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Different acupuncture and moxibustion therapies in the treatment of IBS-D with anxiety and depression: A network meta-analysis.

Medicine·April 2024·Yi Hou, Xiaoli Chang, Ningning Liu et al.
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Key Finding

Moxibustion demonstrated superior efficacy over electroacupuncture, herbal medicine, Western medicine, and placebo for reducing anxiety and depression symptoms in IBS-D patients, while combined acupuncture-moxibustion therapies showed the greatest overall improvement in symptom severity scores.

What This Means For You

Researchers analyzed 26 studies to compare different acupuncture and moxibustion treatments for people with diarrhea-predominant irritable bowel syndrome (IBS-D) who also experience anxiety and depression. IBS-D is a common digestive condition that causes frequent diarrhea, abdominal pain, and bloating, and many patients also struggle with emotional distress. The study looked at eight different treatment approaches, including traditional acupuncture, electroacupuncture (using electrical stimulation), moxibustion (burning herbs near acupuncture points), and combinations of these therapies with other treatments. The researchers found that moxibustion was particularly effective for reducing anxiety and depression symptoms in IBS-D patients, performing better than electroacupuncture, herbal medicine, Western medications, and placebo treatments. Combined therapies—using acupuncture or moxibustion alongside other treatments—showed the best results for improving overall IBS symptom severity and reducing anxiety and depression scores. Traditional acupuncture and electroacupuncture also demonstrated positive effects. Importantly, these treatments were found to be safe with minimal side effects, which is a significant advantage over some Western medications that can cause unwanted reactions. For patients dealing with both the physical symptoms of IBS-D and the emotional burden of anxiety and depression, acupuncture-based treatments offer a promising alternative or complementary approach to conventional care. If you're considering acupuncture or moxibustion for IBS-D with anxiety or depression, seek care from a licensed acupuncturist with experience treating digestive and mental health conditions.

Clinical Notes for Practitioners

This network meta-analysis examined eight acupuncture-moxibustion interventions across 26 randomized controlled trials for treating IBS-D with comorbid anxiety and depression. Data were analyzed using RevMan 5.4 and Stata 15.0, with interventions ranked by surface under the cumulative ranking curve (SUCRA). Moxibustion demonstrated superiority over electroacupuncture, combined therapies, Chinese herbal medicine, Western medicine, and placebo for HAMA scores, and over acupuncture, electroacupuncture, combined therapies, Western medicine, and placebo for HAMD scores. Combined therapies showed greatest efficacy for SAS, SDS, and IBS-SSS scores compared to electroacupuncture, herbal medicine, and Western medicine. Chinese herbal medicine exhibited lower recurrence rates than combined therapies. Moxibustion demonstrated highest total effective rates. SUCRA rankings favored moxibustion, combined therapies, acupuncture, and electroacupuncture across outcomes. Clinical implications suggest moxibustion and integrative approaches offer effective, safe treatment options for IBS-D patients with psychological comorbidities, with combined therapies providing comprehensive symptom management across gastrointestinal and psychological domains.

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