Electroacupuncture for patients with diarrhea-predominant irritable bowel syndrome or functional diarrhea: A randomized controlled trial

• Published in: Medicine (Baltimore) Vol. 95; no. 24; p. e3884
• Main Authors: Zheng, Hui, Li, Ying, Zhang, Wei, Zeng, Fang, Zhou, Si-Yuan, Zheng, Hua-Bin, Zhu, Wen-Zeng, Jing, Xiang-Hong, Rong, Pei-Jing, Tang, Chun-Zhi, Wang, Fu-Chun, Liu, Zhi-Bin, Wang, Shi-Jun, Zhou, Mei-Qi, Liu, Zhi-Shun, Zhu, Bing
• Format: Journal Article
• Language: English
• Published: United States The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved 01.06.2016; Wolters Kluwer Health
• Subjects: Adolescent; Adult; Aged; Clinical Trial/Experimental Study; Defecation - physiology; Diarrhea - etiology; Diarrhea - physiopathology; Diarrhea - therapy; Electroacupuncture - methods; Follow-Up Studies; Humans; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - physiopathology; Irritable Bowel Syndrome - therapy; Middle Aged; Prospective Studies; Time Factors; Treatment Outcome; Young Adult
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000003884

Diarrhea-predominant irritable bowel syndrome (IBS-D) and functional diarrhea (FD) are highly prevalent, and the effectiveness of acupuncture for managing IBS-D and FD is still unknown.The aim of this study was to compare the effectiveness of electroacupuncture with loperamide.It was a prospective, randomized, parallel group controlled trial.A total of 448 participants were randomly assigned to He electroacupuncture group (n = 113), Shu-Mu electroacupuncture group (n = 111), He-Shu-Mu electroacupuncture group (n = 112), or loperamide group (n = 112). Participants in the 3 acupuncture groups received 16 sessions of electroacupuncture during a 4-week treatment phase, whereas participants in the loperamide group received oral loperamide 2 mg thrice daily. The primary outcome was the change from baseline in stool frequency at the end of the 4-weeks treatment. The secondary outcomes were the Bristol scale, the MOS 36-item short form health survey (SF-36), the weekly average number of days with normal defecations and the proportion of adverse events.Stool frequency was significantly reduced at the end of the 4-week treatment in the 4 groups (mean change from baseline, 5.35 times/week). No significant difference was found between the 3 electroacupuncture groups and the loperamide group in the primary outcome (He vs. loperamide group [mean difference 0.6, 95% CI, -1.2 to 2.4]; Shu-Mu vs. loperamide group [0.4, 95% CI, -1.4 to 2.3]; He-Shu-Mu vs. loperamide group [0.0, 95% CI, -1.8 to 1.8]). Both electroacupuncture and loperamide significantly improved the mean score of Bristol scale and increased the weekly average number of days with normal defecations and the mean scores of SF-36; they were equivalent in these outcomes. However, the participants in electroacupuncture groups did not report fewer adverse events than those in the loperamide group. Similar results were found in a subgroup analysis of separating patients with IBS-D and FD patients.Electroacupuncture is equivalent to loperamide for reducing stool frequency in IBS-D and FD patients. Further studies on cost effectiveness of acupuncture are warranted.