The purpose of this work was to assess the evidence for effectiveness of acupuncture (AC) treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed u...The purpose of this work was to assess the evidence for effectiveness of acupuncture (AC) treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome (IBS) trials, 1 Crohn's disease and 1 colitis ulcerosa trial had a robust random controlled trial (RCT) design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life (QoL) improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Effi cacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in in? ammatory bowel diseases (IBD), whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefi t when this harmless and obviously powerful therapy with regard to QoL is demystifi ed by further placebo controlled trials.展开更多
Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for ra...Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.展开更多
文摘The purpose of this work was to assess the evidence for effectiveness of acupuncture (AC) treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome (IBS) trials, 1 Crohn's disease and 1 colitis ulcerosa trial had a robust random controlled trial (RCT) design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life (QoL) improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Effi cacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in in? ammatory bowel diseases (IBD), whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefi t when this harmless and obviously powerful therapy with regard to QoL is demystifi ed by further placebo controlled trials.
文摘Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.
