Syndrome differentiation in chinese herbal medicine for irritable bowel syndrome: a literature review of randomized trials

Qing Li, Guo-Yan Yang, Jian-Ping Liu, Qing Li, Guo-Yan Yang, Jian-Ping Liu

Abstract

Traditional Chinese medicine (TCM) has been commonly used for irritable bowel syndrome (IBS). Syndrome differentiation is one of the important characteristics of TCM. To assess the application and basic characteristics of syndrome differentiation in randomized controlled trials (RCTs) of Chinese herbal medicine for IBS, we performed this paper. We conducted electronic searches in main Chinese and English databases till March 2012. A total of 735 RCTs involving 67,784 IBS participants were included. 224 (30.5%) studies applied syndrome differentiation. The major syndromes of IBS patients were the syndrome of liver stagnation and spleen deficiency (56.8%), spleen-stomach weakness (49.4%), spleen-kidney yang deficiency (48.1%), and cold and heat in complexity (29.6%). Herbal formulas were prescribed based on syndrome differentiation in 202 studies. Chinese patent medicine was more commonly used in studies that only enrolled patients with a specific syndrome. 15 studies compared the therapeutic effect among different syndromes, of which 6 studies showed that there were significant differences among different syndromes. The low use of TCM syndrome differentiation in randomized trials of Chinese herbal medicine for IBS results in the poor pertinence of treatment. TCM syndrome differentiation should be used in further studies at the stage of recruitment, treatment, and data analyses.

Figures

Figure 1
Figure 1
Flowchart of the literature search and study selection.

References

    1. Frank L, Kleinman L, Rentz A, Ciesla G, Kim JJ, Zacker C. Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases. Clinical Therapeutics. 2002;24(4):675–689.
    1. Grundmann O, Yoon SL. Irritable bowel syndrome: epidemiology, diagnosis and treatment: an update for health-care practitioners. Journal of Gastroenterology and Hepatology. 2010;25(4):691–699.
    1. Rahimi R, Abdollahi M. Herbal medicines for the management of irritable bowel syndrome: a comprehensive review. World Journal of Gastroenterology. 2012;18(7):589–600.
    1. Dongmei S, Shengsheng Z, Jianping L, HongBing W. Systematic review of D-IBS treated by Chinese herbal medicine. China Journal of Traditional Chinese Medicne. 2009;24(4):532–535.
    1. Shi J, Tong Y, Shen JG, Li HX. Effectiveness and safety of herbal medicines in the treatment of irritable bowel syndrome: a systematic review. World Journal of Gastroenterology. 2008;14(3):454–462.
    1. liu YC, Lei SQ. Basic Theory of Traditional Chinese Medicine. Beijing, China: Academic Publishing House; 2005.
    1. Lu AP, Chen KJ. Integrative medicine in clinical practice: from pattern differentiation in traditional Chinese medicine to disease treatment. Chinese Journal of Integrative Medicine. 2009;15(2, article 152)
    1. Liu JP, Yang M, Liu YX, Wei ML, Grimsgaard S. Herbal medicines for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews. 2006;(1)CD004116
    1. Bian ZX, Wu TX, Liu L, et al. Effectiveness of the Chinese herbal formula Tong Xie Yao Fang for irritable bowel syndrome: a systematic review. Journal of Alternative and Complementary Medicine. 2006;12(4):401–407.
    1. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2. 2009. (The Cochrane Collaboration).
    1. Xiaoyu Z. Clinical Research Guidelines for New Chinese Herbal Drug. Beijing, China: China Medical Science Press; 2002.
    1. Zhishui C, Wandai Z, Beihan W, et al. The diagnosis and treatment protocol of integrated Chinese and Western medicine for irritable bowel syndrome (Draft) Chinese Journal of Integrated Traditional and Western Medicine on Digestion. 2005;13(1):65–67.
    1. Zhao L, Liu Q. Research on the TCM syndromes and psychological factors of patients with irritable bowel syndrome. Zhejiang Journal of Traditional ChineseMedicine. 2012;47(7):475–477.
    1. Wu B, Zhang S. Progress of syndrome study on diarrhea-predominant irritable bowel syndrome (IBS-D) Beijing Journal of Traditional Chinese Medicine. 2007;26(5):312–314.
    1. Digestive Disease Committee of China Society of Integrated Traditional Chinese and Western Medicine. Consensus and opinion of integrated traditional and western medicine for irritable bowel syndrome. Chinese Journal of Integrated Traditional and Western Medicine. 2011;31(5):587–590.
    1. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. The Journal of the American Medical Association. 1998;280(18):1585–1589.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel