Clinical Effects and Safety of Tongxieyaofang on Diarrhea Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized Trails

Abstract

Background. Tongxieyaofang (TXYF), a prescription originated from traditional Chinese medicine (TCM), has been widely used on treating Diarrhea Predominant Irritable Bowel Syndrome (IBS-D). The purpose of this meta-analysis was to investigate whether TXYF was effective and safe for IBS-D. Methods. We searched seven electronic databases including CENTRAL, MEDLINE, PubMed, CNKI, VIP, CBM, and Wanfang Data up to 26 July 2017. Randomized controlled trails (RCTs) were eligible, regardless of blinding. Risk of bias of included trials was evaluated according to the Cochrane Handbook. Results. The total number of participants analyzed in the meta-analysis was 3062, of which 1556 received TXYF, while 1506 received ordinary treatment. The primary outcome was clinical effective rate. Compared with conventional medication which included probiotics, pinaverium bromide, trimebutine, and Oryzanol, TXYF significantly improved the clinical effective rate (n=37, OR: 4.61; 95% CI: 3.67–5.78; P < 0.00001) and decreased the adverse events (n=10, OR: 0.26; 95% CI: 0.08–0.86; P = 0.03). There was not significant association with the score of abdominal pain, defecating frequency, fecal property, and total symptom. Conclusions. We suggested a moderate recommendation for TXYF on IBS-D, due to the fact that the risk of bias of the finally included trails was not high. Considering that all identified studies were not of high qualities and large samples, further rigorously designed and large scale RCTs were necessary to improve the applicability of our study results.

Efficacy of Tong-Xie-Yao-Fang granule and its impact on whole transcriptome profiling in diarrhea-predominant irritable bowel syndrome patients: study protocol for a randomized controlled trial

“…Previous meta-analysis [ 29 ] and another two clinical trials [ 9 , 30 ] have demonstrated with adequate evidence that TXYF or Tongxie formula (modified TXYF) is pretty effective and safe compared with conventional medications or placebo. Disease and syndrome differentiation are the crux of TCM treatment as we know, TXYF accords with one kind of principal pathogenesis known as liver depression and spleen deficiency of IBS-D in TCM theory so it can work.…”

Efficacy of Tong-Xie-Yao-Fang granule and its impact on whole transcriptome profiling in diarrhea-predominant irritable bowel syndrome patients: study protocol for a randomized controlled trial

“…Previous meta-analysis (29) and another two clinical trials (9,30) have demonstrated with adequate evidence that TXYF or Tongxie formula (modi ed TXYF) is pretty effective and safe compared with conventional medications or placebo. Disease and syndrome differentiation are the crux of TCM treatment as we know, TXYF accords with one kind of principal pathogenesis known as liver depression and spleen de ciency of IBS-D in TCM theory so it can work.…”

Irritable bowel syndrome in China: a review on the epidemiology, diagnosis, and management

“…Although all the studies consistently suggested the effect of TXYF on the IBS-SSS, as for the individual symptoms were concerned, no significant effect was concluded. [ 37 ] Acupuncture is an important Chinese medicine for FGID. Recently, two well-designed RCTs reported the effect of acupuncture on IBS.…”