Overview of systematic evaluation of efficacy of Tongxie Yaofang in treating diarrhea-predominant irritable bowel syndrome.

BACKGROUND: Tongxie Yaofang is commonly used in the treatment of IBS-D. Many systematic reviews have confirmed its efficacy and safety, but the methodology and quality of evidence need to be further evaluated. METHODS: The databases of Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang, VIP, Web of Science (SCI), PubMed, Cochrane Library, and Embase were searched to gather systematic evaluations of TXYF in treating IBS-D. The search time was from inception to January 2021. The search was performed independently by 2 researchers who screened the literature and extracted data. Methodological quality of the studies included in the systematic evaluation was evaluated by the A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) scale. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to categorize the evidence quality of outcome indicators, and the curative effect evaluation was summarized. RESLUTS: A total of 10 systematic evaluations were included, and the results of AMSTAR-2 evaluation showed that 6 reports were relatively complete, 4 reports were poor, and the overall quality was not high. DISCUSSION: It was revealed that TXYF can improve the total clinical effective rate and symptoms of patients with IBS-D, but the GRADE evaluation results showed that the quality of evidence was low to extremely low. It is suggested that further high-quality clinical research should be conducted to provide more reliable evidence-based medical evidence for the application of TXYF in the treatment of irritable bowel syndrome.