 2008 {published data only}
    1. Reynolds JA, Bland JM, MacPherson H. Acupuncture for irritable bowel syndrome ‐ an exploratory randomised controlled trial. Acupuncture in Medicine 2008;26(1):8‐16. [PUBMED: 18356794] - PubMed
Schneider 2006 {published data only}
    1. Schneider A, Enck P, Streitberger K, Joos S, Weiland C, Bagheri S, et al. [Specific physiological and unspecific psychological effects during acupuncture treatment in patients with irritable bowel syndrome: Results of a randomised controlled trial]. Deutsche Zeitschrift fur Akupunktur 2008;51(1):8‐16. [EMBASE: 2008174159]
    1. Schneider A, Enck P, Streitberger K, Joos S, Weiland C, Bagheri S, et al. [Specific physiological and unspecific psychological effects during acupuncture treatment in patients with irritable bowel syndrome: Results of a randomised controlled trial]. Revista Internacional de Acupuntura 2008;2(3):146‐54. [EMBASE: 2009165775]
    1. Schneider A, Enck P, Streitberger K, Weiland C, Bagheri S, Witte S, et al. Acupuncture treatment in irritable bowel syndrome. Gut 2006;55(5):649‐54. [PUBMED: 16150852] - PMC - PubMed
Shi 2010 {published data only}
    1. Shi X, Luo J, Tan T. [Clinical observation of electroacupuncture on diarrhea‐predominant irritable bowel syndrome]. Journal of New Chinese Medicine 2010;42(5):72‐4.
Sun 2011 {published data only}
    1. Sun JH, Wu XL, Xia C, Xu LZ, Pei LX, Li H, et al. Clinical evaluation of soothing Gan and Inbigorating Pi acupuncture treatment on dfiarrhea‐predominant irritable bowel syndrome. Chinese Journal of Integrative Medicine 2011;17(10):780‐5. - PubMed
Xiong 2008a {published data only}
    1. Xiong X, Lin Y. [Acupuncture plus traditional Chinese herb medicine in treating 42 patients with diarrhea‐predominant IBS]. Journal of Fujian University of TCM 2008;18(2):38‐40.
Xue 2009 {published data only}
    1. Xue Y, Tian X. [The clinical research of the relationship between radicals and irritable bowel syndrome and the effect of acupuncture]. Chinese Archives of Traditional Chinese Medicine 2009;27(1):111‐2.
Zeng 2010 {published data only}
    1. Zeng Y, Bao Y, Chu J, Li H, Zhu G, Zhang W. [Effect of moxibustion on diarrhea‐dominant irritable bowel syndrome patients in dog days]. Chinese Archives of Traditional Chinese Medicine 2010;28(8):1774‐6.

References to studies excluded from this review

Chan 1997 {published data only}
    1. Chan J, Carr I, Mayberry JF. The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study. Hepatogastroenterology 1997;44(17):1328‐30. - PubMed
Chen 2005 {published data only}
    1. Chen R. [Clinical study on the electro‐acupuncture combined with ear‐acupuncture treatment of irritable bowel syndrome]. Master's thesis of Guangzhou University of Traditional Chinese Medicine 2005.
Chu 2009 {unpublished data only}
    1. Chu WCW. Effect of electroacupuncture in patients with irritable bowel syndrome [Official title: A pilot study on the effect of electroacupuncture on functional brain mapping in patients with irritable bowel syndrome]. ClinicalTrials.gov Identifier: NCT00900965 2009.
Ding 2004 {published data only}
    1. Ding S, Li D. [Clinical study on acupuncture mainly at BL57 in treating 54 patients of irritable bowel syndrome]. Journal of Clinical Acupuncture and Moxibustion 2004;20(5):53.
