Systematic review and meta-analysis of Chinese herbal formula Tongxie Yaofang for diarrhea-predominant irritable bowel syndrome: Evidence for clinical practice and future trials.

Journal article

Liang, S-B., Cao, H-J., Kong, L-Y., Wei, J-L., Robinson, ., Yang, S-H., Zhu, S-J., Li, Y-Q., Fei, Y-T., Han, M. and Liu, J-P. (2022). Systematic review and meta-analysis of Chinese herbal formula Tongxie Yaofang for diarrhea-predominant irritable bowel syndrome: Evidence for clinical practice and future trials. Frontiers in Pharmacology. 13, p. 904657. https://doi.org/10.3389/fphar.2022.904657
AuthorsLiang, S-B., Cao, H-J., Kong, L-Y., Wei, J-L., Robinson, ., Yang, S-H., Zhu, S-J., Li, Y-Q., Fei, Y-T., Han, M. and Liu, J-P.
Abstract Diarrhea-predominant irritable bowel syndrome (IBS-D) significantly decreases the quality of life of patients and their families, and affects patients' mental health. No specific western medications are available. Ancient classical Chinese medical texts have recognized Tongxie Yaofang (TXYF) as a therapy for diarrhea which is widely used in clinical practice. Standard TXYF prescription (S-TXYF) is composed of four herbal medicines: Koidz. [Asteraceae; .], Paeonia lactiflora Pall. [Ranunculaceae; Paeoniae Radix Alba], Citrus × aurantium L. [Rutaceae; Citri Reticulatae Pericarpium] and Saposhnikovia divaricata (Turcz. ex Ledeb.) Schischk. [Umbelliferae ]. This review aimed to evaluate the therapeutic effects and safety of S-TXYF for IBS-D. Eight English and Chinese electronic databases were searched from their inception to 25 December 2021 for randomized controlled trials (RCTs) comparing S-TXYF with placebo, western medications or no treatment for IBS-D. The primary outcome was the global improvement of IBS-D symptoms. Data were analyzed using Cochrane's Revman 5.4 software. Evidence certainty was assessed using the online GRADEpro tool for the primary outcome. Eleven RCTs involving 985 adults with IBS-D were included. For global improvement of symptoms, S-TXYF was superior to western medication and placebo (moderate evidence by GRADE). Regarding the improvement of stool consistency, stool frequency and abdominal pain, S-TXYF was significantly effective than placebo. In addition, S-TXYF was superior to western medication on improving the quality of life and relieving anxiety. Six trials reported adverse events: five of them reported (non-serious) adverse events occurred in both groups, and one trial reported that 3 cases with adverse events (constipation, elevation in liver-enzyme, nausea) occurred in S-TXYF group and 3 cases with adverse events (abdominal distension, nausea) occurred in placebo group. Although current results showed that S-TXYF may have potential to treat IBS-D and its use appears to be safe, no a clear and confirmed conclusion can be drawn from our review as the overall inadequate design of the included trials reviewed. So more rigorous trials are warranted to establish confirmed evidence on its benefits and safety. [Abstract copyright: Copyright © 2022 Liang, Cao, Kong, Wei, Robinson, Yang, Zhu, Li, Fei, Han and Liu.]
Keywordssystematic review; irritable bowel syndrome; tongxie yaofang; randomized controlled trial; Chinese herbal formula; meta-analysis
Year2022
JournalFrontiers in Pharmacology
Journal citation13, p. 904657
PublisherFrontiers Media
ISSN1663-9812
Digital Object Identifier (DOI)https://doi.org/10.3389/fphar.2022.904657
https://doi.org/904657
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Online25 Aug 2022
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Accepted19 Jul 2022
Deposited27 Sep 2022
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Zanardelli, I and Robinson, N. (2018). Factors that influence patients’ decisions to discontinue with an acupuncture service—A qualitative study. European Journal of Integrative Medicine. 25, pp. 92-99. https://doi.org/10.1016/j.eujim.2018.12.004
If music be the food of life – play on ?
