A Meta - Analysis Of IBS - D In The Treatment Of Spleen And Spleen And Montmorillonite And Pilbromide

Purpose : To compare the clinical efficacy of Traditional Chinese Medicine( Shuganjianpi) with conventional Western Medicine for diarrhea-predominant irritable bowel syndrome( IBS-D).Material and method: With “Diarrhea-predominant irritable bowel syndrome” and“Shuganjianpi” or “Traditional Chinese Medicine” for the search terms, we searched the VIP Chinese technology periodical database, the Wanfang Data, and the Chinese periodical full text database(CNKI) database to identify the randomized controlled studies about Shugan-jianpi for the treatment of IBS-D, which have published before May 2015. The literature evaluation was used the Jadad score standard, and these meta-analyses were performed by Review Manager 5.2 and State Direct 2.7.8 software. Statistical heterogeneity between studies was assessed using the Cochran Q test and the I2 statistic. According to the statistical heterogeneity choose fixed effects model or random effects model, using the odds ratio(OR)and their 95% confidence interval(CI) said intervention results.Results: According to these search terms, a total of 213 articles were retrieved, and 29 articles conformed to the inclusion criteria, including 2611 patients. The Traditional Chinese Medicine(Shuganjianpi) group included 1426 cases and the simple Western treatment group composed with 1185 cases. There was no statistically significant deference in the baseline data among these studies. According to the Jadad score standard, 3 articles had more than 4points, and 26 articles were of low quality research(<4 points). The meta-analysis outcomes of the Traditional Chinese Medicine(Shuganjianpi) and Western Medicine showed as follows.The therapeutic effectiveness rate was 92%(95%CI: 0.90-0.93) and 69%(95%CI: 0.66-0.71)in Shuganjianpi group and Western Medicine group, respectively. No statistical heterogeneity was identified among the studies(P=0.99, I2=0%). Using a fixed effect model, shuganjianpi group was significantly superior to Western Medicine group(OR=5.28,95% CI: 4.19-6.64),Test Z=14.15, P<0.00001, the difference was statistically significant. The cure rate was30.00%(95%CI: 0.24-0.36) and 16.05%(95%CI: 0.1236-0.2012) in shuganjianpi and conventional Western groups, respectively. No statistical heterogeneity was identified among the studies(P=0.90, I2=0%). Using a fixed effects model, shuganjianpi group was significantly superior to Western medicine group(OR=2.30, 95%CI: 1.85-2.87), Test Z=7.45,P<0.00001, the difference was statistically significant.Conclusion: Shuganjianpi was better than Western conventional therapy for the treatment of IBS-D in terms of therapeutic effectiveness and cure. However, due to the poor quality of the included studies, further high-quality randomized controlled clinical trials should be needed.