Bowls-unblocking and mind-regulating acupuncture therapy for constipation-predominant irritable bowel syndrome: An exploratory randomized clinical trial 通腑调神针法治疗便秘型肠易激综合征:随机对照试验

Abstract

Objective

To observe the effects of bowls-unblocking and mind-regulating acupuncture therapy on constipation, anxiety, depression and serum neuropeptide Y (NPY) content for the patients with constipation-predominant irritable bowel syndrome (IBS-C).

Methods

Forty-two IBS-C patients were randomly assigned either into a bowls-unblocking and mind-regulating acupuncture group (acupuncture group) or a mosapride citrate group (medication group) with 21 cases in each group. During the treatment, one patient in the medication group was excluded and 20 patients were included in final statistical analysis; while 21 patients completed the trial in the acupuncture group. Before treatment, after treatment and in follow-up (1 month after the whole treatment), the scores of the Cleveland clinical constipation scoring system (CCS), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were assessed in both groups. The changes in NPY content were compared before and after treatment.

Results

① Total score of CCS: after treatment, the total score in the acupuncture group and the medication group were (4.76 ± 2.10) points and (5.60 ± 1.88) points, respectively, which were significantly lower than those before treatment in both groups (both P < 0.05); and the difference in the score was not significant for the between-group comparison (P > 0.05). In the follow-up, the total scores were (4.19 ± 1.69) points in the acupuncture group, and was (6.35 ± 2.06) points in the medication group. The score in the medication group was higher than that after treatment in the same group (P < 0.05), but there was no significant difference between acupuncture group and the medication group (P > 0.05). ② SAS score: after treatment, the SAS scores were (50.24 ± 2.19) points and (53.45 ± 2.46) points in the acupuncture group and the medication group, respectively, which was lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between two groups (P < 0.05). In the follow-up, the scores were (51.95 ± 2.27) points and (54.55 ± 1.67) points in the acupuncture group and the medication group, respectively; which was lower than that before treatment in the two groups (both P < 0.05), and the difference in the score was significant between two groups (P < 0.05). ③SDS score: after treatment, the SDS scores were (50.71 ± 2.70) points and (53.15 ± 2.25) points in the acupuncture group and the medication group, respectively, which was significantly lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between the two group (P < 0.05). In the follow-up, the score of the acupuncture group was (52.57 ± 3.72) points and it was (56.60 ± 2.42) points in the medication group, which was significantly lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between the two groups (P < 0.05). ④Comparison of serum NPY content: after treatment, the serum NPY content of the acupuncture group and the medication group were (7.08 ± 3.02) mmol/L and (9.89 ± 3.82) mmol/L, respectively, which was significantly lower than that before treatment within each group (both P < 0.05). The difference was significant between the two groups (P < 0.05). ⑤ Effective rate: after treatment, the total effective rate was 95.24% in the acupuncture group and 90.00% in the medication group, without statistically significant difference (P > 0.05).

Conclusions

bowls-unblocking and mind-regulating acupuncture therapy relieved the defecation-related symptoms, anxiety, and depression in IBS-C patients; and it was more effective on abdominal pain compared with mosapride citrate. Acupuncture therapy also had some long-term effect, which may be related to its regulatory effect on the serum NPY content.