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Traditional Chinese Medicine Formulas for Irritable Bowel Syndrome: From Ancient Wisdoms to Scientific Understandings

Hai-Tao Xiao

School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China

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Linda Zhong

School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China

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Siu-Wai Tsang

School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China

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Ze-Si Lin

School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China

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, and

Zhao-Xiang Bian

School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, P. R. China

Correspondence to: Prof. Zhao-Xiang Bian, School of Chinese Medicine, Hong Kong Baptist University, 7 Baptist University Road, Kowloon Tong, Hong Kong, P. R. China. Tel: (+86) 852-3411-2905, Fax: (+86) 852-3411-2929.

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https://doi.org/10.1142/S0192415X15500019Cited by:54 (Source: Crossref)

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.

Keywords:

References

H. Akiho , E. Ihara and K. Nakamura , World J. Gastrointest. Pathophysiol. 1 , 97 ( 2010 ) . Crossref, Medline, Google Scholar
A. Bensoussan et al. , JAMA 280 , 1585 ( 1998 ) . Crossref, Medline, Web of Science, Google Scholar
J. A. Bravo , T. G. Dinan and J. F. Cryan , Int. J. Neuropsychopharmacol. 14 , 666 ( 2011 ) . Crossref, Medline, Web of Science, Google Scholar
M. Camilleri and V. Andresen , Dig. Liver Dis. 41 , 854 ( 2009 ) . Crossref, Medline, Google Scholar
J. Y. Chang and N. J. Talley , Trends Pharmacol. Sci. 31 , 326 ( 2010 ) . Crossref, Medline, Web of Science, Google Scholar
F. S. Chen , H. J. Suo and H. Fan , World Chin. J. Digestol. 18 , 2715 ( 2010 ) . Crossref, Google Scholar
Z. Y. Chen , M. X. Yan and B. K. Xiang , J. Tradit. Chin. Med. 44 , 928 ( 2003 ) . Google Scholar
A. Gerkens , Rev. Med. Brux 33 , 430 ( 2012 ) . Medline, Google Scholar
M. D. Gershon and J. Tack , Gastroenterology 132 , 397 ( 2007 ) . Crossref, Medline, Web of Science, Google Scholar
Q. C. Guan et al. , World Chin. J. Digestol. 16 , 2112 ( 2008 ) . Crossref, Google Scholar
M. Guilarte et al. , Gut 56 , 203 ( 2007 ) . Crossref, Medline, Web of Science, Google Scholar
R. Hu and F. Tang , Shaanxi J. Tradit. Chin. Med. 31 , 914 ( 2010 ) . Google Scholar
X. G. Hu et al. , J. Chin. Med. Mater. 30 , 1563 ( 2007 ) . Web of Science, Google Scholar
X. G. Hu , S. W. Zhang and X. Xiang , Henan Tradit. Chin. Med. 27 , 23 ( 2007 ) . Google Scholar
X. Y. Hu et al. , J. Guangzhou Univ. Tradit. Chin. Med. 25 , 63 ( 2008 ) . Web of Science, Google Scholar
C. Y. Hua , J. Pract. Tradit. Chin. Med. 27 , 41 ( 2013 ) . Web of Science, Google Scholar
S. Huang et al. , Mod. J. Integr. Tradit. Chin. West. Med. 19 , 11 ( 2010 ) . Google Scholar
S. G. Huang and Y. T. Li , J. Guangzhou Univ. Tradit. Chin. Med. 30 , 152 ( 2013 ) . Google Scholar
R. A. Jacob and G. Sotoudeh , Nutr. Clin. Care 5 , 66 ( 2002 ) . Crossref, Medline, Google Scholar
S. I. Jeong et al. , Pharmacol. Res. 59 , 183 ( 2009 ) . Crossref, Medline, Web of Science, Google Scholar
J. H. Kim et al. , Biol. Pharm. Bull. 28 , 2120 ( 2005 ) . Crossref, Medline, Web of Science, Google Scholar
B. H. Lee et al. , Mol. Cells 17 , 51 ( 2004 ) . Crossref, Medline, Web of Science, Google Scholar
W. K. Leung et al. , Am. J. Gastroenterol. 101 , 1574 ( 2006 ) . Crossref, Medline, Web of Science, Google Scholar
D. H. Li et al. , Lishizhen Med. Mater. Med. Res. 18 , 2098 ( 2007 ) . Google Scholar
H. G. Li and J. E. Yu , J. Henan Univ. (Medical Science) 21 , 11 ( 2002 ) . Google Scholar
Q. Li and J. L. Jiang , Guiding J. Tradit. Chin. Med. Pharm. 19 , 41 ( 2013 ) . Link, Web of Science, Google Scholar
Z. F. Liang et al. , Zhong Xi Yi Jie He Xue Bao 7 , 819 ( 2009 ) . Crossref, Medline, Google Scholar
Z. Q. Lin and W. B. Zhou , Jilin Med. J. 31 , 70 ( 2010 ) . Google Scholar
J. P. Liu et al. , Cochrane Database Syst. Rev. CD004116 ( 2006 ) . Medline, Google Scholar
W. Lu , JAMA 282 , 1035 ( 1999 ) . Crossref, Medline, Web of Science, Google Scholar
J. Ma and J. Y. Pan , Mod. J. Integr. Tradit. Chin. West. Med. 16 , 2969 ( 2007 ) . Google Scholar
W. Ma et al. , J. Tradit. Chin. Med. Univ. Hunan 29 , 29 ( 2009 ) . Crossref, Medline, Web of Science, Google Scholar
G. Maciocia , The foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists ( Churchill Livingstone , Edinburgh, New York , 1989 ) . Google Scholar
V. Martinez and Y. Tache , Curr. Pharm. Des. 12 , 4071 ( 2006 ) . Crossref, Medline, Web of Science, Google Scholar
K. T. Min et al. , J. Altern. Complement. Med. 9 , 505 ( 2003 ) . Crossref, Medline, Web of Science, Google Scholar
L. F. Mohammad-Zadeh , L. Moses and S. M. Gwaltney-Brant , J. Vet. Pharmacol. Ther. 31 , 187 ( 2008 ) . Crossref, Medline, Web of Science, Google Scholar
M. Munoz and R. Covenas , Curr. Med. Chem. 18 , 1820 ( 2011 ) . Crossref, Medline, Web of Science, Google Scholar
L. Ohman and M. Simren , Nat. Rev. Gastroenterol. Hepatol. 7 , 163 ( 2010 ) . Crossref, Medline, Web of Science, Google Scholar
O. S. Palsson et al. , Dig. Dis. Sci. 49 , 1236 ( 2004 ) . Crossref, Medline, Web of Science, Google Scholar
F. Pan et al. , Chin. J. Integr. Med. 15 , 216 ( 2009 ) . Crossref, Medline, Web of Science, Google Scholar
X. Q. Pan and J. Q. Xie , Shanghai J. Tradit. Chin. Med. 44 , 106 ( 2010 ) . Google Scholar
X. X. Pan , Chin. J. Mod. Drug Appl. 4 , 24 ( 2010 ) . Google Scholar
S. L. Peng et al. , J. Liaoning Univ. TCM 15 , 187 ( 2013 ) . Google Scholar
W. Peng et al. , Mod. J. Integr. Tradit. Chin. West. Med. 18 , 2697 ( 2009 ) . Google Scholar
H. Y. Qin et al. , Evid. Based Complement. Alternat. Med. 2012 , 239638 ( 2012 ) . Medline, Web of Science, Google Scholar
J. Ross , Zang Fu, the Organ Systems of Traditional Chinese Medicine: Functions, Interrelationships and Patterns of Disharmony in Theory and Practice ( Churchill Livingstone , Edinburgh, New York , 1985 ) . Google Scholar
A. Salonen , W. M. de Vos and A. Palva , Microbiology 156 , 3205 ( 2010 ) . Crossref, Medline, Web of Science, Google Scholar
G. J. Sanger , Trends Pharmacol. Sci. 29 , 465 ( 2008 ) . Crossref, Medline, Web of Science, Google Scholar
J. Shi et al. , World J. Gastroenterol. 14 , 454 ( 2008 ) . Crossref, Medline, Web of Science, Google Scholar
