{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:14:14Z","timestamp":1787242454821,"version":"build-2736575974"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["HI20C0145"],"award-info":[{"award-number":["HI20C0145"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Irritable bowel syndrome (IBS) is a common disorder with abdominal pain and bowel habits changes. Herbal medicines (HMs) are frequently used in the treatment of IBS. Therefore, several systematic reviews (SRs) have been conducted to assess the efficacy and safety of HM in IBS patients. This study aimed to investigate the methodology and quality of evidence of SRs, and to describe the current state of research and evidence for the treatment of IBS with HM.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    SRs published up to January 2022 were searched using six electronic databases. SRs and\/or meta-analyses on the use of HMs for IBS were included. The effects of placebo, conventional medicine (CM), and probiotics were compared with those of HMs. Two investigators independently extracted the data and assessed methodological quality using the Measure Tool to Assessment System Reviews 2 (AMSTAR 2). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each main finding.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Eighteen SRs were included in this overview. Among them, eight SRs reported only specific subtypes of IBS: six SRs reported patients with diarrhea-predominant IBS, and two SRs reported patients with constipation-predominant IBS. In terms of total efficacy, HM was more effective than placebo, CM, or probiotics. HM showed a more significant effect than CM in relieving independent IBS symptom score (abdominal pain score, diarrhea score, abdominal distension score, stool frequency score, etc.) and recurrence rate. The rate of adverse events was significantly lower with HM compared to CM, and no serious adverse events were reported with HM treatment. According to AMSTAR 2, the methodological quality of the included SRs was extremely low. Furthermore, the quality of evidence for total efficacy was considered low or very low according to the GRADE tool.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    HM can be considered as an effective and safe treatment for IBS. However, the methodological quality of the included SRs and the quality of evidence was generally low. Therefore, well-designed randomized controlled trials are needed in the future so that a high-quality SR can be used to better assess the safety and efficacy of HM in the treatment of IBS.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Systematic Review Registration:<\/jats:bold>\n                    <jats:ext-link>https:\/\/osf.io\/nt6wz<\/jats:ext-link>\n                    , identifier\n                    <jats:ext-link>10.17605\/OSF.IO\/NT6WZ<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.3389\/fphar.2022.894122","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:44:21Z","timestamp":1652841861000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["An Overview of Systematic Reviews of Herbal Medicine for Irritable Bowel Syndrome"],"prefix":"10.3389","volume":"13","author":[{"given":"Hyejin","family":"Jun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok-Jae","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keumji","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Woo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1159\/000485456","article-title":"Mechanism of Action of STW 5 in Functional Dyspepsia and IBS: The Origin of Multi-Target","volume":"35","author":"Allescher","year":"2018","journal-title":"Dig. Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.18502\/ijph.v48i11.3538","article-title":"Medicinal Herbal Recommendation for Irritable Bowel Syndrome in Medieval Persian Medicine","volume":"48","author":"Amini-Behbahani","year":"2019","journal-title":"Iran. J. Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2719","DOI":"10.19082\/2719","article-title":"Herbal Medicines for the Management of Irritable Bowel Syndrome: A Systematic Review","volume":"8","author":"Bahrami","year":"2016","journal-title":"Electron. physician"},{"key":"B4","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE Guidelines: 3. Rating the Quality of Evidence","volume":"64","author":"Balshem","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"5163","DOI":"10.2174\/1381612823666170822101606","article-title":"The Efficacy and Potential Mechanisms of Chinese Herbal Medicine on Irritable Bowel Syndrome","volume":"23","author":"Bi","year":"2017","journal-title":"Curr. Pharm. Des."