Clinical study of acupuncture at force-sensitive acupoints in treatment of diarrhea-predominant irritable bowel syndrome

OBJECTIVES: To evaluate the clinical efficacy of acupuncture on force‐sensitive acupoints with different sensitization degrees in treatment of diarrhea‐predominant irritable bowel syndrome (IBS‐D). METHODS: A total of 108 patients with IBS‐D were randomly divided into a high‐sensitivity group (36 cases, 2 cases dropped out), a low‐sensitivity group (36 cases, 1 case dropped out) and a waiting group (36 cases, 2 cases dropped out). In the high‐sensitivity group, 5 high‐sensitivity (the lowest pain threshold) acupoints were selected in acupuncture treatment, and in the low‐sensitivity group, 5 low‐sensitivity (the highest pain threshold) acupoints were selected. The patients in both groups received 3 times of acupuncture treatment per week, lasting 6 consecutive weeks. The patients in the waiting group did not receive any treatment during the research and the non‐investigational standard acupuncture therapy would be provided after follow‐up, 3 times a week, for 6 consecutive weeks. The scores of IBS severity scale (IBS‐SSS) and IBS quality of life scale (IBS‐QOL), and fecal traits of Bristol fecal form scale (BSFS) were evaluated before and after treatment, as well as in follow‐up. The occurrence of adverse reactions was recorded. RESULTS: Compared with those before treatment, the scores of IBS‐SSS and IBS‐QOL in the waiting group were not significantly different after treatment or in follow‐up;the scores of IBS‐SSS and IBS‐QOL in the high‐sensitivity group and the low‐sensitivity group were decreased at each time point (P<0.05). When compared with the waiting group, the score of IBS‐SSS in either the high‐sensitivity group or the low‐sensitivity group were reduced, starting from 2 weeks after treatment and till the follow‐up (P<0.05). In 4 and 6 weeks of treatment and during follow‐up, the score of IBS‐SSS in the high‐sensitivity group was lower than that in the low‐sensitivity group (P<0.05). In comparison with the score in the waiting group, the scores of IBS‐QOL were reduced in both the high‐sensitivity group and the low‐sensitivity group after treatment and in follow‐up (P<0.05);and the score in the high‐sensitivity group was lower than that of the low‐sensitivity group (P<0.05). In the waiting group, there was no statistically significant difference in fecal traits of BSFS after treatment and in follow‐up, but the improvements in BSFS were obtained in the high‐sensitivity group and the low‐sensitivity group (P<0.01). When compared with the waiting group, the improvements in BSFS were presented in the high‐sensitivity group and low‐sensitivity group after treatment and in follow‐up (P<0.01). No significant adverse reactions were observed in all groups. CONCLUSIONS: Acupuncture at force‐sensitive acupoints has a definite curative effect on IBS‐D. This therapy is high in safety and satisfactory in long‐term effect. In the aspects of the alleviation of the severity of symptoms and the improvement of the quality of life in the patients with IBS‐D, acupuncture at force‐sensitive acupoints with high sensitivity is more effective than that with low sensitivity.