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

Abstract

Abstract Background: This study was aimed to compare the clinical efficacy of acupuncture and related therapies onirritable bowel syndrome with predominant constipation (IBS-C) in adults and providing guidance for clinical treatment. Methods: PubMed, The Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP databases were searched to obtain clinical randomized controlled trials (RCTs) on acupuncture and related therapies in the treatment of IBS-C published from establishment of the database to January 2023. The literature was evaluated for quality using the Cochrane 5.3 risk of bias assessment tool, and StataSE 15.0 and GeMTC 0.14.3 software was used fornetwork Meta-analysis (NMA). Results: 27 studies were included eventually in the NMA, involving 7 acupuncture-related therapies.The results of NMA showed that 7 acupuncture-related therapies were more effective than western medicine. Total effective rate showed that acupoint injection combined with medicine 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 of IBS-C (OR=8.38, 95% CI: 2.65, 38.00, P<0.05). The total effective rate on follow-up showed that acupoint injection combined with medicine 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 medicine has the best effect on both short and long-term efficiency and combination therapy may be more advantageous. However, the existing studies have limitations, and more high-quality randomized controlled trials are needed to confirm our findings.