Acupuncture and related therapy for constipation predominant irritable bowel syndrome: A network meta-analysis of randomized controlled trials

Abstract

Abstract Background: The aim of this study was to compare the clinical effectiveness of acupuncture and related therapies in adults with constipation-predominant irritable bowel syndrome (IBS-C) and to provide guidance for clinical management. Methods: PubMed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang and VIP databases were searched for clinical randomised controlled trials (RCTs) of acupuncture and related therapies for IBS-C published from the inception of the database to January 2023. The literature was assessed for quality using the Cochrane 5.3 risk of bias assessment tool, and StataSE 15.0 and GeMTC 0.14.3 software were used for network meta-analysis (NMA).. Results: Twenty-seven trials were finally included in the NMA, including 7 acupuncture-related therapies. The results of the NMA showed that 7 acupuncture-related therapies were more effective than conventional medicine. The overall efficacy rate showed that acupuncture combined with medication was the most effective therapy (OR=6.33, 95% CI: 2.01, 41.74, P<0.05). The recovery rate showed that acupoint catgut embedding was the best treatment for IBS-C (OR=8.38, 95% CI: 2.65, 38.00, P<0.05). The overall efficacy rate at follow-up showed that acupuncture combined with medication had the best sustained effect. Conclusion: Acupuncture-related therapies are more clinically effective than conventional medicine in the treatment of IBS-C. Acupoint injection combined with medication has the best effect in both the short and long term, and combination therapy may be more beneficial. However, the existing trials have limitations and more high-quality randomised controlled trials are needed to confirm our findings.