Electro-acupuncture vs. sham electro-acupuncture for chronic severe functional constipation: A systematic review and meta-analysis. (November 2020)

• Record Type: Journal Article
• Authors: Zhang, Na; Hou, Liangying; Yan, Peijing; Li, Xiuxia; Wang, Yongfeng; Niu, Junqiang; Feng, Lufang; Li, Jingwen; Yang, Kehu; Liu, Xingrong
• Is Part Of: Complementary therapies in medicine. Volume 54(2021)
• Publication Date: 2020-11
• Subjects: Electro-acupuncture -- Chronic severe functional constipation -- Systematic review -- Meta-analysis -- Randomized controlled trials; Alternative medicine -- Periodicals; Complementary Therapies -- Periodicals; Médecines parallèles -- Périodiques; Thérapeutique -- Périodiques; Alternative medicine; Electronic journals; Periodicals; 615.5
• DOI: 10.1016/j.ctim.2020.102521
• Languages: English
• ISSNs: 0965-2299

Abstract

Highlights: Electro-acupuncture (EA) is a new type of acupuncture therapy, which combines traditional acupuncture with electrical stimulation for patients with chronic severe functional constipation (CSFC). We only included studies of randomized controlled trials and excluded animal studies, case reports, review articles, protocols, letters, abstracts, comments and so on. The meta-analyses of primary outcome (complete spontaneous bowel movements per week) showed that mean difference (MD) was nearly twice as high at the eighth week of treatment (MD = 0.80, 95 % CI 0.31–1.28, P < 0.001) than it was at fourth week of treatment (MD = 1.25, 95 % CI 0.53–1.96, P < 0.001); MD at the 12-week follow-up (MD = 0.87, 95 % CI 0.68–1.05, P < 0.001) decreased by nearly 1.6 times compared with that at the 4-week follow-up (MD = 1.38, 95 % CI 0.36–2.40, P = 0.008). Indicating that EA had favorable effects on CSFC, and the longer the treatment duration was, the better was the effect, but the effect showed a certain period of validity. Future studies should pay attention to optimal course of treatment, safety and economic benefits, implementation of strict blinding of EA for CSFC on the basis of existing studies. Abstract: Objectives: To assess the efficacy of electro-acupuncture (EA) relative to sham electro-acupuncture (sham EA) in treating chronic severe functional constipation (CSFC). Methods : A comprehensive search for relevant studies published between January 1, 1951 and May 14, 2020 was conducted in PubMed, the Cochrane Library, Chinese Biomedical Literature Database, Web of Science, and EMbase. Two investigators independently selected studies, extracted data, and assessed the quality of the included studies. The software Endnote X9 was used for screening articles, and the Review Manager 5.3 for analyzing data. Results: The meta-analyses involved 6 studies and 1457 individuals. The pooled results favored the EA group for the increase of complete spontaneous bowel movements (CSBMs) per week in the fourth week (MD = 0.80, P = 0.001) during treatment, and further improved in the eight weeks (MD = 1.25, P < 0.001). During the follow-up period, significant changes in CSBMs per week were seen in the experimental group (MD = 1.38, P = 0.008); the effect decreased in the twelfth week (MD = 0.87, P < 0.001). There was no significant difference in the Bristol stool scale score between the two groups in the fourth week (MD = 0.40, P = 0.08), but significant differences were observed in the eighth week (MD = 0.40, P = 0.03). A significant reduction in patient assessment of constipation quality of life (PAC-QOL) score were observed in the EA group during treatment (SMD = -0.83, P < 0.001). No serious adverse events were reported. Conclusions: EA had favorable effects on CSFC, and the longer the treatment duration was, the better was the effect, but the effect showed a certain period of validity. However, the results may be influenced by the clinical heterogeneity of acupuncture points, depth of needling, intensity, and frequency of EA.