Fireman 2001 {published data only}
    1. Fireman Z, Segal A, Kopelman Y, Sternberg A, Carasso R. Acupuncture treatment for irritable bowel syndrome. A double‐blind controlled study. Digestion 2001;64(2):100‐3. - PubMed
Fu 1993 {published data only}
    1. Fu H, Cai G. [Clinical study on acupuncture based upon differentiation of symptoms and signs in treating 40 patients of IBS]. Chinese Acupuncture and Moxibustion 1993;13(3):1‐2.
Gabuzian 1994 {published data only}
    1. Gabuzian KS, Sarkisian KA, Grigorian NL, Azatian ZG. Long‐term results in the treatment of patients with irritable bowel syndrome. Klinicheskaia Meditsina 1994;72(1):47‐8. - PubMed
Guo 2010 {published data only}
    1. Guo G, Bao H, Zhang Y. [Clinical observation of warming needle moxibustion for diarrhea‐predominant irritable bowel syndrome]. Modern Journal of Integrated Traditional Chinese and Western Medicine 2010 Jun;19(16):1998‐9.
    1. Guo G, Zhong J, Wang Y, Liu Y. [Clinical observation of acupuncture for 50 patients with diarrhea‐predominant irritable bowel syndrome]. Hebei Journal of Traditional Chinese Medicine 2010;32(4):564‐5.
Hou 2011 {published data only}
    1. Hou B, Shi Z. [Discussion of the therapeutic effect of western medicine association with Zi‐Wu Dao‐jiu needling Tianshu and Dachangshu on irritable bowel syndrome]. Heibei Medicine 2011;17(9):1169‐72.
Huang 1999 {published data only}
    1. Huang Z, He X, Zhang G, Huang J. [Clinical observation of single and integrated treatment for 73 patients with irritable bowel syndrome]. Academic Journal of Guangzhou Medical College 1999;27(4):67‐9.
Huang 2006 {published data only}
    1. Huang Z, Liang L, Zhang W. [Acupuncture combined with massage for treatment of irritable bowel syndrome]. Chinese Acupuncture and Moxibustion 2006;26(10):717‐8. - PubMed
Kang 2006 {published data only}
    1. Kang H, Li M. [Auricular‐plaster therapy for 54 patients with irritable bowel syndrome]. Journal of Emergency in Traditional Chinese Medicine 2006;15(6):591.
Kunze 1990 {published data only}
    1. Kunze M, Seidel HJ, Stube G. Comparative studies of the effectiveness of brief psychotherapy, acupuncture and papaverin therapy in patients with irritable bowel syndrome [Vergleichede Untersuchungen zur Effektivitat der kleinen Psychotherapie, der Akupunktur und der Papaverintherapie bei Patienten mit Colon irritabile]. Zeitschrift für die gesamte innere Medizin und ihre Grenzgebiete 1990;45(20):625‐7. - PubMed
Li 2005 {published data only}
    1. Li H, Zhang Z, Chen S. [Acupuncture plus ear‐acupressure treatment for 30 patients of IBS]. Guangxi Journal of Traditional Chinese Medicine 2005;28(3):35.
Li 2007 {published data only}
    1. Li B, Yang L, Feng Y. [Curative effect of acupuncture on diarrheogenic irritable bowel syndrome]. Journal of Beijing University of Traditional Chinese Medicine 2007;14(6):19‐21.
Liao 2000 {published data only}
    1. Liao YC. [Acupuncture treatment for 132 cases of irritable bowel syndrome]. Clinical Journal of Acupuncture and Moxibustion 2000;16(6):13‐4.
Liu 1995 {published data only}
    1. Liu M, Teng S. [Clinical report of ear acupuncture treatment for functional gastric disorder]. Shanghai Journal of Acupuncture and Moxibustion 1995;14(6):247‐8.
Long 2006 {published data only}
    1. Long Z, Yu C, Yu Y, Wang H, Chi X. [Clinical observation on acupuncture combined with microorganism pharmaceutical preparations for treatment of 90 irritable bowel syndrome of constipation type]. Chinese Acupuncture and Moxibustion 2006;26(6):403‐5. - PubMed
Ma 2009 {published data only}
    1. Ma Y, Yin F. [Warming needle moxibustion plus acupoint injection for 61 patients with irritable bowel syndrome]. China's Naturopathy 2009;17(9):22‐3.
