Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work?

World Journal of Gastroenterology

Volumn 20, Issue 20, 2014, Pages 6044-6054

  Ma, Xiao Peng ^a   Hong, Jue ^a   An, Cai Ping ^b   Zhang, Dan ^a   Huang, Yan ^c   Wu, Huan Gan ^a   Zhang, Cui Hong ^a   Meeuwsen, Sian ^d  

^a SHANGHAI RESEARCH INSTITUTE OF ACUPUNCTURE AND MERIDIAN   (China)

^b OBSTETRICS AND GYNECOLOGY HOSPITAL OF FUDAN UNIVERSITY   (China)

^c SHANGHAI UNIVERSITY OF TRADITIONAL CHINESE MEDICINE   (China)

^d Bodystat Ltd   (United Kingdom)

Author keywords

Acupuncturemoxibustion; Brain gut axis; Gastrointestinal motility; Irritable bowel syndrome; Mechanism study; Visceral hypersensitivity

Indexed keywords

AQUAPORIN; CALCITONIN GENE RELATED PEPTIDE; CHOLECYSTOKININ; HISTAMINE; MOTILIN; NEUROPEPTIDE Y; NORADRENALIN; SEROTONIN; SUBSTANCE P; VASOACTIVE INTESTINAL POLYPEPTIDE;

ACUPUNCTURE; ARTICLE; BRAIN; DYSBIOSIS; ELECTROACUPUNCTURE; ENTEROCHROMAFFIN CELL; ENTEROENDOCRINE CELL; FUNCTIONAL MAGNETIC RESONANCE IMAGING; GASTROINTESTINAL MOTILITY; HUMAN; HYPERSENSITIVITY; IMMUNE SYSTEM; INTESTINE FLORA; INTESTINE INNERVATION; IRRITABLE COLON; LOCUS CERULEUS; MOXIBUSTION; NERVE EXCITABILITY; NERVOUS SYSTEM; NEUROENDOCRINE SYSTEM; NONHUMAN; SPINAL CORD; ANIMAL; ENDOCRINE CELL; INTESTINE; IRRITABLE BOWEL SYNDROME; METABOLISM; NERVE CELL; NEUROSECRETION; PATHOPHYSIOLOGY; PHYSIOLOGY;

ACUPUNCTURE THERAPY; ANIMALS; BRAIN; ENDOCRINE CELLS; GASTROINTESTINAL MOTILITY; HUMANS; HYPERSENSITIVITY; INTESTINES; IRRITABLE BOWEL SYNDROME; MOXIBUSTION; NEURONS; NEUROSECRETORY SYSTEMS;

EID: 84901496367     PISSN: 10079327     EISSN: 22192840     Source Type: Journal    
DOI: 10.3748/wjg.v20.i20.6044     Document Type: Article

References (87)

