Li Chun-Yan, Ain Mohd Tahir Nurul, Li Shu-Chuen
Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, P. R. China.
Am J Chin Med. 2015;43(3):385-406. doi: 10.1142/S0192415X15500251. Epub 2015 Apr 27.
Traditional Chinese medicine (TCM) has been commonly used by Chinese practitioners to treat irritable bowel syndrome (IBS). However, the effectiveness of combining TCM with Western medicine in managing IBS has not been evaluated systematically. In this study, we evaluated the clinical effectiveness of combining TCM and Western medicine in the treatment of IBS via meta-analyses. We reviewed 72 eligible randomized controlled trials from January 2009 to December 2013 investigating the effectiveness of integrated TCM and Western medicine in the management of IBS. In the meta-analyses, the relative risks (RRs) and 95% confidence interval (95%CI) were calculated using raw data from each study, and low heterogeneity was detected. When compared to the Western medicine treatment alone, our result showed TCM combined with Western interventions significantly improved IBS global symptoms (RR, 1.21; 95%CI: 1.18-1.24). Additionally, there was no significant difference in therapeutic effects of the integrated approach in the meta-analyses involving the various IBS subtypes. Likewise, both Chinese proprietary herbal medicine plus conventional treatment and compound herbal preparations plus conventional treatment showed similar and statistically significant effects on global improvement compared with western treatment alone, with RRs of 1.22 (95%CI: 1.14-1.30) and 1.22 (95%CI: 1.18-1.27), respectively. These results demonstrated that treating IBS with integrated traditional Chinese and Western medicines showed better effectiveness than conventional Western medicine alone. Although due to the quality of the included studies, our results might possess a high risk of bias. TCM, particularly Chinese proprietary medicine, with the benefits of low-cost, easy to use, and good palatability, would be an attractive option to be used in conjunction with conventional Western medicine to manage IBS patients.
中医从业者常用传统中医（TCM）治疗肠易激综合征（IBS）。然而，中西医结合治疗IBS的有效性尚未得到系统评估。在本研究中，我们通过荟萃分析评估了中西医结合治疗IBS的临床疗效。我们回顾了2009年1月至2013年12月期间72项符合条件的随机对照试验，这些试验调查了中西医结合治疗IBS的有效性。在荟萃分析中，使用每项研究的原始数据计算相对风险（RRs）和95%置信区间（95%CI），并检测到低异质性。与单纯西医治疗相比，我们的结果显示，中医结合西医干预显著改善了IBS的整体症状（RR，1.21；95%CI：1.18 - 1.24）。此外，在涉及各种IBS亚型的荟萃分析中，综合治疗方法的治疗效果没有显著差异。同样，中成药加常规治疗和复方草药制剂加常规治疗与单纯西医治疗相比，在整体改善方面均显示出相似且具有统计学意义的效果，RR分别为1.22（95%CI：1.14 - 1.30）和1.22（95%CI：1.18 - 1.27）。这些结果表明，中西医结合治疗IBS比单纯传统西医治疗显示出更好的疗效。尽管由于纳入研究的质量问题，我们的结果可能存在较高的偏倚风险。中医，特别是中成药，具有成本低、使用方便和口感好等优点，将是与传统西医联合用于管理IBS患者的一个有吸引力的选择。
