Effect of thumbtack needle on functional constipation: A pragmatic randomized controlled trial

Area of Science:

• Gastroenterology
• Integrative Medicine
• Clinical Research

Background:

• Functional constipation (FC) affects a significant portion of the population, with limited evidence on alternative treatments.
• Thumbtack Needling (TN) is a proposed therapy for FC, but its efficacy requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of Thumbtack Needling (TN) in improving symptoms of functional constipation (FC).
• To compare the efficacy of TN against Mosapride Citrate (MC), a common pharmaceutical treatment for FC.

Main Methods:

• A randomized controlled trial involving 482 patients with FC, assigned to either TN or MC group.
• TN involved needle application every three days, with a two-day rest period, over a 4-week follow-up.
• Primary outcome: Complete and Spontaneous Bowel Movement (CSBM) score; Secondary outcomes: BSFS, CCS, and PAC-QOL.

Main Results:

• Both TN and MC groups showed improvements in CSBMs at week 4, meeting the minimal clinically important difference (MCID) threshold from baseline.
• The mean CSBMs at week 4 were higher in the TN group (3.35 ± 0.99) than the MC group (3 ± 1.03).
• The difference in CSBMs between TN and MC groups at week 4 was statistically significant (P < 0.001) but did not meet the MCID threshold.

Conclusions:

• Thumbtack Needling (TN) demonstrated a greater improvement in CSBMs for functional constipation compared to mosapride citrate.
• Despite statistical significance, the observed difference between TN and mosapride citrate did not reach clinical significance.
• Further research is needed to establish the clinical utility of TN for functional constipation.