1. Philpott H, Gibson P, Thien F. Irritable bowel syndrome - An inflammatory disease involving mast cells. Asia Pac Allergy 2011; 1: 36-42 [PMID: 22053295 DOI: 10.5415/apallergy.2011.1.1.36]
2. Almansa C, Díaz-Rubio M, Rey E. The burden and management of patients with IBS: Results from a survey in spanish gastroenterologists. Rev Esp Enferm Dig 2011; 103: 570-575 [PMID: 22149558 DOI: 10.4321/S1130-01082011001100003]
3. Faresjö Å, Grodzinsky E, Hallert C, Timpka T. Patients with irritable bowel syndrome are more burdened by comorbidity and worry about serious diseases than healthy controls--eight years follow-up of IBS patients in primary care. BMC Public Health 2013; 13: 832 [PMID: 24025070 DOI: 10.1186/1471-2458-13-832]
4. Chang L, Lacy BE, Spiegel BM. An Evidence-based Approach to Therapy in IBS-D: A Case Study Compendium. Gastroenterol Hepatol (N Y) 2010; 6: 1-12 [PMID: 22570639]
5. He WR, Zhang FC, Liang LX. The epidemiology of irritable bowel syndrome. Weichangbingxue He Ganbingxue Zazhi 2012; 21: 83-85
6. Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med 2013; 368: 578-579 [PMID: 23388017 DOI: 10.1056/NEJMc1214185]
7. Matricon J, Meleine M, Gelot A, Piche T, Dapoigny M, Muller E, Ardid D. Review article: Associations between immune activation, intestinal permeability and the irritable bowel syndrome. Aliment Pharmacol Ther 2012; 36: 1009-1031 [PMID: 23066886 DOI: 10.1111/apt.12080]
8. Spiller R, Lam C. An Update on Post-infectious Irritable Bowel Syndrome: Role of Genetics, Immune Activation, Serotonin and Altered Microbiome. J Neurogastroenterol Motil 2012; 18: 258-268 [PMID: 22837873 DOI: 10.5056/jnm.2012.18.3.258]
9. Lee H, Park JH, Park DI, Kim HJ, Cho YK, Sohn CI, Jeon WK, Kim BI, Chae SW. Mucosal mast cell count is associated with intestinal permeability in patients with diarrhea predominant irritable bowel syndrome. J Neurogastroenterol Motil 2013; 19: 244-250 [PMID: 23667756 DOI: 10.5056/ jnm.2013.19.2.244]
10. Anastasi JK, McMahon DJ, Kim GH. Symptom management for irritable bowel syndrome: a pilot randomized controlled trial of acupuncture/moxibustion. Gastroenterol Nurs 2009; 32: 243-255 [PMID: 19696601 DOI: 10.1097/SGA.0b013e3181b2c920]
11. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Zhongguo Zhen Jiu 2012; 32: 957-960 [PMID: 23259285]
12. Zhao C, Mu JP, Cui YH, Yang L, Ma XP, Qi L. Meta-analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome. Zhonghua Zhongyiyao Xuekan 2010; 28: 961-963
13. Manheimer E, Wieland LS, Cheng K, Li SM, Shen X, Berman BM, Lao L. Acupuncture for irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol 2012; 107: 835-47; quiz 848 [PMID: 22488079 DOI: 10.1038/ ajg.2012.66]
14. Manheimer E, Cheng K, Wieland LS, Min LS, Shen X, Berman BM, Lao L. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev 2012; 5: CD005111 [PMID: 22592702 DOI: 10.1002/14651858.CD005111]
15. MacPherson H, Tilbrook H, Bland JM, Bloor K, Brabyn S, Cox H, Kang'ombe AR, Man MS, Stuardi T, Torgerson D, Watt I, Whorwell P. Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial. BMC Gastroenterol 2012; 12: 150 [PMID: 23095376 DOI: 10.1186/1471-230X-12-150]
16. Cole SJ, Duncan HD, Claydon AH, Austin D, Bowling TE, Silk DB. Distal colonic motor activity in four subgroups of patients with irritable bowel syndrome. Dig Dis Sci 2002; 47: 345-355 [PMID: 11858232]
