The Efficacy of Shugan Jianpi Zhixie Therapy for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials

Abstract

BackgroundShugan Jianpi Zhixie therapy (SJZT) has been widely used to treat diarrhea-predominant irritable bowel syndrome (IBS-D), but the results are still controversial. A meta-analysis of randomized, double-blind, placebo-controlled trials was performed to assess the efficacy and tolerability of SJZT for IBS-D.MethodsThe MEDLINE, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database and the Wanfang database were searched up to June 2014 with no language restrictions. Summary estimates, including 95% confidence intervals (CI), were calculated for global symptom improvement, abdominal pain improvement, and Symptom Severity Scale (BSS) score.ResultsSeven trials (N=954) were included. The overall risk of bias assessment was low. SJZT showed significant improvement for global symptom compared to placebo (RR 1.61; 95% CI 1.24, 2.10; P =0.0004; therapeutic gain = 33.0%; number needed to treat (NNT) = 3.0). SJZT was significantly more likely to reduce overall BSS score (SMD –0.67; 95% CI –0.94, –0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo. The adverse events of SJZT were no different from those of placebo.ConclusionsThis meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.

Second Asian Consensus on Irritable Bowel Syndrome

“…215 One formulation known as Shugan Jianpi Zhixie had 7 trials of 954 IBS-D patients. 216 Another formulation known as Tongxie Yaofang had 23 publications involving 1972 IBS-D patients. 217 A very recently published RCT had 1044 patients with Rome III criteria IBS randomized to 3 treatments for 4 weeks, and found that Tongxie Yaofang was significantly better than placebo for improving abdominal pain and stool parameters, but not better than pinaverium for abdominal pain.…”

Efficacy and safety of Modified Tongxie Yaofang in diarrhea-predominant irritable bowel syndrome management: A meta-analysis of randomized, positive medicine-controlled trials

“…Moreover, sub-classification of IBS was also left out of consideration. The other study was a meta-analysis of Shugan Jianpi Zhixie therapy for IBS-D [ 9 ]. Although this sub-classification was taken into consideration, placebos were adopted in control groups.…”

Effects of Shugan-Jianpi Recipe on the Expression of the p38 MAPK/NF-κB Signaling Pathway in the Hepatocytes of NAFLD Rats

“…Shugan-Jianpi, a traditional Chinese medicine (TCM) terminology, which means the method of soothing the liver (Shugan) and invigorating the spleen (Jianpi), is widely used in treating liver and gastrointestinal diseases [ 11 , 12 ]. Chaihu–Shugan–San (CSS), the representative of Shugan (soothing liver) recipes, can treat gastrointestinal diseases and depression-related diseases [ 13 , 14 ], while Shenling–Baizhu–San (SLBZS), the representative of Jianpi (invigorating spleen) recipes, can regulate intestinal flora and treat gastrointestinal related diseases [ 15 , 16 ].…”