Zhou Yuhong, Han Shutang, He Yamin
Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China.
Department of Digestive endoscopy, Jiangsu Province Hospital of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China.
Evid Based Complement Alternat Med. 2019 Jan 6;2019:4893876. doi: 10.1155/2019/4893876. eCollection 2019.
Tongxieyaofang (TXYF), a prescription originated from traditional Chinese medicine (TCM), has been widely used on treating Diarrhea Predominant Irritable Bowel Syndrome (IBS-D). The purpose of this meta-analysis was to investigate whether TXYF was effective and safe for IBS-D. We searched seven electronic databases including CENTRAL, MEDLINE, PubMed, CNKI, VIP, CBM, and Wanfang Data up to 26 July 2017. Randomized controlled trails (RCTs) were eligible, regardless of blinding. Risk of bias of included trials was evaluated according to the Cochrane Handbook. The total number of participants analyzed in the meta-analysis was 3062, of which 1556 received TXYF, while 1506 received ordinary treatment. The primary outcome was clinical effective rate. Compared with conventional medication which included probiotics, pinaverium bromide, trimebutine, and Oryzanol, TXYF significantly improved the clinical effective rate (n=37, OR: 4.61; 95% CI: 3.67-5.78; P < 0.00001) and decreased the adverse events (n=10, OR: 0.26; 95% CI: 0.08-0.86; P = 0.03). There was not significant association with the score of abdominal pain, defecating frequency, fecal property, and total symptom. We suggested a moderate recommendation for TXYF on IBS-D, due to the fact that the risk of bias of the finally included trails was not high. Considering that all identified studies were not of high qualities and large samples, further rigorously designed and large scale RCTs were necessary to improve the applicability of our study results.
痛泻要方（TXYF）是源自中医的一种方剂，已被广泛用于治疗腹泻型肠易激综合征（IBS - D）。本荟萃分析的目的是研究痛泻要方对腹泻型肠易激综合征是否有效和安全。我们检索了截至2017年7月26日的七个电子数据库，包括CENTRAL、MEDLINE、PubMed、中国知网（CNKI）、维普资讯（VIP）、中国生物医学文献数据库（CBM）和万方数据。纳入随机对照试验（RCT），无论是否采用盲法。根据Cochrane手册评估纳入试验的偏倚风险。荟萃分析中分析的参与者总数为3062人，其中1556人接受痛泻要方治疗，1506人接受常规治疗。主要结局是临床有效率。与包括益生菌、匹维溴铵、曲美布汀和谷维素在内的传统药物相比，痛泻要方显著提高了临床有效率（n = 37，OR：4.61；95%CI：3.67 - 5.78；P < 0.00001）并减少了不良事件（n = 10，OR：0.26；95%CI：0.08 - 0.86；P = 0.03）。与腹痛评分、排便频率、粪便性状和总症状无显著关联。由于最终纳入试验的偏倚风险不高，我们对痛泻要方治疗腹泻型肠易激综合征提出中度推荐。鉴于所有纳入研究质量不高且样本量不大，需要进一步进行严格设计的大规模随机对照试验以提高我们研究结果的适用性。
