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Traditional Chinese medicine therapies, like acupuncture and moxibustion, effectively alleviate irritable bowel syndrome with diarrhea symptoms, and reduce recurrence rates.
Adhering to the guidelines for systematic reviews, multiple databases including PubMed and Cochrane Library, and several Chinese databases were thoroughly searched. The focus was randomized controlled trials that compared traditional Chinese external therapies with western medicine for irritable bowel syndrome with diarrhea up until the end of 2021. Two authors were independently responsible for screening, data extraction and study assessment. Study quality assessment involved both the Jadad scale and Cochrane Collaborative's risk of bias tool. Meta-analysis was performed on the data collated using Review Manager software.
The gathered data revealed that of the twenty-one studies examined, including a total of 1,862 subjects, acupuncture and moxibustion were the most prevalent external therapies. The results of the meta-analysis indicated that in comparison to the control group, the experimental group demonstrated marked improvement. Notably, the experimental group had superior clinical effectiveness rates, better clinical cure rates, and reduced recurrence. Additionally, there was significant improvement in irritable bowel syndrome related quality of life within the experimental group. Despite these promising results, the publication bias of the included studies was noted as a potential limitation.
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Xiao Yao San can improve symptoms and reduce recurrence rates in patients with disorders of gut-brain interaction.
2022 Frontiers in Pharmacology Efficacy and Safety of Chinese Herbal Medicine Xiao Yao San in Functional Gastrointestinal Disorders: A meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials Liu Q, Shi Z, Zhang T, Jiang T, Luo X, Su X, et al.
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The paper's methodology involved a meta-analysis of randomized controlled trials found in seven databases, up until November 22, 2021. The trials, which totaled 48 all together, were included to determine the efficacy of Xiao-Yao-San in treating disorders of gut-brain interaction (previously known as functional gastrointestinal disorders). A range of measures, including therapeutic efficacy, symptom score, Self-Rating Anxiety Scale score, Self-Rating Depression Scale score, and the recurrence rate, were analysed using both random-effects and fixed-effects models, as well as trial sequential analysis.
In terms of results, Xiao-Yao-San showed a marked improvement in the effective rate of managing disorders of gut-brain interaction compared to western drugs, both when used alone and in combination with western medicine. The paper also found the treatment notably reduced symptom scores, anxiety scores, and depression scores for patients with the disorder. Further, instances of recurrence were also reduced. Overall, Xiao-Yao-San was well tolerated and no serious adverse events were reported in any of the trials included in this analysis.
Acupuncture combined with moxibustion showed the best outcomes in terms of efficacy and quality of life improvement for adults with irritable bowel syndrome complicated with diarrhea.
2022 Computational and Mathematical Methods in Medicine Acupuncture and Moxibustion in the Treatment of Adult Diarrhea Irritable Bowel Syndrome: A Network Meta-analysis Jiang X, Guo X, Zhou J, Ye S
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The study was conducted by searching major databases, including PubMed, The Cochrane Library, Embase, and database from China, for randomized controlled trials. These trials explored the effects of acupuncture and moxibustion on individuals suffering from irritable bowel syndrome complicated with diarrhea. The selected studies underwent a rigorous bias assessment and their data were analyzed using Stata 16.0 statistical software.
The analysis encompassed 21 studies overall, considering 1626 patients undergoing 8 different therapeutic measures. The study found that treatments such as acupuncture, warming needle moxibustion, and a combination of acupuncture with sandwiched or heat-sensitive moxibustion revealed significantly improved outcomes when compared to the drug pinaverium bromide. On the other hand, pinaverium bromide demonstrated the lowest efficacy and effect on quality of life. The most frequently used acupuncture points were GV20, GV29, ST 25, ST37, ST36, SP6, LR3, and CV12.
Peppermint oil proved more effective than placebo in treating irritable bowel syndrome symptoms, but with an increased rate of adverse events.
