Are personalized tongxie formula based on diagnostic analyses more effective in reducing IBS symptoms?—A randomized controlled trial

Wang, Yuanyuan; Fan, Huiying; Xiao, Qin; Lai, Yaoliang; Yan, Zhixiang; Li, Baiwen; Tang, Min; Huang, Dawei; Li, Zhen; Chen, Hongjing; Zhu, Qingping; Luo, Chao; Chen, Xuan; Jin, Fang; Jiang, Zhengyan; Zheng, Liang; Liu, Xingxing; Tang, Qing; Zuo, Dongmei; Ye, Jingyi; Yang, Yongqiang; Huang, Huisuo; Tang, Zongxiang; Liu, Weimin; Xiao, Jun

doi:10.1016/j.ctim.2018.07.002

Cited by 7 publications

(10 citation statements)

References 18 publications

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“…Herbal medicines versus conventional pharmacotherapy for FGIDs. Five trials 54,24,20,62,59 compared the effective rate of HMs versus conventional pharmacotherapy for FGIDs (n = 1284). The risk ratio for improvement of symptom for HMs treated versus conventional pharmacotherapy treated was 1.10 (95% CI 1.03-1.18), which indicated that HMs were non-inferior to conventional pharmacological drugs such as Cisapride in FD, Pinaverium in IBS and Senna or Lactulose in FC ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Literature searches identified 3782 potentially relevant titles after elimination of duplicates. After review of the abstracts, 121 full‐text publications were assessed, of which 50 studies were included in this review, involving a total of 7396 participants. As two of the studies shared the same group of patients with two aspects of results reported, so their data was abstracted as one, resulting in totally 49 trials for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The studies published between 1991 and 2019 were included. Patients had FD, IBS and constipation in 19, 23 and 7 trials respectively. More than 33 different kinds of herbal formulae were tested in the included trials.…”

Section: Resultsmentioning

confidence: 99%

“…Since there were so many kinds of HMs without enough trials for each of them for subgroup analysis, it could not define which formula had the highest probability in improving FGIDs symptoms in this study. But when compared to placebo we did find in several trials conflicting results for STW5 (RR = 1.32, 95% CI 0.93–1.86), rikkunshito (RR = 1.29, 95% CI 1.15–1.44), peppermint oil (RR = 1.75, 95% CI 1.45–2.10), and TongXieYaoFang (RR = 1.62, 95% CI 1.00–2.64) (Fig. S6 to S9).…”

Section: Discussionmentioning

confidence: 96%

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Herbal medicine in the treatment of functional gastrointestinal disorders: A systematic review with meta‐analysis

Tan

Gwee

Tack

et al. 2019

J of Gastro and Hepatol

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Background and Aims The efficacy of herbal medicines (HMs) for functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS), functional dyspepsia (FD) and functional constipation (FC) is controversial. A systematic review with meta‐analysis was conducted to determine their effectiveness for FGIDs. Methods We searched the following electronic databases till July 2019 with English language restriction: The Cochrane Library, EMBASE and PUBMED. Randomized double‐blind controlled trials of HMs compared with placebo or conventional pharmacological drugs for adult FGIDs patients were included. Results In total, 49 trials involving 7396 participants with FGIDs were included. The risk of bias was low in 9, unclear in 36, and high in 4 trials. More than 33 different herbal formulae were tested. HMs demonstrated statistically significant benefits for symptom improvement compared with placebo in 46 trials (RR = 1.67, 95% CI 1.48–1.88). When compared with conventional pharmacological therapy in 5 trials, HMs were found to be non‐inferior (RR = 1.10, 95% CI 1.03–1.18). The number of trials with regards to FD, IBS and FC were 19, 23 and 7 respectively. Subgroup analysis found that HMs were better than placebo in alleviating symptoms for FD (RR = 1.50, 95% CI 1.32–1.69), IBS (RR = 1.62, 95% CI 1.32–1.97) and FC (RR = 3.83, 95% CI 2.26–6.50). HMs tended to have more patients with adverse events than placebo, but similar to conventional pharmacological drugs. Conclusions Our findings provide a positive signal for HMs as a potentially well‐tolerated and effective treatment for FGIDs, deserving further examination in high‐quality trials.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

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Herbal medicine in the treatment of functional gastrointestinal disorders: A systematic review with meta‐analysis

Tan

Gwee

Tack

et al. 2019

J of Gastro and Hepatol

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“…Nine trials assessed the effect of standardized CHM ( Sallon et al, 2002 ; Leung et al, 2006 ; Wang et al, 2006 , 2018 ; Su et al, 2013 ; Bensoussan et al, 2015 ; Fan et al, 2017 ; Chen et al, 2018 ; Tang et al, 2018 , 2019 ; Shih et al, 2019 ). The trials that included participants with diarrhea-predominant IBS used CHM prescriptions based on Tong-Xie-Yao-Fang or its revised version.…”

Section: Resultsmentioning

confidence: 99%

Chinese Herbal Medicine for Irritable Bowel Syndrome: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

et al. 2021

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Purpose: Chinese herbal medicine (CHM) is an important complementary and alternative therapy for the management of irritable bowel syndrome (IBS). Previous meta-analyses suggested that CHM is effective for IBS; nonetheless, its effectiveness is inconclusive owing to repeated significance testing. We aimed to examine the efficacy and safety of CHM for IBS through a meta-analysis and trial sequential analysis (TSA).Methods: We searched OVID Medline, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from January 1, 1980, to September 20, 2020. The primary outcome was adequate relief of global IBS symptoms. The secondary outcomes included relief of abdominal pain and treatment-related adverse events. The relative ratio (RR) and required information size (RIS) were calculated for each outcome.Results: Ten trials recruiting 2,501 participants were included. Seven (70%) trials were at low risk of bias (RoB). Compared with placebo, CHM was associated with a significantly higher proportion of adequate relief of global IBS symptoms [RR 1.76 (95% confidence interval (95%CI), 1.33–2.33); I2 = 81.1%; p < 0.001]. The RIS was 1,083 for the primary outcome, and the accrued information size was 1,716. The analysis of the relief of abdominal pain (three trials with 916 participants) showed similar results compared with placebo [RR 1.85 (95%CI, 1.59–2.14); I2 = 0%; p < 0.001; RIS = 197 participants]. CHM was associated with a higher proportion of adverse events compared with placebo [RR 1.51 (95%CI, 1.14–2); I2 = 0%; p = 0.004].Conclusion: CHM was effective in relieving IBS symptoms but caused a higher adverse event rate than placebo. TSA analysis confirmed the findings with sufficient information size.

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Assessing the post-treatment therapeutic effect of tongxie in irritable bowel syndrome: A randomized controlled trial

Lai

Xiao

Fan

et al. 2022

Complementary Therapies in Medicine

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Are personalized tongxie formula based on diagnostic analyses more effective in reducing IBS symptoms?—A randomized controlled trial

Cited by 7 publications

References 18 publications

Herbal medicine in the treatment of functional gastrointestinal disorders: A systematic review with meta‐analysis

Herbal medicine in the treatment of functional gastrointestinal disorders: A systematic review with meta‐analysis

Chinese Herbal Medicine for Irritable Bowel Syndrome: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

Assessing the post-treatment therapeutic effect of tongxie in irritable bowel syndrome: A randomized controlled trial

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