17. Eshraghian A, Eshraghian H. Interstitial cells of Cajal: a novel hypothesis for the pathophysiology of irritable bowel syndrome. Can J Gastroenterol 2011; 25: 277-279 [PMID: 21647464]
18. Zhou EH, Ding GH, Wu HG, Qi L, Liu HR, Wang XM, Ma XP. Immediate effect of acupuncture on colon motility in patients with irritable bowel syndrome. Zhonghua Zhongyiyao Xuekan 2011; 29: 293-296
19. Chen YP. Effects of acupuncture on irritable bowel syndrome patients with different TCM syndromes in electro-colonogram and brain-gut peptide. Guangzhou, China: Thesis Collection Doctors Guangzhou University Traditional Chinese Medicine, 2000
20. Wang ZJ, Li WM. [Effects of electroacupuncture on disorder of intestinal motility in a rat model of irritable bowel syndrome]. Zhong Xi Yi Jie He Xue Bao 2010; 8: 883-887 [PMID: 20836980]
21. Liu WA, Chang XR, Yu BS, Liu M, Zhang HF, Yue ZH. The influence of herbal-cake-separated-moxibustion on gastrointestinal hormone and gastrointestinal motility in functional gastrointestinal disorders' rats with syndrome of liver stagnation and spleen deficiency. Shijie Huaren Xiaohua Zazhi 2013; 21: 1002-1007 [DOI: 10.11569/wcjd.v21.i11.1002]
22. Kuiken SD, Lindeboom R, Tytgat GN, Boeckxstaens GE. Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome. Aliment Pharmacol Ther 2005; 22: 157-164 [PMID: 16011674 DOI: 10.1111/j.1365-2036.2005.02524.x]
23. Jiang M, Tang H, Liu ZY, Zhang YX, Fu BY. Relationship between visceral hypersensitivity and clinical symptoms in irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2005; 13: 561-564
24. Posserud I, Syrous A, Lindström L, Tack J, Abrahamsson H, Simrén M. Altered rectal perception in irritable bowel syndrome is associated with symptom severity. Gastroenterology 2007; 133: 1113-1123 [PMID: 17919487 DOI: 10.1053/ j.gastro.2007.07.024]
25. Xing J, Larive B, Mekhail N, Soffer E. Transcutaneous electrical acustimulation can reduce visceral perception in patients with the irritable bowel syndrome: a pilot study. Altern Ther Health Med 2004; 10: 38-42 [PMID: 14727498]
26. Xiao WB, Liu YL. Rectal hypersensitivity reduced by acupoint TENS in patients with diarrhea-predominant irritable bowel syndrome: a pilot study. Dig Dis Sci 2004; 49: 312-319 [PMID: 15104377 DOI: 10.1023/B: DDAS.0000017458.55517. 33]
27. Wu HG, Liu HR, Zhang ZA, Zhou EH, Wang XM, Jiang B, Shi Z, Zhou CL, Qi L, Ma XP. Electro-acupuncture relieves visceral sensitivity and decreases hypothalamic corticotropin-releasing hormone levels in a rat model of irritable bowel syndrome. Neurosci Lett 2009; 465: 235-237 [PMID: 19765402 DOI: 10.1016/j.neulet.2009.09.018]
28. Wu JC, Ziea ET, Lao L, Lam EF, Chan CS, Liang AY, Chu SL, Yew DT, Berman BM, Sung JJ. Effect of electroacupuncture on visceral hyperalgesia, serotonin and fos expression in an animal model of irritable bowel syndrome. J Neurogastroenterol Motil 2010; 16: 306-314 [PMID: 20680170 DOI: 10.5056/jnm.2010.16.3.306]
29. Zhang JJ, Xiong HL, Chu D, Cheng PF, Qian W, Liu S. Effect and mechanism of electroacupuncture at ST-36 on visceral hypersensitivity in rats. Weichangbing Xue 2010; 15: 665-668 [DOI: 10.3969/J.ISSN.1008-7125.2010.11.007]
