Welcome to Francis Academic Press

Frontiers in Medical Science Research, 2023, 5(9); doi: 10.25236/FMSR.2023.050917.

A Meta-Analysis of Modified Sijunzi Decoction Combined with Tongxie Yaofang in the Treatment of IBS-D

Author(s)

Jiaxin Yan1, Yaping Cui2, Bozhi Ren1

Corresponding Author:
​Jiaxin Yan
Affiliation(s)

1Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China

2The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China

Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGD), among which the diarrhea-predominant (IBS-D) is the most common in China, significantly affecting patients' life and work due to its long course and easy recurrence. Herb medicine is a viable complementary and alternative treatment option for patients with IBS. Specifically, Sijunzi Decoction combined with Tongxie Yaofang is a clinical prescription commonly used in China for IBS-D.We retrieved randomized controlled trials (RCTs) of Sijunzi Decoction combined with Tongxie Yaofang in the treatment of IBS-D from CNKI, WanFang Data, VIP, CBM, Pubmed and the Cochrane Library, and Embase database. And then we performed quality evaluation, data extraction and pooling. Stata software (version 15.0) was used to perform meta-analysis. Resultly, a total of 14 RCTs were included, including 1,032 subjects, with 522 cases in the test group and 510 cases in the control group. Meta-analysis showed the following results: (1) Clinical efficacy: Compared with conventional Western medicine treatment, the total clinical effective rate of modified Sijunzi Decoction combined with Tongxie Yaofang for IBS-D was significantly increased [RR= 1.229, 95% CI (1.162, 1.299)], and the difference was statistically significant (P<0.05); (2) Daily bowel frequency: Three RCTs counted the number of daily bowel movements before and after treatment, the results showed a more considerable improvement in the number of daily bowel movements in the test group than in the control group after treatment [SMD=-1.791, 95% CI (-3.130, -0.452)], and the difference was statistically significant (P<0.05); (3) Clinical symptom score: Six RCTs recorded clinical symptom scores of the subjects before and after treatment, and the results showed that the clinical symptoms of the subjects in both groups improved significantly after treatment compared with those before treatment, and the test group improved significantly more than the control group (P<0.05). In conclusion, Sijunzi Decoction combined with Tongxie Yaofang is effective in the treatment of IBS-D.

Keywords

IBS-D; Tongxie Yaofang; Sijunzi Decoction; Meta-analysis

Cite This Paper

Jiaxin Yan, Yaping Cui, Bozhi Ren. A Meta-Analysis of Modified Sijunzi Decoction Combined with Tongxie Yaofang in the Treatment of IBS-D. Frontiers in Medical Science Research (2023) Vol. 5, Issue 9: 93-103. https://doi.org/10.25236/FMSR.2023.050917.

References

[1] Defrees D N, Bailey J. Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment [J]. Primary Care, 2017, 44(4):655.

[2] Dale H F, Rasmussen S H, zgün mer Asiller, et al. Probiotics in Irritable Bowel Syndrome: An Up-to-Date Systematic Review [J]. Nutrients, 2019, 11(9):2048.

[3] Grundmann O, Yoon S L. Irritable bowel syndrome: epidemiology, diagnosis and treatment: an update for health-care practitioners [J]. Journal of Gastroenterology & Hepatology, 2010, 25(4): 691-699.

[4] Xu Xiaojuan, Liu Liang, Yao Shukun. Nerve growth factor and diarrhea-predominant irritable bowel syndrome (IBS-D): a potential therapeutic target? [J]. Journal of Zhejiang University ENCE B, 2016, 17(1):1-9.

[5] Zhang Fang, et al. Economic burden of irritable bowel syndrome in China [J]. World journal of gastroenterology, 2016, 22(47): 10450-10460.

[6] Dave Nellesen, Kimberly Yee, Anita Chawla, Barbara Edelman Lewis, Robyn T Carson. A Systematic Review of the Economic and Humanistic Burden of Illness in Irritable Bowel Syndrome and Chronic Constipation [J]. Journal of managed care pharmacy: JMCP, 2013, 19(9):755-674.

[7] Harvey R F, Mauad E C, Brown A M. Prognosis in the irritable bowel syndrome: a 5-year prospective study [J]. The Lancet, 1987, 329(8539): 963-965.

[8] Böhn Lena, et al. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life [J]. The American journal of gastroenterology, 2013, 108(5): 634-641.

