Objective: To evaluate the effectiveness of acupuncture and moxibustion in the treatment of anxiety and depression in irritable bowel syndrome (IBS) by meta-analysis.
Methods: China National Knowledge Infrastructure (CNKI), Wanfang Data, China Scientific Journal Database (VIP), China Biomedical Literature Service System (SinoMed), PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) on acupuncture and moxibustion in the treatment of IBS anxiety and depression from database inception to June 30, 2021. RevMan5.3 and Stata16.0 were used to conduct Meta-analysis of relevant outcome indicators.
Results: A total of 11 RCTs were included in this study, involving 774 IBS patients (431 in the intervention group and 343 in the control group). Eight of them used manual acupuncture (MA) intervention, and the other three used electroacupuncture (EA) intervention. Meta-analysis showed that compared with the western medicine, MA improved the sedation-agitation scale (SAS) scores (MD=5.24, 95%CI=［3.49, 7.00］, P<0.000 01) and self-rating depression scale (SDS) scores (MD=8.50, 95%CI=［4.68, 12.32］, P<0.000 1) in IBS patients, and there was no significant difference between MA or EA and western medicine in the improvement of Hamilton anxiety rating scale (HAMA) scores (MD=1.10, 95%CI=［0.36, 2.56］, P=0.14) and Hamilton depression rating scale (HAMD) scores (MD=0.53, 95%CI=［0.89, 1.94］, P=0.47). In terms of total effective rates (RR=1.21, 95%CI=［1.12, 1.31］, P<0.000 01) and the irritable bowel syndrome severity scoring system (IBS-SSS) scores (MD=42.16, 95%CI=［27.40, 56.91］, P<0.000 01), both MA and EA therapy was superior to western medicine in alleviating gastrointestinal symptoms of IBS patients.
Conclusion: MA and EA can improve the anxiety and depression of IBS patients, while the influence of other acupuncture and moxibustion interventions needs to be deeply explored with more high-quality RCTs.
目的：采用Meta分析评估针灸治疗肠易激综合征(IBS)焦虑抑郁状态的有效性。方法：检索中国期刊全文数据库、万方学术期刊全文数据库、维普中文科技期刊全文数据库、中国生物医学文献数据库、PubMed、Embase和Cochrane图书馆7个数据库, 查找从建库到2021年6月30日发表的与针灸治疗IBS焦虑抑郁状态相关的随机对照试验文献。运用RevMan5.3及Stata16.0软件对相关结局指标进行Meta分析。结果：本研究共纳入11项随机对照试验, 包括774名IBS患者(试验组431例, 对照组343例)。其中8项随机对照试验采用手针干预, 另外3项采用电针干预。Meta分析结果表明, 与西药相比, 手针能改善IBS患者SAS评分(MD=5.24, 95%CI=［3.49, 7.00］, P<0.000 01)、SDS评分(MD=8.50, 95%CI=［4.68,12.32］, P<0.000 1), 而在改善HAMA评分(MD=1.10, 95%CI=［0.36, 2.56］, P=0.14)、HAMD评分(MD=0.53, 95%CI= ［0.89,1.94］, P=0.47)方面手针和电针与西药相比差异均无统计学意义。总有效率(RR=1.21, 95%CI=［1.12,1.31］, P<0.000 01)、IBS-SSS评分(MD=42.16, 95%CI=［27.40, 56.91］, P<0.000 01)的Meta分析显示针灸对IBS胃肠道症状的改善比西药更为有效。结论：手针和电针对IBS患者焦虑抑郁状态均具有改善作用, 其他针灸方式对IBS焦虑抑郁状态的影响研究需更多的随机对照试验不断补充与完善。.
Keywords: Acupuncture and moxibustion; Anxiety; Depression; Irritable bowel syndrome; Meta analysis.