title: Traditional Chinese medicine formulas for irritable bowel syndrome: from ancient wisdoms to scientific understandings.
abstract: Traditional Chinese Medicine (TCM) serves as the most common alternative therapeutic approach for Western medicine and benefits IBS patients globally. Due to the lack of scientific evidence in the past, TCM formulas were not internationally well recognized as promising IBS remedies. In this review, firstly, we present the etiology and therapy of IBS in terms of traditional Chinese medical theory. Secondly, we summarize the clinical randomized controlled trials (RCTs) of TCM formulas for IBS patients that are available in the literature (from 1998 to September 2013), in which 14 RCTs conducted of high quality were discussed in detail. Of the 14 selected trials, 12 of those concluded that TCM formulas provided superior improvement in the global symptoms of IBS patients over the placebo or conventional medicines. As well, all 14 RCTs suggested that TCM formulas have good safety and tolerability. Last but not least, we explore the pharmacological mechanisms of the anti-IBS TCM formulas available in the literature (from 1994 to September, 2013). Collectively, in combating IBS symptoms, most TCM formulas exert multi-targeting actions including the regulation of neurotransmitters and hormones in the enteric nervous system (ENS), modulation of smooth muscle motility in the gastrointestinal (GI) tract, modulation of the hypothalamic-pituitary-adrenal (HPA) axis, attenuation of intestinal inflammation and restoration of intestinal flora, etc. In conclusion, TCM formulas appear to be promising for IBS treatment. This review provides a useful reference for the public in furthering a better understanding and acceptance of TCM formulas as IBS remedies.
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Xiao
authors.forename: Linda
authors.initials: L
authors.lastname: Zhong
authors.forename: Siu-Wai
authors.initials: SW
authors.lastname: Tsang
authors.forename: Ze-Si
authors.initials: ZS
authors.lastname: Lin
authors.forename: Zhao-Xiang
authors.initials: ZX
authors.lastname: Bian
mesh_terms: D002766:Cholecystokinin / Q000378:metabolism; D004365:Drugs, Chinese Herbal / Q000494:pharmacology* / Q000627:therapeutic use*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007422:Intestines / Q000382:microbiology; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D008516:Medicine, Chinese Traditional; D009130:Muscle, Smooth / Q000187:drug effects; D018377:Neurotransmitter Agents / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D012701:Serotonin / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D013004:Somatostatin / Q000378:metabolism; D013373:Substance P / Q000378:metabolism; D014660:Vasoactive Intestinal Peptide / Q000378:metabolism
chemical_list: D004365:Drugs, Chinese Herbal; D018377:Neurotransmitter Agents; D009569:Nitric Oxide; D012701:Serotonin; D013373:Substance P; D014660:Vasoactive Intestinal Peptide; D013004:Somatostatin; D002766:Cholecystokinin; D052247:Nitric Oxide Synthase Type II
keywords: Action Mechanisms; Efficacy and Safety; Irritable Bowel Syndrome; Multi-targeting Therapy; Traditional Chinese Medicine Formulas