ABSTRACT
BACKGROUND: As there is no effective treatment for irritable bowel syndrome (IBS), many patients turn to traditional Chinese medicine (TCM) for possible cure. We investigated the therapeutic efficacy of an ancient herbal Chinese formula in patients with diarrhea-predominant IBS. METHODS: This was a randomized double-blinded placebo-controlled trial. Chinese IBS patients with predominant diarrhea symptoms that fulfilled Rome II criteria were recruited. The diagnosis was verified by a TCM herbalist using TCM criteria. Eligible patients were randomized to receive a standard preparation of TCM extracts that contained 11 herbs or placebo with similar appearance and taste for 8 wk after a 2-wk run-in period. Patients were followed up for an additional 8 wk post-treatment. Primary outcome was patient's global symptom assessment. Other outcome measures included individual IBS symptom scores and health-related quality of life (short form 36). RESULTS: One hundred nineteen patients were randomized: 60 to receive TCM and 59 to receive placebo. There was no significant difference in the proportion of patients with global symptom improvement between the TCM and placebo groups at week 8 (35% vs 44.1%, p = 0.38) and at week 16 (31.7% vs 33.9%, p = 0.62). Moreover, there was no difference in individual symptom scores and the quality-of-life assessment between the two groups at all time points. BACKGROUND: The use of this herbal formulation for diarrhea-predominant IBS did not lead to global symptom improvement. Further controlled clinical studies may be necessary to characterize the role of TCM in the management of IBS.
Subject(s)
Diarrhea/drug therapy , Drugs, Chinese Herbal , Irritable Bowel Syndrome/drug therapy , Medicine, Chinese Traditional , Adolescent , Adult , Aged , Chi-Square Distribution , Double-Blind Method , Female , Humans , Male , Middle Aged , Placebos , Prospective Studies , Quality of Life , Regression Analysis , Statistics, Nonparametric , Treatment OutcomeABSTRACT
BACKGROUND: Traditional Chinese Medicine was frequently used by patients with irritable bowel syndrome. AIM: To evaluate the agreement on diagnoses and prescription of irritable bowel syndrome among Traditional Chinese Medicine practitioners. METHODS: Consecutive irritable bowel syndrome patients were interviewed independently by four Traditional Chinese Medicine practitioners. The study was divided into three phases: (i) blinded individual assessment, (ii) discussion to achieve consensus on diagnosis and treatment, (iii) individual assessment based on consensual diagnostic criteria. Patients with other causes of diarrhoea were recruited as controls in phase (iii). Percentage agreement and kappa-value in diagnosis, treatment principle and regime were determined. RESULTS: Thirty-nine irritable bowel syndrome patients were assessed in phase (i) whereas 65 irritable bowel syndrome patients and 17 non-irritable bowel syndrome controls were studied in phase (iii). The mean agreement rates in diagnosis, treatment principle and regimen were: 57, 58 and 52% for phase (i) and 80, 81 and 80% for phase (iii) (P = 0.002). Accordingly, there was significant improvement in the mean kappa-values in diagnosis (0.11-0.34, P = 0.015) and treatment principle (0.16-0.37, P = 0.002) but not in treatment regime. CONCLUSIONS: Variations in diagnosis and treatment principles do exist among Traditional Chinese Medicine practitioners. Concordant diagnosis can be reached by mutual understanding and converging opinion among Traditional Chinese Medicine practitioners.
Subject(s)
Allied Health Personnel/standards , Irritable Bowel Syndrome/diagnosis , Medicine, Chinese Traditional/standards , Adult , Consensus , Female , Humans , Irritable Bowel Syndrome/therapy , Male , Middle Aged , Observer Variation , Physical ExaminationABSTRACT
'Dang-Gui Decoction for Enriching the Blood' (BE), a traditional Chinese formulation comprising Angelica sinensis and Astragalus membranaceus, is used for stimulating red blood cell production as well as enhancing cardiovascular function. In the present study, we have demonstrated the myocardial protection afforded by BE pretreatment against ischaemia-reperfusion (IR) injury in isolated-perfused rat hearts. A more complete and potent myocardial protection against IR injury was also shown by a Polygonum multiflorum extract supplemented BE preparation (BEA). The results suggest that the more potent cardioprotective action of BEA may be related to its ability to sustain the myocardial glutathione antioxidant status under conditions of IR-induced oxidative stress, which may possibly in turn result from the synergistic interaction between the BE and Polygonum extract.