},{"key":"B6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1089\/acm.2006.12.401","article-title":"Effectiveness of the Chinese Herbal Formula TongXieYaoFang for Irritable Bowel Syndrome: A Systematic Review","volume":"12","author":"Bian","year":"2006","journal-title":"J. Altern. Complement. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"101177","DOI":"10.1016\/j.eujim.2020.101177","article-title":"Chinese Herbal Medicine versus Probiotics for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"38","author":"Bu","year":"2020","journal-title":"Eur. J. Integr. Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11655-021-3521-4","article-title":"Treatment of Irritable Bowel Syndrome by Chinese Medicine: A Review","volume":"21","author":"Chen","year":"","journal-title":"Chin. J. Integr. Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"114119","DOI":"10.1016\/j.jep.2021.114119","article-title":"The Mechanisms of Action of WeiChang\u2019An Pill (WCAP) Treat Diarrhoea-Predominant Irritable Bowel Syndrome (IBS-D) Using Network Pharmacology Approach and In Vivo Studies","volume":"275","author":"Chen","year":"","journal-title":"J. Ethnopharmacol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0192319","article-title":"Efficacy and Safety of Modified Tongxie Yaofang in Diarrhea-Predominant Irritable Bowel Syndrome Management: A Meta-Analysis of Randomized, Positive Medicine-Controlled Trials","volume":"13","author":"Dai","year":"2018","journal-title":"PLoS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/j.pop.2017.07.009","article-title":"Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment","volume":"44","author":"Defrees","year":"2017","journal-title":"Prim. Care - Clin. Off. Pract."},{"key":"B12","first-page":"1","volume-title":"Introducing GRADE: A Systematic Approach to Rating Evidence in Systematic Reviews and to Guideline Development","author":"Dijkers","year":"2013"},{"key":"B13","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/ecam\/nem096","article-title":"Herbal Medicine Today: Clinical and Research Issues","volume":"4","author":"Firenzuoli","year":"2007","journal-title":"Evidence-based Complement. Altern. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e28116","DOI":"10.1097\/MD.0000000000028116","article-title":"The Efficacy of the Traditional Korean Herbal Medicine Tongsayobang for the Treatment of Irritable Bowel Syndrome A Protocol for Systematic Review and Meta-Analysis","volume":"100","author":"Han","year":"2021","journal-title":"Med. Baltim."},{"key":"B15","doi-asserted-by":"publisher","first-page":"102233","DOI":"10.1016\/j.ctim.2019.102233","article-title":"Western Herbal Medicines in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis","volume":"48","author":"Hawrelak","year":"2020","journal-title":"Complement. Ther. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e21502","DOI":"10.1097\/MD.0000000000021502","article-title":"Probiotics, Prebiotics, Antibiotic, Chinese Herbal Medicine, and Fecal Microbiota Transplantation in Irritable Bowel Syndrome: Protocol for a Systematic Review and Network Meta-Analysis","volume":"99","author":"He","year":"2020","journal-title":"Med. Baltim."},{"key":"B17","doi-asserted-by":"publisher","first-page":"101634","DOI":"10.1016\/j.bpg.2019.101634","article-title":"The Rome IV: Irritable Bowel Syndrome - A Functional Disorder","author":"Hellstr\u00f6m","year":"2019","journal-title":"Best. Pract. Res. Clin. Gastroenterol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1186\/1472-6882-13-246","article-title":"The Inhibitory Effect of Tongxieyaofang on Rats with Post Infectious Irritable Bowel Syndrome through Regulating Colonic Par-2 Receptor","volume":"13","author":"Hu","year":"2013","journal-title":"BMC Complement. Altern. Med."},{"key":"B19","first-page":"80","article-title":"Meta-analysis of Randomized Controlled Trials on the Treatment of Diarrhea-type Irritable Bowel Syndrome (IBS-D) with the Method of Soothing the Liver and Strengthening the Spleen","volume":"17","author":"Huang","year":"2011","journal-title":"Chin. J. Basic Med. Tradit. Chin. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e25198","DOI":"10.1097\/md.0000000000025198","article-title":"Effectiveness of Tong-Xie-Yao-Fang Combined with Si-Ni-San for Irritable Bowel Syndrome","volume":"100","author":"Jiang","year":"2021","journal-title":"Med. Baltim."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e26364","DOI":"10.1097\/MD.0000000000026364","article-title":"Herbal Medicine for Irritable Bowel Syndrome an Overview of Systematic Reviews Protocol","volume":"100","author":"Jun","year":"2021","journal-title":"Med. Baltim."