30. Qi L, Liu HR, Yi T, Wu LY, Liu XR, Zhao C, Shi Y, Ma XP, Wu HG. Warming Moxibustion Relieves Chronic Visceral Hyperalgesia in Rats: Relations to Spinal Dynorphin and Orphanin-FQ System. Evid Based Complement Alternat Med 2013; 2013: 920675 [PMID: 23573158 DOI: 10.1155/2013/920675]
31. Gershon MD, Tack J. The serotonin signaling system: from basic understanding to drug development for functional GI disorders. Gastroenterology 2007; 132: 397-414 [PMID: 17241888]
32. Kim DY, Camilleri M. Serotonin: a mediator of the brain-gut connection. Am J Gastroenterol 2000; 95: 2698-2709 [PMID: 11051338]
33. Liu HR, Hua XG, Yang Y, Wu HG. Clinical study on the treatment of diarrhea-predominant IBS with herb-partitioned moxibustion and the expression of colonic mucosal 5-HT. Liaoning Zhongyi Zazhi 2006; 33: 984-985 [DOI: 10.13192/j.ljtcm.2006.08.76.liuhr.046]
34. Liu X, Guo G, Ma YX, Liu CZ, Gao SZ. Effect of navel treatment on serum brain-gut peptide level in the irritable bowel syndrome patients with spleen deficiency. Shandong Zhongyiyao Daxue Xuebao 2013; 28: 262-264
35. Liu HR, Wang XM, Zhou EH, Shi Y, Li N, Yuan LS, Wu HG. Acupuncture at both ST25 and ST37 improves the pain threshold of chronic visceral hypersensitivity rats. Neurochem Res 2009; 34: 1914-1918 [PMID: 19387829 DOI: 10.1007/ s11064-009-9972-1]
36. Tian XY, Bian ZX, Hu XG, Zhang XJ, Liu L, Zhang H. Electro-acupuncture attenuates stress-induced defecation in rats with chronic visceral hypersensitivity via serotonergic pathway. Brain Res 2006; 1088: 101-108 [PMID: 16650387]
37. Zhou EH, Liu HR, Wu HG, Shi Y, Wang XM, Yao LQ, Zhong YS, Yang Y. Herb-partition moxibustion relieves chronic visceral hyperalgesia and 5-HT concentration in colon mucosa of rats. Neurol Res 2009; 31: 734-737 [PMID: 19108755 DOI: 10.1179/174313209X382313]
38. Zhang L, Zhou H, Lv B, Chu L, Li M. Role of CRF on 5-HT signaling pathway and visceral hypersensitivity in rats. Weichangbing Xue 2011; 16: 534-538 [DOI: 10.3969/j.issn.1008 -7125.2011.09.006]
39. Bravo JA, Dinan TG, Cryan JF. Alterations in the central CRF system of two different rat models of comorbid depression and functional gastrointestinal disorders. Int J Neuropsychopharmacol 2011; 14: 666-683 [PMID: 20860876 DOI: 10.1017/S1461145710000994]
40. Hirata T, Funatsu T, Keto Y, Nakata M, Sasamata M. Pharmacological profile of ramosetron, a novel therapeutic agent for IBS. Inflammopharmacology 2007; 15: 5-9 [PMID: 17323187 DOI: 10.1007/s10787-006-1537-1]
41. Nozu T, Kudaira M. Corticotropin-releasing factor induces rectal hypersensitivity after repetitive painful rectal distention in healthy humans. J Gastroenterol 2006; 41: 740-744 [PMID: 16988761 DOI: 10.1007/s00535-006-1848-4]
42. Skórzewska A, Lehner M, Hamed A, Wislowska-Stanek A, Turzyńska D, Sobolewska A, Plaźnik A. The effect of CRF2 receptor antagonists on rat conditioned fear responses and c-Fos and CRF expression in the brain limbic structures. Behav Brain Res 2011; 221: 155-165 [PMID: 21376756 DOI: 10.1016/j.bbr.2011.02.036]
43. Ma XP, Tan LY, Yang Y, Wu HG, Jiang B, Liu HR, Yang L. Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome. World J Gastroenterol 2009; 15: 5211-5217 [PMID: 19891022 DOI: 10.3748/wjg.15.5211]
