Efficacy of Tongxie Yaofang compared with pinaverium bromide on irritable bowel syndrome with liver depression and spleen deficiency: a systematic review and Meta-analysis.

OBJECTIVE

To compare the efficacy of Tongxie Yaofang (, TXYF) versus pinaverium bromide for the treatment of diarrheal irritable bowel syndrome (IBS-D) with liver depression and spleen deficiency.

METHODS

A search of the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang Database, PubMed, EMBASE, Cochrane Library and Web of Science databases was conducted from database creation to the 28th of September 2022. Meta-analysis was performed using Revman 5.4 software.

RESULTS

Twelve randomized controlled trials comprising 1058 patients were included in the analysis. TXYF was more efficacious in improving the clinical symptoms of patients. Comparison of the efficacy rate, Traditional Chinese Medicine Evidence Score (TCM-PES), self-rating anxiety scale anxiety score, self-rating depression scale depression score, adverse reaction rate and calcitonin gene-related peptide (CGRP) levels showed that TXYF was significantly superior to pinaverium bromide treatment (P < 0.05); there was no statistically significant difference in the plasma vasoactive peptide level between the two groups (P > 0.05). Funnel plots of the total efficacy rate and TCM-PES were asymmetrically distributed, suggesting publication bias. The GRADEpro Guideline Development Tool was also used to evaluate the studies, and the evidence rating of the included studies was not high.

CONCLUSIONS

Although the results of this study suggest that TXYF may be superior for the treatment of IBS-D with liver depression and spleen deficiency, as compared to pinaverium bromide, definitive conclusions are unable to be drawn at this time due to flaws in the overall design of the included trials. Therefore, more rigorous trials are needed to determine the benefit and safety of TXYF.