Bonde, LO and Robinson, N. (2017). If music be the food of life – play on ? European Journal of Integrative Medicine. 9 (1).
Women’s health and Chinese integrative medicine
Qu, F, Wang, FF, Robinson, N. and Hardiman, P (2017). Women’s health and Chinese integrative medicine. Journal of Zhejiang University: Science B. 18 (3), pp. 183-185. https://doi.org/10.1631/jzus.B17ed001
TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY
Qu, F, Wang, F-F, Wu, Y, Zhou, J, Robinson, N., Hardiman, P, Pan, J-X, He, Y-J, Zhu, Y-H, Wang, H-Z, Ye, X-Q, He, K-L, Cui, L, Zhao, H-L and Ye, Y-H (2017). TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION IMPROVES THE OUTCOMES OF IN VITRO FERTILIZATION: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY. Explore: The Journal of Science & Healing. 13 (5), pp. 306-312. https://doi.org/10.1016/j.explore.2017.06.004
The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis
Qu, F., Yan, W., Hu, X-Y., Barry, J.A., Zhou, J., Wang, F-F., Ye, Y-H., Han, S-P., Li, R., Taw, M.B., Hardiman, P.J. and Robinson, N. (2016). The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine. 8 (1), pp. 12-18. https://doi.org/10.1016/j.eujim.2016.02.001
The role of complementary and alternative medicine (CAM) in sexual and reproductive health
Qidwai, W, Wong, W, Nanji, K and Robinson, N. (2016). The role of complementary and alternative medicine (CAM) in sexual and reproductive health. European Journal of Integrative Medicine. 8 (1), pp. 1-3. https://doi.org/10.1016/j.eujim.2016.02.003
The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare?
Robinson, N. (2016). The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare? World Journal of Traditional Chinese Medicine. 2 (1), pp. 74 - 79. https://doi.org/10.15806/j.issn.2311-8571.2015.0029
Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group
Kingsbury, SR, Corp, N, Watt, FE, Felson, DT, O'Neill, TW, Holt, CA, Jones, RK, Conaghan, PG, Arden, NK, Adams, J, Appleyard, I, Birrell, F, Blank, M, Callaghan, MJ, Cumming, J, Chapman, GJ, Halstead, J, Hamilton, DF, Hurley, M, Martin, K, Mason, DJ, Nuki, G, Redmond, AC, Reilly, K, Robinson, N., Roddy, E, Simpson, H, Smith, TO, Thomas, C, Thomas, E, Wilkinson, J and Wise, E (2016). Harmonising data collection from osteoarthritis studies to enable stratification: Recommendations on core data collection from an Arthritis Research UK clinical studies group. Rheumatology (United Kingdom). 55 (8), pp. 1394-1402. https://doi.org/10.1093/rheumatology/kew201
Introducing “Evidence for clinical practice” [Editorial]
Alper, BS, Malone-Moses, M, Manheimer, EW and Robinson, N. (2016). Introducing “Evidence for clinical practice” [Editorial]. European Journal of Integrative Medicine. 8 (3), pp. 147-149. https://doi.org/10.1016/j.eujim.2016.04.008
Pediatric integrative medicine needs research evidence to guide decision-making
Gardiner, P and Robinson, N. (2016). Pediatric integrative medicine needs research evidence to guide decision-making. European Journal of Integrative Medicine. 8 (2), pp. 79 - 80. https://doi.org/10.1016/j.eujim.2016.03.015
Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial
Ley, C., NI, Q, Liao, X, Gao, H-L and Robinson, N. (2016). Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial. Chinese Journal of Integrative Medicine. 22 (10), pp. 728-737. https://doi.org/10.1007/s11655-016-2521-2
General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study
Czarnawska-Iliev, I and Robinson, N. (2016). General Practitioners’ use of and attitudes to acupuncture in relation to the UK’s National Institute for Health and Care Excellence (NICE) clinical guidelines—A pilot study. European Journal of Integrative Medicine. 8 (4). https://doi.org/10.1016/j.eujim.2016.07.004
Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]
Hopper Koppelman, M, Bovey, M and Robinson, N. (2016). Evidence is in the Eye of the Beholder: The case of the 2016 draft NICE Guidelines for Low Back Pain [editorial]. European Journal of Integrative Medicine. 8 (4).
