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Wang Y, Fan H, Qi X, Lai Y, Yan Z, Li B, Tang M, Huang D, Li Z, Chen H, Zhu Q, Luo C, Chen X, Fen J, Jiang Z, Zheng L, Liu X, Tang Q, Zuo D, Ye J, Yang Y, Huang H, Tang Z, Lu W, Xiao J. Are personalized tongxie formula based on diagnostic analyses more effective in reducing IBS symptoms?-A randomized controlled trial. Complement Ther Med 2018; 40:95-105. [PMID: 30219477 DOI: 10.1016/j.ctim.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/04/2018] [Accepted: 07/03/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To examine the efficacy and safety ofpersonalized tongxie formulas; to decrease type II errors to minimum. METHODS Patients were randomized (1:1:1) into three groups given tongxie, placebo, or pinaverium 3 times daily for 4 weeks. Patients in the tongxie group were treated with personalized formulas based on TCM differential diagnosis, i.e., basic type of IBS, IBS due to liver depression and qi stagnation, excess heat in the liver, deficient spleen function, deficient kidney function, and others (groups 1-6). Primary endpoints were significantly greater reductions in abdominal pain and Bristol stool score. Secondary endpoints were reductions in pain and stool frequencies and abdominal discomfort and its frequency. RESULTS There were significantly more patients whose stool consistencies were improved than pains were relieved in the entire population (p < 0.001), but there was no significantly difference in subpopulation group 3 (p > 0.05). There were significantly more patients whose stool frequencies were reduced than pain frequencies were reduced in the entire population (p < 0.001), but there were no significantly difference in the subpopulation Groups 1, 3, 4, and 6 (p > 0.05). Multiple active ingredients and their mechanisms of actions to relieve IBS symptoms were identified. CONCLUSION The outcomes in subpopulations may be different from those of the entire population, indicating that personalized formulas are important to achieve optimal outcomes; the active ingredients and innovative mechanisms identified in this study can be the candidates for developing new IBS drugs, and used to manage IBS, respectively. TRIAL REGISTRATION NCT01641224 (www.ClinicalTrials.gov).
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Affiliation(s)
- Yuanyuan Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Heng Fan
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. 1277 Liberty Rd., Wuhan, 430022, China
| | - Xiao Qi
- Washington University School of Medicine. 660 S Euclid Ave, St. Louis, MO 63110, the United States
| | - Yaoliang Lai
- Department of Gastroenterology, Beijing Xuanwu Hospital of Chinese Medicine. 8 Wanming Rd., Beijing 100050, China
| | - Zhixiang Yan
- The Institute of Chinese Medical Sciences, the University of Macau, Av. Padre Tomás Pereira, Taipa, Macao, SAR, China
| | - Baiwen Li
- Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University, 100 Haining Rd. Hongkou, Shanghai 200280, China
| | - Min Tang
- The State Key Laboratory Cultivation Base for TCM Quality and Efficacy, the School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing 210023, China
| | - Dawei Huang
- Department of Gastroenterology, Beijing Xuanwu Hospital of Chinese Medicine. 8 Wanming Rd., Beijing 100050, China
| | - Zhen Li
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Hongjing Chen
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Qingping Zhu
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Chao Luo
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Xuan Chen
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Jin Fen
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Zhengyan Jiang
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Liang Zheng
- Department of Gastroenterology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Second Hospital of Chinese Medicine. 23 Nanhu Rd., Nanjing, 210017, China
| | - Xingxing Liu
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. 1277 Liberty Rd., Wuhan, 430022, China
| | - Qing Tang
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. 1277 Liberty Rd., Wuhan, 430022, China
| | - Dongmei Zuo
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. 1277 Liberty Rd., Wuhan, 430022, China
| | - Jingyi Ye
- The Macrohard Institute of Health. 231 North Ave. Battle Creek, MI 49017, USA
| | - Yongqiang Yang
- The Macrohard Institute of Health. 231 North Ave. Battle Creek, MI 49017, USA
| | - Huisuo Huang
- The Macrohard Institute of Health. 231 North Ave. Battle Creek, MI 49017, USA
| | - Zongxiang Tang
- The State Key Laboratory Cultivation Base for TCM Quality and Efficacy, the School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing 210023, China
| | - Weimin Lu
- Department of Internal Medicine, Jiangsu Province Hospital of Chinese Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine. 155 Hanzhong Rd., Nanjing, 210029, China.
| | - Jun Xiao
- The Macrohard Institute of Health. 231 North Ave. Battle Creek, MI 49017, USA.
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