Ouyang 2003 {published data only}
    1. Ouyang Q. [Clinical observation of ear‐acupressure combined with pinaverium bromide in treating 39 patients with irritable bowel syndrome]. New Journal of Traditional Chinese Medicine 2003;35(9):39‐40.
Ouyang 2006 {unpublished data only}
    1. Ouyangm A. Effect of acupuncture on symptoms of diarrhea and pain in IBS [Official Title: Effect of acupuncture on symptoms of diarrhea and pain in diarrhea predominant irritable bowel syndrome (IBS) and effect on plasma beta‐endorphin and serotonin levels]. ClinicalTrials.gov Identifier: NCT00219505 2006.
Qian 2011 {published data only}
    1. Qian H, Zhu Y, Meng S, Qi G, Zhao X. [Acupuncture treatment of diarrhea‐predominant irritable bowel syndrome: a randomized controlled trial]. World Chinese Journal of Digestology 2011;19(3):257‐61.
Shi 2011 {published data only}
    1. Shi Z, Lei M, Zhu Y, Wang Q. [Curative effect on 20 patients with irritable bowel syndrome by the Son Noon Dao Jiu method of Tianshu and Dachangshu]. Hebei Journal of Traditional Chinese Medicine 2010;32(10):1527‐8.
    1. Shi Z, Zhu Y, Wang Q, Lei M. [Comparative study on irritable bowel syndrome treated with acupuncture and western medicine]. Chinese Acupuncture and Moxibustion 2011;31(7):607‐9. - PubMed
    1. Shi Z, Zhu Y, Wang Q, Lei M. [Curative effect on irritable bowel syndrome by the Son Noon Dao Jiu method of Tianshu and Dachangshu]. Liaoning Journal of Traditional Chinese Medicine 2011;38(4):720‐1.
Song 2005 {published data only}
    1. Song J. [Clinical observation of warming needle moxibustion on irritable bowel syndrome]. The 3rd Congress of Clinical branch of China Association of Acupuncture‐Moxibustion and Symposium of Chinese Clinical Acupuncture‐Moxibustion. 2005.
Song 2011 {published data only}
    1. Song B, Qi H, Ling J. [Ear‐acupressure combined with otilonium bromide for diarrhea‐predominant irritable bowel syndrome]. Chinese Journal of Ethnomedicine and Ethnopharmacy 2011, (12):89.
Sun 2009 {published data only}
    1. Sun D. [Senlin Baizhu San plus Tongxie Yaofang combined with acupuncture for 57 patients with irritable bowel syndrome]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine 2009;9(3):36‐7.
Wang 2002 {published data only}
    1. Wang F. Analysis of the treatment efficacy of moxibustion with warming needle combined with TCM rectal irrigation treatment in irritable bowel treatment. TCM Clinical Magazine of An Hui 2002;14(3):187.
Wang 2007 {published data only}
    1. Wang Y, Li Y. [Acupuncture plus moxibustion treatment for 35 patients of IBS]. Shanghai Journal of Acupuncture and Moxibustion 2007;26(9):30.
Wang 2008a {published data only}
    1. Wang W, Bai L, Gao Z, Lv E. [Clinical study on acupuncture at ST25 and ST37 in treating diarrhea‐predominant irritable bowel syndrome]. Chinese Journal of Misdiagnostics 2008;8(26):6335‐6.
Wang 2008b {published data only}
    1. Wang W. [Clinical study on warming acupuncture in treating diarrhea‐predominant irritable bowel syndrome]. Journal of Emergency in Traditional Chinese Medicine 2008;17(10):1377,1407.
Wang 2009 {published data only}
    1. Wang Yuhai. [Clinical observation on Xuan Shi silver needle acupuncture for irritable bowel syndrome]. Journal of Huaihai Medicine 2009;27(3):234.
