Observation of the efficacy of the Tiaoshen Jianpi acupuncture method in patients with diarrhea-predominant irritable bowel syndrome and its effect on plasma motilin

OBJECTIVE: To treat patients with diarrhea-predominant irritable bowel syndrome (IBS-D) with the Tiaoshen Jianpi (regulating the mind and strengthening the spleen) acupuncture method, using the Western drug pinaverium bromide (Dicetel, Abbott Pharmaceutical Co., Ltd.) as control and the internationally recognized IBS-SSS scale as the objective evaluation index, in order to evaluate the efficacy of Tiaoshen Jianpi acupuncture in the treatment of IBS-D; and to compare the changes in plasma motilin (plasma MTL) concentration after acupuncture versus drug treatment in IBS-D patients, observing the degree of influence of Tiaoshen Jianpi acupuncture on plasma MTL. METHODS: A central randomization system was used for random allocation. 43 patients were randomly divided into the Tiaoshen Jianpi acupuncture group (experimental group, 23 patients) and the Western medicine pinaverium bromide group (control group, 20 patients). The acupuncture group received Tiaoshen Jianpi acupuncture 3 times per week. The Western medicine group received pinaverium bromide tablets (Dicetel, Abbott Pharmaceutical Co., Ltd., 50 mg, tid); the course of treatment was 6 weeks in both groups. Observations included: 1. Patients in both groups completed the IBS-SSS scale at baseline and at the end of treatment in week 6; IBS-SSS symptom scores before and after treatment were compared to observe the efficacy of Tiaoshen Jianpi acupuncture and pinaverium bromide in treating IBS-D, and the efficacy of the two groups was evaluated. 2. Fasting plasma MTL was measured in both groups before and after treatment to observe the effect of acupuncture and Western medicine on plasma MTL, and whether the improvement of symptoms in IBS-D patients is correlated with plasma MTL. RESULTS: 1. After acupuncture treatment, the total IBS-SSS symptom score at week 6 improved significantly compared with the baseline total score (P<0.05); acupuncture also significantly improved the IBS-SSS item scores for abdominal pain, days with abdominal pain, degree of abdominal distension, satisfaction with bowel habits, and impact of IBS-D on life (P<0.05). 2. After pinaverium bromide treatment, the total IBS-SSS symptom score at week 6 improved significantly compared with the baseline total score (P<0.05); Western medicine treatment also significantly improved the IBS-SSS item scores for abdominal pain, days with abdominal pain, degree of abdominal distension, satisfaction with bowel habits, and impact of IBS-D on life (P<0.05). 3. At the end of treatment, according to the total IBS-SSS score, there was no significant difference between the two treatments (P>0.05). There were no significant differences between the two groups in the scores for abdominal pain (P>0.05), abdominal distension (P>0.05) or days with abdominal pain (P>0.05). However, acupuncture was superior to the drug group for satisfaction with bowel habits and impact of IBS-D on life (P<0.05). 4. Plasma MTL concentrations measured in both groups before and after treatment showed that both Tiaoshen Jianpi acupuncture and pinaverium bromide significantly reduced plasma MTL concentration (P<0.05), but there was no significant difference between the two methods in the degree of reduction (P>0.05). CONCLUSIONS: 1. IBS-SSS symptoms improved significantly after Tiaoshen Jianpi acupuncture treatment, and acupuncture significantly improved abdominal pain, days with abdominal pain, degree of abdominal distension, satisfaction with bowel habits and the impact of IBS-D on life. 2. Tiaoshen Jianpi acupuncture can significantly reduce plasma MTL concentration in IBS-D patients; acupuncture may improve the symptoms of IBS-D patients by reducing plasma MTL concentration.