Common mistakes when using plant names and how to avoid them
Dauncey, EA, Irving, J, Allkin, R and Robinson, N. (2016). Common mistakes when using plant names and how to avoid them. European Journal of Integrative Medicine. 8 (5), pp. 597-601. https://doi.org/10.1016/j.eujim.2016.09.005
Integrating acupuncture: are there positive health outcomes for women?
Robinson, N. (2016). Integrating acupuncture: are there positive health outcomes for women? Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology). 18 (3), pp. 233-238. https://doi.org/10.1631/jzus.B1600260
Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis.
Ren, J, Xun, Li, Sun,, J, Han, M, Yang, G-Y., Li, W-Y., Robinson, N. and Lewith, G. (2015). Is traditional Chinese medicine recommended in Western medicine clinicalpractice guidelines in China? A systematic analysis. BMJ Open. 5 (6), pp. e006572-e006572. https://doi.org/10.1136/bmjopen-2014-006572
Traditional Chinese Medicine - challenges for research
Robinson, N. (2015). Traditional Chinese Medicine - challenges for research. in: McCarthy, P.W. and Langweiler, M. (ed.) Methodologies for Effectively Assessing Complementary and Alternative Medicine (CAM) London Singing Dragon.
Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study
Trevelyan, EG, Turner, WA, Summerfield-Mann, L and Robinson, N. (2015). Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study. Trials. 16, p. 158. https://doi.org/10.1186/s13063-015-0668-3
The politics of integrative medicine: The case of CAM
Saks, M and Robinson, N. (2015). The politics of integrative medicine: The case of CAM. European Journal of Integrative Medicine. 7 (6), pp. 557-560. https://doi.org/10.1016/j.eujim.2015.11.019
GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine
Shang, H, Zhang, B, Bian, Z, Li, Y, Clarke, M and Robinson, N (2014). GAP: From sound design to practical implementation in clinical trials for traditional chinese medicine. Evidence-based Complementary and Alternative Medicine. 2014, pp. 1-2. https://doi.org/10.1155/2014/560838
The quest for modernisation of traditional Chinese medicine
Xu, Q, Bauer, R, Hendry, BM, Fan, TP, Zhao, Z, Duez, P, Simmonds, MSJ, Witt, CM, Lu, A, Robinson, N, Guo, DA and Hylands, PJ (2013). The quest for modernisation of traditional Chinese medicine. BMC Complementary and Alternative Medicine. 13 (1), pp. 132-. https://doi.org/10.1186/1472-6882-13-132
A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy.
Franconi, G, Manni, L, Schröder, S, Marchetti, P and Robinson, N. (2013). A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evidence-Based Complementary and Alternative Medicine (eCAM). 2013, p. 516916. https://doi.org/10.1155/2013/516916
The evidence for Shiatsu: A systematic review of Shiatsu and acupressure
Robinson, N, Lorenc, A and Liao, X (2011). The evidence for Shiatsu: A systematic review of Shiatsu and acupressure. BMC Complementary and Alternative Medicine. 11 (1), pp. 88-. https://doi.org/10.1186/1472-6882-11-88
The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom
Robinson, N and Lewith, G (2011). The RCCM 2009 survey: Mapping doctoral and postdoctoral CAM research in the United Kingdom. Evidence-based Complementary and Alternative Medicine. 2011, pp. 1-4. https://doi.org/10.1093/ecam/nep184
How parents choose to use CAM: A systematic review of theoretical models
Lorenc, A, Ilan-Clarke, Y, Robinson, N and Blair, M (2009). How parents choose to use CAM: A systematic review of theoretical models. BMC Complementary and Alternative Medicine. 9 (1), pp. 9-. https://doi.org/10.1186/1472-6882-9-9