Wang 2011 {published data only}
    1. Wang Pengqin, Chen Suning, Liu Yuedong, Chen Xiaoyang, Wang Jian. [Randomized controlled study on the eye‐acupuncture for diarrhea‐predominant irritable bowel syndrome]. Journal of Traditional Chinese Medicine 2011;52(14):1203‐6.
Wu 2004 {published data only}
    1. Wu X. [Clinical observation on combination of warm acupuncture and ear pressing for the treatment of 46 cases of irritable bowel syndrome]. Hunan Guiding Journal of TCM 2004;10(3):42‐3.
Wu 2008 {published data only}
    1. Wu H, Liu H, Wang X, Guan Y, Zuo C, Tan L, et al. [The research of effectivity and cerebral function change on the treatment of irritable bowel syndrome (D‐IBS) with electroacupuncture on Tianshu (ST 25)]. The 20th Anniversary of Foundation of World Federation of Acupuncture‐Moxibustion Societies (WFAS) and International Acupuncture Congress. 2008; Vol. March 4:486‐7.
Xiao 2003 {published data only}
    1. Xiao Futang, Cheng Jihua, Wang Manhua, Li Qingyun. [Clinical observation Chinese and Western integrative medicine for irritable bowel syndrome]. Chinese Journal of Gastroenterololy 2003;8 (Suppl 1):A22.
Xiao 2004 {published data only}
    1. Xiao WB, Liu YL. Rectal hypersensitivity reduced by acupoint TENS in patients with diarrhea‐predominant irritable bowel syndrome: a pilot study. Digestive Diseases and Sciences 2004;49(2):312‐9. - PubMed
Xiong 2008b {published data only}
    1. Xiong J. [The treatment of acupuncture combined with Chinese medicine for 30 patients with irritable bowel syndrome]. Shaanxi Journal of Traditional Chinese Medicine 2008;29(11):1527‐8.
Xu 2009 {published data only}
    1. Xu M, Xiao X, Zhu H. [Clinical observation of acupuncture plus heat‐sensitive moxibustion in treating of irritable bowel syndrome]. Research of Integrated Traditional Chinese and Western Medicine 2009;1(4):212‐3.
Yang 2000 {published data only}
    1. Yang XY. Gastrointestinal dysfunction treated by therapy of acupuncture combined tuina. Journal of Chengdu University of TCM 2000;23(1):35.
Yu 2007 {published data only}
    1. Yu Y, Li G, Liu D. [Clinical study on acupuncture plus Chang Ling capsule treatment on IBS]. Journal of Experimental Traditional Medical Formulae 2007;13(5):48.
Yu 2011 {published data only}
    1. Yu B, Peng Y. [Ear‐acupressure combined with modified Tongxie Yaofang in treating 20 patients with irritable bowel syndrome]. Hunan Journal of Traditional Chinese Medicine 2011;27(4):21‐2.
Zhang 1996 {published data only}
    1. Zhang W, Liu Y. [Tapping acupuncture on paravertebral point in treating 68 patients of irritable bowel syndrome]. Journal of Jiamusi Medical College (former name), Heilongjiang Medicine and Pharmacy (present name) 1997;20(2):87‐8.
    1. Zhang W, Meng Q, Yu Y. [Tapping acupuncture on paravertebral point in treating 68 patients of irritable bowel syndrome]. Chinese Acupuncture and Moxibustion 1996;16(7):4.
Zhang 2000 {published data only}
    1. Zhang L. [Clinical study of acupuncture on Jiaji acupoints in treating 86 patients of irritable bowel syndrome]. Journal of Practical Traditional Chinese Medicine 2000;16(7):31.
Zhang 2010 {published data only}
    1. Zhang J. [Acupuncture treatment for irritable bowel syndrome.]. Chinese Journal of Ethinomedicine and Ethnopharmacy 2010;19(11):117.
