{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:28:48Z","timestamp":1790364528393,"version":"4.1.0"},"reference-count":65,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005090","name":"Beijing Nova Program","doi-asserted-by":"publisher","award":["Z181100006218035"],"award-info":[{"award-number":["Z181100006218035"]}],"id":[{"id":"10.13039\/501100005090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neural Plasticity"],"published-print":{"date-parts":[[2020,11,22]]},"abstract":"<jats:p>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\u2014PubMed, EMBASE, CNKI, VIP, and Wanfang\u2014were 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\u2019s assessments were either moderate certainty or low certainty. Compared with loperamide, acupuncture showed more effectiveness in weekly defecation (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mtext>SMD<\/a:mtext>\n                        <a:mo>=<\/a:mo>\n                        <a:mo>\u2212<\/a:mo>\n                        <a:mn>0.29<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>, 95% CI [-0.49, -0.08]), but no significant improvement in the result of the Bristol stool form (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mtext>SMD<\/c:mtext>\n                        <c:mo>=<\/c:mo>\n                        <c:mo>\u2212<\/c:mo>\n                        <c:mn>0.28<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>, 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 (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mtext>RR<\/e:mtext>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>2.57<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>, 95% CI [0.24, 27.65]), loperamide group (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mtext>RR<\/g:mtext>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>1.11<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>, 95% CI [0.57, 2.15]), and trimebutine maleate group (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mtext>RR<\/i:mtext>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>1.19<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>, 95% CI [0.31, 4.53]), respectively, it was lower than the dicetel group (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mtext>RR<\/k:mtext>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.83<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>, 95% CI [0.56, 1.23]) and affected the overall trend (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mtext>RR<\/m:mtext>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>0.93<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>, 95% CI [0.67, 1.29]). Besides, acupuncture produced more significant effect than dicetel related to the total symptom score (<jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mtext>SMD<\/o:mtext>\n                        <o:mo>=<\/o:mo>\n                        <o:mo>\u2212<\/o:mo>\n                        <o:mn>1.17<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>, 95% CI [-1.42, -0.93]), IBS quality of life (<jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mtext>SMD<\/q:mtext>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>2.37<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>, 95% CI [1.94, 2.80]), recurrence rate (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mtext>RR<\/s:mtext>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.43<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>, 95% CI [0.28, 0.66]), and IBS Symptom Severity Scale (<jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mtext>SMD<\/u:mtext>\n                        <u:mo>=<\/u:mo>\n                        <u:mo>\u2212<\/u:mo>\n                        <u:mn>0.75<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula>, 95% CI [-1.04, -0.47]). Compared to dicetel (<jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mtext>RR<\/w:mtext>\n                        <w:mo>=<\/w:mo>\n                        <w:mn>1.25<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>, 95% CI [1.18, 1.32]) and trimebutine maleate (<jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mtext>RR<\/y:mtext>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>1.35<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula>, 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 (<jats:inline-formula>\n                     <ab:math xmlns:ab=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\">\n                        <ab:mtext>RR<\/ab:mtext>\n                        <ab:mo>=<\/ab:mo>\n                        <ab:mn>11.86<\/ab:mn>\n                     <\/ab:math>\n                  <\/jats:inline-formula>, 95% CI [1.58, 89.07]) and loperamide group (<jats:inline-formula>\n                     <cb:math xmlns:cb=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M15\">\n                        <cb:mtext>RR<\/cb:mtext>\n                        <cb:mo>=<\/cb:mo>\n                        <cb:mn>4.42<\/cb:mn>\n                     <\/cb:math>\n                  <\/jats:inline-formula>, 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.<\/jats:p>","DOI":"10.1155\/2020\/8892184","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T19:11:57Z","timestamp":1606158717000},"page":"1-16","source":"Crossref","is-referenced-by-count":23,"title":["Acupuncture for Adults with Diarrhea-Predominant Irritable Bowel Syndrome or Functional Diarrhea: A Systematic Review and Meta-Analysis"],"prefix":"10.1155","volume":"2020","author":[{"given":"Jianbo","family":"Guo","sequence":"first","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China"},{"name":"Beijing University of Chinese Medicine, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Xing","sequence":"additional","affiliation":[{"name":"Beijing University of Chinese Medicine, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiani","family":"Wu","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Henan University of Chinese Medicine, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongen","family":"Yun","sequence":"additional","affiliation":[{"name":"Beijing University of Chinese Medicine, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5888-461X","authenticated-orcid":true,"given":"Zongshi","family":"Qin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5885-8005","authenticated-orcid":true,"given":"Qingyong","family":"He","sequence":"additional","affiliation":[{"name":"Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.05.003"},{"issue":"8","key":"2","first-page":"734","article-title":"Status analysis of an epidemiological survey of irritable bowel syndrome in China","volume":"22","author":"X. 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H. Qian","year":"2011","journal-title":"World Journal of Chinese Digestion"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1007\/s11655-011-0875-z"},{"issue":"14","key":"22","first-page":"1203","article-title":"Clinical study of 60 cases of diarrheal irritable bowel syndrome treated with eye acupuncture","volume":"52","author":"P. Q. Wang","year":"2011","journal-title":"Journal of Traditional Chinese Medicine"},{"issue":"5","key":"23","first-page":"594","article-title":"Comparative study on efficacy of electroacupuncture combined with probiotics in the treatment of diarrheal irritable bowel syndrome","volume":"32","author":"Y. H. Chen","year":"2012","journal-title":"Chinese Journal Of Integrated Traditional Chinese and Western Medicine"},{"key":"24","volume-title":"Clinical Study on Acupuncture Treatment of Diarrhea-Type Irritable Bowel Syndrome (Liver Depression and Spleen Deficiency Syndrome)","author":"Z. 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Li","year":"2014","journal-title":"Chinese Journal of Clinical Acupuncture"},{"key":"32","volume-title":"Multi-Center, Large Sample Randomized Controlled Study on Acupuncture Treatment of Diarrheal Irritable Bowel Syndrome","author":"H. B. Zheng","year":"2014"},{"issue":"10","key":"33","first-page":"1974","article-title":"Effect of electroacupuncture on fecal symptoms in patients with functional diarrhea","volume":"42","author":"W. Li","year":"2015","journal-title":"Liaoning Journal of Traditional Chinese Medicine"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003884"},{"issue":"12","key":"35","first-page":"1265","article-title":"Clinical efficacy observation of abdominal acupuncture therapy in the treatment of diarrheal irritable bowel syndrome","volume":"37","author":"Y. 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Yang","year":"2016","journal-title":"Shanghai Journal of Acupuncture"},{"issue":"12","key":"42","first-page":"1786","article-title":"Clinical study on the treatment of diarrheal irritable bowel syndrome with spleen and stomach weakness by warm acupuncture","volume":"40","author":"W. Zou","year":"2019","journal-title":"Shaanxi Traditional Chinese Medicine"},{"issue":"6","key":"43","first-page":"422","article-title":"A randomized controlled study of acupuncture treatment for depressive symptoms in diarrheal irritable bowel syndrome","volume":"17","author":"G. J. Meng","year":"2017","journal-title":"Chinese Journal of Acupuncture and Massage"},{"key":"44","first-page":"124","article-title":"Du's heat tonic method of acupuncture treatment of diarrheal irritable bowel syndrome: a randomized controlled study","volume":"2","author":"X. 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