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Meta-Analysis
. 2015 Apr 8;10(4):e0122397.
doi: 10.1371/journal.pone.0122397. eCollection 2015.

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

Ya Xiao  1 , Yanyan Liu  2 , Shaohui Huang  3 , Xiaomin Sun  3 , Yang Tang  1 , Jingru Cheng  1 , Tian Wang  1 , Fei Li  1 , Yuxiang Kuang  4 , Ren Luo  1 , Xiaoshan Zhao  3
Affiliations
Meta-Analysis

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

Ya Xiao et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection process.
Fig 2
Fig 2. Risk of bias assessment.
Fig 3
Fig 3
(a) Forest plot of primary outcomes, global symptom improvement with weights from random effects analysis. (b) Sensitivity analysis was performed by omitting one study.
Fig 4
Fig 4. Funnel plot analysis of global symptom improvement (Begg’s test, P = 0.707).
RR, relative risk.
Fig 5
Fig 5
(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.
Fig 6
Fig 6. Funnel plot analysis of overall BSS score (Begg’s test, P = 1.000).
RR, relative risk.
See this image and copyright information in PMC

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