44. Yoshimoto S, Babygirija R, Dobner A, Ludwig K, Takahashi T. Anti-stress effects of transcutaneous electrical nerve stimulation (TENS) on colonic motility in rats. Dig Dis Sci 2012; 57: 1213-1221 [PMID: 22258717 DOI: 10.1007/s10620-012-2040-8]
45. Lin L, Zhao ZQ, Yan Y, Lin Z, Zhang HJ. Relation between irritable bowel syndrome and gastrointestinal peptides. Zhonghua Xiaohua Zazhi 2003; 23: 501-502
46. Wu HG, Jiang B, Zhou EH, Shi Z, Shi DR, Cui YH, Kou ST, Liu HR. Regulatory mechanism of electroacupuncture in irritable bowel syndrome: preventing MC activation and decreasing SP VIP secretion. Dig Dis Sci 2008; 53: 1644-1651 [PMID: 17999187 DOI: 10.1007/s10620-007-0062-4]
47. Wang W, Zhang Y, Lü EJ, Gao ZX, Zhao JR. Effect of acupuncture at ST 37 on serum gastrointestinal hormones in rat models of IBS chronic visceral hyperalgesia. Gansu Zhongyi Xueyuan Xuebao 2011; 28: 5-7
48. Liu MR, Xiao RF, Peng ZP, Zuo HN, Zhu K, Wang SM. [Effect of acupuncture at "Zusanli" (ST 36 and "Taichong" (LR 3) on gastrointestinal hormone levels in rats with diarrhea type irritable bowel syndrome]. Zhen Ci Yan Jiu 2012; 37: 363-368 [PMID: 23342774]
49. Liu MR, Xiao RF, Zuo HN. Effect of acupuncture at ST 36 and LR 3 on NPY and VIP levels in diarrhea type IBS rat models. Jiangsu Zhongyiyao 2013; 45: 69-71
50. Zhu WL, Li Y, Wei HF, Ren XX, Sun J, Zhang LF, Zhu J. Effect of electro-acupuncture at different acupoints on neuropeptide and somatostatin in rat brain with irritable bowel syndrome. Chin J Integr Med 2012; 18: 288-292 [PMID: 22457140 DOI: 10.1007/s11655-011-0795-y]
51. Silverman DH, Munakata JA, Ennes H, Mandelkern MA, Hoh CK, Mayer EA. Regional cerebral activity in normal and pathological perception of visceral pain. Gastroenterology 1997; 112: 64-72 [PMID: 8978344 DOI: 10.1016/S0016-5085(97)70220-8]
52. Mertz H, Morgan V, Tanner G, Pickens D, Price R, Shyr Y, Kessler R. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention. Gastroenterology 2000; 118: 842-848 [PMID: 10784583 DOI: 10.1016/S0016-5085(00)70170-3]
53. Bonaz B, Baciu M, Papillon E, Bost R, Gueddah N, Le Bas JF, Fournet J, Segebarth C. Central processing of rectal pain in patients with irritable bowel syndrome: an fMRI study. Am J Gastroenterol 2002; 97: 654-661 [PMID: 11926209 DOI: 10.1016/S0002-9270(01)04107-7]
54. Liu HR, Zuo CT, Zhao TP, Wang XL, Wu HG, Ma XP. PET brain imaging study on electroacupuncture at ST 25 for irritable bowel syndrome. Hangzhou, China: National Symposium of Clinical and Scientific Study on Acupuncture and Moxibustion & Study Progress of Spinal Diseases, 2005: 108-115
55. Guo MN, Wang PQ. Study on the effect of eye acupuncture on cerebral blood flow in patients with diarrhea-predominant irritable bowel syndrome. Shanghai Zhenjiu Zazhi 2012; 31: 540-541 [DOI: 10.3969/j.issn.1005-0957.2012.08.540]
56. Chu WC, Wu JC, Yew DT, Zhang L, Shi L, Yeung DK, Wang D, Tong RK, Chan Y, Lao L, Leung PC, Berman BM, Sung JJ. Does acupuncture therapy alter activation of neural pathway for pain perception in irritable bowel syndrome?: a comparative study of true and sham acupuncture using functional magnetic resonance imaging. J Neurogastroenterol Motil 2012; 18: 305-316 [PMID: 22837879 DOI: 10.5056/ jnm.2012.18.3.305]
