Abstract
Aim This study aimed to evaluate the effects and safety of moxibustion in the management of constipation. Background Constipation is extremely common in clinical practice and causes physical and mental pain to patients. This study aimed to evaluate the effects and safety of moxibustion in the management of constipation. Methods Studies on moxibustion for constipation published up to November 2019 were searched in PubMed; EBSCO; EMBASE; Cochrane Library; and three Chinese databases, namely, China National Knowledge Internet, Wanfang, and China Biomedical Network. The methodological quality of the included studies was assessed on the basis of the CLEAR NPT system evaluation methods of Boutron. Further meta-analysis was performed using the RevMan 5.3 and Stata 15.0 software. Results Ten randomized controlled trials involving 760 patients were included in this study. The meta-analysis revealed that, in comparison to western medicine treatment or other Chinese medicine methods (control group), moxibustion (experimental group) had a higher total effective rate (RR = 1.30, 95% CI [1.21, 1.40], P < 0.00001), and the clinical effectiveness of the experimental group was higher than that of the control group in any subgroup analysis. The first defecation time of the experimental group was shorter than that of the control group (SMD = −1.36, 95% CI [−2.03, −0.68], P < 0.0001). The clinical symptom score of the patients in the experimental group was lower than that in the control group (SMD = −0.65, 95% CI [−1.00, −0.30], P=0.0003). The patients in the experimental group had higher scores on Bristol stool form scale than those in the control group (MD = 0.99, 95% CI [0.48, 1.50], P=0.0001). However, there was no obvious difference in safety between the two groups (RR = 0.38, 95% CI [0.01, 11.8], P=0.58). Conclusions Moxibustion may have better effect than other treatments on constipation. However, it is not yet possible to assess the safety level of moxibustion therapy, and the quality of the included literature is low, so rigorous studies are warranted. Implications for Nursing and Health Policy. The focus of this study was to evaluate the effectiveness and safety of moxibustion therapy in constipation. This evaluation showed that moxibustion therapy has a good effect on constipation and provides an effective treatment for constipation patients. Whether moxibustion therapy can be used for different syndrome types deserves further discussion.
Highlights
Constipation [1] is a condition characterized by prolonged periods of stool remaining in the intestine, reduced number of bowel movements, and dry stool which is difficult to discharge
Studies were identified through a comprehensive search in the following databases: Pubmed, Embase, EBSCO, Cochrane Library, China Biomedical Network, China National Knowledge Internet, and Wanfang. e search time was from inception to November 2019. e search terms included “moxibustion,” “moxibustion therapy,” “constipation,” “abnormal bowel movement,” “difficulty in defecation,” and “random.”
According to the intervention measures of the control group, it could be divided into Chinese medicine treatment and western medicine treatment. e results showed that, compared with western medicine treatment or other traditional Chinese medicine methods, moxibustion was more clinically effective (RR 1.31, 95% confidence interval (CI) [1.19, 1.44], P < 0.00001; relative risk (RR) 1.29, 95% CI [1.15, 1.44], P < 0.0001, Figure 6)
Summary
Constipation [1] is a condition characterized by prolonged periods of stool remaining in the intestine, reduced number of bowel movements, and dry stool which is difficult to discharge. Bed rest, reduced activity, application of drugs, pain, bowel habits, position changes, and psychology are factors that have greatly increased the likelihood of constipation in certain disease populations [4]. Western medicine commonly uses oral laxatives, Glycerine anal plug, and enema, which alleviate the symptoms to some extent [14] but cannot fundamentally improve the patients’ intestinal function. These management strategies increase the risk of constipation in the long term
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