A Meta-Analysis of Modified Sijunzi Decoction Combined with Tongxie Yaofang in the Treatment of IBS-D

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGD), among which the diarrhea-predominant (IBS-D) is the most common in China, significantly affecting patients' life and work due to its long course and easy recurrence. Herb medicine is a viable complementary and alternative treatment option for patients with IBS. Specifically, Sijunzi Decoction combined with Tongxie Yaofang is a clinical prescription commonly used in China for IBS-D.We retrieved randomized controlled trials (RCTs) of Sijunzi Decoction combined with Tongxie Yaofang in the treatment of IBS-D from CNKI, WanFang Data, VIP, CBM, Pubmed and the Cochrane Library, and Embase database. And then we performed quality evaluation, data extraction and pooling. Stata software (version 15.0) was used to perform meta-analysis. Resultly, a total of 14 RCTs were included, including 1,032 subjects, with 522 cases in the test group and 510 cases in the control group. Meta-analysis showed the following results: (1) Clinical efficacy: Compared with conventional Western medicine treatment, the total clinical effective rate of modified Sijunzi Decoction combined with Tongxie Yaofang for IBS-D was significantly increased [RR= 1.229, 95% CI (1.162, 1.299)], and the difference was statistically significant (P<0.05); (2) Daily bowel frequency: Three RCTs counted the number of daily bowel movements before and after treatment, the results showed a more considerable improvement in the number of daily bowel movements in the test group than in the control group after treatment [SMD=-1.791, 95% CI (-3.130, -0.452)], and the difference was statistically significant (P<0.05); (3) Clinical symptom score: Six RCTs recorded clinical symptom scores of the subjects before and after treatment, and the results showed that the clinical symptoms of the subjects in both groups improved significantly after treatment compared with those before treatment, and the test group improved significantly more than the control group (P<0.05). In conclusion, Sijunzi Decoction combined with Tongxie Yaofang is effective in the treatment of IBS-D.