Zhang 2011a {published data only}
    1. Zhang Y, Sun Z, Yang S. [Clinical investigation on Yu Shi scalp acupuncture for diarrhea‐predominant IBS plus syndrome of liver depression and spleen deficiency]. Chinese Journal of Traditional Medical Science and Technology 2011;18(3):231.
Zhang 2011b {published data only}
    1. Zhang H, Han S, Tang J. [Scalp acupuncture for 50 patients with diarrhea‐predominant IBS]. Chinese Acupuncture and Moxibustion 2011;31(7):605‐6. - PubMed
Zhao 2003 {published data only}
    1. Zhao S, Shi Z, Wu H, Liu H, Hua X, Yuan L. [Clinical observation of tonifying spleen and stomach by moxibustion for 72 patients with irritable bowel syndrome]. The 10th Anniversary of the Establishment of Sisters Association of China Association of Acupuncture‐Moxibustion and Korean Acupuncture‐Moxibustion Association and Live Demonstration of New Techniques and Therapies of Acupuncture and Symposium of Acupuncture for Incurable Diseases. April 11, 2003:38‐42.
Zheng 2003 {published data only}
    1. Zheng C, Zhang W, Xiao B. [Clinical study on Bifidobacterium capsule plus acupuncture in treating irritable bowel syndrome]. Chinese Journal of Celiopathy 2003;3(3):206‐7.

References to ongoing studies

Anastasi {unpublished data only}
    1. Anastasi JK. Acupuncture/Moxibustion for Irritable Bowel Syndrome (IBS). http://www.clinicaltrials.gov/ct2/show/NCT00945074?term=acupuncture+AND+... ongoing trial.
MacPherson {unpublished data only}
    1. MacPherson H. Acupuncture for irritable bowel syndrome (IBS): a randomised controlled trial to evaluate effectiveness and cost‐effectiveness. http://www.controlled‐trials.com/ISRCTN08827905 ongoing trial.
    1. MacPherson H, Bland M, Bloor K, Cox H, Geddes D, Kang'ombe A, et al. Acupuncture for irritable bowel syndrome: a protocol for a pragmatic randomised controlled trial. BMC gastroenterology 2010;10:63. [PUBMED: 20565790] - PMC - PubMed

Additional references

Adetugbo 2000
    1. Adetugbo K, Williams H. How well are randomized controlled trials reported in the dermatology literature?. Archives of Dermatology 2000;136(3):381‐5. - PubMed
Bijkerk 2003
    1. BijkerkCJ, Wit NJ, Muris JW, Jones RH, Knottnerus JA, Hoes AW. Outcome measures in irritable bowel syndrome: comparison of psychometric and methodological characteristics. American Journal of Gastroenterology 2003;98(1):122‐7. [PUBMED: 12526947] - PubMed
Brandt 2009
    1. Brandt LJ, Chey WD, Foxx‐Orenstein AE, Schiller LR, Schoenfeld PS, Spiegel BM, et al. An evidence‐based position statement on the management of irritable bowel syndrome. American Journal of Gastroenterology 2009;104 Suppl 1:S1‐35. [PUBMED: 19521341] - PubMed
Brenner 2009
    1. Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. American Journal of Gastroenterology 2009;104(4):1033‐49; quiz 1050. [PUBMED: 19277023] - PubMed
Chassany 1999
    1. Chassany O, Marquis P, Scherrer B, Read NW, Finger T, Bergmann JF, et al. Validation of a specific quality of life questionnaire for functional digestive disorders. Gut 1999;44(4):527‐33. [PUBMED: 10075960] - PMC - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2011.
Drossman 1994
    1. Drossman DA, Richter JE, Talley NJ (editors). The functional gastrointestinal disorders, pathophysiology, and treatment: a multinational consensus. Boston: Little Brown, 1994.
El‐Serag 2002
    1. El‐Serag HB, Olden K, Bjorkman D. Health‐related quality of life among persons with irritable bowel syndrome: a systematic review. Alimentary Pharmacology and Therapeutics 2002;16(6):1171‐85. - PubMed
Everhart 2008
    1. Everhart JE (editor). The burden of digestive diseases in the United States. NIH Publication No. 09‐6443. Washington, DC: US Government Printing Office: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2008:142.
