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Acupuncture treatment in irritable bowel syndrome
  1. A Schneider1,
  2. P Enck2,
  3. K Streitberger3,
  4. C Weiland1,
  5. S Bagheri1,
  6. S Witte5,
  7. H-C Friederich4,
  8. W Herzog4,
  9. S Zipfel2
  1. 1Department of General Practice and Health Services Research, University Medical Hospital, Heidelberg, Germany
  2. 2Department of Psychosomatic Medicine, University Medical Hospital Tübingen, Germany
  3. 3Department of Anaesthesiology, University Medical Hospital, Heidelberg, Germany
  4. 4Department of General Internal and Psychosomatic Medicine, University Medical Hospital, Heidelberg, Germany
  5. 5Department of Medical Biometry, University of Heidelberg, Heidelberg, Germany
  1. Correspondence to:
    Dr A Schneider
    Department of General Practice and Health Services Research, University Medical Hospital, University of Heidelberg, Voßstrasse 2, 69120 Heidelberg, Germany; antonius.schneider{at}med.uni-heidelberg.de

Abstract

Background and aims: Despite occasional positive reports on the efficacy of acupuncture (AC) on functions of the gastrointestinal tract, there is no conclusive evidence that AC is effective in the treatment of irritable bowel syndrome (IBS).

Patients and methods: Forty three patients with IBS according to the Rome II criteria were randomly assigned to receive either AC (n = 22) or sham acupuncture (SAC) (n = 21) using the so-called “Streitberger needle”. Treatment duration was 10 sessions with an average of two AC sessions per week. The primary end point was improvement in quality of life (QOL) using the functional digestive diseases quality of life questionnaire (FDDQL) and a general quality of life questionnaire (SF-36), compared with baseline assessments. QOL measurements were repeated three months after treatment.

Results: Both the AC and SAC groups improved significantly in global QOL, as assessed by the FDDQL, at the end of treatment (p = 0.022), with no differences between the groups. SF-36 was insensitive to these changes (except for pain). This effect was partially reversed three months later. Post hoc comparison of responders and non-responders in both groups combined revealed a significant prediction of the placebo response by two subscales of the FDDQL (sleep, coping) (F = 6.746, p = 0.003) in a stepwise regression model.

Conclusions: Acupuncture in IBS is primarily a placebo response. Based on the small differences found between the AC and SAC groups, a study including 566 patients would be necessary to prove the efficacy of AC over SAC. The placebo response may be predicted by high coping capacity and low sleep quality in individual patients.

  • AC, acupuncture
  • BDQ, bowel disease questionnaire
  • FDDQL, functional digestive diseases quality of life questionnaire
  • IBS, irritable bowel syndrome
  • PHQ-D, patients’ health questionnaire (German version)
  • QOL, quality of life
  • SAC, sham acupuncture ( = placebo acupuncture)
  • SF-36, health related quality of life questionnaire
  • TCM, traditional Chinese medicine
  • irritable bowel syndrome
  • acupuncture
  • sham acupuncture
  • quality of life
  • placebo response

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Footnotes

  • Published online first 22 September 2005

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