The Clinical Study Of Electro-acupuncture To Treat Functional Constipation

Section Ⅰ The Clinical Study of Electro-acupuncture to treat Functional ConstipationObjectiveTo evaluate the efficacy of Electro-acupuncture (EA) in treating Functional constipation (FC) through observing the effect of EA in relieving the symptoms, mental health and the quality of life (QOL) of FC patients.MethodsWe conducted a randomised controlled trial undergoing in China.96participants who aged from18to75years with FC were recruited in this study. These participants were randomly allocated into three treatment groups, including Electro-acupuncture (EA), Mosapride&Sham electro-acupuncture (MS) and Mosapride control (MC) groups. Electro-acupuncture (EA) receive16sessions of needling at bilateral Quchi (LI11) and Shangjuxu (ST37) during4weeks of treatment,5times in the first two weeks and every other day in the next two weeks. Mosapride&Sham electro-acupuncture (MS) receive16sessions of needling at bilateral Quchi (LI11) and Shangjuxu (ST37) during4weeks of treatment,5times in the first two weeks and every other day in the next two weeks, meanwhile taking Mosapride Citrate5mg three times a day for4weeks. Acupuncturists administered sham electro-acupuncture treatment using Park Sham Device (PSD). Mosapride control (MC) receive Mosapride Citrate5mg three times a day for4weeks. The observation period was9weeks including1week for screening, a treatment period of4weeks and a follow-up period of4weeks. The outcome measures including the number of spontaneous bowel movements (SBMs), stool consistency, defecating difficulty, MOS item Short Form health survey (SF-36), Self-Rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and the validated Patient Assessment of Constipation Quality of Life (PAC-QOL).Results1The number of weekly spontaneous bowel movements (SBMs/wk):The number of weekly SBMs were significantly improved in both of EA and MC compared with baseline (P<0.05). MS significantly improved of the number of weekly SBMs except the first week compared with baseline (P<0.05). The number of weekly SBMs of EA was significant higher than that of MC in the8th week (P<0.05). There were statistically significant improvements in the proportion of SBMs≧3and the SBMs responder in EA compared with MS (P<0.05). There was no significant difference between MS and MC in improving the indexs of SBMs (P>0.05).2Stool consistency:EA, MS and MC were significantly improved of the mean consistency of stools values compared with baseline (P<0.01). The mean stool consistency score of EA was significant higher than that of MC in the3rd week (P<0.05). The proportion of normal mean stool consistency in EA was significant higher than that in MC (P<0.05). There was no significant difference between MS and MC in improving the indexs of stool consistency (P>0.05).3Defecate difficulty:EA, MS and MC were significantly improved of the defecate difficulty score compared with baseline (P<0.05). There was no significant difference between MS and MC in improving the indexs of defecate difficulty (P>0.05).4Constipation related quality of life:Each item score of PAC-QOL was significantly reduced after EA treatment (P<0.05). The items including Total score, Physical discomfort, Psychosocial discomfort, Worries and concerns of PAC-QOL was significantly reduced after MS treatment (P<0.05). The items including total score, Physical discomfort, Worries and concerns, Satisfaction of PAC-QOL was significantly reduced after MC treatment (P<0.05). The change score including Total score, Physical discomfort, Psychosocial discomfort, Worries and concerns of PAC-QOL in EA was superior to MC (P<0.05).The change score including Total score, Physical discomfort of PAC-QOL in EA was superior to MS (P<0.05). There was no significant difference between MS and MC in improving the scores of PAC-QOL (P>0.05).5The overall quality of life:The items including Role-Physical, Bodily Pain, Vitality of SF-36was significantly reduced after EA treatment (P<0.05). SF-36score was not significantly reduced after MS treatment (P>0.05). The Role-Emotional score of SF-36was significantly reduced after MC treatment (P<0.05). The change score of Bodily Pain in EA and MS was superior to MC (P<0.05). The change score of Social Functioning in MS was superior to MC (P<0.05).6Anxiety and Depression:The SAS and SDS scores were significantly improved in EA compared with baseline (P<0.05). There were no significantly difference in The SAS and SDS scores after MS and MC treatment (P>0.05). The SAS score of EA was significant lower than that of MC in the4th week (P<0.05). The change score of SAS in EA and MS were superior to MC (P<0.05). There were no significantly difference in the change score of SAS between EA and MS (P>0.05). There were no significantly difference in the change score of SDS between three groups (P>0.05).ConclusionsElectro-acupuncture (EA) significantly increased weekly spontaneous bowel movements (SBMs), improved consistency of stools and defecate difficulty in functional constipation patients, and this effective was equally as Loperamide. In addition, Electro-acupuncture (EA) was effective in the improvement of the constipation-related quality of life and the anxiety, and this effective was superior to Loperamide. However, there was no significant difference between MS and MC on defecation function. Sham Electro-acupuncture had an influence on the anxiety status and part of the quality of life. These findings suggest that electro-acupuncture could be effective in the treatment of functional constipation.