Meta-analysis Of Treating Diarrhea Irritable Bowel Syndrome From Spleen And Kidney Yang Deficiency

ObjectiveTo explore the effectiveness and safety of the prescriptions for diarrhea-predominant irritable bowel syndrome(IBS-D)based on spleen and kidney yang deficiency,and to provide evidence-based basis for clinical application.MethodsSearching CNKI,CBM,VIP and Wanfang databases,we searched for randomized controlled trials(RCTs)of treating IBS-D from spleen and kidney.According to the set inclusion and exclusion criteria,the literature was screened,the Cochrane system evaluation method was used to evaluate the bias risk of the literature and extract valid data,and Rev Man 5.3 software was used for Meta-analysis.Results(1)Clinical curative effect: 15 studies were included in this paper,including 1318 patients,among which 6 were treated with IBS-D by integrated traditional Chinese and western medicine compared with western medicine alone,and 9 were treated with IBS-D by traditional Chinese medicine compared with western medicine alone,the comparison results were:(OR = 3.75,95% CI[2.20,6.45]),P﹤0.00001),(OR = 3.66,95% CI[2.44,5.50]),P﹤0.00001).from the data,it can be seen that the relevant prescriptions for treating IBS-D based on spleen and kidney yang deficiency can really improve the clinical effective rate.(2)Improvement results of symptoms such as abdominal pain and diarrhea: The main symptoms such as abdominal pain and diarrhea were selected as evaluation indexes.The comparative results of abdominal pain were(MD =-2.07,95% CI [-3.38,-0.76],P = 0.002)and diarrhea were(MD =-1.91,95%)(3)Results of recurrence rate: Five studies were included in this study to compare the recurrence rate after drug withdrawal.The comparison of recurrence rate after 1 month,3 months and 6 months after drug withdrawal:(OR = 0.21,95% CI [0.05,0.90]),(P = 0.04;OR = 0.25,95%CI[0.12,0.51]),(P=0.0001;OR = 0.21,95%CI[0.11,0.39]),P﹤0.00001)。 From the data,it can be concluded that the relevant prescriptions for treating IBS-D based on spleen and kidney yang deficiency can effectively reduce the recurrence rate.ConclusionIBS-D related prescriptions based on spleen and kidney yang deficiency are superior to western medicine in improving diarrhea,abdominal pain and other symptoms,as well as patients’ quality of life and reducing recurrence rate.However,due to the low methodological quality of RCTs research,less reported recurrence rate,differences in TCM syndrome differentiation and uneven evaluation of symptoms,the risk of literature bias is high.Therefore,the conclusion needs to be further verified by more large-sample,multi-center and high-quality clinical randomized controlled trials.