Efficacy and safety of non-pharmacological interventions for irritable bowel syndrome in adults
Author: Yun-Kai Dai1, Yun-Bo Wu1, Ru-Liu Li1, Wei-Jing Chen1, Chun-Zhi Tang2, Li-Ming Lu2, Ling Hu3
Affiliation:
1 Institute of Gastroenterology, Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China.
2 Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China.
3 Institute of Gastroenterology, Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China. drhuling@163.com.
Conference/Journal: World J Gastroenterol
Date published: 2020 Nov 7
Other:
Volume ID: 26 , Issue ID: 41 , Pages: 6488-6509 , Special Notes: doi: 10.3748/wjg.v26.i41.6488. , Word Count: 231
Background:
Although nonpharmacological interventions (NPI) for irritable bowel syndrome (IBS) have been applied clinically, their relative efficacy and safety are poorly understood.
Aim:
To compare and rank different NPI in the treatment of IBS.
Methods:
Five electronic databases were searched from their inception to January 12, 2020. Data of included publications were analyzed using network meta-analysis (NMA). Quality of endpoints were assessed by tools of the Cochrane Handbook and the GRADEpro software. Pooled relative risk or standardized mean difference with their corresponding 95% confidence intervals were used for statistical analysis. Surface under the cumulative ranking curve (SUCRA) probability value was conducted to rank the examined interventions. Sensitivity analysis was performed to verify the robustness of results and test the source of heterogeneity.
Results:
Forty randomized controlled trials with 4196 participants were included in this NMA. Compared with routine pharmacotherapies and placebo, acupuncture and cognitive behavioral therapy (CBT) had better efficacy in relieving IBS symptoms. Based on the SUCRA values, acupuncture ranked first in improving overall clinical efficacy and avoiding adverse effects. CBT ranked first in lowering the scores of IBS symptom severity scale, self-rating anxiety scale and self-rating depression scale.
Conclusion:
This study confirmed the efficacy and safety of NPI for improving IBS symptoms, which to some extent recommended several interventions for clinical practice.
Keywords: Adults; Clinical practice; Irritable bowel syndrome; Network meta-analysis; Nonpharmacological interventions; Randomized controlled trials.
PMID: 33244207 PMCID: PMC7656202 DOI: 10.3748/wjg.v26.i41.6488
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