/*English:Functional Gastrointestinal Disorders*/ ====== Functional Gastrointestinal Disorders ====== ====== Troubles fonctionnels gastro-intestinaux ====== ===== Systematic Reviews and Meta-Analysis===== | ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | | ☆☆ | Evidence for effectiveness of acupuncture | | ☆ |Limited evidence for effectiveness of acupuncture | | Ø |No evidence or insufficient evidence | ==== Wang 2021 ☆☆ ==== Wang XY, Wang H, Guan YY, Cai RL, Shen GM. Acupuncture for functional gastrointestinal disorders: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2021 Nov;36(11):3015-3026. https://doi.org/10.1111/jgh.15645 ^Objectives| The therapeutic effect of acupuncture treatments (AT) on functional gastrointestinal disorders (FGIDs) is contentious. A meta-analysis was conducted to assess the efficacy and safety of acupuncture for FGIDs.| ^Methods|The Cochrane Library, EMBASE, PUBMED, Web of Science, Wanfang Database, China National Knowledge Infrastructure, and VIP Database were searched through December 31, 2019 with no language restrictions. Risk ratio (RR) with 95% confidence interval (CI) was calculated to determine the improvement in symptom severity after treatment.| ^Results|A total of 61 randomized controlled trials (RCTs) on FGIDs were included. The pooled results illustrated the following: compared to pharmacotherapy (RR 1.13, 95% CI 1.09-1.17), placebo acupuncture (RR 1.69, 95% CI 1.37-2.08), no specific treatment (RR 1.86, 95% CI 1.31-2.62), and AT as an adjuvant intervention to other active treatments (RR 1.25, 95% CI 1.21-1.30), AT had more favorable improvements in symptom severity; **sub-group analysis** results classified according to functional dyspepsia (n=13), irritable bowel syndrome (n=19), and functional constipation (n=8) also supported this finding; and the incidence of adverse events was lower in AT than in other treatments (RR 0.75, 95% CI 0.56-0.99).| ^Conclusions| This meta-analysis found that AT was significantly associated with relief of FGIDs symptoms; however, the evidence level was moderate or low. Further data from rigorously designed and well powered RCTs are needed to verify the effectiveness and safety of AT as a FGIDs treatment.| ===== Specific outcome ===== ==== Emotional symptoms in patients with functional gastrointestinal disorders ==== === Wang 2022 === Wang L, Xian J, Sun M, Wang X, Zang X, Zhang X, Yu H, Tan QW. Acupuncture for emotional symptoms in patients with functional gastrointestinal disorders: A systematic review and meta-analysis. PLoS One. 2022 Jan 27;17(1):e0263166. https://doi.org/10.1371/journal.pone.0263166 ^Background| Patients 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.| ^Objectives|To systematically evaluate the clinical efficacy and safety of acupuncture for emotional symptoms in patients with FGIDs.| ^Methods| Randomized 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.| ^Results| A 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.| ^Conclusions| This 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.| ===== Special Clinical Forms ===== ==== Dyspepsia ==== | See [[acupuncture:evaluation:gastro-enterologie:03. dyspepsie|corresponding item]] | ==== Irritable bowel syndrome ==== | See [[acupuncture:evaluation:gastro-enterologie:06. syndrome du colon irritable|corresponding item]] | ==== Constipation ==== | See [[acupuncture:evaluation:gastro-enterologie:08. constipation|corresponding item]] |