Abstract
BackgroundPatients with functional gastrointestinal disorders (FGIDs) also often have emotional symptoms, such as anxiety and depression. The main drugs used for the treatment of FGIDs mainly target single gastrointestinal symptoms and are not effective in regulating emotional symptoms. Evidence has shown that acupuncture can relieve gastrointestinal symptoms in FGIDs patients, but there is no high-quality evidence to show that acupuncture can relieve psychological symptoms in these patients.ObjectivesTo systematically evaluate the clinical efficacy and safety of acupuncture for emotional symptoms in patients with FGIDs.MethodsRandomized controlled trials (RCTs) published from database inception through July 31, 2021, were retrieved from three English-language databases (PubMed, the Cochrane Central Register of Controlled Trials, and Embase) and five Chinese-language databases (the China National Knowledge Infrastructure, Wanfang, VIP, Chinese Biomedical, and TCM Literature Analysis and Retrieval databases). RCTs that compared acupuncture with sham acupuncture and pharmacotherapy were included in this study. The score on the depression or anxiety scale after treatment were considered as primary outcomes. The ‘meta’ package (version 4.19–0) in RStudio 1.1.463 was used to analyse the data.ResultsA total of 2151 patients from 24 RCTs were included in this study. Compared with sham acupuncture, acupuncture was not significantly better at relieving anxiety (standardized mean difference [SMD] -0.35, 95% CI −1.05 to 0.33) and depression (SMD -0.32, 95% CI −0.71 to 0.07) symptoms. Compared with pharmacotherapy, acupuncture was significantly better at relieving anxiety (SMD -0.64, 95% CI -0.93 to -0.35) and depression (SMD -0.46, 95% CI -0.69 to -0.22) symptoms.ConclusionsThis meta-analysis found that acupuncture can alleviate emotional symptoms in FGID patients better than pharmacotherapy. However, it is not clear whether this effect is based on the placebo effect, specific effect or nonspecific effect of acupuncture. The evidence should be proven by rigorously designed RCTs in the future.PROSPERO registration numberCRD42021271899.
Highlights
Functional gastrointestinal diseases (FGIDs), which are defined as gut-brain interaction disorders [1], are the most common types of gastrointestinal diseases [2]
This meta-analysis found that acupuncture can alleviate emotional symptoms in FGID patients better than pharmacotherapy. It is not clear whether this effect is based on the placebo effect, specific effect or nonspecific effect of acupuncture
The evidence should be proven by rigorously designed Randomized controlled trials (RCTs) in the future
Summary
Functional gastrointestinal diseases (FGIDs), which are defined as gut-brain interaction disorders [1], are the most common types of gastrointestinal diseases [2]. Patients with FGIDs often have emotional symptoms, such as anxiety and depression. It is important to pay attention to emotional symptoms in patients with FGIDs. The main drugs used for the treatment of FGIDs are kinetic agents, proton pump inhibitors, anticholinergics and antidiarrhoeal drugs. The main drugs used for the treatment of FGIDs are kinetic agents, proton pump inhibitors, anticholinergics and antidiarrhoeal drugs These drugs mainly target single gastrointestinal symptoms and are not effective at regulating emotional symptoms. Patients with functional gastrointestinal disorders (FGIDs) often have emotional symptoms, such as anxiety and depression. The main drugs used for the treatment of FGIDs mainly target single gastrointestinal symptoms and are not effective in regulating emotional symptoms. Evidence has shown that acupuncture can relieve gastrointestinal symptoms in FGIDs patients, but there is no high-quality evidence to show that acupuncture can relieve psychological symptoms in these patients
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