Ezzo 2001
    1. Ezzo J, Lao L, Berman BM. Assessing clinical efficacy of acupuncture: what has been learned from systematic reviews of acupuncture?. In: Stux G, Hammerschlag R editor(s). Clinical acupuncture: scientific basis. New York: Springer, 2001:113‐30.
Ezzo 2005
    1. Ezzo J, Vickers A, Richardson MA, Allen C, Dibble SL, Issell B, et al. Acupuncture‐point stimulation for chemotherapy‐induced nausea and vomiting. Journal of Clinical Oncology 2005;23(28):7188‐98. [PUBMED: 16192603] - PubMed
Flum 2006
    1. Flum DR. Interpreting surgical trials with subjective outcomes: avoiding UnSPORTsmanlike conduct. JAMA 2006;296(20):2483‐5. - PubMed
Ford 2009a
    1. Ford AC, Talley NJ, Schoenfeld PS, Quigley EM, Moayyedi P. Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta‐analysis. Gut 2009;58(3):367‐78. - PubMed
Ford 2009b
    1. Ford AC, Brandt LJ, Young C, Chey WD, Foxx‐Orenstein AE, Moayyedi P. Efficacy of 5‐HT3 antagonists and 5‐HT4 agonists in irritable bowel syndrome: systematic review and meta‐analysis. American Journal of Gastroenterology 2009;104(7):1831‐43; quiz 1844. - PubMed
Francis 1997
    1. Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Alimentary Pharmacology and Therapeutics 1997;11(2):395‐402. [PUBMED: 9146781] - PubMed
Furlan 2005
    1. Furlan AD, Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, et al. Acupuncture and dry‐needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. [DOI: 10.1002/14651858.CD001351.pub2] - DOI - PubMed
Gaylord 2011
    1. Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. American Journal of Gastroenterology 2011;106(9):1678‐88. [PUBMED: 21691341] - PMC - PubMed
Groll 2002
    1. Groll D, Vanner SJ, Depew WT, DaCosta LR, Simon JB, Groll A, et al. The IBS‐36: a new quality of life measure for irritable bowel syndrome. American Journal of Gastroenterology 2002;97(4):962‐71. [PUBMED: 12003433] - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. - PMC - PubMed
Heaton 1991
    1. Heaton KW, Ghosh S, Braddon FE. How bad are the symptoms and bowel dysfunction of patients with the irritable bowel syndrome? A prospective, controlled study with emphasis on stool form. Gut 1991;32(1):73‐9. [PUBMED: 1991641] - PMC - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analysis. BMJ 2003;327:557‐60. - PMC - PubMed
Higgins 2011a
    1. Higgins JPT, Altman DG (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2011.
Higgins 2011b
    1. Higgins JPT, Deeks JJ, Altman DG (editors). Chapter 16: Special topics in statistics. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2011.
