Acupuncture for Irritable Bowel Syndrome: A Blinded Placebo-Controlled Trial

This randomized, double-blind, controlled study was conducted at St Mark's Hospital, United Kingdom, to evaluate the efficacy of traditional Chinese acupuncture in the treatment of irritable bowel syndrome (IBS). The research included 59 patients with a well-established diagnosis of IBS according to Rome and Manning criteria, who had failed to respond to conventional therapies such as fiber supplementation, lactose reduction, antispasmodics, and other standard medications. The innovative study design used two acupuncturists: one for diagnosis according to traditional Chinese medicine and treatment prescription, and another for needle administration, the latter being the only one aware of the randomization. Ten weekly treatment sessions were administered.

The control group received sham acupuncture at points without therapeutic value on the anterior thigh, posterior thigh, and lateral lower back. The primary endpoint was a reduction of at least 4 points on the validated symptom score (0-30 scale) at week 13. Researchers expected a 30% placebo response and a 70% response to true acupuncture. Results showed significant improvement in both groups: the mean symptom score dropped from 13.5 to 11.6 in the acupuncture group and from 13.1 to 11.2 in the sham group.

The clinically significant response rate was 40.7% in the acupuncture group versus 31.2% in the sham group, a non-statistically significant difference. Surprisingly, when improvements of any magnitude were considered, the sham group showed a numerically higher result (65.6% vs 59.2%). There were no significant differences in anxiety, depression, or quality-of-life scores between groups. The study recorded no direct adverse events related to treatment.

The intention-to-treat analysis included 8 patients who did not complete the study. The authors acknowledge methodological limitations, including the inability to use moxibustion (important in traditional Chinese medicine) due to hospital regulations, and the difficulty of fully individualizing treatment in the context of a formal trial. The study concludes that traditional Chinese acupuncture is relatively ineffective for IBS in the European hospital setting, and that the magnitude of any effect appears insufficient to justify investment in acupuncture services for this condition. This conclusion is supported by the absence of positive data in the literature and by the exclusion of IBS from the conditions for which the NIH consensus found favorable evidence for acupuncture.

The study represents an important contribution to the debate on the efficacy of acupuncture in functional gastrointestinal conditions.