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Meta-Analysis
. 2018 Feb 6;13(2):e0192319.
doi: 10.1371/journal.pone.0192319. eCollection 2018.

Efficacy and safety of Modified Tongxie Yaofang in diarrhea-predominant irritable bowel syndrome management: A meta-analysis of randomized, positive medicine-controlled trials

Yun-Kai Dai  1 , Dan-Yan Li  1 , Yun-Zhan Zhang  1 , Meng-Xin Huang  1 , Yi-le Zhou  1 , Jin-Tong Ye  1 , Qi Wang  2 , Ling Hu  1
Affiliations
Meta-Analysis

Efficacy and safety of Modified Tongxie Yaofang in diarrhea-predominant irritable bowel syndrome management: A meta-analysis of randomized, positive medicine-controlled trials

Yun-Kai Dai et al. PLoS One. .

Abstract

Objective: To systematically evaluate the efficacy and safety of Modified Tongxie Yaofang (M-TXYF) for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D).

Method: Electronic databases including PubMed, Springer Link, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang, and Chinese Scientific Journals Database (VIP) were conducted from their inception through May 11, 2017 without language restrictions. Primary and secondary outcomes were estimated by 95% confidence intervals (CI). RevMan 5.3 and the Cochrane Collaboration's risk of bias tool were analyzed for this meta-analysis.

Results: Twenty-three literatures with a total of 1972 patients were included for the meta-analysis. The overall risk of bias evaluation was low. The pooled odds ratio showed that M-TXYF was significantly superior to routine pharmacotherapies (RP) in clinical therapeutic efficacy (OR 4.04, 95% CI 3.09, 5.27, P < 0.00001, therapeutic gain = 17.6%, number needed to treat (NNT) = 5.7). Moreover, compared with RP, M-TXYF showed that it can significantly reduce the scores of abdominal pain (standardized mean difference (SMD) -1.27; 95% CI -1.99, -0.56; P = 0.0005), abdominal distention (SMD -0.37; 95% CI -0.73, -0.01; P = 0.09), diarrhea (SMD -1.10; 95% CI -1.95, -0.25; P = 0.01), and frequency of defecation (SMD -1.42; 95% CI -2.19, -0.65; P = 0.0003). The differences of the adverse events between experiment and control groups had no statistical significance.

Conclusion: This meta-analysis indicated that M-TXYF could be a promising Chinese herbal formula in treating IBS-D. However, considering the lack of higher quality of randomized controlled trials (RCTs), highly believable evidences should be required.

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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 the process for literature retrieval.
Fig 2
Fig 2
(a) Risk of bias summary. (b) Risk of bias graph.
Fig 3
Fig 3. Forest plot of clinical therapeutic efficacy.
Fig 4
Fig 4. Funnel plot analysis of clinical therapeutic efficacy.
Fig 5
Fig 5. Forest plot of abdominal pain.
Fig 6
Fig 6. Forest plot of abdominal distention.
Fig 7
Fig 7. Forest plot of diarrhea.
Fig 8
Fig 8. Forest plot of frequency of defecation.
See this image and copyright information in PMC

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