Hrobjartsson 2010
    1. Hrobjartsson A, Gotzsche PC. Placebo interventions for all clinical conditions. Cochrane Database of Systematic Reviews 2010, Issue 1. [DOI: 10.1002/14651858.CD003974.pub3] - DOI - PMC - PubMed
Irvine 2006
    1. Irvine EJ, Whitehead WE, Chey WD, Matsueda K, Shaw M, Talley NJ, et al. Design of treatment trials for functional gastrointestinal disorders. Gastroenterology 2006;130(5):1538‐51. [PUBMED: 16678567] - PubMed
Jailwala 2000
    1. Jailwala J, Imperiale TF, Kroenke K. Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials. Annals of Internal Medicine 2000;133(2):136‐47. - PubMed
Johnson 1998
    1. Johnson JA, Coons SJ. Comparison of the EQ‐5D and SF‐12 in an adult US sample. Quality of Life Research 1998;7(2):155‐66. [PUBMED: 9523497] - PubMed
Kalauokalani 2001
    1. Kalauokalani D, Cherkin DC, Sherman KJ, Koepsell TD, Deyo RA. Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects. Spine 2001;26(13):1418‐24. - PubMed
Kaptchuk 2006
    1. Kaptchuk TJ, Stason WB, Davis RB, Legedza AR, Schnyer RN, Kerr CE, et al. Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ 2006;332(7538):391‐7. - PMC - PubMed
Kleinhenz 1999
    1. Kleinhenz J, Streitberger K, Windeler J, Güssbacher A, Mavridis G, Martin E. Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain 1999;83(2):235‐41. [PUBMED: 10534595] - PubMed
Lim 2006
    1. Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, et al. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews 2006, Issue 4. [DOI: 10.1002/14651858.CD005111.pub2] - DOI - PubMed
Linde 2007
    1. Linde K, Witt CM, Streng A, Weidenhammer W, Wagenpfeil S, Brinkhaus B, et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain 2007;128(3):264‐71. - PubMed
Lindfors 2012
    1. Lindfors P, Unge P, Arvidsson P, Nyhlin H, Bjornsson E, Abrahamsson H, et al. Effects of gut‐directed hypnotherapy on IBS in different clinical settings‐results from two randomized, controlled trials. American Journal of Gastroenterology 2012;107(2):276‐85. - PubMed
Longstreth 2003
    1. Longstreth GF, Wilson A, Knight K, Wong J, Chiou CF, Barghout V, et al. Irritable bowel syndrome, health care use, and costs: a U.S. managed care perspective. American Journal of Gastroenterology 2003;98(3):600‐7. [PUBMED: 12650794] - PubMed
Longstreth 2006
    1. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130(5):1480‐91. [PUBMED: 16678561] - PubMed
MacPherson 2001
    1. MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R. Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complementary Therapies in Medicine 2001;9(4):246‐9. - PubMed
MacPherson 2010
    1. MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, et al. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Medicine 2010;7(6):e1000261. - PMC - PubMed
Mangel 1998
    1. Mangel AW, Hahn BA, Heath AT, Northcutt AR, Kong S, Dukes GE, et al. Adequate relief as an endpoint in clinical trials in irritable bowel syndrome. Journal of International Medical Research 1998;26(2):76‐81. [PUBMED: 9602985] - PubMed
Manheimer 2007
    1. Manheimer E, Linde K, Lao L, Bouter LM, Berman BM. Meta‐analysis: acupuncture for osteoarthritis of the knee. Annals of Internal Medicine 2007;146(12):868‐77. [PUBMED: 17577006] - PubMed
Manheimer 2010
    1. Manheimer E, Cheng K, Linde K, Lao L, Yoo J, Wieland S, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database of Systematic Reviews 2010, Issue 1. [DOI: 10.1002/14651858.CD001977.pub2] - DOI - PMC - PubMed
Manheimer 2011
    1. Manheimer E. Selecting a control for in vitro fertilization and acupuncture randomized controlled trials (RCTs): how sham controls may unnecessarily complicate the RCT evidence base. Fertility and Sterility 2011;95(8):2456‐61. - PMC - PubMed
Manning 1978
    1. Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel. BMJ 1978;2(6138):653‐4. - PMC - PubMed
Maxion‐Bergemann 2006
    1. Maxion‐Bergemann S, Thielecke F, Abel F, Bergemann R. Costs of irritable bowel syndrome in the UK and US. Pharmacoeconomics 2006;24(1):21‐37. - PubMed
Melchart 2004