[9] Mönnikes H. Quality of life in patients with irritable bowel syndrome [J]. Journal of Clinical Gastroenterology, 2011, 45: S98-S101.

[10] Fortea J, Prior M. Irritable bowel syndrome with constipation: a European-focused systematic literature review of disease burden [J]. Journal of medical economics, 2013, 16(3): 329-341.

[11] Muscatello Maria Rosaria A, et al. Personality traits and emotional patterns in irritable bowel syndrome. [J]. World journal of gastroenterology, 2016, 22(28): 6402-6415.

[12] Sugaya Nagisa, Nomura Shinobu, Shimada Hironori. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome [J]. International journal of behavioral medicine, 2012, 19(3): 308-315.

[13] Mei-Fong Wu, Yu-Wen Yang, Yen-Yu Chen. The effect of anxiety and depression on the risk of irritable bowel syndrome in migraine patients [J]. Journal of Clinical Neuroscience, 2017, 44: 342-345.

[14] Lee Changhyun et al. The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis [J]. Journal of neurogastroenterology and motility, 2017, 23(3): 349-362.

[15] Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine [J]. World Journal of Gastroenterology: WJG, 2014, 20(22): 6759.

[16] Katiraei Pejman, Bultron Gilberto. Need for a comprehensive medical approach to the neuro-immuno-gastroenterology of irritable bowel syndrome [J]. World journal of gastroenterology, 2011, 17(23): 2791-2800.

[17] Nee Judy, Zakari Mohammed, Lembo Anthony J. Current and emerging drug options in the treatment of diarrhea predominant irritable bowel syndrome [J]. Expert opinion on pharmacotherapy, 2015, 16(18): 2781-2792.

[18] Talley Nicholas J, Holtmann Gerald, Walker Marjorie M. Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology [J]. Journal of gastroenterology, 2015, 50(6): 601-613.

[19] Bahrami Hamid Reza, et al. Herbal Medicines for the Management of Irritable Bowel Syndrome: A Systematic Review [J]. Electronic physician, 2016, 8(8): 2719-2725.

[20] Zhu Jiajie, et al. Efficacy of Chinese Herbal Medicine for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials [J]. Evidence-based complementary and alternative medicine: eCAM, 2016, 2016: 4071260.

[21] Liu Yang, Yang Junshan, Cai Zongwei. Chemical investigation on Sijunzi decoction and its two major herbs Panax ginseng and Glycyrrhiza uralensis by LC/MS/MS [J]. Journal of Pharmaceutical and Biomedical Analysis, 2006, 41(5): 1642-1647.

[22] Xie Jianhuan, Chu Ruige, Yang Hua. Clinical study of Sijunzi Decoction combined with Tongxie Yaofang in the treatment of diarrheal irritable bowel syndrome and its effect on 5-HT [J]. Health Care Guide, 2020(52):117.

[23] Hao Sheng, Lei He, Jie Xu, et al. Effect of Tongxiyaofang combined with Sijunzi Decoction on inflammatory response in patients with diarrheal irritable bowel syndrome [J]. Journal of Clinical Medical Literature Electronic, 2019, 6(88):26.

[24] B Xu. Clinical study of Tongxie Yaofang combined with Sijunzi Decoction for treating diarrhea with irritable bowel syndrome [J]. World Journal of Clinical Medicine, 2016, 10(23):179.

[25] Yang Weiwu. Study on 60 cases of irritable bowel syndrome with liver-stagnation and spleen-deficiency by traditional Chinese medicine [J]. Journal of Clinical and Experimental Medicine, 2007(01):141.

[26] Wang Gensheng. Treating 40 cases of irritable bowel syndrome with harmonizing liver and spleen combined with psychotherapy [J]. Jilin Chinese Medicine, 2009, 29(02):130-131.

[27] Shi Chenghe. Soothing the liver and strengthening the spleen combined with emotional conditioning in the treatment of 48 cases of diarrheal irritable bowel syndrome [J]. Shanxi Chinese Medicine, 2004(04):14-15.

[28] Li Chunna. Clinical observation on the treatment of 51 cases of diarrheal irritable bowel syndrome with Tongxiyaofang and Sijunzi Decoction combined with massage [J]. Chinese Ethnic and Folk Medicine, 2019, 28(14):121-123.

