Standardizing and Optimizing TCM Acupuncture Treatment for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Abstract Background: Acupuncture has been regarded as a potential physical approach for irritable bowel syndrome (IBS). However, there is still no adequate conclusive evidence on its efficacy and optimal therapeutic strategy of acupuncture for IBS. The purpose of this expert consensus study was to put forward some viable recommendations for clinical acupuncture practitioners in treating IBS.Methods: A panel composed of 74 acupuncturists, was convened to participate in a 2-round clinical issue investigation. Subsequently, systematic reviews on acupuncture for IBS were screened using 3 databases. An initial consensus voting list was generated from the results of clinical issue investigation and literature review. Finally, a multi-round Delphi vote was conducted to develop an expert consensus on these specific issues. 30 authoritative experts were required to respond with agreement, neutrality, or disagreement for the items on the consensus voting list. Consensus achievement was identified as the level of agreement on a given item > 80%.Results: Following a 2-round Delphi vote, there were 19 items achieving consensus; of which 5 items (26.32%) achieved complete consensus, and more than 80% expert agreement was reached for the other 14 items. These items can be roughly categorized into 3 major domains of acupuncture for IBS: (1) therapeutic effects, (2) therapeutic principles and protocols, (3) possible adverse events.Conclusions: Without any ready-made guidelines, this preliminary expert consensus could be helpful for acupuncturists in daily clinical practice and patients with IBS to acquire appropriate and standardized acupuncture treatment. In addition, it also points out the clinical issues which need to be further explored in future studies.

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Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome

Focus on Alternative and Complementary Therapies ◽

10.1111/j.2042-7166.2006.tb04803.x ◽

2010 ◽

Vol 11 ◽

pp. 52-53

Author(s):

C Weiland ◽

A Schneider ◽

S Bagheri ◽

P Enck ◽

S Zipfel ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Acupuncture Treatment ◽

Irritable Bowel

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Optimizing the Use of Linaclotide in Patients with Constipation-Predominant Irritable Bowel Syndrome: An Expert Consensus Report

Advances in Therapy ◽

10.1007/s12325-016-0473-8 ◽

2017 ◽

Vol 34 (3) ◽

pp. 587-598 ◽

Cited By ~ 13

Author(s):

Enrique Rey ◽

Fermín Mearin ◽

Javier Alcedo ◽

Constanza Ciriza ◽

Silvia Delgado-Aros ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Expert Consensus ◽

Irritable Bowel ◽

Consensus Report

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Networks Are Associated With Acupuncture Treatment in Patients With Diarrhea-Predominant Irritable Bowel Syndrome: A Resting-State Imaging Study

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.736512 ◽

2021 ◽

Vol 15 ◽

Author(s):

Tingting Zhao ◽

Lixia Pei ◽

Houxu Ning ◽

Jing Guo ◽

Yafang Song ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Functional Connectivity ◽

Resting State ◽

Large Scale ◽

Acupuncture Treatment ◽

Brain Regions ◽

Attention Network ◽

Frontoparietal Network ◽

Before And After ◽

Irritable Bowel

Background: Irritable Bowel Syndrome (IBS), as a functional gastrointestinal disorder, is characterized by abdominal pain and distension. Recent studies have shown that acupuncture treatment improves symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) by altering networks in certain brain regions. However, few studies have used resting-state functional magnetic resonance imaging (fMRI) to compare altered resting-state inter-network functional connectivity in IBS-D patients before and after acupuncture treatment.Objective: To analyze altered resting-state inter-network functional connectivity in IBS-D patients before and after acupuncture treatment.Methods: A total of 74 patients with IBS-D and 31 healthy controls (HCs) were recruited for this study. fMRI examination was performed in patients with IBS-D before and after acupuncture treatment, but only at baseline in HCs. Data on the left frontoparietal network (LFPN), default mode network (DMN), salience network (SN), ventral attention network (VAN), auditory network (AN), visual network (VN), sensorimotor network (SMN), dorsal attention network (DAN), and right frontoparietal network (RFPN) were subjected to independent component analysis (ICA). The functional connectivity values of inter-network were explored.Results: Acupuncture decreased irritable bowel syndrome symptom severity score (IBS-SSS) and Hamilton Anxiety Scale (HAMA). It also ameliorated symptoms related to IBS-D. Notably, functional connectivity between AN and VAN, SMN and DMN, RFPN and VAN in IBS-D patients after acupuncture treatment was different from that in HCs. Furthermore, there were differences in functional connectivity between DMN and DAN, DAN and LFPN, DMN and VAN before and after acupuncture treatment. The inter-network changes in DMN-VAN were positively correlated with changes in HAMA, life influence degree, and IBS-SSS in IBS-D.Conclusion: Altered inter-network functional connectivity is involved in several important hubs in large-scale networks. These networks are altered by acupuncture stimulation in patients with IBS-D.

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