Across all included studies, acupuncture produced clinically significant improvements in patient-reported quality of life compared with conventional treatment. The pooled data revealed a mean difference of 6.62 points favoring acupuncture on standardized quality-of-life scales. Symptom severity as measured by the IBS Symptom Severity Scale improved by 46.58 points [1].

At HealthCMi, we look forward to future clinical investigations on irritable bowel syndrome (IBS) that include an additional treatment arm integrating Chinese herbal medicine with acupuncture. This combined approach reflects how licensed acupuncturists commonly treat IBS in clinical practice, addressing both digestive function and underlying systemic imbalances. Including herbal medicine in forthcoming randomized controlled trials would provide a more comprehensive assessment of traditional Chinese medical interventions, clarify synergistic effects between acupuncture and herbal therapy, and strengthen the evidence base supporting integrative care for patients with IBS.

Notably, Chinese herbal medicine is formally included and reimbursed under both Taiwan’s National Health Insurance system and China’s National Medical Insurance program, reflecting broad governmental recognition of its therapeutic efficacy and clinical importance. In both regions, herbal formulas are integrated within mainstream healthcare delivery and prescribed alongside biomedical treatments in hospitals and community clinics. This institutional support underscores the value of traditional medicine within modern public health frameworks and highlights the need for future global research initiatives to examine the combined use of acupuncture and herbal medicine. Expanding such integrative models internationally could enhance evidence-based care, promote collaboration between traditional and biomedical systems, and improve outcomes for patients with complex functional disorders such as IBS.

This recent Tianjin University of Traditional Chinese Medicine research does not cover herbal medicine, but confirms the efficacy of acupuncture as a monotherapy. The analysis found acupuncture to be superior to conventional biomedicine. Diagnostic criteria followed Rome I–IV definitions encompassing diarrhea-predominant, constipation-predominant, mixed, and unspecified forms of IBS [1].

Interventions included manual acupuncture, electroacupuncture, and transcutaneous electrical stimulation. Common acupoints across trials were ST36 (Zúsānlĭ), ST25 (Tiānshū), SP6 (Sānyīnjiāo), CV12 (Zhōngwăn), and BL25 (Dàchángshū). Stainless-steel filiform needles measuring 0.25–0.30 mm × 25–40 mm were inserted perpendicularly until the deqi sensation of distention or heaviness was elicited. Needles were retained for thirty minutes with either manual manipulation using lifting-thrusting or twirling techniques, or electroacupuncture at a dense–disperse frequency of 2/100 Hz. These procedures were performed three to five times weekly over a four-week course of care.

Subgroup analysis showed that courses lasting four weeks produced greater quality-of-life improvement than those extending to six weeks. Needle retention times of thirty minutes or less yielded stronger effects than longer sessions. Both moderate and higher treatment frequencies improved outcomes, but benefits plateaued beyond five sessions per week [1]. The authors concluded that thirty-minute sessions administered five or fewer times weekly for four consecutive weeks represent the optimal protocol for clinical application.

The biological mechanisms proposed in the analysis highlight acupuncture’s combined peripheral and central regulatory effects. Peripherally, needling decreases intestinal levels of 5-hydroxytryptamine (5-HT) and down-regulates 5-HT3 receptors while up-regulating 5-HT4 receptors, reducing visceral hypersensitivity. Acupuncture also inhibits transient receptor potential vanilloid-1 (TRPV1) channel activity and modulates enteric glial cells, which collectively suppress inflammatory cytokine release and normalize intestinal motility. Centrally, acupuncture inhibits N-methyl-D-aspartate (NMDA) receptor ion channels within the spinal cord and enhances endogenous opioid release in the anterior cingulate cortex, producing analgesic and anxiolytic effects. Regulation of the hypothalamic-pituitary-adrenal (HPA) axis further stabilizes stress hormones and improves emotional states often associated with IBS [1].

Detailed assessment of the IBS-QOL subscales demonstrated improvements in multiple domains. Somatic complaints improved by 7.05 points, health concerns by 3.80, interpersonal relationships by 2.65, sexual function by 2.09, and daily activities by 5.97. These results indicate that acupuncture not only mitigates gastrointestinal distress but also benefits psychological and social functioning [1].

Pharmacologic therapies for IBS, including rifaximin, eluxadoline, and alosetron, frequently produce adverse reactions such as constipation or nausea. In contrast, acupuncture achieved symptom and quality-of-life improvements without pharmacologic side effects. The authors noted that psychological comorbidities—especially anxiety and depression—strongly influence IBS symptom perception and quality of life. Because acupuncture modulates serotonergic signaling and HPA-axis activity, it provides both gastrointestinal and neuroendocrine benefits within a single intervention [1].

Overall, the study indicates that standardized treatment protocols should include ST36, ST25, SP6, and CV12 as core points with thirty-minute needle retention. A course of four weeks at a frequency of two to five sessions weekly is most effective for enhancing quality of life. Electrical stimulation at 2/100 Hz may augment anti-inflammatory and analgesic effects. The authors emphasize that consistency in frequency and retention time is critical for reproducibility in clinical outcomes [1]. The study analyzed widely accepted and conventionally utilized acupoints but did not incorporate points such as Titou or those located in the middle-jiao zone of the Zhu scalp acupuncture system.

The findings confirm that acupuncture alleviates IBS symptom severity and enhances patient quality of life with a strong safety record. The data suggests that moderate treatment intensity and shorter sessions may optimize therapeutic response. Because IBS imposes a considerable global economic and psychological burden, the authors recommend incorporating acupuncture into integrative management protocols and encourage further large-scale, multicenter studies with long-term follow-up and objective biomarkers such as cytokine profiling or neuroimaging.

The meta-analysis from Tianjin University provides a detailed evidence base for the standardized clinical application of acupuncture in IBS. By combining high methodological rigor with clear treatment parameters, the study substantiates acupuncture as an effective, safe, and practical intervention for improving both gastrointestinal and psychosocial outcomes in this common functional disorder [1].

Source:
[1] Jun Zhou, Narendra Lamichhane, Zhifang Xu, Jiaqi Wang, Vo Dai Quynh, Jing Huang, Feifei Gao, Meidan Zhao, Zelin Chen, and Tianyi Zhao, “The Effect of Acupuncture on Quality of Life in Patients with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis,” PLOS ONE 20, no. 2 (2025): e0314678, Tianjin University of Traditional Chinese Medicine.