},{"key":"B22","doi-asserted-by":"publisher","first-page":"824605","DOI":"10.1155\/2013\/824605","article-title":"Effect of Korean Herbal Medicine Combined with a Probiotic Mixture on Diarrhea-Dominant Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial","volume":"2013","author":"Ko","year":"2013","journal-title":"Evidence-based Complement. Altern. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel Disorders","volume":"150","author":"Lacy","year":"2016","journal-title":"Gastroenterology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3390\/medicina55020046","article-title":"Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey","volume":"55","author":"Larussa","year":"2019","journal-title":"Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e24019","DOI":"10.1097\/md.0000000000024019","article-title":"Xiaoyao-san, a Traditional Chinese Herbal Formula, for the Treatment of Irritable Bowel Syndrome","volume":"100","author":"Lee","year":"2021","journal-title":"Med. Baltim."},{"key":"B26","doi-asserted-by":"publisher","first-page":"152982","DOI":"10.1016\/j.phymed.2019.152982","article-title":"Deciphering the Multicomponent Synergy Mechanisms of SiNiSan Prescription on Irritable Bowel Syndrome Using a Bioinformatics\/network Topology Based Strategy","volume":"63","author":"Li","year":"2019","journal-title":"Phytomedicine"},{"key":"B27","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1142\/S0192415X15500251","article-title":"A Systematic Review of Integrated Traditional Chinese and Western Medicine for Managing Irritable Bowel Syndrome","volume":"43","author":"Li","year":"2015","journal-title":"Am. J. Chin. Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0189491","article-title":"Systematic Review and Meta-Analysis of Traditional Chinese Medicine in the Treatment of Constipation-Predominant Irritable Bowel Syndrome","volume":"12","author":"Li","year":"2017","journal-title":"PLoS One"},{"key":"B29","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/s0254-6272(14)60022-4","article-title":"Treatment of Constipation-Predominant Irritable Bowel Syndrome by Focusing on the Liver in Terms of Traditional Chinese Medicine: a Meta-Analysis","volume":"33","author":"Li","year":"2013","journal-title":"J. Tradit. Chin. Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"309","DOI":"10.5694\/mja17.00457","article-title":"Diagnosis and Management of Irritable Bowel Syndrome : a Guide for the Generalist","volume":"207","author":"Linedale","year":"2017","journal-title":"Med. J. Aust."},{"key":"B31","doi-asserted-by":"publisher","first-page":"CD004116","DOI":"10.1002\/14651858.cd004116.pub2","article-title":"Herbal Medicines for Treatment of Irritable Bowel Syndrome","volume":"8","author":"Liu","year":"2006","journal-title":"Cochrane Database Syst. Rev."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1053\/j.gastro.2005.11.061","article-title":"Functional Bowel Disorders","volume":"130","author":"Longstreth","year":"2006","journal-title":"Gastroenterology"},{"key":"B33","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.cgh.2012.02.029","article-title":"Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-Analysis","volume":"10","author":"Lovell","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1751-0759-8-5","article-title":"Effects of Kampo on Functional Gastrointestinal Disorders","volume":"8","author":"Oka","year":"2014","journal-title":"Biopsychosoc. Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"e26635","DOI":"10.1097\/md.0000000000026635","article-title":"Gwakhyangjeonggi-san for Irritable Bowel Syndrome A Protocol for Systematic Review and Meta-Analysis","volume":"100","author":"Park","year":"2021","journal-title":"Med. Baltim."},{"key":"B36","article-title":"Chapter V: Overviews of Reviews","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.3","author":"Pollock","year":"2021"},{"key":"B37","doi-asserted-by":"publisher","first-page":"7","DOI":"10.7861\/clinmedicine.13-1-7","article-title":"Adverse Effects of Herbal Medicines: An Overview of Systematic Reviews","volume":"13","author":"Posadzki","year":"2013","journal-title":"Clin. Med. J. R. Coll. Physicians Lond."},{"key":"B38","doi-asserted-by":"publisher","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A Critical Appraisal Tool for Systematic Reviews that Include Randomised or Non-randomised Studies of Healthcare Interventions, or Both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"B39","doi-asserted-by":"publisher","first-page":"454","DOI":"10.3748\/wjg.14.454","article-title":"Effectiveness and Safety of Herbal Medicines in the Treatment of Irritable Bowel Syndrome: A Systematic Review","volume":"14","author":"Shi","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1001\/archinte.163.3.265","article-title":"A Systematic Review of Alternative Therapies in the Irritable Bowel Syndrome","volume":"163","author":"Spanier","year":"2003","journal-title":"Arch. Intern. Med."