title: The efficacy of Shugan Jianpi Zhixie therapy for diarrhea-predominant irritable bowel syndrome: a meta-analysis of randomized, double-blind, placebo-controlled trials.
abstract: BACKGROUND
  Shugan Jianpi Zhixie therapy (SJZT) has been widely used to treat diarrhea-predominant irritable bowel syndrome (IBS-D), but the results are still controversial. A meta-analysis of randomized, double-blind, placebo-controlled trials was performed to assess the efficacy and tolerability of SJZT for IBS-D.
  
  
  METHODS
  The MEDLINE, EMBASE, Cochrane Library, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database and the Wanfang database were searched up to June 2014 with no language restrictions. Summary estimates, including 95% confidence intervals (CI), were calculated for global symptom improvement, abdominal pain improvement, and Symptom Severity Scale (BSS) score.
  
  
  RESULTS
  Seven trials (N=954) were included. The overall risk of bias assessment was low. SJZT showed significant improvement for global symptom compared to placebo (RR 1.61; 95% CI 1.24, 2.10; P =0.0004; therapeutic gain = 33.0%; number needed to treat (NNT) = 3.0). SJZT was significantly more likely to reduce overall BSS score (SMD -0.67; 95% CI -0.94, -0.40; P < 0.00001) and improve abdominal pain (RR 4.34; 95% CI 2.64, 7.14; P < 0.00001) than placebo. The adverse events of SJZT were no different from those of placebo.
  
  
  CONCLUSIONS
  This meta-analysis suggests that SJZT is an effective and safe therapy option for patients with IBS-D. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Ya
authors: Y
authors: Xiao
authors: Department of Rheumatic diseases, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
authors: Yanyan
authors: Y
authors: Liu
authors: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Shaohui
authors: S
authors: Huang
authors: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Xiaomin
authors: X
authors: Sun
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Yang
authors: Y
authors: Tang
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Jingru
authors: J
authors: Cheng
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Tian
authors: T
authors: Wang
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Fei
authors: F
authors: Li
authors: Digestive Department of Guangdong provincial hospital of TCM, Guangzhou, 510120, China.
authors: Yuxiang
authors: Y
authors: Kuang
authors: Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China; School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Ren
authors: R
authors: Luo
authors: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
authors: Xiaoshan
authors: X
authors: Zhao
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy* / Q000473:pathology; D002681:China; D003967:Diarrhea / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic
chemical_list: D004365:Drugs, Chinese Herbal; C534230:shugan jianpi