[29] Liu Shaokang, Wang Qin. Treatment of 67 cases of irritable bowel syndrome (diarrheal type) with Tongxie Yaofang and Sijunzi Decoction [J]. Xinjiang Traditional Chinese Medicine, 2015, 33(04): 35-36.

[30] Zhuo Bingfan, Ning Xiaoyan, Zhang Yanqing. Effect of Tongxieyao Decoction and Sijunzi Decoction on immune function of patients with diarrheal irritable bowel syndrome [J]. Journal of Guangdong Medicine, 2017, 38(23):3669-3671+3675.

[31] Gong Yanchun, Chen Xia. Treating 30 Cases of Diarrhea Type Irritable Bowel Syndrome with Tongxie Yaofang plus Four Noble Drugs Decoction [J]. Journal of Practical Traditional Chinese Internal Medicine, 2011, 25(11):52-54.

[32] Chen Yiliang. Treatment of 35 cases of irritable bowel syndrome (diarrheal type) with Tongxie Yaofang and Sijunzi Decoction [J]. Chinese Medical Forum, 2014, 29(01):39-40.

[33] Wang Yongqing. Clinical study of Tongxie Yaofang combined with Sijunzi Decoction in the treatment of diarrhea with irritable bowel syndrome [J]. Beijing Chinese Medicine, 2014, 33(06): 458-459.

[34] Wen Peiyi, Lai Yong. Treatment of 42 cases of diarrheal irritable bowel syndrome (spleen deficiency and liver-depression syndrome) with Tongxie Yaofang supplemented by Sijunzi decoction [J]. Fujian Traditional Chinese Medicine, 2014, 45(01):30-31.

[35] Yao Kaidong. 92 cases of diarrheal irritable bowel syndrome treated with integrated Chinese and Western medicine [J]. Guangming Chinese Medicine, 2014, 29(11):2361-2362.

[36] Ji Jianghong. Sijunzi Decoction combined with Tongxie Yaofang for the treatment of diarrheal irritable bowel syndrome [J]. Guangming Chinese Medicine, 2015, 30(04):781-782.

[37] Wang Changchun. Treating 35 cases of irritable bowel syndrome with the Tongxie prescription plus the Si Junzi decoction [J]. Clinical Journal of Chinese Medicine, 2015, 7(11):52-53+55.

[38] Chen Tianliang. Clinical study of Tongxiyaofang combined with Sijunzi Decoction in the treatment of irritable bowel syndrome diarrhea [J]. Guangming Chinese Medicine, 2016, 31(05): 681-682.

[39] Qi Zhijuan. Effect of Sijunzi Decoction combined with Tongxie Yaofang on diarrheal irritable bowel syndrome [J]. International Journal of Medicine and Health, 2016, 22(24):3816-3819.

[40] Xue Desheng, Shen Zongjian, Zheng Bin. Treatment of 36 cases of diarrheal irritable bowel syndrome by Sijunzi Decoction combined with Tongxie Yaofang [J]. Frontiers in Medicine, 2016, 6(2):44-45.

[41] Zhang Hongfei. Sijunzi Decoction combined with Tongxie Yaofang for the treatment of diarrheal irritable bowel syndrome [J]. World Latest Medical Information Digest, 2016, 16(95):153.

[42] Liu Shaoxi. Clinical efficacy of Tongxiyaofang combined with Sijunzi Decoction in the treatment of irritable bowel syndrome and its influence on immune function of patients [J]. Journal of Clinical Rational Drug Use, 2019, 12(24):157-159.

[43] Ye Tao, Pan Meizhen, Yang Hongbin. Clinical observation of 40 cases of diarrheal irritable bowel syndrome treated by soothing liver and strengthening spleen [J]. Zhejiang Clinical Medicine, 2019(6):760-762. 

[44] Zhuo Bingfan, Zhang Yanqing, Ning Xiaoyan. Effect of Tongxieyao Decoction combined with Sijunzi Decoction on brain intestinal peptides in patients with diarrheal irritable bowel syndrome [J]. Journal of Nanjing University of Traditional Chinese Medicine, 2019, 35(01):25-28.

[45] Zheng Xiaoyu. Trial implementation of Guiding Principles for Clinical research of New Chinese Medicine [M]. Beijing: China Medical Science and Technology Press, 2002:105-109.