Skip to main content

Advertisement

SpringerLink
Log in

Treatment of Irritable Bowel Syndrome by Chinese Medicine: A Review

  • Review
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Irritable bowel syndrome (IBS) is a common refractory disease. Chinese medicine (CM) has remarkable efficacy and advantages on the treatment of IBS. This review summarized the articles focusing on the treatment of IBS with CM to sum up the latest treatment methods for IBS and the underlying mechanisms. Literature analysis showed that prescriptions, acupuncture, and moxibustion are the primary methods of CM treatment for IBS. The potential mechanism centers on the regulation of the enteric nervous system, the alleviation of visceral hypersensitivity, the stability of intestinal flora, and the regulation of the immune system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Qureshi NA, Alsubaie HA, Ali GIM, et al. Holistic treatment of functional irritable bowel syndrome with a spotlight on medical acupuncture: a narrative clinical update. J Comp lement Altern Med Res 2018;3:12.

    Google Scholar 

  2. Li Q, Yang GY, Liu JP. Syndrome differentiation in Chinese herbal medicine for irritable bowel syndrome: a literature review of randomized trials. Evid Based Complement Alternat Med 2013;1–9.

  3. Ryu J. Using traditional Chinese medicine for irritable bowel syndrome. HSOA J Altern Comp lement Integr Med 2018;4:56.

    Google Scholar 

  4. Kua CH, Ng ST, Lhode R, et al. Irritable bowel syndrome and other gastrointestinal disorders: evaluating self-medication in an Asian community setting. Intern J Pharm 2012;34:561–568.

    Google Scholar 

  5. Wu H, Zhang ZY. Consensus on the treatment of irritable bowel syndrome. Chin J Microecol (Chin) 2019;8:944–946.

    Google Scholar 

  6. Cash B, Chey WD. Irritable bowel syndrome: a systematic review. Gastroenterology 2004;3:647–669.

    Google Scholar 

  7. Bi Z, Zheng Y, Yuan J, et al. The efficacy and potential mechanisms of Chinese herbal medicine on irritable bowel syndrome. Curr Pharm Des 2017;34:5163–5172.

    Google Scholar 

  8. Foxx-Orenstein AE. New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists. Therap Adv Gastroenterol 2016;3:354–375.

    Article  Google Scholar 

  9. Ford AC, Sperber AD, Corsetti M. Irritable bowel syndrome. Lancet 2020;396:1675–1688.

    Article  CAS  PubMed  Google Scholar 

  10. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA 2015;9:949–958.

    Article  Google Scholar 

  11. Bordbar G, Miri MB, Omidi M, et al. Efficacy and safety of a novel herbal medicine in the treatment of irritable bowel syndrome: a randomized double-blinded clinical trial. Gastroenterol Res Pract 2020:8213082.

  12. Tao Y, Dong MX, Kou Y, et al. A personal opinion as to the treatment of irritable bowel syndrome with method of Shugan Jianpi. J Beijing Univ Tradit Chin Med (Chin) 2006;8:25.

    Google Scholar 

  13. Xu GZ, Xue Y, Wei SQ, et al. Valproate reverses stress-induced somatic hyperalgesia and visceral hypersensitivity by up-regulating spinal 5-HT2C receptor expression in female rats. Neuropharmacology 2020;165:107926.

    Article  CAS  PubMed  Google Scholar 

  14. Li Q, Yang GY, Liu JP. Syndrome differentiation in Chinese herbal medicine for irritable bowel syndrome: a literature review of randomized trials. Evid Based Comp Lement Alternert Med 2013;2013:232147.

    Google Scholar 

  15. Xiao HT, Zhong L, Tsang SW, et al. Traditional Chinese medicine formulas for irritable bowel syndrome: from ancient wisdom to scientific understandings. Am J Chin Med 2015;43:1–23.

    Article  PubMed  Google Scholar 

  16. Chinese Academy of Traditional Chinese Medicine Spleen and Stomach Disease Branch. Expert consensus on the diagnosis and treatment of irritable bowel syndrome. J Tradit Chin Med (Chin) 2017;18:1615–1619.

