A recent randomized controlled trial has shed light on the efficacy of acupuncture as a treatment for refractory irritable bowel syndrome (IBS), a chronic gastrointestinal disorder that significantly impacts quality of life and often resists conventional treatment. The multicenter study conducted across China investigated the effects of true acupuncture (TA) versus sham acupuncture (SA) on patients who had not responded to standard therapies. The results indicated that TA could offer significant relief from IBS symptoms, providing a potentially effective alternative treatment option for those suffering from this condition.

The study was meticulously designed to ensure a robust evaluation of acupuncture's impact on IBS. It included 170 participants, aged between 18 to 70 years, who had been diagnosed with refractory IBS according to the Rome IV criteria. The participants were randomly assigned to either the TA group or the SA group in a 1:1 ratio. The TA group received treatment at specific acupuncture points known to affect gastrointestinal function, while the SA group received superficial needling at non-acupuncture points. Both groups underwent 12 sessions over a 4-week period, in addition to their usual care.

The primary outcome measure was the change in the Irritable Bowel Syndrome–Symptom Severity Scale (IBS-SSS) total scores from baseline to week 4, a widely used metric for assessing the severity of IBS symptoms. Secondary outcomes included changes in IBS-SSS scores in each domain, the response rate defined by adequate relief of IBS symptoms, and changes in disease-specific quality of life, anxiety, and depression scores.

The findings were promising, with participants in the TA group exhibiting a significantly greater reduction in IBS-SSS total scores compared to the SA group. This indicated a substantial improvement in symptom severity, including abdominal pain, distension, and interference with daily life. The response rate, defined by a 50-point reduction in IBS-SSS total scores, was notably higher in the TA group. Additionally, the benefits of TA were observed to persist throughout the 4-week follow-up period, suggesting a lasting effect beyond the treatment period.

In terms of secondary outcomes, the TA group showed a significant improvement in quality of life, as measured by the IBS-Quality of Life (IBS-QOL) questionnaire. There was also a positive trend in reducing anxiety symptoms, although the changes in depression scores were not significant. The study also found that TA was well-tolerated, with only mild and transient adverse events reported, such as subcutaneous hematoma and residual needle sensation.

Despite the study's rigorous methodology, there were some limitations. The acupuncturists could not be blinded to group allocation, which could have introduced bias. Additionally, the study was conducted in China, and the findings may not be generalizable to other populations with different prevalence rates and healthcare systems. Furthermore, the study did not control for potential influences of other treatments that participants may have been using concurrently, although efforts were made to document these.

In conclusion, this randomized controlled trial provides substantial evidence supporting the efficacy of acupuncture in alleviating symptoms of refractory IBS. The study's findings are a significant contribution to the field of integrative medicine, suggesting that acupuncture could be a viable adjunctive treatment for IBS patients who have not responded to conventional therapies. Future research should aim to replicate these results in diverse populations and explore the mechanisms underlying acupuncture's effects on IBS.
DOI: 10.1007/s11684-024-1073-7