2022 Alimentary Pharmacology & Therapeutics Systematic review and meta‐analysis: efficacy of peppermint oil in irritable bowel syndrome Ingrosso MR, Ianiro G, Nee J, Lembo AJ, Moayyedi P, Black CJ, et al.
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In evaluating the effectiveness and safety of peppermint oil for irritable bowel syndrome, the researchers searched medical literature for randomised controlled trials involving peppermint oil treatments in IBS. A systematic review and analysis included trials up to the date of April 2nd, 2022. The team assessed the efficacy and safety of the peppermint oil treatment based on various factors including effect on global IBS symptoms and abdominal pain along with incidence of adverse events or gastro-oesophageal reflux.
From the literature review, 10 suitable randomised control trials were identified, encompassing a total of 1030 patients. The results showed that peppermint oil performed better than a placebo in lessening overall irritable bowel syndrome symptoms and reducing abdominal pain. However, this was coupled with a higher rate of recorded adverse events in patients who were administered peppermint oil. Despite the positive performance of peppermint oil over placebo, the evidence quality considered for this conclusion was very low.
Acupuncture is shown to be a beneficial supplementary treatment for chronic abdominal pain, improving patients' quality of life and cutting healthcare costs.
2021 Anesthesiology and Pain Medicine Efficacy of Acupuncture in the Treatment of Chronic Abdominal Pain Berger AA, Liu Y, Jin K, Kaneb A, Welschmeyer A, Cornett EM, et al.
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The research explores the utilization of acupuncture to treat chronic abdominal pain, a condition widespread and chiefly affected by Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). This type of pain is defined by three episodes of severe abdominal pain over a span of three months. While its causes are still being looked into, it is believed to be an outcome of the chronicity of acute pain or chronic pain syndromes. A wide array of treatments for these conditions exist but often fall short of fully controlling the symptoms. Acupuncture, a form of traditional Chinese medicine based on the concept of rebalancing the patient's Qi, or Ying/Yang balance, is being investigated as a complementary method.
In terms of results, acupuncture has proven effective in providing additional alleviation of symptoms, leading to improved quality of life and reduced disability for patients affected by chronic abdominal pain. While it's not a curative solution, it aids in minimizing symptoms and enhancing overall life quality. It is also considered a safe and inexpensive alternative that may result in significant healthcare savings. Notably, it's not recommended for all patients; its benefits seem to be more pronounced in a select group.
Small-intestinal release peppermint oil is a cost-effective treatment for Irritable Bowel Syndrome, yielding modest quality of life gains and relieving abdominal pain.
2021 United European Gastroenterology Journal A trial‐based economic evaluation of peppermint oil for the treatment of irritable bowel syndrome Weerts ZZRM, Essers BAB, Jonkers DMAE, Willems JIA, Janssen DJPA, Witteman BJM, et al.
Randomised Controlled Trial Irritable Bowel Syndrome Peppermint Peppermint Oil
In the research study, a multicenter, randomized, placebo-controlled trial was carried out to evaluate the cost-effectiveness of small-intestinal release peppermint oil - an often used treatment - in patients with Irritable Bowel Syndrome (IBS). The cost-effectiveness was analyzed from a societal perspective, using two different approaches: costs per Quality of Life Years (QALY) and costs per successfully treated patient or abdominal pain responder. The later was defined according to Food and Drug Administration (FDA) definitions. Sensitivity analyses were also conducted to further substantiate the results. This comprehensive evaluation involved 126 IBS patients randomly assigned to receive either placebo or peppermint oil.
The findings showcase that peppermint oil took precedence as a dominant and effective treatment compared to placebo in considerable number of cases. Not only did it prove more successful at reducing the abdominal pain experienced by IBS patients, but analysis also positioned it as a viable option with regards to the cost-effectiveness ratio based on QALY. The results displayed that peppermint oil came out as a financially savvy treatment in varying scenarios, demonstrating a high probability of cost-effectiveness when evaluated using the abdominal pain responder outcome measure.
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