    Google Scholar 

  17. MacPherson H, Tilbrook H, Bland JM, et al. Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial. BMC Gastroenterol 2012;12:150.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Liu H, Xie J, Wu H, et al. Acupuncture and irritable bowel syndrome: a population-based epidemiological and clinical study. J Acupunct Tuina Sci 2010;2:70–74.

    Article  CAS  Google Scholar 

  19. Zheng HZ, Chen RX, Zhao XF, et al. Comparison between the effects of acupuncture relative to other controls on irritable bowel syndrome: a meta-analysis. Pain Res Manag 2019;2:1–13.

    CAS  Google Scholar 

  20. Park JW, Lee BH, Lee H. Moxibustion in the management of irritable bowel syndrome: systematic review and meta-analysis. BMC Comp lement Altern Med 2013;13:247.

    Article  Google Scholar 

  21. Bao C, Zhang J, Liu J, et al. Moxibustion treatment for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. BMC Comp lement Alter Med 2016;16:408.

    Article  Google Scholar 

  22. Whelan K, Martin LD, Staudacher HM, et al. The low FODMAP diet in the management of irritable bowel syndrome: an evidence-based review of FODMAP restriction, reintroduction and personalization in clinical practice. J Hum Nutr Diet 2018;2:239–255.

    Article  Google Scholar 

  23. Zernicke KA, Campbell TS, Blustein PK, et al. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med 2013;20:385–396.

    Article  PubMed  Google Scholar 

  24. Gunn D, Garsed K, Lam C, et al. Abnormalities of mucosal serotonin metabolism and 5-HT3 receptor subunit 3C polymorphism in irritable bowel syndrome with diarrhea predict responsiveness to ondansetron. Aliment Pharmacol Ther 2019;5:538–546.

    Article  Google Scholar 

  25. Lu L, Guo F. Effect of Shenling Baizhu Powder combined with piveronium bromide in the treatment of diarrhea type IBS and its effect on gastrointestinal hormones and 5-HT. Harbin Med J (Chin) 2017;6:580–581.

    Google Scholar 

  26. Yang JY, Tao DQ, Zeng Y, et al. Effects of Shenling Baizhu Powder combined with compound glutamine on intestinal mucosal barrier function and levels of 5-HT, IFN- γ and IL-8 in patients with irritable bowel syndrome. Prog Mod Biomed (Chin) 2019;22:4269–4272.

    Google Scholar 

  27. Liang R, Ge W, Wang H, et al. Effect of Tongxie Yaofang with or without Saposhnikoviae Radix on colonic visceral hypersensitivity and brain-gut peptide in irritable bowel syndrome rats. Chin J Exp Tradit Med Form (Chin) 2018;2:152–157.

    Google Scholar 

  28. Wu Z, Tan W, Zhang Z, et al. Effects of Fuzi Lizhong Decoction on serum IL-8 and 5-HT in rats with diarrhea irritable bowel syndrome. Jiangsu J Tradit Chin Med (Chin) 2016;2:75–77.

    Google Scholar 

  29. Shi J, Wang H, Song L, et al. Effects of Xiaoyao Powder on 5-HT and SERT in rats with irritable bowel syndrome. Zhejiang J Tradit Chin Med (Chin) 2012;7:490–491.

    Google Scholar 

  30. Shih YS, Tsai CH, Li TC, et al. The effect of Xiang-Sha-Liu-Jun-Zi tang on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Ethnopharm 2019; 238:111889.

    Article  Google Scholar 

  31. Li HB, Cheng LL, Yuan QY, et al. Clinical efficacy of Simo Soup oral liquid combined with citalopram on patients with diarrheal irritable bowel syndrome with anxiety and depression. J Int Psy 2021;1:162–165.

    Google Scholar 

  32. Liu F, Wei XM, Tang XG. Effects of Sijunzi Decoction on 5-HT3 receptor, 5-HT4 receptor and inflammatory indicators in patients with IBS. J Chin Med Mater (Chin) 2021;44:215–218.

    Google Scholar 

  33. Zhu J, Sun F, Zhu H, et al. Effect of Ganmai Dazao Decoctions on behavior and intestinal tissue 5-HT, SP, CGRP and TNF-α levels in rats with irritable bowel syndrome. Pharm Clin Res (Chin) 2020;28:408–412.

