The dose-effect relationship of acupuncture in the treatment of functional gastrointestinal disorders: A meta-regression of randomized controlled trials

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Siyao Gong, Xin Yu, Jiao Yang, Dan Huang, Shuguang Yu, Sha Yang
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Abstract

Introduction

The efficacy of acupuncture in treating functional gastrointestinal disorders (FGIDs) has been widely acknowledged. However, the dose-response relationship between acupuncture frequency and FGIDs remains uncertain. This review aimed to explore the relationship between the number of acupuncture sessions and the efficacy of acupuncture for FGIDs.

Methods

Seven major databases were searched from their inception to April 25, 2023. Literature screening, risk of bias assessment, and data extraction were performed by two reviewers independently. The quality of included randomized controlled trials (RCTs) was assessed using the Cochrane bias risk tool and Jadad score. The dose-effect relationship between acupuncture sessions and the clinical response rate in patients with FGIDs was investigated by using the cubic spline limited nonlinear meta-regression method in statal5.1. Before the review, we conducted the PROSPERO registration (CRD42022344699).

Results

Our analysis included 100 studies on acupuncture treatment of FGIDs, encompassing 8,589 participants. The meta-analysis of the dose-response relationship indicated that acupuncture could improve clinical symptoms and clinical response in patients with FGIDs to some extent. The clinical response rate increased with the number of acupuncture sessions in the range of ten to twenty sessions, with the odds ratio (OR) value rising from 1.05 (95 % CI: 0.89, 1.21) to 1.38 (95 % CI: 1.22,1.53). The peak of clinical response rate was observed at 24 acupuncture sessions (OR = 1.40; 95 % CI: 1.25, 1.55), representing a 40 % increase in OR. Compared with 24 sessions, the clinical response rate decreased after 56 sessions (OR = 1.22; 95 % CI: 0.64, 1.81).

Conclusion

There is a dose-response relationship between the number of acupuncture sessions and the clinical response in individuals with FGIDs. Twenty-four acupuncture treatments correlate with the optimal clinical response.
针灸治疗功能性胃肠功能紊乱的剂量效应关系:随机对照试验的元回归
引言 针灸治疗功能性胃肠病(FGIDs)的疗效已得到广泛认可。然而,针灸次数与 FGIDs 之间的剂量-反应关系仍不确定。本综述旨在探讨针灸次数与针灸治疗 FGIDs 疗效之间的关系。文献筛选、偏倚风险评估和数据提取由两名审稿人独立完成。使用 Cochrane 偏倚风险工具和 Jadad 评分评估了纳入的随机对照试验(RCT)的质量。我们使用 statal5.1 中的立方样条有限非线性元回归方法研究了针灸疗程与 FGID 患者临床反应率之间的剂量效应关系。结果我们的分析纳入了 100 项针灸治疗 FGIDs 的研究,涉及 8589 名参与者。剂量-反应关系的荟萃分析表明,针灸可在一定程度上改善 FGIDs 患者的临床症状和临床反应。临床反应率随着针灸次数的增加而增加,在十次至二十次的范围内,几率比(OR)值从 1.05(95 % CI:0.89,1.21)上升到 1.38(95 % CI:1.22,1.53)。临床反应率的峰值出现在针灸 24 次时(OR = 1.40;95 % CI:1.25, 1.55),OR 值增加了 40%。结论针灸次数与 FGIDs 患者的临床反应之间存在剂量-反应关系。24次针灸治疗与最佳临床反应相关。
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来源期刊
European Journal of Integrative Medicine
European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
4.70
自引率
4.00%
发文量
102
审稿时长
33 days
期刊介绍: The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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