    1. Melchart D, Weidenhammer W, Streng A, Reitmayr S, Hoppe A, Ernst E, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Archives of Internal Medicine 2004;164(1):104‐5. - PubMed
O'Connell 2009
    1. O'Connell NE, Wand BM, Goldacre B. Interpretive bias in acupuncture research?: A case study. Evaluation and the Health Professions 2009;32(4):393‐409. - PubMed
Pasricha 2007
    1. Pasricha PJ. Desperately seeking serotonin... A commentary on the withdrawal of tegaserod and the state of drug development for functional and motility disorders. Gastroenterology 2007;132(7):2287‐90. - PubMed
Patrick 1998
    1. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Digestive Diseases and Sciences 1998;43(2):400‐11. [PUBMED: 9512138] - PubMed
Ruepert 2011
    1. Ruepert L, Quartero A O, Wit N J, Heijden G J, Rubin G, Muris J W. Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews 2011, Issue 8. [DOI: 10.1002/14651858.CD003460.pub3] - DOI - PMC - PubMed
Saito 2000
    1. Saito YA, Locke GR, Talley NJ, Zinsmeister AR, Fett SL, Melton LJ 3rd. A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome. American Journal of Gastroenterology 2000;95(10):2816‐24. - PubMed
Saito 2002
    1. Saito YA, Schoenfeld P, Locke GR 3rd. The epidemiology of irritable bowel syndrome in North America: a systematic review. American Journal of Gastroenterology 2002;97(8):1910‐5. [PUBMED: 12190153] - PubMed
Schulz 2002
    1. Schulz KF, Grimes DA. Unequal group sizes in randomised trials: guarding against guessing. Lancet 2002;359(9310):966‐70. - PubMed
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Spiller 1999
    1. Spiller RC. Problems and challenges in the design of irritable bowel syndrome clinical trials: experience from published trials. American Journal of Medicine 1999;107(5A):91S‐7S. - PubMed
Streitberger 1998
    1. Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet 1998;352(9125):364‐5. - PubMed
Streitberger 2004
    1. Streitberger K, Diefenbacher M, Bauer A, Conradi R, Bardenheuer H, Martin E, et al. Acupuncture compared to placebo‐acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo‐controlled patient and observer blind trial. Anaesthesia 2004;59(2):142‐9. [PUBMED: 14725517] - PubMed
Talley 1995
    1. Talley NJ, Gabriel SE, Harmsen WS, Zinsmeister AR, Evans RW. Medical costs in community subjects with irritable bowel syndrome. Gastroenterology 1995;109(6):1736‐41. [PUBMED: 7498636] - PubMed
Thompson 2000
    1. Thompson WG, Longstreth D, Drossman DA, et al. Functional bowel disorders. In: Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE editor(s). Rome II: The Functional Gastrointestinal Disorders. 2nd Edition. McLean, VA: Degnon Associates Inc, 2000:355.
Thompson 2001
    1. Thompson CA. Alosetron withdrawn from market. American Journal of Health‐System Pharmacy 2001;58(1):13. - PubMed
Vanner 1999
    1. Vanner SJ, Depew WT, Paterson WG, DaCosta LR, Groll AG, Simon JB, et al. Predictive value of the Rome criteria for diagnosing the irritable bowel syndrome. American Journal of Gastroenterology 1999;94(10):2912‐7. - PubMed
Wechsler 2011
    1. Wechsler M E, Kelley J M, Boyd I O, Dutile S, Marigowda G, Kirsch I, et al. Active albuterol or placebo, sham acupuncture, or no intervention in asthma. New England Journal of Medicine 2011;365(2):119‐26. - PMC - PubMed
White 2001
    1. White A, Hayhoe S, Hart A, Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ 2001;323(7311):485‐6. - PMC - PubMed
Whitehead 2000
    1. Whitehead WE, Corazziari E, Prizont R, et al. Definition of a responder in clinical trials for functional gastrointestinal disorders: Report on a symposium. In: Drossman DA editor(s). ROME II: The functional gastrointestinal disorders. 2nd Edition. McLean, VA: Degnon Associates, 2000.
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta‐epidemiological study. BMJ 2008;336(7644):601‐5. - PMC - PubMed
Wu 2009
    1. Wu T, Li Y, Bian Z, Liu G, Moher D. Randomized trials published in some Chinese journals: how many are randomized?. Trials 2009;10:46. - PMC - PubMed

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