Objective To evaluate the efficacy and safety of Tongxiening granule （TXNG） in the treatment of diarrhea-predominant irritable bowel syndrome （IBS） （stagnation of the liver-qi attacking the spleen）. Methods In a prospective, randomized, placebo-controlled, double-blind clinical trial, 60 patients with diarrhea-predominant IBS were randomly divided into the TXNG group （TXNG, 5.0g, 3 times daily; n =30） and the placebo group （placebo, 5. 0g, 3 times daily; n =30）. The treatment was administered for 3 weeks, and the follow-up was conducted for 4 weeks.Results （1）Abdominal pain： The cure rates were 57. 7% vs. 16. 0% （ by per-protocol analysis, PP） and 31.0% vs. 7.1% （ by intention-to-treat analysis （ITT） ; and the overall improvement rates were 92.3% vs. 44.0% （PP） and 82.7% vs. 39.3% （ITT） in the TXNG and the placebo groups respectively （ P 〈0. 05）. （2） Diarrhea ： the cure rates were 46. 2% vs. 20. 0% （PP） and 41.4% vs. 17. 9% （ITT） , and the overall improvement rates were 96. 2% vs 48. 0% （PP） and 86. 2% vs 42.9% （ITT） in the two groups respectively （P 〈0.05）. （3）Traditional Chinese medicine symptoms： the cure rates were 30.8% vs. 4.0% （PP） and 27.6% vs. 3.6% （ITT） ; and the overall improevment rates were 92.3% vs. 48.0% （PP） and 82.7% vs 42.9% （ITT） in the two groups respectively （P 〈0. 05）. The pain duration after treatment in the TXNG group was significantly shortened compared with the placebo group （7.6 ±4. 6d vs 14. 4 ±4. 3d, P =0. 0125）. After 4-week follow-up, it suggested that the recrudescent duration in symptoms related to IBS in the TXNG group was longer than that in the placebo group （11.5 ±5.3 d vs 6.2 ±6.9 d, P = 0. 019）. No adverse effects were found in the TXNG group. Conclusion It was demonstrated that TXNG is effective and safe in the treatment of diarrhea-predominant ms （stagnation of the liver-qi attacking the spleen）.
Objective To evaluate the efficacy and safety of rifaximin in the treatment of irritable bowel syndrome (IBS). Methods The computer system was used to retrieve PubMed, Embase, Web of Science, Cochrane Library, SinoMed, China National Knowledge Infrastructure, Wanfang and Chongqing VIP databases, and the randomized controlled trials of rifaximin for IBS published before November 30, 2022 were retrieved. The data were meta-analysed using RevMan 5.1 and Stata 12.0 softwares. Results Finally, 8 studies including 5176 patients were included. Meta-analysis results showed that the overall effective rate [relative risk (RR)=1.40, 95% confidence interval (CI) (1.21, 1.62), P<0.00001], abdominal pain relief rate [RR=1.21, 95%CI (1.12, 1.32), P<0.00001], abdominal distension relief rate [RR=1.28, 95%CI (1.15, 1.41), P<0.00001], and stool character improvement rate [RR=1.20, 95%CI (1.10, 1.32), P<0.0001] of rifaximin in the treatment of IBS were better than those of the control group. There was no significant difference in the incidence of adverse reactions (P>0.05). Conclusion Rifaximin can effectively improve the abdominal pain, abdominal distension and stool characteristics of IBS patients, and it is safe and reliable.
目的:观察帕罗西汀治疗非便秘型肠易激综合征的临床疗效。方法:符合罗马Ⅲ诊断标准的非便秘型肠易激综合征患者107例,随机分为2组,治疗组57例,给予帕罗西汀20 mg,每日晨起顿服,匹维溴铵50 mg,3次/d,口服;对照组50例,给予谷维素30 mg, 3次/d,口服,匹维溴铵50 mg,3次/d,口服,疗程4周。观察患者腹痛、腹泻、腹部不适、排便次数、大便性状,以及焦虑、抑郁等改善情况。结果:治疗组总有效率为930%,对照组总有效率为760%,两组比较差异有统计学意义(Plt;001)。结论:帕罗西汀治疗非便秘型肠易激综合征有明确的临床意义。
ObjectiveTo systematically review the correlation between acute gastrointestinal infection and IBS. MethodsLiterature search was performed in The Cochrane Library (Issue 8, 2013), PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data to collect the prospective cohort studies about association between acute gastrointestinal infection and IBS, from inception to August 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality using NOS, and then Meta analysis was conducted using RevMan 5.2 software. ResultsA total of 11 cohort studies involving 6 274 patients were included. According to the different follow-up times for subgroup analysis, the results of meta-analysis showed that, compared with the healthy volunteers who did not expose the acute gastrointestinal infection, the patients with acute gastroenteritis had a increase risk of irritable bowel syndrome within 3 months, 6 months, 12 months, and 2-3 years (3 months: RR=6.46, 95%CI 1.85 to 22.58, P=0.003; 6 months: RR=4.68, 95%CI 2.07 to 10.60, P=0.000 2; 12 months: RR=4.95, 95%CI 2.90 to 8.45, P < 0.000 01; 2-3 years: RR=3.11, 95%CI 2.72 to 3.56, P < 0.000 01). However, after the fifth year of acute gastroenteritis, there was no statistical significance in the risk of irritable bowel syndrome between the two groups (RR=1.69, 95%CI 0.68 to 4.24, P=0.26). ConclusionAcute gastrointestinal infection within 3 years after onset was associated with the risk of IBS. Sex, diarrhea duration, bloody purulent stools and abdominal cramps at acute stage are important risk factors of intriguing the occurrence of post-infectious IBS. The acute gastrointestinal infection and IBS are not associated in the fifth year; however, more high-quality trials are needed for further verifying the aforementioned conclusion.