    Google Scholar 

  34. Pei L, Zhu L, Chen L, et al. Influence of acupuncture on plasma 5-HT, NPY and CGRP in patients with constipation-predominant irritable bowel syndrome. J Nanjing Univ Tradit Chin Med (Chin) 2015;5:416–419.

    Google Scholar 

  35. Kim JH, Nah SY. Effects of Ginsenoside total saponins on experimental irritable bowel syndrome in rats. J Ginseng Res 2005;2:94–99.

    Google Scholar 

  36. Jiang YH, Bai XW, Zhu XL, et al. The effects of Fructus Aurantii extract on the 5-hydroxytryptamine and vasoactive intestinal peptide contents of the rat gastrointestinal tract. Pharm Biol 2014;52:581–585.

    Article  PubMed  Google Scholar 

  37. Yang F, Dong X, Yin X, et al. Radix Bupleuri: a review of traditional uses, botany, phytochemistry, pharmacology, and toxicology. Biomed Res Int 2017;7597596.

  38. Yu B, Xie R, Jin L, et al. Trans-delta-Viniferin inhibits Ca2+ activated Cl-channels and improve diarrhea symptoms. Fitoterapia 2019;139:104367.

    Article  CAS  PubMed  Google Scholar 

  39. Pan F, Zhang T, Zhang Y, et al. Effect of Tongxie Yaofang Granule in treating diarrhea-predominate irritable bowel syndrome. Chin J Integr Med 2009;3:216–219.

    Article  Google Scholar 

  40. He W, Liu J, Chen M, et al. Mechanism of Tongxie Yaofang Decoction on irritable bowel syndrome based on islet-intestinal axis. J Hunan Univer Chin Med (Chin) 2017;11:1204–1208.

    Google Scholar 

  41. Damle M. Glycyrrhiza glabra (Liquorice) a potent medicinal herb. Int J Herb Med 2014;2:132–136.

    Google Scholar 

  42. Yang D, Wang H, Li J, et al. Effect of electroacupuncture at “Zusanli” on vimentin in rats with diarrhea-predominant irritable bowel syndrome. Acupunct Res (Chin) 2017;5:402–406.

    Google Scholar 

  43. Theofanous SA, Florens MV, Appeltans I, et al. Ephrin-B2 signaling in the spinal cord as a player in post-inflammatory and stress-induced visceral hypersensitivity. Neurogastroenterol Motil 2020;4:e13782.

    Google Scholar 

  44. Yang C, Zhang SS, Li XL, et al. Inhibitory effect of TongXie YaoFang Formula on colonic contraction in rats. World J Gastroenterol 2015;10:2912–2917.

    Article  Google Scholar 

  45. Lan X, Shui J, Xiao X, et al. Discussion and research progress on mechanism of Tongxie Yaofang in relieving visceral hypersensitivity of IBS-D by traditional Chinese medicine. Pract Clin J Integr Tradit Chin West Med (Chin) 2016;10:86–88.

    Google Scholar 

  46. Hu Y, Zheng Y, Mei Q, et al. Effects of Tongxieyaofang pieces with broken walls on gastrointestinal tract of mice with high visceral sensitivity. J Chin Med Mater (Chin) 2018;4:975–977.

    Google Scholar 

  47. Yu SP, Ye H, Ha NL, et al. Effect of modified Sinisan on anorectal manometry of the constipation predominant type of irritable bowel syndrome. Chin J Integr Med 2005;11:27–30.

    Article  PubMed  Google Scholar 

  48. Li B, Rui J, Ding X, et al. Deciphering the multicomponent synergy mechanisms of SiNi San prescription on irritable bowel syndrome using a bioinformatics network topology-based strategy. Phytomed 2019;63:15.

    Article  Google Scholar 

  49. Liu J. Study on the mechanism of Xiaoyao Powder in treating diarrhea-type irritable bowel syndrome. Electronic J General Stomatol (Chin) 2019;6:151–152.