J. J. Shi , Mod. J. Integr. Tradit. Chin. West. Med. 14 , 802 ( 2005 ) . Google Scholar
J. J. Shi , Chin. Arch. Tradit. Chin. Med. 26 , 323 ( 2008 ) . Web of Science, Google Scholar
J. J. Shi , Y. Y. Dai and F. Y. Xu , Shandong J. Tradit. Chin. Med. 27 , 46 ( 2008 ) . Web of Science, Google Scholar
J. J. Shi et al. , Zhejiang J. Integr. Tradit. Chin. West. Med. 22 , 172 ( 2012 ) . Web of Science, Google Scholar
X. Sun , G. Cai and W. J. Wang , J. Chin. Integr. Med. 9 , 340 ( 2004 ) . Crossref, Google Scholar
J. J. Y. Sung et al. , Aliment. Pharmacol. Ther. 20 , 1205 ( 2004 ) . Crossref, Medline, Web of Science, Google Scholar
T. Talme and K.-G. Sundqvist, Nerve-Driven Immunity, ed. M. Levite (Springer, Vienna, 2012) pp. 203–225. Crossref, Google Scholar
S. Tan et al. , Am. J. Chin. Med. 33 , 365 ( 2005 ) . Link, Web of Science, Google Scholar
H. M. Tang et al. , Tradit. Chin. Drug Res. Clin. Pharmacol. 19 , 464 ( 2008 ) . Google Scholar
H. M. Tang et al. , Pharm. Today 18 , 1 ( 2008 ) . Google Scholar
Y. W. Tjong et al. , Neurogastroenterol. Motil. 23 , e666 ( 2011 ) . Crossref, Medline, Web of Science, Google Scholar
J. D. van Bergeijk and J. H. Wilson , Mediators Inflamm. 6 , 303 ( 1997 ) . Crossref, Medline, Web of Science, Google Scholar
G. Varga et al. , Br. J. Pharmacol. 141 , 1275 ( 2004 ) . Crossref, Medline, Web of Science, Google Scholar
F. L. Wang et al. , J. Pract. Tradit. Chin. Med. 29 , 795 ( 2013 ) . Google Scholar
G. Wang et al. , Chin. Med. J. (Engl) 119 , 2114 ( 2006 ) . Crossref, Medline, Web of Science, Google Scholar
G. Wang et al. , Chin. J. Evid. Based Med. 6 , 84 ( 2006 ) . Google Scholar
H. Y. Wang , J. J. Shi and X. W. Li , Chin. J. Tradit. Med. Sci. Technol. 13 , 393 ( 2006 ) . Web of Science, Google Scholar
X. Q. Wang and W. Ye , Fujian J. Tradit. Chin. Med. 37 , 10 ( 2006 ) . Google Scholar
M. Y. Wu , T. M. Hu and X. S. Zheng , W. Chin. J. Digestol. 18 , 2966 ( 2010 ) . Crossref, Google Scholar
J. Q. Xie et al. , Acta Univ. Traditionis Medicalis Sinensis Pharmacologiaeque Shanghai 17 , 49 ( 2003 ) . Google Scholar
J. Q. Xie and J. Y. Yuan , World Chin. J. Digestol. 18 , 2230 ( 2010 ) . Crossref, Google Scholar
H. Z. Xu et al. , J. Jiangxi Univ. Tradit. Chin. Med. 19 , 58 ( 2007 ) . Google Scholar
H. Z. Xu et al. , Acta Univ. Tradit. Med. Sin. Pharmacol. Shanghai 23 , 29 ( 2009 ) . Web of Science, Google Scholar
S. Xu et al. , J. Zhejiang Univ. Tradit. Chin. Med. 32 , 590 ( 2008 ) . Google Scholar
J. S. Yang , S. Xu and J. J. Shi , J. Zhejiang Coll. Tradit. Chin. Med. 28 , 53 ( 2004 ) . Google Scholar
Y. Q. Yu and F. J. Guo , Tradit. Chin. Med. Res. 10 , 16 ( 1997 ) . Google Scholar
J. Y. Zhang et al. , Chin. J. Integr. Tradit. West. Med. Digestion 16 , 221 ( 2008 ) . Crossref, Web of Science, Google Scholar
S. S. Zhang , H. B. Wang and Z. H. Li , Chin. J. Integr. Tradit. West. Med. 30 , 9 ( 2010 ) . Crossref, Web of Science, Google Scholar
S. M. Zhao and H. Z. Li , Hebei J. Tradit. Chin. Med. 34 , 1736 ( 2012 ) . Google Scholar
F. S. Zhou and H. H. Cheng , World Chin. J. Digestol. 18 , 2225 ( 2010 ) . Crossref, Google Scholar
Y. P. Zhu et al. , J. Guangxi Tradit. Chin. Med. Univ. 10 , 10 ( 2007 ) . Google Scholar