57. Zhu QY. Regulatory effect of electroacupuncture at ST 37 on colonic function of rats of acute restraint stress and its central mechanism. Wuhan, China: Thesis Doctors Hubei University Traditional Chinese Medicine, 2008
58. Qi DB, Li WM. Effects of electroacupuncture on expression of c-fos protein and N-methyl-D-aspartate receptor 1 in the rostral ventromedial medulla of rats with chronic visceral hyperalgesia. Zhong Xi Yi Jie He Xue Bao 2012; 10: 416-423 [PMID: 22500715]
59. Rong PJ, Zhu B, Huang QF, Gao XY, Ben H, Li YH. [Acupuncture inhibiting responses of spinal dorsal dorsal horn neurons induced by noxious dilation rectum and colon]. Zhongguo Zhen Jiu 2005; 25: 645-650 [PMID: 16318154]
60. Mönnikes H, Rüter J, König M, Grote C, Kobelt P, Klapp BF, Arnold R, Wiedenmann B, Tebbe JJ. Differential induction of c-fos expression in brain nuclei by noxious and non-noxious colonic distension: role of afferent C-fibers and 5-HT3 receptors. Brain Res 2003; 966: 253-264 [PMID: 12618348]
61. Qi DB, Li WM. Effects of electroacupuncture on expression of c-fos protein in the spinal dorsal horn of rats with chronic visceral hyperalgesia. Zhong Xi Yi Jie He Xue Bao 2012; 10: 1490-1496 [PMID: 23257146 DOI: 10.3736/jcim20121224]
62. Wei EQ. Pharmacology Frontier: Signal, Protein, Gene and Modern Pharmacology. Beijing: Science Press, 1999: 120-136
63. Gaudreau GA, Plourde V. Involvement of N-methyl-d-aspartate (NMDA) receptors in a rat model of visceral hypersensitivity. Behav Brain Res 2004; 150: 185-189 [PMID: 15033291 DOI: 10.1016/j.bbr.2003.07.004]
64. Zhou J, Li WM. Influence of electroacupuncture on expression of N-methyl-D-aspartate receptors in the spinal cord of irritable bowel syndrome of rat. Shanghai Zhenjiu Zazhi 2008; 27: 38-40
65. Tian SL, Wang XY, Ding GH. Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome model. Life Sci 2008; 83: 356-363 [PMID: 18694764 DOI: 10.1016/j.lfs.2008.06.027]
66. Wouters MM, Boeckxstaens GE. Neuroimmune mechanisms in functional bowel disorders. Neth J Med 2011; 69: 55-61 [PMID: 21411840]
67. Xu JR, Luo JY, Shang L, Kong WM. Effect of enteric neuron and enteric glia on irritable bowel syndrome subgroups and the interference tegaserod. Shenjing Jiepouxue Zazhi 2006; 22: 643-647
68. Xu JR, Luo JY, Shang L, Kong WM. The plasticity of the enteric submucosal plexus irritable bowel syndrome rats. Zhonghua Xiaohua Zazhi 2007; 27: 107-110
69. Zhu LT, Zhu Y. Plasticity of the enteric submucosal plexus in IBS-C rats by electroacupuncture. Chengdu, China: Eighth National Academic Conference, China Medical Association of Rehabilitation, 2011: 118
70. Yang HY, Guo TT, Ma YN, Liu TY, Gao M. [Effects of 650 nm laser and moxibustion pretreatment on enteric nervous system and medullary visceral zone in rats with visceral traction pain]. Zhongguo Zhen Jiu 2010; 30: 745-751 [PMID: 20886795]
71. Li ZS, Zhan LX, Zou DW, Xu GM, Man XH, Ye XT. Morphological and functional alteration of serotonin-producing intestinal enterochromaffin cells in patients with irritable bowel syndrome. Zhonghua Xiaohua Zazhi 2004; 24: 30-33
72. Wheatcroft J, Wakelin D, Smith A, Mahoney CR, Mawe G, Spiller R. Enterochromaffin cell hyperplasia and decreased serotonin transporter in a mouse model of postinfectious bowel dysfunction. Neurogastroenterol Motil 2005; 17: 863-870 [PMID: 16336502 DOI: 10.1111/j.1365-2982.2005.00719.x]
