Table 2.
Summary of the statements from the expert consensus.
| No. | Statements | References | GRADE ratings | Delphi agreement |
|---|---|---|---|---|
| 1 | For patients with mild and moderate IBS, acupuncture is recommended to relieve clinical symptoms (recurrent abdominal pain or abdominal distension related to defecation, frequency and urgency of stool, fecal appearance, etc.). | 18,37, 38, 39, 40 | Moderate/Low/Very low | Round 1 |
| 2 | For patients with mild and moderate IBS, acupuncture is recommended to improve quality of daily life. | 37,38 | Moderate/Very low | Round 1 |
| 3 | For patients with mild and moderate IBS, acupuncture is recommended to ameliorate psychological and mental conditions. | Round 1 | ||
| 4 | For patients with mild and moderate IBS, relief of clinical symptoms can be maintained for 1 to 6 months after one course of acupuncture treatment. | 38 | Moderate/Very low | Round 2 |
| 5 | Based on the Roman Ⅳ Criteria, acupuncture is recommended for the 3 IBS subtypes (IBC-D, IBS-C and IBS-M). | See also in Item 1 | See also in Item 1 | Round 1 |
| 6 | It is recommended to conduct acupuncture treatment on the basis of syndrome differentiation from liver stagnation and spleen deficiency syndrome, spleen deficiency and damp obstruction syndrome, spleen and kidney yang deficiency syndrome, and damp-heat in spleen-stomach syndrome. | Round 1 | ||
| 7 | It is recommended to select acupoints on Spleen Meridian, Stomach Meridian, Large Intestine Meridian and Liver Meridian. | Round 1 | ||
| 8 | Acupoint selection is a crucial factor for the achievement of favorable therapeutic efficacy. It is recommended to lay stress on the application of specific acupoints. The recommended specific acupoints should be Tianshu (ST25), Zusanli (ST36) and Zhongwan (CV12). | Round 1 | ||
| 9 | It is recommended to choose Mu acupoints and Xiahe acupoints as the common species of applied specific acupoints. | Round 1 | ||
| 10 | It is recommended to choose Shu-Mu combination and Xiahe-Mu combination as the common applied specific acupoint combinations. | Round 1 | ||
| 11 | De qi is a crucial factor for the achievement of favorable therapeutic efficacy. | Round 1 | ||
| 12 | Course of treatment is a crucial factor for the achievement of favorable therapeutic efficacy. The recommended course of treatment should be 4 weeks. | Round 1 | ||
| 13 | It is recommended to choose uniform replenishing-reducing method as the common applied acupuncture manipulation. | Round 2 | ||
| 14 | It is recommended to select 4~6 acupoints per session. | Round 1 | ||
| 15 | The recommended duration time of needle retention should be 30 min per session. | Round 1 | ||
| 16 | The recommended treatment frequency should be 3 times per week. | Round 1 | ||
| 17 | It is recommended to combine acupuncture with other TCM therapies, such as moxibustion or Chinese herbal medicine, so as to improve the clinical efficacy. | Round 1 | ||
| 18 | It is recommended that acupuncture practitioners eligible for IBS treatment should own the TCM license and at least 3-year medical practice experience. | Round 1 | ||
| 19 | Adverse events are uncommon in the treatment of IBS with acupuncture. The possible adverse events include subcutaneous hematoma, abnormal post-acupuncture sensation (such as pain, numbness, etc.). | 37 | Low | Round 1 |
Abbreviations: IBS: irritable bowel syndrome; IBC-D: IBS with diarrhea; IBS-C: IBS with constipation; IBS-M: IBS with mixed symptoms of constipation and diarrhea; TCM: Traditional Chinese Medicine.