Objective To provide best available evidence for clinical practice and further research planning on IBS treatment, we reviewed systematically all the randomised controlled trials on calcium channel blockers for irritable bowel syndrome. The primary objective was to determine whether there was enough evidence that calcium channel blocker was effective and safe in the treatment of patients with IBS. Method Searches were performed in Trials Register of the Cochrane Complementary Medicine Field, data from the pharmaceutical company were also retrieved. In addition we searched the electronic bibliographic databases: Cochrane Controlled Trials Register, Medline, Embase, Chinese Biological Medical Database (CBM-disc). We handsearched some important Chinese journals. Two reviewers included studies, assessed the quality of studies and extracted data independently. Disagreement was resolved by discussion or the third party when needed. The following primary outcomes were assessed: ① Effective rate at the end of experiment, ② Improvmemnt in abodeminal pain and distention, ③ Adverse events. Results 49 potentially eligible trials were identified, of which 9 trials (831 patients) were included. 8 trials were waiting for assessment. The mean percentage of patients with global improvement was 48.9% in control group and 75% in the calcium channel blockers group. In favour of calcium group with a mean OR 4.54, 95%CI (2.38, 8.66). Conclusions Selective calcium channel blockers might be effective and safe in the treatment of patients with IBS.Because the methodological quality of all included studies was poor,further high-quality randomised controlled trials should be performed.
ObjectiveTo systematically review the efficacy and safety of selective calcium channel blockers (SCCBs) versus placebo for irritable bowel syndrome (IBS) patients. MethodsWe searched databases including PubMed, EMbase, the Cochrane Library, CBM, WanFang Data, VIP and CNKI for relevant randomized controlled trials (RCTs) of SCCB versus placebo for IBS patients from inception to August, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software. ResultsA total of 12 RCTs involving 1 325 patients were included. The results of meta-analysis showed that: The total effective rate (RR=2.06, 95%CI 1.56 to 2.73, P<0.000 01, NNT=3), abdominal pain remission rate (RR=1.47, 95%CI 1.31 to 1.65, P<0.000 01, NNT=5), and abdominal distension remission rate (RR=1.48, 95%CI 1.10 to 2.00, P=0.01, NNT=5) in the SCCB group were significantly higher than those in the placebo group. The adverse reaction rate of the SCCB group was also significantly higher than that of the placebo group (RD=3%, 95%CI 2% to 4%, P=0.002), but all adverse reactions of the SCCB group were minor. Subgroup analysis based on different SCCBs showed that there were no significant differences between the otilonium bromide subgroup and the pinaverium bromide subgroup in above outcomes (all P values >0.05). ConclusionCurrent evidence shows that SCCBs can improve the symptoms of IBS with minor side-effects. Due to limited quality and quantity of included studies, more large-scale high-quality studies are needed to verify the above conclusion.
Objective To compare the clinical therapeutic effect of probiotic agents in treating irritable bowel syndrome (IBS) by Meta-analysis. Methods Such databases as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese Biomedical Literature Database were searched from January 2001 to October 2011, and the domestic conference proceedings and relevant papers published in recent 1 year were also searched manually. All domestic randomized controlled trials (RCTs) on probiotic agents in treating irritable bowel syndrome (IBS) were collected, which were then selected according to the inclusion and exclusion criteria. The data were extracted, the methodological quality of the included studies was assessed, and the Meta-analysis was performed with Revman5.0. Results A total of 11 RCTs involving 1 065 patients were included. The total effective rate of the probiotic agents plus conventional treatment group was superior to that of the conventional treatment (trimebutine meleate/ pinaverium bromide) group (RR=1.26, 95%CI 1.18 to 1.34, Plt;0.000 01), it could effectively relieve abdominal pain (RR=1.10, 95%CI 1.03 to 1.18, P=0.004) and diarrhea (RR=1.15, 95%CI 1.07 to 1.24, P=0.000 3). But there was no significant difference between the two groups in alleviating abdominal distention (RR=1.08, 95%CI 0.95 to 1.24, P=0.25). The effectiveness of probiotic agents used alone was similar to that of the conventional treatment used alone, without significant differences (RR=0.85, 95%CI 0.66 to 1.09, P=0.19). Conclusion Probiotic agents combined with conventional drugs can improve the total therapeutic effect of IBS, especially in alleviating abdominal pain, diarrhea and so on. But the effectiveness of probiotic agents used alone is similar to that of the conventional treatment used alone. For the possibility of bias due to the lower quality of the included studies and unclear implementation of RCTs, this conclusion should be verified with more large-scale and high-quality RCTs.
Objective To evaluate the efficacy of probiotics for treating irritable bowel syndrome (IBS). Methods The following databases as PubMed, The Cochrane Library, Web of Science, EMbase, MD Consult, CNKI, CBM and WanFang Data were searched from the data of their establishment to June 2011 to collect the randomized controlled trials (RCTs) on probiotics for treating IBS. The data were extracted and cross-checked independently by two reviewers, the methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria, and Meta-analysis was conducted using RevMan 5.1 software. Results A total of 20 RCTs involving 1 713 patients were included. Results of meta-analyses showed that compared with the placebo, probiotics was statistically and significantly better in improving the overall symptoms, alleviating abdominal pain/discomfort and relieving abdominal distention. Conlusion Current evidence shows probiotics may play a role in improving the symptoms of IBS. Due to a lot of differences existing among the included studies in aspects of methodological quality, diagnostic criteria, evaluation methods, dosage and course of treatment, this conclusion should be further tested with more strictly-designed and high-quality RCTs.