73. Jiang Y, Wu HG, Shi Z, Zhou EH, Zhao TP. Regulatory effect of electroacupuncture on intestinal sensitivity and motility of constipation-predominant IBS rats. Beijing, China: 20th Anniversary of World Acupuncture Association & World Academic Conference of Acupuncture and Moxibustion, 2007: 84-85
74. Song SY, Wang DS, Wang YJ, Zhao JR, Zhang FL. Effect of eye acupuncture on the expression of colonic enterochromaffin cell in IBS rats. Jiangsu Zhongyiyao 2010; 42: 73-74
75. Camilleri M, Lasch K, Zhou W. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2012; 303: G775-G785 [PMID: 22837345 DOI: 10.1152/ajpgi.00155.2012]
76. Wu HG, Wang JH, Chen HP, Hua XG, Shi Z. Therapeutic efficacy of herb-partitioned moxibustion for irritable bowel syndrome and its immunological mechanism. Zhongguo Zhenjiu 1996; 16: 43-45
77. Zhang RH. Therapeutic efficacy of acupuncture-moxibustion for elderly irritable bowel syndrome and its effect on serum IL-18, IL-23, and TNF-α. Zhongguo Laonian Xue Zazhi 2013; 33: 1435-1436 [DOI: 10.3969/j.issn.1005-9202]
78. Wang J, Liang ZX, Zhang ZX, Li GH, Qian W, Hou XH. Alterations of enteric mucosal mast cells in patients with irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2004; 2: 382-384
79. El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol 2012; 18: 5151-5163 [PMID: 23066308 DOI: 10.3748/wjg.v18.i37.5151]
80. Quigley EM, Craig OF. Irritable bowel syndrome; update on pathophysiology and management. Turk J Gastroenterol 2012; 23: 313-322 [PMID: 22965501]
81. Wang XM, Lu Y, Wu LY, Yu SG, Zhao BX, Hu HY, Wu HG, Bao CH, Liu HR, Wang JH, Yao Y, Hua XG, Guo HY, Shen LR. Moxibustion inhibits interleukin-12 and tumor necrosis factor alpha and modulates intestinal flora in rat with ulcerative colitis. World J Gastroenterol 2012; 18: 6819-6828 [PMID: 23239920 DOI: 10.3748/wjg.v18.i46.6819]
82. Wang YJ, Liu HH, Liu XD, Chai JY, Zhao JR, Wang DS. Eye acupuncture therapy up-regulates aquaporin 3 expression in the colon of rats with diarrhea-predominant irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2011; 19: 899-904
83. Liu HH, Liu XD, Wang YJ, Guan HQ, Chai JY, Zhao JR, Wang DS. [Effects of acupoint area and non-acupoint area of eye-acupuncture on expressions of VIP and AQP 8 in colonic tissues in rats with D-IBS]. Zhongguo Zhen Jiu 2012; 32: 919-924 [PMID: 23259274]
84. Xue Y, Tian XD. Clinical study on the relationship between free radical and irritable bowel syndrome and the effect of acupuncture. Chinese Archives Traditional Chinese Medicine 2009; 27: 111-112 [DOI: 10.13193/j.archtcm.2009.01.113. xuey.017]
85. Gilkin RJ. The spectrum of irritable bowel syndrome: A clinical review. Clin Ther 2005; 27: 1696-1709 [PMID: 16368443 DOI: 10.1016/j.clinthera.2005.11.012]
86. Liu HR, Xie JQ, Wu HG, Wang XL, Zhao C, Hua XG, Zhou S, Ma XP, Tan LY. Acupuncture and irritable bowel syndrome: a population-based epidemiological and clinical study. J Acupunct Tuina Sci 2010; 8: 70-74 [DOI: 10.1007/ s11726-010-0070-3]
87. Wang B, Han Z. Current research situation and progress in building animal model of irritable bowel syndrome. Guoji Xiaohuabing Zazhi 2008; 28: 359-360, 367