The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
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A Survey on the Clinical Practice Patterns of Irritable Bowel Syndrome in Korean Medicine

과민대장증후군(Irritable Bowel Syndrome)의 한의임상 진료현황에 대한 설문조사 연구

  • Jun, Hyejin (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Keumji (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Ko, Seok-Jae (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Park, Jae-Woo (Dept. of Internal Korean Medicine, Kyung Hee University Hospital at Gangdong)
  • 전혜진 (강동경희대학교한방병원 한방내과) ;
  • 김금지 (강동경희대학교한방병원 한방내과) ;
  • 고석재 (강동경희대학교한방병원 한방내과) ;
  • 박재우 (강동경희대학교한방병원 한방내과)
  • Received : 2021.07.30
  • Accepted : 2021.09.30
  • Published : 2021.09.30
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Abstract

Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

Keywords

Acknowledgement

본 연구는 보건복지부 한의약선도기술개발사업 한의표준임상진료지침 개발 사업의 지원에 의하여 이루어진 것임(HF20C0051).

References

  1. Lovell RM, Ford AC. Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-Analysis. Clin Gastroenterol Hepatol 2012; 10(7):712-721.e4. https://doi.org/10.1016/j.cgh.2012.02.029
  2. Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel Disorders. Gastroenterology 2016;150(6):1393-407. https://doi.org/10.1053/j.gastro.2016.02.031
  3. Defrees DN, Bailey J. Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Prim Care - Clin Off Pract 2017; 44(4):655-71. https://doi.org/10.1016/j.pop.2017.07.009
  4. Hawrelak JA, Wohlmuth H, Pattinson M, Myers SP, Goldenberg JZ, Harnett J, et al. Western Herbal Medicines in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. Complement Ther Med 2020;48:102233. https://doi.org/10.1016/j.ctim.2019.102233
  5. Liu JP, Yang M, Liu Y, Wei ML, Grimsgaard S. Herbal Medicines for Treatment of Irritable Bowel Syndrome. Cochrane Database Syst Rev 2006;1:CD004116.
  6. Li Q, Liu F, Hou Z, Luo D. Treatment of Constipation-Predominant Irritable Bowel Syndrome by Focusing on the Liver in Terms of Traditional Chinese Medicine: A Meta-Analysis. J Tradit Chinese Med 2013;33(5):562-71. https://doi.org/10.1016/S0254-6272(14)60022-4
  7. Bu FL, Chen RL, Lin ZY, Cao HJ, Robinson N, Liang N, et al. Chinese Herbal Medicine versus Probiotics for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Eur J Integr Med 2020;38:101177. https://doi.org/10.1016/j.eujim.2020.101177
  8. Song KH, Jung HK, Kim HJ, Koo HS, Kwon YH, Shin HD, et al. Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition. J Neurogastroenterol Motil 2018;24(2):197-215. https://doi.org/10.5056/jnm17145
  9. Han WU, Zhenyu Z. An Interpretation of the Eastern and Western Guidelines for Irritable Bowel Syndrome. Chin J Gastroenterol Hepatol 2019;28(9):1-7.
  10. Moayyedi P, Andrews CN, MacQueen G, Korownyk C, Marsiglio M, Graff L, et al. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). J Can Assoc Gastroenterol 2019;2(1):6-29. https://doi.org/10.1093/jcag/gwy071
  11. Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel Disorders. Gastroenterology 2016;150(6):1393-407. https://doi.org/10.1053/j.gastro.2016.02.031
  12. Hellstrom PM, Benno P. The Rome IV: Irritable Bowel Syndrome - A Functional Disorder. Best Pract Res Clin Gastroenterol 2019;40-1:101634. https://doi.org/10.1016/j.bpg.2019.101634