    Google Scholar 

  50. Liu M, Xue H, Hu Y. Experimental study of Sishen Pill on diarrhea-predominant irritable bowel syndrome model rats and isolated colon. Mod Tradit Chin Med Mater (Chin) 2021;23:75–80.

    Google Scholar 

  51. Wu J, Du X, Yang SS, et al. Effect of Dajianzhongtang on visceral pain in rats with irritable bowel syndrome. Chin Exp Tradit Med Form (Chin) 2021;27:1–6.

    CAS  Google Scholar 

  52. Son HJ, Jung K, Park YH, et al. Inhibitory effects of SKI3246, the rhizome extract of Atractylodes japonica, on visceral hypersensitivity in experimental irritable bowel syndrome rat models. Arch Pharm Res 2015;38:642–649.

    Article  CAS  PubMed  Google Scholar 

  53. Liu Y, Lu S. Study on the effect and mechanism of patchouli on visceral hypersensitivity in rats with post-infectious irritable bowel syndrome. J Guangdong Pharm Univ (Chin) 2021;37:72–76.

    CAS  Google Scholar 

  54. Pei L, Zhang W, Song Y, et al. Electroacupuncture of “Tianshu” suppresses visceral pain possibly by down-regulating mast cell activation, and tryptase and SP expression in rats with post-infectious irritable bowel syndrome. Chin Acupunct Moxibust (Chin) 2013;12:1057–1060.

    Google Scholar 

  55. Guo XX, Chen JF, Lu Y, et al. Electroacupuncture at He-Mu points reduces P2X(4) receptor expression in visceral hypersensitivity. Neural Regen Res 2013; 22:2069–2077.

    Google Scholar 

  56. Pimentel M, Lembo A. Microbiome and its role in irritable bowel syndrome. Digest Dis Sci 2020;3:829–839.

    Article  Google Scholar 

  57. Lin LF, Luo LY, Zhong M, et al. Gut microbiota: a new angle for traditional herbal medicine research. RSC Adv 2019;30:17457–17472.

    Article  Google Scholar 

  58. Li JC, Cui HT, Cai YZ, et al. Tong-Xie-Yao-Fang regulates 5-HT level in diarrhea predominant irritable bowel syndrome through gut microbiota modulation. Front Pharmacol 2018;9:1110.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Wang HF, Zhang WM. Recent advances in the study of silver and its mechanism on the surface of lactobacillus and intestinal adhesion. Acta Zoonutr Sin (Chin) 2011;2:179–186.

    Google Scholar 

  60. Feng WL, Wu HT. Study on the mechanism of regulating intestinal flora of IBS-D by polysaccharides of Chinese medicine under the guidance of Neijing theory. Liaoning J Tradit Chin Med (Chin) 2019;46:127–129.

    Google Scholar 

  61. Mao W. Based on intestinal alkaline phosphatase signaling pathway to discuss the mechanism of acupuncture maintaining intestinal flora-immune stability. Chin Med Herald (Chin) 2019;28:126–129.

    Google Scholar 

  62. Zhu Y, Wu Z, Ma X, et al. Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study. BMC Comp lement Altern Med 2014;14:500.

    Article  Google Scholar 

  63. Bao CH, Wang CY, Li GN, et al. Effect of mild moxibustion on intestinal microbiota and NLRP6 inflammasome signaling in rats with post-inflammatory irritable bowel syndrome. World J Gastroenterol 2019;32:4696–4714.

    Article  Google Scholar 

  64. Camilleri M, Lasch K, Zhou W, et al. Irritable bowel syndrome: methods, mechanisms and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2012;303:775–785.

    Article  Google Scholar 

  65. Lee JH, Kim JI, Baeg MK, et al. Effect of Samryungbaekchul-san combined with Otilonium Bromide on diarrhea-predominant irritable bowel syndrome: a pilot randomized controlled trial. J Clin Med 2019;8:1558.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Tan W, Wu Z, Zhang D, et al. Effects of Fuzi Lizhong Decoction on immunological indexes NALP-3 inflammasome in colonic mucosa of rats with diarrhea-type irritable bowel syndrome. J Chin Med Mater (Chin) 2018;4:970–974.

