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The efficacy of Shugan Jianpi Zhixie therapy for diarrhea-predominant irritable bowel syndrome: a meta-analysis of randomized, double-blind, placebo-controlled trials.

Xiao Y, Liu Y, Huang S, Sun X, Tang Y, Cheng J, Wang T, Li F, Kuang Y, Luo R, Zhao X - PLoS ONE (2015)

Bottom Line: SJZT was significantly more likely to reduce overall BSS score (SMD -0.67; 95% CI -0.94, -0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo.The adverse events of SJZT were no different from those of placebo.This meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D.

View Article: PubMed Central - PubMed

Affiliation: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.

ABSTRACT

Background: Shugan Jianpi Zhixie therapy (SJZT) has been widely used to treat diarrhea-predominant irritable bowel syndrome (IBS-D), but the results are still controversial. A meta-analysis of randomized, double-blind, placebo-controlled trials was performed to assess the efficacy and tolerability of SJZT for IBS-D.

Methods: The MEDLINE, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database and the Wanfang database were searched up to June 2014 with no language restrictions. Summary estimates, including 95% confidence intervals (CI), were calculated for global symptom improvement, abdominal pain improvement, and Symptom Severity Scale (BSS) score.

Results: Seven trials (N=954) were included. The overall risk of bias assessment was low. SJZT showed significant improvement for global symptom compared to placebo (RR 1.61; 95% CI 1.24, 2.10; P =0.0004; therapeutic gain = 33.0%; number needed to treat (NNT) = 3.0). SJZT was significantly more likely to reduce overall BSS score (SMD -0.67; 95% CI -0.94, -0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo. The adverse events of SJZT were no different from those of placebo.

Conclusions: This meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.

No MeSH data available.


Related in: MedlinePlus

(a) Forest plot of secondary outcomes, overall BSS score with weights from fixed effects analysis. (b) Forest plot of secondary outcomes, abdominal pain improvement with weights from fixed effects analysis.
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pone.0122397.g005: (a) Forest plot of secondary outcomes, overall BSS score with weights from fixed effects analysis. (b) Forest plot of secondary outcomes, abdominal pain improvement with weights from fixed effects analysis.

Mentions: Four of seven studies used BSS to assess the severity of IBS symptoms [15,16,18,19]. SJZT reduced the overall BSS score compared with placebo (SMD—0.67; 95% CI—0.94, –0.40; P<0.00001) (Fig 5a). No substantial heterogeneity was found (P = 0.39, I2 = 0.0%). Funnel plot analysis demonstrated no evidence of publication bias (Begg’s test, P = 1.000) (Fig 6).


The efficacy of Shugan Jianpi Zhixie therapy for diarrhea-predominant irritable bowel syndrome: a meta-analysis of randomized, double-blind, placebo-controlled trials.

Xiao Y, Liu Y, Huang S, Sun X, Tang Y, Cheng J, Wang T, Li F, Kuang Y, Luo R, Zhao X - PLoS ONE (2015)

(a) Forest plot of secondary outcomes, overall BSS score with weights from fixed effects analysis. (b) Forest plot of secondary outcomes, abdominal pain improvement with weights from fixed effects analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4390216&req=5

pone.0122397.g005: (a) Forest plot of secondary outcomes, overall BSS score with weights from fixed effects analysis. (b) Forest plot of secondary outcomes, abdominal pain improvement with weights from fixed effects analysis.
Mentions: Four of seven studies used BSS to assess the severity of IBS symptoms [15,16,18,19]. SJZT reduced the overall BSS score compared with placebo (SMD—0.67; 95% CI—0.94, –0.40; P<0.00001) (Fig 5a). No substantial heterogeneity was found (P = 0.39, I2 = 0.0%). Funnel plot analysis demonstrated no evidence of publication bias (Begg’s test, P = 1.000) (Fig 6).

Bottom Line: SJZT was significantly more likely to reduce overall BSS score (SMD -0.67; 95% CI -0.94, -0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo.The adverse events of SJZT were no different from those of placebo.This meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D.

View Article: PubMed Central - PubMed

Affiliation: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.

ABSTRACT

Background: Shugan Jianpi Zhixie therapy (SJZT) has been widely used to treat diarrhea-predominant irritable bowel syndrome (IBS-D), but the results are still controversial. A meta-analysis of randomized, double-blind, placebo-controlled trials was performed to assess the efficacy and tolerability of SJZT for IBS-D.

Methods: The MEDLINE, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database and the Wanfang database were searched up to June 2014 with no language restrictions. Summary estimates, including 95% confidence intervals (CI), were calculated for global symptom improvement, abdominal pain improvement, and Symptom Severity Scale (BSS) score.

Results: Seven trials (N=954) were included. The overall risk of bias assessment was low. SJZT showed significant improvement for global symptom compared to placebo (RR 1.61; 95% CI 1.24, 2.10; P =0.0004; therapeutic gain = 33.0%; number needed to treat (NNT) = 3.0). SJZT was significantly more likely to reduce overall BSS score (SMD -0.67; 95% CI -0.94, -0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo. The adverse events of SJZT were no different from those of placebo.

Conclusions: This meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.

No MeSH data available.


Related in: MedlinePlus