Combination of acupuncture and traditional Chinese medicine for functional constipation: A meta-analysis

Abstract

To systematically assess the effectiveness and safety of using acupuncture with traditional Chinese medicine for functional constipation so as to provide the evidence-based data for clinical practice. Wanfang databases, CBM, VIP, CNKI, PubMed, Cochrane Library and EMbase were searched for trials based on randomization and control for use of acupuncture in combination with CHM for functional constipation published from the inception of the database to Dec. 2019. We used the risk of bias of Cochrane Collaboration for literature quality assessment, extracted trial data in duplicate, and then assessed the risk of bias. The data were discussed by adopting Review Manager 5.3 program. A total of 22 RCTs with 2574 cases were retrieved. Meta-analysis showed that acupuncture with CHM could improve the clinical effectiveness (OR6.10, 95% CI 4.72–7.87, P ​< ​0.00001); heterogeneity was not identified (Chi2 ​= ​32.84, P ​= ​0.43, I2 ​= ​2%), and the difference was statistically significant. Second-level outcomes (e.g., defecation interval time (P ​< ​0.00001), Bristol Stool Scale (P ​= ​0.002), defecation difficulty (P ​= ​0.01) and accompanying symptoms (P ​< ​0.00001)) in the treatment groups were significantly different after the acupuncture with CHM compared with control groups, whereas defecation symptoms were not significantly different (P ​= ​0.06). The use of acupuncture with CHM can significantly improve the clinical efficacy of functional constipation, ameliorate Bristol Stool Scale, defecation difficulty, defecation symptoms, and accompanying symptoms, as well as shorten the defecation interval time, with better safety.

Keywords

• Acupuncture
• Moxibustion
• Traditional Chinese medicine
• Functional constipation