    Google Scholar 

  67. Wang H, Deng S, Chen Y. Effects of Sini Powder and Tongxie Yaofang on serum IL-1 β and IL-8 levels in patients with diarrhea type of IBS. Chin J Tradit Med Sci Technol (Chin) 2015;5:487–488.

    Google Scholar 

  68. Xuan C. Effect of Si Ni Powder combined with moxibustion on the treatment of diarrhea type irritable bowel syndrome and T lymphocyte subsets. Mod J Integr Tradit Chin West Med (Chin) 2017;25:2831–2833.

    Google Scholar 

  69. Yang J, Shang BX, Shi HT, et al. The role of toll-like receptor 4 and mast cell in the ameliorating effect of electroacupuncture on visceral hypersensitivity in rats. Neurogastroenterol Motil 2019;6:1358.

    Google Scholar 

  70. Ma XP, Hong J, An CP, et al. Acupuncture-moxibustion in treating irritable bowel syndrome: how does it work. World J Gastroenterol 2014;20:6044–6054.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Guo J, Ma L, Kang W. Effect of Tongxie Yaofang on p38 MAPK pathway associated protein and its target gene expression in colon tissues of D-IBS rats with Liver-stagnation and Spleen-deficiency. Chin J Exp Tradit Med Form (Chin) 2020;4:8.

    Google Scholar 

  72. Luo S, Shui D, Chen Q, et al. Clinical effect of Fuzi Lizhong Decoction combined with Sishen Pill in treatment of diarrhea-type irritable bowel syndrome (Spleen and Kidney deficiency syndrome) and its effect on serum TNF-α, IL-6 and IL-8. Liaoning J Tradit Chin Med (Chin) 2019;9:1915–1918.

    Google Scholar 

  73. Li B, Rui J, Ding X, et al. Exploring the multicomponent synergy mechanism of Banxia Xiexin Decoction on irritable bowel syndrome by a systems pharmacology strategy. J Ethnopharmacol 2019;233:158–168.

    Article  CAS  PubMed  Google Scholar 

  74. Ko SJ, Cho SH, Kim KJ, et al. Herbal medicine Banhasasim-tang for the treatment of functional dyspepsia protocol for a systematic review of randomized controlled trials. Medicine 2019;98:22.

    Article  Google Scholar 

  75. Bai X, Xie X, Li M, et al. Effects of Jia Wei Sini Powder on expression of c-fos in different areas and nucleus of rats with irritable bowel syndrome. Chin J Basic Med Tradit Chin Med (Chin) 2010;27:40–41.

    Google Scholar 

  76. Chen WB. Effect analysis of Wumei Pill on diarrhea predominant irritable bowel syndrome. Chin Foreign Med Res (Chin) 2021;19:118–120.

    Google Scholar 

  77. Xie Y, Zhan X, Tu J, et al. Atractylodes oil alleviates diarrhea-predominant irritable bowel syndrome by regulating intestinal inflammation and intestinal barrier via SCF/c-kit and MLCK/MLC2 pathways. J Ethnopharmacol 2021;272:113925.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China

    Guan-ru Chen, Xiao-fang Xie & Cheng Peng

  2. State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, China

    Guan-ru Chen, Xiao-fang Xie & Cheng Peng

Authors
  1. Guan-ru Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiao-fang Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cheng Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Chen GR was responsible for conducting the work and wrote the main manuscript text. Xie XF was responsible for the analysis of articles. Peng C was coordinating professor of the project and wrote the main manuscript text.

Corresponding author

Correspondence to Cheng Peng.

Additional information

Conflict of Interest

The authors declare no competing financial interests or personal relationships that could influence the work reported in this paper.

Supported by National Science and Technology Innovation Major New Drug Creation Project (No. 2018Zx09721001-008), Southwest Characteristic Traditional Chinese Medicine Resource and Gene Innovation Platform, Central Guidance Local Special Project (No. 2020ZYD058)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, Gr., Xie, Xf. & Peng, C. Treatment of Irritable Bowel Syndrome by Chinese Medicine: A Review. Chin. J. Integr. Med. 29, 377–384 (2023). https://doi.org/10.1007/s11655-021-3521-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-021-3521-4

Keywords

Search

Navigation