Abstract
BackgroundAcupuncture has been demonstrated to be effective and safe for chronic severe functional constipation (CSFC). However, which patients with CSFC will have a better response to acupuncture remains unclear.ObjectiveTo explore factors related to acupuncture response in patients with CSFC.MethodsWe performed a secondary analysis of a previous multicenter randomized controlled trial consisting of a 2-week run-in period, 8-week treatment, and 12-week follow-up without treatment in which patients with CSFC were randomly allocated to an electroacupuncture group or a sham electroacupuncture group. Responders were defined as participants with an increase of at least one complete spontaneous bowel movement (CSBM) in week 20 compared with the baseline period. The CSBM responder rate in both groups was described, and the baseline characteristics of participants potentially related to acupuncture response were mainly analyzed using logistic regression analysis with bootstrapping techniques.ResultsA total of 1021 participants were analyzed in this study, of whom 516 (50.5%) were classified as responders. The CSBM responder rate in week 20 was significantly greater in the electroacupuncture group than in the sham electroacupuncture group (62.9% vs. 37.9%, respectively; P<0.001). Both age and comorbidity were negatively associated with clinical response: with every one-year increase in age, the likelihood of clinical response was reduced by 1.2% (OR 0.988, 95%CI 0.980 to 0.996; P = 0.005), and patients with comorbidities were approximately 42% less likely to respond to treatment (OR 0.581, 95%CI 0.248 to 0.914; P = 0.001).ConclusionCSFC patients with increasing age and comorbidity may be less likely to respond to acupuncture. These findings contribute to guiding clinical practice in terms of pretreatment patient selection. Further research is needed to confirm the association.
Highlights
Chronic constipation is a common symptom that can influence the patient’s quality of life
We performed a secondary analysis of a previous multicenter randomized controlled trial consisting of a 2-week run-in period, 8-week treatment, and 12-week follow-up without treatment in which patients with chronic severe functional constipation (CSFC) were randomly allocated to an electroacupuncture group or a sham electroacupuncture group
Responders were defined as participants with an increase of at least one complete spontaneous bowel movement (CSBM) in week 20 compared with the baseline period
Summary
Chronic constipation is a common symptom that can influence the patient’s quality of life. The therapeutic effects of acupuncture remain controversial. Some trials have demonstrated that acupuncture was no more effective than sham acupuncture [5, 6]. One of the most important reasons is that the therapeutic effects of acupuncture are multifactorial, including both specific and non-specific factors [7]. There are few studies exploring which patients are more likely to benefit from acupuncture, while most clinical studies focus on the evaluation of acupuncture effectiveness. The question of which factors influence patient response to acupuncture needs to be addressed. Acupuncture has been demonstrated to be effective and safe for chronic severe functional constipation (CSFC). Which patients with CSFC will have a better response to acupuncture remains unclear.
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