Acupuncture vs Sham Non-Acupoint Acupuncture for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Irritable bowel syndrome (IBS) is a recurrent abdominal disease affecting people worldwide, with limited efficacious therapeutics. Acupuncture is increasingly gaining attention for the treatment of IBS, with inconsistent evidence. This study aimed to evaluate the specific effect of acupuncture on IBS compared with sham non-acupoint controls.

International and Chinese databases were searched to identify eligible randomized controlled trials. Primary outcomes included response rate, overall symptom severity, and quality of life. Data for dichotomous and continuous variables were extracted and pooled using risk ratios and standardized mean differences (SMDs) or mean differences and 95% CIs.

Twelve randomized controlled trials encompassing 1105 participants were included for systematic review and 11 of the randomized controlled trials were included for meta-analysis. Acupuncture demonstrated a significantly higher response rate for IBS compared with sham control (risk ratio, 1.61; 95% CI, 1.25-2.07; I² = 77%; 1004 participants). Acupuncture significantly improved total symptom severity at the end of treatment (SMD, 0.79; 95% CI, 0.30-1.28; I² = 86%) and at follow-up (SMD, 0.70; 95% CI, 0.22-1.18; I² = 83%) compared with sham acupuncture. Significance was also noted for quality of life at the end of treatment (SMD, 0.36; 95% CI, 0.01-0.71). However, sensitivity analysis only confirmed the robustness regarding response rate and symptom severity at the end of treatment.

Acupuncture significantly improved response rate and overall symptoms at the end of treatment in patients with IBS compared with sham non-acupoint acupuncture. Due to the significant heterogeneity and low certainty of evidence, this work merits more confirmation by large-scale and high-quality trials.