  13. Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global Prevalence of Irritable Bowel Syndrome According to Rome III or IV Criteria: A Systematic Review and MetaAnalysis. Lancet Gastroenterol Hepatol 2020; 5(10):908-17. https://doi.org/10.1016/S2468-1253(20)30217-X
  14. Bellini M, Gambaccini D, Salvadori S, Bocchini R, Pucciani F, Bove A, et al. Different Perception of Chronic Constipation between Patients and Gastroenterologists. Neurogastroenterol Motil 2018;30(8):1-8.
  15. Linedale EC, Andrews JM. Diagnosis and Management of Irritable Bowel Syndrome : A Guide for the Generalist. Med J Aust 2017; 207(7):309-15. https://doi.org/10.5694/mja17.00457
  16. Lena B, St S, Hans T, Bengtsson U, Simr M. Self-Reported Food-Related Gastrointestinal Symptoms in IBS Are Common and Associated With More Severe Symptoms and Reduced. Am J Gastroenterol 2013;108(5):634-41. https://doi.org/10.1038/ajg.2013.105
  17. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome. Gastroenterology 2014;146(1):67-75. https://doi.org/10.1053/j.gastro.2013.09.046
  18. Larussa T, Rossi M, Suraci E, Marasco R, Imeneo M, Abenavoli L, et al. Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey. Medicina (Kaunas) 2019;55(2):46. https://doi.org/10.3390/medicina55020046
  19. Li DY, Dai YK, Zhang YZ, Huang MX, Li RL, Ou-yang J, et al. Systematic Review and Meta-Analysis of Traditional Chinese Medicine in the Treatment of Constipation-Predominant Irritable Bowel Syndrome. PLoS One 2017; 12(12):e0189491. https://doi.org/10.1371/journal.pone.0189491
  20. Zhu JJ, Liu S, Su XL, Wang ZS, Guo Y, Li YJ, et al. Efficacy of Chinese Herbal Medicine for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials. Evidence-based Complement Altern Med 2016;2016:4071260.
  21. Bian Z, Wu T, Liu L, Miao J, Wong H, Song L, et al. Effectiveness of the Chinese Herbal Formula TongXieYaoFang for Irritable Bowel Syndrome: A Systematic Review. J Altern Complement Med 2006;12(4):401-7. https://doi.org/10.1089/acm.2006.12.401
  22. Zhou Y, Han S, He Y. Clinical Effects and Safety of Tongxieyaofang on Diarrhea Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized Trails. Evidence-based Complement Altern Med 2019;4893876.
  23. Dai YK, Li DY, Zhang YZ, Huang MX, Zhou YL, Ye JT, et al. Efficacy and Safety of Modified Tongxie Yaofang in Diarrhea-Predominant Irritable Bowel Syndrome Management: A Meta-Analysis of Randomized, Positive Medicine-Controlled Trials. PLoS One 2018;13(2):e0192319. https://doi.org/10.1371/journal.pone.0192319
  24. Li CY, Ain Mohd Tahir N, Li SC. A Systematic Review of Integrated Traditional Chinese and Western Medicine for Managing Irritable Bowel Syndrome. Am J Chin Med 2015;43(3):385-406. https://doi.org/10.1142/S0192415X15500251
  25. Guo J, Xing X, Wu J, Zhang H, Yun Y, Qin Z, et al. Acupuncture for Adults with Diarrhea-Predominant Irritable Bowel Syndrome or Functional Diarrhea: A Systematic Review and Meta-Analysis. Neural Plast 2020;2020:8892184.
  26. Park JW, Lee BH, Lee H. Moxibustion in the Management of Irritable Bowel Syndrome: Systematic Review and Meta-Analysis. BMC Complement Altern Med 2013;13:247. https://doi.org/10.1186/1472-6882-13-247
  27. Lee SH, Nam DW, Kang JW, Kim EJ, Kim HW, Song HS, et al. E-Mail Survey for Developing Clinical Guideline Protocol on Acupuncture Treatment for Low Back Pain. J Acupunct Res 2009;26(3):115-31.