Effectiveness comparisons of acupoint stimulation therapies for irritable bowel syndrome: A Bayesian network meta‑analysis

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional disorder that significantly impacts patient health, causing physical discomfort and diminished quality of life. We aimed to compare various acupoint stimulation modalities for treating IBS using network meta-analysis (NMA). METHODS: We conducted a systematic search of five electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and ClinicalTrials.gov) for randomized controlled trials (RCTs) on acupoint stimulation interventions for IBS published from inception to November 8, 2024, without language restrictions. Two authors independently performed data extraction and assessed the risk of bias. Outcomes included symptom severity and quality of life. Bayesian NMA was conducted using STATA 14.0 and Open BUGS 3.2.3. RESULTS: We identified 12 RCTs that included three different acupoint stimulation interventions (1839 participants)-namely, acupuncture, moxibustion, and placebo. Our NMA results showed that the three acupoint stimulation intervention therapies were effective in reducing symptom severity and improving the quality of life for patients with IBS. The most effective acupoint stimulation intervention was moxibustion, which significantly reduced symptom severity (mean difference MD = 101.50; 95 % credible interval CrI: 80.36, 122.30) and improved quality of life (MD = -19.75; 95 % CrI: -28.86, -10.75) compared to conventional medication in patients with IBS. Moreover, the adverse events of all interventions were acceptable. CONCLUSIONS: The NMA suggests that moxibustion was the most effective modality in alleviating symptom severity and improving quality of life in patients with IBS, followed by acupuncture.