Clinical Trials Study
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World J Gastroenterol. Oct 7, 2014; 20(37): 13563-13572
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13563
Factorial study of moxibustion in treatment of diarrhea-predominant irritable bowel syndrome
Ji-Meng Zhao, Lu-Yi Wu, Hui-Rong Liu, Hong-Yi Hu, Jia-Ying Wang, Ren-Jia Huang, Yin Shi, Shan-Ping Tao, Qiang Gao, Ci-Li Zhou, Li Qi, Xiao-Peng Ma, Huan-Gan Wu
Ji-Meng Zhao, Lu-Yi Wu, Hong-Yi Hu, Ren-Jia Huang, Jia-Ying Wang, Li Qi, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Hui-Rong Liu, Yin Shi, Ci-Li Zhou, Xiao-Peng Ma, Huan-Gan Wu, Key Laboratory of Acupuncture-Moxibustion and Immunology, Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
Jia-Ying Wang, Traditional Chinese Medicine Hospital of Shanxi Province, Taiyuan 030012, China
Shan-Ping Tao, Jiading Hospital of Traditional Chinese Medicine, Shanghai 201800, China
Qiang Gao, Jiading District Central Hospital, Shanghai 201800, China
Author contributions: Zhao JM, Wu LY, Liu HR and Hu HY have the same rights; Liu HR, Hu HY and Wu HG made the concept of the manuscript; Zhao JM, Wu LY, Huang RJ, Shi Y, Tao SP, Gao Q and Qi L collected the data; Wu LY, Wang JY, Zhou CL and Ma XP analysed the data; Zhao JM, Wu LY and Liu HR wrote the manuscript together; Zhao JM, Liu HR, Hu HY and Wu HG approved the final version of the manuscript.
Supported by National Basic Research Program of China (973 Program), No. 2009CB522900, 2009CB522901; Shanghai Top Clinical Medical Center of Acupuncture, Moxibustion and Tuina; and National Natural Sciences Foundation of China, Nos. 81303031 and 81202752
Correspondence to: Huan-Gan Wu, PhD, Key Laboratory of Acupuncture-Moxibustion and Immunology, Shanghai Research Institute of Acupuncture and Meridian, No.650 South Wanping Road, Xuhui District, Shanghai 200030, China. wuhuangan@126.com
Telephone: +86-21-64644238 Fax: +86-21-64644238
Received: May 16, 2014
Revised: June 11, 2014
Accepted: July 11, 2014
Published online: October 7, 2014
Processing time: 175 Days and 19.4 Hours
Abstract

AIM: To identify an appropriate therapeutic regimen for using aconite cake-separated moxibustion to treat diarrhea-predominant irritable bowel syndrome (D-IBS).

METHODS: A factorial design was employed to examine the two factors of moxibustion frequency and number of cones. The two tested frequencies were three or six moxibustion sessions per week, and the two tested doses were one or two cones per treatment. A total of 166 D-IBS patients were randomly divided into four treatment groups, which included each combination of the examined frequencies and doses. The bilateral Tianshu acupoints (ST25) and the Qihai acupoint (RN6) were selected for aconite cake-separated moxibustion. Each patient received two courses of treatment, and each course had a duration of 2 wk. For each group, the scores on the Birmingham irritable bowel syndrome (IBS) symptom questionnaire, the IBS Quality of Life scale, the Self-Rating Depression Scale (SDS), the Self-Rating Anxiety Scale (SAS), the Hamilton Depression (HAMD) scale, and the Hamilton Anxiety (HAMA) scale were determined before treatment, after the first course of treatment, and after the second course of treatment.

RESULTS: The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all 4 aconite cake-separated moxibustion groups were significantly lower after the first and second courses of treatment than before treatment (P < 0.001 for all). The symptom, quality of life, SDS, SAS, HAMD, and HAMA scores of the patients in all four aconite cake-separated moxibustion groups were significantly lower after the second course of treatment than after the first course of treatment (P < 0.001 for all). Between-group comparisons after the second course of treatment revealed that the symptom scores for group 1 (1 cone, 3 treatments/wk) and group 3 (2 cones, 3 treatments/wk) were significantly lower than that for group 2 (1 cone, 6 treatments/wk) (5.55 ± 5.05 vs 10.45 ± 6.61, P < 0.001; 5.65 ± 4.00 vs 10.45 ± 6.61, P < 0.001). Regarding the two levels of the two examined factors for aconite cake-separated moxibustion, after the first course of treatment, the changes in HAMA scores were significantly different for the two tested moxibustion frequencies (P = 0.011), with greater changes for the “6 treatments/wk” groups than for the “3 treatments/wk” groups; in addition, there were interaction effects between the number of cones and moxibustion frequency (P = 0.028). After the second course of treatment, changes in symptom scores for the 2 tested moxibustion frequencies were significantly different (P = 0.002), with greater changes for the “3 treatments/wk” groups than for the “6 treatments/wk” groups.

CONCLUSION: An aconite cake-separated moxibustion treatment regimen of 3 treatments/wk and 1 cone/treatment appears to produce better therapeutic effects for D-IBS compared with the other tested regimens.

Keywords: Diarrhea-predominant irritable bowel syndrome; Aconite cake-separated moxibustion; Factorial design; Moxibustion quantity; Clinical research

Core tip: This is a clinical factorial study focusing on aconite cake-separated moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome. What is the effect of this ancient therapy on diarrhea-predominant irritable bowel syndrome patients? Which is the key factor in the treatment, the number of cones or the moxibustion frequency? This paper details answers to these questions.