},{"key":"B41","first-page":"113","article-title":"Systematic Review of Randomized Controlled Trials of Tongxie Yaofang and its Modified Prescriptions for the Treatment of Irritable Bowel Syndrome","volume":"26","author":"Su","year":"2009","journal-title":"J. Guangzhou Univ. Tradit. Chin. Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1111\/jgh.14905","article-title":"Herbal Medicine in the Treatment of Functional Gastrointestinal Disorders: A Systematic Review with Meta-Analysis","volume":"35","author":"Tan","year":"2020","journal-title":"J. Gastroenterol. Hepatol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"368","DOI":"10.4103\/0974-8520.127717","article-title":"Clinical Evaluation of Bilvadileha in the Management of Irritable Bowel Syndrome","volume":"34","author":"Tiwari","year":"2013","journal-title":"AYU An. Int. Q. J. Res. Ayurveda)"},{"key":"B44","doi-asserted-by":"publisher","first-page":"897","DOI":"10.19852\/j.cnki.jtcm.2020.06.001","article-title":"Efficacy of Shenlingbaizhu Formula on Irritable Bowel Syndrome: a Systematic Review","volume":"40","author":"Wang","year":"2020","journal-title":"J. Tradit. Chin. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1142\/S0192415X15500019","article-title":"Traditional Chinese Medicine Formulas for Irritable Bowel Syndrome: From Ancient Wisdoms to Scientific Understandings","volume":"43","author":"Xiao","year":"","journal-title":"Am. J. Chin. Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0122397","article-title":"The Efficacy of Shugan Jianpi Zhixie Therapy for Diarrhea-Predominant Irritable Bowel Syndrome:A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials","volume":"10","author":"Xiao","year":"","journal-title":"PLoS One"},{"key":"B47","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.3748\/wjg.v21.i10.2912","article-title":"Inhibitory Effect of TongXie-YaoFang Formula on Colonic Contraction in Rats","volume":"21","author":"Yang","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"e23394","DOI":"10.1097\/MD.0000000000023394","article-title":"Traditional Chinese Medicine for Irritable Bowel Syndrome: A Protocol for Meta-Analysis","volume":"99","author":"Yao","year":"2020","journal-title":"Med. Baltim."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.3969\/j.issn.1674-1749.2021.09.040","article-title":"Meta-analysis of the Curative Effect of Traditional Chinese Medicine Compared with Pinaverium Bromide in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome","volume":"14","author":"Yao","year":"2021","journal-title":"Glob. Tradit. Chin. Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"111426","DOI":"10.1016\/j.biopha.2021.111426","article-title":"Herbal Medicine WangShiBaoChiWan Improves Gastrointestinal Health in Mice via Modulation of Intestinal Tight Junctions and Gut Microbiota and Inhibition of Inflammation","volume":"138","author":"Yin","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"B51","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.11569\/wcjd.v22.i12.1747","article-title":"Traditional Chinese Medicine for Treatment of Irritable Bowel Syndrome: An Overview of Systematic Reviews and Meta- Analyses","volume":"22","author":"Zhang","year":"2014","journal-title":"World Chin. J. Dig."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fphar.2021.694741","article-title":"Chinese Herbal Medicine for Irritable Bowel Syndrome: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials","volume":"12","author":"Zheng","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"4893876","DOI":"10.1155\/2019\/4893876","article-title":"Clinical Effects and Safety of Tongxieyaofang on Diarrhea Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized Trails","volume":"2019","author":"Zhou","year":"2019","journal-title":"Evidence-based Complement. Altern. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"4071260","DOI":"10.1155\/2016\/4071260","article-title":"Efficacy of Chinese Herbal Medicine for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials","volume":"2016","author":"Zhu","year":"2016","journal-title":"Evidence-based Complement. Altern. Med."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.894122\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:44:29Z","timestamp":1652841869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.894122\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":54,"alternative-id":["10.3389\/fphar.2022.894122"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2022.894122","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,18]]},"article-number":"894122"}}