Complementary Therapies in Medicine (2007) 15, 255—263
Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome
Objectives: Quality of life (QoL) improvement in patients with irritable bowel syndrome (IBS) during acupuncture (AC) treatment seems to be due to a placebo effect.
The aim was to explore if acupuncture has some specific influence on the neuroendocrinic and autonomic nervous system (ANS). Design/setting: Patients with IBS were randomly assigned to receive either acupuncture (AC) or sham acupuncture (SAC) using the so-called ‘‘Streitberger needle’’. QoL was measured with the functional quality of life diseases quality of life questionnaire
(FDDQL) and SF-36. The effect on ANS was evaluated by measuring salivary cortisol and by cardiovascular responses on a tilt table before and after 10 AC treatments. Complete data sets of tilt table and salivary morning cortisol were available for 9 patients in the AC and 12 in SAC group.
Results: QoL increased in both groups (p = 0.001) with no group differences. Salivary cortisol decreased in all groups (F = 10.55; p = 0.006). However, the decrease was more pronounced in the AC group (F = 4.07; p = 0.033) (ANOVA repeated measures model). Heart rate response decreased during orthostatic stress in the AC group while it increased in the SAC group (F = 9.234; p = 0.005), indicating an increased
parasympathetic tone in the AC group. Improvement of pain was positively associated with increased parasympathetic tone in the AC group (F = 10.1; p = 0.006), but not in the SAC group.
A. Schneidera et al.
Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial
Background A recent randomised controlled trial (RCT) of acupuncture as a treatment for irritable bowel syndrome (IBS) demonstrated sustained benefits over a period of 12 months post-randomisation.
Aim To extend the trial follow-up to evaluate the effects of acupuncture at 24 months post- randomisation.
Methods Patients in primary care with ongoing IBS were recruited to a two-arm pragmatic RCT of acupuncture for IBS. Participants were randomised to the offer of up to 10 weekly sessions of acupuncture plus usual care (n=116 patients) or to continue with usual care alone (n=117). The primary outcome was the self- reported IBS symptom severity score (IBS SSS) measured at 24 months post-randomisation. Analysis was by intention-to-treat using an unstructured multivariate linear model incorporating all repeated measures.
Results The overall response rate was 61%. The adjusted difference in mean IBS SSS at
24 months was −18.28 (95% CI −40.95 to 4.40) in favour of the acupuncture arm. Differences at earlier time points estimated from the multivariate model were: −27.27 (−47.69 to−6.86) at 3 months; −23.69 (−45.17 to −2.21) at 6 months; −24.09 (−45.59 to −2.59) at
9 months; and −23.06 (−44.52 to −1.59) at
Conclusions There were no statistically significant differences between the acupuncture and usual care groups in IBS SSS at 24 months post-randomisation, and the point estimate for the mean difference was approximately 80% of the size of the statistically significant results seen at 6, 9 and 12 months.
MacPherson H, et al.
Neurobiological Mechanism of Acupuncture for Relieving Visceral Pain of Gastrointestinal Origin