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acupuncture:evaluation:gastro-enterologie:07. diarrhees [13 Dec 2020 16:04]
Nguyen Johan
acupuncture:evaluation:gastro-enterologie:07. diarrhees [21 Feb 2021 08:17] (Version actuelle)
Nguyen Johan [1.1. Generic Acupuncture]
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 ====== Diarrhées : évaluation de l'​acupuncture ====== ====== Diarrhées : évaluation de l'​acupuncture ======
 ===== Systematic Reviews and Meta-Analysis ===== ===== Systematic Reviews and Meta-Analysis =====
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 ==== Generic Acupuncture ==== ==== Generic Acupuncture ====
  
 +=== Guo 2020 ===
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 +Guo J, Xing X, Wu J, Zhang H, Yun Y, Qin Z, He Q. Acupuncture for Adults with Diarrhea-Predominant Irritable Bowel Syndrome or Functional Diarrhea: A Systematic Review and Meta-Analysis. Neural Plast. 2020.   ​{{:​medias securises:​acupuncture:​evaluation:​gastro-enterologie:​guo-215399.pdf|[215399]}}. [[https://​doi.org/​10.1155/​2020/​8892184|doi]]
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 +^Objective|To evaluate the clinical effectiveness and safety of acupuncture therapy in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea (FD) in adults. |
 +^Method| Five electronic databases-PubMed,​ EMBASE, CNKI, VIP, and Wanfang-were searched, respectively,​ until June 8, 2020. The literature of clinical randomized controlled trials of acupuncture for the treatment of IBS-D or FD in adults were collected. Meta-analysis was conducted by Using Stata 16.0 software, the quality of the included studies was assessed by the RevMan ROB summary and graph, and the results were graded by GRADE. |
 +^ Result| **Thirty-one studies with 3234 patients were included**. Most of the studies were evaluated as low risk of bias related to selection bias, attrition bias, and reporting bias. Nevertheless,​ seven studies showed the high risk of bias due to incomplete outcome data. GRADE'​s assessments were either moderate certainty or low certainty. Compared with loperamide, acupuncture showed more effectiveness in weekly defecation (SMD = -0.29, 95% CI [-0.49, -0.08]), but no significant improvement in the result of the Bristol stool form (SMD = -0.28, 95% CI [-0.68, 0.12]). In terms of the drop-off rate, although the acupuncture group was higher than the bacillus licheniformis plus beanxit group (RR = 2.57, 95% CI [0.24, 27.65]), loperamide group (RR = 1.11, 95% CI [0.57, 2.15]), and trimebutine maleate group (RR = 1.19, 95% CI [0.31, 4.53]), respectively,​ it was lower than the dicetel group (RR = 0.83, 95% CI [0.56, 1.23]) and affected the overall trend (RR = 0.93, 95% CI [0.67, 1.29]). Besides, acupuncture produced more significant effect than dicetel related to the total symptom score (SMD = -1.17, 95% CI [-1.42, -0.93]), IBS quality of life (SMD = 2.37, 95% CI [1.94, 2.80]), recurrence rate (RR = 0.43, 95% CI [0.28, 0.66]), and IBS Symptom Severity Scale (SMD = -0.75, 95% CI [-1.04, -0.47]). Compared to dicetel (RR = 1.25, 95% CI [1.18, 1.32]) and trimebutine maleate (RR = 1.35, 95% CI [1.13, 1.61]), acupuncture also showed more effective at total efficiency. The more adverse effect occurred in the acupuncture group when comparing with the dicetel group (RR = 11.86, 95% CI [1.58, 89.07]) and loperamide group (RR = 4.42, 95% CI [0.57, 33.97]), but most of the adverse reactions were mild hypodermic hemorrhage. |
 +^ Conclusion|Acupuncture treatment can improve the clinical effectiveness of IBS-D or FD, with great safety, but the above conclusions need to be further verified through the higher quality of evidence. |