Comparison of electroacupuncture and medical treatment for functional constipation: a systematic review and meta-analysis

Objectives To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC). Design Systematic review and meta-analysis. Setting To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication. We searched Medline, the Cochrane Library and Embase databases for articles published up to 30 June 2016. Intervention EA or anti-constipation medication. Primary and secondary outcome measures The primary outcome was the change in the number of weekly spontaneous bowel movements. Secondary outcomes were total response rate (or total effective rate), symptom reduction and Cleveland Clinic constipation scores. Results The pooled results showed significantly more improvement in the frequency of spontaneous bowel movements in the EA treatment group compared with the medicine-treated group (pooled SMD 0.244, 95% CI 0.065 to 0.424, P=0.008). Deep-needling EA was significantly more effective than treatment with medication at increasing the frequency of spontaneous bowel movements (p=0.019). Significantly greater improvement was also seen for total response rates (p=0.018) and reductions in symptom score (p<0.001) in EA-treated patients. Conclusions EA was more effective than medication at improving spontaneous bowel movements and total response rate, and reducing the symptoms of FC.