Objective: Irritable bowel syndrome (IBS) is a common problem, but treatment is unsatisfactory.
Although Chinese herbal medicines have been tried, there are limited data to support their usage. The authors set out to systematically review the effectiveness of the Chinese herbal medicine TongXieYaoFang (TXYF) and TXYF with different Chinese herbal additions (TXYF-A) in the management of IBS in order to make evidence-based recommendations.
Methods: The authors searched the literature to identify randomized trials of TXYF or TXYF-A for patients with IBS by using MEDLINE,® EMBASE, the Cochrane Controlled Trials Register (CCTR), the Cochrane Complementary Medicine Fields Specialized Register from 1966 to 2004, the CMB Disc database from January 1978 to December 1988, and the Full Text Chinese Journal database from January 1994 to December 2004. Standard forms regarding study design, treatment course, outcome measures, and adverse events were used to abstract data. Studies were assigned a quality score based on published methodology. Relative risk (RR) and 95% confidence interval (CI) were analysed.
Results: Twelve studies (n _ 1125) that met the criteria for review were identified. There was heterogeneity in the studies with regard to herbal formulas, control medicine, treatment course, and outcome measurement. The quality of all studies was low. The pooled analyses of effectiveness for the near-term (immediately after finishing the treatment course), short-term (3 months after finishing the treatment course), and long-term (6 months or more after finishing the treatment course) effectiveness showed that the effect of TXYF-A was better than that of conventional medicine in four, two, and six studies, respectively. The RRs were 1.34 (95% CI 1.16–1.54, p _ 0.05), 1.39 (95% CI 1.17–1.64, p _ 0.05), and 1.34 (95% CI 1.12–1.61, p _ 0.05), respectively. Overall, combining all data from the 12 studies, the effectiveness of TXYF-As was higher than that in control groups, with statistical significance and RR of 1.35 (95% CI 1.21–1.50, p _ 0.05).
Conclusions: There is evidence to indicate the potential usefulness of TXYF-A for IBS patients. The results were limited by the poor quality and heterogeneity of these studies. Further studies with carefully designed, randomized double-blinded placebo-controlled trials will be needed to confirm the effectiveness of TXYF or TXYF-A for IBS.
Medical Condition
The Characteristics of Irritable Bowel Syndrome (IBS) are abdominal pain , which often occurs before needing to evacuate the bowels, alternating diarrhea and constipation. In IBS suffers Inflammation has been present in the small intestine and colon tract and it is now proven stress does worsen symptoms. It is believer that 20% of population have IBS! Despite this surprising statistic there is no cure or no medication that provides continuous relief from the pain and gut disharmony. In TCM there are hundreds of formulas designed to treat condition involving the lower digestive tract. This review looked at twelve clinical studies of an ancient formula called TongXieYaoFang.
More about Treatment and Study
TongXieYaoFang is commonly used for treating IBS. It contains Bai Zhu (Atractlyodis Macrocephalae) , Bai Shao (Radix paeoniae alba), Chen Pi (percarpium citri reticulatae) , Fang Feng (radix saposhnikoviae).
However all of the studies included in the analysis modified this base formula adding additional herbs. This means there is no consistent formula across the studies.
In this study it says the main pattern associated with IBS is liver insulting spleen. In TCM each pattern has a list of key symptoms. Once a practitioner determines the main pattern, or patterns, a suitable formula can be chosen. The practitioner can then add other herbs to tackle other symptoms providing these additional herb are not contraindicated to any herbs in the base formula.
This approach is a challenge for clinical trials because when you do systemic analysis you have no consistency across trials,which will never satisfy the current medical trial standards that define high quality trials.
Source: Effectiveness of the Chinese Herbal Formula TongXieYaoFang for Irritable Bowel Syndrome: A Systematic Review
ZHAOXIANG BIAN, Ph.D.,1 TAIXIANG WU, M.D.,2 LIANG LIU, Ph.D.,1 JIANGXIA MIAO, M.D.,3 HONFAT WONG B.Sc.,1 LISA SONG M.Sc.,1 and JOSEPH J.Y. SUNG, Ph.D., MD.4