Is manual acupuncture effective in treating irritable bowel syndrome?
Date of publication of the systematic review: February 2014
Design
Systematic review of 6 randomized controlled trials (RCTs).
Participants
664 patients with irritable bowel syndrome (IBS). Age range and gender proportion of the participants were not reported by the reviewers.
Intervention
Manual acupuncture was provided with a range from 3 weeks to 13 weeks. Each session varied between once per week to 5 times per week.
Comparator
Comparison: Manual acupuncture versus usual care, sham acupuncture and pinaverium bromide.
Major Outcomes
Outcome 1: Clinical improvement in IBS symptoms at the end of treatment.
Settings
The reviewers did not state whether the trials were conducted in inpatient or outpatient settings. Two trials were conducted in the United Kingdom; two trials were conducted in the United States; and the remaining trials were conducted in China and Canada respectively.
Comparison    Manual acupuncture versus usual care, sham acupuncture and pinaverium bromide
Main Results
Compared to usual care, sham acupuncture and pinaverium bromide, manual acupuncture showed significant clinical improvement for treating IBS symptoms (pooled odds ratio (pooled OR): 1.75, 95% CI: 1.24 to 2.46).
Comparison: Manual acupuncture versus usual care, sham acupuncture and pinaverium bromide among patients with IBS
Outcomes (units) No. of studies (Total no. of participants) No. of events / No. of participants Heterogeneity test (I2) Pooled OR (95% CI) p value Overall quality of evidence*
Intervention Comparator
1 (NA) 6 (583) 165/ 292 126/ 291 0% 1.75 (1.24 to 2.46) 0.001 Moderate
Keys: OR = odds ratio; CI = confidence interval.
Comparison    Manual acupuncture versus usual care, sham acupuncture and pinaverium bromide
Main Results
Compared to usual care, sham acupuncture and pinaverium bromide, manual acupuncture showed significant clinical improvement for treating IBS symptoms (pooled odds ratio (pooled OR): 1.75, 95% CI: 1.24 to 2.46).
Comparison: Manual acupuncture versus usual care, sham acupuncture and pinaverium bromide among patients with IBS
Outcomes (units) 1 (NA)
No. of studies (Total no. of participants) 6 (583)
No. of events / No. of participants Intervention 165/ 292
Comparator 126/ 291
Pooled OR (95% CI) 1.75 (1.24 to 2.46)
p value 0.001
Overall quality of evidence* Moderate
Keys: OR = odds ratio; CI = confidence interval.
Conclusion
Benefits
Compared to usual care, sham acupuncture and pinaverium bromide, manual acupuncture showed significant clinical improvement for treating IBS symptoms. For outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No serious adverse events associated with acupuncture were reported in the review.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930986/
The synopsis is based on the following article:
Chao GQ, Zhang S. Effectiveness of acupuncture to treat irritable bowel syndrome: a meta-analysis. World Journal of Gastroenterology. 2014 Feb; 20(7):1871-7.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.