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      Efficacy of acupuncture based on acupoint combination theory for irritable bowel syndrome: a study protocol for a multicenter randomized controlled trial

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          Abstract

          Background

          Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, diarrhea or constipation, and changes in defecation patterns. No organic disease is found to explain these symptoms by routine clinical examination. This study aims to investigate the efficacy and safety of acupuncture therapy for IBS patients compared with those of conventional treatments. We also aim to identify the optimal acupoint combination recommended for IBS and to clarify the clinical advantage of the “multiacupoint co-effect and synergistic effect.”

          Methods and analysis

          A total of 204 eligible patients who meet the Rome IV criteria for IBS will be randomly stratified into acupuncture group A, acupuncture group B, or the control group in a 1:1:1 ratio with a central web-based randomization system. The prespecified acupoints used in the control group will include bilateral Tianshu (ST25), Shangjuxu (ST37), Neiguan (PC6), and Zusanli (ST36). The prespecified acupoints used in experimental group A will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Neiguan (PC6). The prespecified acupoints used in experimental group B will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Zusanli (ST36). Each patient will receive 12 acupuncture treatments over 4 weeks and will be followed up for 4 weeks. The primary outcome is the IBS-Symptom Severity Scale (IBS-SSS) score. The secondary outcomes include the Bristol Stool Form Scale (BSFS), Work and Social Adjustment Score (WSAS), IBS-Quality of Life (IBS-QOL), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores. Both the primary outcome and the secondary outcome measures will be collected at baseline, at 2 and 4 weeks during the intervention, and at 6 weeks and 8 weeks after the intervention.

          Ethics and dissemination

          The entire project has been approved by the ethics committee of the Beijing University of Chinese Medicine (2020BZYLL0903).

          Discussion

          This is a multicenter randomized controlled trial for IBS in China. The findings may shed light on the efficacy of acupuncture as an alternative to conventional IBS treatment. The results of the trial will be disseminated in peer-reviewed publications.

          Trial registration

          Chinese Clinical Trials Register ChiCTR2000041215. First registered on 12 December 2020. http://www.chictr.org.cn/.

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          Most cited references26

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          SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials

          High quality protocols facilitate proper conduct, reporting, and external review of clinical trials. However, the completeness of trial protocols is often inadequate. To help improve the content and quality of protocols, an international group of stakeholders developed the SPIRIT 2013 Statement (Standard Protocol Items: Recommendations for Interventional Trials). The SPIRIT Statement provides guidance in the form of a checklist of recommended items to include in a clinical trial protocol. This SPIRIT 2013 Explanation and Elaboration paper provides important information to promote full understanding of the checklist recommendations. For each checklist item, we provide a rationale and detailed description; a model example from an actual protocol; and relevant references supporting its importance. We strongly recommend that this explanatory paper be used in conjunction with the SPIRIT Statement. A website of resources is also available (www.spirit-statement.org). The SPIRIT 2013 Explanation and Elaboration paper, together with the Statement, should help with the drafting of trial protocols. Complete documentation of key trial elements can facilitate transparency and protocol review for the benefit of all stakeholders.
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            Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction.

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              The epidemiology of irritable bowel syndrome

              Irritable bowel syndrome (IBS) is a functional condition of the bowel that is diagnosed using clinical criteria. This paper discusses the nature of the diagnostic process for IBS and how this impacts epidemiological measurements. Depending on the diagnostic criteria employed, IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult physicians for their IBS symptoms. These people do not have significantly different abdominal symptoms to those who do not consult, but they do have greater levels of anxiety and lower quality of life. Internationally, there is a female predominance in the prevalence of IBS. There is 25% less IBS diagnosed in those over 50 years and there is no association with socioeconomic status. IBS aggregates within families and the genetic and sociological factors potentially underlying this are reviewed. Patients diagnosed with IBS are highly likely to have other functional disease and have more surgery than the general population. There is no evidence that IBS is associated with an increased mortality risk. The epidemiological evidence surrounding these aspects of the natural history is discussed.
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                Author and article information

                Contributors
                lizhigang620@126.com
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                19 October 2021
                19 October 2021
                2021
                : 22
                : 719
                Affiliations
                [1 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, School of Acupuncture-Moxibustion and Tuina, , Beijing University of Chinese Medicine, ; Beijing, China
                [2 ]GRID grid.479672.9, Department of Endocrinology, , Affiliated Hospital of Shandong University of Traditional Chinese Medicine, ; Jinan, China
                [3 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, Department of Acupuncture and Moxibustion, , Dongzhimen Hospital Affiliated with Beijing University of Chinese Medicine, ; Beijing, China
                [4 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, Department of Rehabilitation, , Third Affiliated Hospital of Beijing University of Chinese Medicine, ; Beijing, China
                [5 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, Department of Gastroenterology, , Third Affiliated Hospital of Beijing University of Chinese Medicine, ; Beijing, China
                [6 ]GRID grid.411304.3, ISNI 0000 0001 0376 205X, Chengdu University of Traditional Chinese Medicine, ; Chengdu, Sichuan China
                [7 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, , Capital Medical University, ; Beijing, China
                [8 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, Department of Acupuncture and Moxibustion, , Dongfang Hospital Affiliated with Beijing University of Chinese Medicine, ; Beijing, China
                [9 ]Chinese Association of Chinese Medicine, Beijing, China
                Author information
                http://orcid.org/0000-0003-3176-6941
                Article
                5432
                10.1186/s13063-021-05432-0
                8525000
                34666815
                af77fee5-5b92-443a-88b8-864d7d28c4d7
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 6 March 2021
                : 7 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100012166, national basic research program of china (973 program);
                Award ID: No. 2019YFC1709004
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2021

                Medicine
                acupuncture,irritable bowel syndrome,acupoint combination,randomized controlled trial,protocol

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